I'm curious about the current experiences nurses are having with the charting programs in use today. Obviously there are going to be problems with each and every charting method (nothing's ever perfect, right?), but I'd like to know what you all are running into with the various computer charting options.
So what versions do you love or hate? Why? What would your perfect computer charting program include and exclude?
Okay, so the leading contenders so far are Meditech (handily winning the Nightmare Relic From 1985 award) and EPIC (useful but repetitive). Other positive contenders are Health Management Systems and ICIP (and an option that's still in development).
I'm trying to get a good handle on what drives patient care providers crazy about the charting programs they have to use. Have you all found that computer charting is helping you or just making things more complicated? To me (from my oh-so-wise HIM student perspective ), it seems as though there are many advantages to charting that way, but there's a lot of resistance and frustration surrounding it, so I'm curious about your experiences.
Specifically about EPIC's repetitiveness: Are we talking fail-safe type repetition that's irritating but serves a purpose or pointless, nonsensical repetition that does nothing but bog down users?
I apologize for being such a detail freak. My thanks to all of you for your responses so far!
I'm trying to get a good handle on what drives patient care providers crazy about the charting programs they have to use.
In my specific situation we are using Cerner Powerchart with iView. It is simply just not user friendly in any shape, form, or fashion. It's a clunky interface with 100 different buttons all on the screen at one time. There are about 2-3 frames that stay constantly. It's extremely tiring for the eyes and the mind. Documentation of q15m vitals and gtt titration is an absolute nightmare. If you're actively titrating something vasoactive....that patient may as well be a 1:1 assignment. With the extreme amount of charting that we do in my hospital system in the ICU (q1h-->Vitals, I/O, Safety, Problem oriented assessments, restraints, pain, Q2h-->Comprehensive physical assessment) we spend a significant amount of time charting than we did when using our fantastic flowsheets.
For charting serial vitals....You end up having to do double the work because you have to write down the q5/10/15min vitals and then chart 3-4 of them at a time. So...we write them and then chart them...It's double work.
I am not against computer charting by a long shot, I love it! I think the downfall is that often the user interface is built by licensed clinicians who've not documented a patient care encounter in decades.
As for the double charting, do you use the hand held devices at your facility? We chart at the bedside using the handheld scanner. I can't chart an assessment, but I can chart vitals, i/o's, meds, PCA and pain assessments, weights, etc at the bedside with it.
My complaint is that the hand held device is too big. I would like it to be more like a cell phone. I would also like the keyboard to be like a cell phone's qwerty keyboard; I can text pretty fast, and I would be able to document very fast on a cell phone-like device.
In my specific situation we are using Cerner Powerchart with iView. It is simply just not user friendly in any shape, form, or fashion. It's a clunky interface with 100 different buttons all on the screen at one time. There are about 2-3 frames that stay constantly. It's extremely tiring for the eyes and the mind. Documentation of q15m vitals and gtt titration is an absolute nightmare. If you're actively titrating something vasoactive....that patient may as well be a 1:1 assignment. With the extreme amount of charting that we do in my hospital system in the ICU (q1h-->Vitals, I/O, Safety, Problem oriented assessments, restraints, pain, Q2h-->Comprehensive physical assessment) we spend a significant amount of time charting than we did when using our fantastic flowsheets.
For charting serial vitals....You end up having to do double the work because you have to write down the q5/10/15min vitals and then chart 3-4 of them at a time. So...we write them and then chart them...It's double work.
I am not against computer charting by a long shot, I love it! I think the downfall is that often the user interface is built by licensed clinicians who've not documented a patient care encounter in decades.
Excellent. Thanks for the feedback. That program sounds miserable! One of the big points of computer charting is to make the process more efficient, not to make things more cumbersome!
Could you clarify something for me, though? Does your facility give staff members a chance to give regular feedback or make suggestions about the current system (through an IT or process improvement committee, for instance)?
My complaint is that the hand held device is too big. I would like it to be more like a cell phone. I would also like the keyboard to be like a cell phone's qwerty keyboard; I can text pretty fast, and I would be able to document very fast on a cell phone-like device.
One think I was told to beware of (as the nursing informatics person, who will be looking at all sorts of devices for our hospital) is the age of our nursing staff. I talked to hospitals that had older nurse populations... those that can't use a blackberry, iphone, etc.... they hate the small PDA's and hand held devices. Ideally, having a variety of sizes and devices would be my choice. But $$$$ is an issue
Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.
Have worked with Meditech in two different facilities for 14 years. For me at least, it is easy to use but must be set up correctly. We had a different system for ICU and another system for OB, talk about a nightmare. 3 systems in one hospital and NONE of them interfaced. So someone transferring from ICU to floor, all charting had to be printed. What really irritates me is the hospital I work at now is not using meditech to its full potential and still prints all labs, admission forms etc.. What a waste of paper.
Could you clarify something for me, though? Does your facility give staff members a chance to give regular feedback or make suggestions about the current system (through an IT or process improvement committee, for instance)?
Unfortunately no. They don't seem to care about what works and doesn't work. We are told to just deal with it.
One think I was told to beware of (as the nursing informatics person, who will be looking at all sorts of devices for our hospital) is the age of our nursing staff. I talked to hospitals that had older nurse populations... those that can't use a blackberry, iphone, etc.... they hate the small PDA's and hand held devices. Ideally, having a variety of sizes and devices would be my choice. But $$$$ is an issue
You're right. Those of us 40 and under have done much better with the hand held devices. Although, since it is a requirement to use it, all of us do it and even the older nurses get used to it.
I do wish our training was more geared toward the comfort level. I hate attending a two hour session for something that I can learn in 10 minutes, but that someone else really needs 4 hours to learn. I wish they would offer brief overviews with the option of an extended class for those who need more help.
My facility uses a combination of Meditech and Cerner powerchart.....I wish the two systems were interfaced with eachother. Powerchart is for routine documentation and meditech for meds, nursing narratives, special treatments and wound care. And in addition to these two systems - we have McKesson Accudose, Outlook, and Inteli-shelf.
my facility is still living in the stone age....paper charting! can you believe it? although we are moving to a new facility in the near future with actual computers. 21st century here we come!
my facility is still living in the stone age....paper charting! can you believe it? although we are moving to a new facility in the near future with actual computers. 21st century here we come!
i'll take a good and well designed paper flowsheet for the icu any day over the computer charting programs that i have used. unfortunately, well designed flowsheets are few and far between. one facility i work at per diem has a very detailed icu flowsheet that is quick to use and extremely user friendly.
TDCHIM
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Okay, so the leading contenders so far are Meditech (handily winning the Nightmare Relic From 1985 award) and EPIC (useful but repetitive). Other positive contenders are Health Management Systems and ICIP (and an option that's still in development).
I'm trying to get a good handle on what drives patient care providers crazy about the charting programs they have to use. Have you all found that computer charting is helping you or just making things more complicated? To me (from my oh-so-wise HIM student perspective
), it seems as though there are many advantages to charting that way, but there's a lot of resistance and frustration surrounding it, so I'm curious about your experiences.
Specifically about EPIC's repetitiveness: Are we talking fail-safe type repetition that's irritating but serves a purpose or pointless, nonsensical repetition that does nothing but bog down users?
I apologize for being such a detail freak. My thanks to all of you for your responses so far!