790 likes | 960 Views
ED Phase 3 Training for Nurses. Should be documented within the Triage Screen. On the Allergies/Home Meds tab Computer Based Trainings:. Home Medications. Home Meds Questions?. OM Ordering for RN’s Order Source: Either Verbal or Med Exec Approved
E N D
Should be documented within the Triage Screen. On the Allergies/Home Meds tab Computer Based Trainings: Home Medications
OM Ordering for RN’s • Order Source: Either Verbal or Med Exec Approved • Order Source of Med Exec Approved should be utilized for RN Protocol Order Sets • Order Source of Verbal should be used in emergent situation only (use your professional discretion)
Select New Meds Select New Meds to order IV fluids
Search for IV fluids using the type ahead look-up. Place a check mark next to the fluidyou want to order Click Next to continue. Search for IV Fluid by Name
Select the volume you want to administer Note the OK is not lit Click on the blue edit to enter the rate Select the Volume to Infuse
Titrate defaults to No Type in the rate mls/hr defaults in the units field Click OK > Save Enter Rate and Units ml/hr
Click on New Sets House sets on the left; specialty sets on the right Click on the + to expand the ED RN Protocol sets Check the order set (s) you need ED RN Protocols
Order set expands to a pick list w/scroll bar on the right to scroll down the list Check all the orders you need: NEW status Note orders that have already been ordered Click Edit all to complete required fields > OK > SAVE Order Set View
If you need an order that is not contained in the set click on Any Order Any Order
Any Order, continued You can add orders, meds, or sets. This example shows adding a Rapid Group A Strep which was not part of the order set The order will show at the bottom of the set under “Additional Orders”
Code Orders Major Trauma Restraints Stroke STEMI Blood Product Request for Transfusion What Stays on Paper
eMAR/BMV Training Session
Introduction eMAR/BMV MAR Layout ACK Orders from RN Tracker and MAR Prerequisite CBT Viewing: Agenda
The ED Physicians will be placing order in CPOE (computer provider order entry) this will now include medication orders RN’s will be documenting and scanning the Medications through scanning/BMV (bedside medication verification) on the eMAR (electronic medication administration record) Introduction
MAR Layout EMR, PCS, & OM Routine Buttons Inclusion Criteria MAR Headers Footer Functions
MAR Headers • Clickable & Sort able • Start/Stop • Status • ACK Status • Medication • Route • Scheduled times
Time Column • Time Column • Scheduled times • Last administrations
Start and Stop Date and Time Please note: Once and One Time Medication will automatically stop one minute after being ordered. This does not mean that they can not be documented against.
Active Order is active and available to administer Discontinued Order has been discontinued Canceled Order has been cancelled MAR Order Status
Unacknowledged Acknowledged Rejected ACK Status
Medication Information Jump to the next slide to review the information in the med order info cell.
Medication Order Cell Generic Name Dose Route Frequency Schedule Trade Name Rx Number Symbols: Addl Info Give Field: How much of the dispensed dose to give. More about the Give Field on the next Slide… PRN Reason
MAR Symbols Associated Data Titration Drug Monograph Special Instructions Assessment Protocol Co- Signature
Clickable & Sortable: Symbols Links Co Signature Titration MAR Symbols: Clickable
GIVE FIELD Ordered Give Dispensed Give Field: How much of the dispensed dose to Give to Pt ie: Give 2 Tabs of the (dispensed) 325 mg tab 2 Tabs x 325 mg (dispensed) = 650 mg (ordered)
GIVE FIELD: Split Tab Give Give Field: How much of the dispensed dose to Give to Pt ie: Give 1/2 Tabs of the (dispensed) 50 mg tab 1/2 Tabs x 50 mg (dispensed) = 25 mg (ordered)
GIVE FIELD Give Give Field: How much of the dispensed dose to Give to Pt ie: Give 6 ml of the (dispensed) 100 ml/4 ml suspension 6 ml (admin) x (100 mg/4ml) (dispensed) = 150 mg (ordered)
GIVE FIELD: Partial Injection Give Field: How much of the dispensed dose to Give to Pt ie: Give 2.5 ml of the (dispensed)5 mg/5 ml Ampule 2.5 ml (admin) x (5 mg/5ml) (dispensed) = 2.5 mg (ordered)
GIVE FIELD: Multi Dose Container • Give Field: Does not appear • Dose Instructions indicate Multi Dose Container • Order Indicates amount to administer & units as appropriate
Viewable Dates • Viewable Dates • Currently: Yesterday & Today • You can manipulate the display to determine appropriate viewable date range
Refresh: Refresh new data manually Change View: Changes the view of data displaying on the MAR Document: Document an administration (manually-not using scanning) Not Recommended! Document Unscheduled: Document an administration that is not scheduled Document Assess: Document an MAR assessment Detail: View the detail of the MAR Order Manual Barcode: Enter Medication Barcode Manually Renewal: Will not be utilized Schedule Comment: Enter a comment for a medication schedule MAR Layout Footer Functions
Medication Detail Panel Includes Many Tabs of Order Information • Med Detail Info Tabs • Detail • MAR Detail • History • Audit Trail • Flowsheet • Assessment Documentation • Associated Data • Related Queries, Labs, etc • Protocol/Taper • As Indicated • Order Detail • Audit
Medication Detail: History Tab Order Information Audit Trail Line Items Audit Trail Detail
Medication Detail: Flowsheet Tab Flowsheet Documentation as associated to the Medication
Medication Detail: Monograph Tab Order Detail • Medication Monograph • Viewable • Print-able • English/Spanish
Medication Detail Associated Data Tab Order Detail • Associated Data • Query Documentation • Lab Results
Medication Detail: Protocol/Taper Tab Order Detail • Associated Data • Query Documentation • Lab Results Protocol or Taper as Indicated
Order Detail Order Detail Fluid Volume Info Titration Info & Protocol ACK Audit Trail
Medication Detail Panel Review All of the info just covered, is viewable from the MAR Detail Tab • Med Detail Info Tabs • Detail • MAR Detail • History • Audit Trail • Flowsheet • Assessment Documentation • Associated Data • Related Queries, Labs, etc • Protocol/Taper • As Indicated • Order Detail • Audit
Next, topic: Acknowledging Meds • Two Methods to Ack Meds • RN Tracker • MAR
Acknowledging Orders • Two places to Acknowledge Med Orders • MAR Ack Routine • RN Tracker Ack Routine Acknowledging Orders from the RN Tracker will Auto - Ack on the MAR!
To Acknowledging from the RN Tracker: Click on the ACK prompt from your Tracker RN Tracker ACK
List of Medication Orders and Status of Each Place a checkmark to the left of the first Order RN Tracker ACK