Pave your staff’s road through cyberspace

Education coordinators rarely will face a bigger challenge than teaching nurses who are scared of computers how to use them for all documentation.

Archbold Home Health Services in Thomasville, GA, faced that challenge last year when the agency switched from paper documentation to having nurses and therapists use laptop computers in patients’ homes.

"Everybody has a different learning curve; some are scared to death of computers," says Linda Chick, RN, staff development coordinator for the freestanding full-service agency, which covers five counties in south Georgia and four counties in north Florida.

It took about a year to fully train the staff, as the agency focused on one county at a time, Chick says.

"We give them all the support we can," she adds. "We don’t abandon them; we stay with them until they get it."

The formal training includes technical support and hands-on experience eight hours a day for five days. Each nurse was given some patient files to load into the computer. "That’s the only way you can learn with this system — it has to be hands-on experience," says Linda Canady, RN, staff development assistant coordinator.

"Linda Chick gave each nurse a patient to load, and she went over it out loud, form-by-form, and they each typed their individual patient in, and each nurse could ask questions as they went," Canady explains.

The week-long training session also helped smooth the way for nurses to accept the change in how they document cases. Nurses began to see how computerized documentation would allow them to have files at their fingertips when they were in patients’ homes, Canady says.

On the first Monday after the training, the nurses took the laptops with them out in the field. It went well, Canady notes. "They had numerous questions, and we handled them as they went along because it’s an ongoing learning process."

Employees found that the computers made the documentation slower at first, but eventually that changed. And although none of the staff took extra typing lessons, those who didn’t know how to type developed their own typing methods, Canady says.

Benefits outweigh hassles

Education about the computers has continued with updates presented in memos and newsletters.

"It’s like WordPerfect where you get updated versions," Canady explains. "This is the same thing; you get updated versions, so we sent out memos of what changes are on updated versions."

Sometimes employees who have grown accustomed to the computers have expressed a desire for some updated features, and the educational memos sometimes serve as a reminder that some interesting change is on the way, Chick says. "It keeps them excited."

Despite the extensive training and gradual implementation of the computer documentation, some problems have arisen, Canady says. For instance, the staff learned that some patients’ homes have such poor electricity that the computers cannot be plugged in. So nurses have to make sure the back-up batteries are charged before they enter a home.

On the positive side, the patients have grown accustomed to the computers.

"One of our 90-year-old patients says, ‘Now the nurse comes in, and she pecks in that box too,’" Canady relates.

The benefits have outweighed the hassles. "This is a wonderful system; it has made our patient plan of care more accessible to our nurses," she adds. "And it’s a fantastic assessment tool and allows more in-depth documentation."

[Editor’s note: To contribute to Tips From the Field, send your suggestions to Melinda Young, editor of Homecare Education Management, at P.O. Box 1024, Tryon, NC 28782. Telephone: (704) 859-2066. Fax: (704) 859-5954. E-mail:]