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IT system to check nurses' observation practice


A hospital trust in Birmingham is to use an IT system to identify where nurses are not carrying out patient observations properly.

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It is thought to be the first time such a system has been used in this way.

University Hospitals Birmingham Foundation Trust is already using a computerised prescribing system that tells nurses which drugs patients should receive and when they need to be dispensed.

The system notifies clinicians automatically when medication is due and highlights potential problems, for example if a prescription conflicts with another drug the patient is taking. It also measures the delay between prescription and dispensing.

Results are shown for different wards, bays and individual clinicians.

The trust’s director of nursing Kay Fawcett said it had seen significant improvements in both errors and dispensing delay.

Ms Fawcett said: “There is a very overt audit trail. If it is particular individuals [who appear to be making mistakes], we can investigate and see if what is being done is appropriate, or for example if they need more training.”

She told Nursing Times the system was being extended to cover patient observation in order to help prevent unchecked deterioration. Nurses would record observations on mobile computers, with alerts sent to the outreach team if there was a concern.

Ms Fawcett said recording observation results on computers gave clearer results and evidence of who has carried them out than paper systems.

She said: “The data is much more presentable in electronic form. In written form, some can be unclear.”

Ms Fawcett said that when bays or nurses appeared to have problems, their managers looked at the reason.

She said: “There are multiple reasons. Having the data helps us to be much clearer about whether training is needed, or if enough resource wasn’t available, for example.

“I don’t think the system is there to measure performance, it is there to improve what we offer.”


Readers' comments (2)

  • This system firstly relies on the observations being measured and recorded accurately. In my experience and as highlighted by the research, this is not always the case. Perhaps it would be wise to get NURSES doing the observations as they seem to have become deskilled at this. This computer system is in danger of deskilling nurses (and medics) further by automatically alerting the outreach team. The nurses (and medics) working in our hospitals should be able to recognise and respond to patient deterioration. Don't let technology be a replacement for a lack of essential knowledge. Correct the knowledge deficit – just in case the technology breaks down!

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  • I think anything that alerts us to when things should be done (it is so easy to forget that medication due at an out of normal drug round time) or highlights problems are useful tools.

    But nursing is in danger of becoming a clerical job... form filling, computers, etc too much of which takes us away from the bedside.

    On my ward we struggle to have enough BP machines where is the money coming to have mobile computers!!!

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