Tell us about your computer system

Magicat · Aug 14, 1999

We just instituted MediTech charting in our hospital. We went "LIVE" on August 1 after two weeks of 'parallel' charting.

We use PC's at the nurse's station and laptops in the rooms....the laptops are very slow d/t battery usage.

I personally love the aspect of computerized charting! It enables the nurse to do more thorough admission assessments in re: past medical history. Many of our nurses are still quite apprehensive about charting on the computer, and we have even had some resign because of it.

All in all though, many of the nurses that I had to help extensively in the beginning, are now zipping right through their charting. And doing it WELL!!! I have also heard many converts. Many are saying, "this isn't so bad after all."

We still have some kinks that we are working out, and additions and subtractions to some of the interventions. But we eventually will have the program streamlined and fine tuned. I think everyone will eventually like it and wonder how we ever got along without it....

------------------

Ramona · Aug 14, 1999

I have worked at two Home Care agencies with computer documentation and would not go back to the old way. Oasis is killing us in Home Care but with computer documentation, it is much easier. Our nurses have the complete patient chart in the home. No more wondering if the office nurse called the MD, the info is sitting in her lap.

3651bht · Aug 15, 1999

Hi Brian,

Yes we use computer charting at the small (150) bed hospital I work at in Southern Maine. We have been using it for approximately 3-4 years. We use the handheld computer that is advertised on TV. Columbia, I think? We also chart by exception. I think the charting by exception is more of a problem for nurses because they all want to write a book. I like the concepts because it keeps me organized. We have a daily system review that covers all the body systems. If any system doesn't meet protocol them a specific system has a more detailed review screen to chart on. We build our care plans from canned text ( can't do this with the handheld though) and customize them as needed. I hated the computer and especially the handheld at first. The handheld is definitely slower but the hospital spent alot of money and is insistent that we use them. The handheld has caused a large increase in the patient load in PT. Carpel tunnel TOS etc. The handheld is great for data collection ie. I&O, VS. Can't type any text in it and where numbers are used to designate a value you don't know what value the number stands for ie. pulses 1= weak/thready 5=doppler. If someone is contemplating using this type of system make sure you have a nurse backing up the system to upgrade things on a constant basis.

3651bht · Aug 15, 1999

Hi Brian,

Yes we use computer charting at the small (150) bed hospital I work at in Southern Maine. We have been using it for approximately 3-4 years. We use the handheld computer that is advertised on TV. Columbia, I think? We also chart by exception. I think the charting by exception is more of a problem for nurses because they all want to write a book. I like the concepts because it keeps me organized. We have a daily system review that covers all the body systems. If any system doesn't meet protocol them a specific system has a more detailed review screen to chart on. We build our care plans from canned text ( can't do this with the handheld though) and customize them as needed. I hated the computer and especially the handheld at first. The handheld is definitely slower but the hospital spent alot of money and is insistent that we use them. The handheld has caused a large increase in the patient load in PT. Carpel tunnel TOS etc. The handheld is great for data collection ie. I&O, VS. Can't type any text in it and where numbers are used to designate a value you don't know what value the number stands for ie. pulses 1= weak/thready 5=doppler. If someone is contemplating using this type of system make sure you have a nurse backing up the system to upgrade things on a constant basis.

amber z · Sep 6, 1999

Our L&D unit has hundreds of thousands of dollars invested in a computer based external monitoring system that includes computer charting. However, we (the nursing staff) do not use the electronic charting system because it is too time consuming. The concept of electronic charting seems efficient (eliminating multiple entries), but in our case, it is not. The simple task of charting AROM by the physician requires that the nurse go into 4 or more screens. It takes about 2 or 3 min. to do so, whereas the traditional written charting takes about 30 seconds. Also the charting is all mouse driven which makes things like time entry a pain because we have to move the hand of a clock to the correct "time" position. Several of us (nurses) seem to think that the program was not written by nurses, and perhaps that is the reason charting is so complex. If anyone is using "Birthnet" by Spacelabs for electronic charting post a note about your experience and any advice about the system.

------------------

ckipp · Sep 23, 1999

We were using a partial electronic system that is no longer supported. Went live with Lastword in February. Has some great advantages, but like most software technology has glitches and problems. Many issues we have been able to work around--spending much time and energy to do so. Do not under estimate the level of frustration and resistance in dealing with new systems. I must here daily "Why can't this system work like the old system?"

I believe the electronic record will be worth it in the long run....but it's a long road. Please e-mail directly if you want more info.

Jpolos · Sep 25, 1999

We have computerized charting at my hospital and it is hard for mr to get used since I work on a casual basis(prn). It is very difficult to get into the nitty gritty re: restratint documentation. We also chart by exception and that is easy on the computer. It has been difficult coordinating downloading and report times, and ensuring that the work has been completed as it is supposed to be. Another issue for us has been the nurses time involvement in the computer. Seems like we are so busy trying to get things done in a timely fashion, the patient is low on the list.

[This message has been edited by Jpolos (edited September 24, 1999).]

Sister · Oct 3, 1999

I work in a small hospital (113 beds), one of the few in the USA with the same system throughout;our business office, nursing, supply, etc. is all same system. We use CPSI

Point of Care. Not a bad system, but plenty of room for improvement. We have been doing this for about 5 years, continually improving. I have learned that nurses do like to chart a lot(in case of lawsuits! I think), but waste much time. Charting by exception is good, the important thing is to have a system that is adaptable to your environment. Would be interested in hearing from anyone else using CPSI, want to network to improve our usage.

JJC · Oct 11, 1999

The hospital that I work at has been using the meditech computer charting for about 2 years now. We use handheld computers as well as PC's that are at the nursing station. At first it seemed time consuming, but now I can't imagine going back to paper & pen documentation. I work in an 8 bed CCU/ICU and we recently installed an interface which allows vital signs/o2 sats etc to cross over into the main computer which saves even more time as we don't have to individually enter them. One draw back to this form of documentation is that if your facility uses registry nurses it breaks up the continuity of the documentation as they use pen and paper charting. I also don't care for the I&O

on our system as it puts it in 8hour time periods and you can't look back and see a patients hourly output. Everyone I have talked to prefers the computer documentation over paper!

icurn · Nov 3, 1999

I work in a seven bed icu in a small community hospital.. We are getting ready to change to computerized charting.. Our nurse manager is wanting us to update our assessment flow sheet for the computers, but not sure exactly what she wants.. Was wondering if I could get examples from other as to what their screens look like, what kind of information they are putting into the computer and how... thanks for any help you can give me....

iamme8557 · Nov 8, 1999

I work in a 26 bed med/surg/neuro ICU that is using the computer charting program called Carevue; after 8 months the program is liked by most.

The problems I have seen are due to how easy this is to use. The vital signs are defaulted from the monitor to the computer so charting is either accept default or type in the numbers. The pulse ox reading does not default and piggy back meds such as pepcid and antibiotics need to be added as do the oral liquids when meds are given or the patient eats. Hourly urine of course needs to be added. I have found that the original defaulted rhythm needs to be changed occasionally and the piggy back meds need to be added....these are the biggest charting mistakes at this time. For any hospital looking at using a computer charting program in the future please look into Carevue, it does take some time to set up the system but it allows so many variances that being very specific to each unit is not difficult. Charting is very quick and very complete. I can do a complete systems assessment in 3-5 minutes after I have assessed my patient. The program guides you through the systems assessment and actually keeps you from forgetting something. Any item that needs to be further defined can be added as extra comment then type in what is specific and an exclamation mark appears before that notation so further info may be checked on, this keeps the chart looking clean and simple but extra comments are quickly available to the docs or other nurses if needed.

any further questions

e-mail [email protected]