Organize our Nursing Stations!

[oKIMMYo]

I didn't know where else to go, but I need some intelligent ideas from people "out of the box".

We are a 54 bed Med/Ortho/Surg/Cardiac Unit. We have 1 main centrally located nursing station. Each Wing (we have 3) has 18 beds and a mini or satellite nursing station at each wing.

Currently, ALL of the charts are being kept at the main nursing station. THere are lots of problems w/ doctors and nurses not knowing when/where to put the charts so that orders can be taken off.

Before you get too excited... we are only allowed 1 charge nurse and 1 unit secretary for the whole unit per shift.

How can we organize this chart/orders business so we can function more smoothly. It's nuts! I appreciate any input you guys/girls have!

Thanks!

[Okami_CCRN, BSN, RN]

I understand exactly where you are coming from, we recently put stickers on the front of all charts stating "Dear Doctor, please return chart to the chart rack so your orders can be entered." We also put labels on the computer monitors saying "please return charts to rack." I have to say it has been working very well, occasionally we will have a doctor leave his 5 charts lying around but we let them know to put them back when they are finished. Hope that helps a little.

[RheatherN, ASN, RN, EMT-P]

that stinks! i cant imagine the probs that could cause! probably even endangering pt safety!

we have 30 rooms on my floor. one central nsg station. sometimes the docs will take charts to review in another room, but they are good at bringing them back and i think that will be most of your problem to solve. getting them to know where to and actually following thru with bringing charts back.

we have a circular file holder thingie (lack of better medical terminology :))

then we have a rack next to it, when they do orders they pull up the dr order tab so whomever needs to do it knows there are orders to be entered. then the chart is put back in the circular file thingie with the rn to check tab up and the chart sideways in the thing so that the nurse knows there are orders to sign off.

but, if you had issues with 2 racks, you could just use the one circular one and have them leave charts sideways with the tab up when needed to be checked.

i hope this helped/helps at all.

gl!

-h-rn

[wooh, BSN, RN]

I remember back in nursing school, one hospital I did clinicals at that had a huge floor would leave the chart at the room (outside the door in one of those fold down things, that way you could stand there and chart.) Anyway, they had a flag system. One color sticking up means new orders (for the secretary to pick up) and one color was after the sec had done their thing and for the nurse to sign off. The secretary would every so often go and make a round picking up charts. The nurses would watch their rooms for when there were orders.

This is actually one of the benefits of computerization, chart is always available if you can get to a computer, no wasting time hunting for the one and only chart.

[Duckyaryj]

I worked on a HUGE unit (65 beds) with two main NUS stations one on each end covering 25 beds each and a station in the inside 15 when staffing decided to be extra nice. The charting system was partial paper and partial computer (Orders and MARS were paper). The charts were in locked cabinets (Nurse servers) next to each door. Then there were flags on the wall next to the door also that signaled when a doc wrote an order we would then take them off and then place them in a bin at the Station. Then the NUS does their job. We also would round not only to check on the patients but to also make sure that the orders have been taken off.

[NursePaula]

i work in a 40 bed surgical (post-op) floor. we have the "wallaroo" outside the patient room with the fold down "desk" where the charts stay. we are allowed to take one chart at a time to the nurse's station to sit to chart if we want, otherwise very easy to enter a short note as you leave the patient rooms. (ours is not locked and we have no problems with people getting into the wallaroo that are not authorized cause you stick out like a sore thumb.) personally i love :redbeathe these things, saves time and steps, and it is easy to jot something down as you leave the room. after doctors write orders they are put in a rack by the doctor(which has wheels and can be pushed around for a couple of the doc's that do rounds with the charge nurse), at the nurse's station near the unit secretary. once the unit secretary enters orders into the computer for labs, diets, etc. and faxes things to the appropriate place, s/he puts it in a rack directly in front of them where the "nurse" then knows that orders are ready to be noted. works very well. takes minimal amount of time for the docs to get into the habit of where to put them.