Clinical Systems

1. Clinical Systems StarBrowser/StarPanel

2. Welcome • This class follows a standardized structure. The learner is expected to: • Listen and watch the instructor demonstrate and explain at the beginning of each lesson with HANDS OFF THE WORKSTATION. • Practice individual exercises • Participate in knowledge check activities • Practice working through group activities. • The material presented in this class is a foundational overview of the Clinical Systems. Unit specific information and practice will be covered when you are active on your unit.

3. StarBrowser/StarPanelLearning Objectives • Locate and define the purpose of primary menus and icons in StarBrowser/StarPanel. • Define the purpose of the StarBrowser/StarPanel systems.

4. Video Introduction: StarBrowser/StarPanel • Click hereto load video

5. StarBrowser/StarPanelLesson 1.1 Logging Onto the System INDIVIDUAL ACTIVITY • Demonstrate logging onto the system using the training ID. • Review the Training Resource called Super User’s Guide for Setting up Virtual Clinical Workstation (VCWS) for RN’s and CP’s to set up VCWS and password tips.

6. StarBrowser/StarPanelLesson 1.2 Defining StarBrowser Icons INDIVIDUAL ACTIVITY • Locate the following icons: • Print • Go to Desktop • Sign Off • Launch HEO/Wiz Order • Launch HED • Launch Helpdesk • Kronos • Email

7. StarBrowser/StarPanelLesson 1.3 Defining StarPanel Menus INDIVIDUAL ACTIVITY • Demonstrate logging out completely.

8. StarBrowser/StarPanelLesson 1.4 Defining StarPanel Tabbed Menu, Secondary Menu and Table INDIVIDUAL ACTIVITY • Demonstrate logging back in to the system. • Demonstrate sorting column headers in the patient list.

9. StarBrowser/StarPanelLesson 1.5 Defining StarPanel Colors and Indicators INDIVIDUAL ACTIVITY • Demonstrate hover information box and indicators to display more information.

10. StarBrowser/StarPanelknowledge Check Write a response to the following: • Recall one important idea from this lesson. • Verbalize one question about material from this lesson that you want answered. • Rate your confidence with the material from this lesson.

11. Clinical Systems The Actions Menu

12. Actions MenuLearning Objectives • Define the purpose of the Actions Menu and identified links within the Actions Menu. • Demonstrate the ability to reference and apply the Training Resource information to a provided scenario. • Define the purpose of the OPC and demonstrate the ability to successfully navigate and print the required components within the Actions Menu.

13. Video Introduction: Actions Menu • Click here to load Video

14. Actions MenuLesson 2.1 Functionality of the Actions Menu • Demonstrate accessing the Actions Menu, using the training patient on your training card. • Demonstrate changing the default setting to “Inpatient Nurses”. • Demonstrate opening and expanding panels by clicking any Actions menu link.

15. Actions MenuLesson 2.2 Overview of Patient Care (OPC) • Demonstrate the steps necessary to open the OPC. • Demonstrate expanding the panels to correctly view the OPC. • Demonstrate hovering over lab values to gain more information.

16. Actions MenuLesson 2.3 All Documents • Demonstrate accessing the “All Documents” in the Actions menu. • Demonstrate locating the “Chest Portable PXR” document in the radiology tab.

17. Actions MenuLesson 2.4 Fast Labs • Demonstrate accessing Fast Labs using the Actions Menu. • Demonstrate hovering over links to display additional information. • Demonstrate clicking a lab value to display trending activity over the length of stay. • Demonstrate clicking the “Graph Info” link for PCV to display a graph with additional lab value information. • Demonstrate clicking CBC to show all CBCs collected on a patient.

18. Actions MenuLesson 2.5 Medication Administrations Record (MAR) • Demonstrate accessing the MAR. • Demonstrate clicking on the blue medication name link while holding down the ctrl key. • Demonstrate clicking on medication “Esomeprazole magnesium .R. 40 mg”.

19. Charting a New Patient’s Admission HistoryLesson 2.6 Assigning a Pathway • Demonstrate accessing E-Docs Pathway from the Actions Menu. • Demonstrate expanding the E-Docs Pathway frame. • Demonstrate searching for and assigning the Medicine Admission pathway.

20. Actions MenuQuiz Show

21. Actions MenuKnowledge Check • The link in the Actions Menu that is a record of any document that pertains to a patient’s medical history at Vanderbilt University Medical Center.

22. Actions MenuKnowledge Check All Documents

23. Actions MenuKnowledge Check • The link in the Actions Menu that displays medications, dosages and time administered for a specific patient.

24. Actions MenuKnowledge Check MAR

25. Actions MenuKnowledge Check • The link in the Actions Menu that allows you to assign or view a pathway.

26. Actions MenuKnowledge Check E-Docs Pathway

27. Actions MenuKnowledge Check • The link in the Actions Menu that provides a snap shot of important information charted for a patient using the SBAR format

28. Actions MenuKnowledge Check OPC

29. Actions MenuKnowledge Check – Tie Breaker! • The link in the Actions Menu that provides an overview of lab results from a patient’s hospital stay.

30. Actions MenuKnowledge Check Fast Labs

31. Charting a New Patient’s Admission History

32. Charting a New Patient’s Admission HistoryLearning Objectives • Locate required sections of the Admission History and define the completion deadlines for those sections. • Demonstrate the ability to complete a patient admission history.

33. Admission History Form Group Activity • Partner 1Open a new Adult Admission History Form • Demographics • Allergy and sections in between and save as draft. • Partner 2Open the draft admission history and complete the following sections: • Immunization and sections in between • Nutrition and sections in between • Save as complete • Each partner should have an opportunity to practice!

34. Clinical Systems Order Entry – HEO/Wiz

35. Order Entry – HEO/WizLearning Objectives • Define the purpose of the HEO/Wiz system. • Demonstrate searching for and locating active orders. • Demonstrate entering orders.

36. Video Introduction: HEO/Wiz • Click here to load the video

37. Order Entry – HEO/WizLesson 4.1 Navigating HEO/Wiz • Access HEO/Wiz Train from the desktop. • Demonstrate searching by patient name on the patient card in the search box. • Demonstrate using the “Go to desktop” button.

38. Order Entry – HEO/WizLesson 4.2 Locating Active Orders Use patient name on the patient card. • Demonstrate selecting a patient and looking up a diet order for the patient on your patient card.

39. Order Entry – HEO/WizLesson 4.3 Entering Orders • Demonstrate entering an order for CBC w/platelets. • Demonstrate clicking done and Accept Orders.

40. Order Entry – HEO/WizLesson 4.4 Requesting a Blood Product • Demonstrate requesting a blood product from the blood bank for a training patient.

41. Order Entry Group Activity • With a partner, enter the following order: • Protocol order • Test, Physician • Diabetic diet consistent cho • Daily • NXT meal • Until discontinued • Partners can provide patient information as needed. • Each partner should have an opportunity to practice!

42. Clinical Systems Charting HED

43. Charting HEDLearning Objectives • Define the purpose of the HED system. • Demonstrate the method for assigning patients in Care Organizer. • Locate and define the purpose of primary menus in HED.

44. Video Introduction: HED • Click here to load the video

45. Clinical Systems Charting Navigation and Processes

46. Charting Navigation and ProcessesLesson 5.1 • Configure Care Organizer using the Training Resource. • Use the training unit on the laminated sheet with armband and bar codes.

47. Charting HEDLesson 5.4 Navigational Overview of HED • Demonstrate accessing HED through Care Organizer. • Demonstrate opening and closing the patient census. • Demonstrate locating allergy information. • Demonstrate using the down arrow to access additional tabs. • Demonstrate using the arrow keys on the keyboard to move up and down the additional tab menu.

48. Charting Navigation and ProcessesLearning Objectives • Demonstrate the ability to enter vitals in a patient chart. • Based on provided patient conditions, define the completion guidelines and demonstrate documenting the appropriate Plan of Care.

49. Charting Navigation and ProcessesLesson 5.5.2 Charting a New Patient’s Vitals in HED • Demonstrate opening HED Train. • Demonstrate clicking “Show All” • Demonstrate entering the following in the Vital Sign section of the chart: • Change time to 30 minutes ago. • Enter temp of 102.4 Oral. • Click exclamation point to make significant finding. • Enter heart rate/DAS of 116 apical. • Enter this annotation “prior to digoxin” • Enter O2 Sats of 95% on Oxygen • Enter O2 Liter Flow of 2L, Nasal Cannula • Demonstrate clicking “Save and Confirm” after vitals have been entered.

50. Charting Navigation and ProcessesLesson 5.5.3 Charting the Physical Assessment and Care Plan in HED • Demonstrate navigating to HED train and the “ICU/SD Asmt/Interventn” tab. • Demonstrate clicking “Show All” to display every section of the chart. • Demonstrate entering the following in the Pulmonary section of the chart: • Select Respiratory ASMT (Problems) and select Gas Exchange • Demonstrate using the “Start Priority” hyperlink to start a new pulmonary problem and enter the following: • Choose a priority problem: Gas Exchange • May be related to - Secretions • Expected Outcome – Improve • Start Time “T” • Demonstrate the functionality of the magnifying glass icon which allows you to see more information or open an existing problem. • Demonstrate documenting a short term shift goal using the following: • Maintain O2 Sats>94% on supplemental O2 • Demonstrate charting abnormal breath sounds using the following: •Click Chart then SHOW ALL • Click RLL and fine crackles • Click LLL and select fine crackles • Click cough • Click productive • Make up nasty secretions • Incentive Spirometer: 600X5 • Scroll to Pulmonary intervention: D B and Cough and Suction • Demonstrate documenting a Braden skin assessment and a Falls Risk Assessment 4. Demonstrate: “save and confirm”.