New hosptial computer systems pull nurses away from patient care

[lee1]

Hi all,

Just want to know if any of you have been involved in a new computer roll out in your hospital where bedside paper charting is being eliminated and all done in the computer----eclypsis, cerner, etc. have systems

How was it handled. How many hours of computer instruction? The whole place going "live" or only selected units??? How many "super users" on all shifts. How long did it take to learn the system? What were your nurse/pt ratios? Did you feel you denied care to your patients while trying to learn this system???

[suzanne4, RN]

You can learn the system in less than four hours. After using partial computer charting and going back to everything by hand, and in triplicate, I would kill for a computerized system. You will find that it won't be taking away from your time but actually giving you more time to get things done for your patients. The first few days may be a little scary, but you will find it so much better. I worked on a few units that had trial programs when the computer charting was first starting, and that was well over 12 years ago, and have never stopped loving it. The programs have actually improved immensely since then, and I love them. Especially when you can get a computerized system that uses a laptop built into a movable cart, then you can get your work done at anyplace around the unit.

[gwenith, BSN, RN]

I worked with the system in ICU and it might have just been that hospital but I resented nursing being reduced to a "tick and flick" response - mouth/eye care - 2nd hourly - tick appropriate boxes.

But could have just been them:(

[DutchgirlRN, ASN, RN]

Once you go computer for charting and especially for meds you'll never want to go back. It actually allows me more patient time. The patient ratio and patient accuity are the factors that cut down on my patient time.

[caroladybelle, BSN, RN]

Once you go computer for charting and especially for meds you'll never want to go back. It actually allows me more patient time.

I agree with this. Done right, computerized charting decreases the fight over who has the chart/info and allows things to get much quicker and more efficiently. If MDs use order entry, it decreases errors.

That said, it only works if there are enough working terminals, and all use it, including the MDs to input their own orders. However, too many facilities do not have enough terminals or let the MDs skate on (have a secretary put their orders in, look things up) not learning to use the system. And that defeats the system.

[Keysnurse2008]

Having online immediate access is great....after it gets going and all the kinks get worked out.It will make patient care better, safer etc.Its just the getting the kinks worked out part.Superusers....we had about 2 per shift per unit.But there needs to be a quick reference card posted beside each computer so you will be able to emergently place orders or at least allow a way to override the system/bypass it when it is an emergency until the "bugs" are worked out.

[lee1]

So, I see most of you liked it once the kinks were worked out. What systems did you use?? What was pt/nurse ratios during computer rollout??

Did you go completely live or just piece by piece? What if your unit was unstable---not enough regular staff, hi acuity patients, too many travelers/agency??

Pros apparently come down the line but cons seem to be at the beginning if things are not organzied right???

So far it seems that 12 hours instruction are not enough at my facility, not enough super users, too hi acuity patients, massive OT, nurses not able to get out on time, etc. All at the Holiday season when people just want to go home. System too complicated. Have not even started MD order entry or pharmacy yet. Docs not trained, asking nurses to help them too often and they cannot get their own charting done.

[RNadvocate]

We really like it now, but when we got our new system there wasn't nearly enough training. We did get a lighter patient load for the first two days of training, but after that they thought we should be able to handle it and bumped us back up. We all demanded more training time though, and ended up getting it.

[DutchgirlRN, ASN, RN]

That said, it only works if there are enough working terminals, and all use it, including the MDs to input their own orders. However, too many facilities do not have enough terminals or let the MDs skate on (have a secretary put their orders in, look things up) not learning to use the system. And that defeats the system.

We have plenty of terminals + we each have our own portable while we're working. I consider us very lucky indeed.

[SmilingBluEyes]

it depends on the technology. Some systems actually make the job harder, like where I work. I would go back to all paper charting tomorrow, if I could. It's that bad, and yes, that slow. It's dos-based and needs to go away.

[SFCardiacRN]

Hospitals that try to computerize "on the cheap" are doing a dis-service to patients and staff alike. Ancient software, minimal terminals and understaffed IT departments are a recipe for disaster. If a hospital is not ready to commit huge amounts of money and time to institute one of the proven systems, it should not bother at all.

[Keysnurse2008]

The nurse/pt ratio did not change...but we did have safety features to bypass during computer downtime.It is great once it gets going.Past admit hx..at the click of a mouse.Lab values at the click of a mouse,surgical notes same too.H&P's....anything you want to know about that patient....is right there available in seconds.So...be patient, ask for reference sheets to be given to all the employees ...so that you can quickly get any orders in and processed that you need.Good luck!!!