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What is a Nursing Kardex?

If you're a nurse or are in nursing school, I'm sure you've heard of something called a "Kardex." But what is a Kardex, exactly?

medical record with nurse stethoscope

With the evolution of electronic health records (EHRs), the existence of the Kardex has become long-forgotten, in many instances. However, it does exist in many different hospitals, and among many different software/EHRs. It may not be called a Kardex (for

example, Holland Hospital uses something called the Patient Summary to replace the Kardex), but its purpose remains highly valuable.


Why Should I Use The Kardex?


I'm sure you're asking yourself, "If a Kardex is "antiquated," because it's really not used, then why should I use it?"


This goes back to an important point of the original Kardex...


The Kardex is a tool that provides a holistic view of the patient while communicating interdisciplinary and team decisions that impact patient outcomes.


In other words, the Kardex is a valuable historical and communication tool that exists still in EHRs and should be used at every shift.


In fact, many nurses are required to chart that they've reviewed the Kardex at the start of a shift.


What's in a Kardex?


While there is no clear cut answer (as many organizations will change what's included), there are still some pretty consistent Kardex data points:

  • Chief Complaint

  • Admit Day (you can calculate the length of stay)

  • Allergies

  • Nurse to Nurse Communication

  • Diet Orders

  • Critical, Current, or otherwise important Medications

  • Lab draws and their frequency

  • Other relevant orders like consults, etc.

While these things are available somewhere in the medical record, the beauty of the Kardex is that it allows you to get a more clear-cut view of the patient.


Why does the Kardex matter?


Think of it like this. If you had a single portrait of the patient and their condition (including things like medical history through discharge), it would live in the Kardex. Many different EHRs have workflow features that allow you to complete tasks. However, the Kardex still exists because it's a relevant and valuable tool to understand the patient holistically.


Want to look at a patient's allergy list? Look at the Kardex. Reason for coming in? Kardex.


Diet orders? One guess...


...Kardex.


It's a single, evolving document that helps you understand the patient's current and past condition.


So now that I know what a Kardex is, how do I use it?

  • First, understand its purpose and use it at the start of the shift, especially if you are unfamiliar with your patient. It is highly valuable in giving you the complete picture of the patient.

  • Follow your organization policy regarding the Kardex, especially when it comes to Nurse-to-Nurse communications.

  • Find a way to implement Kardex (or whatever EHR feature is similar) into your workflow. Nothing is more valuable than beginning your shift by looking at the data that has been reflective of your patient's stay - don't rely on the nurse giving you report!

The goal of this website is to give you the ultimate resources to improving your practice of documentation. Please remember to always practice an abundance of caution and seek answers regarding your documentation's legality with your organization or through your state board of nursing.


This site is run completely free of charge. If this site helped you in your documentation journey, and you have a few quarters lying around in couch cushions, it's so helpful to keep this site up and running! Thanks for your donation!

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References

Mount-Campbell, Austin F., et al. “Uncovering the Value of a Historical Paper-Based Collaborative Artifact: The Nursing Unit's Kardex System.” Frontiers, Frontiers, 30 June 2020, www.frontiersin.org/articles/10.3389/fdgth.2020.00012/full.




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