Frequently Asked Questions

Transcription

1 Contents General Questions... 3 How will assigned and temporary locations work?... 3 Can the admitting diagnosis be added in the header?... 3 How will we Save the Adult Patient Profile if our patient is unable to answer?... 3 The Adult Patient Profile is lengthy. How will we be able to have a med calc weight for order entry in the event that this document has not yet been completed?... 3 Is it possible for Abnormal Vital Signs to appear in another color on the patient header?... 3 Will MedHost be available to view past visits?... 3 How much information will be backloaded into the system?... 4 Patient Lists... 4 Can we create Criteria-Based lists by Diagnosis?... 4 Medication Management... 4 Does the system alert you if the medication is new for the patient so that we know to address side effect, etc.?... 4 How will we know what medications were given in the Cath Lab or Interventional Radiology?... 4 The Low-Dose Heparin Order currently allows you to exceed the low dose limits. Will this be corrected?... 4 Where will we co-sign for fentanyl patch removal?... 5 Registered Nurse and PCT... 5 What should the RN do when placing an order on behalf of a doctor if the MD hangs up prior to acknowledging alerts?... 5 Will nursing be able to change the Attending provider?... 5 Will there be a choice for milk and molasses on the enema order?... 5 How do we acknowledge that we have reviewed the patient s Plan of Care at the beginning of each shift?... 5 How will we document arterial sheath removal? There is currently no parameter available on the Assessment Intervention Flow sheet... 5 Why is there no choice for Secondary Diagnosis?... 6

2 Currently when documenting Limited Vascular Access on the Patient Profile, the user can only choose one option? We need to be able to choose multiple What is the difference between the frequencies of 12 hours and 12 hours Interval?... 6 How will PCTs be able to document the vital signs section of the Patient Profile at the same time that the RN is filling it out to answer the admission questions?... 6 Can we have a column added for Assigned PCT, like we do for RN and RT?... 6 Can we have a column added for Mental Health SW, like we do for RN and RT?... 6 Surgery Services... 6 Will Surgical RNs be changing the patient s temporary location as they move throughout the surgical areas?... 7 How will the I&Os from the patient s surgery be included in the Shift and Daily totals on the Intake & Output flow sheet?... 7 Will PACU be trained to edit the VTE Risk Assessment post-surgery?... 7 Will the ASA Score be viewable on the reports from OR?... 7 What orders will be suspended for a transfer to OR?... 7 Maternal Child Services... 7 Will OB be keeping their WOWs?... 7 Is there a separate pediatric/newborn patient profile?... 7 Does the daily weight populate the patient header for newborns?... 8 Are the GE Monitors in the NICU interfaced for auto entry on the Vital Signs flowsheet?... 8 There is currently not an option for an admission weight on the Pediatric Patient Profile... 8 Emergency Department... 8 Are the GE Monitors in the ED interfaced for auto entry on the Vital Signs Flowsheet?... 8 Will ED RNs use the in-patient discharge process for in-patient holds that are discharged?... 8 Can the CVA section of the ED Note say Stroke TPA treatment initiated to Stroke Protocol Initiated?... 8 How will Critical Results populate in the ED?... 9 Respiratory Therapy... 9 Will Respiratory Therapy be auto paged when orders are written in the ED?... 9 Where do we document the Ramsey Scale for patients on ventilators?... 9 Currently when documenting Airway Safety Measures on the Assessment Intervention Flow sheet, the user can only choose one option? We need to be able to choose multiple.... 9

3 General Questions How will assigned and temporary locations work? Assigned locations can be updated by Registration, Nursing, or Unit Secretaries. The temporary location will be updated by the receiving unit. There is a one-way interface with TeleTracking. When the locations are updated in AllScripts, it should feed into TeleTracking and update the locations there as well. Can the admitting diagnosis be added in the header? Due to the amount of space on the header, the decision was made to limit the content added here. We do, however, have a patient column that can be added so that you can see the admitting diagnosis for each patient in your patient list. How will we Save the Adult Patient Profile if our patient is unable to answer? An answer choice of unknown is being added, per Super User request, to ensure that these questions can be answered appropriately for patients who cannot answer. The Adult Patient Profile is lengthy. How will we be able to have a med calc weight for order entry in the event that this document has not yet been completed? The med calc weight can also be entered during order entry. The user will be asked if they want this weight to apply to this order entry session only or for all sessions. Is it possible for Abnormal Vital Signs to appear in another color on the patient header? This will not be possible for July 1st, however, we have added it to the list of possibilities for Optimization. For now, the vital signs will appear in one color and abnormal results will be indicated by the red arrows on the flow sheet Will MedHost be available to view past visits?

4 Yes. Both MediTech and Medhost will be available as viewers in order to view past visit histories. How much information will be backloaded into the system? A change has been made and only Patient Demographic information will be backloaded into the system. All clinical information will be available in MediTech/MedHost to view. Patient Lists Can we create Criteria-Based lists by Diagnosis? This request has been put in for optimization. For the Go Live date of July 1 st, however, you will be able to create Criteria-Based lists by: provider, location, service, and orders. Medication Management Does the system alert you if the medication is new for the patient so that we know to address side effect, etc.? No, there is no way for the system to recognize at this time whether or not a patient has been on a medication either this visit or during a previous visit. There is, however, the Drug Info Tool Bar button that can be utilized to quickly access information about medication side effects once it is determined that this type of information is needed. This information can also be printed out. How will we know what medications were given in the Cath Lab or Interventional Radiology? Cath lab medications will still be available on the paper Procedure Log that is placed on the patient s chart. RNs in Interventional Radiology will Mark their Meds as done on the emar. They will not be barcode scanning. The Low-Dose Heparin Order currently allows you to exceed the low dose limits. Will this be corrected?

5 Pharmacy and Dr. Sanders are working to adjust the order form so that these limits cannot be exceeded, regardless of patient size. Where will we co-sign for fentanyl patch removal? There will be a MLM that triggers the co-signature from the emar. This is currently not configured, but we will demo the co-signature option for all Super Users once it is functioning. Registered Nurse and PCT What should the RN do when placing an order on behalf of a doctor if the MD hangs up prior to acknowledging alerts? The current TORV Policy & Procedure will be updated to explain that doctor s must stay on the phone when someone is placing orders on their behalf in order to acknowledge all alerts, etc. The RN cannot complete the order or act on any orders if the MD does not stay on the phone to acknowledge alerts. Will nursing be able to change the Attending provider? Yes. They will be adding this right to Nursing. It will need to be done through the Registration Menu Bar. We will add instructions to the QRG for how to perform this task. Will there be a choice for milk and molasses on the enema order? A text box has been added to the order form to allow for the free text of this choice. How do we acknowledge that we have reviewed the patient s Plan of Care at the beginning of each shift? The acknowledgement is not required. The policy will be that the plan of care is initiated at admission and viewed at the beginning of each shift. While a formal acknowledgment is not required, it is expected that the Plan of Care is updated and modified according to the patient s status. How will we document arterial sheath removal? There is currently no parameter available on the Assessment Intervention Flow sheet.

6 The Venous Sheath Removal Parameter has been edited. The parameter is now titled Sheath Removal. RNs will need to modify the row label to indicate whether it is Venous or Arterial. Why is there no choice for Secondary Diagnosis? Doctors will be adding one admitting diagnosis. In addition, they will have the opportunity to add additional Patient Problems or Visit Problems. Currently when documenting Limited Vascular Access on the Patient Profile, the user can only choose one option? We need to be able to choose multiple. The buttons have been changed from radial buttons to check boxes to allow users to make multiple selections. What is the difference between the frequencies of 12 hours and 12 hours Interval? 12 hours indicates a frequency of 0900 and 2100, 12 hours-interval is now and in 12 hours. How will PCTs be able to document the vital signs section of the Patient Profile at the same time that the RN is filling it out to answer the admission questions? PCTs will not document vital signs in the Adult Patient Profile. They will document on the Vital Signs flow sheet. The only sections that MUST be filled out for Vital Signs in the Patient Profile are the admission weight and height. Can we have a column added for Assigned PCT, like we do for RN and RT? Yes. This column has been added as an option. Can we have a column added for Mental Health SW, like we do for RN and RT? Yes. This column has been added as an option. Surgery Services

7 Will Surgical RNs be changing the patient s temporary location as they move throughout the surgical areas? No. The location will not change as the patient moves from holding, intra-op, recovery, etc. How will the I&Os from the patient s surgery be included in the Shift and Daily totals on the Intake & Output flow sheet? The floor RN will need to view the Clinical Summary from the OR from the documents tab. There is a table that indicates the patient s Is & Os. The RN will then need to add a time column on the I & O flowsheet, edit the text to indicate the column is for surgery totals, and add document the totals from surgery. Will PACU be trained to edit the VTE Risk Assessment post-surgery? Yes. The PACU will modify the OPS note that is initiated prior to surgery in order to edit the VTE Risk Score if necessary. Will the ASA Score be viewable on the reports from OR? Yes. This score will be included in the Anesthesiology Report. We are also looking into having it added to the Clinical Summary Report if possible. What orders will be suspended for a transfer to OR? For now, the decision is that all orders (with the exception of the pre-op antibiotic) will be suspended. Maternal Child Services Will OB be keeping their WOWs? Yes, until your remodeling is complete, you will continue to use the WOWs. Is there a separate pediatric/newborn patient profile?

8 Yes. There is a KBC Pediatric Patient Profile and there is a KBC Newborn/NICU patient profile. These profiles are location driven they can only be initiated from the Maternal/Child Services area. Does the daily weight populate the patient header for newborns? Yes. The daily weight is recorded on the Vital Signs flow sheet and then will populate the header for the newborns. Are the GE Monitors in the NICU interfaced for auto entry on the Vital Signs flowsheet? Yes. These will be interfaced for device monitoring. There is currently not an option for an admission weight on the Pediatric Patient Profile. The admission weight field is being added to the Pediatric Patient Profile. Emergency Department Are the GE Monitors in the ED interfaced for auto entry on the Vital Signs Flowsheet? No. This will be added to the list for optimization; however, it will not be available by July 1 st. Will ED RNs use the in-patient discharge process for in-patient holds that are discharged? Yes. In-patients will need to follow the in-patient discharge process. ED RNs will need to print the Exit Care materials, utilize the Discharge Instructions note and the Adult Discharge Note Nursing. Can the CVA section of the ED Note say Stroke TPA treatment initiated to Stroke Protocol Initiated?

9 Unfortunately, this question is tied to Meaningful Use reporting and cannot be changed at this time. How will Critical Results populate in the ED? Critical results will appear in red, bold, italicized font in the Crit Res column. Only one test name will appear, even if multiple critical results are returned. Users can hover over the test name to get an expanded list of all of the critical results. Respiratory Therapy Will Respiratory Therapy be auto paged when orders are written in the ED? No. Respiratory Therapists will need to watch the badges that appear on the Tracker Board indicating that new orders have been placed. In addition, they will be called on Companion Phones for any STAT orders. Where do we document the Ramsey Scale for patients on ventilators? There is a parameter that can be added on the Assessment Intervention flow sheet to document this scale. Currently when documenting Airway Safety Measures on the Assessment Intervention Flow sheet, the user can only choose one option? We need to be able to choose multiple. The buttons have been changed from radial buttons to check boxes to allow users to make multiple selections.