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For example, she said, nurses are notorious for not completing individualized nursing care plans for each patient, a time-consuming process. But the $2.2 million Medi-Tech system provides templates for all conditions, problems, and associated outcomes.
“You don’t have to start writing from scratch,” de la Cruz-Reyes said.
Instant results
Not only does the system compensate for messy, hurried, varied, or incomplete handwritten notes, it offers instant results. In keeping with the fast pace of the information age, X-rays are available on screen as soon as they are done, with no smudged fingerprints obscuring the results. A nurse can look at a patient’s lab work the minute the results are in.
And everyone with security access — from physician to nurse to administrator — can look at the chart at the same time, de la Cruz-Reyes said.
Bonnie Brock, RN, BSN, is the informatics nurse at Fresno Heart Hospital who helps nurses make the transition to computerized charting.
“The ease of information retrieval is really key on this,” she said. “I can see the picture of what took place with the patient so much faster than looking through a paper chart.”
When Fresno Heart Hospital opened its doors Oct. 15, Brock had been training her nurses for six weeks. She gave them four four-hour sessions, plus four hours on the system outside the classroom using fake patients. Now that she has nurses on the floor who know how to use the system, she has reduced the number of four-hour sessions for new nurses to three.
“It’s very scary that first day,” Brock said, remembering some comments she heard from new users. “The first day you take patients and use the system you will probably say, ‘I can’t do this.’”
Yet not even one year later, Brock has discovered some of the nurses she worried would have the hardest time with new technology have been the best users.
Getting up and running on the computerized ICUs is perhaps the smallest drawback to the system. System upgrades or changes can cause serious or hard-to-find errors, said Bickford of the ANA.
“Software coding is a complex process, and if you’re not paying attention, things go wacko,” she said.
Errors have happened in the past, she said, and no governing body tracks these errors.
While computer errors are the nightmare of programmers, other more seemingly mundane problems must be discussed as the country’s health care facilities move toward computerization, Bickford said.
If software becomes obsolete or a software maker goes out of business, how is the stored data retrieved for use? Then there is cost — wires, monitors, disposal, updated software, electricity. How do facilities absorb the cost? Finally, a move to standardize terminology and practice is just getting under way, Bickford said.
And, of course, sometimes systems go down. Roberts of Cedars-Sinai said the hospital has a paper backup system in case of technical trouble.
Weena Gorospe, RN, BSN, an overnight nurse on the Cedars-Sinai surgical ICU, loves the system for making her job easier, but agrees that things become much more difficult when the system goes down.
“You’re helpless,” Gorospe said. “All your data is in the computer, so there’s no way you can access it. You have to go back and forth, grab vital signs from the bedside, and copy all medications onto the trifold.”
Yet such breakdowns are rare, and Gorospe said she loves the system.
“It makes it easier for us, and it’s really more accurate,” she said. “To me, it gives more time for direct patient care.”
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