Jena,
We looked into patient record computer programs when we started
renting pumps.  We didn't find too many out there.  TLC (The
Lactation Consultant) from Infonation is the one we decided on (I
have no financial  interest in this company).  We use this for all
outpatient records, including phone calls.  They have advertised, I
believe, in JHL and have been at all the US ILCA conferences.  You
can get it in just a consulting form or with rental information (for
a higher price).  For the rental section, it has the ability to
track rental records even after pumps have been returned, a
shortcoming we found in the other programs we looked at.  The
various lists (actions taken, problem list, strategy list) fell very
short of what we needed.  Some options made no sense and there were
many more we wanted to add.  Fortunately, this was quite easy to do,
so we now have our own "custom" version.  Some other lists were
locked in and don't have exactly what we want, but it works pretty
well anyway.  (For example, positions are listed as "cradle",
"football", "side lying" and "other"  I would like to see "cross
cradle" as a separate one instead of considering it "other" since we
do use it so often when mom is having trouble getting an effective
latch.The biggest problem is that it can't be linked to other
systems like your MIS (Material Information System or whatever you
call it) at your hospital.  This made for some challenges being sure
the records weren't considered "shadow charts".
For inpatient records, we devised a computer charting program where
we assess and report interventions in the categories of latch,
suckling, ending, infant assessment (as it relates to
breastfeeding), breast, nipples prefeed and nipples postfeed.  Each
has a list of "normal" which we simply check if all is OK in that
category. We can indicate this is by LC observation, RN report or
mother's report.  Then when a category doesn't fall in the "WNL"
(within normal limits)  category, We have a list of potential common
variances, plus a place to write in any not on that list.  Then from
that screen, we go to one where we type in the intervenions/plan for
dealing with the variation.  We originally planned to have a list of
interventions to select from, but decided that was too involved and
typing in each situation hasn't been that big a job.  We fill in all
seven items at least once during the hospital stay and will repeat
any areas where there have been changes at subsequent
observations/visits. Since this program belongs to the hospital, I
believe it is copyrighted and don't think I can share the full
listings.  Sorry.

Hope this information is helpful.

Winnie

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