Related Links

Advocates of mobile computer carts acknowledge they may not be appropriate for every part of a hospital. For instance, Christiana Care Health System originally planned to use carts for the dialysis units at two hospitals. But the hospitals decided against using the carts because of lack of space. Dialysis patients are in a single big room and always within sight of nurses, and many of the medications are standardized, notes Carolyn Zsoldos, R.N., clinical support specialist at the Wilmington, Del.-based delivery system. "It's a ward type of unit and there isn't much space. The dialysis machines themselves are huge."

Shands at the University of Florida in Gainesville uses carts extensively in most units. But emergency department physicians dislike pushing carts or carrying laptops, so they use locked-down laptops at the nurse station. "That was an area where physicians would not make the change," says Veronica Carr, R.N., information systems coordinator for nursing and patient systems.

But carts can be a good fit in hospitals with curtained recovery and emergency departments and little wall space, says Shannan Pfeiffer, director of information technology and services at Centerpoint Medical Center in Independence and Lee's Summit Medical Center in Missouri. They're also handy in operating rooms where they can be moved in and out like much of the other equipment, she adds.

Carts offer a side benefit of making it easier to analyze how often electronic records are accessed throughout a hospital, says Carr of Shands.

Doctors don't want to log into a computer on a cart in each unit they visit during rounds. So they wind up taking the computer cart from their first unit around the rest of the facility as they complete rounds.

Consequently, carts tend to navigate to the units where they are most used. If a unit is supposed to have seven carts and only has four - but the missing ones weren't reported - that's a good indicator of a unit that has too many carts or isn't heavily using them, Carr says.

When choosing carts, it isn't just important to get nurse buy-in, Zsoldos says. High acceptance is essential from all departments, such as I.T., clinical engineering or facilities management, that will be supporting the carts. "They need to know it is critical equipment that cannot wait until morning to be repaired," she advises. "Carts become 24x7 supported equipment. They're not just four wheels and a drawer."

(c) 2009 Health Data Management and SourceMedia, Inc. All Rights Reserved.

http://www.healthdatamanagment.com/ http://www.sourcemedia.com/