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 adaily basis. After writing my initial post, I realized I forgot tomention Vocera (fancy walkie talkie / portable panic button), pneumatictube system, and our patient registration system… I’m sure there’smore, too!
- Cerner / CIS – Electronic health record
- Nursing is one of the primary populations to utilize this resource
- Ihave a tough time providing recommendations on making CIS more nursingfriendly. I know there are a million version of CIS based on what thehospital subscribe to and the location. For example, as a clinicalinstructor on a Med Surg floor, CIS looks much different than it doeswhen I work in the ER. I think it is good enough in each area I work inand gets the job done without any huge problems, in my opinion.
- Applicationsincluding Lexicomp, UpToDate, Scribble- most up to date information onmedications, diagnoses and treatment guidelines, and facility policies
- Theinformation within lexicomp, up to date, and scribble directly affectshow nurses care for the patients in the ER. We use these tools as apoint of reference to guide our own care when working autonomously, andto cross reference when reviewing orders and the plan of care.
- Ifind lexicomp and uptodate very user friendly. Scribble, our policyplatform, is really difficult to use. You would think that you couldtype in DKA and the Care for Children in Diabetic Ketoacidosispolicy would flag, but the search is not that sensitive. I have printed afew of the policies that I use frequently just because they aredifficult to find. The issue with this is that 1. Not everyone willprint the policies so the problem is not solved for the majority and 2.If the policy is updated, I wont have the most current information.
- TigerConnect- secure texting app for healthcare workers
- Nursingutilized this application to communicate with many other disciplines,including doctors, nurses, PA / NP, pharmacy, crisis clinicians, socialwork, the chaplin, and more.
- Iactually really like this application. It auto deletes messages after30 days so I feel secure with that. It is very easy to search forpeople, and the app will share their name and role so you know its theright person. You can send an urgent message that will trigger an alarmsound to get the recipients attention. The app is available on computeror mobile phone. Overall it is user friendly and I like using it.
- SunQuest lab printers- application for printing labels for lab specimens
- Manyplaces in the hospital, phlebotomy does all of the blood draws. In theER, nursing does blood draws. We also use this label printer for thingslike temporary labels for rapid POC covid swabs and for POC urinetesting.
- The applicationitself isnt too bad, but the printers often need to be reset orreconnected to the computer, which can be frustrating.
- Phillips monitors and Zoll monitors- monitor and defibrillators
- Nursingutilizes monitors for both intermittent vitals as well as continuousmonitoring. They are portable so we can monitor a patient during atransport. Nursing is managing the monitor probably about 80% of thetime.
- I prefer Phillipsmonitors to Zoll monitors just because it is what Im most used to. Ihave also used a LifePak when I worked as an EMT and really liked thoseas well. I like that LifePak and Zoll have more options for documentingand timestamping interventions, where the Phillips dont provide that inmy experience.
- Strattus Interpreter Services- application to access medical interpreters in numerous languages
- Nursing utilizes interpreter services all day every day to communicate with patients and families.
- Theapp is very slow and often disconnects. In the emergency department, wecannot afford to lose the connection. The app is run from an iPad, butmost of the time the iPad is not plugged back in and the device has alow battery.
- MicrosoftTeams / Outlook / Zoom for meetings- team is used for communicationamong groups, outlook is used for email and for calendars, and zoom isused for meetings, such as committee meetings, staff meetings, andinterviews
- Teams,Outlook, and Zoom are used by nursing to communicate. I dontnecessarily think these services were created with the nurse in mind,but they do work well in a corporate setting, like a hospital.
- Ithink these are generally user friendly and fine. I think the calendarcould be better for nursing staff but overall I have no issues.
- Dynamap- automatic vitals cart with display screen
- Dynamaps are used very frequently by nursing or nursing support staff and were definitely designed with nurses in mind.
- Similarto the Strattus, these machines are rarely ever plugged in, which meansthe battery is always low. This can be frustrating and really slow downthe pace of work. They do not have that much storage on them, so wehave 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 equipment
- Much like the Dynamap, POC testing machines are designed to be used by nurses and are functional for our needs.
- Theglucometers and iSTAT are easy to use. Clinitek for POC urine testingis a great tool but sometimes causes documentation issues due to thescanning process. To use the machine, the user must scan their badge.Next you must scan the patients barcode two times. Then you must scanthe urine test strip barcode. Often times users will accidentally scanthe wrong barcode and this results in charting errors.
- Alaris and Baxter- IV pumps
- Thesepumps were designed for use by nursing and definitely created withnurses in mind. Nursing using IV pumps daily, sometimes multiple at atime to deliver safe and appropriate medication dosing.
- Sometimesour pumps have issues like low battery, needing to be calibrated, orjust wont turn on. They are frequently checked by the equipmentmanagement folks, which is helpful. It is frustrating when there is anissue or malfunction with a pump, especially in the event of anemergency where the medication delivery cannot be delayed.
- Pyxis(medication and supply)- locked cabinet storing medications andsupplies that help to track and charge inventory to patients
- Pyxis was designed for use by nurses in order to dispense medication and supplies while also maintaining appropriate inventory.
- Thepyxis in the ER is automatically set to override. This is because Icannot always wait until someone is registered and that informationcrosses over from the computer into the pyxis and then ask a providerfor an order, wait for that to be entered and also cross over into thepyxis. If a patient shows up in triage in anaphylaxis, we dont havetime to go through all of those steps before pulling epinephrine. I needto be able to pull the medication immediately. Other places, like themed surg floor where I teach clinical, does not operate on override, andsometimes it does take a while for medications to appear in thepatients medication list on the pyxis.
