New hosptial computer systems pull nurses away from patient care

lee1 · Feb 24, 2006

Those of you who work in the ICUS when these new computer systems went live. Did you have interfaces from your monitoring system??? How did you computer chart all of the many IVs, drips, titrations, frequent VS???? How did you differeniate artifact, false VS readings??? Did you end up doing double charting just to remember what took place, say in a code situation or a plain old hectic hi acuity patient undergoing procedures simulataneously. What about field trips, say to CAT scan, MRI, etc.

bethin · Feb 24, 2006

I think computer charting can be better in some cases. At the hospital where I work now, nurses chart everything on the computer but one MD refuses to use the computer so that means no MD uses the computer. We still have to chart on the hard chart also. From what I've seen, it is much safer when it comes to passing meds. You need to scan the med you're going to give and then you have to scan the patient's ID band.

I'm a CNA so when I need to chart a BM I have to chart it in 3 places. Once in output, another in stool, then I need to chart in GI regarding size, color, etc. Then to exit out of the thing I have to hit exit 5 times. Very time consuming. The nurses have it worse. I feel so sorry for them. They have to double chart because one doc refuses to catch up with the times. Plus, the things don't like to be unplugged longer than 5 mins.

We use CPSI system. Of course our hospital stuck us with the cheapest system. We could be upgraded to make our lives easier.

Otessa, BSN, RN · Feb 26, 2006

I've been using computer charting at my hospital for the past 9 years -it saves time and you don't have to worry about reading someone's writing......

JLynnOR · Mar 12, 2006

My hospital system implemented it on a hospital-wide basis for our brand new hospital before the rest of the system went live on this particular system. The software system, although not in its infancy, has a lot of "issues". And, in many ways, my hospital system was not ready with the IR support or infrastructure that we needed. I work in the OR, and I'd go back to paper OR documentation and paper charge forms in a heartbeat.

And I think that, in some ways, it has been a pt. care and safety issue--orders placed by doc and being overlooked by nursing staff on the floors, taking time away from patients, documents that seemingly "disappear" in the computer system. It could be a real time-saver, but totally depends on how good the software, IR support, and hospital implementation is.

tlcprn2u · Mar 12, 2006

My hospital system implemented it on a hospital-wide basis for our brand new hospital before the rest of the system went live on this particular system. The software system, although not in its infancy, has a lot of "issues". And, in many ways, my hospital system was not ready with the IR support or infrastructure that we needed. I work in the OR, and I'd go back to paper OR documentation and paper charge forms in a heartbeat.
And I think that, in some ways, it has been a pt. care and safety issue--orders placed by doc and being overlooked by nursing staff on the floors, taking time away from patients, documents that seemingly "disappear" in the computer system. It could be a real time-saver, but totally depends on how good the software, IR support, and hospital implementation is.

I work in a hospital where only some units have gone to computerized charting, and it just so happened that the staff there was mostly senior nurses that had graduated before 1990, which according to common sense as well as AJN research, means that there is a strong possibility of decreased computer literacy among them. On top of that, typing skills were never a part of their CV, so the start up was very painful, frustrating and slow. You would have thought that the hospital's administration would have known their employee population and would have made adjustments for their individual requirements, but that would have made too much sense, right?

Because we work in a unionized facility, we were able to grieve the process and have input into the remedial program. Otherwise, both patient care and the nurses' job performance would have suffered.:balloons:

RNadvocate · Mar 13, 2006

sorry -- i just cant belive that they have the money for these computers systems (ours was 30k per mobile terminal) but not for raises or staff or linen pads.

See the IWPR on misplaced priorities for hc industry: http://www.iwpr.org/ and the report on how higher wage would help recruit & retain (duh) is there or

http://www.valuecarevaluenurses.org/toolkit/40980_SEIU_Book.pdf

ps -- great that you are at union facility -- makes a difference!!

Nellie Nurse · Mar 19, 2006

Our hospital just switched to Cerner. We had started out with using computerized MAR but we just went back to the paper MAR because pharmacy was totally unprepared for the change and a lot of scary things were happening- meds were being put in twice, insulin was listed under PRN section and was being missed. One of our patients didn't get their coumadin for 5 days because the nomogram orders were being overlooked. I'm really glad we went back to the paper MARs. I do like the computerized assessments but it also seems as though the paper work has doubled. For instance when a patient is admitted you have to not only document all of their home meds in the computer but also write is out on paper for the chart. Also the aides have to chart blood sugars on a paper flow sheet, on their assignment sheets, and in the computer. There is too much double and triple charting involved at this time. Management has also not told us which paper forms we are no longer using and which ones are still to be used so every other day they change their minds about how to chart. One example of this is there is a place to chart restraints in the computer but the paper form is still on the unit so some people are using the computer and others are using the paper because it is still available. There is still a lot of confusion. We have had this system for a month now.

tlcprn2u · Mar 19, 2006

Your statement just mirrors what I have heard throughout my state: the computer becomes another patient! And everybody, including management, is still trying to iron the kinks out of the new technology!

I never cease to wonder why was the staff that eventually would have to utilize the system not involved in the whole process? The pharmacists, the CNAs, the nurses? That would make too much sense, right?

In my facility, where we are represented by SEIU, we have the right to participate in the process and we have vehicles to hold administration accountable if we are not allowed to do so.

Misty1 · Mar 19, 2006

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???

I've used eclypsis which was pretty user friendly and went well when we went live. I also worked at a hospital that uses Meditech.......that system sucks no other way to say it. So I guess it depends on the system.

busykim · Mar 19, 2006

My experience so far with what I believe is eclypsis-- but called "health connect" at our facility (which we have dubbed "hell connect") is not good. I know change is hard, but to go from a computer program that was a couple of screens to input a new patient (triage or ambi, I work in the ER) to literally about 10 screens is very time consuming. We spend more time at the computer to input patient data (more for accounting and records) and it has taken away time for patient care. We no longer have a viable way to communicate via computer with our ER doc's for orders, etc. We have gone backwards with red clothespins stuck on charts to let us know we have orders vs. old system that flags everyone via computer screen to let staff know when there is orders, or pt. to be d/c, or patient has a bed assignment!!!:smackingf I literally had a meltdown :crying2: on the first "go live" day when I had to input an ambi. (OK I have a few other stressors going on in my defense---marriage problems, dad dx with lung ca etc. etc.) so I think it was partially "the final straw" but I was finally feeling competent in my job as an ER nurse of nearly 2 years, and then they have to make things harder and more complicated!!! I NEED a secretary!!! HELP!!! I am actually looking at other positions as the ER itself is overwhelming at times, but now--- almost impossible. :behindpc:

RNKITTY04 · Mar 19, 2006

Meditech here.

Pro: Its almost impossible to give the wrong med, the computer will show a red box that says : this med is not on the patients emar are you sure you want to give?

Cons: The system has many glitches, alot of the time the whole computer will just freeze and you have to start all over again.

The system we have is bulky, heavy and hard to steer.

If the patient does not get their meds EXACTLY when they are due A big red flag pops up and tells you that you are late, and it wants to know why.

The patients band does not always scan, especially if it gets wet.

Pharmacy's turn around time is SLOW, sometimes we have to fax the same order 2 or 3 times just to get them to add med to emar so we can give it.

unhappynurse · Mar 20, 2006

I work for an HCA hospital in Florida, which may explain my username. Yes, we have both computer charting, meditech and computer MAR's, EMAR. One is worse than the other. In the last year, the amount of charting we do has nearly tripled. Supposedly the purpose of meditech was to "limit" the amount of charting we did. Ha Ha. NOT! And EMAR! What a nightmare! It's not difficult. In fact, it's fairly easy. IF the barcode on the med scans. And if the barcode on the patient scans. And if we don't kill ourselves, a patient or a visitor with the contraptions we lug around with us called COWS (computer on wheels). And if the batteries don't die. And if... And if...

Then of course there is management threatening us that if we don't have a 90% or better scan rate we'll be written up and eventually fired. Oh the threats I could tell you about. :angryfire

Truthfully, in my opinion there is less charting done now than there was when we did it on paper as not all nurses are doing their charting. You'd be amazed at how many times you just about finish an assessment in the computer, get distracted for a second and the computer dies on you or shuts off. Then of course you have to start ALL OVER AGAIN!!!! :madface:

Oh yeah, computer charting is the way to go! :rotfl: