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Nursery Chart System Development

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Title: Nursing Chart Development Author: John Last modified by: scottbc Created Date: 11/26/2007 4:42:43 PM Document presentation format: On-screen Show – PowerPoint PPT presentation

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Title: Nursery Chart System Development


1
Nursery Chart System Development
  • Team Members John Fonge, Brandy Scott, Kendra
    Mills
  • Faculty Advisor Dr. William Walsh, Chief
    Nurseries Pediatrics Neonatology Vanderbilt
    University Children's Hospital Department of
    Neonatology

2
Vanderbilt University NICU
  • 61-bed, 60,000 square foot Level IIC unit that
    admits 1200 infants per year
  • Rooms are divided into 7 clusters, or pods, each
    containing 6 or 7 infant rooms arranged so that
    the nursing staff can see into all rooms
  • Our prototype is in a patient room in Pod C
  • Each single-patient room is 13 feet x 14 feet
  • Wall adjacent to the corridor is a 4-foot sliding
    glass door with privacy curtains

3
Background
  • In the past, nurses have written down vital signs
    on paper and manually transferred them to the
    computer, but in a busy NICU this method has led
    to insufficient documentation.  Patient charting
    is now being entered directly into the computer
    to dispose of the double charting that leaves
    room for documentation error. 

4
History of Computing Systems
  • Initially when rooms were converted from double
    rooms to single rooms, each room was equipped
    with a mobile cart known as a COW - computer on
    wheels
  • Negatives short battery life, wheels would fail,
    often difficult to locate

5
Background
  • At Vanderbilt Childrens Hospitals NICU, Dr.
    William Walsh has placed a prototype of the
    computer nursing chart in the patient room where
    the nurses can directly enter patient
    information.

6
Advantages for Changing to Computing System
  • Scanner in every room helpful for Admin RX (used
    in dispensing of drugs)
  • At Minneapolis VA Medical Center
  • Nurses spent 7 of their time gathering data and
    17 charting data prior to the installation of
    the computer system
  • After the installation of the system, gathering
    time reduced to 4 and charting time reduced to
    10
  • Computerized charting did not alter time spent in
    patients rooms (43 before installation and 43
    after installation)

7
Problem Statement
  • Is the computer station going to affect the
    nurses work area at Vanderbilt Childrens
    Hospital?
  • What adjustments can be made to the existing
    prototype to fix the instability?

8
Project Objectives
  • Determine an inexpensive way to stabilize the
    computer station setup
  • Assess the stability/ergonomics of the support
    leg/keyboard
  • Perform nurse evaluation of effectiveness of new
    prototype

9
Computing Systems
  • Dual Screen system was installed to improve upon
    COW.
  • One screen shows vital signs and the other shows
    informatics
  • Negatives instable keyboard, system too heavy,
    extremely bulky

10
Second Prototype
  • Lightweight arm
  • Vital screen above patient bed
  • KVM (Keyboard video mouse) switch to toggle
    between informatics and vital screen

11
Solutions
  • A pole was attached to stabilize the computer
    station.
  • 20
  • Pole manufactured by Shur-Line, a painting
    accessory manufacturer
  • Can vary in height
  • 35 in. 43 in.
  • Push button pole makes adjustment very easy

12
Projected Cost Per Bed
  • NICU Admin-Rx Equipment Proposal
  • Item Number Description Cost
  • 1 28 Flat Screen Monitor 650
  • 2 Mounting bracket for 28 70
  • 3 Ergotron arm and Combo 800
  • 4 Extensions for key board 55
  • 5 Keyboard stabilizer 50
  • 6 Headwall adapters 100
  • 7 KVM and misc. cables 100
  • 8 Wall Channel 40
  • 9 Scanner bracket 30
  • 10 Mount for Philips CPU 40
  • 9 Mouse and Keyboard 40
  • 10 Plant operations work 250
  • 12 CWS cpu and mount ?
  • Estimated maximum Expense (2225 CWS)
  • (Less 500 if mounts are reused, less 300 for 22
    - 24 and possible extended price savings)

13
Stability/Ergonomics of Keyboard and Support Leg
  Dual-Screen Monitor Single Screen Monitor
Screen Size (inches) 41.125 18.25
Range of Height (inches) 16.125 15.1875
up-to-down time (sec) 7.65 2.37
down-to-up time (sec) 5.55 1.69
duration of oscillation (sec) 14.24 1.5
oscillations/sec 3 2
keyboard deflection with 2kg weight (inches) 0.75 0.1875
14
Results
  • Time it takes to raise and lower the arm
    decreased by 69
  • Stability of keyboard improved by 75 based on
    deflection test
  • Duration of oscillation decreased by 90
  • Range of vertical motion comparable, but range of
    horizontal motion will increase since the single
    screen is less than half the width of the dual
    screen

15
Current Work
  • Observe installation of single screen prototype
    in two rooms in Pod C
  • Survey nurses on new prototype on Friday, March
    14, 2008 after the patient rooms go live
  • Researching more alternatives to the Shur-Line
    paintbrush arm for stabilizing the new keyboard

16
Future Work
  • Complete a quality function deployment (QFD)
    process once the surveys from the nurses are
    collected
  • Research a way to adjust the angle of the
    keyboard
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