Welcome to TiddlyWiki created by Jeremy Ruston, Copyright © 2007 UnaMesa Association
In order to standardize the documentation of 3-way bladder irrigation in Meditech this voice thread was created. Please click on the link to view and listen to the mini tutorial.
http://voicethread.com/view.php?b=3360
For futher information regarding I&O please go to [[Intake/Output|http://mchtechwiki.tiddlyspot.com/#Intake%2FOutput]]
Canned Text Cheats
http://www.divshare.com/download/3641269-c97
Canned Text Document
http://www.divshare.com/download/3641246-ac2
catherine.murphy@pullmanregional.org
Coulee Community Hospital
411 Fortuyn Road
Grand Coulee, WA 99133-8718
Phone: (509) 633-1753
Fax: (509) 633-0295
www.couleecommhosp.org
Douglas, Grant, Lincoln, Okanogan Counties Public Hospital District No. 6
Congressional District: 4
Legislative District: 12
Columbia Basin Hospital Council
County: Grant
Critical Access Hospital,
Acute Care, 25 beds
Long-Term Care, 2 beds
We have have more of an issue here than just coping NUR documentation and restoring orders. I am wondering if we have a complete solution. I also am wondering how an incomplete solution works with CPOE? Our MDs are really using Mercury MD. How do these solutions work with Mercury MD?
[img[0002D|http://farm2.static.flickr.com/1306/800988013_5e51cd54da.jpg][http://www.flickr.com/photos/9652272@N04/800988013/]]
!COPY NUR DOCUMENTATION
[img[0002D|http://farm2.static.flickr.com/1028/801060307_5a1237a24e.jpg][http://www.flickr.com/photos/9652272@N04/801060307/]]
''Select Copy NUR Documentation from your cascade menu…..''
[img[0002D|http://farm2.static.flickr.com/1007/801060725_3b1c7b3ebf.jpg][http://www.flickr.com/photos/9652272@N04/801060725/]]
''Enter the Account # that you are transferring FROM….''
''Enter the Account # that you are transferring TO…..''
''Must be the same Medical Record # ……''
''What will copy (checkboxes) will automatically fill in.''
''Say YES to Copy''
BigeloD@couleecommhosp.org
[[Welcome]] [[Getting Started]]
dstillman@masongeneral.com
1450 Battersby Avenue
Enumclaw, WA 98022
(360) 825-2505
http://www.enumclawhospital.org/
[[Map|http://maps.google.com/maps?f=q&hl=en&geocode=&q=1450+Battersby+Avenue,+Enumclaw,+WA+98002&sll=37.0625,-95.677068&sspn=43.578243,74.267578&ie=UTF8&om=1&ll=47.206158,-121.991844&spn=0.018339,0.036263&z=15]]
http://navinhaffty.com/
http://www.meditechbulletin.com/newsletter/default.asp
@@GeneMiller@@ Pharmacist
MasonGeneralHospital, Shelton
Rember to get the [[TIDDLYWIKI CHEAT SHEET |http://www.nothickmanuals.info/lib/exe/fetch.php/cheatsheets:tiddlywiki_cheatsheet.pdf?]]
Get your password from a member of the group.
To navigate Go to HowToUseThisWiki.
An easy to use [[Tutorial |http://www.giffmex.org/twfortherestofus.html]]
Slide Show
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This Wiki is a nonLinear knowledgebase for sharing information.This means that there are many topics linked together. Topics can be expounded upon and linked one to another adinfinitum (as much as one wants). The blue highlighted words are links. Click on a link and that topic will appear on the screen. Sometimes this "appearing" will seem different or odd. This is because, in regular search engines, when a link is clicked-on it usually opens in a new window. For example, click the word [[example]]
JHamm@SamaritanHealthCare.com
§
<<gradient vert #ffffff #ffdddd #ff8888>>RURAL COMPUTER GROUP MEETING>>
Thursday January 17, 2007
0830-1700
(Ellinor Conference room)
!!MASON GENERAL HOSPITAL
901 Mtn. View Drive
Shelton, WA 98584
360-427-3620
Welcome Everyone!
We will be having our quarterly meeting on the west-side. Come and enjoy our beautiful scenic Northwest area, where it’s always green come rain or shine. Our guest will be INHS NUR Analyst’s to demo and share with us the following enhancements and changes.
1. VFS enhancements
2. Order Management will replace OE (demo)
3. Med Recon enhancements
4. New Outpatient Status Board (SDC) available
5. Acuity functionality now available (demo)
6. Remodel of allergy screen
7. BMV enhancements
8. E-MAR enhancements
9. NUR Order enhancements
10. EDM updates
11. RXM “Prescription Management” module available (demo)
12. POM available (demo)
13. Careplan Evaluation enhancements
14. Rural Computer Group Wiki (demo-Jim)
!!!Driving to Mason General Hospital
Directions from Seattle/Airport
1. South I-5
2. Take exit 104 Hwy 101 to Shelton
3. Follow to Wallace-Kneeland Blvd (towards Wal-Mart.)
4. Turn right (south) at the light onto Olympic Highway North.
5. At first light turn left onto "K" Street.
6. Drive 6 blocks, passing Mountain View School, to Sherwood Lane.
7. Turn right onto Sherwood Lane.
8. Turn left on Mtn.View Drive to hospital parking and entrance.
----
Travel Accommodations
Shelton Area
Little Creek Casino Resort (10 minutes) there is a $10 discount if you tell them you are from Mason General Hospital. Great rooms, food, and reasonable prices.
http://www.little-creek-casino.com/Resort/accommodations.htm
Alderbrook Resort Spa (15 minutes) this is a beautiful spa resort on the Hood Canal. Excellent food and nice rooms.
http://www.alderbrookresort.com/
Super 8 Motel (2 minutes) The Super 8 of Shelton (very basic) is conveniently located just off Hwy. 101 and Wallace Kneeland Blvd. Property features 39 rooms, Super Start Breakfast, Free Wireless Hi Speed Internet, Interior Corridors, Refrigerators, Hair Dryers and is AAA rated. Numerous fast food, full service restaurants and 24 Hr. Super Walmart are with in short walking distance from property.
Olympia is only 30-35 minutes away and has many choices.
Jim Divis R.N.
Informatics Nurse/Nursing Supervisor
Mount Carmel Hospital
982 East Columbia
Colville, WA 99114
509-685-2418
divisj@mtcarmelhospital.org
UlrichJ@OthelloCommunityHospital.org
medrecsuper@tristatehospital.org
carperj@mox.inhs.org
!RuralComputerGroup Meeting
June 13, 2007
The first meeting of the rural computer group was held on June 13, 2007 at Othello Community Hospital. Participation from other rural Meditec hospitals was excellent and we spent the day discussing each of our facilities and what we were doing with Meditec. Confidentiality was discussed at the beginning of the meeting and everyone agreed to maintain patient confidentiality if we utilized the “live” system of Meditec. We decided to go around the room with introductions. Individuals were asked to describe their hospital, what clinical modules of Meditec they were using and how they were staffing the IS department.
!!Introductions
OthelloCommunityHospital:
Present: TinaBernsen, RN. IS nurse at OCH. JodyUlrich, RN. Director of Nursing Services at OCH. RhondaGolladay, RN, manager of pharmacy, and KariBlaak, RN, who works as discharge planner but helps Tina with maintaining order sets in POM.
OCH is a CAH. ADC is 9. Large OB department with approx 600 deliveries a year. Meditec clinical modules include NUR, ED, OM, POM, BMV with e-MAR. Also have lab, radiology, pharmacy, admitting, abstracting, BAR, and payroll. All departments utilize Meditec. Use Iatrics visual flow sheet and Watchchild for OB monitoring. Utilize MicroMedex for drug information and discharge planning information. Use Telepharmacy for pharmacy coverage. IRM maintains the server. All computers have same version of Meditec and computers are upgraded every years. Tina is full time and takes care of the clinical modules. She works with the physicians. She has one nurse in ED who over-sees the ED module (she is full time ED nurse), Kari who keeps the order sets updated, and Rhonda who over-sees BMV and the pharmacy module ( pharmacy director is in Spokane and he only comes one to two days a month). Jody helps out with Iatrics. Tina works with the other departments in the hospital, such as lab, radiology, dietary, respiratory therapy, and physical therapy. Othello also has one IT person in maintenance who keeps takes care of printers, computers, wiring, etc. Utilize the help-desk at INHS for daily problems if Tina cannot fix them.
MidValleyHospital, Omak:
Present: SuzanneRector, RN Administration, RebeccaChristoph, RN/OB Manager, RachaelWeber, RN/AC Manager, and SuePeterson, RN/ICU Manager.
Mid Valley is a CAH. ADC is 13. Do approx 200 surgeries/month. Meditec clinical modules include EDM, MSN(OR), Mercury MD, and NUR. Use Iatrics visual flow sheet. Use Telepharmacy when their pharmacist is not in house. They have three clinics, all with Meditec access. Have about 25 physicians. Suzanne does the orientation and training with the new physicians. They do not have a dedicated nurse who takes care of IT and the clinical modules. Suzanne does a lot with Iatrics. Their IT department had four individuals, but they have problems with computers not always working.
EnumclawCommunityHospital
Present: ShellyPricco RN/OB manager and Clinical Informatics nurse and MichelleWylie, RN/Med-Surg manager.
Enumclaw hospital is on the west side of the state. It is a CAH. ADC is ?. Meditec clinical modules are NUR and OE. They still do paper shift assessments. Their ED does computer documentation but it is a different program and does not interface with Meditec. They do outpatient charting and some OB charting. Shelly and Michelle have a link to OE in some of the modules so nurses can enter charges. This worked well with outpatient OB’s. They have no IT department. Shelly has implemented clinical pathways in the OB department.
WhitmanHospital, Colfax
Present: LynetteMcCanna, RN. Med/sur/ob/Informatics
Whitman Hospital is a CAH. ADC is ? Meditec clinical modules are NUR, EDM, and MSN. Use NUR for OB charting. Have approx 40-60 deliveries/year. Currently Lynette works with the clinical modules part time. Their IT department consists of one person in Colfax 5 days/wk and 3 days/wk they have an IRM person on site.
PullmanRegionalHospital
Present: CathyMurphy RN/Informatics nurse and MikeMurphy, board member of Pullman Hospital.
Pullman Hospital is a CAH. ADC is 11. Meditec clinical modules are MSN, NUR, EDM. They utilize Watchchild for OB’s, Iatrics clinical flow sheet. Use Telepharmacy when regular pharmacist not available. Busy ED and Outpatient departments. Will implement BMV in October. Their IT department consists of three individuals. Cathy’s position as Chief Informatics nurse is a new position (full time). Nurse/patient ratio is 1:4.
MasonGeneralHospital, Shelton
Present: GeneMiller, Pharmacist, SusanPowell RN/Informatics nurse and KellyNettle RN/Informatics nurse.
Mason General Hospital is a CAH. ADC is 18. Meditec clinical modules are OE and nursing (phase one). Implementing rest of NUR and MSN for OR. Utilize iatrics clinical flow sheet and are implementing Iatrics “smart board” to help manage census. Use QS system for OB dept. Use the “T” system in ED. Large surgery department, do bariatric surgery. Do approx 300 deliveries/year. They have an IS director Monday thru Friday. Kelly and Suzanne work in informatics. Have one person who works with physicians (over 100 physicians). Have a computer programmer to extract data and a clinical liaison person. One major problem with Meditec has been downtimes. Longest downtime approx. 22 hours.
MtCarmelHospital, Colville
Present: [[Jim Divis]], RN/Informatics nurse
Mt. Carmel Hospital is a CAH. ADC is 14-15. Meditec clinical modules are NUR, MSM, EDM. Use modules in physical therapy, occupational therapy, respiratory therapy, PACU and day surgery. Jim does informatics and is nursing supervisor one day a week. They have a director of “IT” who is from INHS. They have an IT tech who does the hardware in the hospital. Plans to implement BMV. Jim often rebuilds screens to better utilize them for their facility. He trains and educates nursing.
Kelly and Susan showed us the Iatrics “smart board” in test. It looked like a great management tool. Shelly and Michelle showed us some of their outpatient screens and how they have the charges built into them. They also showed us some OB clinical pathways. Jim showed us some of the screens he designed for the PACU. Tina showed us POM and BMV. We also visited the second floor of OCH and looked at some of the new computers and stands. Enumclaw offered to host the second meeting, which will be held the end of September.
Unable to attend: Sunnyside Hospital in Sunnyside ( TinaGlockner ) and Samaritan Hospital in Moses Lake ( JadieHamm ).
!!ISSUES:
1. Copying accounts, especially for Medicare patients. This needs to get fixed.
2. Training needs to be more standardized between the facilities.
3. Analysts for modules are always changing. There is no update when this happens.
4. Need more interfaces. Please do not tell us you have them or it will work. We would like you to get them working.
5. It appears INHS is growing too fast. Not spending time taking care of the rural sites.
6. Do some of the analysts know what they are doing?
7. When basic information is needed from INHS, it is hard to get.
8. Would like to receive the Meditec newsletter.
9. One or two people from the group should go to MEWS each year and report back to the group what new things Meditec has. This was suggested by Suzanne Rector. She has gone in the past and felt it was a positive experience and the group would benefit from someone going.
!!Questions Jody has to the group:
We indicated we would like an analyst assigned to us to work on issues we have. Two names came up when we talked about this. Debbie Jahn and Robert Hester. From experience Othello would pick Debbie. She has worked on the NUR, EDM, BMV, POM modules with us. She is detail orientated and has always kept us up to date. We have requested to have her on our projects. Omak has worked with Robert and have a very good working relationship with him. He does an excellent job and keeps them up to date. Jody’s question: Does he know the POM and BMV modules?
If we decide as a group we want an analyst assigned to us, who will discuss this with INHS? Would two or three individuals go to Spokane? Personally, I like to have face to face conversations with people. If we went to Spokane, who would we want to meet with? Marcie is head of the clinical modules. I think it is only fair to include her since we are discussing clinical modules and that is what she is in charge of.
!!In Conclusion
So, these are my thoughts for now. Please send your thoughts to the group so we can keep our group active and together. If I missed something important about your hospital, please let me know so I can add it. I tried to keep notes, but found myself doing a lot of listening and not a lot of writing!
As always, have a great day!!
Jody
@@KellyNettle@@ RN/Informatics nurse
MasonGeneralHospital, Shelton
Printable: [[PDF|http://www.divshare.com/download/1172135-7d1]]
!INTRA-OPERATIVE DOCUMENTATION ROUTINES
!!BASIC KEYSTROKES
''T'' Today
''T+1'' Tomorrow
''T –1'' Yesterday
Dates can also be entered with or without slashes, i.e. 101298, or 10/12/98 or 10122000
''N'' Now – current TIME
Times can also be entered as military values without the colon, i.e. 1410 (2:10 pm)
''F6'' Moves back one field
''F9'' Lookup up entry mnemonics from a table. A window appears which displays each entry with a number next to it. Enter the number next to the selection at the "Select:" prompt.
* Performs a lookup into the description of an entry. Type an asterisk * followed by a portion of the text to be found. To search on two words in the description, separate the string of characters in each word by a comma. The case and order of the string do not matter.
''Space Bar then Enter'' = Brings up the last printer used.
''F12'' Files the record
''F11'' All modifications will be LOST. In Case Record routines, the user will always be prompted with a warning “Exit without Saving Changes”. Type Y for yes, or N for no to return to the record
''Escape key'' Pressing Escape will usually return the screen to the documentation screens from a lookup or help screen
|!Action|!Result|
|Page up|Moves to next screen|
|Page down|Moves to previous Screen|
|Down Arrow Key| |
|F12 and enter screen number|Jumps to a specific screen|
''F10'' Deletes a line
__While in the Case Record Section Screen:__
''F5'' = Change Current User
''F7'' = Change Patient
''F9'' = Menu Link Options (i.e. jump to Order Entry)
__While in the Case Record Screens:__
''Shift & F9'' = Menu Link Options
!!MSM INTRAOPERATIVE DOCUMENTATION
''In MSM, select menu Item #11 – Enter/Edit Surgical Case Records''
''• Patient Identification''
The first step to entering or editing a Case Record is to identify the correct patient and case. A patient can be identified by name, unit #, account # or social security number. __The most accurate method is to enter the patient’s account number.__
|!To identify the Patient by:|! |
|Account Number *Preferred Method|Enter the account number including any prefixes.|
|Patient Name|Enter a full or partial name in the format Lastname,Firstname - no spaces|
|Unit (MR) Number|Enter "U" then the number, including any prefixes.|
|Social Security Number|Enter "#" and then teh social security number with or without dashes.|
Enter the ''Account Number**'', Patient Name, Unit Number, or Social Security Number
[img[0001C|http://farm2.static.flickr.com/1344/738138969_0d0e22f982.jpg?v=0]]
You Will See….
[img[0002C|http://farm2.static.flickr.com/1413/738138941_3788e4aaf3.jpg?v=0]]
• Type the index number in front of the patient name only after you have verified the name, status, and correct Adm/Svc date.
• At the bottom of the screen, you will see New Case? Enter Y for yes.
• At the Scheduled Date field, enter T for today.
• A screen will show the first 3 letters of the first name and the first 3 letters of the last. Select enter and the system will search for the scheduled case.
You Will See….
[img[0003C|http://farm2.static.flickr.com/1174/738138849_7ce5caa63c.jpg?v=0]]
''(IF THE WRONG DATE/CASE IS SELECTED, DOCUMENTATION WILL BE RECORDED FOR THE INCORRECT PATIENT OR CASE.)''
If the correct case and date is listed, type the index number preceding the case.
You Will See….
[img[0004C|http://farm2.static.flickr.com/1435/738138845_c51d8e629b.jpg?v=0]]
''*******If the list of patients does not include the correct case********''
If you are looking at the case list for your patient and the case has not been entered in the system or scheduled, you will have to enter the case as a New Case.
From the list screen:
• Do not select a number…..Press [enter] instead.
• The system will prompt “New Case?”.
• Enter “Y” for yes, then a prompt “Schedule Date” will appear. If it is a non-scheduled add-on case, simply enter through this.
• This will take you to the screen shown above and you can proceed.
• You will complete the fields as you normally would for your case. __HOWEVER, the physician /surgeon information and the procedure will need to be added to the appropriate fields.__
To proceed with documentation:
• With your arrow key, move down to the Intraoperative Documentation section.
• Press [enter] when you have the correct item highlighted.
• Once a selection is made, the fields related to the section appears.
• Move through the fields and enter the appropriate data. If you need to move ahead or back a page, select PageUp or Page Down. Use your Enter key, F6, and up and down arrows to move around the screen.
• When you are finished entering the data, press [F12] to file your changes. If you are on the last screen, an F will appear in the box at the bottom. Select F12 again. This will take you back to the main menu.
''• While on the main menu, hit the space bar to change the section status from Open (o) to Complete (c).''
• Required fields will be checked.
• If a field has not been completed, you will be returned to that field for completion.
• Complete the entries. When the last required field is completed, you will be returned to the menu.
• If all required fields are complete, the O following the menu item will change to a C.
• Press [F12] to Save the data. The following will appear on the bottom of the screen.
[img[0005C|http://farm2.static.flickr.com/1242/738138831_c32a089e1f.jpg?v=0]]
''• Be sure that you see this before you exit, as this is the screen that saves your work!''
• Check to see that an S is in the field and press Enter
• Filing Surgical Case Record……… Please Wait will appear. This is what saves your documentation…………..
• You may see system messages appear. Enter through them and wait for them to disappear.
You Will Then See….
[img[0006C|http://farm2.static.flickr.com/1056/738125735_3e253094e0.jpg?v=0]]
• Enter P for the Intraop document.
You Will See….
[img[0007C|http://farm2.static.flickr.com/1122/738125669_6c9b7133a1.jpg?v=0]]
• Enter the appropriate printer. Remember [Space Bar] [Enter] will recall the last printer used.
• The printed Nurses notes will print at the selected printer.
• Place in the chart per hospital policy.
!!CHANGING A RECORD TO A NEW PATIENT
If you have chosen the WRONG patient, you may “switch” patients.
• From the case record menu that lists the patient name at the top, select F7.
You Will See….
[img[0008C|http://farm2.static.flickr.com/1355/738125647_746174f250.jpg?v=0]]
Notice it says “NEW” patient ID.
Enter the correct patient name and/account number.
You Will See….
[img[0009C|http://farm2.static.flickr.com/1369/738125621_ce18f79cbe.jpg?v=0]]
The system pulls the data from the scheduled case you just identified and copies it into the Documentation Screen of your current patient.
Confirm and proceed.
!!Recovering Lost Data – All is not lost!!
In the event that power is lost or some other type of interruption occurs such as being "kicked out" of the system, a mechanism is in place to recover the data that was just entered. ''You must do the recovery from the SAME PC or laptop.''
__You will be given only once chance to recover this procedure.__ If at any point you choose N, the data will be lost.
To Begin . . .
• Log back into Meditech and MSM.
• Choose #11 Enter/Edit Surgical Case Records from your MSM menu.
You Will See….
[img[0010C|http://farm2.static.flickr.com/1089/738125593_12c216b3d2.jpg?v=0]]
• Enter a [Y] and press [enter].
You Will See….
[img[0011C|http://farm2.static.flickr.com/1008/738125561_f7d117e206.jpg?v=0]]
• If you are absolutely sure you are pulling the correct account, key in a [Y] and press [enter].
• Select the appropriate patient as usual and continue through the patient selection screens until you reach the document.
• When you enter the Intraoperative document, all of your previous work will be there. Proceed with documentation.
!!Finding a Case Record using Manage Case Records #12
• Select #12 Manage Case Records.
• Enter the date range you are searching for. ''Always'' enter a date range of some sort. It can be the same day or a month, as long as the system has a date range to search in. The closer you can pin down the date, the shorter the search will be.
• Enter the patient last name and/or the physician mnemonic. Select F12. The system will search for all cases matching the criteria and bring them up on the screen. Remember to spell the patient name correctly or the system will not find it.
• Highlight the correct patient.
• At the bottom, notice that the white box is on Edit Case Record. Select F12 and the case will load.
• Arrow down to IntarOperative Doc and hit the space bar to Open the section.
• If the entire case record has been Completed, you will see an error message. Simply arrow down to Change Status and select Enter. This will change the Complete to In Process.
• Then arrow up to the correct section, Open the section and proceed.
• Save your changes as usual.
[[Welcome]]
[[Getting Started]]
[[Topics]]
[[Manuals]]
[[Videos]]
[[Meetings]]
[[Members]]
[[Resources]]
VisualFlowSheetQuickReference
VisualFlowSheetManual
[[MSM Intra-Operative]]
[[NUR-Assessment:Phase I]]
[[NUR-Assessment:Phase II]]
[[3-way Bladder Irrigation]]
RestoreOrdersFeature
[[New Born ReAdmit]]
[[BMV]]
<!--{{{-->
<link rel='alternate' type='application/rss+xml' title='RSS' href='index.xml'/>
<!--}}}-->
Mason General Hospital
901 Mt. View Drive, Bldg. 1, P.O. Box 1668
Shelton, WA 98584-1668
Phone: (360) 426-1611 SCAN 795-1011
Fax: (360) 427-9569 (360) 427-2399 (360) 427-1921-Admin
www.masongeneral.com
Mason County Public Hospital District No. 1
Congressional District: 6
Legislative District: 35
Southwest Washington Hospital Council
County: Mason
Critical Access Hospital, 68 beds
[[June 13, 2007]]
[[September, 2007 @ INMIS]]
[[January 17, 2007]]
|!Member|!Hospital|
|ShellyPricco|EnumclawCommunityHospital|
|TinaGlockner|SunnysideHospital|
|KateGillespie|PullmanRegionalHospital|
|KellyNettle|MasonGeneralHospital|
|MichaelMurphy|PullmanRegionalHospital|
|TinaBernsen|OthelloCommunityHospital|
|RebeccaChristoph|MidValleyHospital|
|[[Jim Divis]]|MtCarmelHospital|
|RhondaGolladay|OthelloCommunityHospital|
|JadieHamm|SamaritanHospital|
|LynetteMcCanna|WhitmanHospital|
|SusanPowell|MasonGeneralHospital|
|RectorSuzanne|MidValleyHospital|
|JodyUlrich|OthelloCommunityHospital|
|RachelWeber|MidValleyHospital|
|CathyMurphy|PullmanRegionalHospital|
|GeneMiller|MasonGeneralHospital|
|JoleenCarper|TriStateHospital|
|DebbieBigelow|CouleeCommunityHospital|
|DianeStillman|MasonGeneralHospital|
|MelissaClark|MasonGeneralHospital|
Tryphena Cockroft Alaska tcockroft@cpgh.org
Randy Flanagan St. Joseph's Chewelah Steven.Flanagan@providence.org
Rhonda Mason TriStateMemorial Clarkston dns@tristatehospital.org
Joleen Carper TriStateMemorial Clarkston medrecsuper@tristatehospital.org
Lynette McCanna Whitman Colfax mccannl@whmc.org
Theron DePaulo Mt. Carmel/SJH Colville depault@inhs.org
Jim Divis MountCarmelHospital divisj@mtcarmelhospital.org
Deb Borden Lincoln County Davenport bordend@lhd3.org
Danielle Rogers EnumclawRegionalHosptial Enumclaw DanielleRogers@fhshealth.org
Shelly Pricco Enumclaw Regional Enumclaw shellyPricco@fhshealth.org
Debbie Bigelow Coulee Community Grand Coulee bigelod@couleecommhosp.org
Tim Campbell Coulee Community Grand Coulee campbetg@couleecommhosp.org
Melanie Neddo Coulee Community Grand Coulee neddom@couleecommhosp.org
Brenda McIntosh St. Joseph Regional Lewiston, ID bmcintosh@sjrmc.org
Lynette Ford St. Joseph Regional Lewiston, ID lford@sjrmc.org
Andrew Bair Samaritan Healthcare Moses Lake abair@samaritanhealthcare.com
Jennifer Clark Samaritan Healthcare Moses Lake Jclark@samaritanhealthcare.com
Louise Omsted Samaritan Healthcare Moses Lake Lolmsted@samaritanhealthcare.com
Kathy Brown Mid-Valley Omak brownkm@mvhealth.org
Rebecca Christoph Mid-Valley Omak christophr@mvhealth.org
Lori Koby Mid-Valley Omak kobyl@mvhealth.org
Rachel Weber Mid-Valley Omak weberr@mvhealth.org
Tina Bernsen Othello Community Othello bernset@othellocommunityhospital.org
Rhonda Golladay Othello Community Othello golladr@othellocommunityhospital.org
Jody Ulrich Othello Community Othello ulrichj@othellocommunityhospital.org
Cathy Murphy Pullman Regional Pullman catherine.murphy@pullmanregional.org
Mike Murphy Pullman Regional Pullman serdwarf@verizon.net
Diane Stillman Mason General Shelton dstillman@masongeneral.com
Kelly Nettle Mason General Shelton Knettle@masongeneral.com
Susan Powell Mason General Shelton spowell@masongeneral.com
Tina Glockner Sunnyside Community Sunnyside tina.glockner@sunnysidehospital.org
Kathleen Nelson Franciscan Health Tacoma kathleennelson@fhshealth.org
Mary Sterhan North Valley Hospital Whitefish Mo msterhan@nvhosp.org
Michael.Murphy@providence.org
Mid-Valley Hospital
810 Jasmine
Omak, WA 98841
Phone (509) 826-1760
Fax (509) 826-7379
http://www.mvhealth.org/site/public/index.php
[[Map|http://maps.google.com/maps?f=q&hl=en&geocode=&q=Mid+Valley+Hospital++810+Jasmine,+Omak+WA+98841&ie=UTF8&ll=48.396275,-119.545391&spn=0.00224,0.004533&z=18&om=1]]
Mount Carmel Hospital
982 East Columbia
Colville, WA 99114
509.684.2561
http://www.mtcarmelhospital.org
http://extranet.mtcarmelhospital.org
[[Map|http://maps.google.com/maps?f=q&hl=en&geocode=&q=982+east+columbia,colville+WA+99114&sll=46.830202,-119.154372&sspn=0.009234,0.018132&ie=UTF8&z=16&iwloc=addr&om=1]]
[img[0001E|http://farm2.static.flickr.com/1054/761713661_efee617237_o.jpg][http://www.flickr.com/photos/9652272@N04/761713661]]
!@@color(red):Clinical Documentation@@
Training Manual
Meditech NUR Module
General Phase I
!!!Table of Contents
Introduction
Security and Confidentiality
CHARTING BY EXCEPTION (CBE)
KEYBOARD FUNCTIONS
VERB STRIP
SYMBOLS
Logging on:
Main Nursing Menu:
Integrated Desktop
Status Board
My List
Quick Admit
Admission :Allergies/Vaccinations Screen
Home Medications
Care Area Statement
Vital Signs
Document Notes:
Entering numerous vital signs:
Late Entries
Wrong Patient
Vital Signs Critical Care
Weight
Newborn Weight
Blood Glucose:
Intake/Output:
Output screens
IV Parenteral Fluid
IV Site Management Screen:
Change Status:
Blood Glucose:
Quick Admit 2
Iatric’s Visual Flowsheet
Print Custom Reports
!!!Introduction
Why computerized charting?
''Communication''
• Access to patient’s home medication list and allergy history as documented on previous hospitalizations in the region
• Care plans automatically built based on assessment of the patient
• Automatic referrals to social services, dietary, and chaplain
• Continuity of care with different hospitals and departments
• Less repetition and duplicate documentation
• Legibility in charting
''Safety''
• Automatic screenings identify high risk patient early
''Quality''
• Access to results and information quickly
• Continuity of care with different hospitals and departments
• Increased security and HIPPA compliance
• Track department statistics
''Expectations''
''Short-term expectations''
• Paper printed may increase during implementation and transition to computerized charting
• It will take you longer to chart while you learn the new system
• Learning and change may result in stress.
''Long-term expectations''
• Fewer papers to fill out
• Reduction in duplicate documentation
• Legible documentation
• Overall streamlined care with continuity of information
• Standardized information
!!!Security and Confidentiality
Now that information is readily available to all nurses and staff, it is important to keep patient confidentiality in mind, and only access information on patients for whom you are caring.
What is the policy on confidentiality?
Confidential information is intimate and private information (written, electronic, or spoken) that unauthorized or careless disclosure could be embarrassing, discriminating, causes undo hardships for the person whose information is shared without permission or knowledge. It is in violation of Health Insurance Portability and Accountability Act of 1996 regulations (HIPAA).
As a MCH employee you have a legal and ethical responsibility to protect the privacy rights of patients and employees.
Therefore, it is important to only access patients on a “need to know” basis.
Definition of “Need to know”.
Information about patients, customers, and employees should only be shared with those who need to know the information to perform their job. If an employee is not directly involved in caring for the patient the employee does not need that information.
If employees are involved, every precaution must be taken to give information only to those whose jobs are also directly impacted by the information. Friends and family members do not have an automatic right to an adult patient’s confidential information. Employees must have a patient’s approval before sharing information with anyone.
If in doubt about someone’s right to know, get the patient’s permission before sharing confidential information.
Individual Access:
You are liable / responsible for everything that is charted under your login. Your password is considered your electronic signature, SO DO NOT LEAVE A COMPUTER UNATTENDED WHILE YOU ARE LOGGED ON.
!!!CHARTING BY EXCEPTION (CBE)
This section is a general overview of patient documentation at Holy Family Hospital.
''CHARTING BY EXCEPTION''
• Mount Carmel Hospital uses Charting by Exception (CBE) as its nursing documentation system in the patient medical record
• CBE is premised on an assumption that the patient has experienced a normal response to all interventions unless an abnormal response is charted
• CBE reduces charting time, makes abnormal data more obvious, and it is a more efficient use of nursing time
!!!KEYBOARD FUNCTIONS
You will frequently use the function keys:
|F12|OK/File. Exits and files (saves) entries|
|Shift + F12|Hot key menu/magic menu|
|F11|Exits and does not file (deletes) entries|
|F10|Deletes line in current field (one at a time)|
|F9|Lookup key for a list of choices|
|F8|Page down (same as green arrow down) |
|Shift + F8|Access on-line Documentation|
|F7 |Page up (same as green arrow up) |
|F6|Takes you back to the previous field|
|F5|Auto fill (not always available)|
|Right Ctrl|Use to check multiple options at once|
For more function key options refer to the laminated function key strip
available on most computer keyboards in the department
!!!VERB STRIP
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|DocumentNow|charting at current time|
|DocumentInterv’s|allows you to change the time to document past assessments|
|PatientNotes|Enter patient notes – narrative nursing notes|
|AddIntervention|add an intervention|
|ViewProtocol|protocols (starred interventions) can be reviewed|
|ViewHistory|view history of documentation|
|SelectInterventions|Not now used|
''CLICK ON MORE AND YOU WILL SEE:''
|EditAdministrativeData |update allergies, diet, view data|
|ChangeStatus |changes status of interventions (i.e. active, complete, cancel)|
|ViewNotes|view narrative nurses notes|
|EnterOrders |ability to enter orders into meditech|
|ChangeDirections |allows you add narrative that pertains to interventions|
''SYMBOLS''
Symbol Definition
|:| Free Text|
|?| Yes / No|
|/| Look up list|
|+| Additional information*|
*~~can be accessed using “Shift F8” or clicking on binocular iconif there is a protocol to view on the computer via the “VP” function on the process intervention screen.~~
''up arrow'' or ''down arrow'' beside F9 look up box indicates you have chosen multiple items from the look up.
Logging on:
The first step in getting into the system is getting logged on. Every staff member should have signed the security agreement and been given a password. The first step is:
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Double Click on Meditech, NUI remote workstation
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During training: Chose #4 Test 5.4 APPLICATIONS
When you are documenting on an actual patient you will select #1 (LIVE 5.4)
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Use F9 look-up
Choose #1 DEA5.4A
Press ENTER
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Type in user ID and press ENTER. For Test: MCHNUR
Type in password and press ENTER. For Test: NURSES06
Once you are working in LIVE you will use your assigned user ID and the Password you have selected. If you have not used the system for a while you may need to verify you still have access prior to GO-LIVE. Call the help desk.
Main Nursing Menu:
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Description of Main Nursing Menu.
o Assessments = Direct access to patient assessments
o Process Interventions = Direct access to process intervention screens.
o Process Intervention by location = User can enter an intervention for all patients on a unit. For example, if a user (CCA) wanted to enter all the vital signs for a unit s/he would perform this activity through this intervention.
o PCI = Patient Care Inquiry. This module displays all results and transcription for a patient.
o Status Board = Most work is accomplished through this menu. This is where the user can see the list of patients for their unit and create their own patient list from here. Access to Process Interventions and Assessments through this screen.
o Visual Flowsheet = Allows user to see the work accomplished in a flowsheet format. This is a good place to check if work is completed for the shift. Access to Iatrics
o Reports = The clinical record and Glucose screen will automatically print each day. This screen allows user to print reports on demand. These will be available as data bases are completed.
The menu choices are based on your access assignments. Different staff may have different menu choices.
Click once on the Status Board.
Integrated Desktop
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o Allergies – allows the user to view patient allergies Process Intervention – access to process intervention screens. These screens are where patient interventions will be documented.
o Assessments – access to all unit specific assessments. This section will be added in Phase II of the Clinical Documentation implementation.
o My List – this function allows the user to create own patient list
o Pt Notes – direct access to patient notes. User can view, enter, edit, or undo patient notes from this screen.
o PCI – access to Patient Care Inquiry
o Admin Data – allows user to view Patient Administration data. Patient’s allergies and admin data needs to be updated through Process Intervention.
o Flow Shee t- allows the user to view/enter patient data in a different format which allows view of data over a specified time period.
o Print Report - access to print reports i.e. patient record, diabetic flow sheet
o E-Mail - access to MOX
o References – access to MicroMedex
Status Board
Brief description ~ this is a list of patients in assigned unit. Room in order lists patients. This is a base for moving to other screens to chart in.
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During Test, select Find Patient (bottom of screen) and enter test patient into the pop up window. When in GO-LIVE, the patients will automatically fill the status board.
Note the room, attending physician, patient status, account number, age, lab results, diet, activity, and last vital signs. HM Status
Note: If floating to a different unit, click on Location at bottom of screen to access the patients for that floor (F9 look-up).
My List
My List is a compilation of patients assigned for the day (i.e., instead of seeing all of the patients for the unit on your status board, you will only see the 4 or 5 that are assigned to you for your shift.)
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Use Manage List to add and remove patients from your list.
1. Click Manage List at the bottom of status board.
2. Enter your mnemonic in the USER box (may use F9 look-up function to find)
3. Press ENTER until you are in the first space in the Patient section
4. Select by patient or location. To find a patient, enter last, first name, partial last name, unit number, or account number in the pt field.
5. Or find patients by location. In patient column enter L for location, followed by a space and enter F9. Select department from the list. If department mnemonic known, enter it after the space instead of performing F9 look-up. Press right control key on selected highlighted patients.
6. Right arrow to File selection and F11 out of screen.
7. On the status board, click My List (may have to wait a few seconds while the status board updates).
8. Individual list will appear.
Note: If floating to a different unit, click on Location at bottom of screen to access the patients for that floor (F9 look-up). You can build My List from there.
Quick Admit
This function is to set up the online chart and initiate Erickson’s developmental stage. This is the first step in admitting a patient.
A quick admit is required for all patients that are new to the unit.
1. From the Status Board used the mouse to click on patient’s name.
2. The name is now highlighted.
3. Click on Process Intervention bar or type letter I.
4. Select AI menu.
5. Enter a “Q” in the query field and press F9 (Look Up).
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6. Make sure the Quick admit is highlighted or Checked (Right CTRL key).
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7. Press F12 once and then press F12 twice.
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8. New Admission? Type Y for yes, press ENTER.
9. Care area admitted to: Press F9 key to look-up option. Select appropriate number for department, press ENTER.
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10. Patient’s age: Press F9 key to look-up options. Select appropriate number for patient’s age, press ENTER.
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11. Enter “Y” and press ENTER
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Enter through this screen and press F12 and then ENTER.
Start Documenting
Highlight the Intervention you would like to document, enter DN and press ENTER.
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Admission :Allergies/Vaccinations Screen
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1. From Process Intervention menu scroll to Admission: Allergies/Vaccinations using the up () or down () key.
2. Enter DN to get into Admission: Allergies/Vaccinations.
NOTE: This information will flow from previous visits, but all admission meds and allergies must be verified by the RN. This information flows from any hospital that has Meditech and will automatically fill in. You must update this file with every admission.
There will be a query for pneumovax and a date when changes are made in the admin screen and should be in place when we go live.
3. Assess for allergies:
a. Assess for allergies to drugs, food and other substances. It is important to ask clarifying questions to determine the reaction to the substance. It is the role of the nurse to know and educate the patient about the difference between allergic reaction (e.g., hives, anaphylaxis) versus a side effect (e.g., nausea, rash). Substances that cause a true allergic reaction must not be given. Medications that cause side effects may need to be given if no substitutes are available to achieve desired response.
b. If no allergies, mark “NKA” in the fields Allergy #1, Latex Allergy, and Iodine Allergy. If this is a new admit with no allergies, press ENTER and NKA will default to these fields. This clearly communicates to pharmacy and other team members the assessment was completed.
c. If a new allergy is identified, enter the information with the response. F12 will file and send information to pharmacy.
d. Document MRSA and VRE history.
e. Document Pneumovax and Flu vaccine. Information will autofill, but must be verified.
Home Medications
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1. Answer questions in first section.
2. Complete medication information. First query is a look up query field – enter the first 2-3 letters of the medication name (generic or trade). Second query field is the medication name, it will auto populate if the med was found in the pharmacy database. If you could not find the medication in the database enter the name of the medication here.
3. This area is an autofill, if this information has been previously entered it will automatically populate.
4. If you are unable to complete a field and you have questions for the Pharmacy please enter “????” in the field before medication name.
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5. F12, you will be asked about home med history status:
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6. F12 to file.
Care Area Statement
Remember to Document the Care Area Statement. Simply highlight “Care Area Statement” enter DN for Document Now and then click on the “OK” button.
Vital Signs
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From Process Intervention screen scroll to Vital Signs.
Enter DN to Document Vital Signs for current date and time.
Enter DI to Document Interventions to a previous date and time.
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Change Date and Time as needed. Enter Y in OK field. Press ENTER.
Enter vital sign data and F12 to file.
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You can verify date and time change in left upper window.
Document Notes:
Enter Y to enter any notes about the patient’s intervention. Remember to only use charting by exception.
Documenting Notes:
o Notes can be accessed from the process intervention verb strip Patient Notes, at the end of certain screens and the integrated desktop Pt Notes.
o Notes can be entered through many screen options.
o Notes can only be edited or undone through Pt Notes on the process intervention on the verb strip.
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Entering numerous vital signs:
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1. Select Intervention by highlighting Vital Signs on Process Intervention screen.
2. Enter DI or click on Document Intervention on Verb Strip.
3. Enter Date and Time of the vitals you want to enter. Once completed enter Y in OK field and hit ENTER.
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4. A documentation loop will be created. Enter the data for each screen and enter N for next until all screens are completed. You can verify which screen you are on by looking at the top left of screen where date and time is displayed. Once task is completed enter E to exit Document Loop.
5. To verify if all entries have been completed select View History to check entries.
6. More than one intervention can be linked when performing this function.
Late Entries
This is designed to allow user to go into the appropriate screen and “back time” entries to the actual time the intervention was done.
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1. Highlight the intervention by using the up () or down () arrow keys.
2. Type in “DI” and ENTER for document intervention, or use the mouse and click once on “Document Intervention”.
3. Press ENTER to advance to the time box. Use the F10 key to line feed out the current time and type in the time intervention was done (use military time).
4. Press the ENTER key until the cursor is located in the “OK” box. Place a “Y” in the box and press ENTER.
5. Document data in the screen, press ENTER until the confirmation box appears. Press ENTER to file the data.
6. A message box will appear, press OK and the data is filed.
7.
Wrong Patient
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1. Highlight the intervention to be edited or undone on the Process Intervention screen.
2. Click View History on the Verb Strip or enter VH in the box and enter.
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3. Highlight the item to edit or undo.
o Edit – add or change information on the correct patient
o Undo – remove information that was entered on the wrong patient
4. Click on undo or edit or enter U or E.
5. Make change and F12 to file.
Vital Signs Critical Care
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From Process Intervention screen scroll to Vital Signs.
Enter DN to Document Vital Signs for current date and time.
Enter vital sign data and F12 to file.
Weight
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1. From the Process Intervention screen scroll down to highlight Weight.
2. Type in DN or click on Document Now to enter current intervention.
3. Or enter DI or click on Document Intervention to document past intervention.
4. Once data is complete press F12 to file.
Weight differences will automatically calculate.
Newborn Weight
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This screen will be used in OB or Post Partum.
Let us know if you need further instruction for this screen.
Blood Glucose:
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1. From Process Intervention screen scroll to Assess Blood Glucose using () or () arrow key.
2. Type DN for Document Now.
3. Type DI to document an earlier time.
4. Type in patient’s blood glucose information.
5. Press F12 key to file.
6. Click OK when prompted to verify.
Change status:
If the patient you are caring for does not need this screen you can remove this from the Process Intervention list by Changing the Status. See page 29.
Intake/Output:
The Intake/Output screens are where the patient’s intake and output are documented. This function keeps a running total of all the I&O charted in the screens.
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Intake:
1. From Process Intervention screen, scroll to Intake/Output using up () or down () arrow key.
2. Type in DN and ENTER for document now.
3. Type patient’s intake in screen.
4. Press F12 key to file.
5. Click OK when prompted to verify.
The following fields are used to calculate Intake: PO Fluids, Free Water, T.F. Amount Infused and IV Parenteral amounts from IV Parenteral screen.
Output screens 1, 2 & 3:
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Remember to Press F9 for Dictionary Look Up
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Recall function:
If the previous user has entered information in any of the I&O fields the user can click function key F5 to recall the previous entry. (i.e., instead of reentering JP drain, F5 to recall the JP output).
The following fields are used to calculate Output: #1 and #2 Irrigation fields, Voided Amount, Urine Amount #1 and #2, GI Amount #1 and #2, Drain Amounts and CT amounts.
IV Parenteral Fluid
This screen tracks IV input, solution, site, tubing, titration, infusion, and rate.
When using this form think of it as one line/one solution. Complete the Infused portion only when clearing the pump or completing a bag of fluid.
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1. From Process Intervention screen, scroll to Intake IV Parenteral using up () or down () arrow key.
2. Type DN for document now or DI to type in appropriate time.
3. Type in patient’s parenteral information.
4. Press F12 to file.
5. Click “Y” when prompted to verify.
Note: The infused box is the only amount that adds to the intake total. If changing solutions, total the pump and enter the infused amount and file F12. Go back in and delete the old solution and enter the new, change the ml/hr (rate), if needed and file F12.
IV Site Management Screen:
0040E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
1. From Process Intervention screen, scroll down to IV Site.
2. Type DN for document now or DI to type in appropriate time.
3. Type in patient’s information.
4. If documenting PICC information, F8 to go to end of first screen to open 2nd screen.
5. Select F12 to file.
6. Click Y when prompted to verify.
EVR = Extended vein routine (reflects MCH protocol).
Change Status:
0041E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
Choices:
A Active
C Complete
H Hold
I Inactive
X Cancel (think twice before using this one, maybe even three times)
Directions:
1. Scroll using the () or () arrow key to the intervention you want to change.
2. Type CS for Change Status.
3. Select desired option from F9 look-up.
4. Select C for complete (if you are no longer charting on it).
5. Press ENTER.
6. When prompted to file, type Y for yes or click Yes.
7. Letter will change to C in status column for completed intervention.
NOTE: The A (active) and I (inactive) will be most commonly used to change the status to/from active/inactive. The X (cancel) or C (complete) can be used when a duplicate intervention is added.
Blood Glucose:
0042E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
7. From Process Intervention screen scroll to Assess Blood Glucose using () or () arrow key.
8. Type DN for Document Now.
9. Type DI to document an earlier time.
10. Type in patient’s blood glucose information.
11. Press F12 key to file.
12. Click OK when prompted to verify.
Change status:
If the patient you are caring for does not need this screen you can remove this from the Process Intervention list by Changing the Status. See page 29.
Quick Admit 2
As with most programs there is more than one way to get a job done right. Here is an alternate way to do the “Quick Admit”
A quick admit is required for all patients that are new to the unit.
12. From the Status Board used the mouse to click on patient’s name.
13. The name is now highlighted.
14. Click on Assessment bar or type letter A.
15. Select Enter Form from Patient Form Functions menu.
16. Use the right arrow key () to make selection.
0043E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
17. Select A Quick Admit from Select Assessment menu.
18. Use the right arrow key () to make selection.
0044E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
19. New Admission? Type Y for yes, press ENTER.
A Quick Admit (cont’d)
0045E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
20. Care area admitted to: Press F9 key to look-up option. Select appropriate number for department, press ENTER.
0046E[img[0002E|http://farm2.static.flickr.com/1055/761713567_598e67350b_o.jpg][http://www.flickr.com/photos/9652272@N04/761713567/]]
21. Patient’s age: Press F9 key to look-up options. Select appropriate number for patient’s age, press ENTER.
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Printable: [[PDF|http://www.divshare.com/download/1173754-3be]]
Voice Thread: http://voicethread.com/view.php?b=3107
!Assessment: Phase I (Recovery,PAR,PACU)
From the NUR Status Board highlight the patient you are assessing. Click on the Process Interventions button. If Intervention Assessment: Phase II is not there Quick admit the Patient to the Location Surgical Services. Highlight Assessment: Phase II and DN.
The first field is to clear previous documentation. Use this field if you are starting a ''New'' Phase II recovery and there is data already in the fields or if the flow section on the same recovery is ''full'' and you need to document for an extended amount of time. Enter the arrival time.
[img[0001D|http://farm2.static.flickr.com/1399/740613616_0ee561e3d5.jpg?v=0]]
Each additional field may be recalled by pressing F5. If you do not agree with the previous assessment simply change the data. To enter an Anesthesia care provider, type the first three letters of the last name and the first two letters of the first name.
To enter an RN type “\name” where name=the RNs last name. Or, type in the RNs mnemonic i.e. PAH9
[img[0002D|http://farm2.static.flickr.com/1145/740613602_9234786510.jpg?v=0]]
Enter the wound site(s). Enter a “Y” or “N” for Drains/Tubes and Chest Tubes.
Assess the Urinary system of the patient.
[img[0003D|http://farm2.static.flickr.com/1021/740613586_0ab34eed5e.jpg?v=0]]
Enter the drains and tubes.
[img[0004D|http://farm2.static.flickr.com/1312/740613572_573ad52dfa.jpg?v=0]]
Enter the Chest tubes if applicable.
[img[0005D|http://farm2.static.flickr.com/1180/739744513_1bbe8644e0.jpg?v=0]]
This is the flow section of the Phase II documentation. The arrival time was documented on the first screen. Each column represents a 15 minute time interval starting from the documented time of arrival. Each field has an associated look-up “F9”.
[img[0006D|http://farm2.static.flickr.com/1329/739744493_e0acfaf613.jpg?v=0]]
Page down to continue the assessment.
Continue documenting on the 2nd page of the flow section of the assessment
[img[0007D|http://farm2.static.flickr.com/1417/739744433_182c8a4a45.jpg?v=0]]
Page up to enter the next 15 minute assessment.
When ordered by the Physician and when Discharge Criteria are met complete the Discharge section of the Phase II assessment.
[img[0008D|http://farm2.static.flickr.com/1405/739744421_194502c962.jpg?v=0]]
Printable: [[PDF|http://www.divshare.com/download/1173756-b61]]
Voice Thread: http://voicethread.com/view.php?b=3110
!Assessment: Phase II (Recovery)
From the NUR Status Board highlight the patient you are assessing. Click on the Process Interventions button. If Intervention Assessment: Phase II is not there Quick admit the Patient to the Location Surgical Services. Highlight Assessment: Phase II and DN.
First you will notice at the top of the screen shots that many of the screens say "Phase I" - not to worry, Phase I and Phase II recovery have some common screens.
The first field is to clear previous documentation. Use this field if you are starting a New Phase II recovery or if the flow section on the same recovery is full an you need to document for an extended amount of time. Enter the arrival time.
[img[0001D|http://farm2.static.flickr.com/1399/740613616_0ee561e3d5.jpg?v=0]]
Each additional field may be recalled by pressing F5. If you do not agree with the previous assessment simply change the data. To enter an Anesthesia care provider, type the first three letters of the last name and the first two letters of the first name.
To enter an RN type “\name” where name=the RNs last name. Or, type in the RNs mnemonic i.e. PAH9
[img[0002D|http://farm2.static.flickr.com/1145/740613602_9234786510.jpg?v=0]]
Enter the wound site(s). Enter a “Y” or “N” for Drains/Tubes and Chest Tubes.
Assess the Urinary system of the patient.
[img[0003D|http://farm2.static.flickr.com/1021/740613586_0ab34eed5e.jpg?v=0]]
Enter the drains and tubes.
[img[0004D|http://farm2.static.flickr.com/1312/740613572_573ad52dfa.jpg?v=0]]
Enter the Chest tubes if applicable.
[img[0005D|http://farm2.static.flickr.com/1180/739744513_1bbe8644e0.jpg?v=0]]
This is the flow section of the Phase II documentation. The arrival time was documented on the first screen. Each column represents a 15 minute time interval starting from the documented time of arrival. Each field has an associated look-up “F9”.
[img[0006D|http://farm2.static.flickr.com/1329/739744493_e0acfaf613.jpg?v=0]]
Page down to continue the assessment.
Continue documenting on the 2nd page of the flow section of the assessment
[img[0009D|http://farm2.static.flickr.com/1035/739744409_c241de4a5d.jpg?v=0]]
Page up to enter the next 15 minute assessment.
When ordered by the Physician and when Discharge Criteria are met complete the Discharge section of the Phase II assessment.
[img[0010D|http://farm2.static.flickr.com/1365/739744341_7fe56afcef.jpg?v=0]]
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Hi All,
EnumclawCommunityHospital would like to extend an invite to all the members of the newly formed Rural Computer Group to a group meeting at Enumclaw Hospital on October 5th starting at 0900 and continuing into the afternoon. We will try to finish up early so members can begin the trek home not too late. Or you might consider staying over and exploring the area. Let me know if you want ideas of things to do around here. Breakfast and Lunch will be provided. Please RSVP before September 21st.
I suggest we start an agenda of issues we would like to discuss. Please email me with your issues and I will start tracking them. Have a great week-end. Shelly
Shelly Pricco Nurse Manager
EnumclawCommunityHospital
1450 Battersby Ave.
POB 218
Enumclaw, WA 98022
360-802-3294
Shelly.Pricco@EnumclawHospital.org
!Agenda Items
# INHS Analyst / Individual Hospital Relations ''versus'' INHS / Collective Rural Hospital Relations
Othello Community Hospital
315 North 14th Ave
Othello, WA 99344
Phone:(509)488-2636, Fax:(509)311-2617
http://www.othellocommunityhospital.org/
[[Map |http://maps.google.com/maps?f=q&hl=en&geocode=&q=315+North+14th+Ave,+Othello+WA+99163&sll=46.712973,-117.168819&sspn=0.002314,0.004533&ie=UTF8&z=16&iwloc=addr&om=1]]
Pullman Regional Hospital:
835 SE Bishop Boulevard
Pullman, WA 99163
509-332-2541, Fax: 509-332-6767
http://www.pullmanhospital.org/
[[Map|http://maps.google.com/maps?f=q&hl=en&geocode=&q=835+SE+Bishop+Boulevard,+Pullman,+WA+99163&sll=47.208419,-121.988129&sspn=0.009169,0.018132&ie=UTF8&z=16&iwloc=addr&om=1]]
MountCarmelHospital
!PullmanTrainingManual
As a Reminder, ''eMAR'' stands for:
''e''lectronic every
''M''edication Medication
''A''dministration Always
''R''ecord Right
!!!BMV MANUAL
TABLE OF CONTENTS
Section 1: OBJECTIVES…………………………………………………..Page 3
Section 2: PATIENT SAFETY INIATIVE - BEDSIDE MEDICATION VERIFICATION……………………………………………………………..Page 3-4
Section 3: ACCESSING THE ELECTRONIC MAR……………………..Page 4-6
Section 4: MEDICATION SPECIFIC INSTRUCTIONS…….…………...Page 6-8
Section 5: ACKNOWLEDGE ORDERS (AO)……………………………Page 9 -12
Section 6: SCAN MEDICATIONS (SM)…………………………………..Page 13-14
Section 7: MEDICATION VARIANCE LIMIT……………………………..Page 15
Section 8: CUSTOMER DEFINED SCREEN…………………………….Page 16
Section 9: FULL DOCUMENT (FD)……………………………………….Page 16-18
Section 10: EDIT DOCUMENT (ED)……………………………………...Page 18-19
Section 11: UNDO DOCUMENT (UD)……………………………………Page 19-21
Section 12: ADDITIONAL VERB STRIP OPTIONS…………………….Page 21-22
Section 13: 24 HOUR MAR CHECK……………………………………...Page 22
Section 14: TROUBLE SHOOTING………………………………………Page 23
Section 1: OBJECTIVES
1. Understand and explain the purpose and uses of Bedside Medication Verification (BMV) and electronic Medication Administration Record (eMAR)
2. Understand and perform the BMV / eMAR processes used in administration of medications.
a. Scan Med (SM)
b. Acknowledge Order (AO)
3. Understand additional functions of the verb strip options, including:
a. Recompile Screen (RS)
b. View Comments (VC)
c. Patient Notes (PN)
d. Full Document (FD)
e. Edit Document (ED)
f. Undo Document (UD)
g. Drug Information (DI)
h. Sort Orders (SO)
i. DC Order (DO)
j. View Order <Right Arrow>
4. Understand the different Status flags for medications.
5. Understand the reports available and where to find them on the menu, and when to print them.
6. Understand the various screens, warnings, and alerts that will be encountered with the use of BMV
7. Understand the process for downtime.
Section 2: PATIENT SAFETY INITIATIVE – BEDSIDE MEDICATION VERIFICATION
• At Mount Carmel Hospital, we are committed to providing exceptional clinical care. The Bedside Medication Verification (BMV) project is an effort to ensure that we are using the best practices demonstrated for medication administration.
• Mount Carmel Hospital is implementing BMV with bar coding of the patient’s ID band and medications. The medication and the patient will be scanned at the time of medication administration. The electronic MAR will allow real-time documentation and viewing of medication administration, monitoring information, alerts and automatic verification of the “Five Rights”.
• While BMV is primarily for patient safety and not clinician convenience, there are some added benefits. Some of these include:
-Automatic confirmation of the 5 rights of drug administration with the addition of 2 new rights – right start time and right stop time
-Increased awareness of medication variances
-Increased awareness of drug-drug interactions
-Increased awareness of relevant lab result
-Prompt for required data
-Increased communication between RN, RT, and Pharmacy
-Increased patient satisfaction (literature shows that patients perceive nurses spending more time at their bedside)
-Decreased duplication of work practices
-Drug information readily available in the BMV MAR
• Computer equipment utilizing wireless technology, bar-code scanners and rolling carts will allow bedside verification and documentation of medication administration.
• The goal of the BMV project is to improve Patient Safety by reducing medication errors that occur at the time of medication dispensing and administration. Literature shows that there is a 50-90% reduction in errors with the implementation of BMV. Using barcode scanners to document medication administrations increases patient safety because it allows health care providers to immediately verify they are giving the correct medications and doses to patients.
Section 3: Accessing the Electronic MAR
1. Sign into Meditech
2. Choose Test 5.5A, #3
3. F9 look-up and choose #1 DEA 5.5
4. User ID: MCHNUR, User Password: NURSES08
5. Choose -UR.MCH NUR MCH FACILITY **TEST**
6. Click on the status board icon
7. Highlight your patient name
8. There are 4 ways to access a patient MAR
• From the status board, click on the MAR tab or type “M”
• From the status board, click on the medication in the “next meds” column. This will give you a quick view of the late meds (in red) for the past 12 hours, and meds due (in black) in the next 12 hours. Click on the MAR tab.
• From the Process Intervention (I) tab, select Process Medications (PM) from the verb strip \
• From the Visual Flow Sheet on the Medications
The following screen will appear:
PICBMV1
9. The Process Medication (PM) screen represents the patient MAR. It allows you to view the medications for your patient arranged in order of next administration date & time.
10. This screen also allows you to view your patient’s height and weight, admitting diagnosis and your patient’s allergies as entered by pharmacy and nursing. If you cannot view all of the information contained in this box use the “Page Up” key to allow your cursor access to this part of the screen. To scroll through the information, use the up and down arrow keys. To exit this part of the screen, use the <enter> key.
11. You can view an order on any medication in this screen by highlighting the medication and using your right arrow key. This displays the pharmacy order. By viewing the order, you can also view any duplicate orders, interactions, administrations and alerts. Close this screen with the left arrow key
PICBMV2
Section 4: MEDICATION SPECIFIC INSTRUCTIONS
(Horizontal strip located above medication list)
Prompt Meaning
Dose Inst * Dose Instructions have been entered for medication highlighted. The first line is viewable under Dose/Rate MAR column, but to view more info, press the <right arrow> key.
Special Inst Seldom used. Pharmacy will use the medication “Label comments” for instructions
PRN Rsn This identifies the reason the PRN medication has been ordered. PRN is entered on the medication order in the pharmacy.
Taper Medications have a tapered schedule if the administered dose decreases over time. Ex. Prednisone is often ordered with a large initial dose that decreases over time.
Admin Crit Administration Criteria are instructions on how to administer the medication. Ex. Insulin will often have an Admin Crit based on a sliding scale. Pharmacy will put this info in “Label comments”.
Linked Order * * Other medication(s) have been linked to the medication highlighted. Each medication will have the same number indicating they are linked. Ex. Demerol and Vistaril would both have the Link Order 1.
MAR COLUMNS
A * Indicates the order has been Acknowledged. No * - order needs to be Acknowledged.
Medication Identifies the medication name and strength. Generic names are displayed.
Dose/Rate Indicates the Dose to be given or the Rate to be infused.
Sig/SCH Indicates how often medication is to be given.
Route Indicates the Route the med is or can be given.
C • L – Label comments
• A – Administration comments
• B – Both Label and Admin. comments
Always read these comments by highlighting the med and pressing the <right arrow> key.
Last Doc Last date/time medication was documented as given.
Next Admin Next date/time medication is scheduled to be given
Status Status of medication – see status section
Medication Status
Status Description
*** More than one action has been taken on the order by pharmacy.
*DC Discontinue requested by user (RN or RT).
DC Discontinue by pharmacy, no * in A column – user must acknowledge DC’s. DC’d meds will remain on the eMAR for 1 hour.
FDC Fix discontinue by pharmacy (order DC’d in error and fixed).
E Order edited by pharmacy – no * in A column - user must acknowledge edits.
*HA User holds acknowledgement
ADJ Adjusted by pharmacy – no * in A column – user must acknowledge the adjustment.
CKD Indicates dosage/indication warning was generated in pharmacy when order was entered. Viewable in warning section of order.
Anytime Pharmacy acts on a request by the user, the order must be acknowledged before it can be administered.
Section 5: Acknowledge Orders (AO)
1. All new medication orders entered and any order a pharmacist has edited requires acknowledgement by a nurse or respiratory therapist before medication administration. Acknowledging an order is the process verifying correctness that the physician’s written medication order matches the order entered by the pharmacy.
PICBMV3
2. Identify the meds that require acknowledgement by highlighting the med and check with the right control key or by clicking on the * in the right vertical tools column (if all the meds require acknowledgement use the shift and right control key to check all listed medications or click the “check all” in the right vertical tools column).
3. Click on Acknowledge Orders from the verb strip or type AO and press the <Enter> key.
4. If multiple meds are selected, the following appears:
PICBMV4
5. Acknowledged - to acknowledge only the orders that are checked and have already been acknowledged. If an order is not already acknowledged, it will not display even if it has been checked.
6. Requiring Ack – to acknowledge only those orders checked that require acknowledgement. If the order is checked and has already been acknowledged, it will not display.
7. Both – to acknowledge all orders checked whether they require acknowledgement or not. This is the default.
8. None – to exit and not acknowledge any orders that are checked.
The next screen displays for each of the meds needing Acknowledgement, whether selected individually or as a group:
PICBMV5
9. This displays all the information about the med as it was entered by Pharmacy. (Contraindications and allergies are also displayed on this screen).
• Verify the order was entered correctly
• Include the start/stop date/times
• Compare the order information against the written order in chart
10. You must compare the physician’s order with the MAR before acknowledging orders!
11. Press <Enter>. The following screen will appear at the bottom of the screen:
PICBMV6
12. An A for Acknowledge defaults on this screen. If you wish to acknowledge the order, press the <Enter> key. Each med will have to be reviewed and acknowledged.
• A Acknowledge
• H Hold
• E Exit – Takes you out of screen to next med. screen
• S Stop – Takes you out of screen to Process Medication screen
13. If the med is not correct, backspace to clear A, select “H” for Hold Acknowledgement and enter the reason the med is being held.
PICBMV7
14. You may still administer this med but a warning will tell you that this order is currently on hold. If you choose to administer this med, you must remove the hold.
PICBMV8
PICBMV9
15. After all medications have been acknowledged, the screen will go back to the MAR and an asterisk will appear in the “A” column next to the medication to show that they have been acknowledged.
PICBMV
16. Remove all check marks with “shift, Rt. Control” or click the “Check all” in the right vertical tools bar of the screen.
Section 6: Scan Medication (SM)
1. Use this routine to document medication administrations using a barcode scanner. Type SM (Scan Med) and press <Enter> or click “Scan Med” on the verb strip. The highlight bar does not have to be on any certain med when you type SM as the system will find the scanned med if it is on the current MAR.
2. Scan all of the meds you wish to administer at this time. The bar code number will appear in a box on the bottom of the screen, a checkmark will appear next to the medication and the medication will be highlighted. The system verifies the following information:
-the patient has an order for the medication
-the dose of the medication you scanned equals the ordered dose
-the order is acknowledged
-you have the authorization required to administer the medication
PICBMV10
3. If the scanned dose is higher than the ordered dose, a screen appears for the user to document the actual dose being administered.
4. If the scanned dose is lower than the ordered dose, a screen appears allowing you to scan the additional dose to equal the ordered dose. If you administered a dose lower than the ordered dose, enter an override comment. For example, Tylenol 650 mg is ordered, but they only come in a 325 mg tab. You would need to scan both 325 mg tabs to equal the 650 mg ordered.
PICBMV11
5. Meds are to be scanned at the patient bedside prior to removing from bar coded packaging. If a patient has a combination drug order (for example, HCTZ and Triamterene make up Maxide), these drugs will be linked in the MAR and you must scan both medications.
6. Once you have scanned the meds you want to give press <F12>. If a medication you have scanned is missing information, the Full Document screen appears. Enter the required information in the Full Document screen (for example, you may need to document the site of an injection).
The Verify Patient screen will appear next.
PICBMV12
7. Scan the patient’s armband – Scan the longer barcode this is the patient’s account number.
8. The final step is to enter your password. This ensures that all safety checks have been completed and medication is ready to be administered.
9. Once medications are administered, they fall in order of next scheduled due date/time on the MAR.
Section 7: Medication Variance Limit
1. If the medication is being administered outside the acceptable window (one hour before and one hour after the scheduled time), the following warning appears.
PICBMV13
This information is just to keep track of variances.
2. Answer Y to continue.
3. The next screen shows the scheduled time (if an additional dose, it shows “Non-scheduled” – refer to Full Document section), actual administration time, given box, reason code box, and comment box. Enter to the Reason box. F9 and select a reason. If you need to type in a comment, type “Y” in the Comment column and enter a comment. Press <Enter>. Press <Enter> again to verify file.
PICBMV14
4. This will take you to the next med. Enter the information for all of the meds if needed.
5. If using a reason code of “Other” or “Clinical Judgement”, make a comment to be more specific. It is also O.K. to say that you were busy with another patient (prioritizing patient care).
Section 8: Customer Defined Screens
Customer Defined Screens (CDS) are pop up screens that are attached to specific medications in which a lab result is or assessment is pertinent. The most recent lab result is recorded on this screen. The following medications have a CDS screen attached:
Lab CDS Screens
Digoxin = dig level, pulse
Dilantin = dilantin level
Coumadin = INR
Heparin = PTT
IV Potassium = Potassium
and Creatinine Clearance
PO Potassium = Potassium
Vaccines = Lot number
and expiration date
BP Med - BP
PICBMV15
Section 9: Full Document (FD)
The FD routine should be used only in the following circumstances:
• When the medication barcode will not scan (remember to verify the patient name and birthday prior to administration).
• When a medication has to be given urgently (i.e. Narcan).
• When documenting a medication that was not given.
The Full Document routine should be the exception rather than the rule. You MUST use the Scan Med function whenever possible. This guarantees automatic confirmation of the 5 rights of medication administration.
This function should not be used when the armband will not scan. You must print a new armband .
1. Type FD: The following screen appears.
PICBMV16
2. The scheduled dates/times lookup appears. It is very important that you choose the correct scheduled date and time for the dose you are administering. It will not necessarily be the first choice. Taking doses out of order will impact future doses.
3. If you are going to document a medication that is non-scheduled (such as an extra “now” dose), enter through this screen without selecting a scheduled time. “Non-scheduled” will appear in the Date Time column.
4. If a medication is not given, you will backspace to eliminate the Y under the Gvn column and enter N. A reason code is required when documenting medications that are not given. Use the F9 key to look up reason codes.
PICBMV17
5. If you document a dose as not given, the date and time of the dose is highlighted in blue on the Process Medications screen. The date and time are highlighted only if the last documented dose was recorded as not given.
6. It is important to remember that the safety mechanisms of scanning the medication and scanning the patient do not occur when using the FD (Full Document) routine.
Section 10: Edit Document (ED)
1. Use the Edit Documentation (ED) to edit administration information for a medication. With this function the patient is still charged by pharmacy for the medication.
2. Place the highlight bar on the desired med and press “ED” and <Enter>. A lookup of all the recorded administered doses will come up. Select the event to edit. You may make edits to:
• Whether a user gave the selected dose to the patient
• Administration date and/or time
• Reason code
• Site
• Comments
3. You may only edit your own documentation.
PICBMV18
***Make sure you edit the correct medication event occurrence***
Section 11: Undo Document (UD)
1. Use the Undo Document (UD) to undo all administration information for a previously documented dose that was not actually given. It releases that dose to be given again.
2. Place the highlight bar on the medication you wish to undo and press “UD” and <Enter>. You must enter a reason/comment for undoing this documentation.
3. Full Document to allow a scheduled medicine to drop to the next scheduled time.
Continued Next Page
4. If a patient received an incorrect dose, you must fill out a Quality Assurance Memo.
PICBMV19
5. Enter your comments and press the F12 key to file.
6. A lookup of all administration times associated with the highlighted med will appear.
PICBMV20
7. Before answering YES, double check medication and event date and time for correctness.
PICBMV21
***Make sure you undo the correct medication event occurrence***
There is an Edit and Undo Documentation cut off date parameter that will not allow the user to back document more than 5 days.
8. Only Nurse Managers, Directors and select Super Users will have the ability to undo for others. Everyone will have access to edit/undo his or her own documentation, just like NUR.
Section 12: Additional Verb Strip Options
1. Drug Information (DI) takes you to Lexi Comp.
Use this function to perform the following tasks:
-check interactions
-print monographs
2. Patient Note (PN)
This is another way to access the patient notes in NUR
3. View Order (VO)
This is another way to view an order on a medication
4. View Comment (VC)
This is how you can view comments written on specific medications
5. Sort Order (SO)
This routine allows you to view medications discontinued in the past and medications with future start dates and times so the user can acknowledge a med that is ordered in the future.
6. DC Order (DO)
Use this routine to discontinue an order as written by the doctor. It will not be removed from a MAR until it is discontinued by pharmacy. Discontinued meds will stay on your electronic MAR for 1 hour after discontinued by pharmacy.
7. Batch Document (BD)
Use this routine when you want to document the same reason code on medications with the exact same administration time. For example, you may want to say the patient took all their 0900 meds prior to admission or patient is NPO and no medications were given.
Section 13: 12 HOUR MAR CHECKS
1. Using the Sort Order function, enter down to “From Date” and backdate it one day (T-1 works here) with a time of 0000.
2. Enter to the “Thru Date” and future date it 30 days (T+30). This ensures that you will capture all medications with a future start date. Enter a time of 2359.
3. F12 and file.
4. View each new medication order written in the past 12 hours by highlighting the medication and using the right arrow key to enter in to each medication.
5. When you have verified all new medication orders, you may F11 out of the MAR. Sign off on your 12 hour chart check with a red pen, date, time, and signature in the physician order section of the patient’s hard chart.
Section 14: Trouble Shooting Guide
1. If medication barcode does not scan
• Make sure cap locks are on
• Make sure you have told the computer to “Scan Med”
• If an IV bag will not scan, make sure that you lay it down on a surface. Try covering barcode with non-glaring tape.
• If a medication will still not scan use the “Full Document” routine. Return the intact barcoded package to pharmacy for review.
• Be sure to put in a reason code as to why you are not scanning a medication
2. If patient barcode does not scan
• Flatten the armband on the patient’s wrist. Try covering with non-glaring tape.
• If a patient armband will still not scan a new armband must be printed
3. Patient unit number does not match warning
• Verify that you are scanning the correct patient
4. Medication not on the current MAR warning
• Verify the medication package against the patient’s medication profile displayed. Pay particular attention to the drug package vs. the medication profile such as whether there is a difference related to extended release, enteric coated, long acting, etc.
5. Scheduled med time not defaulting in
• If scheduled med time for med administration does not appear on the Process Medications screen, make sure someone has not documented your time by mistake. You may check this by using the right arrow key and viewing the history on the medication.
• If someone has documented your time by mistake, you may use the non-scheduled routine. Be sure to enter a comment.
•
PICBMV22
6. Warning for Future Dated Orders
• If a warning appears when you scan a med that has a start date for the future, this indicates you may be attempting to give a medication before its start date.
• Before answering yes, please verify the medication order on the chart and the entered start date and time. You may give the med but an override comment is required.
SMTP:christrk@mox.inhs.org
Printable: [[PDF|http://www.divshare.com/download/1280425-53c]]
!Introduction to Restore Orders Feature:
The restore orders feature allows the user to restore orders from a previous visit. Upon discharge, orders for a patient that have procedures flagged as restorable will be saved in MRI.
The restore order function is available when the users access the Order Entry module.
!!Key Points about Restore Orders:
•Facility determines what procedures are restorable. This is set by the Order Entry Analyst.
•Facility determines how many days after discharge that orders from a previous account can be restored.
!!How Restore Orders Works:
1.User logs into the Order Entry Module and selects Enter Orders Routine.
2.User selects the patient they are going to restore orders for.
3.User is presented with the restorable orders screen:
[img[0001H|http://farm2.static.flickr.com/1197/830238836_1f54dc3271.jpg][http://www.flickr.com/photos/9652272@N04/830238836/]]
4.User will highlight account and hit the <CTRL> button to select account.
5.User will be presented with three options:
>a.Restore – will restore all orders.
>b.Cancel – will take the user out of the restore function and allow them to continue to enter orders.
>c.Don’t Ask Again – will not prompt future users with the restore screen again.
[img[0002H|http://farm2.static.flickr.com/1047/830238954_5db675c299.jpg][http://www.flickr.com/photos/9652272@N04/830238954/]]
6.If the user chooses to restore orders they will click on the restore button and the orders from the previous account will be displayed in Enter Orders screen. They will then:
>a.Cancel, change and delete orders.
>b.Enter a service time for the new orders.
>c.Fill in any necessary queries.
Hi Jim,
As we discussed, I'm attaching the document that gives an overview of Restore orders.
There are some gliches with this, when you restore orders they don't come up with tcorect service date. The date and time must be corrected.
Thanks
Barbara G Hill
Systems Analyst Order Entry
Information Resource Management
601 West 1st Avenue
Spokane WA 99201
phone 509-232-8226
cell 509-991-9058
fax 509-232-8289
GolladR@OthelloCommunityHospital.org
Samaritan Healthcare
801 E. Wheeler
Moses Lake, WA 98837
509)765-5606
http://www.samaritanhealthcare.com/
[[Map|http://maps.google.com/maps?f=l&hl=en&geocode=&q=samaritan+health+care&near=Moses+lake+WA&ie=UTF8&ll=47.129235,-119.2682&spn=0.009183,0.018132&z=16&om=1]]
shellypricco@fhshealth.org
[img[panorama|http://farm2.static.flickr.com/1385/859185897_707699a4a2_o.jpg][http://www.flickr.com/photos/9652272@N04/859185897/]]
Sunnyside Hospital
10th & Tacoma
Sunnyside, WA 98944
(509) 837-1500
http://www.sunnysidehospital.com/home.php
[[Map|http://maps.google.com/maps?f=q&hl=en&geocode=&q=Sunnyside+Community+Hospital,+Sunnyside+WA&sll=46.334129,-119.996796&sspn=0.298205,0.580215&ie=UTF8&z=16&iwloc=addr&om=1]]
@@SusanPowell@@ RN/Informatics nurse
MasonGeneralHospital, Shelton
Here is a test of the VoiceThread
<html>
<object width="800" height="600"><param name="movie" value="http://voicethread.com/book.swf?b=899"></param><param name="wmode" value="transparent"></param><embed src="http://voicethread.com/book.swf?b=899" type="application/x-shockwave-flash" wmode="transparent" width="800" height="600"></embed></object>
</a></html>
<html>
<object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" codebase="http://fpdownload.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=9,0,18,0" width="425" height="374" id="divflv"><param name="movie" value="http://www.divshare.com/flash/video?myId=1350508-a33" /><param name="allowFullScreen" value="true" /><embed src="http://www.divshare.com/flash/video?myId=1350508-a33" width="425" height="374" name="divflv" allowfullscreen="true" type="application/x-shockwave-flash" pluginspage="http://www.macromedia.com/go/getflashplayer"></embed></object>
</a></html>
BernseT@OthelloCommunityHospital.org
tina.glockner@sunnysidehospital.org
[[BMV]]
[[VFS]]
CannedText
Tri-State Memorial Hospital
1221 Highland Avenue, Box 189
Clarkston, WA 99403-0189
Phone: (509) 758-5511
Fax: (509) 758-3566
www.tristatehospital.org
Congressional District: 5
Legislative District: 9
Northeastern Washington Hospital Council
County: Asotin
Critical Access Hospital, 25 beds
/***
Contains the stuff you need to use Tiddlyspot
Note you must also have UploadPlugin installed
***/
//{{{
// edit this if you are migrating sites or retrofitting an existing TW
config.tiddlyspotSiteId = 'ruralcomputergroup';
// make it so you can by default see edit controls via http
config.options.chkHttpReadOnly = false;
window.readOnly = false; // make sure of it (for tw 2.2)
// disable autosave in d3
if (window.location.protocol != "file:")
config.options.chkGTDLazyAutoSave = false;
// tweak shadow tiddlers to add upload button, password entry box etc
with (config.shadowTiddlers) {
SiteUrl = 'http://'+config.tiddlyspotSiteId+'.tiddlyspot.com';
SideBarOptions = SideBarOptions.replace(/(<<saveChanges>>)/,"$1<<tiddler TspotSidebar>>");
OptionsPanel = OptionsPanel.replace(/^/,"<<tiddler TspotOptions>>");
DefaultTiddlers = DefaultTiddlers.replace(/^/,"[[Welcome to Tiddlyspot]] ");
MainMenu = MainMenu.replace(/^/,"[[Welcome to Tiddlyspot]] ");
}
// create some shadow tiddler content
merge(config.shadowTiddlers,{
'Welcome to Tiddlyspot':[
"This document is a ~TiddlyWiki from tiddlyspot.com. A ~TiddlyWiki is an electronic notebook that is great for managing todo lists, personal information, and all sorts of things.",
"",
"@@font-weight:bold;font-size:1.3em;color:#444; //What now?// @@ Before you can save any changes, you need to enter your password in the form below. Then configure privacy and other site settings at your [[control panel|http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/controlpanel]] (your control panel username is //" + config.tiddlyspotSiteId + "//).",
"<<tiddler TspotControls>>",
"See also GettingStarted.",
"",
"@@font-weight:bold;font-size:1.3em;color:#444; //Working online// @@ You can edit this ~TiddlyWiki right now, and save your changes using the \"save to web\" button in the column on the right.",
"",
"@@font-weight:bold;font-size:1.3em;color:#444; //Working offline// @@ A fully functioning copy of this ~TiddlyWiki can be saved onto your hard drive or USB stick. You can make changes and save them locally without being connected to the Internet. When you're ready to sync up again, just click \"upload\" and your ~TiddlyWiki will be saved back to tiddlyspot.com.",
"",
"@@font-weight:bold;font-size:1.3em;color:#444; //Help!// @@ Find out more about ~TiddlyWiki at [[TiddlyWiki.com|http://tiddlywiki.com]]. Also visit [[TiddlyWiki Guides|http://tiddlywikiguides.org]] for documentation on learning and using ~TiddlyWiki. New users are especially welcome on the [[TiddlyWiki mailing list|http://groups.google.com/group/TiddlyWiki]], which is an excellent place to ask questions and get help. If you have a tiddlyspot related problem email [[tiddlyspot support|mailto:support@tiddlyspot.com]].",
"",
"@@font-weight:bold;font-size:1.3em;color:#444; //Enjoy :)// @@ We hope you like using your tiddlyspot.com site. Please email [[feedback@tiddlyspot.com|mailto:feedback@tiddlyspot.com]] with any comments or suggestions."
].join("\n"),
'TspotControls':[
"| tiddlyspot password:|<<option pasUploadPassword>>|",
"| site management:|<<upload http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/store.cgi index.html . . " + config.tiddlyspotSiteId + ">>//(requires tiddlyspot password)//<<br>>[[control panel|http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/controlpanel]], [[download (go offline)|http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/download]]|",
"| links:|[[tiddlyspot.com|http://tiddlyspot.com/]], [[FAQs|http://faq.tiddlyspot.com/]], [[announcements|http://announce.tiddlyspot.com/]], [[blog|http://tiddlyspot.com/blog/]], email [[support|mailto:support@tiddlyspot.com]] & [[feedback|mailto:feedback@tiddlyspot.com]], [[donate|http://tiddlyspot.com/?page=donate]]|"
].join("\n"),
'TspotSidebar':[
"<<upload http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/store.cgi index.html . . " + config.tiddlyspotSiteId + ">><html><a href='http://" + config.tiddlyspotSiteId + ".tiddlyspot.com/download' class='button'>download</a></html>"
].join("\n"),
'TspotOptions':[
"tiddlyspot password:",
"<<option pasUploadPassword>>",
""
].join("\n")
});
//}}}
| !date | !user | !location | !storeUrl | !uploadDir | !toFilename | !backupdir | !origin |
| 02/04/2008 12:52:26 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . | ok |
| 03/04/2008 11:40:27 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . | ok |
| 03/04/2008 11:43:08 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . | ok |
| 03/04/2008 11:43:53 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
| 03/04/2008 11:45:55 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
| 16/04/2008 12:29:38 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
| 23/05/2008 07:56:09 | YourName | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . | ok |
| 23/05/2008 07:56:26 | YourName | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
| 02/09/2008 10:47:16 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
| 18/09/2008 12:44:33 | Jim Divis | [[/|http://ruralcomputergroup.tiddlyspot.com/]] | [[store.cgi|http://ruralcomputergroup.tiddlyspot.com/store.cgi]] | . | [[index.html | http://ruralcomputergroup.tiddlyspot.com/index.html]] | . |
/***
|''Name:''|PasswordOptionPlugin|
|''Description:''|Extends TiddlyWiki options with non encrypted password option.|
|''Version:''|1.0.2|
|''Date:''|Apr 19, 2007|
|''Source:''|http://tiddlywiki.bidix.info/#PasswordOptionPlugin|
|''Author:''|BidiX (BidiX (at) bidix (dot) info)|
|''License:''|[[BSD open source license|http://tiddlywiki.bidix.info/#%5B%5BBSD%20open%20source%20license%5D%5D ]]|
|''~CoreVersion:''|2.2.0 (Beta 5)|
***/
//{{{
version.extensions.PasswordOptionPlugin = {
major: 1, minor: 0, revision: 2,
date: new Date("Apr 19, 2007"),
source: 'http://tiddlywiki.bidix.info/#PasswordOptionPlugin',
author: 'BidiX (BidiX (at) bidix (dot) info',
license: '[[BSD open source license|http://tiddlywiki.bidix.info/#%5B%5BBSD%20open%20source%20license%5D%5D]]',
coreVersion: '2.2.0 (Beta 5)'
};
config.macros.option.passwordCheckboxLabel = "Save this password on this computer";
config.macros.option.passwordInputType = "password"; // password | text
setStylesheet(".pasOptionInput {width: 11em;}\n","passwordInputTypeStyle");
merge(config.macros.option.types, {
'pas': {
elementType: "input",
valueField: "value",
eventName: "onkeyup",
className: "pasOptionInput",
typeValue: config.macros.option.passwordInputType,
create: function(place,type,opt,className,desc) {
// password field
config.macros.option.genericCreate(place,'pas',opt,className,desc);
// checkbox linked with this password "save this password on this computer"
config.macros.option.genericCreate(place,'chk','chk'+opt,className,desc);
// text savePasswordCheckboxLabel
place.appendChild(document.createTextNode(config.macros.option.passwordCheckboxLabel));
},
onChange: config.macros.option.genericOnChange
}
});
merge(config.optionHandlers['chk'], {
get: function(name) {
// is there an option linked with this chk ?
var opt = name.substr(3);
if (config.options[opt])
saveOptionCookie(opt);
return config.options[name] ? "true" : "false";
}
});
merge(config.optionHandlers, {
'pas': {
get: function(name) {
if (config.options["chk"+name]) {
return encodeCookie(config.options[name].toString());
} else {
return "";
}
},
set: function(name,value) {config.options[name] = decodeCookie(value);}
}
});
// need to reload options to load passwordOptions
loadOptionsCookie();
/*
if (!config.options['pasPassword'])
config.options['pasPassword'] = '';
merge(config.optionsDesc,{
pasPassword: "Test password"
});
*/
//}}}
/***
|''Name:''|UploadPlugin|
|''Description:''|Save to web a TiddlyWiki|
|''Version:''|4.1.0|
|''Date:''|May 5, 2007|
|''Source:''|http://tiddlywiki.bidix.info/#UploadPlugin|
|''Documentation:''|http://tiddlywiki.bidix.info/#UploadPluginDoc|
|''Author:''|BidiX (BidiX (at) bidix (dot) info)|
|''License:''|[[BSD open source license|http://tiddlywiki.bidix.info/#%5B%5BBSD%20open%20source%20license%5D%5D ]]|
|''~CoreVersion:''|2.2.0 (#3125)|
|''Requires:''|PasswordOptionPlugin|
***/
//{{{
version.extensions.UploadPlugin = {
major: 4, minor: 1, revision: 0,
date: new Date("May 5, 2007"),
source: 'http://tiddlywiki.bidix.info/#UploadPlugin',
author: 'BidiX (BidiX (at) bidix (dot) info',
coreVersion: '2.2.0 (#3125)'
};
//
// Environment
//
if (!window.bidix) window.bidix = {}; // bidix namespace
bidix.debugMode = false; // true to activate both in Plugin and UploadService
//
// Upload Macro
//
config.macros.upload = {
// default values
defaultBackupDir: '', //no backup
defaultStoreScript: "store.php",
defaultToFilename: "index.html",
defaultUploadDir: ".",
authenticateUser: true // UploadService Authenticate User
};
config.macros.upload.label = {
promptOption: "Save and Upload this TiddlyWiki with UploadOptions",
promptParamMacro: "Save and Upload this TiddlyWiki in %0",
saveLabel: "save to web",
saveToDisk: "save to disk",
uploadLabel: "upload"
};
config.macros.upload.messages = {
noStoreUrl: "No store URL in parmeters or options",
usernameOrPasswordMissing: "Username or password missing"
};
config.macros.upload.handler = function(place,macroName,params) {
if (readOnly)
return;
var label;
if (document.location.toString().substr(0,4) == "http")
label = this.label.saveLabel;
else
label = this.label.uploadLabel;
var prompt;
if (params[0]) {
prompt = this.label.promptParamMacro.toString().format([this.destFile(params[0],
(params[1] ? params[1]:bidix.basename(window.location.toString())), params[3])]);
} else {
prompt = this.label.promptOption;
}
createTiddlyButton(place, label, prompt, function() {config.macros.upload.action(params);}, null, null, this.accessKey);
};
config.macros.upload.action = function(params)
{
// for missing macro parameter set value from options
var storeUrl = params[0] ? params[0] : config.options.txtUploadStoreUrl;
var toFilename = params[1] ? params[1] : config.options.txtUploadFilename;
var backupDir = params[2] ? params[2] : config.options.txtUploadBackupDir;
var uploadDir = params[3] ? params[3] : config.options.txtUploadDir;
var username = params[4] ? params[4] : config.options.txtUploadUserName;
var password = config.options.pasUploadPassword; // for security reason no password as macro parameter
// for still missing parameter set default value
if ((!storeUrl) && (document.location.toString().substr(0,4) == "http"))
storeUrl = bidix.dirname(document.location.toString())+'/'+config.macros.upload.defaultStoreScript;
if (storeUrl.substr(0,4) != "http")
storeUrl = bidix.dirname(document.location.toString()) +'/'+ storeUrl;
if (!toFilename)
toFilename = bidix.basename(window.location.toString());
if (!toFilename)
toFilename = config.macros.upload.defaultToFilename;
if (!uploadDir)
uploadDir = config.macros.upload.defaultUploadDir;
if (!backupDir)
backupDir = config.macros.upload.defaultBackupDir;
// report error if still missing
if (!storeUrl) {
alert(config.macros.upload.messages.noStoreUrl);
clearMessage();
return false;
}
if (config.macros.upload.authenticateUser && (!username || !password)) {
alert(config.macros.upload.messages.usernameOrPasswordMissing);
clearMessage();
return false;
}
bidix.upload.uploadChanges(false,null,storeUrl, toFilename, uploadDir, backupDir, username, password);
return false;
};
config.macros.upload.destFile = function(storeUrl, toFilename, uploadDir)
{
if (!storeUrl)
return null;
var dest = bidix.dirname(storeUrl);
if (uploadDir && uploadDir != '.')
dest = dest + '/' + uploadDir;
dest = dest + '/' + toFilename;
return dest;
};
//
// uploadOptions Macro
//
config.macros.uploadOptions = {
handler: function(place,macroName,params) {
var wizard = new Wizard();
wizard.createWizard(place,this.wizardTitle);
wizard.addStep(this.step1Title,this.step1Html);
var markList = wizard.getElement("markList");
var listWrapper = document.createElement("div");
markList.parentNode.insertBefore(listWrapper,markList);
wizard.setValue("listWrapper",listWrapper);
this.refreshOptions(listWrapper,false);
var uploadCaption;
if (document.location.toString().substr(0,4) == "http")
uploadCaption = config.macros.upload.label.saveLabel;
else
uploadCaption = config.macros.upload.label.uploadLabel;
wizard.setButtons([
{caption: uploadCaption, tooltip: config.macros.upload.label.promptOption,
onClick: config.macros.upload.action},
{caption: this.cancelButton, tooltip: this.cancelButtonPrompt, onClick: this.onCancel}
]);
},
refreshOptions: function(listWrapper) {
var uploadOpts = [
"txtUploadUserName",
"pasUploadPassword",
"txtUploadStoreUrl",
"txtUploadDir",
"txtUploadFilename",
"txtUploadBackupDir",
"chkUploadLog",
"txtUploadLogMaxLine",
]
var opts = [];
for(i=0; i<uploadOpts.length; i++) {
var opt = {};
opts.push()
opt.option = "";
n = uploadOpts[i];
opt.name = n;
opt.lowlight = !config.optionsDesc[n];
opt.description = opt.lowlight ? this.unknownDescription : config.optionsDesc[n];
opts.push(opt);
}
var listview = ListView.create(listWrapper,opts,this.listViewTemplate);
for(n=0; n<opts.length; n++) {
var type = opts[n].name.substr(0,3);
var h = config.macros.option.types[type];
if (h && h.create) {
h.create(opts[n].colElements['option'],type,opts[n].name,opts[n].name,"no");
}
}
},
onCancel: function(e)
{
backstage.switchTab(null);
return false;
},
wizardTitle: "Upload with options",
step1Title: "These options are saved in cookies in your browser",
step1Html: "<input type='hidden' name='markList'></input><br>",
cancelButton: "Cancel",
cancelButtonPrompt: "Cancel prompt",
listViewTemplate: {
columns: [
{name: 'Description', field: 'description', title: "Description", type: 'WikiText'},
{name: 'Option', field: 'option', title: "Option", type: 'String'},
{name: 'Name', field: 'name', title: "Name", type: 'String'}
],
rowClasses: [
{className: 'lowlight', field: 'lowlight'}
]}
}
//
// upload functions
//
if (!bidix.upload) bidix.upload = {};
if (!bidix.upload.messages) bidix.upload.messages = {
//from saving
invalidFileError: "The original file '%0' does not appear to be a valid TiddlyWiki",
backupSaved: "Backup saved",
backupFailed: "Failed to upload backup file",
rssSaved: "RSS feed uploaded",
rssFailed: "Failed to upload RSS feed file",
emptySaved: "Empty template uploaded",
emptyFailed: "Failed to upload empty template file",
mainSaved: "Main TiddlyWiki file uploaded",
mainFailed: "Failed to upload main TiddlyWiki file. Your changes have not been saved",
//specific upload
loadOriginalHttpPostError: "Can't get original file",
aboutToSaveOnHttpPost: 'About to upload on %0 ...',
storePhpNotFound: "The store script '%0' was not found."
};
bidix.upload.uploadChanges = function(onlyIfDirty,tiddlers,storeUrl,toFilename,uploadDir,backupDir,username,password)
{
var callback = function(status,uploadParams,original,url,xhr) {
if (!status) {
displayMessage(bidix.upload.messages.loadOriginalHttpPostError);
return;
}
if (bidix.debugMode)
alert(original.substr(0,500)+"\n...");
// Locate the storeArea div's
var posDiv = locateStoreArea(original);
if((posDiv[0] == -1) || (posDiv[1] == -1)) {
alert(config.messages.invalidFileError.format([localPath]));
return;
}
bidix.upload.uploadRss(uploadParams,original,posDiv);
};
if(onlyIfDirty && !store.isDirty())
return;
clearMessage();
// save on localdisk ?
if (document.location.toString().substr(0,4) == "file") {
var path = document.location.toString();
var localPath = getLocalPath(path);
saveChanges();
}
// get original
var uploadParams = Array(storeUrl,toFilename,uploadDir,backupDir,username,password);
var originalPath = document.location.toString();
// If url is a directory : add index.html
if (originalPath.charAt(originalPath.length-1) == "/")
originalPath = originalPath + "index.html";
var dest = config.macros.upload.destFile(storeUrl,toFilename,uploadDir);
var log = new bidix.UploadLog();
log.startUpload(storeUrl, dest, uploadDir, backupDir);
displayMessage(bidix.upload.messages.aboutToSaveOnHttpPost.format([dest]));
if (bidix.debugMode)
alert("about to execute Http - GET on "+originalPath);
var r = doHttp("GET",originalPath,null,null,null,null,callback,uploadParams,null);
if (typeof r == "string")
displayMessage(r);
return r;
};
bidix.upload.uploadRss = function(uploadParams,original,posDiv)
{
var callback = function(status,params,responseText,url,xhr) {
if(status) {
var destfile = responseText.substring(responseText.indexOf("destfile:")+9,responseText.indexOf("\n", responseText.indexOf("destfile:")));
displayMessage(bidix.upload.messages.rssSaved,bidix.dirname(url)+'/'+destfile);
bidix.upload.uploadMain(params[0],params[1],params[2]);
} else {
displayMessage(bidix.upload.messages.rssFailed);
}
};
// do uploadRss
if(config.options.chkGenerateAnRssFeed) {
var rssPath = uploadParams[1].substr(0,uploadParams[1].lastIndexOf(".")) + ".xml";
var rssUploadParams = Array(uploadParams[0],rssPath,uploadParams[2],'',uploadParams[4],uploadParams[5]);
bidix.upload.httpUpload(rssUploadParams,convertUnicodeToUTF8(generateRss()),callback,Array(uploadParams,original,posDiv));
} else {
bidix.upload.uploadMain(uploadParams,original,posDiv);
}
};
bidix.upload.uploadMain = function(uploadParams,original,posDiv)
{
var callback = function(status,params,responseText,url,xhr) {
var log = new bidix.UploadLog();
if(status) {
// if backupDir specified
if ((params[3]) && (responseText.indexOf("backupfile:") > -1)) {
var backupfile = responseText.substring(responseText.indexOf("backupfile:")+11,responseText.indexOf("\n", responseText.indexOf("backupfile:")));
displayMessage(bidix.upload.messages.backupSaved,bidix.dirname(url)+'/'+backupfile);
}
var destfile = responseText.substring(responseText.indexOf("destfile:")+9,responseText.indexOf("\n", responseText.indexOf("destfile:")));
displayMessage(bidix.upload.messages.mainSaved,bidix.dirname(url)+'/'+destfile);
store.setDirty(false);
log.endUpload("ok");
} else {
alert(bidix.upload.messages.mainFailed);
displayMessage(bidix.upload.messages.mainFailed);
log.endUpload("failed");
}
};
// do uploadMain
var revised = bidix.upload.updateOriginal(original,posDiv);
bidix.upload.httpUpload(uploadParams,revised,callback,uploadParams);
};
bidix.upload.httpUpload = function(uploadParams,data,callback,params)
{
var localCallback = function(status,params,responseText,url,xhr) {
url = (url.indexOf("nocache=") < 0 ? url : url.substring(0,url.indexOf("nocache=")-1));
if (xhr.status == httpStatus.NotFound)
alert(bidix.upload.messages.storePhpNotFound.format([url]));
if ((bidix.debugMode) || (responseText.indexOf("Debug mode") >= 0 )) {
alert(responseText);
if (responseText.indexOf("Debug mode") >= 0 )
responseText = responseText.substring(responseText.indexOf("\n\n")+2);
} else if (responseText.charAt(0) != '0')
alert(responseText);
if (responseText.charAt(0) != '0')
status = null;
callback(status,params,responseText,url,xhr);
};
// do httpUpload
var boundary = "---------------------------"+"AaB03x";
var uploadFormName = "UploadPlugin";
// compose headers data
var sheader = "";
sheader += "--" + boundary + "\r\nContent-disposition: form-data; name=\"";
sheader += uploadFormName +"\"\r\n\r\n";
sheader += "backupDir="+uploadParams[3] +
";user=" + uploadParams[4] +
";password=" + uploadParams[5] +
";uploaddir=" + uploadParams[2];
if (bidix.debugMode)
sheader += ";debug=1";
sheader += ";;\r\n";
sheader += "\r\n" + "--" + boundary + "\r\n";
sheader += "Content-disposition: form-data; name=\"userfile\"; filename=\""+uploadParams[1]+"\"\r\n";
sheader += "Content-Type: text/html;charset=UTF-8" + "\r\n";
sheader += "Content-Length: " + data.length + "\r\n\r\n";
// compose trailer data
var strailer = new String();
strailer = "\r\n--" + boundary + "--\r\n";
data = sheader + data + strailer;
if (bidix.debugMode) alert("about to execute Http - POST on "+uploadParams[0]+"\n with \n"+data.substr(0,500)+ " ... ");
var r = doHttp("POST",uploadParams[0],data,"multipart/form-data; boundary="+boundary,uploadParams[4],uploadParams[5],localCallback,params,null);
if (typeof r == "string")
displayMessage(r);
return r;
};
// same as Saving's updateOriginal but without convertUnicodeToUTF8 calls
bidix.upload.updateOriginal = function(original, posDiv)
{
if (!posDiv)
posDiv = locateStoreArea(original);
if((posDiv[0] == -1) || (posDiv[1] == -1)) {
alert(config.messages.invalidFileError.format([localPath]));
return;
}
var revised = original.substr(0,posDiv[0] + startSaveArea.length) + "\n" +
store.allTiddlersAsHtml() + "\n" +
original.substr(posDiv[1]);
var newSiteTitle = getPageTitle().htmlEncode();
revised = revised.replaceChunk("<title"+">","</title"+">"," " + newSiteTitle + " ");
revised = updateMarkupBlock(revised,"PRE-HEAD","MarkupPreHead");
revised = updateMarkupBlock(revised,"POST-HEAD","MarkupPostHead");
revised = updateMarkupBlock(revised,"PRE-BODY","MarkupPreBody");
revised = updateMarkupBlock(revised,"POST-SCRIPT","MarkupPostBody");
return revised;
};
//
// UploadLog
//
// config.options.chkUploadLog :
// false : no logging
// true : logging
// config.options.txtUploadLogMaxLine :
// -1 : no limit
// 0 : no Log lines but UploadLog is still in place
// n : the last n lines are only kept
// NaN : no limit (-1)
bidix.UploadLog = function() {
if (!config.options.chkUploadLog)
return; // this.tiddler = null
this.tiddler = store.getTiddler("UploadLog");
if (!this.tiddler) {
this.tiddler = new Tiddler();
this.tiddler.title = "UploadLog";
this.tiddler.text = "| !date | !user | !location | !storeUrl | !uploadDir | !toFilename | !backupdir | !origin |";
this.tiddler.created = new Date();
this.tiddler.modifier = config.options.txtUserName;
this.tiddler.modified = new Date();
store.addTiddler(this.tiddler);
}
return this;
};
bidix.UploadLog.prototype.addText = function(text) {
if (!this.tiddler)
return;
// retrieve maxLine when we need it
var maxLine = parseInt(config.options.txtUploadLogMaxLine,10);
if (isNaN(maxLine))
maxLine = -1;
// add text
if (maxLine != 0)
this.tiddler.text = this.tiddler.text + text;
// Trunck to maxLine
if (maxLine >= 0) {
var textArray = this.tiddler.text.split('\n');
if (textArray.length > maxLine + 1)
textArray.splice(1,textArray.length-1-maxLine);
this.tiddler.text = textArray.join('\n');
}
// update tiddler fields
this.tiddler.modifier = config.options.txtUserName;
this.tiddler.modified = new Date();
store.addTiddler(this.tiddler);
// refresh and notifiy for immediate update
story.refreshTiddler(this.tiddler.title);
store.notify(this.tiddler.title, true);
};
bidix.UploadLog.prototype.startUpload = function(storeUrl, toFilename, uploadDir, backupDir) {
if (!this.tiddler)
return;
var now = new Date();
var text = "\n| ";
var filename = bidix.basename(document.location.toString());
if (!filename) filename = '/';
text += now.formatString("0DD/0MM/YYYY 0hh:0mm:0ss") +" | ";
text += config.options.txtUserName + " | ";
text += "[["+filename+"|"+location + "]] |";
text += " [[" + bidix.basename(storeUrl) + "|" + storeUrl + "]] | ";
text += uploadDir + " | ";
text += "[[" + bidix.basename(toFilename) + " | " +toFilename + "]] | ";
text += backupDir + " |";
this.addText(text);
};
bidix.UploadLog.prototype.endUpload = function(status) {
if (!this.tiddler)
return;
this.addText(" "+status+" |");
};
//
// Utilities
//
bidix.checkPlugin = function(plugin, major, minor, revision) {
var ext = version.extensions[plugin];
if (!
(ext &&
((ext.major > major) ||
((ext.major == major) && (ext.minor > minor)) ||
((ext.major == major) && (ext.minor == minor) && (ext.revision >= revision))))) {
// write error in PluginManager
if (pluginInfo)
pluginInfo.log.push("Requires " + plugin + " " + major + "." + minor + "." + revision);
eval(plugin); // generate an error : "Error: ReferenceError: xxxx is not defined"
}
};
bidix.dirname = function(filePath) {
if (!filePath)
return;
var lastpos;
if ((lastpos = filePath.lastIndexOf("/")) != -1) {
return filePath.substring(0, lastpos);
} else {
return filePath.substring(0, filePath.lastIndexOf("\\"));
}
};
bidix.basename = function(filePath) {
if (!filePath)
return;
var lastpos;
if ((lastpos = filePath.lastIndexOf("#")) != -1)
filePath = filePath.substring(0, lastpos);
if ((lastpos = filePath.lastIndexOf("/")) != -1) {
return filePath.substring(lastpos + 1);
} else
return filePath.substring(filePath.lastIndexOf("\\")+1);
};
bidix.initOption = function(name,value) {
if (!config.options[name])
config.options[name] = value;
};
//
// Initializations
//
// require PasswordOptionPlugin 1.0.1 or better
bidix.checkPlugin("PasswordOptionPlugin", 1, 0, 1);
// styleSheet
setStylesheet('.txtUploadStoreUrl, .txtUploadBackupDir, .txtUploadDir {width: 22em;}',"uploadPluginStyles");
//optionsDesc
merge(config.optionsDesc,{
txtUploadStoreUrl: "Url of the UploadService script (default: store.php)",
txtUploadFilename: "Filename of the uploaded file (default: in index.html)",
txtUploadDir: "Relative Directory where to store the file (default: . (downloadService directory))",
txtUploadBackupDir: "Relative Directory where to backup the file. If empty no backup. (default: ''(empty))",
txtUploadUserName: "Upload Username",
pasUploadPassword: "Upload Password",
chkUploadLog: "do Logging in UploadLog (default: true)",
txtUploadLogMaxLine: "Maximum of lines in UploadLog (default: 10)"
});
// Options Initializations
bidix.initOption('txtUploadStoreUrl','');
bidix.initOption('txtUploadFilename','');
bidix.initOption('txtUploadDir','');
bidix.initOption('txtUploadBackupDir','');
bidix.initOption('txtUploadUserName','');
bidix.initOption('pasUploadPassword','');
bidix.initOption('chkUploadLog',true);
bidix.initOption('txtUploadLogMaxLine','10');
/* don't want this for tiddlyspot sites
// Backstage
merge(config.tasks,{
uploadOptions: {text: "upload", tooltip: "Change UploadOptions and Upload", content: '<<uploadOptions>>'}
});
config.backstageTasks.push("uploadOptions");
*/
//}}}
Printable: [[PDF|http://www.divshare.com/download/1159706-521]]
''Iatric’s Visual Flowsheet''
1.From the NUR desktop select Visual Flowsheet by Patient or Visual Flowsheet by Location.
[img[0001A|http://farm2.static.flickr.com/1024/708473455_a4cc289eda.jpg?v=0]]
>a. Visual Flowsheet by Patient
>>i. Enter and select patient.
>>ii. [img[0002A|http://farm2.static.flickr.com/1380/708473465_51273a83d0.jpg?v=0]]
>>iii. If you are coming from the Status Board Press – [Space Bar] [Enter]
>>iv. Or Enter Patients name – Press [F9] for look up or press [Enter] to go to next field
>>v. Format – Press[F9] for look up – use the format for your department. The format >>should default to your department-(If default is wrong contact Informatics nurse to change)
>>vi. The rest of the fields should fill in automatically-Press [F12]
>b.Visual Flowsheet by Location
>>i. Enter Location
>>ii. [img[0003A|http://farm2.static.flickr.com/1378/708473475_a69c6aa27d.jpg?v=0]]
>>iii. i.e. N.2ND, N.ENDO, N.2IC etc…
>>iv. Select patient from list
>>v. [img[0004A|http://farm2.static.flickr.com/1023/708473483_f0f43dedb7.jpg?v=0]]
>>vi. Press [Right Arrow Key]
>>[img[0005A|http://farm2.static.flickr.com/1366/708473499_83f57a7112.jpg?v=0]]
>>into all fields, adjust parameters & press [F12]
To view patient data click on the listed tabs. Some of the options are VS/weight, I&O, IV, IV site management and glucose.
[img[0006A|http://farm2.static.flickr.com/1129/708473511_80630a1dc4.jpg?v=0]]
''Changing view of flowsheet''
>>1.The Adjust key allows user to adjust cell interval
>>2.The View key adjusts columns, rows, and cells to display all or only those with data
''Meditech Functions accessible from the VFS''
>1.Process intervention (good way to document VS, glucose, etc.)
>2.Care plan (Phase II implementation)
>3.Notes
>4.Orders (Phase III implementation)
>5.PCI
>6.Assessements (Phase II implementation).
''Graphing Patient Data''
>1.Vital Signs are already graphed. Select VS Graph to visualize these.
>2. Other tabs can be graphed by selecting that tab and clicking on the graph key once data >is selected.
>3. Using mouse drag choice over to the graph column every field wanted to graph.
>4. Once list is complete select either single graph or multiple graph. Single field displays >are best displayed on the single graph. Multiple fields are best displayed on multiple >graphs.
''Refresh Screen''
When changing parameters you may be prompted to refresh screen.
>1.If not in the middle of entering data always enter Yes to this prompt to ensure your parameters are reset and data is retrieved from Meditech.
>2.If in the middle of a task, select snooze to finish task. Once work completed press refresh button on the verb strip.
''Date and Time Display''
By hovering mouse over cell the actual date and time the data was entered will be displayed.
''To Add Value to Cell''
Right click on cell. The options to enter data will be displayed. Click on appropriate choice.
''To Change a Value''
Enter Process Intervention and space bar, ENTER to bring up current patient.
Printable: [[PDF|http://www.divshare.com/download/1159640-1b4]]
[img[0001B|http://farm2.static.flickr.com/1165/708841231_82dc62c0e4.jpg?v=0]][img[0002B|http://farm2.static.flickr.com/1337/708841245_7d1b1e06dd.jpg?v=0]][img[0003B|http://farm2.static.flickr.com/1308/708841253_d4cd5ef25a.jpg?v=0]]
[img[0004B|http://farm2.static.flickr.com/1308/708841275_7f96258c8d.jpg?v=0]][img[0005B|http://farm2.static.flickr.com/1081/708841293_7531dc0cc3.jpg?v=0]][img[0005B|http://farm2.static.flickr.com/1014/708841305_d7b5a6a1a1.jpg?v=0]]
This is a little webpage where the Washington Rural Hospital Computer Group can collaborate. Make sure you go through the [[Getting Started]] tiddler. To take a quick look at what we can do and share look at the VisualFlowSheetQuickReference and the VisualFlowSheetManual. You can copy and paste anything you see here into your own tiddlyspot. Get a wiki for your hospital that you can taylor for your hospital at http://www.tiddlyspot.com/ Also take a look at a work in progress for MtCarmelHospital [[here|http://mchtechwiki.tiddlyspot.com/]]
This document is a ~TiddlyWiki from tiddlyspot.com. A ~TiddlyWiki is an electronic notebook that is great for managing todo lists, personal information, and all sorts of things.
@@font-weight:bold;font-size:1.3em;color:#444; //What now?// @@ Before you can save any changes, you need to enter your password in the form below. Then configure privacy and other site settings at your [[control panel|http://ruralcomputergroup.tiddlyspot.com/controlpanel]] (your control panel username is //ruralcomputergroup//).
<<tiddler TspotControls>>
See also GettingStarted.
@@font-weight:bold;font-size:1.3em;color:#444; //Working online// @@ You can edit this ~TiddlyWiki right now, and save your changes using the "save to web" button in the column on the right.
@@font-weight:bold;font-size:1.3em;color:#444; //Working offline// @@ A fully functioning copy of this ~TiddlyWiki can be saved onto your hard drive or USB stick. You can make changes and save them locally without being connected to the Internet. When you're ready to sync up again, just click "upload" and your ~TiddlyWiki will be saved back to tiddlyspot.com.
@@font-weight:bold;font-size:1.3em;color:#444; //Help!// @@ Find out more about ~TiddlyWiki at [[TiddlyWiki.com|http://tiddlywiki.com]]. Also visit [[TiddlyWiki Guides|http://tiddlywikiguides.org]] for documentation on learning and using ~TiddlyWiki. New users are especially welcome on the [[TiddlyWiki mailing list|http://groups.google.com/group/TiddlyWiki]], which is an excellent place to ask questions and get help. If you have a tiddlyspot related problem email [[tiddlyspot support|mailto:support@tiddlyspot.com]].
@@font-weight:bold;font-size:1.3em;color:#444; //Enjoy :)// @@ We hope you like using your tiddlyspot.com site. Please email [[feedback@tiddlyspot.com|mailto:feedback@tiddlyspot.com]] with any comments or suggestions.
Whitman Hospital
1200 W Fairview St
Colfax, WA 99111
(509) 397-3435
http://www.whitmanhospital.com/
[[Map|http://maps.google.com/maps?hl=en&q=whitman+hospital&near=Colfax,+WA&fb=1&cid=0,0,17843616533398512317&ie=UTF8&ll=46.86884,-117.375065&spn=0.004614,0.009066&z=17&iwloc=A&om=1]]
This example appears on the screen suddenly, with a graphic. If the information is already on the screen you will see an annimation that draws your attention to that information. Click on HowToUseThisWiki.
Note: The previous information is still available for you to reference.
Locate the Search feature, it is at the top of the right column. (Don't use this feature yet) If you start typing in a key word, information will begin poplulating in the main middle screen. Sometimes there will be so much information that you will have to scroll down the center section and find what you are looking for.
Now, scroll to the top right column and Type in the word __@@color:red;e x a m p l e@@__ in the search box and find this information snipet again.
Did you notice that you didn't have to press enter. Now that you have returned read on:
Under the search box are several options,
1. close all - this will close all information topics
2. permaview - PermaView
3. options - this is used if you have privledges to edit the page.
Note: You can edit information on the page at any time, but you will only be able to save it if you have the password.
If you would like to know more I will refer you to:
>[[More about Tiddlywiki |http://www.tiddlywiki.com/]]
A most useful section of the Wiki is also in the column on the right.
1. Timeline - Find topics by date of update and/or input.
2. All - Find all of the topics in an alphabetized format.
3. Tags - Find topics by tags
4. More - Find topics that still need to be expounded upon or need links etc..
Have fun searching this knowledge base. Please E-mail contributions, suggestions or comments to the IS department at Mount Carmel Hospital.
Click in the box below to start using the Wiki.
<<closeAll>>