looking for kardex to use in NICU

[missapoo]

Hey everyone! this is my first time in the forum. I work in a NICU in AR and we are trying to find a usable sample for a bedside pt kardex system at the request of one of our Drs....any suggestions or pointers would be very helpful. Thanks :smilecoffeecup:

[BittyBabyGrower, MSN, RN]

Ours is very simple. It is landscape form and the top has baby's name, parent's names, date/time of birth, band number, person with the fourth band, admitting diagnosis, weight, dry weight, and where the baby came from IE DR, transport.

Then it is listed by systems in columns, so say under neuro you would list your HUS, under cardiac you would put PDA ligation, echos, under Resp you would put RDS, surfactant, under GI put r/o nec, colostomy and we have a column for ID and a blank one. We don't list our IVF or feeds on it because it is all on the flowsheet and med sheets. Keep it simple!

[missapoo]

thanks BBG...I am wondering about the effectiveness of a Kardex when the unit is very busy and the time it takes to update--will it take time away from pt care? I see the benefits for certain and I think with a little getting used to it will be a great thing...we just aren't accustomed to it on my unit. The old-timers remember the days when the Kardex was used always and somehow things migrated away from it. We use a very detailed report sheet at change of shift, which is updated often with daily changes, new orders, etc...& some on the unit think of this as taking place of the bedside Kardex. Do you see what I mean about some nurses balking at the idea of a Kardex because it seems redundant to what we already do?

[BittyBabyGrower, MSN, RN]

We don't have a detailed report sheet...we do bedside report so we aren't having to write everything out. Our charge nurse has a report sheet that is general such as vent/02 settings, tests/procedures, feeds (q3hours, etc) and anything pertinent that she needs to know such as social. The bedside kardex makes it easier for us to go back and say, well the cardiac section is pretty filled, so this kids main issue appears to be cardiac. No digging for info, nothing lost.

[grlgid]

We have preprinted report sheets that have all the diagnoses from the progress notes, all the current vent settings (or other esp requirements), current IV fluid/rates, feeds, meds, immunizations, other follow ups, you name it. It makes it pretty handy for giving report plus there is a big space to write everything else that you might need hx wise that isn't already on there. So much info one little sheet (1/2 of a letter size piece of paper). It also includes little blank (hour) blocks to plan your care...I'd be lost without my brains.

[missapoo]

thanks grlgid! I appreciate your input:) Having not had this habit before will make it a little harder to start but I am sure that soon we will be thinking... whatever did we do before?? That is my hope at least. Keep up the good work!!

[Mags4711, RN]

Melissa, I'd be happy to snail mail you a copy of our Kardex if you'd like, just PM me with your info. We are (sadly) going to stop using it in a week or so because we are going to an online system, so it will be going on the computer. But we do use our Kardex. Lots of times we don't give a report straight from it but it is very helpful to have a place where we keep all of the ongoing info about what is happening with the baby. No matter how detailed your one on one report may be, everything cannot be covered every time, and unless it is written down, things can get skewed over time. Remember the old game of Telephone? You sit in a circle of friends and one person whispers something into the first person's ear and then it gets retold around the circle. What was "Johnny had a red ball" becomes "John's dad threw his baseball out."

We have a calendar on the back that is customizeable and we use it to track things like drips, vents, NC, ECMO, PRBC's, and to easily track the current AGA.

I can send you a copy of one that is filled out (as a sample) with the appropriate identifying info blanked out, as well as a blank one, and I can also send one of the report sheets that some folks like using. It breaks things down into systems. The offgoing person does not write anything out for report currently, but with our new online "Nursing Summary" we are anticipating keeping it filled out with much of the info we now give out verbally (IV rates, drips, events that happened that day, etc...).

[missapoo]

Kewl Faith...thanks so much!!!:)

[3yrDiploma]

please, is there a way I could get a sample of your Kardex and shift report forms??????

[iyqyqr]

Hi, Babybug,

I'm from your border state, OK, and I traveled to three NICU's last year, but liked my home unit's system the best. We had a nurse committee that developed all our clinical pathways, a kardex of sorts, but we truly use the front of our daily flow sheet as a kardex and then have a calendar with blank squares that we update briefly on each baby as things occur. I hate kardexes that are separate forms as they are rarely current. Our flow sheets are always current. I'll be happy to snail mail if you give me an address. I work tomorrow night and could get out on Wed. It took us about a year, but everyone now gives report the same way and this is one system that works. Cindy