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Hospitals to replace bedside charts with iPads
Buy this photo » Nurse Julia Knight at Oxford’s John Radcliffe Hospital tries out the new iPad-based early warning system for patient monitoring Picture: OX64145 Jon Lewis
BEDSIDE charts are to be replaced by computer tablets such as iPads at county NHS hospitals in a move towards a digital era.
Hospital bosses said the scheme – to be rolled out with up to 500 tablet devices throughout the year – will save time and improve safety.
Doctors and nurses currently use paper charts to record and assess vital signs like heart rate and blood pressure. If they need advice from a doctor, the chart has to be taken to them or consultants have to visit the ward. But under the scheme – devised with Oxford University – staff will input data that can be read at another iPad or tablet via a staff wi-fi network.
The computer programme will also calculate a score based on the vital signs, a process previously done manually.
These are then compared to records of similar patients’ vital signs to help medics better predict when someone is deteriorating.
They are currently going through final trials at the Churchill’s haemotology, oncology and Geoffrey Harris (respiratory, diabetes and endocrinology) wards, but £550,000 granted to the trust from the Department for Health’s £260m Safer Wards NHS Technology Fund, will allow the scheme to be rolled out across all adult wards across the trust.
Dr Peter Watkinson – who helped devise the scheme – said: “Doctors can be immediately aware of the data instead of the patients being hidden by being on paper in a ward.
“You are trying to prevent patients from deteriorating badly by picking things up early, such as a cardiac arrest that could be avoided.”
Under the paper system, time gaps were “very variable”, stretching from hours to minutes, said Dr Watkinson, a clinical researcher in critical care medicine.
Already some 3.8 million patient records are stored at hospitals and a storage facility at Upper Heyford, near Bicester.
He said: “If you look at how a hospital works at night, one doctor will be looking after several wards.
“A nurse will want to ring up a doctor to say ‘I am concerned about this patient’.
“They can now have both a conversation whereas previously the chart was on the ward.”
Electronically linking vital signs to other records will show which patients are among the “most abnormal”, he said.
“Other patients in a similar situation are the best model to show when you are falling out of the normal area for that group of patients.”
Other vital signs include temperature, respiration rate and the level of oxygen being received.
Research assistant and A&E nurse Julia Knight said: “Bits of paper would go missing and charts would go somewhere else. It means more time at the patients’ bedside.
“Previously you had a paper chart and you are trying to get someone to review the patient and it is only in one place that is difficult for people working across different areas.”
University Professor of Electrical Engineering Lionel Tarassenko, who has led the project, said: “The new system will help nurses, who work in busy, high-pressure environments, care for patients more efficiently and effectively.
“The traditional chart-based method of recording vital sign data is susceptible to errors in both recording and analysis of vital signs.”
He said it is a “major step towards the digital hospital in which all sources of patient information are linked and all healthcare staff are interconnected”.
Prof Tarassenko said: “This can only have a positive impact on patient safety.”
Major development costs have been saved by Oxford University Hospitals Trust – which manages the sites – working with the university.
Another project involves cutting prescription turnaround times by allowing doctors to enter a prescription at the bedside when it will automatically be processed by a ‘pharmacy robot’.
This means that when a doctor on the ward, or in outpatient clinics, prescribes medicine for a patient to take home, it will be prepared, packed and dispatched automatically by the robot.
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