AdminRx & IV Manage FAQ's

Transcription

1 AdminRx & IV Manage FAQ's Care Organizer AdminRx Flowsheet Communication with Pharmacy Medication Administration Times Care Organizer (CO) What do I do if I don't see new med orders on CO or a med(s) is (are) missing? Same as current process when a med has not been profiled: Call unit Pharmacist, Pharmacy, or resend the order. Can I change my CO view? Yes; HOWEVER, Overdue meds may not show up on your "To-Do" list if you have your view at "Current Shift. What do I do if the medication is profiled incorrectly? The RN or RT will NOT confirm the incorrectly profiled medication(s). Use the Not Confirm button to send an electronic message to Pharmacy by either selecting a reason from the dropdown list or annotating a note. Remember to include your name & phone # with the message. See Medication Administration Guidelines/Orders Needing Clarification. Why is the "Confirm Unconfirmed" feature unavailable from the View menu in Care Organizer? You need to have one patient's orders selected to have "Confirm Unconfirmed" choice available. To single out one patient's orders on the display, select the patient by clicking on their name, then click on the "This Patient" button at the top of the screen.

2 All the meds have been given but the order is still active in the Care Organizer and in AdminRx This will occur with medications that have stop dates into the future. You will see this on stat and one time orders. Check the end date of the order. The med will discontinue once it reaches its end date (or one hour after the end date on the Care Organizer). Why don t Preop or one time med orders show up on the To-Do list? One time medication orders and pre-op orders that are profiled by Pharmacy. discontinue after 24 hours. If the patient does not go for his/her procedure or the one time med was not given, the RN is to send an RxComm message to Pharmacy to reschedule the med (s). If this is not done, then these meds will not show up on the To Do list after midnight of the scheduled day; however, they will show up as "Overdues" on the AdminRx flowsheet. The pharmacy discontinued a med but the med is showing as active in the Care Organizer Some orders based on when they start or if they are only ordered for a certain number of doses will not become discontinued on the Care Organizer until one hour after it has been discontinued Click on confirm button and look at the details of the med. It should have an end date/time. The order can be confirmed based on the end date. You do not have to wait an hour for the med to discontinue on the Care Organizer before the med is confirmed. Schedules that were due before the order was discontinued will still display Future schedules will disappear immediately. How do I document that a transdermal patch was removed (example: apply at 9am, remove at 9PM)? An order for patch removal will be placed by Pharmacy & the name of the patch will be placed in the comments If you do not have a patch removal order, send an RxComm message to Pharmacy asking them to place a patch removal order No need to scan - remove patch and select override reason as "patch removal" AdminRx Flowsheet (Back to top) Where do I chart VS that are associated with medication administration? All VS are charted on the appropriate flowsheet. This allows any clinician to see trending of the VS. Chart VS on the Handheld using "Record Observation" & will "flow" over to the VS Flowsheet. Documentation Time Documentation of medications given in AdminRx occurs at the time of the scanning. If the actual time of medication administration needs to be adjusted, this is done by modifying the documentation. See CareLink Policy #108.

3 When should I use the "Med Not Given" function? Use this function when you are certain that the medication will NOT be given at all. This function removes the med from the scheduled "To-Do" list. See Medication Guidelines/Definitions. How do I chart that scheduled insulin was not given based on the BG value? Chart as Not Given, with a reason of "Physician order" How do I scan and chart an ADD Vantage IVPB? Scan the medication vial only Address the "Drug/Order Units Don t Match" warning with the override reason "ADVANTAGE". How do I view what meds have been given to the patient? The AdminRx review flowsheet displays all meds that have been given via the AdminRx application Remember, you may need to configure your review to see all meds Where do I chart Tube Feedings? Tube Feedings are charted in AdminRx, indicating that a new bottle/bag was hung Subsequent charting (rate/residuals/goal rate/tubing flush/bag change etc.) is charted in the GI section Volume is charted in the Intake section See Enteral Nutrition Support Protocol. How do I chart PCAs / Epidurals? PCAs and Epidurals are charted in AdminRx, indicating that a new bag was started. PCA and Epidural rate changes/bolus/amount infused/waste volume are documented in the PCA/Epidural Flowsheet.

4 See Epidural Procedure and Protocol. Do I chart meds given during a Code or MET in AdminRx or IV Manage? Meds & IV s given during a MET or Code will be charted on the paper record. How are High Risk Medications identified? Pharmacy will place a comment when they enter the order into the Pharmcay System (HMM). The High Risk comment will appear on the CO with the medication. Do I scan CT contrast? No, this is currently supplied from the CT department & does not contain a barcode. Record volume ingested by patient in the Intake section under Contrast Medium. What is the process for Immunization / Vaccine orders? Immunizations & vaccines are set for a duration of 7 days in the AdminRx application. Vaccines scanned more than 36 hours after the order start date/time will trigger a "No Schedules Found" message. You may override this warning with the reason "Physician Order." How do I know when to give the pneumococcal or influenza vaccine? Once it has been determined the patient meets the criteria for the vaccination, the RN places an order. using the *MED order group, indicating that the vaccine is to be given before discharge. Administration of the vaccine is to include an annotated note indicating the lot # of the vaccine & administration site. After administration: Update the Immunization result in Clinical Profile & reprint the Admission History Report. Discontinue the *MED order in CareLink Orders. See Pneumococcal & Influenza Vaccine Protocol in the Nursing Services Manual. Administration of the PPD is to include an annotated note indicating the lot #. How will I know when to read the patient's PPD? After administering the PPD, the RN places an order in CareLink Orders, using the Medication Communication order group (*MED), indicating the date the PPD is to be read, The start date will default to three days into the future. Document amount of induration in the POC Class in CareLink Clinicals. Complete the *MED order in your "To Do" list after reading the PPD - it will d/c since it is a one-time order, See Skin Testing Procedure - Tuberculin PPD in the Nursing Services Procedure/Protocol Manual, Communication with Pharmacy (back to top) RxComm Message Function This is a one-way electronic messaging function. Message is sent to Pharmacy.

5 Remember to include your name & phone # with any message. RxComm when would I use this function? To communicate to Pharmacy: med or IV was not profiled correctly, patient is no longer NPO, request another IV, notify Pharmacy that a titrated drip has been stopped etc. What is the expected turnaround time for Pharmacy to address my RxComm message? 60 minutes Medication Administration Times (back to top) What is the Staggering Dose Grid used for? To administer doses that are late. To administer a 1st dose that is not administered at a standard time. To transition medications back to standard administration times. See Medication Guidelines/Standard Administration Times and Staggering Dose Grid. What is the best way to manage meds that are being transitioned back to the standard times? Print a copy of the MAR Profile Report, this will assist you in managing the med timing & will serve as an additional communication tool to coworkers. Why & When do I use the "Extra Dose" function? Used to administer a med that does not have an associated profiled time with it. Example: Order received at 4PM for Lopressor 20 mg daily. Pharmacy profiled the med to begin in the morning (next day). Medication should be given today use the "Extra Dose" function. This function will avoid "stealing" future-scheduled doses. See Medication Guidelines/Definition. Where do I chart my medicated IV dose changes? Document initial & any subsequent dose adjustments for titrated medicated drips in the "IV Medication" section on the flowsheet. See Medication Guidelines/Procedure for Charting in IV Manage Flowsheet.

6 . Can I continue to print the IV or IVPB label from the ADC machine ("Pyxis") to place on my IV or IVPB? Yes. As per our policy, all medications given IV are to be labeled with: Patient name, medication, time of administration, & RN signature. How do I document IV flushes into more than one port when I have a multi-dose vial? Scan the vial, enter the total dose given for the ports, annotate a note indicationg how much was given & into what ports. How do I chart a 250 ml NS that I use for blood transfusion? This is part of the blood procedure, but I do not have a specific "order" for 250 ml NS. Scan the 250 mls of NS and chart this as a "Zero" order. Record the volume infused in the Intake section.