Skilled Nursing Facility | Wheeler, Oregon

Project Abstract:

Nehalem Valley Care Center (NVCC) utilizes an inefficient electronic medical record (EMR) that causes consistent and significant stress for nursing and care staff. NVCC is the only skilled nursing facility in Tillamook County and provides critical SNF/ICF services to loved ones all along the Oregon Coast. As a non-profit facility licensed for 50 beds and currently serving an average of 28 census due to staffing limitations, NVCC currently has limited financial resources to be able to fund a conversion to a more user friendly EMR, Point Click Care (PCC). The target audience is the nursing staff and support staff working within this rural, under-resourced, independently operated, and underrepresented location.

Because of our remote location, we lack connections with large hospital organizations, legislative lobbyists, or other community support networks leaving us as an underrepresented location at many levels. Our nursing staff includes nurses who are English as a Second Language (ESL) users, immigrants, BIPOC, LGBTQ+, and economically disadvantaged workers. These care staff report the current EMR to be particularly challenging especially for those already navigating the frustration of a language barrier. Converting to a more user-friendly option such as PCC would allow more efficient documentation, less workarounds for inefficient charting systems, and more time providing vital resident care. Long term care facilities are held to stringent documentation expectations, and this is not an easy task with our current EMR. PCC offers increased efficiency as well as a preferred EMR charting system among many critical agency care staff.

Currently, we have frequently had agency staff refusing to work in our facility due to dislike and/or unfamiliarity with our current EMR. Adopting PCC could remove this barrier for agency staff and allow more support and additional nurse wellness. As a rural/frontier facility, recruiting and retaining our staff is imperative. This is a challenge when we have an antiquated, clunky, and unreliable charting system that does not perform to expectations. Often work is lost and must be recreated and this is a waste of time and a frustration to staff. Workarounds create double documentation. These are a few examples of the overall inefficiencies that staff are constantly battling within our current EMR. A nurse focus group identified examples of nurses crying in their shift because EMR system shut down, they could not get the support they needed from help desk, and they felt exhaustion and fatigue from the daily grind of working with an inadequate EMR.

Once the facility has successfully converted to Point Click Care, we hope to see improved staff morale, less documentation errors, improved engagement in proper procedures, as well as improvements in staff reported overall wellness and a reduction in workplace stress. We also hope that through this grant process nursing staff become more engaged in dialogue and decision-making, which will improve recognition, governance, and autonomy.