Safety of Electronic Documentation

Published

Are nurses and others at your facility acting to ensure the safety of computer systems?

This article gives personal and facility examples of safety issues.

Digital Health Records' Risks Emerge as Deaths Blamed on Systems

... Last month, nurses at Marin General Hospital in California complained about an electronic medical-record system made by McKesson that they said was causing medications to be ordered for the wrong patients.

Jamie Maites, a spokeswoman at Marin General, said the hospital has made "significant progress" in dealing with the issues. The rollout has been "challenging," yet "has resulted in a safer hospital for our patients," she wrote in an e-mail. Kris Fortner, a spokesman for McKesson, said the company is working with Marin General to address the concerns.

"Aside from some initial issues related to changes in nursing workflow, feedback from Marin's leadership to McKesson about the implementation has been positive," Fortner wrote in an e-mail. ...

Epic Systems was the target of criticism last year by nurses working in Contra Costa County, near San Francisco. They complained that glitches in the county's $45 million system, such as medications disappearing from electronic files, were endangering patients' lives. ...

... In one month, 129 complaints were filed by nurses at county detention facilities, where the problems were most acute, according to Jerry Fillingim, labor representative at National Nurses United.

Some problems in Contra Costa arose because of human error -- medications were entered incorrectly into the Epic system when it went live, said Rajiv Pramanik, chief medical information officer for the county. There has been "dramatic improvement" among staff members in using the technology and the system's "strengths are tremendous," he said.

Barb Hernandez, a spokeswoman for Epic, declined to comment. ...

Specializes in women/children, pacu, or.

My problem w/ Epic is when the PCP does write new orders (all PCPs do it electronically), I have no way of knowing unless I seek that info. I've had docs put in orders from home in the middle of the night w/o my knowledge. I believe the designers of Epic think we sit around at the computer while at work. Hello???? This is not an office job!

Specializes in Med/Surg, Academics.
My problem w/ Epic is when the PCP does write new orders (all PCPs do it electronically), I have no way of knowing unless I seek that info. I've had docs put in orders from home in the middle of the night w/o my knowledge. I believe the designers of Epic think we sit around at the computer while at work. Hello???? This is not an office job!

Serious question: how is that different from paper? Although I've been at this for only 2.5 years, I was in a paper environment for about a year. If that little yellow tab wasn't sticking up and the chart wasn't placed on its side in the rack, I didn't know that a doc had entered an order either. I have my issues with CPOE--primarily orders entered incorrectly that nursing MUST be knowledgeable enough to catch for patient safety reasons--but I believe your issue with CPOE isn't unique to CPOE.

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