Use of an App for Improved Documentation During a Code

A code or rapid response announced over the hospital PA system typically leads to a flurry of activity and a swarm of people responding to the patient’s needs. Many steps of the ACLS algorithm happen rapidly and concurrently, and can be difficult to track with accurate timestamps by the person assigned the role of scribe.

Clear and accurate documentation is critical for post-event analysis to demonstrate the team did everything according to standards and determine if things could have gone better. Many facilities use a code sheet kept on or near the crash cart and others use real-time charting in the EHR. Often the details are written on scrap paper and added to a document later. All of these methods are cumbersome and can lead to inaccurate data collection.

Using an app for documentation during code events.

This month’s Cultivating Quality article, “Improving Accuracy in Documenting Cardiopulmonary Arrest Events,” describes the use at one hospital (Beth Israel Deaconess Medical Center in Boston) of a handheld electronic device for code documentation that makes it simpler and more organized to capture this information.

The project took place on four medical–surgical pilot units, where nurses were trained in the use of a documentation app for live cardiopulmonary arrest events. The American Heart […]

2022-06-15T14:10:43-04:00April 21st, 2022|Nursing|0 Comments

Missed Empathy, Missed Care: Is It Time to ‘Reconceptualize Efficiency’?

A physician’s lament is nursing’s, too.

By Maureen Shawn Kennedy, AJN editor-in-chief

By Alan Cleaver/via Flickr By Alan Cleaver/via Flickr

Last week, the New York Times Well blog published “The Importance of Sitting With Patients” by Dhruv Khullar, a Harvard medical resident. Khullar expressed regret over not spending more time with a patient who was near death, and then discussed how little time residents actually spend with patients—eight minutes, according to a Journal of General Internal Medicine study (2013) that analyzed the time of 29 interns over a month. (The study found that only 12% of the residents’ time was spent on direct patient care; 40% of their time was spent on computers.)

Khullar detailed the various activities that take him away from direct patient contact and noted as well that the shorter working hours mandated for residents had the unintended consequence of reducing time with patients. He wondered:

By squeezing the same clinical and administrative work into fewer hours, do we inadvertently encourage completion of activities essential in the operational sense at the expense of activities essential in the human sense?

The second part of the question seemed especially pertinent for nurses. Hospital nurses have long lamented that paperwork, insufficient staffing, and nonnursing tasks keep them from the bedside. The promise of computers […]

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