Transitioning from paper charting

[CoffeeRTC, BSN, RN]

We are currently in the process of changing ownership and will be getting electronic health records. Any words of wisdom in making the change? We will be using PCC.

[vampiregirl, BSN, RN]

I was working at SNF when PCC was implemented. Change is never easy but in this case, so much for the better!

If I recall correctly, the charting/ assessment modules were implemented in all units on the same date. We had training and "cheat sheets". Once we got the hang of it, most of us loved it. So much more efficient and easier to look up info.

I think the EMAR/ETAR was implemented one unit a month (on the 1st of the month). Extra admin staff (who were familiar with it) were physically on the unit every shift for a couple of days. I recall those first couple days being really stressful, but it quickly got better. I think it would be that way for any program. Very easy to make sure all meds were passed. And helped with time management because you see when you had meds due.

I don't remember when we implemented the CNA charting portion during the process. I did appreciate that it was super quick to verify all CNA charting was complete before they escaped at the end of the shift. Once you figure out how to run specific reports, it really makes life easy and can be a huge time saver.

I work in a different area of nursing (in patient hospice) and I miss PCC compared to the EHR we use.

Good luck!

[Neats, BSN]

I have implemented this program a lot first do not be afraid, the instructions are easy. After you get the hang of it remember that a person can get real comfortable with knowing where to click and just go through the motions, this can be harmful to the patient and to your career. You should always check yourself before submission.

[mander]

We just switched from Sigma to PCC. We did it in sections (which we didn't agree with because we went from paper to Sigma a few years go and it was easier just to do the whole damn thing at once!)

We entered in waves (general orders, then treatments, then meds). I think it would have been easier to do this all at once by resident. Have your order templates sorted out beforehand. Decide if you are changing any policies or ways of doing anything beforehand. For instance, we switched from exact times to "AM" "PM".

Make sure once you put a resident in people are updating orders on paper and the eMAR. Plan a few days of reconciliation and run the building like you would a weekend, with all "extra" nurses checking orders and care plans.

If you have one, have staff play around in the "sandbox" (we had a fake account with fake resident names and orders). When we went from paper to eMAR it was a LOT more difficult than going from one eMAR to another. I had 50 year olds crying. It was awful. Just make them practice!

If you can, have extra staff to make the first day easier. We went live at 7 am. We had the third shift pass a couple of meds for 7 am so they can get the hang of it before we got phone calls at 4 am.

[sheneeg]

I have gone from paper to PCC before. Change is never easy, but once you learn the system you will love PCC. No more digging through stacks of papers or going through chart after chart to see that everything has been done. It will all be available to you in your dashboard and reports you can easily run. PCC will alert you of documentation not completed. You can schedule assessments to automatically trigger for each shift, or once a week, or whenever they need to be done. Seeing any skips on your MARs and TARs are easy. Making sure the CNAs chart their ADLs will be quick. I think your going to really like it, once you learn it.

[River&MountainRN, ADN, RN]

Computer documentation is only as good as your computers and network. Just throwing that out there. We've had more than one shift get totally derailed because the computers went down halfway through the shift or just became laggy. With paper charting, your med pass is as quick as you can flip through the MAR/TAR. With computers, you need to wait for each screen to load---and hope it does! So make sure you have an ACCURATE backup MAR/TAR on paper in case the computers go down! Fully invest in any training available, as well. I've seen several very experienced nurses suddenly foundering because they weren't taught how to do tasks on the computer that they were incredibly proficient doing on paper.

[CoffeeRTC, BSN, RN]

Well, we are right in the middle of the transition. I'm being trained as a superuser and trainer. So far, so good. Toughtes paret is just getting the prn employees involved in the training. I'm also loving that we have a few nurses that are already using PCC at other facilities!