Archive for the ‘Patient Bedside Care’ Category

Nursing And The Electronic Invasion

November 15, 2010

I started my medical career as a Care Attendant, then a Licensed Practical Nurse, and finally a Registered Nurse. Over this time I have worked in two different states and seen many changes in the continuing evolution of the nursing profession.

The most recent changes have been primarily within the way we record our care. Over the past few years electronic charting has overtaken more and more aspects of our daily routines, not only do we record each patients vital signs within the electronic record, we record whatever they eat and drink, each use of the ladies and gentleman’s room, and most stressful for nurses, the exact times we medicate. We are given an hour, half our prior and half hour after the scheduled time of a medication to administer it. That doesn’t sound hard to do, but when staffing is short a nurse or a nurse assistant, more is expected to be done by each nurse on the floor. It is not always possible to adhere to this tight timeline, and all the time in the back of your mind you know that each day a printout is generated and sent to each nurse manager showing who was late with their medications, and each floor is sent a monthly record that is hung in the medication room showing each floor within the hospital and the percentage of times medications are administered on time, and when they are late.

We find that our computers on wheels are never more than a fingertip away, and the information that we put within the electronic record is growing with each passing day. It is an electronic strangle hold that has the floor nurse’s attention rather than the patient having the attention.

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Use of PDAs to assess time spent in patient bedside care

May 6, 2009

In the medical center where I currently work, I and a few other staff have undertook a PDA study of time spent at our patient bedside. Our medical center has listened to the complaints of many nurses who feel we have too little time to assess and care for our patients at the bedside. Many have found they spend more time documenting their care, than actually performing it. We have thus undergone a PDA study to assess our time spent. The PDA is used by one person/ day 2 days/wk over the course of 3 months. The PDA is equipped with a program that will randomly alert the nurse approximately 8 times/ shift. At those times, the nurse will choose from various options of what they are doing, either in the patient room, out of the room, discussing care, documenting, searching for equipment, preparing meds, etc. At the end of every month, we then download the information gathered into a pie chart to evaluate how much time we spend assessing our patients (our goal is 70% of the time). If we aren’t reaching that goal, what may be eating up the time we could be spending there? At the end of the study we will then gather the information and plan to change either where we keep equipment that may be hard to find, where we place our computers to document, etc in hopes of minimizing the factors that keep us from having sufficient time to see, assess and evaluate our patients. I feel this is an important example of the ways technology can be used to increase patient care, time spent in assessment and bedside interaction.

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