In recent years, progress has mercilessly taken hold in hospitals and nursing homes. The new names are a sign of the open-mindedness of the institutions. Our elderly fellow human beings are certainly glad that they no longer have to live in a homelike home, but are housed in a modern center.
“Retirement Center” or “Seniorama” are names that evoke a really cool feeling. It is reinforced by the fact that instead of a nurse caring for the resident, an accomplished nurse practitioner cares for her. New quality assurance tools have also found their way into geriatric care centers. Thanks to the detailed electronic nursing documentation, the performance of the institutions can be compared. These documentations are meticulously maintained by the qualified nursing professionals. They spend two to three hours per workday at the PC so that all procedures, examination results and prescriptions are recorded. This is to prevent a claim from the health insurance company due to a missing entry in the documentation. Documentation should also protect against lawsuits and liability claims.
However, I personally am not aware of any convictions of nurses for inadequate documentation. When there have been lawsuits against nurses in nursing homes in the past, it has always been for patient misconduct. The advantages of the systems in everyday care are difficult to discern. Besides the fact that the most capable nursing professionals are deprived of patients for hours, there are also weighty shortcomings. For example, physicians’ orders are still received in writing, visualized on paper, entered into the system by the qualified nurse, printed out. The printout is then used to provide the medication. Hopefully the latest version is always ready! On sober reflection, however, one realizes that “digital documentitis” has created two new sources of error at great expense. In fact, in most centers it is not possible to digitally visualize the doctor’s prescription and the provision of the medication is not done directly on the screen, but from a printout. The traditional method of providing medications on paper based on the card index (medical visa with each medication) has ensured that the medications have always been spread according to the most current prescription without transcription errors. Thus, the benefit to caregivers is poorly proportioned to the effort required.
The perversion of quality assurance is that “digital documentitis” takes nurses away from patients for hours at a time. Indeed, patient satisfaction is highly dependent on the duration of patient contact. One of the most common complaints I hear is, “The nurses don’t have time for me because they have a lot of work and are always in the office.”
The patient must always be at the center of our quality efforts. Digital documentitis must not be allowed to take up the already limited working time of nurses and doctors to such an extent.
Cordially yours