Nursing and The Art of Arboricide

My company recently transitioned to computer charting. I was so excited to cut down on the time spent on paper....HA!!! Now, when a patient falls, I have to document the details of the fall in three different places in the e-chart, revise the care plan, and document that I notified the MD and family. Then, I have to fill out an incident report on paper!!!! It generally takes me an hour to fill everything out. Can't help but wonder if I spent that hour in direct pt care if maybe I could prevent some of these falls...

It was on the tip of my tongue to mention that it was hard to come up with interventions to prevent resident falls when I couldn't get away from the computer long enough to actually go and assess the resident, but I kept that thought to myself.

Remember when the fax machine was going to cut down on time and paper?

I wish everything could be done electronically. We're supposed to be the flagship facility for our company's EMR rollout, but they keep delaying......in the meantime, the arthritis in my left hand (the dominant one, of course) is so bad I can barely grip a pen on cold days, yet most of the forms are fillable only by hand. I cheat a little by typing my prog notes on my own form, then I print them out and file them in the chart in chronological order with the written notes; so far, Corporate hasn't objected to it, and I suspect they won't because I always sign them by hand. I've done that for years; and I'm happy to report that no surveyor has ever questioned the authenticity or the thoroughness of my notes.

This reminds me of a cross-stitched picture of a little girl on a potty with the roll of tissue on the wall next to her. The caption read, "No job is finished till the paperwork is done."I take my hat off to you, Marla. I'm an odd duck who actually doesn't mind paperwork, but even I would find what you're dealing with daunting. Just the sheer repetition would push me over the edge. And heaven forbid you used a different word or phrase in document #7506 than you did in document #3609. Someone here at AN has this tagline, and it's true--some days it doesn't pay to chew through the restraints.

This post made my day! Are all healthcare facilities not supposed to be switching to computerized charting here in the next couple years b/c of a federal law/healthcare reform? Anyone know anything more about this?

With all the paperwork we have to do--and with how management likes to give us even more--I'd often say to my staff that we were sending yet another tree to its doom

have you considered adding tai chi classes at your facility, especially for those involved in falls?tai chi may reduce falls in the elderlyprinciples of tai chi ... - tai chi falls prevention - arieh lev breslow

Electronic medical records is just one part of the solution to Arborcide. Need a fax server and document management program to be able to send+ store documents electronically. Home care agencies are even BIGGER generater of paper than hospitals. We initiated an EMR in 2002. Processing over 2,000+ patient referrals a month, I was going through over 10 CASES paper/month just in my department --everything came in via fax, printed out and upon review and assigning Medical record number was faxed back out to branch offices with paper copy for bililng dept: 4 fax machines and 2 highspeed Xerox printers to keep up with demand. My Xerox contract was up in 2009, so invited to their open house. Took along a referral form to test machines + learn latest in document imaging. Came back with idea for faxserver and Nuance Paperport Professional desktop software. Within one year contract signed, product installed, education provided then design for implimentiation in our work setting and rollout Nov 2010. My office supply costs have gone down by 2/3, using 1 case paper every 2-3 months, efficiency increased 30% and suprise: reduced noise level by 50%. Constantly learning every week how to tweek another process sending documents via email or storing on our shared drive for other departments viewing and processing use.George and Johnny Appleseed very happy with me today.

Beautiful!!!!

Quote from nrskarenrnhave you considered adding tai chi classes at your facility, especially for those involved in falls?tai chi may reduce falls in the elderlyprinciples of tai chi ... - tai chi falls prevention - arieh lev breslow

It doesn't even need to be tai chi, though that's awesome for balance - my (seventy year old!) mother participated as an instructor in a clinical trial at Monash University running weekly strength and flexibility classes with eighty-plus year old aged care residents. Not only did they have fewer falls, and less damage when they did fall, they also had improved cognition, communication and mood.I have to say, my mum's pretty great for an old broad - she teaches yoga and flexibility classes three times a week, can touch her malleoli on a straight leg side stretch, and works full time as a massage therapist/naturopath. I just hope some of these traits are hereditary!PS When I clicked on this thread I thought it was going to be about nursing and black thumbs, with which I could relate, as I can't keep cacti alive. This, though, even more relatable!