PATIENT ACCESS LIST (PAL)

Transcription

1 PATIENT ACCESS LIST (PAL) The Patient Access List (PAL) helps clinicians work effectively and efficiently by providing key patient and workflow information in an easy-to-access format. The PAL is built for Inpatient use. Set Up Your PAL We ask that you only view the PAL for the patients that are assigned to you on your current shift. Displaying all the patients on your unit on the PAL might be confusing so there is a way to set up list that would only show your assignment. This requires you to create a custom list of your assigned patients and choose that list to display in the PAL. You will need to update this custom list at every shift. The light blue bar in the PAL is called the Information Bar. 1. Right-click on the Information Bar to display a shortcut menu. 2. Click Change Patient List from the menu choices. 3. The Available Patient Lists window opens. 4. For most nurses, you won t want to select your unit here because this would list all of the patients on your unit. You only want patients assigned to you this current shift. However, a unit clerk may wish to select your unit so that all patients are listed on the PAL. P a g e 1

2 5. You ll set up a new list and add your assigned patients. 6. In the Available Patient Lists window, click the New button. 7. The Patient List Type dialog box opens asking you to select a patient list type. 8. You are setting up a custom patient list. 9. Double-click Personal/Custom. 10. The next step is to give your custom patient list a name. 11. Type a name for your list, e.g., My PAL, in the Enter a name for the list: field. 12. Click the Finish button and you re done creating your new list. 13. Notice that the Information Bar of the PAL now displays the name of the custom patient list you created. You need to add patients to this custom list. 14. You need to access the Patient List, so that you can see all of the patients on your default unit. 15. Locate and click the icon the main toolbar. 16. Next, you ll select only those patients under your care this shift. 17. From the patient list, click the first patient under your care. P a g e 2

3 18. Next, hold down the Ctrl key on your keyboard and click another patient on this list. The Ctrl key allows you to select patients randomly. 19. Select the other patients under your care this shift using this method. 20. Next you need to add these patients to the My PAL custom patient list. 21. Right-click on one of the highlighted patients a shortcut menu of options displays. 22. Remember you want to add these highlighted patients to your custom patient list. 23. From the shortcut menu, click Add to a Patient List. 24. From the extended menu, click My PAL (or whatever you called your list). 25. The patients have been added to the custom patient list, but now you need to return to the PAL to see them displayed there. 26. Locate and click the icon on the main toolbar. 27. You are returned to the PAL. The Information Bar shows your custom patient list of My PAL but none of the patients you just added are listed. 28. Remember you need to refresh the screen for the patients to populate here. 29. Click Refresh (Minutes Ago). 30. You will be asked to establish a relationship. Click the down-arrow and select RN and click OK. 31. The PAL now displays the My PAL custom patient list populated with your patients. Next you need to change the timeframe to reflect the shift that you are working. P a g e 3

4 Change Time Frame The default settings will need to be set every shift to reflect the time frame of the shift worked. It is recommended to set your PAL to 24 hours, so you do not have change the default time when you change shifts. Only current shifts show at any given time in the Timeframe Selection box. Shifts that have not yet begun will not display here, e.g., you can t see the shift until at least 1800 and you can t see it after Right-click on the Information Bar to display a shortcut menu. 2. Click Change Timeframe from the menu choices. 3. Choose 24 hrs ( ) to filter the tasks that will display on your PAL. 4. Click OK. Remember that you only view the PAL for the patients that are assigned to you on your current shift. P a g e 4

5 Modify Custom List The PAL opens to the last list that was chosen, which might be outdated and not reflect the patients who are assigned to your care on this current shift. This requires you to review and modify the custom list at every shift. Remove a Patient from PAL 1. In the PAL click on the patient to be removed. 2. From the PAL toolbar, click the Remove Patient icon. Add Patients to Custom Patient List 1. You need to access the Patient List, so that you can see all of the patients on your default unit. 2. Locate and click the icon the main toolbar. 3. You ll select only those patients under your care this shift. 4. Hold down the Ctrl key on your keyboard and click on your patients. The Ctrl key allows you to select patients randomly. 5. Right-click on one of the highlighted patients. 6. From the shortcut menu, click Add to a Patient List. 7. From the extended menu that appears, click the name of the list that was created. Establishing a Relationship using the PAL Tool Bar As new patients appear on your patient list, you will be required to establish a relationship with the new patients. 1. Click the Establish Relationship icon on the PAL toolbar. 2. Click the Select an appropriate relationship down-arrow. P a g e 5

6 3. Select RN/RPN, etc. 4. Click the button. Important You will only have to create your custom list once, however, each shift as your assignment changes, you will have to add patients to your custom list and also delete patients from the list that are there from previous shifts Delete a Custom Patient List 1. Locate and click the icon the main toolbar. 2. Click List Maintenance icon. 3. Click the list under Active lists. 4. Click the to move your list to the Available lists. 5. Right-click on the list and choose Delete Patient List. 6. Click Yes. 7. Click the button. P a g e 6

7 PAL Sections and Icons The PAL includes an Information Bar and five (5) sections, each section containing a specific category of patient information. Information Bar Displays your location to the left and shift information to the right. Both the shift and location can be changed. Right click to modify. Name Section The Name section contains the list of patients from the patient list you selected. This section always is displayed at the farthest left position. Demographic Section The Demographic section contains selected patient demographic information such as bed location, age, allergies, infection control, IV indicator, diet order, tube feeding order, attending physician, and visit reason. Icon indicators located in this section: Allergy documentation No allergy documentation No known allergies documented (region only) Patient has a continuous IV order P a g e 7

8 To display a patient s demographic information in more detail than is displayed in the PAL, you must open the patient s chart. Notifications Section The Notifications section alerts the clinician to new orders and new lab and DI results. Icon indicators located in this section: New routine priority orders requiring nurse review New stat priority orders requiring nurse review New routine priority orders that do not require nurse review New routine results New critical results Task Section All activities that generate a task will display in the appropriate column, including patient care, meds, and specimen collection. Only nursing positions will see medication tasks. Medication tasks do not appear on the Patient Access List (PAL) for unit clerk/registration clerk positions. Only the patient care and specimen collection tasks will be seen. Icon indicators located in this section: Patient care task Lab task Medication task Stat medication task Result Section The Result section contains the patient s height and weight measurements, both actual and estimated. Height will populate from the last entry up to one year ago. Weight will populate from the last entry up to within the last three months. P a g e 8

9 Interact with the Sections in Your PAL View Allergies from the PAL 1. In the Demographic section of the PAL, double-click the Allergy icon to view allergy infomation. 2. The Allergies dialog box opens. 3. Click the X at the top right to close the Allergies dialog box. View IV Details 1. In the Demographic section of the PAL, double-click the IV icon to view details. 2. The Orders dialog box opens. 3. Click the X at the top right to close the Orders dialog box. View/Nurse Review In all inpatient areas, EMERG, and selected ambulatory areas, all new orders will fire for nurse review regardless of who entered them. P a g e 9

10 The expectation is that all orders will be read and reviewed for accuracy and reasonableness. By completing nurse review, you are saying that the orders are appropriate and that actions will be completed for those orders. It is best practice that, before the end of your shift, you complete nurse review of all orders for your patients. The exception would be if you are questioning an order and the provider has not responded and this should be part of shift report. IMPORTANT: Medications cannot be documented nor administered in the MAR until nurse review is complete. 1. In the Notifications section of the PAL, double-click the Nurse Review icon to see new routine priority orders requiring nurse review. 2. The Orders dialog box opens. 3. Click the button to launch the Actions Requiring Review window. 4. Click the button to stamp your electronic signature to these orders. 5. You are returned to the Orders dialog box click the X to close and return to the PAL. View/Review Lab Results 1. In the Notifications section, in the New Lab Results column double-click the New Routine Results icon to see the details. P a g e 10

11 2. The Results dialog box opens. Important: Abnormal results will be identified with a (H), (L), or (C). View a Task 3. Click the button to clear clipboard icon from your PAL. 4. Click the X at the top right to close the dialog box. Important: Medication tasks should not be completed from the PAL. 1. In the Task section, double-click the Patient Care icon in any column. 2. All tasks for the column/patient display in the Tasks dialog box. 3. All tasks appear and are pre-selected you can deselect, reselect any of the options. Chart a Task Complete 1. Ensure only the desired task is checked and click on the button. Important: Medications will not be charted from the PAL. Medications will be charted using the Medication Administration Wizard and the MAR. P a g e 11

12 View Details about a Result 1. In the Results section, hover over a results to display further details. Order Entry Details Task A task continues to fire every day at 0800 hours for a nurse to review these order entry details and sign if the information is still correct or make any necessary changes on the form. This starts the day after admission. 1. From the PAL, double-click the Patient Care icon ( ). 2. The Tasks dialog box opens. 3. All tasks will appear and be preselected deselect other tasks if you are not going to review them at this time. 4. With the Order Entry Details checked click the button. 5. The Order Entry Details PowerForm opens. 6. Select your patient s Transport Mode. 7. Click the appropriate Infection Control Precautions. P a g e 12

13 8. Sign the completed PowerForm by clicking the Sign icon at the top left of the form. 9. When the task is complete it falls off the Tasks list. 10. If you are finished with the tasks list, click the X at the top right to close the Tasks dialog box. Open a Patient s Chart From your PAL, double-click a patient name to open the patient s chart. It opens directly to the Summaries ViewPoint component of the chart. P a g e 13