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???
My opinion is paper charting is best. As an International Nurse observing nurses using the computer method is slower to use, it might be a good security tool but nothing is guaranteed. When there is downtime, nurses have to use paper method and then put all data back into the computer once downtime is completed. I find that it does take you away from patient care and doting more on the time on the computer. I dont think its useful when in the end you have to use paper charting. So whats the point of using the computer program when there is downtime.
Also when it comes to computer programmes for hospitals, it can be confusing and for those that are not good with computer programmes it can be frustrating. Paper method is so much quicker. Thats my opinion anyways and also speaking to a few nurses they are getting frustrated with the the computer method too.
Plus, I have witnessed SOME nurses use the computer to act more busy on it when really they are not and could be assisting another co worker or helping with patient care.
I have dealt with at least a handful of computer charting programs. At least half of them wer more time-consuming that your "known" paper charting.
I do like getting access to patients labs, H&P's and other stuff. But there are computer charting programs out there that are WAY more time-consuming to do and YES they pull you away from patient care. By the way, I am very quick with computers and teach people how to use them.
HAHA! I worked in medical records in a facility that used Meditech prior to becoming an RN. The chart was printed after D/C and was more cumbersome to read than you would ever believe. It prints every question you are asked even if you don't answer that section. We had to pay some company to store our records within 2 years of going live after 15 years of barely using our own offsite storage because the charts became so large. The only satisfaction that I got from it was that the attorneys would have so much garbage to wade through!
We went live with a McKesson product in March. Admissions are a bear but are fairly quick on readmissions because all of the info is right there instead of waiting for medical records to find the chart. Charting does take longer but I wouldn't go back to paper. I wish someone would take the best from all of the programs and make a more universal product. It must be a nightmare to travel these days. My main complaint about McKesson is that it obviously had more input from IT than nursing. There are so many things listed that are inappropriate. We have to chart tremors under psychosocial and edema under skin! I can't chart that my patient is oliguric or anuric without making an annotated note and the docs have a really hard time reading our assessments (which of course means that they need a ton of hand holding!).
As far as the questions about go-live...all staff had 3 - four hour sessions of training. Superusers had 16 hours of training. Biggest issue was that the people training us were either non-clinical people or had never used the system. Staffing was improved for a few days and we had superusers on every unit who did not take pts (unless we were short-staffed) for about 3 weeks. We rolled out everything at once, but I do wish that they had done charting first and then meds at a later date. It's nice to have one thing stay the same for awhile.
Good luck to whoever is going-live soon. It's a rough transition, but good God, they don't even teach cursive in school anymore. Computers are the way of doing business for all professionals now, including us.
I've worked with computer charting at the VA about 7 years ago, I type pretty fast so the narrative charting was a breeze. As far as "known paper" charting, there is a learning curve to anything you do. I remember getting my first desk top that was as big as an SUV and wondering why I couldn't just use my old electric typewriter. I also remember going from a manual typewriter to an electric one, I smashed the crap out of the Right side of the electric typewriter for about 4 days looking for the return lever (I"m sure there are VERY few of you that even know about manual type writers and manual returns). Just like the thread about cell phones and other technology, it's here, it's gonna stay here, we may as well adjust. The BIGGEST suggestion I could give is to brush up on your typing skills and if you have ANY input in the selection of a computerized product, INSIST that it has spell checker as part of the program. It's one thing to see messy handwriting on a chart in court and have to defend yourself for possibly misspelled words, it's a WHOLE different story when you have to look at misspelled works and poor sentence structure that is typeset.
Here's a nightmare even the bravest will quake at..............I work in a Critical Care unit, we were charting using paper flow sheets but had to do admissions in Meditech and process interventions documentation which most nurses would just check everything off whether done or not and hit the enter key through all the screens.....then we got a new computer charting system in the Critical Care Unit only. It does not talk to Meditech which the rest of the hospital uses and the other floors do not have access to the application. We still have to do admissions histories in Meditech and document our meds and fall risk scores and look up H&P's in the same Meditech. For our assessments you log out of Meditech log into the other program name escapes me at this point......and chart our nursing assessments and vitals and I&O's and interventions in the other program.
When a patient is transferred out of the ICU we have to print all of our charting out (it generates about 20-30 pages per pt day in the ICU) and send all that mess with the pt to the other floor................print outs are not user friendly so I really don't see some poor Med-Surg or Tele nurse pawing through all that garbage to find information without getting really steamed over it. And when the pt is finally dc'd from the hosiptal the medical record department has to scan all those pages into Meditech so if the pt comes back in at some point in the future the information will be available..........................this is paperless charting??????????? We are going to be killing entire forests monthly with this nonsense...................
Oh and there is no plan in the future to upgrade the computers to cross communicate and eliminate paper waste...............And nurses and techs are not getting raises this year because the hospital just can not afford to give us another 30 cents..............yeah we are spending more than that on the stupid paper for our paperless system...............
i would rather have the paper mar. we just went to the computerized emar and etar. the red and yellow boxes come up at wrong times. yet the order will read the correct time. so its an error in computer cause it is not done when its suppose to be. not sure which program we are using for sure.
Oh my gosh, the Medi-WRECK E-MAR! Duplicate, triplicate meds, times messed up, only lets you use 2 saline flushes at a time (one scheduled, one PRN) so you have to go out and back in and rescan foe a triple lumen flush!
[Critical Care Unit only. It does not talk to Meditech which the rest of the hospital uses and the other floors do not have access to the application. We still have to do admissions histories in Meditech and document our meds and fall risk scores and look up H&P's in the same Meditech. For our assessments you log out of Meditech log into the other program name escapes me at this point......and chart our nursing assessments and vitals and I&O's and interventions in the other program.
When a patient is transferred out of the ICU we have to print all of our charting out
Sheesh...sounds like the system we just started. We now use E-care with meditech. What a headache and the doctors hate it.
I am a newly graduated RN working at a hospital in Georgia. We are supposed to scan all NS using the emar but no one does because of similar issues you mentioned. I would like to hear from nurses at other facilities who have maybe found a way to solve this issue. Not scanning flushes results in a significant financial loss for the hospital.
AussieKylie
410 Posts
My opinion is paper charting is best. As an International Nurse observing nurses using the computer method is slower to use, it might be a good security tool but nothing is guaranteed. When there is downtime, nurses have to use paper method and then put all data back into the computer once downtime is completed. I find that it does take you away from patient care and doting more on the time on the computer. I dont think its useful when in the end you have to use paper charting. So whats the point of using the computer program when there is downtime.
Also when it comes to computer programmes for hospitals, it can be confusing and for those that are not good with computer programmes it can be frustrating. Paper method is so much quicker. Thats my opinion anyways and also speaking to a few nurses they are getting frustrated with the the computer method too.
Plus, I have witnessed SOME nurses use the computer to act more busy on it when really they are not and could be assisting another co worker or helping with patient care.
Thats my opinion:rolleyes: