Kardex ?

[nursecompassion]

I'm a new grad and am working on a med/surg floor which is having difficulty with staff not reading the kardex's and missing orders, data, etc. Where does your unit keep your Kardex? Where I precepted at spring quarter they were kept with the pt MAR, which seems to me like a great idea for where I'm working now. What do you think?

[CHATSDALE]

if you are using a kardex than it should be utilized..the idea that you didn't get it in report is not excusable if it is written in kardex

as for where it needs to be kept it should be in one place all the time, every shift

[TigerGalLE, BSN, RN]

On my floor we have mini chart type notebooks that each nurse uses. In the chart we keep all of the mars and kardex for each patient. Each nurse keeps up with their notebook all day and it is very helpful.

[GrumpyRN63, ADN, RN]

I haven't seen a Kardex in 15 yrs, we get a computer report / Pt care summary all the orders are all together, new one auto prints each shift, you either carry them on a clipboard or 3 ring binder

[meandragonbrett]

We don't have kardex. In fact, I've never used a kardex in my life.

[RN1989]

That sounds like a personal and professional problems with the nurses. Obviously they have decided they don't require the information in order to do their job. This is something that the manager should have dealt with already. Getting ideas on where to keep the kardex is not going to fix the problem. If they were my staff, they'd be in trouble already and their annual evals would definitely reflect their lack of professionalism and concern for pt safety.

[CyndieRN2007]

When I was in nursing school the hospital I had my clinicals at used kardexes (sp?). They were always wrong, never updated and the handwriting couldnt be read. I hated them. I went by the doctor's orders in the pts chart. It saved my a$$ whenever the busy med surg unit would get rapidly changing orders and the charge nurse couldnt keep up with changing the kardex. The doctors orders are a nurses bible, so I never rely on the Kardex.

[truern]

The doctors orders are a nurses bible, so I never rely on the Kardex.

Same here. Then again, we don't use a Kardex :)

[donsterRN, ASN, BSN]

At the facility where I do clinicals, we're taught not to rely on the Kardex; it's rarely current. We're taught to use the MD's orders as the most current information available.

[mscsrjhm]

Without a kardex, how is general information passed?

I have worked at only one facility that did not have Kardex, and we received no information during report. Other departments were not happy with the lack of communication, teaching wasn't done because no one knew about it, IV sites without dates, not charted in nn.

The information that I am concerned about is diagnosis, history, orientation, mobility status, teaching needed, diet, dates of IVs and dressings, etc. If it is not passed on in report- no way of knowing.

How do you communicate basic information at the beginning of a shift? There is no way that I would have time to check all charts and review all orders at the beginning of a shift (and sometimes throughout the shift).

What do you use instead?

[RNperdiem, RN]

Kardexes only work if kept updated, and this does not always happen.

A better way, is a flowsheet that gives all the pertinent information. At the top is a box listing past medical history, date admitted, surgeries done etc. The diet ordered is filled out in the dietary section.

At change of shift, the nurses go over the orders for the previous shift in the chart.

With a detailed flowsheet and a chart check, Kardexes can be eliminated.

[Piki]

Without a kardex, how is general information passed?

I have worked at only one facility that did not have Kardex, and we received no information during report. Other departments were not happy with the lack of communication, teaching wasn't done because no one knew about it, IV sites without dates, not charted in nn.

The information that I am concerned about is diagnosis, history, orientation, mobility status, teaching needed, diet, dates of IVs and dressings, etc. If it is not passed on in report- no way of knowing.

How do you communicate basic information at the beginning of a shift? There is no way that I would have time to check all charts and review all orders at the beginning of a shift (and sometimes throughout the shift).

What do you use instead?

Everything we have is on the computer. We get printed out MARs, and Patient Care summaries, which have the pt's dx, hx, allergies, code status, fall risk and mobility status, IV site, and all orders, including diet, meds, etc.

I am a new graduate from last year, and never saw a Kardex until my very last rotation at a hospital that didn't do anything on computer. I was amazed (and a little horrified, to tell you the truth) that in this day and age, this info isn't kept in a centralized place on a computer somewhere, but penciled in on a Kardex. Any Joe blow off the street could come in and take a pencil and change IV fluids or orders, or dressing changes (oh, also the charts were kept RIGHT outside each pt's door in little pull down desks). I'm telling you, it was an eye-opening experience (and rather medieval, if you ask me!)