- Joined
- Apr 5, 2005
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Current good/neutral/undesirable thoughts about electronic charting.
and the pressure on your A-line rockets because the transducer was mounted to the side of the bed. Are you going to have to explain in court three years later when you don't remember when you rotated the bed why you didn't treat the acute hypertensive episode?
and the pressure on your A-line rockets because the transducer was mounted to the side of the bed. Are you going to have to explain in court three years later when you don't remember when you rotated the bed why you didn't treat the acute hypertensive episode?
and the pressure on your A-line rockets because the transducer was mounted to the side of the bed. Are you going to have to explain in court three years later when you don't remember when you rotated the bed why you didn't treat the acute hypertensive episode?
and the pressure on your A-line rockets because the transducer was mounted to the side of the bed. Are you going to have to explain in court three years later when you don't remember when you rotated the bed why you didn't treat the acute hypertensive episode?
All your paper charts must be train tracks.
Just remember fetal heart monitoring hasn't done jack for OBs except give lawyers documentation to sue.
All your paper charts must be train tracks.
and the pressure on your A-line rockets because the transducer was mounted to the side of the bed. Are you going to have to explain in court three years later when you don't remember when you rotated the bed why you didn't treat the acute hypertensive episode?
I've been floored at times by the amount of pre-charting and vital sign smoothing some people do.
I've taken over cases with hours to go yet and seen the extubation and PACU turnover notes written already - I'm sure everyone here has had similar experiences.
I like electronic charting if for no other reason than it keeps those people a little more honest.
A well-configured system can be a great timesaver for fast cookie-cutter cases like the 15 BMTT and T&A days. For cases that are very busy it's nice to not have to go back and spend 20 minutes transcribing vitals from the monitor history.
It's not hard to put in an artifact note when a BP of 190/182 gets recorded because the surgeon won't stop leaning on the cuff.
Well said. It saves me time when I'm solo and keeps them honest when I'm not. Though you could change the vitals manually for that period. Unlikely but possible. Of course that change is noted in the "complete" record. That's damning evidence, unlike making a 10 second note explaing an erroneous reading.
I admin our system (Innovian) and there's an option in there to permit users to edit vital signs. Edited values are bolded so they're apparent on the paper printouts, and of course there's an electronic log of all changes.
We decided to disable that feature. Seems safer to force people to write the artifact note. I wouldn't want to defend a case in which machine-recorded vital signs were edited without a text explanation.
While most of us do seem to have medicolegal-type fears (myself included) I think that scenario is pretty far-fetched and I wouldn't concern myself over it. Anyways if there is an erroneous measurement, just correct it yourself.
Again. I am very opposed to computerized charting unless I manually put everything in myself.
My buddy is currently involved in a lawsuit. The lawyers are trying to point the fingers on anesthia after neurosurgery settled the case.
Guess what they were are using as evidence? The electronic anesthesia medical records are off by 7 minutes from nursing charts and lawyers are saying anesthesia didn't react in time to vital sign changes when patient was coding on table. Its a mess since surgery settled the
Patient got revived but had stroke.