Bye bye bed chart, hello electronic 'obs'

December 2014 Vol 14 (6)

The country's first public hospital is a step closer to farewelling the paper chart at the end of the bed and replacing it with electronic recording of nursing observations and automatic alerting of a high-risk early warning score (EWS). FIONA CASSIE finds out more.


Sue WoodOne of the keystones of nursing practice – recording vital signs and other observations – is going electronic.

Rather than deciphering somebody else's handwriting, the Canterbury DHB is looking to be the second public hospital system in Australasia to farewell paper charts at the end of the bed. Not only will nurses be able to electronically record vital signs via a tablet or smartphone at the bedside, but the software system can also calculate an early warning score and automatically alert clinicians if the score indicates that patient is starting to deteriorate.

Sue Wood, director of quality and patient safety and former director of nursing at MidCentral DHB, says after getting expressions of interest they sought tenders for a software platform to enable electronic nursing observations and selected an Australian/New Zealand partnership as their preferred provider.

The next step is working with the provider to build a business case to the DHB board to get the capital necessary for not only the software but also the tablets, smartphones and/or laptops so nurses can record patient observations at the bedside that can be viewed in real time by the patient's doctor and others in their health team, from anywhere across the hospital.

All going well, a DHB ward will be piloting the new Patientrack system in the second half of 2015. Waitemata DHB is also understood to be interested in following suit.

Wood says the software platform not only records and tracks the essential vital signs like blood pressure, pulse, temperature and respiration etc. but also can replicate anything currently recorded by a paper chart. So it can include risk assessments for falls, pressure injuries, and infections, as well as calculate an early warning score to help early detection of a deteriorating patient.

Once the data is recorded on Patientrack, it is visible to all team members from whatever electronic device they chose to access it – not just the desktop computers at the nurses' station. Wood says the software platform is also compatible with eHealth developments like electronic prescribing, which is currently being rolled out at Canterbury DHB, or acuity systems like TrendCare, currently used by other DHBs.

Throwing away the paper chart and pen at the end of the bed is still some time away but the first steps are on the way, with Patientrack systems already in place in a number of English NHS hospitals, where the system was adopted first before the creator's home country Australia. It is now being used in Canberra Hospital.

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