Not settled. No, I would not say "settled," possibly not ever. But there is an agreed-upon Care Plan for my mom, she's got an in-room helper 24/7 (and the offspring are dropping in at random times throughout 24/7) until they can get her moved opposite the nurse's station, they're checking daily for skin damage (she's got a neck collar and a long removeable cast on her left hand and forearm and can't move much: you need to keep watch) and they are well aware that we're watching them. Physical Therapy knows exactly what her range of motion/weight bearing limits are and to be gentle and always have at least two people helping her when she's moving. (This has been a problem; the PT people, well-intentioned as they are, really try to get patients moving and stretching; which is great if you don't have a cracked hip, broken fingers, broken vertebra, etc.) And we belive we have all of her medical orders posted on both forms the place uses.
Yeah, "both," and 'splain me that? Or at least why it's a separate entry process? One's her actual chart, listing all medical orders, medications,observations, etc. including history, to which access is restricted to upper-level nursing types and on up; the other is a summary of active orders and meds, available to all staff via touchscreens in the halls and some pad-type wireless devices. There are good reasons for limiting access to the first one, but the second one is -- or should be! -- just the currently-applicable parts of the first, possibly plus notes. They're both nothing but glorified spreadsheets and getting the current parts of the chart onto the widely-available version should be a trivial bit of software. Discrepancies between the two can be dangerous, especially since the chart is the primary document and where new information is first entered. Be that as it may, it's not my job -- what my siblings and I can make our job is comparing the two, preferable with nurses looking over our shoulders, and make sure nothing gets overlooked.
Software in the medical industry is in the dark ages.
ReplyDeleteThe recent federal mandate didn't help, in fact some feel it has ossified a set of broken processes.
The other problem is data entry, because doctors don't feel it is a good use of their time. They GAVE the order to the nurse. It isn't their fault if they were mumbling, or didn't bother to see that the nurse was doing something else at the time.
(So you know, saw this with aunts and uncles, and a cousin, and my mother. My father refused to let the medical profession get their claws into him. He even singed the release after a fall so that 911 wouldn't take him to the emergency room. I doubted his decisions at first, but I have come to understand his position.)