Critical Care Beds and Clinical
Documentation
Stephanie Allen
Sukanya Bhattaccharya
Sarah Manning
Surabhi Satam
Temidayo Yembra
Introduction to Critical Care
Beds
When it comes to life-threatening illness or injury, Critical
care beds offer design enhancements and safety features
that assist in the efficient delivery of care
• Specifications
o
o
o
o
o
o
Frame: L2160 x W1100
Bed: L1900 x W980
Back: 0 ~ 80°
Knee: 0 ~ 35°
Adjustable height
Nursing Panel
Types
• InTouch
o
o
o
o
Benefits patient
Benefits caregiver
Touchscreen pads
USB upgradeable
• Positionable bed
o
o
Customizable
Modern
Types (cont)
• Epic II
o
o
o
Integrated scale
Side rail controls
Back rest position
• Resuscitation bed
o
o
o
Multi-care
Easily maintainable
Tilting, Weighing, X-Ray
Issues
• Obesity
o
o
o
Number increasing
Proper equipment
Patient lifts
Issues (cont)
• Impatient falls
o
o
o
Control out of reach
Height of bed
Automatic adjustment
Objectives
• Lateral Tilting
o
o
Prevents complication
Assists treatment
• Impatient fall
protection
o
Side rails
Objectives (cont)
• X-Ray scanning
Reduces patient
transfer
o Ease for staff
o
• Pressure redistribution
o
o
Proper mattresses
Prevent pressure
sores
Objectives (cont)
• Accurate Weighing
o
o
o
Constant examination
Accurate results
Eliminates patient
transfer
• Staff support
o
Multi-function screens
Objectives (cont)
• Recovery
o
o
Mobilizing lifts & rails
Ease on healthcare
staff
• Optimization of heart
and lung performance
o
o
Treatment positions
Prevent complications
What is Clinical Documentation?
Clinical documentation in a patient's
record includes any and all
documentation that relates to the care of
the patient during the patient's stay or
encounter.
In the inpatient setting, some of the important
pieces of the patent’s clinical documentation
include:
•
•
•
•
•
•
•
•
•
•
•
Patient History & Physical
Progress Notes
Orders
Procedure Reports
Anesthesia Reports
Pathology Reports
Radiology/Nuclear Medicine Reports
Cardiology Reports
Consultation Reports
Notes Provided by Nursing Staff
Discharge Summary
Why is Clinical Documentation
Important
•
•
•
•
•
•
Patient Care & Quality
Legal Protection
Operations and Management
Strategic and Financial Planning
Research
Reimbursement & Revenue
The move toward Electronic Medical Records
(EMRs) and Critical Care Information Systems
(CCIS)
EMRs are meant to facilitate more
efficient work processes for staff by
automatically gathering physiological
data, allowing medical records to be
accessed both at the point-of-care
and at terminals throughout the
ICU.
A CCIS is a computerized patient
charting system that has been
specifically designed for use in
intensive care, providing a physician
with access to a central data
repository containing patent
information including, demographic
data and physiological data retrieved
from bedside monitors.
Bumps in the Road:
Physician Note Taking in the ICU
Some of the problems identified as occurring during
the note taking process are as follows:
• Collecting relevant and correct patient information
• The EMR systems are too rigid and time consuming to
navigate
• Information requested by the physicians is not known
during the ‘rounds process, requiring after-the-fact
lookup and documentation annotation
• Repetition of patient treatment and observation
information in different sections of the EMR
Ongoing CCIS Prototype Work:
activeNotes
Clinical Documentation in the
Remote ICU Model
With respect to clinical documentation
sophisticated ICU clinical information
systems (CISs) must provide the remote
care team with access to all relevant patient
data, including lab test results, medication
lists, progress notes, and bedside flow
sheet documentation.
The patient’s EMR must be imported from
the hospital information systems (eg, lab
results, pharmacy) and ICU devices
(bedside monitors, ventilators), and can be
used by ICU nurses and physicians for
establishing/tracking care plans, charting
patient data, and generating progress notes.
Implementation of EMR's
Success Factors
•
•
•
•
•
•
Collaboration and Communication
Staff Training
Implementation Plan and Schedule
Resource Availability
Ease of Use
Staff Buy-in
Implementation of EMR's
Issues
•
•
•
•
•
Cost
Lack of Training
Resistance to Change
Duplicate Work
System Errors (i.e. system downtime)
EMR Design Considerations
• Information Overload
o Summarize information
o Maintain current data
o Archive/Remove unnecessary
data
• Dashboard
• Ease of Use
o Intuitive
o Follows work flow