NICU IPOCs

[nicu_gal]

Hi There,

My unit just started using CareCompass and IPOCs in Cerner. The standardized IPOCs really don't apply to our population, and I am wondering if there are any nurses who can share how your NICUs are using IPOCs and if you have created some that are more specialized for our patients? Thank you in advance for your advice and information!

[HyperSaurus, RN, BSN]

What's an IPOC?

[NicuGal, MSN, RN]

Is this an acuity tool?

[KRVRN, BSN, RN]

Interdisciplinary plan of care. It's like a care plan. They're stupid and useless but apparently, they fulfill a JCAHO requirement.

[NicuGal, MSN, RN]

That's the real name of our team plan lol. Nursing is the only one that writes on it.

[HyperSaurus, RN, BSN]

Oh, gotcha. We do have nurse initiated care plans (We use McKesson Paragon), and ours are specialized to the neonatal population. When we start a care plan, we can just search "Neonatal" and that pulls up all of the nursing diagnoses with the work "neonatal" in it. It's pretty basic--covers impaired gas exchange, impaired breathing pattern, risk for infection r/t hospitalization, risk for injury r/t high serum bilirubin or low serum glucose, ect.

That being said, almost no one pays attention to the care plan once it's formed, except when it's time for discharge and one wants to 'complete' the care plan.

[Bortaz, MSN, RN]

Plans of care were stupid in nursing school, and they are stupid in practice (for the same reason) because no one uses them correctly (if at all...) and no one updates them and no one follows up.

[nicu_gal]

Yes, it seems that the whole purpose for this Cerner "enhancement" was to make the job of JCAHO reviewers easier. But, as with other aspects of computerized charting, it's making my colleagues crazy because the needs of our patient population aren't covered. Often, the pre-fab plans have goals and interventions that are totally irrelevant in NICU and we have to basically uncheck all of the suggested interventions (i.e. encourage pt to ambulate, encourage use of incentive spirometer).

Also, the opportunity to create (and free-text) patient specific plans of care has already led to some colorful, varied, and not very clinical attempts (i.e. "baby will maintain temp by himself"). Our goal is to have a NICU folder with appropriate care plans that our nurses can use and not have to pull things out of thin air. We are currently working on making care plans for thermoregulation, jaundice, glucose instability...does anyone have other suggestions?

[nicurnstefani]

Hi, we also use cerner and do ipocs. We have nicu/patient specific ipocs that were created by our it team. So we can pull up Ipocs-newborn from the order screen and activate the ones that apply. So it is possible to create your own but may require more work from your it department. I wasn't there when our system was created, so can't tell you about that process.