Implementing an Electronic Health Record and Computerized Physician Order Entry System in a Small Acute Care Hospital: A Staff Nurse Perspective

by Rachel Smith, RN

Tenet Healthcare, our parent company, launched a large project in 2009 called IMPACT (Improving Patient Care Through Technology) for all its hospitals to implement Electronic Health Records (EHRs) and Computerized Physician Order Entry (CPOE) in response to the national call to action to improve America’s health care.

Twin Cities Community Hospital went live with EHR in November 2010, but the new processes related to the order entry and nurse charting weren’t exactly putting me in the Thanksgiving spirit. Charting initially took longer, and I began questioning the value of the EHR. But that changed virtually overnight.

In December, an elderly woman (“Martha”) and her friend (“Emily”) came to visit Martha’s husband in our Intensive Care Unit, where he was admitted the day before in critical condition. She spent a good deal of time at her husband’s bedside. Suddenly, Martha began to seize and fell to the floor, hitting her head. We issued a code blue.

Martha’s friend, Emily, also very elderly, suffered from dementia and could provide no specific help regarding the woman’s health problems. However, she did offer me one key piece of information:  Martha recently received treatment at Twin Cities. As emergency procedures on her continued, I searched our EHR and found Martha had just been discharged after suffering from seizures.

Thanks to our EHR, I quickly learned Martha was placed on coumadin for new onset atrial fibrillation. In addition, Martha’s electronic chart indicated she had a severe allergy to ativan, which is commonly used on patients who are seizing. Because this information was literally at my fingertips, I stopped the emergency team from administering ativan, which would have likely led to a catastrophic outcome.

Immediate access to health information through our EHR proved instrumental in expediting the nursing care for Martha and avoiding complications associated with unknown facts. As a result, Martha recovered nicely and soon returned home to her husband. Thanks to our EHR, Martha received the right care, at the right time and positively influenced nursing outcomes.