IMPACT Unit Expert Meeting

1. IMPACTUnit Expert Meeting December 30, 2011 Nursing Informatics

2. Meeting will be the last Friday of every month from 0900-1100 Place: WP Conference Center Room B or D IMPACT Unit Expert Meeting Dates Nursing Informatics

3. Changes that have occurred since 10/28/11 • BMDI (P2DA/CE) upgrade – completed • New Order “Cerebral/Renal NIRS” • Added responses to Wound Location • Additions to Positioning/Pressure Reducing devices • Response addition to Peripheral IV site care • Additions made to Wound Description • Additions made to wound/incision dressing activity • Additions made to wound type • Re arrange wound/incision documentation order • Relocated Bladder pressure documentation in IView • Added DTA Wound/Incision Device Dressing Nursing Informatics

4. Changes that have occurred since 10/28/11 • Add additional responses to Nursing Care items used – Barrier Wipes and Barrier Cream • Added additional response to Skin Abnormality Location • Additions made to Assistive devices • Added Return to Work form to the UED RN folder • Added order to discontinue Urinary catheter on POD#2 to the General Surgery Post op powerplan • Added quick pick sentence to the urinary catheter order to discontinue the foley on POD#2 if catheter present Nursing Informatics

5. Updates • Nursing M Page – Pilot Done. The Handoff PACT has meet – education to go out to staff • Vitalslink – will be scheduling Train the Trainer classes in January for downloading of Vital Signs • Barcoding IVF’s – on Hold for now • Care Compass – waiting on packages for load into production • Outcomes/careplans project – to be presented to the NLC in January Nursing Informatics

6. Things that are being worked on • Burn Dressing Team orders and documentation • BMDI roll out for NICU, TBICU, CCN and RNICU • BMDI Rollout for TBNU • Fetalink Upgrade – after the P2DA/CE upgrade should be Jan. 12th • Sepsis Pilot • UED Sepsis Pilot Nursing Informatics

7. Things that are being worked on • Changes to WOCN forms to for Ostomy documentation • E notes for the system – outcomes based Powerplans – Work in Progress – presentation to be done for NLC/ANC group in Jan • Downtime Documentation – not started • Weight Based Insulin protocol orders • Addition to Travel Tracker Report • Filtering the Site box on the MAR to show only the sites appropriate for the Route Nursing Informatics

8. Things that are Being Worked on • Addition of two forms in power chart called PES Violence Risk Assessment and PES Suicide Risk Assessment • Epoprostenol orders and process for HTICU • Working on the MAR with times report so that the CIWA orders print correctly • Working on NPASS for addition to sedation section • Addition of Blood Glucose Documentation for sliding scale aspart insulin on MAR • Changes to the Heart Rhythm powerplans • Changes to the Pnuemonia Vaccination screening and documentation Nursing Informatics

9. Things that are Being Worked on • TB skin Test read documentation – orders, task, form • OB Summary M Page • Bereavement documentation • SICU admission powerplan • New order for POC Bilirubin order • Rehab Admission assessment • Addition of VAD education form • New order for VAMP • Powerform for Anesthesia for log Nursing Informatics

10. Chart Review Issues/Discussions Nursing Informatics

11. TB Skin Test results documentation • Power plan will include orders for Test results to be read and documented • Task will fire to PAL to read results 48 hours and 72 hours post order • Task will take you to the Form to document the results • Task and Order will complete upon documentation of the form thru the task Nursing Informatics

12. TB Skin Test – powerplan and documentation 1/10/12: • Order as powerplan: • Drug and read orders are all preselected: Nursing Informatics

13. The read orders display the date the read is due on the orders page: • 48 hours after the order is placed a Heart task appears on the PAL: Nursing Informatics

14. When you click chart it takes you to the form to document: Nursing Informatics

15. Changes for Testing and/or Final Approval/Information Nursing Informatics

16. Change Request #1Addition to Wound Dressing Type • Add: • Antimicrobial incise drape – this is ioban Nursing Informatics

17. Change Request #2Additions to Wound Description or Wound Type • Add: • Open surgical incision or ??? Nursing Informatics

18. Change Request #3 • Request to add Height to the Banner Bar • Pulls forward in the Measurement section Nursing Informatics

19. Change Request #4Add question to adult admission assessment • Add question to Adult admission “Do you drink more than 7 drinks a week” with Yes/No response. If answer Yes have the CAGE form open Nursing Informatics

20. Change Request #5Behavioral Advance Directives • Make Behavioral Advance Directives required field on Admission History Nursing Informatics

21. Change Request Review • Discussion • Approval • Change Request #1 – Addition to Wound Dressing Type- Antimicrobial incise drape - Approved • Change Request #2 – Request to add Open Surgical Incision to Wound Incision description - Approved • Change Request #3 – Request to add height to the banner bar – Not Approved – see minutes • Change Request #4 – Addition to Admission Assessment - Approved • Change Request #5 – Make Behavioral Advance Directives Required on Admission History – Placed on Hold by Requestor Nursing Informatics

22. Change Request from Meeting • None this meeting Nursing Informatics

23. Open Discussion Nursing Informatics

24. Minutes • Reviewed changes that occurred in the last 2 months • Reviewed what is in process • Update given on Outcomes/Careplans – work group has completed 4 and will present to the NLC/ANCC in Jan. • Update given on Vitalslink – if all goes well with the Fetalink upgrade 1/12/12, we should be able to have the Welch Allen devices working and sending the V/S to IMPACT by first of Feb. Plan on Train the Trainer classes the end of Jan. • Reviewed TB Skin Test reading orders, tasks, forms that will go into production 1/10/12 Nursing Informatics

25. Minutes • Reviewed Change requests – see change request slide • Only Change request not approved – Addition of Height to the Banner Bar – Pros and Cons discussed. Decision made based on the Height data is easily accessible on the Nursing Communication page and the Patient Care Summary in own section and the measurement section in IView. The Height pulls forward if click in the measurement section. Nursing Informatics