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Leann Kennedy
Anyone doing computerized charting?


We are starting computerized charting.  For reasons I won't bore you with, if a pt goes home with a PICC, we have to document the line as being discontinued, then under comments chart "line remains in place for..."

Obviously, our nurses are concerned about the legal ramifications (charting they did something they didn't do).  I'm tring to get something in writing stating we need to chart as such, but so far, NO LUCK (huh.)

Anyone else encounter a similar issue?  Suggestions?  Are we falsifying the record by charting this way?


Speaking as a testifying

Speaking as a testifying expert in cases involving these catheters, you are taking a huge risk, causing enormous amounts of confusion, and opening yourself for liability if there is a serious problem that leads to a lawsuit. If I were reviewing a case for a plaintiff (patient) discharged from your hospital, this conflicting information would be a huge red flag that there was something wrong!! What happens when busy nurses forget to add the comment? I can see so many issues with this as I review the record and I would be obligated to provide this information to the plaintiff's attorney. Have you discussed this with your risk management dept? I simply can not see any RM worth their salt that would sit still for this. Keep fighting and I would flatly, firmly, politely refuse to chart something that was not done and not true. Check INS standards and ANA Code of Ethics. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

ann zonderman
documentation - issue


I agree this is a very scary idea.  Any rational for this???


E mail me privately    - glad to discuss  [email protected]


Ann Zonderman, BSN, JD, CRNI, LHRM

IV Nurse Services


Ann Zonderman, BSN, JD, CRNI

I wouldn't do it.

We went live with electronic health record 6 months ago.  It was clear that the vendor did not have good understanding even of standard of practices that have been in place for many years.  Don't know who they used as their consultant for vascular access and infusion therapy, but we've had to struggle a bit with some issues.  After a few months we're making progress, but it takes a while partly because the implementation is such a huge job - the experts from our staff have very full plates.

Stick to your guns, and don't chart what you haven't done.

I agree 100% with Ann and Lynn.


Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

PICC charting

We have been doing computer charting for a long time.  If the PICC is discontiued, the nurse charts this on the IV/invasive form:  select PICC discontiued, tip intact, and the length.  If the patient goes home or ECF with the PICC, they add a note in their depart form,  "Patient sent home with PICC.  Dressing dry and intact. PICC flushed per policy."

PICC charting

I would recommend charting IV assessment.  Then under other one could chart, "Patient sent home with PICC."

another problem with discontinuing line in EHR

is that the EHR won't carry line info into record when patient is readmitted with that same line.  When it works well (we're still having trouble getting ours to work 100%), all of the pertinent information is automatically populated in the flowsheet for vascular access lines.  For example - it will automatically populate how long the trim length was (to compare with when line actually d/c'd), what the exposed catheter length was with tip in optimal location (to check for line migration), etc.

If you discontinue the line in the EHR before it's discontinued in the patient, you'll have to manually find the info and re-enter it if the patient is readmitted.

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

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