How to Sign onto CPSI & Access POC From the Desktop Double-Click on the CPSI shortcut If you require Point-of-Care support assistance, MedVerify general questions answered, When prompted enter your Employee Number or additional training Use the <Tab> key to proceed to the password field please contact Mayo’s Enter your CPSI Password, then <Enter> IT Clinical Support Specialist Reference at x 4152 Guide This will bring you to the Hospital Base Menu Click ‘POC Access’ For After Hours/Weekend Support Please Call 717-4988 You will now be in the Point of Care System Employees can “Sign On” or “Sign Off” from the POC Mayo Regional Hospital system, without returning to the Hospital Base Menu. How do I Select My Patients? White Board & My Patient List cont. Single-click on column name to sort list by room or by patient’s name. Plus Sign (+) is used to add patients to your ‘My Patients’ list. If you don’t see patient in list click here to enter their Open the patient’s virtual chart by account number. selecting either the patient’s name or account number. At the start of your shift your assigned patient’s can The Location drop-down can be used to track when a patient be added to your “My Patients” list by selecting the is not in their room. You can also set reassessment red plus sign (+) …when added the + turns to a red reminders. Examples would be: CT, MRI, X-Ray, OR, minus sign (-) that will then allow you to remove a Cardio, Physical Therapy, Reassess in,etc. The accuracy of patient from your “My Patients” list. Using the “My this tool is dependant on manual selection. Patients” list will make it easier to access and monitor Note: the term “select” refers to a single mouse click your patients throughout the shift. or single touch of the tablet pen to the tablet screen. Understanding the Virtual Chart? How do I Select Chart Type? !!!VERY IMPORTANT!!! From base virtual chart select “Chart Type” Always verify Chart Type before you begin charting (if new patient Select Chart Type) Use back arrow to return to chart Chart Type turns red when selected Review Demographics, Precautions, Recent Vital Signs, Labs, Select Appropriate Chart type. These control the I&O Allergies, Access Multiple Areas, View Reports, Leave “sticky” types AND your vital sign out or parameters notes for communication with other staff. Staff Communication warnings. IF YOU DO NOT select chart type you is not recorded as part of the medical record, once typed over or will not have the correct I&O for the Nursery and will deleted it’s permanently gone. not have the safety of vital sign our of range warnings. How do I begin documenting? How do I Select a New Flow Chart Move mouse or pen over Flowchart tab, menu will drop- down without clicking. Select the “Flow Chart Menu” Select ‘New (all)’ with a single-click or touch of the pen. Minnie Mouse Select Flow Chart from Existing List Use Scroll Bar to move up / down through list Select Flow Chart with a single mouse click, If the chart you need is not on the list of existing flow or touch of the tablet pen to the tablet screen charts select from the “New (all)” list Understanding the Flow Chart Demographic Information Screen Tools for future use Problem List, Never Use, Demographic Window NEVER change any of this information. This data is to be changed by Registration ONLY! Navigate to other areas of virtual chart Verify and/or respond This data auto fills MEDACT (aka KARDEX) with a Y or N answer as from the initial interview flow chart NEVER!!!! Select Completed (never ever) appropriate. Takes you back to White Board Exit takes you back to the Flow Chart selection list Please Call Registration x4150 if changes need to be made to areas highlighted in orange. How to Document on the Flow Chart How to Document on the Flow Chart Select first item in Flow Chart column Select from list of answers to build narrative Cell Free Text Window Select large white box to open window for free text entries. (select OK when done) When response is complete select Next to move to the next question. If a question does not apply, or does not require an answer, select Next to continue. Select this box to open Responses to special coded questions such as free text window Current Meds, Drug Allergies, Food Allergies, Height & Weight will not display directly in the flow chart column. These questions will display in Answer List red once answered. To view the data select the answer cell to view the data. Selecting ‘Update’ takes you The ‘Next’ button helps users move through flow back to the flow chart chart questions, reducing the possibility of skipping Select ‘Next’ to automatically over a question. update and proceed to next question How do I chart my How do I create my DAILY ASSESSMENTS? PLAN of CARE? Select “NEW PROBLEM” on Select the appropriate flow chart and answer the Flowchart. appropriate questions. NOTE: Problems can be created & documented on any flowchart. NEW PROBLEM MAKE SURE YOUR ON SHIFT Checking the date/time will also helps to assure you that you’re charting correctly. HOW DO I SELECT MY How do I select my PROBLEMS? PROBLEMS & GOALS? Select the appropriate Problem List category . 1. Select the action to be taken on the Problem Enter problems on the flow chart on admission. Document on them during the patient’s stay. No need to double document. How do I document on my How do I find the Plan of Care (“PROBLEMS”)? MEDACT (KARDEX) Select PROBLEM from flow chart, problem activity screen Placing Orders On The MedACT will open. Select action to be taken on the problem: Addressed, MedACT = Electronic Kardex ~ Displays All Medical Orders ~ Intervention, Evaluation, Reviewed, Resolved, N/A, Inactive, Selecting Medact button on the left will take you to or free text option. Select Update to save answer, or cancel to return to flow Medical Order Entry = interventions on problem list & flowchart chart. If there are questions pertinent to the problem will display red and the flow chart will be in Problem Mode. Currently there are none – so click on the problem mode button to turn off the notice. All goals must be resolved before the system will allow a problem to be resolved. Problems display in Red Placing Orders on the MEDACT Example: Blood Glucose MEDACT (KARDEX) Blood Glucose AC & HS takes you to Diabetic Record & then documents interventions on flow chart * Touch the Medical Order category diabetic record. * Pick your task and the order will highlight *OK MEDACT Example: Blood Glucose cont. MEDACT Example: Blood Glucose cont. Jetting Capabilities provide the ability to set medical orders to jet to three areas: Pharmacy, Diabetic Record, and Education. MEDACT Example: Blood Glucose cont. MEDACT (KARDEX) Documenting the Medact Touch the medical order Select (Performed, Discontinued, Completed, or Other) Update to save documentation – Best way to document actions. If you document here you DO NOT have to re-document in flow chart. Update How Do I Medication Verification cont. VERIFY MEDICATIONS? Medication Verification cont. Medication Verification cont. 1. Select Pharmacy Application 2. Select Verify Orders 3. Select Med to Verify (Highlights Blue) 4. If Required to Look Touch Look (PCA and Insulins MUST LOOK) Verify button will not appear till you look. 5. Update VERIFY BUTTON HOW DO I ADMINISTER Medication Verification cont. MEDICATIONS THROUGH MEDICATION VERIFICATION? Medication Verification Administration Medication Verification Administration Step 1: Scan patient’s armband Step 2: Scan medication to be given Step 3: Update the Give/Omit, Site and Reason fields as Using The Med List needed In Medication Verification Administration Step 4: For multiple meds, repeat steps 2 and 3 Touch Med List from the Medication Verification Step 5: After all meds have been scanned, select Update It is only necessary to scan the patient’s Armband one (1) time. NOTE: If med does not scan, select Med List option. and choose the medication from the patient’s Pharmacy Profile. Pharmacy MEDLIST ADMINISTRATION SCREEN Pharmacy MAR Color Code Documenting Administration via MEDLIST Select the medication to be administered Blue – X1 Medication Light Blue – Medication has no documentation Red – Verified Routine or PRN Medication Gray – Unverified Medication Black – Discontinued Medication Orange-Reaction/response is overdue Green- Medication is overdue Pharmacy MAR Display Order X1 Orders Routine Orders PRN Orders Linked Orders IV Piggyback Orders Large Volume IV Orders MEDICATION ADMINISTRATION For meds that were not scanned due to emergency or How do I document not on the MAR at the time the dose needed to be given: MEDICATION ADMINISTRATION? This is for documenting medications given without Select 24HR MAR Form the Pharmacy Screen Select the appropriate medication the use of the scanning system and is not the Select change date and time recommended policy. Scanning both patient and Select Medication Given, if the medication is a PRN the medication is the policy of the hospital unless in an dose field may need to be addressed emergency situation. Select Update to save the documentation MEDICATION GIVEN BUTTON PCA PCA 25 BOLUS +25 JUST USED DO NOT USE PCA FEATURE AT THIS TIME. Scan pt. Scan vial to MAR and then document attempts and usage on paper. PCA Shifts Almost Over. What do I need to check? Review Patient Progress notes for accuracy Review Plan of Care Review MEDACT (Kardex) Review Patient Meds END SHIFT (aka LOCK SHIFT) END OF SHIFT MULTIPLE PATIENT SELECTION These VS are hard-codes, the other options are loaded according to each hospital END OF SHIFT for MULTIPLE PATIENTS END OF SHIFT & DISCHARGE WHAT DO I DO REPORTS WHEN A PATIENT IS GOING TO BE At End Of Shift these reports print when nuse DISCHARGED? selects End of Shift: When A Patient Is Going To Be Discharged the Nurse All discipline Patient Progress Notes Needs To: Nurse is responsible to make sure they printed 1. Nurse or UC – Print Medication And place them on the chart. Reconciliation Form for MD to complete. At 6am and 6pm: Pt Summary for past 12 hours to be used in 2. Review MAR for accuracy and completeness report with oncoming staff. At 7am: 3. Review MedAct for accuracy and completeness Graphic I&O 4. Review patient Progress Notes for accuracy and At 1am: completeness: POC Patient Function Screen – MAR for past 24 hours Review Progress Notes At discharge these reports print when you select Print Discharge Reports. DO not take patient out 5. Review Plan of Care-May need to resolve of system till these are printed. Problems & Goals. Pt. Progress Notes with all disciplines notes in 1 report. Graphic I&O & VS 6. Complete Discharge Information in Logicare PCA/Diabetic FC Signature Report 7. Print Discharge Report then can Discharge form Medication Record / Final MAR system HOW DO I DISCHARGE A PATIENT? WHAT IS MY FINAL STEP IN DISCHARGING A PATIENT? From the Virtual Chart The last step in DISCHARGING a Patient is to Click on the Discharge Button Touch DISCHARGE REPORTS Complete the required fields Discharge Reports will end the shift and print final copies of selected reports for the selected patient. harmacy WHAT Order DO I Entry DO Standar DISCHARGING A PATIENT? TRANSFERING A PATIENT? WHEN d GET A From the Patient Function Menu IRoutine From the Virtual Chart “BAD Medicat Click on #3 DISCHARGE Click on the Transfer Button Complete the required fields NDC” ion MESSA 1. Acc GE? ess the the 1. Call Phar PHARMA mac CYy 2. Keepapplthe icati Medication Bar Codeon 3.2. Tou Give ch Medication New through the Ord MEDLIST er 3. Tou ch Sch edul ed Notes: & 1- Tim e Me ds 4. Tou ch the first few lette rs of the med icati on desc ripti on.
Pages to are hidden for
"HELP files OURS from jen"Please download to view full document