The birth center I work in uses multiple computer programs to do different things. In L&D and postpartum we use QS to record the contraction 'strips' so we can view them from any desk. We document mostly by clicking options with a mouse, but there are different entry types: numeric (vital signs), narrative (free text), analog (fetal monitoring strips), and images (ultrasounds). It creates graphs of certain information like vitals, I&O's, and glucose monitoring. There are different places for documenting shift assessments, careplans, teaching, IV's, magnesium administration, admission, and delivery information. There are also 'screening tools' that you simply click on things and it generates a risk score. Examples of these are APGAR scores, latch scores, Bishop scores, fall risk, mental health, and domestic violence risk.
We use the Omnicell to pull out our medications; the rest of the hospital uses handheld scanners but we don't have them yet. Ceridian is used to input our schedule preferences. Logicare generates discharge paperwork for the parents with postpartum and newborn care along with appointments. Meditech is used for entering orders and looking up labs. We also have a prompt in our QS that reminds us to make sure that PKU's or birth certificates (for example) are completed before discharge.
Unfortunately, although these programs are meant to make our jobs easier, we all have problems with this technology. We each have to remember 17 different passwords or codes. And forget about paperless charting! We have more paperwork than ever now! In many ways technology does help, but it can also be a hindrance.
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13 years ago
You would expect that with IT, paper charting will disappear, this is just one of the challenges that needs to be addressed. Plus with IT comes security and privacy issues hence a million passwords. Great comments!
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