Laptop / Tablet / COW for electronic flowsheet?

[SummitRN, BSN, RN]

For those using electronic flowsheets in the ICU, I'm curious what people are using for access to electronic flowsheets, particularly when dealing with the crashing patient, admits, or multidisciplinary rounds?

What model dod you use and do you like it?

Do you wish you had a Toughbook or Tablet with a dock?

[Ruby Vee, BSN]

For those using electronic flowsheets in the ICU, I'm curious what people are using for access to electronic flowsheets, particularly when dealing with the crashing patient, admits, or multidisciplinary rounds?What model dod you use and do you like it?Do you wish you had a Toughbook or Tablet with a dock?

We have fixed computer stations and computers on wheels. Some of the physicians also have laptops, but the issue with that is that they get set down somewhere and immediately covered with the trash that an emergency situation seems to generate -- discarded lab coats, dressing wrappers, dirty gloves, etc. The computers on wheels and the fixed computer stations stay relatively (and I do mean relatively) clean.

[Nalon1 RN/EMT-P, BSN, RN]

Desktops primarily, WOW's (Workstation on wheels, were not supposed to call them COW's, apparently several people complained because they thought people were talking about patients/visitors) in the rooms to scan meds.

We have had a few doc's that have tried tablets, but most all have gone back to using the desktops. I only know of one of our doc's that still uses his tablet when rounding, but still does the bulk of his stuff on a desktop.

[SummitRN, BSN, RN]

We have fixed workstations and are considering what to replace them with including drop-proof spill-proof tablets or laptops.

With very small and crowded rooms, we are worried about the WOWs being much bigger than a dockable tablet or convertible touchscreen laptop.

Those who use WOWs in the ICU. Do you have one per patient or are you wheeling that thing between two rooms disinfecting it each time? (seems like a pain in rooms crammed full of dialysis, balloon pumps, vents, and IVs).

[Cook26]

We have desktops all over the place. You can't step 5 feet without hitting another one. We also have computers in every room. I work in a large university level 1 hospital with new towers that we are slowly moving into. I feel lucky to have a new space and updated technology.

As far as the docs, most use the desktops. I occasionally see a service with a COW/WOW. I know of one resident that puts in orders on the spot during rounds with his iPad (which I greatly appreciate).

[Chaswald]

We have a hard wired desktop per 2 patient rooms and we have quite a few of our computers on wheels. Enough of them that if almost all of our unit is 1 to 1 nursing care then we would only be short a couple of computers for each room. Most of the time we are doubled, so we either move our computer room to room or use the pod computers. The nice thing about our electronic flow sheets is that we only have to input changes in patient condition, assessments, vitals that don't record properly and verify them, our i&o, and vent settings really. So it can be quite convenient

[applewhitern, BSN, RN]

We have a fixed computer station in each ICU room. We are not allowed to use the desktop computers; this is supposed to encourage us to spend more time at the bedside. This is cumbersome as it prevents us from being able to talk to the docs and look at the computers at the same time. We have to go to the desk to answer the phone, but then we have to run back into the patient's room to look anything up on the computer. If a doctor or any ancillary personnel has their own means of accessing a patient's chart, then no problem, but unfortunately many of them do not, especially consulting physicians.

[Corey Narry, MSN, RN, NP]

There is a dedicated computer or workstation in each room (throughout the hospital, not just ICU). The ICU's have 2 computers for each room, one outside by the sliding door and one inside that is equipped with bar code med administration scanner. The RN's use this workstation to document. When we round, we use a computer or workstation on wheels that we can bring with us as we go. Some physicians carry their own tablet since our EMR is compatible with those devices. We have completely eliminated paper records except for EKG's and rhythm strips, blood transfusion flowsheets, and consents.

[Corey Narry, MSN, RN, NP]

We have a fixed computer station in each ICU room. We are not allowed to use the desktop computers; this is supposed to encourage us to spend more time at the bedside. This is cumbersome as it prevents us from being able to talk to the docs and look at the computers at the same time. We have to go to the desk to answer the phone, but then we have to run back into the patient's room to look anything up on the computer. If a doctor or any ancillary personnel has their own means of accessing a patient's chart, then no problem, but unfortunately many of them do not, especially consulting physicians.

You ICU should make sure nurses have Spectralink phones that they can carry with them. There are workflow issues in your ICU.

[Myrtle1061RN, BSN]

Our floor is about to undergo a renovation and they are talking about putting computers at stations along the hallways with stools for us to perch on while we chart. I feel that there are privacy issues putting computers out in the open hallways, but I know I have seen hospitals that have done this. Does anyone have any experience with this sort of arrangement? Can anyone tell me the pros and cons they have found?

[Corey Narry, MSN, RN, NP]

I don't think people can easily read information on a computer screen from a distance. You would obviously make sure nobody unauthorized to look at the medical record is standing behind you and looking over your shoulders while you do your work.

Also, you will be responsible for making sure you log off from the medical record screen when you're done accessing the electronic chart. All screens should have a screensaver activated when the computer is idle.