The amount of administration nurses have to do is baffling. It’s not that I think the administration is not necessary. That’s a double negative. I mean, the registration of so much of the patient-related info is important! But when a nurse retypes info from one system to another, it should raise some eyebrows. Or at least one per person. And for the IT-designers, these are your opportunities!
Should we take a step back and track all the necessary administrative tasks and structure it and then design (new) administrative systems? Or are we ‘stuck’ with different systems and programs which don’t communicate? Is IT in a hospital just like medicine? One system can’t solve it all, like an Oxycodone-patient needs a laxative? So for every side effect or lack of effectiveness we add something new?
Nightshift starts.
The most important program of the shift is the Electronical Medical Record (EMR). A printout of the patient info is used for the transfer of the shifts and patients. On an A4-sheet, portrait, a segment of 20cm wide and 3,5cm high of it is used for one patient. Just name, age, some admission notes, warnings and some other info. And white space. The nurse of the previous shift gives relevant information on her patients. The extra information is written by hand in the white space on the paper. Short words, reminders.
The nurse does her round. Visiting her patients, which who she makes a short conversation when awake and clear…or not. A help to a toilet. A request for a painkiller. A tuck into bed. A kind word.
Then a stop at the computer. Reading through all the health records of her patients in the EMR. Pages filled with info, history, warnings, medication, activities. A partial summery is already written on the sheet of paper.
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Another program. On a big monitor pages are filled with the names of new patients, corresponding rooms and appointed nurses for the next shifts.
In the EMR the next tasks for the day shift are placed, the files are updated.
A letter for transferring a patient to another hospital or nursing home is made in a third program. Parts are merged from the EMR and the rest is retyped using the many pages and info in the EMR. This letter is started even before the date of transfer is known, because of the amount of time needed to complete its. And when there is time during a shift…
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The fourth program is started. Another system for information on food and help requests. The paper is printed and put in a mailbox (you know, a tangible one).
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Medication is prepared in the medication room. The EMR is consulted. The medication drawers of the COWs are filled. The boxes are ticked. Medication is missing. The integrated ordering system fails. A paper note is made as a reminder to order the medicine, by phone or email.
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The EMR is updated.
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Nighshift is over.
Posted on November 17, 2016 on ‘Design for Nurses’-blog