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Discussion

Think outside of the box

I've been asked to think outside of the box for a workflow issue. Our beloved hospital system has computer charting. One program for L&D, ante and post partum IPROB and another for babies and every other patient in the hospital cerner. Our hospital is one of the last to go online for cerner, we have been doing IPROB for a year. Anyway the problem is we are a level 111 and have Nursery come down for the "wacky" deliveries 24 weekers, patients on mag, insulin drip, meconium, iugr etc.. The problem is they come down for these deliveries while they have an assignment up in NICU while it may take them 15 minutes to do what they need to do and now have to write on a piece of paper it will take them 15 minutes to do and 30 minutes to document (the labor nurses have to put in information for the baby to get admitted so they can get drugs and orders in etc...) Any suggestions?.

Right now the only suggestion is for L&D to hire a NICU nurse to do that role at least mon-fri during the day. Any other ideas?

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While i'm not familiar with your computer charting I will tell you what we do at my facility. We use OB tracevue and we print out a baby H&P that has all the mother's pertinent information, like blood type, hep B status, HIV, Chlamydia etc etc results. There is also a place on there for apgar scores and a place for a delivery note. The NICU team has a form they bring, with all of the information in checkbox form so as to speed up their charting. They check boxes for type of rescucitation used, apgar scores etc. And they have a place to add a delivery narrative as well. When NICU comes to our deliveries, they are there for the initial apgars and leave when the baby is stable. Their charting is swift and doesn't seem to slow them up at all. The NICU charge nurse is the one who comes along with an RT, and doctor or NP if needed. The charge nurse generally doesn't have an assignment, but of course that often isn't the case. Oh and also, the NICU does not give the Vitamin K and Erythromycin. The OB baby nurse or labor nurse is responsible for those. Good luck.

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