Health care organizations throughout the country are looking at computer technology and automation to improve patient outcomes and safety. In 2002, Nicklaus Children's became the first pediatric hospital in the nation to introduce medication bar-code technology - the most sophisticated technology available for medication administration control. Nicklaus Children's Hospital, formerly Miami Children's Hospital, has partnered with Bridge Medical, Inc., to implement and develop a pediatric component for its MedPoint™ System of bar-code-assisted medication administration. Here's how it works. Upon inpatient admission, patients receive a bar-code wristband. All medications from the pharmacy also have a specific bar-code. Upon receipt of a medication order, the pharmacist reviews and enters the order in the computer. The medication to be given is displayed on the nurse's computer. The nurse verifies the order for accuracy, scans his or her employee badge and finally scans the patient wristband to verify information. The nurse then selects medication to be administered with the bar-code scanner. The computer checks it for accuracy and the nurse then administers the medication after verifying the match. Through the shared governance model, staff provide a leadership role in reviewing reports from the MedPoint™ system and developing suggestions and action plans to ensure safety of the pediatric patient.
In 1997, Nicklaus Children's Hospital began using a computerized documentation system. We use the computerized system to document the care provided by the healthcare staff in all our inpatient areas. The system contains the patient history, flow sheets and progress notes for all disciplines to document their assessments, observations, education and interventions. The computerized system is located at the nursing stations and on mobile workstations, computers on wheels or COWs, that can be taken to the patient's bedside. Throughout the campus, the system is available to other healthcare providers (that have access) to view patient information.
As we advance with technology, Nicklaus Children's Hospital will be introducing a new Electronic Medical Record (EMR) system to ensure integrated communication among all settings and disciplines within the hospital. A team of nurses have been identified and are the leading force in determining standardization of documentation and criteria for the new system.
Electronic Medical Record
On April 17, 2012, Nicklaus Children's Hospital successfully transitioned to an electronic health record system that has provided significant enhancements for patients and caregivers alike. Internally known as PEDS (Pediatric Electronic Data System) this state-of-the-art program captures all data related to patient care from throughout the multi-facility pediatric healthcare system, including information from radiology, the laboratory, pharmacy, inpatient care, outpatient care, rehabilitation, and urgent and emergency care all in one comprehensive system. PEDS could not have been developed without involvement and collaboration of nurses across all levels. Known as subject matter experts, or “SMEs”, nurses were selected from units throughout Nicklaus Children's Hospital to provide input into the development of the PEDS clinical documentation system. This process took eighteen months to bring Nicklaus Children's Hospital to the final “launch” date, and included process mapping, product testing, end-user education and support during go-live. SMEs continue to lend their expert assistance post implementation. SMEs were instrumental in the success of MCHs transition to the PEDS system.
Nicklaus Children's Hospital, formerly Miami Children's Hospital, is the first children’s hospital in the nation and first hospital in South Florida to install the HyGreen Hand Hygiene System. 3 North, Oncology, is the first unit to integrate the HyGreen system which enhances the first line defense in preventing healthcare associated infections. As part of the hospital’s Squeaky Clean program, the system reminds staff to wash their hands. The system consists of a hand washing sensing device mounted near hand cleansing stations. After the caregiver cleans their hands with alcohol-containing soap or gel, the sensor provides an “all clean” message, green illumination, on a badge worn by the healthcare provider. As the provider approaches the bedside, a bedside mounted monitor wirelessly searches for a signal from the badge for the “all clean” message. If the message is absent, the badge vibrates reminding the provider to perform hand hygiene.
Read more on how Nicklaus Children's Hospital is using Hygreen and view a video
Spectra Link Phones
Spectra Link phones are utilized by the nursing staff on the inpatient units. These wireless phones allow nurses to place and receive calls from wherever they are in the hospital. The nurses and physicians enjoy the direct line of communication and find that it allows them to discuss patient issues in a more timely fashion. The system also provides a direct link of communication from the patient’s room to the nurse. When the patient utilizes the call bell, the patient is directly connected to the nurse via the phone, allowing for enhanced communication and timely follow-up.
Web Access from Home
All Nicklaus Children's Hospital staff have the ability to access the Nicklaus Children's Hospital Intranet Portal from home. The system allows for remote access of email, personalized files, web-based scheduling, educational references, up to date Nicklaus Children's Hospital news and much more.
Nicklaus Children's Hospital Portal
Nicklaus Children's Hospital has its own intranet, or Nicklaus Children's Hospital Portal, through which staff can access a wealth of information. The portal is the home of all nursing and system wide policies. The portal is also used as a communication tool for employees about Nicklaus Children's Hospital events and initiatives. Many applications are also readily at the staff’s finger tips such as links to regulatory and state websites, educational materials for patients, self-scheduling, telephone numbers, email, individual HR information and dozens of other applications.
Web Based Scheduling
In 2004, Nicklaus Children's Hospital implemented a web-based scheduling system for the Nursing Department. The Nightingale system allows staff to access their unit's schedules via the web and allows them to input their scheduling preferences. The unit based Self-Scheduling committee reviews all submissions and produces a balanced schedule to meet the needs of the unit. Once schedules are published, all staff has the ability to view their unit's schedule. The system also allows the Nursing Department to view current and future staffing across all inpatient units easily allowing for wise allocation of nursing resources.
Mosby’s Nursing Skills
Nicklaus Children's Hospital nurses have access to Mosby's Nursing Skills. Mosby’s offers nurses and nurse educators the convenience of online access to evidence-based skills and procedures. Easily accessed from Nicklaus Children's Hospital's portal, Mosby’s content provides nurses with resources and insight from leading nursing societies. Mosby’s is updated continuously to reflect the latest in evidence-based practice.
Professor MCHex is an on-line learning center available free to all Nicklaus Children's Hospital employees on the hospital's portal as well as the internet. Professor MCHex is a web-based service focused on serving the educational needs of pediatric hospitals. As an employee of the hospital you are given full access to MCHex courses free of charge. Courses offered, many of which provided CEUs, include: Nicklaus Children's Hospital mandatory requirements, clinical development, individual development, legal and ethical, PC skills, organizational performance, professional development, safety, work/life skills, social responsibility/advocacy and management and leadership skills.
Pediatric Human Patient Simulator
Nicklaus Children's Hospital has a Pediatric Human Patient Simulator lab on-site which provides training to nursing, clinical and medical staff. The lab is managed and run by nurses. Simulations include a variety of situations that nurses may face as they care for pediatric patients. In the interactive simulator lab, nurses and other health care professionals can enhance their clinical skills and become more comfortable with how to respond in emergency situations - all in a non-threatening environment. The opportunity to utilize the lab starts during the orientation process.
As a national and international center for Pediatric Excellence, Nicklaus Children's Hospital is continually called upon to provide clinical sites for nursing students regionally, nationally, and internationally. To provide a more efficient process for orienting students and faculty, Nicklaus Children's Hospital developed a web-based orientation program. At their convenience, students and faculty are able to access the orientation module and complete it prior to their arrival at Nicklaus Children's Hospital. This innovative web-based approach to training has proved to be a major cost saving and effective tool that complements the hospital's efforts in recruiting and reaching out to the largest number of students anytime, anywhere.
iSTAT Point of Care Testing
Nicklaus Children's Hospital nurses utilize iSTAT to perform point of care testing. The iSTAT is a portable machine not much bigger than a phone that is brought to the bedside for patient lab testing. With 0.1 cc of blood the nurse can run labs such as blood gas, lactic acid, electrolytes and the results are available within 120 seconds. The results are then downloaded into the patients computer database and available to the entire health care team.
Nicklaus Children's Hospital nurses also utilize bar-coding technology for laboratory testing. As with the medication bar-coding system, Soft ID allows the nurse to simplify the lab collection process through bar-code management. The nurse/phlebotomist scans the child’s ID band, lab slip and lab collection container ensuring the right lab for the right patient.
Get Well :) Network
As a leading provider of interactive patient care solutions, Get Well Network was implemented in 2008. The Get Well Network is recognized by and works in conjunction with Child Health Corporation of America (CHCA) and National Association of Children’s Hospitals and Related Institutions (NACHRI).The bedside interactive computer/TV monitor allows for the patient and family to be involved and their care. The system provides education materials through KidsHealth®, both standard and those prescribed by the nurse, interactive games, surveys for the families to complete as well as “pop-ups” for patient specific reminders. The system also allows the patient/family to access the Daisy Award to nominate outstanding nurses.