When the University of Colorado Hospital (UCH) moved to a new facility in July 2007, it saw an opportunity to improve nurse satisfaction by upgrading the computer process nurses used at the bedside. The Aurora-based hospital first received ANCC Magnet Recognition Program® (MRP) designation in 2002 and was redesignated in 2006.
In the old facility, nurses in med-surg areas had carts assigned to them, which they rolled from patient room to patient room as they made their rounds so they could use the computer on the cart as they administered medication and documented at the bedside.
The carts were a huge frustration for nurses, says Kathy Smith, MS, PMC, RN, nursing informatics supervisor and former MRP project director at UCH. The carts were difficult to roll on the carpet when moving from one patient room to another, and if the cart encountered a bump, it often logged nurses off the computer. The computers also had batteries, which made the carts heavy to maneuver, and nurses found the batteries often died at inopportune moments.
In addition, UCH realized that having one cart per nurse wouldn’t work with the new bar code medication administration its system was implementing.
“We could see right away that was not going to work,” says Smith. “It would require that every time a nurse wanted to administer a medication, she would have to go find her cart, unplug it, move it into the room, then plug it back in, then boot it up, then administer the meds.”
Although the hospital had already budgeted and expended money on the new bar code medication administration system, the CNO went back to the executive leadership to stress the need for nurses to have a computer in every room in the hospital. Despite the significant budget, the hospital invested in its nurses.
UCH chose another cart system, rather than a wall-mounted computer, because nurses wanted flexibility with moving the cart around to different parts of the room. Also, UCH had already planned the rooms in the new building, which weren’t designed for wall-mounted computers.
To choose the best system, the hospital staged a cart fair, at which nurses could examine the types of carts on the market and determine the ones that would best meet their needs. They eventually chose mobile computing carts from Rubbermaid® Medical Solutions.
“The new carts now stay put in every patient room,” says Smith. “They are plugged into the wall so nurses don’t have to worry about the battery ever being run down.” But still having the computer on a cart gives nurses the freedom to move around the room and use the computer where it makes the most sense for them and their patients.
The carts have a computer screen, the central processing unit in box, a big work space, a drawer, and a light. The light enables nurses to see medications and other supplies during the night shift without turning on the lights in the room and disturbing patients.
The new computers were crucial to the successful adoption of the bar code medication administration system. “I think we would have had a revolt if we hadn’t done it,” Smith says. “And it would probably have been a failure for our bar code medication administration project.”
The carts also contribute to nurse satisfaction. “The nurses made a big poster with a big thank-you card and gave it to the CNO,” Smith says. It said ‘Cow-a-bunga! [“Cow” is an abbreviation for “computer on wheels.”] We love the new computers in patient rooms!’”
Adapted from HCPro’s Advisor to the ANCC Magnet Recognition Program®, December 2009, HCPro, Inc.