Friday, November 30, 2007

Electronic charting for nurses

Our hospital is building a new tower and is in the design process phase. They want to move to a model that decentralizes the typical nurses' stations and go with documentation "cock-pits" right outside the patient rooms. There would be windows so the staff can see into the patients' rooms while they are doing their computer charting. There has been a great deal of controversy over whether these stations should be sitting or standing. Everyone wants the option to sit down to document, but that means using high stools for the standing work stations. I have encountered other high stools in some of our current nursing units, and many of the older nurses do not like them because of hip/knee/back issues and lack of proper foot support. These stations in the new facility are meant to be the nurse's primary work area so they need to be comfortable. The other issues is the hallways are only 8 ft. wide, with the cock-pit recessed, but our public health department is not crazy about chairs/stools migrating out into the hallways. I am curious what the official stance is on using high stools in various areas and if there is any research that discusses the pros/cons of using these stools. Our Facilities Dept. is asking me for evidence to support one direction vs. another. What experience do you have with nursing documentation areas, sit vs. stand, chairs vs. high stools, etc.?


Alexandra Rella said...

My hospital has already started using nursing "touch-down stations", these include cock-pits in the hallways, as well as standing computer stations in patient rooms and bedside. The hallway stations actually have to be in cockpits in order to adhere to the 8 ft. clearance necessary according the NFPA,National Fire Protection Association. The hallways need to be clear with the exception of necessary equipment which is then to be stored on only one side of the hallway and must be on wheels so that it can be moved in an emergency. This is why we wouldn't be able to consider the use of stools.

I did however want to comment on the experience I have had regarding Nurses complaints who already use the stations. Complaints regarding foot, leg and back pain from standing have been addressed with fatigue mats and reinforcing proper shoe wear. Proper standing computer ergonomics were limited when some Nursing departments previously installed standing laptop stations instead of separate Keyboard and monitor mounts. I have also beeen in-servicing these employees on taking the time to adjust the equipment height before using it.
I do hope this information is helpful.

Tracy Marker said...

I'm interested in what other hospitals are doing for electronic charting. Mobile carts? Wall mounts? Seated nursing stations? We have challenges with each option so I'm curious how others have overcome some of the issues. Any experiences will be helpful!