i need to respond to this post from a peer. It has to be 800 Words at least.
Once again, I didn’t realize how much IT equipment we are using on a
daily basis. After writing my initial post, I realized I forgot to
mention Vocera (fancy walkie talkie / portable panic button), pneumatic
tube system, and our patient registration system… I’m sure there’s
more, too!
Cerner / CIS – Electronic health recordNursing is one of the primary populations to utilize this resource
I
have a tough time providing recommendations on making CIS more nursing
friendly. I know there are a million version of CIS based on what the
hospital subscribe to and the location. For example, as a clinical
instructor on a Med Surg floor, CIS looks much different than it does
when I work in the ER. I think it is good enough in each area I work in
and gets the job done without any huge problems, in my opinion.
Applications
including Lexicomp, UpToDate, Scribble- most up to date information on
medications, diagnoses and treatment guidelines, and facility policiesThe
information within lexicomp, up to date, and scribble directly affects
how nurses care for the patients in the ER. We use these tools as a
point of reference to guide our own care when working autonomously, and
to cross reference when reviewing orders and the plan of care.
I
find lexicomp and uptodate very user friendly. Scribble, our policy
platform, is really difficult to use. You would think that you could
type in “DKA” and the “Care for Children in Diabetic Ketoacidosis”
policy would flag, but the search is not that sensitive. I have printed a
few of the policies that I use frequently just because they are
difficult to find. The issue with this is that 1. Not everyone will
print the policies so the problem is not solved for the majority and 2.
If the policy is updated, I won’t have the most current information.
TigerConnect- secure texting app for healthcare workersNursing
utilized this application to communicate with many other disciplines,
including doctors, nurses, PA / NP, pharmacy, crisis clinicians, social
work, the chaplin, and more.
I
actually really like this application. It auto deletes messages after
30 days so I feel secure with that. It is very easy to search for
people, and the app will share their name and role so you know it’s the
right person. You can send an urgent message that will trigger an alarm
sound to get the recipients attention. The app is available on computer
or mobile phone. Overall it is user friendly and I like using it.
SunQuest lab printers- application for printing labels for lab specimens Many
places in the hospital, phlebotomy does all of the blood draws. In the
ER, nursing does blood draws. We also use this label printer for things
like temporary labels for rapid POC covid swabs and for POC urine
testing.
The application
itself isn’t too bad, but the printers often need to be reset or
reconnected to the computer, which can be frustrating.
Phillips monitors and Zoll monitors- monitor and defibrillatorsNursing
utilizes monitors for both intermittent vitals as well as continuous
monitoring. They are portable so we can monitor a patient during a
transport. Nursing is managing the monitor probably about 80% of the
time.
I prefer Phillips
monitors to Zoll monitors just because it is what I’m most used to. I
have also used a LifePak when I worked as an EMT and really liked those
as well. I like that LifePak and Zoll have more options for documenting
and timestamping interventions, where the Phillips don’t provide that in
my experience.
Strattus Interpreter Services- application to access medical interpreters in numerous languagesNursing utilizes interpreter services all day every day to communicate with patients and families.
The
app is very slow and often disconnects. In the emergency department, we
cannot afford to lose the connection. The app is run from an iPad, but
most of the time the iPad is not plugged back in and the device has a
low battery.
Microsoft
Teams / Outlook / Zoom for meetings- team is used for communication
among groups, outlook is used for email and for calendars, and zoom is
used for meetings, such as committee meetings, staff meetings, and
interviewsTeams,
Outlook, and Zoom are used by nursing to communicate. I don’t
necessarily think these services were created with the nurse in mind,
but they do work well in a corporate setting, like a hospital.
I
think these are generally user friendly and fine. I think the calendar
could be better for nursing staff but overall I have no issues.
Dynamap- automatic vitals cart with display screenDynamaps are used very frequently by nursing or nursing support staff and were definitely designed with nurses in mind.
Similar
to the Strattus, these machines are rarely ever plugged in, which means
the battery is always low. This can be frustrating and really slow down
the pace of work. They do not have that much storage on them, so we
have to restock the disposable items like BP cuff and SpO2 probes often.
The buttons work well and are pretty self explanatory.
Glucometer, Clinitek, and i-STAT machine- point of care lab testing equipmentMuch like the Dynamap, POC testing machines are designed to be used by nurses and are functional for our needs.
The
glucometers and iSTAT are easy to use. Clinitek for POC urine testing
is a great tool but sometimes causes documentation issues due to the
scanning process. To use the machine, the user must scan their badge.
Next you must scan the patient’s barcode two times. Then you must scan
the urine test strip barcode. Often times users will accidentally scan
the wrong barcode and this results in charting errors.
Alaris and Baxter- IV pumpsThese
pumps were designed for use by nursing and definitely created with
nurses in mind. Nursing using IV pumps daily, sometimes multiple at a
time to deliver safe and appropriate medication dosing.
Sometimes
our pumps have issues like low battery, needing to be calibrated, or
just won’t turn on. They are frequently checked by the equipment
management folks, which is helpful. It is frustrating when there is an
issue or malfunction with a pump, especially in the event of an
emergency where the medication delivery cannot be delayed.
Pyxis
(medication and supply)- locked cabinet storing medications and
supplies that help to track and charge inventory to patientsPyxis was designed for use by nurses in order to dispense medication and supplies while also maintaining appropriate inventory.
The
pyxis in the ER is automatically set to override. This is because I
cannot always wait until someone is registered and that information
crosses over from the computer into the pyxis and then ask a provider
for an order, wait for that to be entered and also cross over into the
pyxis. If a patient shows up in triage in anaphylaxis, we don’t have
time to go through all of those steps before pulling epinephrine. I need
to be able to pull the medication immediately. Other places, like the
med surg floor where I teach clinical, does not operate on override, and
sometimes it does take a while for medications to appear in the
patient’s medication list on the pyxis.