What happens to the paper charting when the system is back up?

[Natkat, BSN, MSN, RN]

I am an acute dialysis nurse. For most of my career we have done paper charting that we then put in the patient's chart. I am now working for a hospital that has a dialysis unit and we do our charting in Epic. When Epic is down we can generate paper forms and document our treatment information there. What I want to know is how is this information added to the EMR once the system comes back up? Is it imaged, scanned or entered manually by a data entry clerk? This hasn't come up yet, but I have been thinking about it.

[BittyBabyGrower, MSN, RN]

We have to manually re-enter the information if the system comes back up during our shift. If it doesn't then it is put in the chart and later scanned in to the EMR.

You our should have a downtime algorithm to follow.

[Natkat, BSN, MSN, RN]

That's funny because one day I asked to see a policy and procedure manual, after a co-worker said something really crazy and said it was policy, and I was told we don't have one. So whatever she said was policy clearly isn't, and just a mad case of a nurse eating her own. A downtime algorithm would be like finding the Lindbergh baby.

Thanks is you for the explanation. I tried to imagine unit clerks trying to enter all the manual charting that was done while the system was down, and decided that it would be physically impossible. And then I tried to imagine trying to enter our own hours of charting on several patients and still clock out on time, and that also seemed physically impossible. Imaging the pages makes more sense.

[mydesygn]

There should be a downtime process available. I would contact the Info Systems or Education depts so they can get you the correct information if you are unsure what to do.

Generally, each institute does something slightly different - typically orders are entered once the system comes up. This may be done by the ancillary depts such as lab, pharmacy etc... There may be a timeframe for documentation. For example, if the system was down less than 2 hrs - you would enter your documentation - if it was more than 2 hrs, you would have the paper documentation scanned in and enter a note in Epic stating the timeframe in which the paper documentation that was scanned covered.