Scanning meds/computer charting

bargainhound, RN · Dec 16, 2004

We use a handheld tool for the scanning/med pass.

rntg · Dec 16, 2004

Ours is a handheld tool, but its attached to a laptop on a cart. Is yours attached or does it fit in your pocket...that woudl be sooo much easier!

rntg · Dec 16, 2004

Another thing we are finding , the only time we sat down in 12 hours was to chart meds, now there is no rest and our feet are killing us at the end of the shift... :scrying: Selfish, but true.

bargainhound, RN · Dec 16, 2004

Ours would fit in your pocket.

brigaily2000 · Dec 16, 2004

We just started scanning meds/pt bracelets this week at our hospital. We are the pilot unit. I work on a very busy surgical unit. People are coming and going constantly, not unusual to have 20 people discharged, and 20 new patients admitted in a 12 hour shift. There is clutter in the hall always, with beds, linen carts, etc and now we have added 12 computers on wheels to the mix. My question for those of you who use this system for giving meds, does it ever get easier and faster? I know we are just learning the system, but taking the computers into every room every time you give a med, is time consuming, and cumbersome. Our rooms are very crowded with equipment and visitors (most are semiprivate) and it is difficult to maneuver. Also, we have again begun to chart vital signs only in the computer and not on the hard copy of the chart. They say we will eventually go to all computer based charting, but right now we have to go through extra steps to find vital signs in the computer if our PCA's have done them, doctors are constantly asking for their last set of vitals, and then in an emergency situation when you need the last set, or a trend,it takes extra time to go in and retrieve the info. We did this a few years ago, and within a few weeks went to double charting in the computer and chart, and eventually back to just the chart. I am tired of listening to angry docs, and taking time out of my already overly busy day to find stuff in the computer for them...I guess I am just venting, but also asking for advice, or maybe a pep talk of how it will get better, or advice on how to improve the system. Any would be gladly appreciated.

At the hosp. I was working in, we had hand held "computers" where we scanned the pt's bracelet and scanned the med even after taking it out of Pyxis. After many fits and starts it was abandoned. Too time consuming. The meds were automatically charted in pyxis anyway. Another way to spend money without giving us raises. This in a magnet hosp., too. :rolleyes:

Mulan · Dec 16, 2004

We just started scanning meds/pt bracelets this week at our hospital. We are the pilot unit. I work on a very busy surgical unit. People are coming and going constantly, not unusual to have 20 people discharged, and 20 new patients admitted in a 12 hour shift. There is clutter in the hall always, with beds, linen carts, etc and now we have added 12 computers on wheels to the mix. My question for those of you who use this system for giving meds, does it ever get easier and faster? I know we are just learning the system, but taking the computers into every room every time you give a med, is time consuming, and cumbersome. Our rooms are very crowded with equipment and visitors (most are semiprivate) and it is difficult to maneuver. Also, we have again begun to chart vital signs only in the computer and not on the hard copy of the chart. They say we will eventually go to all computer based charting, but right now we have to go through extra steps to find vital signs in the computer if our PCA's have done them, doctors are constantly asking for their last set of vitals, and then in an emergency situation when you need the last set, or a trend,it takes extra time to go in and retrieve the info. We did this a few years ago, and within a few weeks went to double charting in the computer and chart, and eventually back to just the chart. I am tired of listening to angry docs, and taking time out of my already overly busy day to find stuff in the computer for them...I guess I am just venting, but also asking for advice, or maybe a pep talk of how it will get better, or advice on how to improve the system. Any would be gladly appreciated.

It's a very time consuming and cumbersome system, and I don't think it gets any better.

Another RN told me that she is still passing 9 pm meds at 1230 in the morning.

SmilingBluEyes · Dec 17, 2004

It takes, rather than saves, time. That is a given, and anyone using E-mar or similar systems knows this, painfully well. And those of you not using automated sytems------don't worry, you will be in the near future, if yours is a JCAHO-accredited facility.

I also note these systems are not purchased or designed by nurses or with US in mind. Funny how that works. It' s just another way hospitals cover their you-know-whats. Yes, 5 rights are crucial to safe med administration--- but what is the old saying? Oh yea,"build better idiot-proof technology, and likely, someone will build a better idiot". Sometimes, the old ways are best. But we are the computer age and we have to get used to it.....

I have learned over time, people do find ways to circumvent such systems, to save time----thereby, removing the "safety stopgaps" that are in place to prevent errors in the first place. Seems sad, potentially dangerous, and counterproductive to me, for all concerned.

SmilingBluEyes · Dec 17, 2004

It takes, rather than saves, time. That is a given, and anyone using E-mar or similar systems knows this, painfully well. And those of you not using automated sytems------don't worry, you will be in the near future, if yours is a JCAHO-accredited facility.

I also note these systems are not purchased or designed by nurses or with US in mind. Funny how that works. It' s just another way hospitals cover their you-know-whats. Yes, 5 rights are crucial to safe med administration--- but what is the old saying? Oh yea,"build better idiot-proof technology, and likely, someone will build a better idiot". Sometimes, the old ways are best. But we are the computer age and we have to get used to it.....

I have learned over time, people do find ways to circumvent such systems, to save time----thereby, removing the "safety stopgaps" that are in place to prevent errors in the first place. Seems sad, potentially dangerous, and counterproductive to me, for all concerned.

rntg · Dec 17, 2004

I have yet to see the saftey system, in fact I can forsee more errors. Overridden meds out of the pyxis whether it be lasix, kcl, pain meds etc (we have alot on our unit) can be scanned and entered in before the pharmacist transcribes it, and the preset dosage and time interval comes up thereby putting it on our mar like we transcribed the order. Then the pharmacist puts in the real order and you have it on the mar twice in different time intervals. Our original system was better than that. This could be more dangerous.

rntg · Dec 17, 2004

I have yet to see the saftey system, in fact I can forsee more errors. Overridden meds out of the pyxis whether it be lasix, kcl, pain meds etc (we have alot on our unit) can be scanned and entered in before the pharmacist transcribes it, and the preset dosage and time interval comes up thereby putting it on our mar like we transcribed the order. Then the pharmacist puts in the real order and you have it on the mar twice in different time intervals. Our original system was better than that. This could be more dangerous.

meownsmile, BSN, RN · Dec 17, 2004

We use the COW for our charting, and probly will move into the scanning in the near future. Heaven help us. We have the same problem with vitals. However, our docs are getting better about looking up their own info. But as for new surgicals i hate it. We usually have our CNA's doing the post-op vitals and before we could just pick the clipboard and look at the trends, now we have to pull up the computer screen, jump back and forth and I really dont find it condusive to good care and monitoring when you have a surgical that is boarderline.

And i find them cumbersome to push around. My thought is there is someone who is going to blow a disc or something by not manuvering them correctly. They are on wheels but they are still fairly heavy with the battery on board. If you have a patient who has a couple suctions, cords for pumps, iv poles, FAMILIES etc. there isnt any way taking it in the room is feasable. Leave it in the hall outside the door.