Nursing Kardex form used by all disciplines

Form gives staff information at a glance

When therapists at Kernan Hospital in Baltimore determine a patient’s functional level has changed, they note the change on a Nursing Kardex form to alert the rest of the staff. If a family member visiting in the evening has concerns about the patient’s discharge plan, the evening nurse writes the question in the Nursing Kardex to alert the day therapy team.

The treatment team on each unit uses it to identify patient issues that occur on each shift. Devel oped by an interdisciplinary team, the form has information on patient diet, lab and diagnostic studies that have been ordered, protection issues such as special mattresses, skin and wound care, procedures and treatment, isolation precautions, if any, patient and family teaching needs, and miscellaneous orders. It’s in a flip chart format; each patient has one page, and pages are kept together.

"Instead of using the Kardex as only a nursing tool, we have changed it over time so it’s a communications tool for all disciplines on all shifts," says Linda Hutchinson-Troyer, MGA, CRTS, patient therapy manager of the brain injury unit.

At the start of each shift, staff have a reporting meeting in which changes in status or teaching approach are noted for each patient. For example, if the occupational therapist has identified a change in splinting procedure, he or she changes the splinting schedule on the Kardex; the therapist also changes the schedule on the Quick Bedside Evaluation form at bedside. The change is noted at shift report, which is a way of notifying every person on every shift of the new procedures.

The night and evening shifts also use the Kardex to report to the day staff. For instance, a family member visiting in the evening may have a question or a problem with family training initiated by therapy. The evening staff note it on the Kardex so it’s passed on to the day staff and shared with the therapy staff.