nursery chart system development
DESCRIPTION
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. Vanderbilt University NICU. - PowerPoint PPT PresentationTRANSCRIPT
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
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
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.
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
Background
At Vanderbilt Children’s Hospital’s 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.
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)
Problem Statement
Is the computer station going to affect the nurses’ work area at Vanderbilt Children’s Hospital?
What adjustments can be made to the existing prototype to fix the instability?
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
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
Second Prototype
Lightweight arm Vital screen above
patient bed KVM (Keyboard video
mouse) switch to toggle between informatics and vital screen
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
Projected Cost Per BedNICU 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)
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
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
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
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