Downtime Quick Reference Medipac, HEO/Wiz, HED, Admin-Rx, StarPanel, Network

1. Downtime Quick ReferenceMedipac, HEO/Wiz, HED, Admin-Rx, StarPanel, Network Preparing for Scheduled Downtime(DT) During Downtime(DT) • MEDIPAC: track admissions/transfers/discharges (ADT) on Patient List/Charge Nurse Worksheet (VPH done by Respond) • HEO/Wiz: • See COS & StarPanel for orders entered prior to DT • MD should write orders on Physician Order sheet, print & sign name, write pager #, & then give to MR • A copy of each POS is tubed to Pharmacy • The MR transcribes new, modified, & discontinued orders to the paper MAR • RN’s verify transcription is correct & signs MAR • MR completes DT requisitions for labs, ancillary depts & blood bank (one requisition per dept) • HED: Nurses document on manual flowsheets & should NOT use HED even if it appears to be available • Admin Rx: • Meds are documented on paper MARs. • MR transcribes new, modified, & discontinued orders to paper MAR (some areas nurses do this) • RN’s verify transcription is correct and signs MAR • RN checks StarPanel e-MAR for previous med admin times & verifies schedules are correct on paper MAR • StarPanel: • Print Nursing Admission History from e-docs • Lab will contact unit with STAT results • Indicators on Inpt WB will not receive updates • Network: All of the actions above • Post DT notices & remind staff time DT is starting • Check DT kits & fill to par levels (for each form par level = # of beds on unit plus 5 additional copies) • Listen for overhead announcements for start of DT • MEDIPAC: Print Patient List /Charge Nurse worksheet from HEO/Wiz • HEO/Wiz:Print COS on all patients for RNs • HED:Addressograph both pages of DT flowsheet & place in pt’s chart • Admin-Rx: • Retrieve MARs from designated printer & distribute. Prints to (CCT on each unit, VUH on south side, VCH on B pods, MCN on each unit, VPH adult units on ADL1, peds on ADOL) • For new admissions, stamp interim MARs and place in chart. • StarPanel: RN: Print “Overview of Patient Care” (OPC) & address outstanding Inpt Whiteboard (Inpt WB) indicators while information still current( VAP, Falls) • Lab Computer System: call center # 322-1164 • Network: All of the actions above

2. Downtime Quick ReferenceMedipac, HEO/Wiz, HED, Admin-Rx, StarPanel, Network Recovery From Downtime(DT) Emergency Departments Whiteboard (WB) Preparing For DT • MR • Print ED Order Summaries on every pt in treatment area 15 minutes prior to scheduled DT or at beginning of unscheduled DT & place on pt’s clipboard • Stamp & place on clipboard: Physician Order Sheet (1), DT reqs (2), Facility Charge Form (1) • Charge Nurse: • Initiate manual whiteboard During DT • Maintain accurate census on manual whiteboard Recovery From DT • Charge nurse performs DCRN function to update census on WB using the Facility Charge form Listen for overhead announcements for end of DT • MEDIPAC: From ADT Tracking List, MR • Discharge pts who left during the DT • Transfer pts to correct locations • Continue to track new admissions & calls Admitting Dept (Respond in VPH) if pt not on census in one hr • HEO/Wiz: • MR back-enters all on-going non-med orders • Pharmacy enters all on-going med orders • HED: • RN enters cumulative I&O • Admin-x: RN • Confirm ed orders & schedules in Care Organizer are correct (allow time for PHM to catch-up) • Note overdues and document as “already given-see MAR” if administered & charted during DT • StarPanel: • RN: print new OPC if needed and address indicators • Alert banner displays with start/end times of DT & instructs staff to see paper documentation • Network: All of the actions above All paper documentation is a permanent part of the medical record. MR should restock DT kit to par level ASAP. Workstations on Wheels (WOW) and scanners are unavailable. Use DT procedures for Admin-Rx and locate hardwired computer for other tasks. Wireless Network DT V:downtime/1.7.2009DT Quick Reference