Working with Barcode Medication Administration and electronic charting

[courage2care]

I work at a high acuity unit in NYC. We recently shifted to electronic charting. As much as it was an inevitable move as apparently it has numerous benefits over paper charting, I find that bringing the clunky WOWs (workstation on wheels) at the bedside can be tedious when space is limited and most of all I feel personally that I lose the connection with my patient as I stare at my computer screen most occasions instead of looking at them as we are conversing. In an increasingly electronic world, I feel like nursing is unfortunately less about building rapport it's more about documenting what was done at the bedside. Does anyone feel this way? How do you organize your time so you are able to maintain good "old fashioned" connection with your patients and their families while at the same time satisfying the increasingly convoluted electronic charting?

[Double-Helix, BSN, RN]

As you get more accustomed to the electronic charting, you'll be able to spend less time looking at the screen and more time looking at your patient. In reality, there are very few tasks that require documenting at the same time that you are performing the assessment/asking the question/completing the skill. Medication administration with barcode scanning, as is in your title, is one of those tasks. In those cases, it's perfectly fine to explain to the patient why you have the computer with you, and let them know that you will be looking at the screen to double check each medication as you give it to them. Similarly, if I'm doing an admission assessment and documenting it in real time, I explain to the patient that it is important that I accurately record the information, and I'm more likely to be thorough if I have the questions open as I speak to them. I apologize in advance that I may have my head turned or my back to them, if the computer is positioned awkwardly. I also make a conscious effort to look at the patient while I speak and while they answer.

[Sour Lemon]

I often leave my COW right outside the patient's door and just hop in to scan their wrist band. Not only is it easier space-wise, but I get to scan and review their medications without the distraction of them talking to me. I rarely chart in a patient's room. The exceptions involve patients who are high fall risks and need extra supervision. In those cases, I may sit in that room and chart on every patient.

[mmc51264, BSN, MSN, RN]

I am getting ready to do a paper on "socialization of the new nurse with bedside charting" I love charting in the room (we have computers in the room, the ones on wheels are for the aides). I spend more time talking to the patients as I chart and I position myself so that I can look at them. It is a change, but I have embraced it. This way if I think of something I have forgotten to ask or tell them, I am in the room, looking at the chart and it is an easy add or fix.

The barcodes/scanners have caught a few errors when I have many pts that are on similar meds and are from similar demographics. It works, it really does! :)

[quazar]

You just get used to it, and incorporate it into your rapport, kinda. Our computers are at the bedside, so charting is done in the room, in front of the patient (mostly). As for medication administration, that seemed like a huge PITA at first (and it still kind of is), but it's really not a big deal once you get used to it. It's like any new technology, I'd say: you'll be slow when you're learning but soon you will be able to incorporate it pretty seamlessly into patient care.

[courage2care]

thank you for the great insight,guys. Double Helix, I will try utilize your language so I can build trust with my patients as far electronic charting. I find that in older patient population groups, this is an issue as like me, they have to get accustomed to the "new" way of doing things. Some of these old folks always have the snarkiest comments like, "here comes the ice cream truck" (meaning the WoWs) and scanning makes them feel like a cereal box. Of course, you are all right, there is always resistance to any new technology. I'm looking forward to getting electronic charting incorporated in my practice. Thanks for all the tips. If you think of any additional tips on how you organize your time between direct patient care, BCMA and computerized charting please PM me. We use SCM/Allscript at work. Part of the difficulty might also be related to the system we use so if any one of you uses it currently, I appreciate your insight on how I can take care of my patients while optimizing documentation