Nurse covering midshift in a 'pull till full' ER consistently inherits undocumentented chest pain and critical patients whose initial assessments, vitals, and charting were not started by any nurse for 2-3 hours until she arrives.

Workarounds Described

• Nurse walks into midshift and finds initial assessments and charting not started on chest pain patients
• Patients wait 2-3 hours with no nurse assigned until midshift arrives
• Nurse has to do all flagged assessments, labs, meds, and discharge from scratch

Implied Software Gaps

• A system that automatically assigns a pre-nurse to critical patients upon arrival to initiate assessments and charting
• A real-time shift handoff dashboard that shows documentation completion status and pending tasks
• Enforced workflow that prevents pull-till-full from deferring critical patient care to next shift

NurseFlow Triager

NurseFlow Triager is a mobile and desktop app that streamlines ER nursing handoffs by enforcing mandatory initial assessments and real-time vitals logging for any patient arriving before the assigned nurse's shift. It assigns a 'pre-nurse' automatically for critical cases, ensuring no patient goes undocumented for hours.