Clinical Orientation Basic Cerner Computer Course Day 2

Transcription

1 Clinical Orientation Basic Cerner Computer Course Day 2 Description This course is basic computer teaching for RNs only. Learning Objectives At the conclusion, participants should be able to: 1. Utilize PM conversation nursing function 2. Navigate CareCompass 3. Identify Quality Measure window locations and methods to satisfy requirements of incomplete measures 4. Submit, document, cancel, and void orders within Cerner. Orders include provider orders and nursing care plans 5. Document patient home mediations and pharmacy preference 6. Document administration of medications 7. Document patient education 8. Navigate the discharge readiness mpage 9. View Sepsis Advisor Video with demonstration Course Outline Utilize PM conversation nursing function 1. Bed Transfer upon arrival to floor 2. Discharge encounter

2 3. Nursing-overview Navigate CareCompass 1. Patient lists details 2. Establish relationship 3. Orders review 4. Assignment list a. Charge Nurse assigns b (day nurse list) c (night nurse list) 5. Care Compass Task List a. Time Frame Options b. Medication Activities c. Patient Care Activities d. Assessment Activities e. May Chart Done/Not Done or document on the task 6. Activity Timeline 7. New column in production that includes care plans Identify Quality Measure window locations and methods to satisfy requirements of incomplete measures 1. Must be addressed and completed prior to discharge this is the responsibility of Providers and Nursing a. Order b. Administrator c. Document 2. Access from tool bar and able to filter by patient lists 3. SBAR mpage 4. Discharge readiness mpage 5. Order 6. Administrator

3 7. Document 8. Lighthouse documents a. Fall Prevention b. Pressure Ulcer Prevention c. VTE Prevention d. Quality Measures Solution Submit, document, cancel, and void orders within Cerner. Orders include provider orders and nursing care plans 1. mpage Overview 2. Review View menu 3. Orders a. Bold vs Unbold b. Right click options making the proper selection c. Cancel and reorder d. Cancel/Discontinue e. Void 4. Plans a. Powerplans b. IPOC 5. Communication Types 6. MSTs are ready to transcribe written or faxed orders any changes goes to nurse to clarify 7. +Add button 8. Add Order pop-up a. Search Criteria Select from drop down or enter to search b. Select an order sentence if prompted c. Select the appropriate communication type d. Enter Physician name e. Your item will then go to scratch pad

4 f. Select done if no more orders g. Highlight order on scratch pad to make changes as needed h. Missing Required Details button i. Sign when complete 9. Supplies must right click and print to SPD Printer when supplies are needed Document patient home mediations and pharmacy preference 1. It is a nurse s responsibility to document patient s: a. Home medications by history b. Compliance c. Each medication s last date/time taken d. Address any existing home medications listed on patient s list 2. Physician s responsibility to complete a patients medication reconciliation 3. A physician is also the only one that can complete a prescribed or ordered medication 4. Physicians are also to complete a transfer Medication Reconciliation if applicable 5. A physician is also required to complete a Discharge Medication Reconciliation 6. Patient Pharmacy a. Nurse s responsibility to add patient s preferred pharmacy b. Patients may have multiple pharmacies Document administration of medications 1. Best Practice Patient Safety 2. MAR a. Overview b. Filters c. Icons

5 d. Time frame criteria 3. Medication Requests to Pharmacy 4. MAW a. Orders mpage or MAR b. Right Click on medication c. Choice Medication Request d. Select reason and enter in to comment area additional details a. Patient s wristband b. Nurse Review c. Scan Medication Aztecs d. Early/Late reason e. Address details f. Sign 5. Administer Scheduled Medications 6. Continuous IV Fluids a. Begin a Bag b. Site change c. IV rate change d. Discontinue Bag e. Start a second bag f. Stop bag (IV pole) 7. Insulin Administration 8. Documentation for PCA pump Document patient education 1. Patient Education (Krames) to print and add to discharge summary (limit editing) 2. iview to document education Navigate the discharge readiness mpage

6 1. Discharge Dashboard 2. Discharge Order 3. Follow Up 4. Patient Education 5. Review Results and Outstanding Orders 6. Quality Measures must ALL be complete 7. Review and Sign (Diagnosis and Medication Reconciliation MUST be addressed by Provider) View Sepsis Advisor Video with demonstration 1. SIRS/Sepsis Criteria 2. Notifications 3. Queued Tasks 4. Powerform Documentation