What would be your perfect computer charting system?

sometimes fast, easy, and intuitive.

Not sure if this will help much, but here goes....

1. I don't like a lot about our current system (McKesson Care Manager), there's no easy way to chart skin issues, too much mouse movement (instead of being able to hit 'enter' to go to the next field), nearly impossible to edit, and no continuity on what needs charted. The list can go on and on.

2. What would keep me at the bedside more would be a program where you can type your nurses note rather than scrolling through hundreds of boxes to find what you want to chart.

3. Directly related to number 2, you can actually chart whats wrong instead of finding the closest related box and hoping that covers it.

4. Our pain section involves charting many items and then followup documentation 15-30 minutes after charting the pain depending on our intervention.

Sorry if this didn't help or sounds negative, but I have a few issues with our program.

I would like to see a computer screen with a picture (cartoonish) of a pt in a bed. I would like to be able to click on the IVF and have a menu pop up that will let me enter the input this shift. Then I would click on the foley and get a pop up that would allow me to enter the output, then click on the sacral wound and get a free text box to describe the wound and dressing, etc. If the vitals were out of the MD parameters the computer would send a stat message to the MD. In my imaginary computer system it would automatically order supplies for the next shift and a delivery person would deliver them to the room.

In my dreamland hospital I would have an avatar that would be able to virtually walk down to the pharmacy and discuss medication issues with a virtual pharmacist. Then on my way back down the hall I could stop in at the NM office and request a vacation day and get an immediate response as to whether or not that day is available.

I would also like to be able to call in sick via the net (that way I have proof that I did indeed call out and not be at the mercy of some half asleep disgruntled employee).

Sigh, If they don't get nurse/software developers who can think outside the box soon we are doomed to another ten years of hunt and peck documentation and endless mundane phone calls.

I hate EPIC and I miss EMStat. More click boxes make faster and easier charting.

A voice recognition program to record your VS and initial asessment so you don't have to jot it down or run to a computer and record before you forget. Our asessment takes at a minimum 11 different screens and if the system is slow...Not to mention the MAR, the worklist(electronic Kardex) and daily care. Plus the system won't support the care plan and pt timeline, so this is separate and on paper.

It would be nice to have more than 1 window open so that when you are phone a doc you could have meds, allergies, VS, labs, imaging results right there instead of having to click on mutliple screens, or try to have it all written down before you call. It would be nice to have VS, I and O and wts show up as a graphic so you could pickup on trends.

How about linking VS, labs, pain to the MAR so that is a value is abnormal the med changes color---low BP: the metoprolol turns yellow, high glucose the insulin turns green, etc. And if you have forgotten to chart on a screen it would be nice to have something that pops up to remind you.

Any system needs to be as fast as possible. I seem to spend more time nursing the computer than the pt. :icon_roll

Our pain documentation is a continual struggle to document level, pt's goal, and response to treatment.

I hate SOARIAN. Blech!! I worked with EPIC on one day last week at a large children's hospital, and I'm not sure how I feel about it.

I'll stick w/ the paper charting at two of the hospitals I've been to. SO simple, covers everything, can be done in 2 minutes.

I think McKesson CareManager is terrible, too much clicking all over the place and not conducive to writing my own narrative.

I am OK with Meditech. What I like most about it is that new results (for lab, radiology, etc) appear on my status board when they are available. It also tells me when a specimen is still uncollected. It's by no means perfect, but it meets most of my needs. I also appreciate the space to write my own notes and I dont have to use the mouse alot.

I have never paper charted, and even though it sounds like "duh" --I didn't understand the paper forms in some places the one day when our system was out! By the time I was figuring it out, the system came back on!

A program that would allow for narrative charting (a blank page) as in the old days; how one can see the progression of nursing care from day to day. I miss this. Nothing worse than having to push that tab or raise that window many times to get the full RN clinical picture.

This might sound minor, but I would love a computerized system that does not require me to change my password every 45 days(no reusing passwords).

When I have 7 other changing passwords with other computerized systems at work, too much time gets spent calling tech support to get my password reset.

A lot of my coworkers end up writing down all their passwords on the back of their name badges which defeats the purpose of even having a secret password.

We use CPSI and I actually love it.

my favorite computer charting would be to get rid of the computer except for order enteries and go back to paper!!!

I love computer charting. I love scanning meds - it is almost impossible to make an error. Mostly, I love having physician orders computerized and typed in by the ordering physician! It is wonderful. No more wasting time through a chart or a stupid Kardex. No more missing medications or orders. I despise paper charting. I like everything to be on one system and absolutely zero paper charting involved! And no double charting of anything.

Anyway, I have used several different systems and my preferred is Epic, though there just a few things I would like to tweak with it. Too much double charting going on in a few places, hopefully though they will get it worked out.

Wish all hospitals nationwide used the same charting. That way we could PERFECT IT! There's too much to explain on this message board about what system I like.

Pain charting: If on a pain drip, like fentanyl drip, we chart q1hr. If you gave a pain med, you chart the response in 30 min for IV and I believe it's 1 hr after PO.

If sedated, you chart q2hr.

Your regular pt who isn't in pain and hasn't received pain meds, you chart q4hr.

Also heard of them getting upset when you charted it too much! So freakin annoying.