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Electronic documentation in the NICU


NCDeb

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Hello, We have recently started using Centricity Perinatal, an electronic form of documentation in our NICU. Have any of you had any experience with this type of charting? Are there issues that we need to be auditing. Some of our staff have had a difficult time moving from paper charting to this. We offered very intensive training before begining the system, but I feel that time actually charting in the system is the only way to really become comfortable. Thanks in advance for any suggestions or words of wisdom.

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Thank you for your response. Our system will also access information from the monitors and ventilators. I think it will just involve a long learning curve, especially for some of our older staff members who are not as accustomed to advanced technology. We have a few of our older nurses and CNAs who don't even own a computer.

I also think it will be a big time saver once they become adjusted to the change.

Thank you again

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We have an excellent electronic system in the NICU connected to all the equipment (monitors ventilators ..) and to the lab + imaging

It works very nice save lot of time.

Have you ever experienced a "crash"?

We have computerized medical records and we recently had a major database failure for about 18h, which dramatically influenced patient care. The hospital admin told everyone to move over to "manual routines", but that was not easy since noone is used to real paper work any longer. I reckon that technical problems with a system when everything is connected may a great impact.

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We also use Centricity and I think there are a lot of mixed feelings about it. Our biggest issue is that the nurses feel like they have to enter the same info multiple times because it doesn't carry over from mom to baby or from one flowsheet to another. I find that it makes it easier for me to do my pre-rounding and calculations in the morning assuming everything has been filled in correctly. We are supposed to be getting GE monitors (some day...) that will tie in to the charting system which may make everything easier. Our nurses do audits every month, making sure that safety checks have been done, lab values entered, etc. For the new nurses the change over was fairly painless, but for the older ones it's been a struggle (if it isn't broken, don't fix it mentality). Our biggest issue is that there are only 3 stationary computers in our unit to chart on so everyone is always fighting for time. It would be much easier if we had some sort of laptop or rolling computer system so things could be charted while the baby is getting hands on, that way things may not get missed.

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  • 2 weeks later...

Not having enough computers in the unit would make things more difficult. Luckily we knew that we were going to begin using electronic documentation when we began planning a new unit. Each pod / room in the new unit is equipted with it's own computer. We also have approx. 10 COWs (computers on wheels) that Resp, NNPs, fellows etc. can take to the bedside.

We also have the same problem with the "if it isn't broke" mentality. Fortunately, they seem to be getting used to everything.

The GE monitors are a plus with the system. Nurses really like being able to set Aquires from the monitor and not have to disturb a minimal stim baby for VS. I just worry that some may become somewhat lazy in assessing the child and not really look at the baby like they should.

We had the oppurtunity to redesign some parts of the system so that the "flow" from different sections seems to work better. We were also able to make some things flow to other areas. (such as charting the newborn screen in the flowsheet and it will also show up on the discharge check list)

Thanks for the input and the suggestion for an audit. We need to work on putting together an audit tool now that the system has been up and running for a few months now.

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Stefan, we have also worried about a major crash with the system. We have "down time" forms that duplicate the computer screen in different areas such as the admission, flowsheet, resp. etc. We have a policy that if the system is down for 3 hrs. or less then the info will be back charted into Centricity. If the outage is greater than 3 hrs. we leave everything on paper. Luckily we haven't had to test this out. The monitors, vents etc. all continue to work independently, we just wouldn't be able to "aquire" the data into the electronic record.

Debbie

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