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Provider HUGO User Guide

1. 4 Please Endorse any results to acknowledge that you have seen them and will act upon abnormal values d Please only select Refuse if it is not your patient gi The process to refuse is to click Refuse radio button oo Choose Not my patient as the Reason 29 To Limit 5 9 Type refuse and press Enter 10 Double click either Refused Lab Results or Refused Rad Results Type a name or select from list Show names from refuse Global Address Book Right click to add remove a name in the personal Send to address book Name Position Name Refused Lab Results HIM Administrator Inbox Refused Lab Results Refused Rad Results HIM Administrator Inbox 11 Click the button 12 Click Jorl Message Center Results to Endorse Modifications 1 Open your Message Center 2 Click the Inbox menu PowerChart Organizer for WET Test HUGO Physician Task Edit View Patient Chart Links Notifications ad Home A Patient List Ha Scheduling J Message Center 82 Multi Patient Task List Q Medication Information QF R ED i New Sticky Note View Sticky Notes Message Center 3 Click Management Configuration Empty Trash Manage Ad Hoc List Manage Configuration Manage Out of Office Manage Pools Manage Preferences Manage Proxy Query Future Reminders Show Completed Show Preview Pane Scroll down the list on the left hand side of the scre
2. 5 Right click the medication 6 Click Convert to Prescription FH Medications Renew Modify Suspend Complete Cancel DC Delete Convert to Prescription O Add Modify Compliance Order Information Comments Reference Information Advanced Filters Customize View v Disable Order Information Hyperlink 7 Click the ellipse button beside Send To VHC3205RP1 on Ihprint2 from PBD569 in sessi 8 In the Prescription Routing window ensure Send To has Printer selected 9 Click the Other Output Devices tab 10 You may need to scroll down to see and click Unknown 11 Find and select your printer under Device Name Send Prescription Routing i to Printer v lt q Apply to All Pending Prescriptions Selected Pending Prescription s All Pending Non Tamperproof Prescriptions Default O Always treat my personal default output destination as the default Always use the default output destination associated with the computer that am using Dutput Devices Other Output Devices BEI REIS EHE be ed Bed EH e Filter By B 4 lt eb Listowel Memorial Hospital Eh LRCP eb Mount Hope Campus p Old LRCC eb Parkwood Campus fp RMHC London eb South Huron Hospital Associa Eh Southwest Centre for Forgnsic eb St Joseph s Campus p eb St Thomas Elgin General Host 1 Eh Strathroy Middlesex General H Eh Tillsonburg
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4. E Limit by organization Limit by position E Limit by relationship Click the name of secretary and click the L 0K button Ta Provider Selection Last Name wbt 4 E Limit by group Limit by organization E Limit by position E Limit by relationship ec C ES 5 uffis O Search ha New Provider Preview Clear First Mame Ma data filtering Mo data filtering No data filtering Ma data filtering View physicians only WET Test WET Test WET Test WET Test WET Test WET Test WET Test WET Test WET Test WET Test WET Test WET Test Aliases HUGO Audiology HUGO Dietitian HUGO Medical Secretary HUGO Occupational Ther HUGO Pharmacists HUGO Physician HUGO Physician 2 HUGO Physiotherapist HUGO Ph Unitheg Clerk HUGO Resident HUGO AN HUGO APN Allmitting Physicta Cancel 8 You are returned to the Proxy dialog box 9 Click the down arrow beside the Access field and choose Read Full Access Maintain 10 In the To field set your date to 2100 01 01 and a time of 2359 To 2100 0101 E 5 2359 11 12 Next click the button 13 The secretary s name now appears under Name in the Proxy dialog box Mame Limited to 50 ch Access End Date WET Test HUGO Medica Read 2100 01 01 Group Provider New Apply Cancel 14 Click the button 15 You are returned to the Modify
5. Late Postings Assign gt lt Unassign Details Public Event Types Include Assigned Subscriptions Emergency Attending Admitting Emergency Copy to Hugo Subscription Inpatient Copy to Inpatient Attending Admitting da oon M Delete Type 9 Relationship Encounter Types Exclude Include Emergency HLA QC Inpatient One Day Stay Outpatient PreReg Inpatient PreReg One Day Stay PreReg Outpatient Referred In Stillborn Telephone Communication 11 You need to name the rule click the Name field and type a name 12 Click the button when done 13 A dialog box alerts you that your settings have been saved successfully 14 Click the button Commit Progress Settings saved successfully ORDER ENTRY Adding a Medication Order 1 Select the icon from the table of contents menu 2 In the Find field of the Add Order window type the name of the medication to administer Find lasid M Contains Bmw LA B 3 Select the correct Order Sentence P Order Sentences Order sentences for furosemide Lasix 20 mg tab ORAL BID 20 mg tab ORAL daily 40 mg tab ORAL BID 40 mg tab ORAL daily 80 mg tab ORAL BID 80 mg tab ORAL daily 120 mq tab ORAL BID 120 mg tab ORAL daily
6. Load My Favorite EJ Customizations to the following component s cannot be applied because the component s no longer exist in the plan metoclopramide COMMON Mausea Vomiting Module 6 Click the button and then click the button 7 Your favorite appears with the pre checked metoclopramide ORAL unavailable and replaced with an unchecked metoclopramide subcutaneous Now you know the metoclopramide has been changed so will pay special attention to the ordering of maxeran Pann Pais Tice TOCERC LH UTA HR Opera nom Tas da gum Falamd Chas Lido Pee Opium Cue o Gad Hop Qin Preis Dictador Gea Cee le Patent Teck Let eco iros AQ dd Rp Leccion AQUI flee DEl leo acto Penta ta ten cry it TEL Pau Der T oe echange iier al te caesum senes m dins dean v Goce ET ater Locator o Pcr Jr bean Renan copian don EI ptes Mama Demy ater Dummy Patient Today LOCKBOX PTH 118 HK b9 Mem Aiegi ig od MESA Co MOMO yi Dat Earl A ery Orders Ja Cinch ddr Birin a orina mem dad dete Perales i li w als ORAL ll thri PES Aidai ies u ONC Gage ue xd ardarcetion ONAE Er Eri i ma erecta Us ab hort Peri names D mdr Lene rio icboantere uro k pared ud inpoci n SUSCUTAHECLR Orc khecueg eene rl mcr A PEN rinsed i om ra Dipraniz magna Pared habra rg ul ORAL di buy PEN S neg H oq TME Beura do inier alepa Bi g mjin SUBCUTAHCLE of bourn PRA Ror aaa mommies Meeting Pleni talon tad Bra reple D
7. 4 Click the button 5 Expand the Details section of the order by placing your mouse on the border of the Details pane your mouse will turn into a two headed arrow 6 With the two headed arrow visible click and hold the left mouse button while you drag the pane up to increase its size Details for furosemide Lasix Details Era Order Comments Diagnosis Drug Form Route of Administration a Dose This field will be automatically filled out based on the dosage entered b Dose Unit enter the units that the dosage will be administered in c Drug Form enter the drug form Ensuring that tab is not entered as a plural d Route of Administration specify what the route of administration will be Frequency PRN Yes No PRM Reason Infuse Over Infuse Over Unit Duration e Frequency enter the frequency of the dose 8 If you want the medication to have a stop date then you must complete the Duration and Duration Units fields a Duration enter the number of the duration E g if 3 weeks enter 3 the unit will be entered next Requested Start Date Time 2014 04 30 12 25 Stop Date Time pue ai di gt First Dose Priory b Duration Unit based on what was entered in the Duration select the unit When to Use the Order Comment Tab Details for furosemide Lasix Details is Order Comments E Diagnosis Order comments The Order Comm
8. af 250 mcg rescribed 1 tab ORAL daily 30 tab 0 Refill s 2014 06 12 12 43 Ja digoxin digoxin 0 25 ral tablet Maintenance Qe metoprolol metoprolol Prescribed 1 tab ORAL BID 60 tab 0 Refill s 2014 06 12 12 43 tartrate 50 mq oral tablet Maintenance other Patient Compliance Patient compliance can also be modified This is used to reflect a self imposed change in the patient s medication regime 1 Highlight the medication you wish to change 2 Right click on the medication to display a shortcut menu 3 Select Modify on the menu Y Last Documented On 2014 06 12 12 43 Test Documented Medications by Hx x acetaminophen caffeine co Documented 2 tab ORAL q4 hours PRN for pain 0 Refill s deine acetaminophen caf A digoxin digoxin 125 mca Documented 1 tab ORAL daily 30 tab 0 Refill s 2014 04 28 22 49 0 125 mg oral Modify ce y metoprolol me s d AL daily do not chew or break tablets 30 tab 0 tartrate 200 mg xir 014 06 12 12 41 Maintenance xy metoprolol me Complete AL BID 60 tab 0 Refill s 2014 04 28 22 49 tartrate 50 mg a Cancel DC nce Prescription Delete Be acetaminophen AL q6 hours PRN pain 120 tab 0 Refill s deine acetamir Add Modify Compliance Ele digoxin digoxir AL daily 30 tab 0 Refill s 2014 06 12 12 43 0 25 mg oral t Order Information nce Ele metoprolol me ere AL BID 60 tab 0 Refill s 2014 06 12 12 43 tartrate
9. 17 Review the orders and then click the Sign button 18 Click Refresh Minutes Ago Order an Intermittent IV Solution Daily x 5 days Example Normal saline 1 L over 8 hours for 5 days P Order Sentences fo Ja Pez Order sentences for sodium chloride 0 9 sodium chloride 0 9 bolus Mone 250 mL injection IV OMCE infuse over 30 min 500 mL injection IV ONCE infuse over 1 hr 500 mL injection IV ONCE infuse over 30 min 1 000 mL injection IV ONCE infuse ower 1 hr 1 000 mL injection IV ONCE infuse over 30 min 1 In the Ingredient Details tab change Infuse Over from 1 hour to 8 hr and Frequency from once to daily Details for Sodium chloride 0 9 sodium chloride 0 9 bolus Details Ingredient Details E Order Comments Diagnosis HAS Ingredients Dose Hate Infuse Over Frequency Duration sodium chloride 0 9 bolus 1 000 mL 5 8 hr daily Total valume mL 2 Click the Details tab 3 n the Duration field type 5 and click the down arrow beside the Duration Unit field and choose day Details for Sodium chloride 0 9 sodium ch Details Ingredient Details lie Order Comments Diagnosis p Jj Infuse Over Infuse Over Unit Duration 4 Click the button to sign the order and then refresh the screen 5 The order will appear on the MAR with a medication task to sign off daily 2014 07 10 2014 07 08 Medications 08 00 12 20 Scheduled 1 000 mL injection
10. 10 Click the button and refresh your screen Important Once you click the button the prescription is printed to your default printer Cancel a Single Lab Order from a Larger Frequency Order 1 On the Orders page you will see the main lab order parent 2 Click the plus sign E to expand the main order to see all the daily frequency children orders Order Mame Status Complete Blood Count and Differential CECD CBC Ordered mplete Blood Count and Differential CBCD CBC Ordered Ordered Dispatched To Cancel a Single Lab Order 1 Right click on the specific lab order check under details 2 Click Cancel DC from the shortcut menu D 2 um xe y E Active BH EY Complete Blood Count and Differential CBCD CBC Ordered and Diff and Difp E Diagnostic Imaging E Active amp L Chest PA AP 1View Cancel Reorder E Inactive E s Abscess Drain Suspend Activate LJ e Abscess Drain Complete Ef e Abscess Drain sees Delete L d oe Reschedule Task Times E Non Categorized Add Modify Compliance Complete the Cancel Reason field Click the button Click the button Once you sign the single order you will see the parent order is still there and the single child order is canceled Laboratory H Active a EY Complete Blood Count and Differential CECD CBC Ordered and Diff Complete Blood Count and Differential CBCD CBC Canceled and Diff Refresh the s
11. E 9j Remaining Administrations Q0 Stop Unknown Reason for NF 10424078 Drug name Freetext Dose Strength Dose Strength Dose Unit v Volume Dose Volume Dose Unit Iv m Route of administration Y Frequency udi E PRN Yes No PRN reason L Ly Duration Duration unit v Requested Start Date Time 2014 05 20 10 47 Stop Date Time 77 7 7 el First Dose Priority y Rx Considerations 8 Click the button 9 Refresh the screen Admission Reconciliation Admission Provided a complete and accurate Medication history the work of the Admission Reconciliation is straight forward There are two choices e Continue a medication e Do Not Contine a medication With each med you have the option of continuing the medication and altering the dosage or frequencies by choose Continue and then on the right side they click on the medication to bring up the order details to change the appropriate field Status w Meds History w Adm Mads Rec Disch Meds Rec Medications Prior to Admission Reconciliation Medications After Admission Reconciliation Add 5 Manage Plans G Order Name Details Status p CL Order Name Details Continue Medications 3 docusate Colace 100 mq oral capsul 1 cap ORAL BID 20 cap PRN for c Documen x ethosuximide ethosuamide 250 mg 2 cap ORAL daily 350 cap Documen Musate Colace 100 mq 1 cap ORAL BID FRM c
12. Years Laity Allan H 24 Any Street Last Name First Name Middle Name Client Med Service Facility 4 Age To Visit Number Anon Visit Number Nurse Unit Room Bed Reg Date Disch Date Enc Type Attending Physician Med Service 3 422344745 V C51 C5 103 4 2013 07 31 14 46 Inpatient Yoo John H Otolaryngology DK Cancel Preview 5 Select the correct patient and encounter and then click the button 6 If prompted assign a relationship and click the button 7 The patient is added to your custom list Patient List PERRERA B 8 Bla A V Zone C Level 5 100 My Follow up List Anon Age Sex t Note Attending Physician Visit Reason Medical Service LOS Leave Status Admitted Discharged Visit 1187 05 03 CI DocMedi 64 years Female Yoo John H surgery Otolaryngology 33 9 Days 2013 07 31 14 46 422344745 8 Repeat the steps to add additional patients Method 2 When a Patient Chart is Open When a patient chart is open click Patient on the menu bar and select Add Patient to a Patient List and then click the desired custom list Practice HUGOG 1187 03 52 Opened by WET Test HUGO Physician Task Edit View MEGA Chat Links WNotifications Mawigation Help aj Home 4 Patie Search P JNewStickyNote Pecent Tee se re Previous Patient s Chart a Mext Patient s Chart Practice HU New Sticky Note es ViewPoint View Stic
13. 2 tab tab ORAL daily Request Ordered 10 mg 2 mL injection IM q6 hours Ra 14 01 aL F The first time a nurse or unit clerk open the patient s electronic chart after a proposed order is entered the system will place an order called Proposed Orders Exist This order will fire a task that is viewable for nurses and unit clerks Order Placed by System This order will change to complete when the task is completed but will fire again if the proposed order is still in place E Patient Care E Active v ero Proposed Order Exists Ordered A Proposed order exists and requires attention by the MRP 2014 0 Tasks Firing to Nursing and Unit Clerk Task List This task is meant to alert nurses and unit clerks to notify the admitting team of the proposed order It is recommended that the task is marked as complete after the provider accepts rejects the proposed order Task retrieval completed Task Status Scheduled Date Time Task Description Order Details Provider Name En Pending 2014 04 27 17 52 Proposed Order Exists A Proposed order exists and requires attention by the MRP System System Please check with the MRP for the Proposed orders on this chart Proposed Order Alerts in FirstNet When a proposed order is placed on a patient s chart in FirstNet the Proposed Orders Exist order will be placed by the system and a Proposed Orders icon ie will appear in the To Do section on the tracking board Bed Status TLOS
14. Order Service o The system is unable to save changes to plan orders Retry Cancel Solution When ordering Routine xray T 1 for Post Op Day 1 ensure you select tomorrow s date and time in the Requested Date Time field as shown below Details iz Order Comments Ts Offset Details w Priority Routine Requested Date Time 2014 05 04 peoo Send Appt notification to if not Ordering Physician E PowerPlans in Planned State We are implementing a new rule for planned PowerPlans including Suggested Orders PowerPlans so that a pop up window will show up whenever Providers RNs RPNs or Unit Clerks open a chart In addition an order will be entered that has a task associated with it that will show up for RNs RPNs and Unit Clerks so that they are aware the provider has entered the planned PowerPlan Nursing staff either need to address the planned plan or call the Attending physician or someone from their team so that they can review the Suggested Orders plan an initiate it if appropriate with any changes deletions that they deem appropriate The alert will look very similar to this E Discern Open Chart Dell Sam 1 of 1 e PowerPlans in PLANNED or SUGGESTED state Cerner The following powerplan s have been left in planned status 1 COMMON Nitroglycerin Patches 2 PAED ENDO Endocrinology Clinic 3 ANESTH Initial Post Op PCA Neuraxial Opioids Multi Phase 4 ANESTH Initial
15. P Modify Patient Lists Available lists Active lists Thoracic Surgery Group Dr Test Patients H WBT Test U8 OK Cancel 14 Click the L9 button to return to the Organizer screen You can modify the order of the lists using the up El and down arrows 15 The new list now appears as its own tab with all patient names automatically generated for that location Build a Relationship List You can build a patient list based on your established relationship to the patient For example if you are identified as the admitting physician the patient s name is automatically displayed when you build the relationship list In this example we will show a provider the steps to build the Relationship List and grant proxy to this list to a medical secretary There are three steps in the creation of a Relationship List for the provider medical secretary workflow 1 The provider needs to create the list 2 The provider then grants the medical secretary Proxy Access to the list 3 The medical secretary moves this list to the Active lists in the Modify Patient Lists window Step 1 Provider Creates a Relationship List 1 From the Patient List toolbar click the List Maintenance icon Patient List Ej E a amp amp ge E BS 2 The Modify Patient Lists dialog box opens 3 It displays Available lists on the left an Active lists on the right 4 Tocrea
16. Placing Proposed Orders As an alternative to Suggested Order PowerPlans physicians have been given the ability to propose orders Proposed orders will appear with an amp icon and the status of Proposal Proposed orders will also show up in Message Center of the physician it is directed to gre ER MT Order Mame Status A Laboratory H Active lb E a ud Glycated Hernoglobin GLYHB Proposal If you see these orders please keep a watch to ensure the MRP team addresses them If the order is urgent please page your team to make them aware of the order s We are working on an alert that will fire when a patient has a proposed order This alert also fires a task to nursing and unit clerks to remind them to make sure the order s is addressed by the MRP team From a Consulted Physician Proposed orders from a consultant will now show in a Proposal status on the Orders page Customize View Status Details Ordered 2 g injection IV q24 hours infuse over Requested Start Date Time 2014 04 18 1 Ordered 80 mq 2 tab tab ORAL daily Request Ordered 10 mg 2 mL injection IM q6 hours Ra 14 01 E The first time a nurse or unit clerk open the patient s electronic chart after a proposed order is entered the system will place an order called Proposed Orders Exist This order will fire a task that is viewable for nurses and unit clerks Order Placed by System This order will change to complete when the task is comple
17. Reconciliation History 2 Right click the order and select Print to reprint the requisition and then fax it to the appropriate department Order Information eb Throat Culture THRC Commens Results E Diagnostic Imaging Ng EI NEUE Reference Information Eh A s E Chest PA Lat H Allied Health Advanced Filters Active rll nj Outpatient Allied Health KE Disable Order Information Hyperlink 3 The process for booking a patient will continue in the same way as it is today Important This referral does not go to the task list of the allied health professional so verbal communication is still encouraged STAT Allied Health Referral Orders Please ensure STAT allied health referrals are followed up with a page to the allied health professional ALC Order Required Fields Leave as To Be Determined The two mandatory fields are to remain as To be determined The Social Worker will modify the order to the most appropriate option when she he does their review Please ensure that the Social Work is checked off in the PowerPlan y Details for Alternate Level of Care ALC Designation Details IE Order Comments s Diagnosis 0 Requested Date Time 2014 05 02 M 1448 Most Appropriate Discharge Destination To be determined v Discharge Destination To be determined M Date D C Destination Determined g Specialized Supports Indicator Yes
18. Right click anywhere in the blank white area 2 3 4 Select Drug Allergy 5 You will be taken to the Allergy documenting tool 6 Oncethe allergy has been recorded click OK 7 Continue to your next task Height and Weight Alert You may also get a notification that the Height and Weight have not been recently documented on this patient This is not a Hard Stop Alert and can be bypassed Discern 2 of 2 E DISCERN ALERT Cerner The height and weight for this patient has not been documented in the past 30 days Please document prior to placing an order Medication Alert An Interaction Checking message is a notification that the medication you have entered is not recognized by our pharmacy tools and will not be able to compare this entry to the other medications that are ordered for this patient to check for possible interactions Differences between the Admission and Transfer Reconciliations Some of the key differences between the Admission and Transfer Reconciliations are as follows Admission Reconciliation Home medications that were initially continued on admission will be grouped with their in hospital carried over counterparts You will not get a Radio button for each medication Transfer Reconciliation Home medications that were not continued initially will be blank once again and left for you to reconcile Medications that appear without their as per home counterparts were ordered in
19. Type Kidney Urine right Type Kidney Washing Left Type Kidney Washing Right Type Post Cystoscopy Voided Type Renal Pelvis Washing Left Type Miscellaneous Type Neobladder hs NT CI Gladys 1187 07 36 DI Order Changes LHSC With HUGO you no longer complete paper requisitions for radiological tests performed at LHSC and St Joseph s This includes Ultrasound Nuclear Medicine CT MRI Fluoroscopy Interventional and General Radiology These orders will be entered electronically Pi Foot Bilat Routine Foot Bilat Routine Portable Foot Care Foot Drop Dynamic Large 12 X 24 charge noL enumebleon Exercises Foot Lt Routine Foot Pump Foot Rt Routine Foot Rt Routine Portable Requested Hospital Field 1 Sharks with r Advanced Options Type 5 Ambulatory All Search within At location In the order details you can change the default between the two hospital sites of LHSC UH Main and VH Main as they are considered the same facility Parkwood Main Details for CT Head Details lie Order Comments UJ Impaired Renal Function Patient on Dialysis Date of Creatinine Level Requested Hospital Precautions RMH London 5 Satellite Imaging South Huron St Josephs Main 5t Thomas Strathroy Middlesex Tillsonburg VH Main Wingham Woodstock General 2 However if you require a test done at
20. A Check Alerts iLjComrments Est Start 2014 06 dd Outcome Intervention Platelets Multi phase Labor ood LRCP Module Plann ntial CECD dd Prescription Packed Red Blood Cells and Platelets Phases Right click on the ADULT Packed Red Blood Cells PRBC or ADULT Platelets PLT order and select Modify Planned Order m BEST PRACTICE Transfuse slowly 50 mL haur for the first 15 minutes where appropriat X E ADULT Packed Red Blood Cells PREC Iv A Transfuse Packed Red Blood Cells Modify Planned Order E W Solutions Complete the Rate of Infusion each unit over and Reason for PRBC transfusion fields Details for ADULT Packed Red Blood Cells PRBC Details g Order Comments Es Offset Details Diagnosis p Reporting Priority Routine Number of Units Required 1 Rate of Infusion each unit over Special Requirements Reason for PRBC transfusion v Important Do not enter transfusion parameters intended for Nursing staff in this order This order is for Blood Transfusion Lab only Please use the Conditional If Then order for Nursing related information Select any PreTransfusion or PostTransfusion medications required Medications PreTransfusion Consider pretreatment only if there is a history of SIGNIFICANT allergic or febrile reactions Diphenhydramine has high sedative and anticholinergic properties Use th
21. Compliance dl 0 days A q60 hours Dose Route of Administration Show All uration Dispense 2t8b Y ORAL e lh 3 a q6 hours Press ENTER to select PRN for pain v Special Instructions Type Of Therapy C Acute 0009 e i Stop Date Time 77 777 Maintenance Select Prescriber Address Print DEA Number Yes No Samples Performing Location v Order Output Destination v Drug Form tab 5 You can hide the order details by clicking the small arrow to the left of the order details window and proceed to the next medication that requires your attention y Pbi 2eetaminophen Tylenol Details ig Order Comments Diagnosis silos 2 lin i Y Cancelling a Medication If a medication is no longer being used by a patient or they have since their last visit had the medication discontinued for them by another health professional the medication can be removed from the history of active medications 1 Highlight the medication you wish to stop 2 Right click on the medication to a display shortcut menu 3 Select Cancel DC from the list of options 4 Add rares m Di Document Medicalion by Hx i A Order Narne Status Detail Last Dose Date Time in Y Last Documented On 2014 06 12 12 43 Test HUGO Ph Documented Medications by Hx acetaminophen caffeine co Documented 2 tab ORAL ql hours PRN for pain 0 Refills deme acetarnmnoph
22. Dystonia Info source Not Specified EPS Euphoria Onset lt not entere Specified Facial swelling Patient Survey Fever Gastrointestinal upset Hallucination Increased blood pressure not hypertension Chronological Itchy watery eyes Laryngeal spasm O Reverse chronological Lethargy Lightheadedness Lip swelling Malignant hyperthermia 13 Click Apply then New when you need to add the other allergies 14 Click OK when all allergies have been documented 15 The green checkmark indicates that the allergy qualifies for cross referencing with pharmacy s drug database 16 Click OK to return to the patient s chart IP Custom Information PKWD Learn Practice64 Task Allergy MarkAllasReviewed e Add Modif No Known Allergies i Reverse Allergy Check Display Active v D Substance Category Reactions Seve Type C Est Onset Reaction S Updated By Source Reviewed Drug Hives Allergy Active 2014 04 1 2014 04 17 13 00 Environm Active 2014 04 1 2014 04 17 13 00 Food Active 2014 04 1 2014 04 17 13 01 Cancel Documenting No Known Allergies When documenting allergies it is important to document all three categories of allergies Drug Food and Environment If your patient s has no known allergies in any of the three categories follow these instructions 1 From the table of contents menu add an allergy by clicking Add Allerg
23. HbA1C J olr Creatinine eGFR Y olr Uric Acid Ei olr Sodium Ei olr Potassium A olr ALT Ei olr Alk Phosphatase r F r r F Z J olr Bilirubin A olr Albumin rii olr Lipid Assessment 4 Lipid Assessment Includes Cholesterol HDL C Triglycerides calculated LDL C amp Chol HDL C Ratio For individulal lipid tests use the the Other test A olr Albumin Creatinine Ratio Urine a olr Urinalysis Chemical Y olr Neonatal Bilirubin Hematology and Coaqulation Y ol CBC a olr Prothrombin Time INR Immunoloqy a olr Pregnancy Test Urine Ooo ooo ooo olr Rubella olr Prenatal ABO RhD Antibody Screen titre and i olr Repeat Prenatal Antibodies Microbioloqy olr Cervical olr Vaginal olr Vaginal Rectal Group B eu 7 olr Chlamydia a olr Sputum olr Throat 7 7 olr Wound olr Urine 7 olr Stool Culture Er OOO 00000010 uad r i olr Fecal Occult Blood Test non CCC 4 olr Colon Cancer Check FOBT Viroloqy Seroloqy A olr Viral Acute Hepatitis E olr Viral Chronic Hepatitis Bloodwork olr Free Prostate Specific Antigen Insured olr Free Prostate Specific Antigen Uninsured olr Total Prostate Specific Antigen Insured olr Total Prostate Specific Antigen Uninsured olr Vitamin D 25 Hydroxy Insured Meets OHIP eligibility criteria
24. No Specialized Supports As a Need Specialized Supports As a Barrier v Comments Ambulatory Medication Order as a Prescription Open the patient s chart to the Orders page 2 Click the Add icon 3 The Add Order window opens 4 Ensure you change the Type field from Ambulatory to Ambulatory Meds as Rx 5 In the Find field type the drug name and select the closest match it will turn bold and blue 6 Select the order sentence closest to the order intended and click the button m T 0K J Fz P Order Sentences G3 Order sentences for acetaminophen caffeine codeine Tylenol No 3 oral tablet None 1 tab ORAL a4 hours PRN for pain 2 tab ORAL g4 hours PRN for pai 2 tab ORAL q hours May take 1 2 tabs q4 6 hours 60 tab Cancel 7 Click the button 8 Complete the order details as required needed Y Details for acetaminophen caffeine codeine Tylenol No 3 oral tablet y Details j Order Comments E Diagnosis Send To RP1031 on LHPRNI1 Ih tvh ca from QCP387 in session 10 Dose Route of Administration Frequency Duration Dispense 20 90 Refill 2 tab Y ORAL J a4 hours 360 tab eo 2 PRN for pain v Special Instructions Type Of Therapy Acute Stop Date Time 777 777 p Maintenance Select Prescriber Address Samples
25. Nurses will continue to complete an LOA Request From picked up by or sent to pharmacy b RMHC and South West Centre Nurses will generate a paper LOA report complete and sign as appropriate and fax to pharmacy 2 The site specific process for dispensing meds for LOAs does not change What is Changed after HUGO 1 Pharmacy will not see orders to discontinue medications 2 There is no alert a message to let pharmacists know that an LOA has been dispensed 3 There is a risk that pharmacy may not be aware that there are changes to prescriptions between the time the LOA request was sent from the unit and the time it is dispensed in Pharmacy What does this Mean 1 Nurses must carefully check the LOA meds dispensed against the patient s MAR prior to giving the LOA meds to the client 2 There may have been changes to the med orders after the LOA was processed Important Pharmacy will continue to ensure medications dispensed for LOAs are accurate and up to date at the point in time the prescription is checked LEAVE OF ABSENCE LOA REQUIRING MEDICATION PATIENT ADMINISTRATION PROCESS LHSC This process aligns with the LHSC Corporate Policy PCCO81 Patient Leave of Absence Ordering the LOA 1 Provider to add 5ECOMMON Leave of Absence Module to Orders Tab 2 Complete details of Leave of Absence order including a Start date and time b Length of time c Accompaniment etc in special instructions 3
26. Once orders have been added to Orders for Signature you may choose to modify them if needed remove them or sign them 7 Clicking Modify opens the Order Details screen Details for Complete Blood Count and Differential CBCD Details E Order Comments Priority 201420722 5 1558 WH AED Label Printers Minor Proc LP635 Specimen Type Label Comment 8 Click Sign to complete the order entry process POD ALP754 POD B LP735 POD C AC LP602 POD C LP603 Trauma LP633 Triage LP760 9 Please note that if something that you would like to order is not on this Quick Orders page you can simply search for the item in the New Order Entry component without leaving the page Inpatient Ordering Recurrent Transfusions in Outpatient Settings This is to assist in ordering the COMMON Recurrent Packed Red Blood Cells and Platelets Multi Phase PowerPlan Adding the Plan 1 In the Add Order window search and select the COMMON Recurrent Packed Red Blood Cells and Platelets Multi phase PowerPlan 2 The Add Plan window will display 3 Enter in the estimated date you would like the recurrent transfusion to begin LRCP Nilsson Add Plan Le keje COMMON Recurrent Packed Red Blood Cells and Platelets Multi phase Select Visit and Start Time Fi This Visit Estimated Start Date of Timing and Parameters Future Inpatient Visit In Day s Future Outpatient Visit In Week s 5 In Month
27. Quick Orders and Charges POC Blood Glucose F POC Urinalysis 7 Complete Blood Count and Differential Chest PA Lat CBCD Chest AP Portable CT Abdomen P elvis Creatinine CRE CT Spine Cervical Electrolytes Serum E Urea U F Elbow Glucose Random F Elbow GLUR Foot Lt Routine acetaminophen 375 Abdomen 1 view ma tab ORAL ONCE Abdomen Series acetaminophen 1 00 Ankle Lt Routine 0 mg tab ORAL ONCE F Ankle Rt Routine acetaminophen oxyCODONE 325 mg 2 5 mg oral tablet 1 tab tab ORAL ONCE acetylsalicylic acid 80 mg CHEW Lt Routine tab ORAL ONCE Rt Routine azithromycin 250 ma tab ORAL ONCE View Selector ED View Adi v 1 ED Common Scripts A F Advair Diskus 250 mcg 50 mcg inhalation powder puff INHALE BID 180 ea F Advair Diskus 500 mcg 50 mcg inhalation powder puff INHALE BID 180 ea F amoxicillin 500 mg oral capsule 1 cap ORAL TID X 7 day 21 cap 21 cap amoxicillin Inpatient v LO LC PubliShare Favorites J Imaging QJ IV Fluids J Labs J Meds My Plan Favorites Patient Care 5 The selected orders will appear in the New Order Entry component under Orders for Signature Orders for Signature 2 Complete Blood Count and Differential CBCD Creatinine CRE 6
28. These additional responses will make the ordering of multiple doses within a day less confusing e g Albumin 596 500ml times 2 doses Medication Order Discontinue or Cancel Reorder 1 When you need to change a medication order please use the Cancel Reorder or Cancel DC functionality NOT Modify Cancel Reorder Activate Complete Cancel DC D elete Convert to Prescription Reschedule Administration Times Medication Request Add Modify Compliance Order Information Comments Results Ingredients Reference Information Print Advanced Filters Disable Order Information Hyperlink It is also important to expand the Details section of the medication order by placing your mouse on the border of the Details pane your mouse will turn into a two headed arrow With the two headed arrow visible click and hold the left mouse button while you drag the pane up to increase its size Details for LORazepam Details E Order Comments Diagnosis E HJ This is so that you see the Requested Start Date Time field clearly preventing confusion with medication administration times Details for LORazepam Details le Order Comments s Diagnosis o B Remaining Administrations PRN Stop Unknown Dose Dose Unit mg E Drug Form tab Ly Route of Administration ORAL LY Fre
29. af metoprolol metoprolol Documented 1 tab ORAL daily do not chew or break tablets 30 tab 0 tartrate 200 mg oral tablet Refill s 2014 06 12 12 41 Maintenance zx digoxin digoxin 125 mcg Documented 1 tab ORAL daily 30 tab 0 Refill s 2014 04 28 22 49 0 125 mg oral tablet Maintenance x metoprolol metoprolol Documented 1 tab ORAL BID 60 tab 0 Refill s 2014 04 28 22 49 tartrate 50 mg oral tablet Maintenance E Prescription B digoxin digoxin 250 mcg Prescribed 1 tab ORAL daily 30 tab 0 Refill s 2014 06 12 12 43 0 25 mg oral tablet Maintenance Be metoprolol metoprolol Prescribed 1 tab ORAL BID 60 tab 0 Refill s 2014 06 12 12 43 tartrate 50 mg oral tablet Maintenance other B acetaminophen caffeine c Prescribed 1 tab ORAL q6 hours PRN pain 120 tab 0 Refill s odeine acetaminophen c How to Fix Inconsistences Adding a Medication Click the ti button In the upper left hand corner of the screen Type the medication in the Find field Select the medication Click Done L PA Ii o Add all pertinent information Modifying a Medication 1 Click on the medication in question 2 Right click on the medication 3 Then click Modify from the shortcut menu i Int PPE Pl Document Medication by Hx amp Order Name Last Dose E Y Last Documented On 2014 06 12 12 43 T Status Details Documented Medications by Hx Y acetamin phen caffeine c
30. eal MED Suggested Orders Medical Transport Request Medication Desensitation Medication Instruction medication ternplate m Medicine Hepatology Workup Care Set sal Medicine Paracentesis Care Set Important CareSets cannot be saved in a PowerPlan nor can other PowerPlan modules be save into a PowerPlan as a favorite Discharge PowerPlan 1 Please use the COMMON Patient Discharge Module and not the single Patient Discharge order when discharging your patient Find COMMON Patien Contains a fi vw Ga ba SS COMMON Patient Discharge Module Rationale The PowerPlan includes other discharge orderables that may be required to facilitate the patient s discharge 2 All the orders in the COMMON Patient Discharge Module fire to nurse and unit clerk as tasks to complete si ee Add to Phase 0JComments Start Now Duration Mone ae Y Component Status Details COMMON Patient Discharqe Module Planned Pending E Patient Care C Y Return to Clinic E Allied Health Y Outpatient Allied Health Referral Outpatient Allied Health Referral VH H Discharge Planning Discharge Patient Discharge Medical Transportation Emergency Medical Transport Y Follow Up Office Appointment Y Outpatient Clinic Referral Qutpatient Clinic Referral VH Initiating Discharge PowerPlans 1 Toclearly communicate pending discharges please remember to Initiate and Sign all Discharge Power Plans 2 If the disc
31. gm Inpatient 2014 04 07 13 43 lt No Discharge date gt Location U 8SAMU A8 232 A NemisdanrtAfall MARIAE 1 Discharge Status Red fe Print 13 minutes ago 2 To change the encounter you are viewing click the location hyperlink on the demographic bar to open the Custom Information dialog box P Custom Information Education Tracey Inpatient sugery General Surgery 2014 04 07 13 43 00 Inpatient surgery Plastic Surgery 2014 01 25 20 37 00 Inpatient readmission Cardiology 2014 01 14 07 49 00 Inpatient ill General Medicine 2013 12 03 14 00 00 Inpatient ill General Medicine 2013 12 03 13 51 00 Emergency unknown Emergency 2013 12 03 13 50 00 Emergency headache Emergency 2013 11 26 10 06 00 Inpatient surgery Plastic Surgery 2013 11 19 13 56 00 Fmarnanene haarnarha Fmarnaenn IAA AA Wan n GENERAL INFORMATION Full Name Education Tracey Reg Date Time EMC Phone 4 ii 3 Double click the desired encounter to change encounters Placing a Patch Order Add Patch Order 1 Click Order s ASE from the Table of Contents menu 2 Inthe Find field of the Add Order window type the name of the medication to administer Find nicoti n Ga fab 7 LE B Folder GCMS Nicotine pea ER ie M 3 Click COMMON Nicotine Replacement PowerPlan 4 Enter the Physician name and Communication type Ey Physician name Order Date Time Ls k 2D 4 05 23 gl 1254 Communication type Yerba
32. hospital Icons will also appear if the medication was ordered via an initiated plan Transfer Reconciliations cannot be signed until they are completed Important When you are accepting a Transfer you may need to D C medication from the previous service no longer needed ie Med Admission first prior to reconciliation and ordering of new meds Status rana Lr cd wf Meds History s Adm Meds Rec Disch Meds Rec pl Medications Prior to Transfer Reconciliation Medications After Transfer Reconciliation ES X Order Name Details Status gt P E Y Order Name Details Status Continue Do Not Continue B Medications y acetaminophen caffeine codeine T 0 Refill s Documen O PE Eb acetaminophen caffeine codeine T 1 tab ORAL daily PRN pain Ordered O Eb acetaminophen caffeine codeine T 1 tab ORAL daily PRN pain Ordered d acetaminophen caffeine codeine T 1 tab ORAL daily PRN for pain Documen x p acetylsalicylic acid 80 mq 1 tab ORAL daily Ordered 9 O Eh acetylsalicylic acid 80 mg 1 tab ORAL daily Ordered yy acetylsalicylic acid acetylsalicylic ac 1 tab ORAL daily Documen fp amp atorvastatin Lipitor 20 mq 1 tab ORAL daily Ordered O fp amp atorvastatin Lipitor 20 mq 1 tab ORAL daily Ordered fp cef TRIAXone 1 q 100 mL hr IV q12 hours Ordered O gp cefTRIAXone 1 q 100 mL hr IV q12 hours Ordered y cefTRIAXone cefTRIAXone 1 q injec 1 q IV q12 hours 28 ea Docum
33. metoprolol tartr 1 tab ORAL BID 60 tab Documen y nicotine nicotine 14 mg 24 1 patch transDERMAL Documen 3 Continued Home Medications acetaminophen caffeine co 0 Refill s Documen acetaminophen caffeine co 1 tab ORAL daily PRN for p Documen acetaminophen caffeine co 1 tab ORAL daily PRN pain Ordered acetylsalicylic acid acetylsali 1 tab ORAL daily Documen acetylsalicylic acid 80 mq 1 tab ORAL daily Ordered cefTRIAXone cefTRIAXone 1 1 q IV q12 hours 28 ea Documen cefTRIAXone 1 q 100 mL hr IV q12 hours Ordered risperiDONE Risperdal 2 mq 1 tab ORAL daily 60 tab Documen risperiDONE Risperdal 2 mq 1 tab ORAL daily Ordered sitaGLIPtin Januvia 50 mq or ORAL Documen sitaGLIPtin 50 mq 1 tab ORAL daily Ordered Medications fp amp atorvastatin Lipitor 20 mq 1 tab ORAL daily Ordered amp IV Solutions gp 3 lactated ringers 1 000 mL 125 mL hr IV continuous Ordered metoprolol metoprolol tartr 1 tab ORAL BID 60 tab Documen nicotine nicotine 14 mq 24 1 patch transDERMAL Documen acetaminophen caffeine co 0 Refill s Documen acetaminophen caffeine co 1 tab ORAL daily PRN for p Documen acetylsalicylic acid acetylsali 1 tab ORAL daily Documen cefTRIAXone cefTRIAXone 1 1 q IV q12 hours 28 ea Documen risperiDONE Risperdal 2 mq 1 tab ORAL daily 60 tab Documen sitaGLIPtin Januvia 50 mq
34. 0 Refill s oral capsule extended release HYDROmorphone Hydromerph Contin 3 mg 1 cap ORAL before breakfast 0 Refill s oral capsule extended release Printing the BPMH Facilities may elect to print out a Medication history or BPMH This is a common need in cases of inter facility transfers This may prove especially useful for patients going to non cerner non HUGO facilities 1 Click Task on the menu bar Click Reports 2 3 Place a checkmark in the Transfer Medication Administration box 4 Click Print CI Paul 1187 07 27 Open D Reports View Patien O Discharge Medication Plan Dl Leave of Absence Medication Chart Diet Worksheet C Diet Worksheet TVHPP HUGO BPMH Form Periop OL ule Password ication Ad Documenting Medication History for a Unknown Medication With a medication template you get to specify the details provided to you by a patient or family or friend that does not force you to conform to the fields that usually accompany other templates The entries generated through this method cannot be reconciled They will appear on the list of medications but will not be matched to any entries in the pharmacy catalogue of existing or formulary medications Non Formulary Tip Rather than using the non formulary template please try to find a match in the catalogue You can then modify the strength of the med or modify the order sentence If you cannot find a medication call P
35. 1 Click the Start button and then click Settings and click Printers and Faxes 2 Find the printer you want as default 3 Right click on the printer you want as default and select Set as Default Thin Clients A Client Support person will need to do this as it requires a special login and password Contact the HelpDesk RECORD WHY YOU WERE IN A PATIENT S CHART We encourage that only Regulated Health Professionals who are in the patient s circle of care go into a patient s chart It is recommended for auditing reasons to record why a patient s chart has been accessed e g reviewing a medication request from Pharmacy after discharge 1 From the menu bar click Chart CI Gladys 1187 07 36 Opened by WBT Test HUGO Physician Task Edit View Patient wee Notifications Options Current Add Help 2 Click Chart Accessed By and then click Most Recent 3 In the Chart Access Log window find your name in the Most Recent Chart Accessed Per Provider list 4 Click in the Comment field beside your name and type the reason you are accessing the patient s chart Pl Chart Access Log CI Gladys 1187 07 36 o kaJz Most Recent Chart Access per Provider Access Date Time Provider Name Position Comment 2014 05 02 14 48 24 WET Test HUGO Physician HUGO Physician 4 L oo 5 02 08 38 WBT Test HUGO RM HUGO RM Test HUGO Phys2 Cerner HUGO Physician 2013 09 14 08 51 47 Brown Tracey Lee RN HUGO Physician 2013 09 10 13 49 14 Test
36. 1 000 mL IV continuous Start date 2014 04 sodium chloride 35 mmol L potassium chlori 41 71 mL hr Total volume mL 1 001 The TPN will also then show on the MAR as follows Continuous Infusions Administration Information amino acids dextrose variable concentrat sodium chloride potassium chlaride magnesium sulfate calcium gluconate sodium phosphate multivitamin trace elements with selenium and iodide fat emulsion intravenous TPN Form in PAED is Not Available at this Time PAED Dietitians must call Pharmacy to notify them that they have completed the form Pharmacy will then view the form of the Clinical Documents Reports page Placing Verbal and Telephone Orders There will always be times when verbal phone orders are appropriate e Aurgent situation for a patient e Aphysician is scrubbed in to a case procedure e Acall for changes to existing orders in the night e The physician is travelling e The physician is in a setting where no computer is available You need to keep provider engaged until verbal or telephone order is signed so he she can address any alerts that might fire Please refer to the Telephone and Verbal Orders policy for further information Verbal Orders Start Date and Time When completing verbal orders with readback ensure that the start date and time of the order is appropriate For example an order for bedtime placed in the morning should start at 2200 hours not toda
37. 11 Sex Male Discharge Status Red Find electrocon G Contains Type P Inpatient a A 3 Ge Ba Fold Search within ll v Atlocation LHSC YC 53 MENT HLTH Electroconvulsive Therapy ECT Treatment Cl Paul 1187 07 27 4 Right click on ECT Lead Placement and select Modify Planned Order Iv x E ECT Lead Placement O A ECT Elec Modify Planned Order ECT Elec 5 Complete the Requested Start Date Time Number of Treatments and ECT Lead Placement fields Print 15 minutes ago Add Document Medication by Hx Status quos EMO O Meds History Adm Meds Rec Disch Meds Rec Orders Medication List Moa i T Addto Phase A Check Alerts jComments Start Now m Duration None Ka Component Status Dose Details MENT HLTH Electroconvulsive Therapy Treatment ECT Planned Pending Y Details for ECT Lead Placement Details Jis Order Comments Es Offset Details D lin Requested Date Time M Number Of Treatments O ECT Lead Placement nn Special Instructions AX Initiate Orders For Signature 6 In the Special Instructions field enter the Treatment Number the number Consented Treatments and the number of Total Lifetime of treatments ME Orders Print 31 minutes ago Add Document Medication by Hx Status Meds History Adm Meds Rec Disch Meds Rec Orders Medication Li
38. 2014 02 26 12 00 stop date 2015 02 2 1 g injection IV q8 hours infuse over 15 min ort Requested Start Date Time 2014 02 26 14 00 stop _ j Diagnostic Imaging Other Diagnostic Test ICancilte n b Related Results A Displayed All Active Orders Orders For Nurse Review Orders For Signature 3 The Customize View dialog box opens A Select a column to move 5 Click the Jor Gg arrows to move the column to the desired location P Customize View Select the columns you want to see Available columns Source Last Dose Date Time Compliance Status Notifications Information Source Order Mame Compliance Comments Status Order Comment Details Dose Adjustment Stop Ordering Physician ast Updated Last Updated By Quick Discontinue Select how You want to group amp sort orders Group orders by Clinical Category Sort orders by Order Name O Descending 8k Cancel 6 If necessary select a column to remove and then click the button Then by Active Inactive Ascending Change Group and Sort Orders 1 Next change settings in the Select how you want to group amp sort orders section of the Customize View dialog box for both Orders and Medication List views P Customize View Select the columns you want to see Available columns Source Last Dose Date Time Quick Discontinue Compliance Status Notifications Information Source Order Mame Complia
39. Blood Culture x 2 Module LAB Confirmation Test MHA Baas Cord Group MHA STEGH WH 53 Lab External Ontario Lab Requisition Beas External Public Health Requisition s SB LAB Fecal Occult Blood x 3 Module Baas Group and Screen MHA BS LAB Heel Group MHA STEGH WH S3LAB Sputum Culture x 3 Module MERE CENE 4 Click the button 5 PRINTER has been made mandatory because if the checkmark is removed then the OLR won t print anywhere d Component Status Dose Details Order Com LAB External Ontario Lab Requisition Module Initiated Pending E Laboratory 3 REQUISITION PRINTS gt to the patient location as noted on the demographic bar You can change the output destination by completing the olr Printer order You must sign the printed requisition for it to be accepted by an external laboratory iv FZ olr PRINTER rt click to change from default Chemistry O G olr Glucose Random E Ef olr Glucose Fasting C amp on Hbeac m 7 olr Creatinine eGFR m E 7 olr Uric Acid V L2 CTS 6 Check off the lab tests you require E Laboratory 9 REQUISITION PRINTS gt to the patient location as noted on the demographic bar You must sign the printed requisition for it to be accepted by an external laboratory NOTE For Other you must order one test per item required Chemistry Ei olr Glucose Random Ei olr Glucose Fasting olr
40. C icine acetaminophen ca Modify chew or break tablets 30 tab 0 Suspend Maintenance tartrate 200 mawa x digoxin digoxin 125 me gt O Refill s 2014 04 28 22 49 425 rir tablet PPM y metoprolol metoprolol Dc Cancel DC 0 Refill s 2014 04 28 22 49 tartrate 50 mg oral tablet Delet S Prescription De digoxin digoxin 250 meg Pri Add Modify Compliance gt 0 Refill s 2014 06 12 12 43 0 25 mg oral tablet Djs metoprolol metoprolol Pn Order Information 0 Refill s 2014 06 12 12 43 tartrate 50 mg oral tablet omment Be acetaminophen caffeine co Pri Reference information N pain 120 tab 0 Refill s deine acetaminonhen caf 4 Change all pertinent information in the Details box at the bottom of the screen In our example notice the medication is being changed from q4 to q6 hrs in this example x metoprolol metoprolol Documented ab 0 Refill s 2014 04 28 22 49 tartrate 50 mg oral tablet Prescription None Frequency Ble digoxin digoxin 250 mcg Prescribed See Instructions tab 0 Refill s 2014 06 12 12 43 0 25 mg oral tablet W 6 hours B metoprolol metoprolol Prescribed A 96 hours onc ab 0 Refill s 2014 06 12 12 43 tartrate 50 mg oral tablet q6 hours empty stomach _A q6 hours while awake Y Details tr acetaminophenjcaffeine q a weeks ophen caffeine codeine 30 mg oral tablet ES Details Order Comments
41. Cl idiomes A Checa Licor Amen how ee E Pia fonds COPLEY Hiini ior rg Phi WIS area Peral ig DELCHM Las Bode Plan MC gt angie Modality Pepbde Roi ener Radbrsietepe Planer SNT Detr s Ve Cei Pench pir bum Prad PNC feura io Eiee detec Pemai igi ash LA aradaki eer Mira apra D lor PE na ca rr uio k panda Enr inpoci n SUSCUTAHECLR ratt ETES sn mir DEO na pect D e Secun PEN Pini na omn Sabicea idol Dag ORAL gd bou PRA a banaa di vo ME Meg decida h era injection CI TAMI LE ab bearr PER Pcr venea ees EL B eua Apr DLE ml faces PER Fir nim ioi i cna Cuspror magng F aeunedi tren Deal D mg wa ORAL zii hoan PEH ARTE or ery Follies p Aggoicirrest Lets Ple derarhe AHATE idad DATE racial ul reg supp RECTAL 34 boa PEN sunaa m sn PAID ET sd chara Frane dde upper Eresin nessa Pia I e Serer hy DEAT err ete NIHA EE ern bon M O n Aetia Fe Ber e etd FRE Aitan Er ee THOR SLES ung Bartis Ferr Cp Vial baies Seg Kener Por Lp List Hanse COMMON gt irren Taconite 818 Popty giska 0307 wu Secs fin Leagan Coen ai Mp Fey 9 The Plan Favorite Notification dialog box will continue to appear until you have re saved your favorite plan Plan Favorite Notification MESA Resave your favorite plan to no longer receive this notification The changes below have been made to the standard plan since this Favorite was created An additional message may foll
42. Complete the Leave of Absence Pharmacy Medication Request order including the a Priority b Start date c Atime d Anyinstructions to pharmacy e g 72 hours 4 Initiate the PowerPlan Leave of Absence Order Start End Date and Time The Leave of Absence order has a field to identify a Requested Start Date Time but there is no field currently to identify a Requested Stop Date Time Therefore please enter the Start and End dates of the leave in the Special Instructions field of the order details v Details for Leave of Absence Details E Order Comments g Diagnosis Requested Start Date Time 2014 05 30 S 1100 Frequency Duration Duration Unit v PRN Yes 9 No pecial Instructions End of Leave 3 June at 0900 Start of Leave 30 May at 1100 Special Instructions start of Leave 30 May at1100 End of Leave 3 June at 0900 What you type in the Specialist Instructions field appears in the Details column of this order on the Orders page Status Jose PDetails Ordered Start of Leave 30 May at 1100 End of Leave 3 June at 0900 Entering your specific requests dates for a leave will ensure clear directions and indications to other staff of the status of that patient MAR ADMINISTERING MEDICATIONS The majority of medications will be administered using closed loop medication administration scanning the armband scanning the medication administ
43. Discharge Medication Reconciliation follow the steps described above Reprint a Prescription 1 2 From the Discharge Medications Reconciliation window right click on the medications that needs to be reprinted and select Renew Make the necessary changes to the prescription 3 Once completed you will again have the option to print the prescription via the Reconcile and Sign button at the bottom of the window 4 Ensure the old prescription is destroyed View Reconciliation History 1 View reconciliation history in the navigation pane of Orders or Medication List 2 Click the in front of Reconciliation History to expand and view details E Reconciliation History Admission 06 01 11 12 33 Meza Armando Transfer Discharge MESSAGE CENTER From your Message Center you are able to easily view the orders that you need to Co Sign as well as the Pools and Proxies that you belong to or have granted been granted access to Proxy Access Proxies allow you to grant another provider or resident rights to your co sign orders If you have been given proxy by another provider you have rights to perform tasks on a patient outside of your patient list The Proxies tab allows you to access the messages in accounts that you have been granted access to It also allows you to manage your account such as granting or removing proxy to others Grant Proxy to Others 1 Click the Proxies tab from Inbox Summ
44. District Memorial Eh Wingham and District Hospita eb Woodstock General Hospital 2 Unknown Th r Device Name E ab100 E ab101 E ab102 E ab103 Es ab104 E ab105 E ab 106 Es ab107 E ab108 E ab109 amp ab110 E ab111 E ab112 E ab113 Es ab114 2 ab115 Location Type PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER PRINTER VH Learn Practice19 1187 17 10 12 Click the dd button Unfortunately printers connected to external Apple computers Max OS X iOS are not accessible at this time PRINTERS CHANGING YOUR DEFAULT PRINTER IN WINDOWS Windows 7 1 Click the Start button 5 and then click Devices and Printers gt 2 Under Printers and Faxes find the printer you want as default Documents Pictures Music Computer Control Panel Devices and Printers Default Programs Help and Support All Programs 3 Right click on the printer and select Set as default printer 4 Printers and Faxes 6 See what s printing T id s ent i LL L IS Printing preferences Fax gt f Printer properties Microsoft XPS RP1395 on Document Writer Ihprni1 Create shortcut 4 a Unspecified 1 Troubleshoot Remove device Properties 4 You ll see a check mark on the printer s icon signifying that it s now your default printer Windows XP
45. Encounter Types on the left hand side of the dialog box There will be no checkmark initially E Relationship Patient List s Admitting P Encounter Types Locations Medical Services Care Teams C Time Criteria _ Admission Criteria _ Discharged Criteria Use Best Encounter 2 Click in the checkboxes to select appropriate encounter types e g Inpatient Outpatient and One Day Stay Relationship Patient List Relationships Admitting P Emergency Encounter Types Inpatient A QC _ Locations 2 e Inpatient E Medical Services 2 e One Day Stay Care Teams 2 FEE Time Criteria E reReg Inpatien Admission Criteria gt PreReg One Day Stay C Discharged Criteria T PreReg Outpatient Use Best Encounter C Referred In J Stillborn Telephone Communication Enter a name for the list Limited to 50 characters Dr Test Patients 3 Click the button Step 2 Provider Grants Secretary Proxy to Relationship Patient List 1 The Proxy dialog box opens 2 Click the button Proxy Name Lim Access End Date uu Group Provider Access From Provider Provider types secretary s name for proxy and click the E amp I icon amp Provider wbtl Multiple Matches d The Provider Selection window opens Make sure the provider does not select any Limit by filters Limit by group
46. LIDNDXDNBDRDLPBDLDGLDLUD pad E RJ El INRPTT International Normalised Ratio INR Activated Partial Thromboplastin Time PTT General Chemistry Electrolytes Serum Plasma LYTE Creatinine CRE Urea LU Glucose Fasting GLUA Glucose Random GLUR Glucose PC GLUP Alanine amp minotransferase ALT Aspartate Aminotransterase AST Alkaline Phosphatase ALP Lactate Dehydrogenase LD Gamma Glutamyl Transferase GGT LIPIDS Chol Triq HDL LDL Phosphate PHO Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood Routine T M Blood m mo mo mo m mo a A Urate UR Routine T N Blood 9 Complete any order details as necessary 10 Click the button only Important Do not click the ntse button 11 Click Refresh Minutes Ago 12 In the View section of the Orders profile you will see the COMMON Outpatient Labs PowerPlan in a Planned state Orders for Signature E Plans E Medical COMMON Outpatient Labs Planned 13 Clinic provides patient with a card with the instructions to go to Lab Test
47. Ltd Wee Code e End of Presermplions O Outpatient O Inpatient Emergency Prescribed by HUGO Physician WET Test Registrations Phone 5159 683 8500 Fax Prescoriber Signature Attending Deug Quan MD FRCSC LHS University Campus 339 Windennere Road E eeustrationit CP5061106 Londen ON Prone 519 655 8500 BoA SAS Fax Page 1 Narcotic Prescriptions Prescriptions for narcotics have been designed to print off on a separate page as community pharmacies have legislative requirements to store narcotic prescriptions for longer periods than regular prescriptions Placing an Ambulatory Medication Order as a Prescription Open the patient s chart to the Orders page Click the Add icon The Add Order window opens ad Lm Ensure you change the Type field from Ambulatory to Ambulatory Meds as Rx 5 Inthe Find field type the drug name and select the closest match it will turn bold and blue 6 Select the order sentence closest to the order intended and click the L button P Order Sentences Order sentences for acetaminophen caffeine codeine Tylenol Mo 3 oral tablet None 1 tab ORAL g4 hours PRN for pai 2 tab ORAL g4 hours PRN for 2 tab ORAL qb hours May take 1 2 tabs q4 6 hours 60 tab Cancel Click the button Complete the order details as required needed Details j Order Comments s Diagnosis Send To RP1031 on LHPRNI1 Ih tvh ca from QCP387 i
48. NKA metoprolol Free tex Category 2 Reaction type Allergy lypersensitiviby reactions mediated by the immune system Allergy 4 Allergy details Side Effect Status Active E Mark As Reviewed Intolerance Click the Catalog tab Click the plus sign to expand the Common Allergic Reactions folder Important If you are unable to find a medication substance ask a colleague Google check Micromedex or call Pharmacy For non medication allergies try using existing substances and adding comments For example green apple allergy Substance of apple with Comments green My Favorites Search Substance Double click the Common Allergic Reaction to move the reaction to the Reaction symptoms field Click the drop arrow to record the relationship of the person who provided the allergy information Select gt 1 Substance required AAA NKA metoprolol El amp Common Allergic Reactions Abdominal pain Allergic asthma Allergic diamhea Allergic headache Anaphylaxis 2 Reaction type Angioedema Allergy m pe reactions mediated by the immune system Anxiety Confusion 3 Reaction symptoms 4 Allergy details Constipation Convulsion Status Active y Y Mark As Reviewed Decreased blood pressure not hypotension Diamhea Reviewed 2014 04 17 11 56 Difficulty breathing Hives 34 p Difficulty in swallowing Severity Do Not Use Recorded on behalf of Double vision j
49. Phase y Check Alerts UjComments Start Now Duration de v Component Status Sickle Cell gt SICKLE CELL care set select both tests 3 Y Sickle Cell Screen SICL Y Complete Blood Count and Differential CECD Diagnostic Imaging LY Chest PA Lat Other Diagnostic Testing Treatment Y ECG 12 Lead Consults LONDON Pre admission Clinic Anesthesia Consult Fi Pre admission Clinic Medicine Consult A Consult to Physician OTHER Y Consult to Physician Y Consult to Physician Allted Health A Occupational Therapy Referral HUGO Occupational Therapy Referral London Y Physiotherapy Referral HUGO Physiotherapy Referral London A Social Work Referral 3 CA Skin Wound Care Referral A Dietitian Referral HUGO Dietitian Referral UH VH FR OOOO 00 OFF Ooo DS c Complete all required details yellow highlighted fields for all orders there is only one exception DO NOT choose a label printer if requested Details for Pre admission Clinic Anesthesia Consult Details E Order Comments CE Offset Details Diagnosis 9 Requested Start Date Time 7 7 gt m enon sorces NEVER EVER click the 4 liie button to initiate the PowerPlan click the button only to put the PowerPlan into a Planned state Enter Day of Procedure PowerPlan Once you have the pre admission clinic orders complete then proceed to Day of Procedure orders 1 From your patient s chart clic
50. Phosphatase ALP 3 When complete click the button to review all the selected orders 4 Ifall orders are correct click the button OOO OOOO oOo Return to Clinic With Diagnostic Imaging Required 1 Click the appropriate Return to Clinic PowerPlan as per previous instructions 2 Keep the Diagnostic Imaging Phase Action as Order now PracticeOncology Patientl Add Plan ONC Return to Clinic Select Visit and Start Time This Visit Estimated Start Date of Scheduling Future Inpatient Visit In Day s Future Outpatient Visit O In Week s amp In 3 Month s Est start 2014 07 02 Confirm Phase Action Start Date Time Action 2014 07 02 08 00 Diagnostic Imaging 2014 07 02 08 00 Y Follow Up Appointment Labs Est 2014 07 02 08 00 PracticeOncology Patientl 1187 05 71 3 Select the appropriate scheduling appointment completing the Reason for Exam Visit and selecting Yes for Follow up Diagnostics required Details for LACP Return to Clinic LU Details E Order Comments CS Offset Details w Requested Date Time 2014 07 02 0800 Followup Diagnostics required 8 Yes Scheduling Instructions Schedule Priority Reason For Exam Visit Attending Physician Click the Diagnostic Imaging Phase from the Orders View Orders for Signature Plans E Medical E zl ONC Return to Clinic Errata Initiated Pending AE Diagnostic Imaging Initiated Pending E Follow U
51. Physician Nurse Unit Clerk Workflow ccccccccccccccccceeecceseeeeeseeceececcccssseeeeseeeuueeeeneeeeeess 69 OS O y O A a O A a a 70 Grave af KO dE i a NEN 71 DI Order chahges EPISC used id oe CE a o Soa Ee oee Ono ELEC FA heguested Hospitalidad 72 Notifica tonto CINE S DC soc tud ees T dba De Dust bet te usa dealer D NE GPs da veia ad Cut eu oa o Ree 72 AOM UCF AN TT ICE OLD mem 73 No Auto NotificatiOnizs st ases eto eue e eese eu ben edente a ar M inus aad a A 74 DI Order cnanges St Jose pst ina aia 74 REGUESTER Hospital Field serne A A 74 Notificacion toC liic Pace sesiono E oE E E E a E sev ERN tage Mov ca tod e 74 AULO Maat da Datum eo toi Iesu UMS Ec ied aeo 75 Dl Order D0 Not Activate DI Orders isis e 75 DI Order Placing Diagnostics Imaging Orders cccoooccnnccnccnncnnncnnnnnaconnonanonnnnononnnonaronnonanonnnnanocnnnnaronnnnns 75 Change Date and Time to Reflect the Time of the Test cccccccccsssecececessecceeeeeecceseaeeecesseaaeecesseeaeeessaansees 75 PE P 76 Miti Tests on Patent 3e ne bna ede etc Pee Daniae Gare eeu a 76 Mica Seisa m 76 Datesana Time TOM ONES erat 76 ECG OCIS RTI no UTE 77 Reocculkrirg ECG DIAS Gn eb uU tents m eis Men Ras eM IN M d MM T MM 77 FUE ECO gl of mem T eC Ee a eee ee ee ne ae eee cee ree 77 AIMDUIATORY ECGS mar e AA AAA 78 EM TOTI NR E E mE 78 REO AU OC A O mede 78 NN pee 78 Order an Intermittent IV Solution Daily x 5 UayS cooocccncon
52. Post Op PCA Neura This patient has Planned OR Suggested plans on them Please Review The above listed powerplans are NOT ACTIVE and the patient will NOT receive the intended treatment if you do not take action Enter the patient s chart Dell Sam and click the Initiate button to place these orders now If there are any questions call the physician who started the powerplan Again if the above listed powerplans are not initiated the orders are not active in the system Stop Notifications Soft Stop Notification 1 In this example you saved a favorite of COMMON Nausea and Vomiting with oral metoclopramide pre checked and dose set as different from standard plan 2 The PowerPlan Orderset team made a soft stop change to metoclopramide ORAL and it is now only available IV or subcutaneous Other medications also pre checked ondansetron and haldol 3 The Plan Favorite Notification dialog box opens to let you know of these changes 4 Click Continue Plan Favorite Notification ES Resave your favorite plan to no longer receive this notification The changes below have been made to the standard plan since this favorite was created 4n additional message mar follow to provide notifications specific to your plan choices Review the plan in its entirety Notifications 2014 06 25 13 18 Siwapped Maxeran SC for PO I Load standard catalog plan 5 This second message populated by system displays
53. PowerPlan favorite Notification of Plan Modifications After modifications have been made to a Standard Catologue Plan you will be notified when accessing the PowerPlan from your plan favorites The Plan Favorite Notification window will open and identify any changes that have been made Review all changes that have been made carefully before proceeding Plan Favorite Motification Resave your favorite plan to no longer receive this notification The changes below have been made to the standard plan since this Favorite was created An additional message may follow ta provide notifications specific to your plan choices Review the plan in its entirety Matificatians 201 4 06 18 17 51 The Group and Screen order has been modified from a LAB module to a single order Please review pour plan carefully and reselect the new Group and Screen order if required in your plan Favorite Thanks continue _ Load standard catalog plan Cancel If you would like to continue to use your favorite plan click Continue If an orderable was preselected in your favorite plan you may receive a Load My Favorite alert notification stating that the order is no longer available Load My Favorite Customizations to the following component s cannot be applied because the component s no longer exist in the plan LAB Group and Screen VH Parkwood LRCP Module Follow Up Appointment Tests Click OK to proceed to the plan Reviewing th
54. SNC TI Re a Ee y E UE e E EE 87 HOW to Complete Other Tests oor EIS ere Deoa aos 89 Labels Changes to Lab Label Printing as ee ope Lot dada 89 Labels Do Not Reprint old Label Suri 90 Label Printing Solution for Future Lab OrdkerS cccooccccnnccnnnnccnonancnonannnonacnnononnnnarononarnnonacononacnonarononanoss 90 Steps to Order Outpatient Labs within a Power Plan cccccccsssccccessecccssccceuececsenecesseuseeseaecessenseessuesessaaees 90 tabe REpNN a babes stas Saadasicabnebercasaesntcopacaceted a acosta Ne Coss 91 Labels Required for all Blood Samples oomocccnonocnononnoronnonariononacionconoronnonariononaoronconoricnonasiononaarenes 92 Leave of Absence Order Start End Date and Time ccconccccnnniccnnnnncccnnnnarinnonaricnonnccnnnnnarinnonarncnonanicons 93 MESAS W I Sica autc auta pA ec EP EE EM MEC E epis E EU 93 Medication Order Albuimin Orders reads 94 Tratistusion Fredleney Field iris 94 DUFaton mie RENE EUER DU TEMPE TNNT 94 Medication Order Discontinue or Cancel Reorder eeeeeeeeeeeeeeeene eee nennen nennen nnne 94 Medication Order Dose Times Associated with Hourly Frequencies LHSC seeeeees 96 Medication Order Saline Lock Flush esses nemen nnne 96 Discontinuing Saline LOCK and FIUSDds iiie a nea een NI ER EE sey vens dead o sanas Qnae i eap Ma ete ds M omes bends 96 Medication Order Starting or Tapering
55. Then If platelets less than or equal to 10 Then transfuse 1 adult unit platelets Conditional If Then If platelets less than or equal to 15 and patient is bleeding Then transfuse 1 adult unit platelets mS XI Timing of Infusion Order The Timing of Infusion order contains three default sentences from the drop down menu for Mon Thurs Tues Fri or weekly transfusions Select the appropriate sentence and enter in the desired number of weeks for possible transfusions in the Duration field Y Details for Timing of Infusion Details lis Order Comments Es Offset Details Diagnosis Ij Order Possible Transfusion Frequency daily Mon Thu Duration Duration Unit week Special Instructions Requested Start Date Time 77777 ly Future Order Indicator Yes No If the required frequency is not available as one of the defaults select the drop arrow to find the desired frequency daily Mon Thu Special Instructions n daily Tue Fri The Laboratory orders will also be completed on this same schedule based on the Communication order Conditional If Then Orders The most common transfusion parameters have been included in the Conditional If Then orders Select the appropriate transfusion parameter for your patient A Conditional If Then If hemoglobin less than or equal to 70 Then transfuse 2 units packed red blood cells Y Conditional If Then If hemo
56. drop down list and select Transfer F Add 4 Document Medication by Hx Reconciliation 6 Check Interactions Admission 2 The Order Reconciliation window opens and there are two sections Orders Medication List a Medications Prior to Transfer Reconciliation historical medications and current inpatient orders b Medications after Transfer Reconciliation new inpatient orders 3 For each medication choose to Continue or Do Not Continue 4 When all medications are reconciled and order details are complete click Transfer to Discharge Reconciliation When these changes move from the Transfer to the Discharge Reconciliation you ll notice the following changes These are default settings e Even though some home medications were continued in hospital then discontinued on the Transfer they will once again default to Continue on discharge because they are home medications They will appear at the top of the list e n hospital meds that were marked as Do Not Continue on the Transfer will not re appear in the discharge list They remain discontinued Status Add Manage Plans 3 3 xf Meds History Adm Meds Rec Disch Meds Rec gt Medications Prior to Discharge Reconciliation Medications After Discharge Reconciliation ES Order Name Details Status B E E Y Order Name Details Status Continue After Disch Create New Rx Do Not Continue After Discharge Home Medications metoprolol
57. encounter specific while the Medication List crosses encounters Suggested Order of Columns Orders Type Quick Discontinue Notifications Order Name Status Details Ordering Physician Start Last Updated Medication List Type Quick Discontinue Notifications Order Name Status Details Ordering Physician Compliance Status Compliance Comments Start Last Updated Change Order of Columns 1 In the patient s chart click Orders or Medication List 2 Click Customize View at the far right ae Add 4 Document Medication by Hx Status 0 Meds History Adm Meds Rec Disch Meds Rec Orders Medication List View Orders for Signature Display All Active Orders Customize View ES Y Order Name Details Plans Medical RESP Chronic Obstru COMMON Venous m Orders Active a M Y 66 dextrose 5 sodium chloride 0 45 1 000 mL Ordered 1 000 mL IV continuous Start date 2014 02 26 11 Admission Resuscitation Status Alerts Diet Activity Vital Signs Patient Care IV Solutions Medications Laboratory Medications Active Eb Y Go acetaminophen p Y Y 66 amoxicillin Eb M Y 66 ceFAZolin A A _ 2 4 Ordered Ordered Ordered 4 m Total volume mL 1 000 80 kg 650 mg tab ORAL q4 hours PRN for pain Reque max 4 g acetaminophen in 24 hr from all sources 500 mg cap ORAL q6 hours order duration 52 v Date Time
58. is required to discontinue the phase Click Order Completed Cancelled by Nurse Cancelled by Provider Patient Transferred Transcription error System troubleshooting Order details changed Patient Deceased Cancelled by Dietitian Cancelled by Speech Language Pathologist Change in Condition Order Completed Discontinued Canceled Home Medication 9 Click the button and refresh the screen 10 The PowerPlan is completed and will no longer be available on the patient s return visit Multi Phase PowerPlans To understand more about Multi Phase PowerPlans please see the following quick guide https apps Ihsc on ca regional training powerchart assets HUGO JobAids QUICKGUI DECPOEMultiphasePowerPlans pdf No Proposing Functionality PowerPlans cannot be proposed Oncology Return to Clinic PowerPlan Return to Clinic Without Imaging 1 Click the ONC Return to Clinic or ONC Return to Clinic Chemotherapy PowerPlan from the Add Order window 2 The ONC Return to Clinic Chemotherapy PowerPlan is to be selected for any patient currently receiving Systemic or Oral chemotherapy Find onc retu e Contains w Gi ta Ea El BONC Return to Clinic BONC Return to Clinic Chemotherapy Select Return Date 1 The Add Plan window will open prompting you to select the estimated date of scheduling the next appointment 2 After selecting the appropriate number of weeks or months the Est s
59. it and typing a normalized rate The actual rate will auto calculate based on the weight shown below 13 Important The patient s actual weight must be documented for the auto calculate to work Details for heparin additive 20 000 units unit kg hr dextrose 5 in water 500 mL EST Details 1 3 Continuous Details lo Order Comments Es Offset Details Diagnosis Base Solution Bag Volume Rate dextrose 5 in water 500 mL Additive Additive Dose Normalized Rate Occurrenc x hepadin addive 2000udis Blunt PESE ENS Total Bag Volume Weight Dx Table Orders For Cosignature Save as My Favorite Xy Initiate Sign 14 Refer to the Order Comments tab for the heparin nomogram Details to heparin additive 20 000 units unit kg hr dextrose 5 in water 500 mL EST Details ti 3 Continuous Details GP Order Comments le Offset Details Diagnosis Order comments Adjust heparin infusion as per following nomogram PTT Bolus Hold Rate change Recheck seconds lessthan50 5000 units 0 160 units hr 4mL hr 50 59 0 0 80 units hr 2mL hr 60 85 0 0 No change 86 110 0 0 80 units hr 2mL hr Greaterthan 0 60 mins 160 units hr 4mL hr 110 Dx Table Orders For Cosignature Save as My Favorite XJ Initiate Sign 15 Once all details are complete click the Initiate button to active the orders 16 Click the Orders for Signature button
60. locations devices have a required field to select a lab label printer This field can be bypassed when ordering labs within a single phase Power Plan allowing the label printer to be selected during the Initiated process It cannot be bypassed when placing single lab orders For this reason if you are ordering single labs for a future date time and you are working at a PC that asks you to complete the required field for a label printer back out of the order and enter your labs orders within a Power Plan Steps to Order Outpatient Labs within a Power Plan 1 Select a Power Plan For example there is a COMMON Outpatient Labs PowerPlan that houses most commonly ordered labs There is also a blank AMBULATORY Clinic Orders Power Plan in which users can Add to Phase lab orders Find common ou Ph Starts with Find ambulatory M Starts with w com MON Outpatient Labs Module EMAMBULATORY Clinic Orders 2 Complete the PowerPlan ignoring the required label printer field 3 Click the button to sign the PowerPlan 4 You will receive a message there are missing required details There are missing required details on an order s in a PowerPlan These details must be completed in order to initiate the plan at a later time Do you want to continue signing IV Solutions Medications Eii Communication Order Laboratory Eb LAB Group and Screen VH Parkwood LRCP Modul ES A Complete Blood Count CBC A
61. mouse down and drag down to select all orders 6 Enter the desired changes 7 Click the button Rationale Many lab tests can be completed from one tube of blood Batching blood tests together with the same Collection Date Time will minimize the amount of blood drawn from a patient and the potential for multiple needle picks to access blood Electrolytes Serum Plas Order 2014 04 16 3 00 AM Routine 2014 04 16 3 00 Blood ma LYTE Glucose Random Order 2014 04 16 3 00 AM Routine 2014 04 16 3 00 Blood GLUR Lab Order Help with Ordering a Lab Test If you need assistance ordering lab tests contact your Unit Clerk Nurses or a SuperUser It is important that when you order a lab test with a frequency that you also include a Duration and Duration Unit Lab Order If You Cannot Draw Blood If a blood order has been placed the labels have been printed but you are unable to obtain the specimen e g patient refuses or you cannot access a vein you need to cancel and reorder as an electronic order for the next day 1 Open patient s chart to the Orders page 2 Right click over the blood order and choose Cancel Reorder Modify Copy P Cancel Reorder Suspend Activate Complete Cancel DC Delete Reschedule Task Times Add Modify Compliance Order Infarmation Comments Results Reference Information Print Advanced Filters Disable Order Information Hyperlink The Ordering Phy
62. nursing can enter the saline flush order It is found in the system as Sodium Chloride 0 996 flush Discontinuing Saline Lock and Flush Please do not send a Med Request to pharmacy to discontinue a saline lock and or saline flush This can be done by nursing 1 Right click on the check mark beside the order 2 Select Cancel DC p uu X Es v Order Name Status Patient Care b Complete Cancel DC Delete Reschedule Task Times Add Modify Compliance Order Information Comments Results Reference Information Print Advanced Filters Disable Order Information Hyperlink Enter a Cancel Reason Click the button Click the button Click Refresh Minutes ago Medication Order Starting or Tapering Medications in Ambulatory 1 2 3 4 Once in the patient s chart click Orders from the table of contents menu Click Add The Add Order window opens In The Find field type ambulatory c make sure you are searching with Contains set Find ambulatory d Pt Contains w 58 AMBULATORY Clinic Orders Click the AMBULATORY Clinic Orders PowerPlan it will turn bold and bue Click the button Click the Add to Phase icon and then click Add Order Add Order AM Add Quiet Mc Add Prescription 8 In the Add Order window change the Type field to Ambulatory Meds as Rx F PKWD Learn Ambulatory6 Add Order LLLI Lj VISIT 422350702 Loc
63. order carefully and only pick orders that are for PAEDS when appropriate For example some blood transfusions PowerPlans have Adults PAEDS and Neonatal as options Occupational Therapy and Physiotherapy referrals are available for both adults and paediatrics Allied Health Outpatient Allied Health Referrals 1 From the Order Screen type Outpatient in the Find field 2 Choose the Outpatient Allied Health Referral Order P UH Learn Nurs 13 Add Order UH Learn PIN 1187 1 Allergies TT Inpatient 2014 02 25 00 00 No Disc VISIT 42234997 Location U 7 A7 1 Age 68 years Sex Male Provider Fullerto DOB 1945 09 11 Find outpatient an Contains Type Eh Inpatient Ti 3 m 7 la sa Search within ll tlocation Outpatient Allied Health Referral UH J Date ric J S PMDU Oncology OutPatients Care Set j UH Learn Nurs 13 1187 19 31 3 There are 2 mandatory fields that need to be completed for this referral a Choose afollow up time frame for the patient b Choose an outpatient allied health profession you would like your patient to follow up with Detaili lor Cutpalient Allied Health Referral Gulpatient Allied Health Helerral UH Dask JE Order Comm ets Priority Routine Requected Date Time Alked Health Cervicala Reque Ju Instrucbons B osea 3 moni b merkie Wear ether See Reason for Eetum teen to Outpatient Allied He
64. pc or ee 38 HOWTO SOD IN CONSIS CCE Sc renr a N TE S E A E N 39 LISE DOSE fe E 39 Patient Taking Medication More than Once Per Day with Different DOSES cccccoooccnncccnoccnnnnnnancnnnnonanonononos 40 Printing the BPMDEL essit A atn n esadivt can Sut bdefleut 40 Documenting Medication History for a Unknown Medication cccccccsssseceecceeseceeeceeseceeesaeeceeseaeeeeeseeeees 40 NOD FONLI Y TI t E c NIE Cc eC ES ER 41 Add Non Formulatry Medication Using the Template eiiis eese nnne nnne nnn nnns naar ssa aaa sns saa annes 41 Ordering a Medication when the Medication Cannot be Found in Order Catalogue ssse 41 Admission RECOMCIMALION ae us 4 hotest sd em ep a LI ELO Due LN 42 o aurea tien ap UMRLI M IL UeL tata nanaaek tele a LIU d 42 Complete AdmissioriReconclllalloDpisssseusevi ve evoase vti aeedia ut n deri vul muti Cr pude v n xd tei vut a 43 Formulary v Non Formulary Medications ccccsssccccssssccceescccceececsenecccauecccsesccsaesecesaaecesseuecessauseessaeeessanseees 43 AUtO SUDSEICUCIODISEodespe us comtodued Poen oaiadiedn a lac Ao A fcu Io rete a 45 Patients OWN MEOS ocius esr taser ads Re IU LEM places 45 POSSIDIe ENO MOSSSBBS c d ehe imu tente tmu tai 45 UCT OV Aler amc a a a 46 Height and Wein AIekt saisie qc Ed DR ERE UM et ues Ud mua DN MI DI MIR a id MM dM cM A M M M LI 46 Medication AE aa 46 Differences between the Admission and Trans
65. s Est start 2014 06 07 Confirm Phase Action Phase Start Date Time Action Timing and Parameters Est 2014 06 07 8 00 HR Order far future visit Laboratory Est 2014 06 07 8 00 Packed Red Blood Cells Est 2014 06 07 8 00 Platelets Est 2014 06 07 8 00 z LRCP Nilsson 1187 04 44 Cancel 4 Ifa phase is not required e g patient does not require platelet transfusions then change the Plan for a later date to Do not Order from the drop arrow Confirm Phase Action Phase Start Date Time Action Timing and Parameters Est 2014 06 07 8 00 Laboratory and Transfusion Parameters Est 2014 06 07 8 00 Packed Red Blood Cells Est 2014 06 07 8 00 Platelets Est 2014 06 07 8 00 Si lPlan for a later date Do not order TUTLIET IU LRCP Nilsson 1187 04 44 l Plan for a later date m 5 Click the L_ K button and click the button Timing and Parameters Phase The Timing and Parameters phase contains all the instructions that Nurses and Laboratory Technicians require to complete this plan appropriately All instructions should be contained within this phase e A Timing of Infusion wi Select an order sentence Communication Order Laboratory phase to be completed prior to each transfusion A Conditional If Then If hemoglobin less than or equal to 70 Then transfuse 2 units packed red blood cells A Conditional If Then If hemoglobin less than or equal to 80 Then transfuse 1 unit packed red blood cells A Conditional If
66. the border line separating two columns your mouse pointed will become a two headed arrow and dragging until the column is the desired width FoLLOW UP ON DISCHARGE SUMMARY A provider may also enter a communication when completing a discharge using the Discharge summary Important This will not appear on your Task list View Follow Up Communication in Discharge Summary 1 You must be in the Summaries ViewPoint in the patient s chart 2 Click the Discharge Summary tab MEE Summaries ViewPoint 4 Complete all required details Instructions Follow Up Who When Provider Search Within Organization Clinic Search X Clear O Free text Follow Up Where Follow up Address Free Text Quick Picks Follow up with primary care provider Return to Emergency Department Comment Predefined Comments Edit Comments These will post to the depart summary when printed and to the Summaries Viewpoint Follow up 1 4f Selected visit Doc Test Within 2 to 5 weeks only if needed Workflow Example 1 Labs to be done in house today and now 1 2 3 4 Patient seen in clinic Lab orders entered electronically for today and now Labels generated and Patient sent to Lab Test Centre with labels Workflow Example 2 Labs to be done in house in the future not connected to a clinic visit Future Order 1 2 Patient seen in clinic Provider determines labs to be done later before n
67. the patient s name is highlighted on the patient list and click the PM Conversation icon and then Quick Inpatient Registration PM Conversation View Sticky Quick Inpatient Registration 4 You will be asked if this is an admission from Emergency choose No 5 Complete the blank yellow fields in the window that opens Dx admit service admit provider and click OK 6 A pop up will query Do you want to open the patient s chart Select Yes and this will open the inpatient encounter to the order window 7 Complete the medication history in Document Medication by Hx 8 Complete admission medication reconciliation 9 Complete and initiate an admission PowerPlan Entering Height and Weight on Admission It is essential that heights and weights are documented as soon as possible after admission These values flow to Pharmacy and are part of the automatic calculations for weight based drugs The Admission Database PowerForm is the best place to enter the initial height and weight This PowerForm is ordered automatically on admission and is found on the Task List or in the Task section of the PAL ALLERGIES Allergies to be Documented An Allergy Status alert will appear when allergies have not been documented You need to document all three alleriges if known or document all allegeries as Unable to Obtain Collect Also if food allergies are not documented the patient will not receive a tray until further investig
68. verified by Pharmacy Order has been rejected by Pharmacy Search or filter Hover to view more information Merges view of PowerPlan with current orders Filters view in PowerPlan only to checked items in a planned PowerPlan View excluded components in an initiated PowerPlan Discontinue PowerPlan le AddtoPhase Gateway to add orders to PowerPlan PowerChart Icon Legend PowerForm i Sign form Wes Clear amp Cancel HA Clinical calculator AT Previous page e Next page Document Meds by Hx a Medication documented manually Ele Prescription entered by provider Medication Reconciliation MedRec Compliance documentation e g Still taking not as prescribed Prescription medication Inpatient medication Medication documented manually Order not yet reconciled Formulary drug Non Formulary drug Order details not complete
69. 00 Entering your specific requests dates for a leave will ensure clear directions and indications to other staff of the status of that patient MRSA Swabs MRSA swabs do not print automatically on direct admits MRSA swabs will need to be ordered on these patients as per the LHSC Medical Directive with Dr Michael A John as the ordering physician and Medical Directive as the Communication type IP Ordering Physician Physician name John Michael A Order Date Time 2014 04 22 5 1525 Communication type Verbal with Readback Phone with Readback Initiate Orderset signed Paper Order Conditional Non Provider Fax Electronic Medication Order Albumin Orders New responses have been added to albumin order detail fields Transfusion Frequency Field In the Transfusion Frequency field two news responses have been added Twice and Other y Details for Albumin 5 Albumin 5 Details 32 Order Comments sh Diagnosis Y Reporting Priority Routine Required Date Time 2014 04 23 Strength Dose 5 Albumin Transfusion Frequency Duration albumin ja Rate of Infusion 596 alb 5 Missing Required Details Dx Duration Field In the Duration field one new response has been added Not Applicable Duration albumin Rate of Infusion 5 alb 4 days o Missing Required Details D3 5 da li Hot applicable
70. 1187 10 98 Allergies Inpatient 2014 01 06 14 02 No Disc Display Since 2013 10 20 Sex Male Visit 422348151 Location U 5 A5 30 DOB 1968 12 13 Inbox Items 60 ES Documents On hold pending signature amp Orders 33 36 Proposed Copy Regular Diet Regular Diet LHSC Renewal Orders 1 1 Details Start 2014 04 15 22 03 Orders to Approve 32 35 Comments Messages Results 0 2 Other 0 2 Proposed By Test HUGO Studentl Cerner Results FYI 27 28 Other 25 26 Critical 1 1 On hold pending signature Abnormal 1 1 Proposed Discontinue acetaminophen Cancelled by physician Work Items 0 Details 325 mg 1 tab tab ORAL ONCE Requested Start Date Time 2014 03 25 08 45 stop date 2014 03 25 08 45 Saved Doce Proposed By Test HUGO Studentl Cerner Paper Based Documents Documents to Dictate Reminders Notifications Reject All and Next Accept All and Next Sent Items Results 1 Any lab work or diagnostic tests entered by you or with your name in the Ordering Physician box will appear in the Results section of your Message Center Inbox 2 Double click the patient s name to open the results 3 You have two options Endorse or Refuse Additional E i To est HUGO Dietitian 1 Cerner x Duc juich Reminder 1 m ue 2014 04 2 Forward Action Limit 5 S e Comments Limit 255
71. 5 74 37 years Female koali CICC 00 Sen I Note PEendang Fretician Wan Reason Miera Serge Emergency Phyrici n ten Lris rgeney Emergency Physician muts Emergenrg Emergency Phytitian ben Lrergenty Emrrgenry Physician unwell Emergency Preytitian admission Emergente Emergency Physician fad aAudisingy Test Doc Testing Lmergen Emergency Physician Shut Emergency Physiti n Shut Emengenry Phyriria m knee pain Emergency Phycici n TestingOne Lrergenty chri pain Emergency Physician ency Fhytician Ponent to aime ime DA DG Dis 34 0 Et BR3 Days 255 7 Dayi 553 Bayt Leave Matus amp dmiteu ZOOS 14 40 20140409 350 2040S 14 47 2014 04 01 11737 2014 02 05 14 77 ILIO 1 7 NIA 300 13H AE EET LE ree Eriharged Primary Care Aion 3 Click the PM Conversation icon and then Quick Inpatient Registration PM Conversation Quick Inpatient Registration 4 A pop up will query Is this patient being admitted from Emergency 5 Click Yes to admit a patient from Emergency Yes will keep them in the emergency location and No will put them in a clinic location IE Quack Inpalsert Registration Latt Hane Finit Mare 5 un ari Patent PIN Visit Humber 1107 27 60 422152104 Reason for Exams Vick Medical Dennce Loc ation Bid a T Accident Type Mode al Visit Middle Mame Tesi Patent Type Inpatient Fon Hen Lori Bith Dra Sex Patient Flag T8955 02 02 z Male Hesh Coed
72. 50 mg o i Ki nce other Reference Information 4 Choose an option form the Status menu 5 Fill in all required fields 6 Again you minimized with the black arrow in the upper left hand corner Y Details 2 Compliance Status Information source Still taking as prescribed Patient Still taking as prescribed Not taking Still taking not as prescribed Unable to obtain Investigating Last dose date time v Qe xd AIF When the compliance has been modified it will appear to the right of the medication Ww 0 125 mg oral tablet y metoprolol metoprolol Documented tartrate 200 mg oral tablet Refill s 2014 06 12 12 41 Maintenance Maintenance How to Stop Inconsistences What not to do Re prescribe a home medication in the outpatient setting now both medications have to be reconciled at discharge Re prescribe a home medication to increase a dosage Re prescribe when the paperwork is lost or the printer the prescription was sent to is now not available Leave medications no longer used such as antibiotics Last Dose 1 tab ORAL daily do not chew or break tablets 30 tab 0 Documented Medications by Hx y acetaminophen caffeine co Documented 2 tab ORAL q4 hours PRN for pain 0 Refill s deine acetaminophen caf E digoxin digoxin 125 mcg Documented 1 tab ORAL daily 30 tab 0 Refill s 2014 04 28 22 49 Patient Still ta
73. 55 Riz ene THEE O TNR REI 55 Message Center Results to Endorse Modifications eese 56 eed mn ROM H n 60 Addihga Medication Orde anida rh e oti o oet oae tient tutes iol cid etu noeud Pei Ut ake 60 Whern to Usethe Order COMMENT lr ion 62 Do Not Use the Orders Comimients Tab e eee vero ia 62 Help Firiding a Meditat M sese i e ees ete esie PEU te a 62 Medications tom Pharma Velo cla 62 Additional Precaution S is a E 63 AQUIEVS Paediatrics dt 63 ANE A mE 63 OutpatientAllied Health Reterrelsuss as n 63 Paper Copy of the Referral REGUIT CO sui tt daret rr ai d dst 64 STAT Allied Health RelerTal Orde S aaora va Gn teve om ip Io eb Ea aot a vast ocv let VORS otv Ente m et Rupe v obe tos 65 ALC Order Required Fields Leave as To Be Determined ccccccsssecccessececeeneceeeeeseceeaenecessueeceesegeeeeeas 65 Ambulatory Medication Order as a PreSCription cccccsscccccsseccccessccccaesececeeecceeeeeccesseecessunececseeeeetas 65 Cancel a Single Lab Order from a Larger Frequency Order ccccccsssececeesecceeesccecaesececeueceesenseeeeauaeses 66 To Cancela single Lab eoo PP m 67 Care of the Body after Deathania iene ve oo o b a Aes edu eode Hate odis 67 CCAC BSrerral o A e A nb Co m oaE Ee Patet auc 68 Communication Orde siga ees nd torch ESA 68 Consult Orders Inpatient vs Outpatient Consult Referral eese 68 Consult Provider Consult Order Process sima aia 69 Consult to
74. 9 Pick your printer from the Label Printer drop down and then click the Print button f PathNet Collections Label Reprint ee C fm File View Help Accession Starting Accession 1 4 027 02594 Ending Accession 14 027 02598 Service Resource Label Types Label Printer Specimen Labels selpdel til x Ready P 207 NEMIROVA 2014 01 31 10 40 Labels Required for all Blood Samples It is very important that blood samples not be taken until there is a label for the sample Leave of Absence Order Start End Date and Time The Leave of Absence order has a field to identify a Requested Start Date Time but there is no field currently to identify a Requested Stop Date Time Therefore please enter the Start and End dates of the leave in the Special Instructions field of the order details Y Details fo Leave of Absence Details 138 Order Comments Diagnosis Requested Start Date Time 2014 05 30 1100 Frequency Duration Unit v Duration rn PRN Yes No pecial Instructions End of Leave 3 June at 0900 Start of Leave 30 May at 1100 Special Instructions Start of Leave 30 May at 1100 End of Leave 3 June at 0900 What you type in the Specialist Instructions field appears in the Details column of this order on the Orders page Status se Details Ordered Start of Leave 30 May at 1100 End of Leave 3 June at 09
75. A Name Age All Patient Reason for Visit Pod A 7 A Another Test 80 yO EE Nursing will be responsible for completing the icon after the proposed order is accepted rejected This will complete the Proposed Order Exists order Direct To Comment To Do Lab Rad Meds NR test IP ene 9 0 4 0 14 T gt Proposed Order Reminder 1 When opening a chart that has a proposed order the following alert will fire 2 Click the L button to clear the alert it doesn t accept the proposed order Discern Open Chart Education Tracey 1 of 1 c T Proposed Order Reminder Cerner You have opened a chart with a proposed order Please remind the MRP of the Proposed orders on this chart If you are not part of the MRP team and this proposed order is not within your decision making scope to accept or reject disregard this alert Quick Check Box ial Proposed Ordering a BE 3 212 B VISIT 422351957 E Glycated Hemoglobin Order 2014 05 01 3 00 AM Routin GLYHB Quick Orders Page The Quick Orders page is specifically designed for the emergency department enabling providers to quickly place orders with a single click Task Edit View Patient Chart Links Navigation Help Tracking List Message Center ETear Off Medication Information Q UpToDate Q Muse Emergency Referrals Links B El Attach Til Suspend AL exi Calculator 8 Explorer Menu Patient Locator PM Conver
76. A vith Readback hone with Rea Adliack ledic al Directive Init iate ay de 5 Igne Ti Condition al Mon Provider Fax lectronic 5 Clickthe button Add Removal Order If a patch dosage is continuing from a home med remember to add the removal order 1 Select the icon beside Orders on the table of contents menu 2 Inthe Find field of the Add Order window type the name of the medication to administer Find patch a b La La COMMON Fentanyl Patches Epidermal Patch Test Eye Patch Eye Patch Coverlet charge EZE Patch charge patch removal 3 Select patch removal 4 Select the correct Order Sentence if applicable Order sentences for patch removal l patch transDERMAL 5 Click the button 6 Complete the blank yellow fields w oo 2 E MN Route of Administration o fy Frequency J PRN Yes No PRN Reason Infuse Over Placing Post Op APS Orders Multi phase anesthesia post op orders have three main components Phase 1 PACU Stage One Phase 2 PCA Neuraxial Opioids or Epidural Phase 3 Anesthesia Multimodal Post Op Orders for Signature Plans Medical EjANESTH Initial Post Op PCA Neuraxial Opioids Multi PACU Stage One Planned Pending PCA Neuraxial Opioids Planned Pending Anesthesia Multimodal Post Op Planned Pending All phases of this plan will be initia
77. Cancel 4 Click the button 5 Click the eders For Signature button 6 Click the button and refresh Minutes ago Discontinue a PowerPlan When You Need to Cancel a Phase of a PowerPlan To ensure all orders on a phase are cancelled it is best to discontinue the complete PowerPlan and then re enter it For example the LAB Group and Screen PowerPlan Discontinue Completed Blood Transfusion PowerPlans Issue Too many orders appear active on the chart For example all blood products in a Power Plan have been infused but supporting orders multiple vital signs are still ordered on the chart Reason Nurses not realizing they may discontinue Power Plans when all components have been completed Solution When all components of the Power Plan are complete including post transfusion bloodwork 1 Right click on Power Plan in the View pane and select Discontinue 2 In the Ordering Physician dialog box enter the MRP name and choose Non Provider as the Communication type ECT PowerPlan 1 Under the Orders section of the table of contents menu select Add 2 Search for the MENT HLTH Electroconvulsive Therapy ECT Treatment PowerPlan 3 Click the PowerPlan and then click the button P CI Paul Add Order ole E CI Paul PIN 1187 07 27 Allergies Inpatient 2013 08 29 10 52 No Discharge date gt Weight VISIT 422346035 Location V C51 C5 1 Age 86 years Ht Length Provider WBT Test HU DOB 1927 09
78. Centre before next clinic visit Workflow Example 3 Completing an Ontario requisition electronically 1 Patient seen in clinic 2 Provider determines lab work to be done externally 3 The lab order is entered electronically 4 From the Add Order window change the Type to Ambulatory 5 Inthe Find field type lab external Find lab external itae scd Type 5 Ambulatory a ab oux Search within Al Atlocation LHSC VE GLA External Ontario Lab Requisition LAB External Public Health Requisition s 6 Click the LAB External Ontario Lab Requisition PowerPlan 7 Click the Done button 8 Select the lab orders you wish to order di 4 Add to Phase Check Alerts jComments Start Now Duration None as oe F Component Status Dose Details LAB External Ontario Lab Requisition Initiated Pendinq E Laboratory 3 REQUISITION PRINTS gt to the patient location as noted on the demographic bar You must sign the printed requisition for it to be accepted by an external laboratory 3 NOTE For Other you must order one test per item required Chemistry O 7 olr Glucose Random 7 pues y ye ATT Y ol HbA1C Iv Eii olr Creatinine eGFR J olr Uric Acid 9 Click the button to review the orders 10 Click the button 11 Click Refresh Minutes Ago 12 Once signed the Ontario Lab Requisition prints out Important The provider must manu
79. Click in the checkboxes to select appropriate encounter types you wish to see Provider Group Patient List Provider Groups Thoracic 7 Encounter Types Outpatie Medical Services _ Locations LC Time Criteria C Admission Criteria _ Discharged Criteria PreReg One Day Stay Use Best Encounter PreReg Outpatient 1 Referred In Y Stillborn C Telephone Communication Enter a name for the list Limited to 50 characters Thoracic Surgery Group 9 Click the L t button 10 Click the button 11 The Modify Patient Lists dialog box displays 12 Click to highlight the new list name in the Available lists pane and then click the blue arrow to move the name to the Active lists pane Available lists Active lists Thoracic Surgery Group Dr Test Patients H WBT Test U8 PB Modify Patient Lists Available lists Active lists Dr Test Patients H WBT Test u8 Thoracic Surgery Group 13 Click the button to return to the Organizer screen You can modify the order of the lists using the up El and down arrows 14 The new list now appears as its own tab with all patient names automatically generated for that location Patient Lists Thoracic Surgery Group Outpatient PreReg Outpatient Build a Medical Service List Build a Medical Service list to show all patients admitted to a medical service The names are displayed automatically Patient
80. Complete Blood Count and Differential CBCD ES CA INRPTT e Y Electrolytes serum Plasma LYTE e Urea U 5 Click the button to continue E A E C E T M E Iz cd cd m Please Note Ifa user is placing a multiphase plan from that same area this solution will not work Labels Reprint a Label 1 Open the Orders component of the table of contents menu and find the lab test you want to reprint the label for D Right click the order and click Order Information d The Order Information for window opens p Find the Accession Number and write it down P Order Information for Electrolytes Serum Plasma LYTE o EE Task View Help E Original order entered and electronically signed by Black Robert T on 2014 01 27 at 07 12 Laboratory Department Electrolytes Serum Plasma LYTE Additional Info Details History Comments Ingredients Pharmacy Ordered As Electrolytes Serum Plasma LYTE Start Date Time 2014 01 27 08 30 Stop Date Time 2014 01 27 09 55 Accession Number 14 027 02598 Order ID 893595892 Department Status Completed P0207 NEMIROVA 31 January 2014 10 32 Close the Order Information for window On the toolbar click the icon The PathNet Collections Label Reprint window opens d Se In the Starting Accession field type the accession number you previously wrote down
81. F For Hematology Use select loading dose PRN bolus and continuous infusion orders below Recommended starting infusion rate is 18 unit kg hr 0 45 mL kg hr 3 heparin heparin loading dose 5 000 units injection IV ONCE infuse over 10 min Dilute in DSW 50 mL 7 heparin heparin bolus 5 000 units injection IV as directed PRN for Other See Comments infuse over 10 5 heparin 20 000 units in 500 mL dextrose 5 500 mL IV Adjust heparin infusion as per following nomogram PTT Bolus Laboratory 3 Iri Activated Partial Thromboplastin Time PTT ASAP T N Blood Baseline Frequency ONCE 3 7 Activated Partial Thromboplastin Time PTT Routine T N 360 Blood 6 hours post heparin bolus Frequency ONCE 7 Complete Blood Count CBC CBC ASAP T N Blood Frequency q72 hours ARNO ad A Details Dx Table Orders For Cosignature Save as My Favorite X Initiate Sign J H0207 WBTPHYSICIAN 08 November 2013 13 41 9 Click the check box beside the heparin infusion order you will be using 10 Next right click on the order name and select Modify Planned Order Hematology m For Hematology Use select loading dose PRN bolus an Recommended starting infusion rate 16 unit kg hr A heparin heparin loading dose A heparin heparin bolus F heparin 20 000 uate im GW eel dieters RAL Modify Planned Order 11 18 Laboratory 5 0 12 Complete the beginning unit kg hr field by clicking in
82. Find ecg nurse order n d f vw Lm Ga 2 This orderable has a free text field where the provider can identify the frequency or criteria with which they want the ECG completed Y Details for ECG Nurse order when Details 45 Order Comments B Diagnosis s Requested Sat DateTime 20140427 n E CA 3 Whenanurse sees the order it is authorization to enter the actual ECG order at this frequency Future ECG Order 1 Place the ECG order 2 In the details field select Future Order Indicator and change the Requested Date Time to the desired time v Details for ECG 12 Lead Details E Order Comments Priority Routine Requested Date Time ULT Reason for ECG Cardiac Disease Assessment v ECG Type Routine Reason For Exam Clinical History Contact Name and 55555 Portable Location Requested Hospital UH Main Precautions Copy to Physician E Future Order Indicator 6 Yes No Visit Type Inpatient I Orders For Cosignature Dx Table 3 Click the button Rationale The Requested Date Time field defaults to the current date and time and the Future Order Indicator defaults to No If these fields are not changed the order goes in the system and automatically notifies the ECG tech to complete the test today Ambulatory ECGs For Ambulatory ECG tests please use the Future Order option when se
83. HUGO RM 2 Cerner HUGO RN 2013 09 10 07 55 44 Test HUGO PM Unit Reg Clerk 2 HUGO PM Unit Reg Clerk 2013 09 10 07 07 48 Test HUGO PM Unit Reg Clerk 1 HUGO PM Unit Reg Clerk 2013 09 10 07 01 35 Test HUGO Physl Cerner HUGO Physician Number of Records amp Save Print 5 Click the se button 6 Click the L_Clese button Important Do not use a Sticky Note in PowerChart to record chart access SURGERY BOOKING YOUR PATIENT FOR SURGERY Complete Surgical Procedure Request Form 1 Complete Surgical Procedure Request form https apps Ihsc on ca regional training powerchart assets HUGO JobAids Sugical ProcedureRequestForSecBooking pdf and give to your secretary replaces the top portion of the previous Pre Admit preprinted order sheet 2 If you need a PAC visit with anesthesia or internal medicine you must indicate that on the Surgical Procedure Request form so that the appropriate PAC visit is booked You still need to order the consult in the Periop Pre Admission Clinic PowerPlan 3 Validate that allergies are entered If allergies are not documented electronically you cannot proceed with order entry as it is a hard stop Enter Pre Admission PowerPlan 1 From your patient s chart click Add in the Orders component of the table of contents menu Orders 2 The Add Order window opens 3 In the Find field type periop to see the PERIOP PowerPlans or ortho to see the ORTHO Pow
84. IP Ordering Physician Physician name WET Test HUGO Physician Order Date Time 2014 05 26 a 1209 Communication type Verbal with Readback Phone with Readback Medical Directive Initiate Orderset Signed Paper Order Conditional Fax Electronic Click the button Enter the name of the consultant you contacted in the Requested Consultant field of the order details 5 Requested Consultant HUGO TEST HUGO Physician G i f Click the button g Click the button and refresh your screen 5 Complete the task from the task list Ensure a Consult form is stamped completed including service physician name and date contact and placed in the patient s chart Co sign Orders 1 Physicians will be able to co sign all orders that need to be co signed by clicking the Orders for Cosignature button P Coding Scenario20 Actions Requiring Cosignature Coding Scena PIN 1187 14 54 No Known Allergi Inpatient 2014 04 07 15 35 lt No Discharge date gt VISIT 422351168 Location V B41 B4 1 Provider Moayyedi Paul Discharge Status Red Age 23 years Sex Female DOB 1991 04 07 Action Action Date Time Entered By Order Details On Hold Orders Pending Cosignature Order 2014 04 18 13 44 12 Jeria Calcium Serum Plasma CA AM Routine 2014 04 19 03 00 Blood until 2014 04 19 03 00 ym Y Select All Y Show All Details No dose range checking is performed upon cosign Coding Scenario20 C
85. IV daily infuse over 6 hr order duration 5 day Requested Start Date Time 2013 07 10 08 00 stop date 2014 07 14 08 00 Sodium Chloride 0 4 Lab Orders e Batch your blood work by clicking on the first test dragging the mouse down to highlight all tests or by holding down the Ctrl key and clicking on the tests e Choose the appropriate Priority e Tests do not need to be individually signed instead add all desired tests and then signed off all together e Ensure the Collection Date Time is correct e 2 ES Order Name Status Start Details 4 Laborato Complete Blood Count Order 2014 07 14 13 59 Routine 2014 07 14 13 59 Blood and Differential CBC Electrolytes Serum Plas Order 2014 07 14 13 59 Routine 2014 07 14 13 59 Blood ma LYTE 4 m w Details for selected orders Details j Order Comments e Diagnosis Future Order C Yes e No Priority Collection Date Time 2014 07 14 Z z 1359 D Missing Required Details Dx Table Orders For Cosignature Lab Order Add Ons e Lab test can be added on to previous draws collections that are still in the lab e When you are unsure if the blood has already been drawn collected or processed the order status will provide you with the information you need to determine if additional testing can be added E Laboratory PM Routine 2014 07 15 13 00 Blood until 2014 07 15 17 00 and Differential GBC I
86. LE inl fnac PEN en rimini rt Deporti magn aed f terre Deal dd mg wa DEA gi hoen PEH nas or ere Folia Lip Aggpointrrest Latas Planen dSerarhyDEIHATE iden EB LATE cial 138 reg supp RECTAL gf Fou F neuen n ering PAID ANE STE Arial sbrdia Praes pph LAG Ge ind crus A Pia I o derer RIMATE gares IH IE ron Mo e nets Fs Bere e biri PEH aian Ex vem bag THOR SEX Dur Erben Fecit Cp Wists haie Seng ims Isi Dg case sed COLPA ci rre Pusmbccntalar TE Propia pisha Pees arcis repicrr Meragerast Finardi PIC Baben bo Eni Dapet imaging romain Volticem Lips Apra Lacri D isle DC etas h Cni A Ding peti Ehapi lois Tii ett ain feller Uo Appi Lats Fitter eh DC gt artus bo Cis at Din Diaria keun losin Lalo Us Apparel Late tral POR 170 M Egan da Liri 8 Next you need to save and override your favorite with the same name amas rem Tady GEO JUTE E Opera y eye Mead tende I Tas O gem Fiksi Chas Lido Pete plo Cue dd Hop ipee Prenda Dictada GM Creer Pr Tad let cosa ierat AYE lady A ciclo debebam AQUA py nea n Elie tier Parte ta n Orr Mates TS Taur Cet To oen a crenge Mb a tee cese Machos a PR Cievernamer a LE necanmmi FI Fate Locator ie apra fie Inner y redu paper boot EE Deieser Mena l Grammy ober Dummy Patent Today iem iu PINC1157 E 69 Mie Aagba DE ig si MEA ACen MDUD Delt Gakic A ery LE Gries ELI t ricas bis 1 EI A Ade dr dd E hed ipy AA ANA y H 41 7E
87. Medications in Ambulatory ooocccconoccnnonaccnnnonacononanonononos 97 Medication Order When Ordering any Me iCation cccccccsssccccsssececeesececeeeceeeeeseeeseeecessuneceseeees 99 Orders that Do Not Fire to your Multi Patient Task LiSt cocoooccnnonocnnnonnnonnnnnnccnnonanonnnnnnonnnonanos 100 Orders that Fire to Multi Patient Task List for Ambulatory seen 100 Placing Diet Orders Use Drop Down Fields Not Order Comments eem 100 VSS US M mM a PREIS 100 RETO Ma E 100 feld TT m 101 Placing Orders on the Correct ENCOUNTEL ccccccessecccessececcenscccceesececeesececeeeceeseesecessuecesseeceeseeseeeeas 101 Placing a Patel ONG CU isse dote roto ta aes 102 PGP A TREES 102 ACGsREMOVAal EIS iE 102 Placing Post ODAPS Ode sostener ite cte redo EE Crap vt EE oe no ti 103 Ortho PowerPlans not Processing Due to Missing Date for a Routine Xray T 1 for Post Op Day 1 104 Placing Proposed Orders sida v b dep dbexc etd saisis tuse si beo dete uds 105 Frona Consulted Physieldblsctienios bur d eosdem eben E irata ted ome eld d dais 105 order Plated by SUSteli ducet taossdut s uade NA t N rad d onn De S Ped rU d DUE 105 Tasks Firing to Nursing Gnd Unit Clerk Task EISU vds oed feo ee Po atia eM o ode ex roe ces ewe dd o ve equi ga 106 Proposed Or
88. NMENSO DARA AS io 140 CONQUE ITA AOS eae pea uM sa Re ved dead pen uela o HUE AR GN eM d ua 141 A ELEMENT TH TENTER TEES 141 Packed Red Blood Cells and Platelets Phases ccccssccccsssccccensccceensccceessecssuseceseecesseeesssueeesseuseessaeseesaases 142 Completing the POWeEPIAaTlss ciet bebe reat tni Pe vodka eed ER peu Sa E nsaeaundehesancardadounascecievenweden ad Dua ped a tup aut 142 View Planned POWBFPLIGssdimasise mn i ite rei rias 143 fed RET m Um 143 Orders PaO en teen near ee et oem Cnn EE A LAE E D ED Oe PT TP 143 Pantene SS REOR REM MEMS 144 Buld Loca tons diadoecdalec oce a a ate disco trera certet a pecus rese copus e deo ede census 144 Buila a Relationship EISE cipue ld ol etu Ee oon UL 148 Step 1 Provider Creates a Relationship LiSt oooocccccoocnnononnnnnnnnnnnnnnnnnnnonononnnnnnnnnnnnnononnnnnnnnnnnnnnnnnnnanininns 148 Choose VISIE REIOLIONS BS AAA nce Pra di bia pied Dco boda brt ut dations 149 Choose Encounter TV DCS sm o SS o 150 Step 2 Provider Grants Secretary Proxy to Relationship Patient List ooooccnccoccncnnonnnnnnacononononcnnnnnnnnnos 151 Step 3 Secretary Logs and Activates List its 154 Build a Provider Group EISE so cte e eb Ea US Uli bens beni m dia eoo laa 155 Build adledical service Ut dico 158 Builda Perso al CUSTOMISE sect A ii ISE 160 AGA a Patient to a CUSTOM el 163 Method A ePatlent SCONE roii vectors cieeuepreosuseamteh Haws sbieeeweaniesouaaatiOus a S E 163 M
89. P London Health s QSEPH HEALTH CARE Sciences Centre LONDON HUGO User Guide Provider CLINICAL INFORMATICS Version 9 Date July 21 2014 Table of Contents a Eo cuum acesesadeeno tee aeos uude vas Re e Dec Po DU cLsE E Ud CoD depre pd 9 Admit To Order Admit from the Emergency Department ccccooccnncccnnnccnnnnnnnnccnnnnonanacnnnnnnanaconnnonanonos 9 Quick patient REES O israel 10 Admitting to a Specialty Bed from the ED ccoooccnnccccnnccnnnnonononnnnnonocnnnnonanonnnnnnnncnnnnnnnnnnnnnonnnnnnnnnnnnrnnnnnnaninnnnnns 11 AdamitFrom sn Ambtlatery Clinica dota 12 Entering Heigntand Welght on Adan Na 12 Alero S NETT NE 12 Allergies to bpe Documented PO E hates NAS NEA 12 ICONS A a da da 13 Add a NAM T 14 Documenting No Known Allergies ccccccccsseccceesseccceesececeesececeeeecceceesececeeececeeuceeseesecessuecessuneceesenes 16 Modi amAllerB En orem criollo std 17 To Cancela Reaction SV INNO COMM dodo 18 Change No Known Allergy Entry to a New Allergy cooooccccconoccnncnnccnncnnconnonaronnonanonnnonaconnonanonnnnnnoss 18 Cancel an Alter ENYA er N al ans ub fece reque 18 A A TT TR UD RD RE 19 Customize Orders and or Medication List ViewWw oooooccccnnccnnnonnnananonnccnnnononananocinoccnonononanos 19 Follow Up on Discharge Summary cccccsssesssseccccccccesessssesccccccceseeussssecccssceeseuaessseeceeseeeaeas 22 View Follow Up Communication in Discharge Summary
90. Patient Lists dialog box P Modify Patient Lists Available lists Active lists Dr Test Patients 16 Click the button to return to the Organizer screen Step 3 Secretary Logs in and Activates List 1 From the Patient List toolbar click the List Maintenance amp icon Patient List 2 The Modify Patient Lists dialog box opens 3 It displays Available lists on the left an Active lists on the right 4 Click to highlight the relationship list name in the Available lists pane and then click the blue arrow to move the name to the Active lists pane IB Modify Patient Lists Available lists Active lists Dr Test Patients H WBT Test Cancel 5 P Modify Patient Lists Available lists Active lists Dr Test Patients H WBT Test Click thel button 6 This list will appear as a new tab on the Organizer Patient Lists Pg u 536 eBmej mmma Dr Test Patients H WBT Test Admitting Physician Attending Physician Inpatient One Day Stay Outpatient 86 years Male WBT Test HUGO Physician cellulitis Medicine Blue Team 252 1 Days 51 years Female WBT Test HUGO Physician laryngectomy Otolaryngology 253 8 Days 51 years Female WBT Test HUGO Physician pneumonia Medicine Blue Team 260 2 Days 86 years Male WBT Test HUGO Physician pneumonia Medicine Blue Team 260 2 Days V C51 C5 104 C 1187 07 36 CI Gladys 86 years Female t WBT Test HUGO Physician
91. Physician H a F pacal Medical SJH Preadmission Clinic Attending Physician SJHL Radiologist Attending Physician SHE Thyroid Cancer Clinic SJHC Thyroid Clinic ME 4l Automatic Fax An automated fax with the appointment details will go to the ordering physician s office or the clinic space if the order is scheduled more than 48 hours in advance If the order is scheduled less than 48 hours in advance the Bookings office will contact you directly with the appointment date and time DI Order Do Not Activate DI Orders Unlike lab orders please do not right click on the order and activate a medical imaging order The order will be activated by Digital Imaging DI Order Placing Diagnostics Imaging Orders This section is a reminder from the Radiology Department Change Date and Time to Reflect the Time of the Test Please remember to change the requested date and time to reflect the actual date you want the tests done Leave the Requested Date and Time as today if you would like the test scheduled as soon as possible DI Tests When ordering DI tests if the body site is not included in the title you may need to input the individual test to cover all areas you want imaged Multi Tests on a Patient If you want CT Thorax Abd and pelvis you need to enter 2 tests CT Thorax and CT Abd Pelvis Radiology bookings have alerts in place to ensure these test are scheduled together Ultrasounds P
92. Pumita Heath Cad Version Code Attending Phyris ih this patient being admitted Irem Ernergency Le 6 Complete the blank yellow fields First Name Patent Last Name Susan PIN 1187 21 60 Visit Number 422352104 Reason for Exam Visit Medical Service Building VH Main Nurse Ambulatory V AEM Registration Date Registration Time Middle Name Test Patient Type Inpatient Admitting Physician ee Birth Date 1956 02 02 Health Card Number Health Card Version Code Attending Physician al Patient Flag CDAD MORO Seana CDAD MDRO Status 7 Click OK 8 A pop up will query Do you want to open the patient s chart PowerChart Ez Do you want to open the chart 9 Select Yes and this will open the inpatient encounter to the Orders page P Susan Patent Test 1187 21 60 Opened by Channon Carrie Ann Task Edit View Patient Chart Links Options Current Add Help ES Patient List 22 Multi Patient Task List E3jScheduling Message Center aj Home Tracking Board 5 Test Cerner JIn Box 85 Quick Orders Configuration ous gt 6 Change Till suspend An Exit Es Calculator Scheduling Appointment Book e Explorer Menu Patient Locator E AdHoc amp PM Conversation Conversation Lau Susan Patent x Susan Patent Test PIN 1187 21 60 VISIT 422352104 Age 58 years Sex Male DOB 1956 02 02 Menu fi Orders Flowsheet ef Add Microbiology Viewer Orders Me
93. RMAL 0 Refill s Maint e Best Match es No Available Alternatives E Other Options No Available Alternatives Same Therapeutic Class acamprosate calcium polystyrene sulfonate H cinacalcet 3 i P hyaluronidase W isotretinoin nicotine orlistat sodium benzoate sodium phenylacetate 9 sodium phenylbutyrate W sodium polystyrene sulfonate sterile talc Kent Clark Superman 1187 23 64 Cancel V ETT A gs ois pts pied pete pp HTA Convert to Inpatient Medication ENT Orders to Convert Available S order Neme Joao Possible Conversions or Januvia 50 mg oral tablet K SitaGLPtin Januvia 5 ORAL 0 Refill s 2014 06 12 13 32 Main C Best Match es 0 sitaGUPtin No Available Alternatives ha 4 linagliptin po bw saxagliptin Non Formulary Alternatives No Available Alternatives Kent Clark Superman 1187 23 64 Cancel Auto substitutions Some home medications will be automatically substituted when the decision is made to continue them in hospital These Auto Sub decisions will appear as shown below eg Therapeutic Substitution VA Provider Assigned 2 Selected Order pantoprazole Pantoloc Choose Therapeutic Substitution No Exact Match lansoprazole 15 mg DR cap ORAL Equivalent to Pantoloc 20 mg EC tab ORAL lansoprazole 30 mg DR cap ORAL Equivalent to Pantoloc 40 mg EC tab ORAL OR Choose Decline R
94. Rec a Disch Meds Rec As each step is completed a green check mark will precede the phase ww Meds History 4 Adm Meds Rec 4 Disch Meds Rec Important Transfer medication reconciliation is to be completed each time a patient moves from one level of care to another This is an excellent opportunity to refresh the patient s medication regime to reflect their current and sometimes drastic changes in condition Please refer to the policies of the facility in which you are practicing as well as the practices of the services between which the transfers are taking place Reconciliation Icons Icon Icon Description What the icon means Blue and white exclamation mark Work has not yet been addressed w Green check mark Work has been completed 3 Blue re cycling icon Work is incomplete Accessing Medication Reconciliation Order and Medication List Medication reconciliation is accessed from the Orders or Medication List components of the table of contents menu You can click on Document Medication by Hx 4 Document Medication by Hx Reconciliation 2 Check Interactions Best Possible Medication History Accuracy Completion of the Document Meds by Hx page becomes your BPMH When completing a Best Possible Medication History here are a few pointers that may be of use e Avoid Free Texting medications and dosages The information available to providers at the time of Reconciliation admission and otherwis
95. TTICe Favorites Misc 1 Dexamethasone taper A list of your favorite plans will display Right click on the PowerPlan you would like to remove from your favorites Click Remove Plan e Retum t to Clin i testi locu HAEM Admission test Ga 2014 06 18 A Remove Plan alert dialog box will open to confirm the removal of the PowerPlan from the favorite folder Click to remove the plan Remove Plan Are you sure you want to remove ONC Return to Clinic BR 2014 06 18 PRESCRIPTIONS Mo Loves JUN Do Not Print a Duplicate Prescription for the Chart There is no need to print a prescription twice for hospital records Once a prescription is issued the record of the prescription is captured and available for viewing in the system Non Medication Template Prescription Changes have been made to the non medication template to increase the ease of use when prescribing Previous Non Medication Template Details 35 Order Comments A Diagnosis Dose Route of Administration Frequency Send To RP534 on LHPRNI1 Ih tvh ca from UKY794 in session 0 PRN Type Of Therapy Acute Special Instructions Stop Date Time Select Prescriber Address Samples New Non Medication Template If you search by non medication template you will now get the new version and this will continue to be used if the orderable does no
96. Taxi 1 4 Make sure that the Send To field is displaying your default printer Send To RP534 on LHPRNI11 Ih teh ca from QCP387 in session11 Important Providers should convert all the medications they want on the prescription first and only click the button when they are done so all the medications are batched together 5 Click the button 6 Click the button and refresh your screen Important Once you click the button the prescription is printed to your default printer A provider can generate a prescription for an inpatient medication order without going through discharge medication reconciliation Important By generating the prescription in this manner the patient s discharge medication reconciliation will not necessarily be reflective of all of his her discharge medications 7 Open the patient s chart to the Medication List component of the table of contents menu 8 Right click on the inpatient medication order and choose Convert to Prescription Renew Modify Copy Cancel Reorder ogram amp p Messa 0 Order 1 Suspend Weight 65 kg Activate Sex Female Complete Cancel DC Delete e Add 4 Document Medicatio Convert to Prescription f Medication Lis Orders Medication List Reschedule Administration Times Medication Request d em Display MERA Add Modify Compliance Order N Order Information Comments acetyls Results o
97. Thomas opy to Physician au Strathroy Middlesex ollow Up Request Tillsonburg UH Main SJ CT Protocol n pain Name and Ingham Woodstock General Requested Hospital f SALAS ERES Requested Hospital SAAS ERES 2 However if you require a test done at a different facility LHSC Woodstock etc the provider needs to complete a paper requisition Important Do not change the defaulting location to an external facility the order will not route to the correct site Notification to Clinic Space 1 If you want the appointment notification to go to the clinic space and not the ordering physician s office type SJH in the Send Appt notification to if not Ordering Physician field and click the binoculars icon Send Appt notification to if not Orderin Multiple Matches 3 From the Provider Selection window select the appropriate clinic i e SJHC Pain Clinic and click the button Yi Provider Selection Last Hame First Name Sule s h Search New Provider Tithe Preview Clear F Limit by group No data filtering Limit by organization Ma data filtering Limit by position No data filtering Limit by relationship Ma data filtering Mew physicians only SJHL Inpatient Attending Physician SJHL Lithotripsy Attending Physician F SJHC Nuclear Medicine Attending Physician SJHL Nurse Attending Physician SJHC Nursing d LLa EPI a F SJHC Pain Clinic Attending
98. Y olr Other Test Y olr Other Test ponnn i T d gnature Save as My Favorite Orders For Signature 3 Complete all missing details 4 Click the button 5 Requisition will print Y Detats tor Olr Other Test Chromium pf Details Order Comments Offset Details i Diagnosis Other Test Chromium Requested Start Date Time 2014 02 06 le 0911 Important This order will only print on the defaulted printer Labels Changes to Lab Label Printing The build of the Routine collection priority is being changed to ensure Laboratory orders will honour pre built collection routes for Inpatient areas Collection routes are scheduled hourly runs that group Laboratory orders together and print labels For Outpatient areas without these collection routes Routine T N will print immediately In an INPATIENT area If you used Routine T N to print a label immediately for a non stat Laboratory order you will now have to use the priority of Timed with T N Priority options include Collection date and time AM Routine Default for standard labs in Collection date time will be set to the next inpatient areas excluding critical day at 0300 care areas Blood will be drawn in AM as per hospital routine PM Routine Collection date time will be set to today for 1300 Ifthe blood work is ordered after 1300 then the label will batch to the next printing
99. aE BB tr HU EH REPE D Cer be ev ud t creda ae estriado 172 Print a Prescription for an Inpatient Medication oocccccococccnnnnnnncnnnnnnanenonnnnnnonnnnonononnnnonnncnnnnnnnnonnnnnnnnnnnnns 173 Printa Prescription Through JUNIDE odio cido 175 Pinta Prescription Using d Tablet ainia nien toon HD in abe dios pente ds Cola io ee Duo eoo to dI 175 CONVERT and Print PrescriDEIODssesie esso a GE die keeper ta bsp E 175 REDNA Prescripciones 175 Printers Changing Your Default Printer in Windows een 177 WIDOWS Teto n 177 WINGOWS m TH 178 O P T 178 Record Why You Were in a Patient s Chart cccccooocccccnnononcconcnnnonnnacncnnnnonaninicnnnononiniccnnnonos 178 Surgery Booking your Patient for SUTgery cccccccncnnnnnnccnnccnnnnononanininocccnnononananionicicacononananos 179 Complete Surgical Procedure Request Fo Mii 179 Enter PresAurmissiop PoOWeSrPIab seite eb AD 179 Enter Day ot Procedure POW ELPA essa 181 Add an Orderto a POWerP Mision 183 A B abs cl compe rome es me EE E EE E EI ME EE CIE 184 Print the Transfer Medication Administration Report esses ene 184 Tiransrer Between Campuses sisi coepti pe teibistolsis ule A LO RC e Aet UE Ee eB coe 185 View Laboratory Guides and Tests ccccecccccssssseccccccccssecccccceesseeccccceesseccceseeaescececessensecceeeeas 186 PowerChar ICOM LOGGING casino ind 187 ADMISSIONS Admit To Order Admi
100. ally complete and sign the printed requisition for it to be accepted by an external laboratory Workflow example 4 Bloodwork required in the future on the day of the next clinic visit prior to coming to the clinic Future Order 1 Patient seen in clinic 2 Provider determines labs to be done later before next clinic visit 3 The lab order is entered electronically changing the Future Order field to Yes in the Details tab Ee ous E a i Details EE Order Comments Priority Routine Specimen Type Blood Future Order 8 Yes The lab order will appear on Orders profile as Future On Hold Display All Active Orders gm VT Order Name Status EH Active Ej Complete Blood Count and Future On Hold Differential CBCD CBC and Di Patient returns to hospital for clinic visit and goes to Central Registration Patient then goes to clinic and future lab orders are activated by clinic staff clerk Labels are generated Patient sent to Lab Test Centre with labels In the event the clinic is unable to activate the orders same day they will need to keep the future orders on paper The reason is that the patient is registered to the clinic and if the Lab Test Centre activates the future lab order the labels will print out to the location the patient is registered the clinic LEAVE OF ABSENCE LOA MEDICATION PROCESS ST JOSEPH S What is the Same 1 Notify Pharmacy a Parkwood
101. alth Referral Outpatient Allied Health Referral UH eu Details JE Order Correnente Friuiby Routine Requevied Date Time 4 week Allied Health Servicefd Esque Audie Cleucal Pr cheleqy Meuin Fiyxihelagy Occupational Therapy leatnactiens 4 Oncethis order is signed it is tasked as a communication order to e the Nurse e Medical Secretary e Unit Clerk positions 5 Depending on the workflow established for the area one of these positions will print off this order and then it will be faxed sent to the outpatient service Paper Copy of the Referral Required 1 Scroll on the Orders page to see the Outpatient Allied Health Referral order Orders Medication List Display All Active Orders uo Orders for Signature Y Order Name Status Dose Details zi Plans Medical A Allied Health Outpatient Allied Processing Routine Return 4 weeks to Physiotherapy RESP Chronic Obstructive Pulmonary Disease COPD gold copy load f Health Referral Outp COMMON Venous Thromboembolism VTE Prophylaxis Module L Orders 7 Admission Resuscitation Status Alerts Diet Activity Vital Signs Iti Patient Care ES TV Solutions iti Medications Ed Laboratory Diagnostic Imaging Other Diagnostic Testing Treatment 7 Consults El Allied Health Patient Education Discharge Planning Non Categorized Medical Supplies E Medication History
102. ame KA n ree text Dru C3 Common Allergic Reactions M Senicillin Category g 2 Reaction type Allergy F eso reactions mediated by the immune system 3 Reaction symptoms 4 Allergy details Status Active Y Mark As Reviewed Add Free Text Reviewed 2013 10 28 09 54 Or Hives Severity Do Not Use Y Recorded on behalf of Info source Patient Onset lt notentered gt notentered y pp 7 5 Comments Add Comment Chronological O Reverse chronological 3 Click the button to save the changes but stay in the window to add a new allergy if needed or click the button to save the allergy entry and return to the patient s chart To Cancel a Reaction Symptom 1 Right click on the symptom 2 Select Cancel 3 Reaction symptoms Cancel 3 If cancelled in error right click again and select Undo Cancel 4 Cancelled reactions will be displayed with a red X 3 Reaction symptoms Change No Known Allergy Entry to a New Allergy If a patient had no known allergies recorded in any of the three categories and then the patient develops an allergy you must CANCEL the no known allergy entry before you can enter the new allergy information Cancel an Allergy Entry 1 Click it once and then click Allergy on the menu bar to select Cancel from a pull down menu or right click the entry and then click Cancel from the shortcut menu 2 You must provide a reason for the
103. an external facility e g Woodstock or Listowel the provider will need to complete a paper requisition Important Do not change the defaulting location to an external facility the order will not route to the correct site Notification to Clinic Space 1 If you want the appointment notification to go to the clinic space and not the ordering physician s office type the clinic name in the Send Appt notification to if not Ordering Physician field and click the binoculars icon Details for CT Abdomen Pelvis CT Abdomen Details Era Order Comments Priority Routine Tip When typing in the Send Appt notification to if not Ordering Physician field type LR LH or SJH to see clinic names for the various locations LRCP LHSC and St Joseph s 2 From the Provider Selection window select the appropriate clinic i e LRCP Clinic 1 and click OK jm Provider Selection a Last Name First Mame Search licp Mew Provider Title e Preview Clear E Limit by group Mo data filtering Limit by organization Ma data filtering E Limit bv position Ma data filtering E Limit by relationship Ma data filtering View physicians only Chart Copy PETA TIBI SII i Physician Billing Clinic 1 Physician Billina Physician Billing Clinic 3 Physician Billing Clinic 4 Physician Billing Health Records Physician Billing New Patient Reterral P
104. ar the alert it doesn t accept the proposed order Discern Open Chart Education Tracey 1 of 1 E gt Proposed Order Reminder Cerner You have opened a chart with a proposed order Please remind the MRP of the Proposed orders on this chart If you are not part of the MRP team and this proposed order is not within your decision making scope to accept or reject disregard this alert Quick Check Box for Proposed Ordering When you have selected a c ES Order Name Status A V 452 E 5 212 B VISIT 2 422351957 H 4 E Glycated Hemoglobin Order 2014 05 01 3 00 AM Routin GLYHB Placing Respiratory Care Orders For all blood gas orders please call when the order is placed and call RRT to collect For all RRT related requests please continue to page as you have previously Placing a Titration Order Placing the Order Open the patient chart to Orders From the table of contents menu click Add The Add Order window opens Search for and select the desired drug The orderable will turn bold and blue vr ode x qp Contains Advanced Options e Type fh Inpatient Search within 4ll At locatic F Practice HUGOS 1187 03 56 6 Click the Done button 7 On the order Details tab complete appropriate fields including Titration Range Titration Range Unit titration instructions and vital parameters Y Details for dextrose 5 in water titrate 250 mL DOPamine additive 400
105. ary Inbox Proxies 4 Display Last 60 Days Inbox Items 31 Documents Orders 22 22 Orders to Approve 22 22 2 Tothe right of the Proxy field click the Manage button In the User field type in the name to whom you want to grant proxy Click on the binoculars if you need to search for the name New Given Proxy In the Provider Selection window click on the name Click the OK button Ta Provider Selection e JUS Jes Last Name First Name Suffix an a New Provider Title E Clear Limit by group No data filtering Limit by organization No data filtering Limit by position No data filtering Limit by relationship No data filtering View physicians only Organizations Services Aliases WBT Test HUGO Audiology WBT Test HUGO Dietitian WBT Test HUGO Medical Secretary WBT Test HUGO Occupational Ther WBT Test HUGO Pharmacists WBT Test HUGO Physician Admitting Physicia WBT Test HUGO Physician 2 WBT Test HUGO Physiotherapist WBT Test HUGO PM UnitReg Clerk WBT Test HUGO Resident WBT Test HUGO RN WBT Test HUGO RPN 4 If required set a Begin Date and End Date when you grant proxy You can change the date using the up and down arrows or to set a longer date range click the black down arrow to open the calendar Important If the person being granted proxy always needs access to your accoun
106. ate Orderset signed Paper Order Conditional Non Provider Fax Cancel Lab Order Check for Existing Lab Orders Before Ordering More Many patients currently have lab orders on their charts that are scheduled as daily blood work Before ordering blood work on a patient please look at the laboratory section on the Orders page to ensure you are not duplicating existing orders 1 You must be on the Orders page 2 Make sure Display is set to All Active Orders Scroll down to Laboratory section Review all active Orders All active orders will have a checkmark IB Education Tracey 1187 10 25 Opened by Test HUGO Physi Imik Edil View Pobent Chet books Nebheabom Upbons Curent Add Help TA Home t Patient List Scheduling 3 Message Center a Multi Patient Task List 0 Med cation Informati n ar RED E Microbiology Antibiograrmn t Ea Miena Order 11 BA Change PE Suspend e Fr a Calculator Bj AdHac d Socuments V Patient Locator En abel Reprint 2 Inquiry Bj Scheduling Appointment Book E Explorer Menu Education Tr List faa Recent Education Tracey2 PIN 1187 10 35 Allergies Not Recorded Inpatient 2014 01 14 22 15 Ho Discharge dates ST PARZE Location W C61 C6 104 C Agha yrart reFrmae ProwidenGurr Kevin A CARA f Menu A Orders summaries ViewPoint JB Add ay Document Medication by Hx Reconcilisti n 4 Check Interactions satus Randis ftereus B Meds Histor
107. ation P AMPUTEE Age 58 years Sec Male DOB 1945 09 11 ion Contains Advanced Options fTppe da Ambulatory Meds as Ax e Folder Neurology Search within ll Allocation Parkwood Campus a Provider Fullerton 6 PKWD Learn Ambulatory6 P104035 9 In the Find field type the name of the medication you are starting or tapering 10 Choose correct order sentence or the closest to it A Ambulatory Practicel Add Order Ambulatory Practi PIN 1187 03 69 No Known Allergies Outpatient 2013 05 28 10 24 Fin 422344008 VISIT 422344008 Location U 5CARD CVT Age 51 years Sex Female Provider DOB 1963 01 01 Diagnosis Problem being Addressed this Visit Find eh SH Order Sentences ET Toa ee Order sentences for LORazepam LORazepam 1 mg oral tablet None 1 tab ORAL TID PRN for anxie LORazepam 0 5 mg oral tablet 2 tab ORAL TID PRN for anxiety LORazepam 0 5 mg sublingual tablet LORazepam 1 mg oral tablet LORazepam 1 mg sublinqual tablet LORazepam 2 mg LORazepam 2 mg sublingual tablet LORazepam 4 mg mL injectable solut Problems LORazepam injection __ Name of Problem LORazepam ED Ambulatory Practicel 1187 03 69 11 Click the button to close the Order Sentences window 12 Click the button 13 Complete the Dose time Duration put the space day or week 14 In the Dispense field ensure number correlates for that duration 15 NOTE Spec
108. ation as there is no corresponding order If the medication needs to be continued in hospital then it needs to be entered as a non formulary order in the inpatient catalogue Add a Medication in the BPMH 1 Click Add in the Document Medication by Hx window istory Home Medications Unable To Obtain Information Use Last Compliance Document Medication by Hx ES Order Name Status Details 2 Type the medication in the Find field 3 Select the medication 4 Choose the order sentence that best matches what the patient is taking Find h Contains Type 4 Document Medication by Hs 3 0 5 c oL Search vila l At kcalion Last Lasix 10 mg ml oral liquid Lasix 20 mg oral tablet lt q Lasix 40 mg oral tablet Lasix 500 mg oral tablet P Order Sentences o er s Order sentences for furosemide Lasm Z0 mg oral tablet Mone tab ORAL daiky 30 tab 1 tab ORAL daily 90 tab Click OK Click Done Add all required information in Order Details gt i Click Document History Compliance 1 When completing medication history for your patient it is important to address compliance by clicking the Compliance tab P Document Medication by Hx CH Order Name Status Details Last Dose Date Information So O Medication history has not yet been documented Please document the medication history for this patient en Documented Medications by Hx A digoxin digoxin 125 meg 0 125 m
109. ation occurs The three allergies that must be documented for each patient are e Drug e Food e Environment There are several ways to open the Allergies window to document allergies 1 There are 3 ways in the Summary ViewPoint IB PKWD Learn Practice64 P104169 Opened by Lon IPRN HugoTrain257 Task Edit View Patient Chart Links Notifications Navigation Help Home Patient List 33 Multi Patient Task List 4 Message Center E Q Medication Information Links E Messa S New Sticky Note View Sticky Note E Tear Off C52 Attach S Change Pt suspend MB Exit B Calculator Sij AdHoc Mill Medication Administration PKWD Learn E PKWD Learn Pr Age 64 years Sex Female Pre DOB 1949 05 17 Menu Summaries ViewPoint A B Bb a a 100 0 8 a Task List Patent MAR Summary MAR li Patient Information Problems and Diagnoses x ej Visits 1 All Visits Medication List Allerniec iT 3 A a s Order En TETTE NR SATUS CGassihcaton oC AJ Visits Orders Inpatient v TIER pubic Shared ra Favorites J My Plan Favorites 2 In the Admission Database PowerForm right click in the Allergies section choosing Add New on the menu Zudmuission Infarmatmn ee i E Eh Ont Heb Y Dag agp Drug Stin EHe Hiu Hg Eraser Aliigi MER Na me PEWLD Learn Practiced PEW D Learn Practice59 Icons The first icon means that information ha
110. ble GENERAL LABORATORY REQUISITION POWERCHART ICON LEGEND PowerChart Icon Legend Patient Access List PAL Allergies documentation No allergies documentation No known allergies documentation Region only Patient has a continuous IV order New routine priority orders requiring nurse review New stat priority orders requiring nurse review New routine priority orders that do not require nurse review New routine results New critical results Patient care task Lab test task Medication task Stat medication task p Scan successful Medication order not verified by Pharmacy Medication order rejected by Pharmacy Cross order interval checking has been turned off Cosign by Provider needed Required field not completed Critical task such as an overdose or unmatched drug Additional charting may be required Underdose Unscheduled medication cFRrPA 08 OJD Nurse review is required ohn iae MAR note click to see comment f Overdue task medication Order is part of an PowerPlan Orders iG up Q Denote an ambulatory order Denotes an inpatient order Inactive order Active order Collapse Details pane Expand Details pane Expand a clinical category Collapse a clinical category Order details not complete Reference text information available Cosign by Provider needed Provider cosign refusal Nurse review is required Order is part of a PowerPlan Proposed order pending approval Order yet to be
111. cancellation in the Reason field 3 Click the drop arrow beside the Info source field to see the menu options and select the person who provided the allergy information 4 Click the 79 button to save the changes but stay in the window to add a new allergy if needed or click the button to save the allergy entry and return to the patient s chart Review Allergies 1 You may click the Mark All as Reviewed button once you have reviewed the allergy record made any revisions and the record is correct as listed OR Mark All as Reviewed 2 You may select and review individual allergy entries by right clicking the entry and selecting Mark as Reviewed Add New gt Modify penicillin View penicillin View History of penicillin Cancel penicillin Mark As Reviewed Display r Check Interaction 3 You have now recorded that you reviewed this allergy record and it is correct Review information includes the date and time of the review and your name Last Reviewed By 2013 10 28 10 35 TrainRM ClinicalbocO1 sp 2013 10 28 09 49 TrainRM ClinicalbocO1 Reaction Type Unspecified gt Allergy Reviewed H 2013 10 28 10 35 TrainRM ClinicalDocO1 2013 10 28 09 49 TrainRM ClinicalDocOd CUSTOMIZE ORDERS AND OR MEDICATION LIST VIEW You can change the order of columns for Orders and Medication List You can also change how information is grouped and sorted Important The Orders page is
112. cation List Transfer b Or click the in the Medication Reconciliation section of the Discharge Summary The Order Reconciliation window opens and there are two sections a Medications Prior to Discharge Reconciliation historical medications prescriptions and inpatient medications b Medications after Discharge Reconciliation historical medications and prescriptions Select the status of the patient s medications after discharge For each medication you must choose Continue After Discharge Create New Rx or Do Not Continue After Discharge B Continue After Disch Create New Rx Do Not Continue After Dis Under Medications Prior to Discharge Reconciliation all the patient s home medications as well as medications taken while admitted are listed Important Once again the Medications After Discharge Reconciliation can be amended by clicking the Create New Rx radio button Create New Rx to convert an inpatient medication to a new prescription If the dose or route needs to be changed from what is currently being administered you will be able to modify the order details as needed Selecting a routing should not be necessary Computers in your area will be assigned a default printer If the route needs to be changed click the drop arrow beside Send To and select the correct location There may be some areas where there are multiple printers and selecting the routing will be necessar
113. cation type electronic Nurse IV team draws sample labels appropriately and sends to lab for resulting If this is a difficult draw or a special population the nurse may speak with provider if they wish to have the sample redrawn Provider Requests to Append Add Laboratory Tests to Samples Already in Lab Scenario Lab work has been drawn and sent to the lab Provider now requests to add a new test to existing sample in lab 1 2 3 Provider to call the lab to append lab work to current sample If new order is required lab will request provider to enter Nurse IV team draws sample labels appropriately and sends to lab for resulting Lab Order Tests Requiring a Public Health Requisition If a laboratory test requires a public health requisition that paper needs to be completed separately on paper and sent down with the specimen You need to order what is required for lab tests at one time and sign once For those lab tests you do not find within the Ontario Lab Requisition you can add to the bottom of the plan under Other Place Lab External Public Health Requisition 1 Click Add order Orders 2 Search for the lab order that would require a Public Health Lab for completion 3 Select the Lab External Public Health Requisition PowerPlan Bioavailable Testosterone FAI Cancel ALL Lab Blood Tests ED Lab Order SM STAT d HLA B27 HLAB27 8 Hypercoagulable Screen HCS Baas
114. ccnnnonaconnnnnncnnonnncnnnonanonnonnnronnonaronnonanonnnnanoss 80 Eje Weiz TR DO EU UTEM 81 Lab Order Add OM sud eddie du mE bor ibam uei uv ed avai atone 82 Lab Order Addon Blood WORK sei Decade tu Me eh eu beta bius vr eus di D ab fO REEL UN RP eM LE Due LA 82 Lab Orders Batching Lab Ordes ceja o 82 Lab Order Help with Ordering a Lab Test o ccccconcncncnnccnncnnaconnnnncnnnonanonnnnononononanonnonaronnonanccnnnnancnnnnns 83 Lab Order If You Cannot Draw BlOG ie 83 Lab Order Insuficient VOIUMEC isis iei reads 85 Lab Order Check for Existing Lab Orders Before Ordering More ccccceseccccesseceeeeseceeeeneceeeeeeeeeees 85 Lab Order Request for Repeat Collection or Appended Addition cccooccccconoccnncnnonononononononanonnos 86 Laboratory Request Tor Repeat Colector di 86 Scenario Sample clotted hemolysed insufficient quantity tube broke in centrifuge eese 86 Provider Requests to Append Add Laboratory Tests to Samples Already in Lab ooocccnncnnoccnnncnnnccnnnnnos 86 Scenario Lab work has been drawn and sent to the lab Provider now requests to add a new test to existing sample MAAD reaper ore trees here RT ee Tie ern apte iuc iU LOC ERE SONS GENE bU M d M I RTT See arte 86 Lab Order Tests Requiring a Public Health Requisition o occcoooccnncnnncnncnnncnnnonaronnnnanonnnonaronnnnanonnos 87 Place kap External Public Health Requisitloli sees ad ei e e Ete E mte
115. creen Care of the Body after Death Please follow the current Care of the Body After Death policy which includes filling out the death pack and notifying patient registration by phone This policy will be reviewed and revised in the coming months to reflect any necessary changes as a result of the HUGO project Discharge medication reconciliation and a discharge order are not required However there are two electronic orders in the system May Release Body to Morgue and May Release Body to Funeral Home Entering these orders is not mandatory CCAC Referral Request 1 Enter the Request for CCAC Referral order for the patient This will not go to CCAC 2 The order will task to the nurse or clerk to tell them to fill out the form and send it to CCAC Orders for Signature H U 8 AB 102 D VISIT 4272349133 A Discharge Planning ral Request for CCAC Order 2014 04 22 15 38 Referral Communication Order The Communication Order is available to use for communicating orders that are not available in the order catalogue Orders for Signature es 2 BY Order Name Status Start Details E U 8 A8 102 D VISIT 422349133 E Patient Care EE HEX Communication Order Order 2014 04 22 15 39 Y Details for Communication Order Details 135 Order Comments Diagnosis 9 Requested Start Date Time 2014 04 22 a 1539 Enter verbatim order o Please do not use communication orders to order medicati
116. der Alerts TES Oda dd deca dh de UR d cadet add at a d ous sede RERO Red us 106 Proposed OrderiRemillideE osse iesu dI A A 106 Quielccheck Box Tor Proposed Ordena tias 107 Placing Respiratory Care ONO ONS uos etie io eph ve aet ab rabie e eee beant ctas A ia 107 Piacins 3 TIbES OR Orde cde scoe teste M evita buta unAREeca A ODE o ota ELS Leste det 107 PAGING tAS Order aces mr H 107 deso o pie ERE RON A a 108 MATAN Or AET aaa ORT cT 108 Changing an Existing TPN Ord ET einnar 108 TPN Form in PAED is Not Available at this Time sese 109 Placirie Verbal and Telephone Orders uni ES 109 Verbal Orders Start Date alid TIITIG 0 mee esi teu E ea ebd etui Coe cdo Eno Coe cuu 110 Placing Vitamin Order side te aioe cio 110 POW OUP Al TERT TTE TL a a 111 Add an Order to a PowerPlan with Add to Phase NOT Add cccssssccccsseccceesecccensccceeseceseaeceseenseessueseesaaees 111 Blood Transr stobPoWeFPI3f5 ns Mateus ue cbe daria 111 CareSet and PowerPlan OFGGTSBE urera AN T 112 Disclidrge PoWetrPlatla eiie OE e an t ut aeo min E ee ppc I D Y uina Eit mdut cin usce sa dum loeo de easton see ODE 113 Maung Discharge PoWerPIahs OS A A A N 113 Discontinue PowerPlanS nai ada dates 114 Discontinue a PowerPlan When You Need to Cancel a Phase of a PowerPlan eese 114 Discontinue Completed Blood T
117. der Ordered heart rate lt 40 Activity PICC Flush Peripherally Inserted Central Catheter Ordered Closed Ended Valved Vital Signs 4 Patient Care TV Solutions x m Diagnoses amp Problems Displayed All Active Orders Related Results Dx Table Orders For Cosignature Orders For Signature If yours is not visible click on the arrow to open it Orders a Add 4 Document Medication by Hx Orders Medication List isplay All Active Orders PATIENT LISTS The process for adding and removing a patient is unchanged from your current practice Some patient lists are maintained by the system and automatically add new admissions and remove transfers or discharges However you can also build custom patient lists that might be more relevant to your workflow or role Custom list patient entries are not generated automatically You may need to manually add or remove patients from a custom list Build a Location List 1 E ow SS From the Patient List toolbar click the List Maintenance icon Patient List The Modify Patient Lists dialog box opens It displays Available lists on the left an Active lists on the right To create a new list click the button The Patient List Type dialog box opens Double click Location Patient List Type Select a patient list type a Medical Service Personal Custom Provider Group Relationship 6 The Location Pati
118. dication List Transplant Lab HLA Overview K NE Displayed All Active Orders All Inactive Orders All Orders All Statuses Chart Review Orders for Signature Pla V OrderName Interactive View P Orders Orders iFJAd aes toe mission PO Y Admissi s Medication List Resuscitation Status e EE OV Admission Database DAlerts b M Document Home Medications i Diet Infection Control FJ Activity Task List _ Vital Signs Allergies Order Entry Details Clinical Documents Reports __ IVSolutions Important Taking these steps ensures that you are set to place the admission orders and complete admission medication reconciliation on the proper encounter type Admitting to a Specialty Bed from the ED 1 To request a specialty bed select a unit using the Special Unit Request drop down list V AED Pod A 9 VISIT 426356494 Admit 2014 05 04 08 01 00 EDT Order 2014 05 04 10 58 Adolescent PICU Burn Unit Details for Admit To CCU CSRU lis Order Comments ENT Observation Unit ICU CCTC NeuroObs NICU Ew amp lli Paediatric Observation Unit Trachs etc Palliative Care Special Unit Request Important Prior to completing the Quick Inpatient Registration you must place the Admit To order on the patient s ED encounter Admit From an Ambulatory Clinic 1 Call Admitting and request a bed 2 Close the patient s chart 3 Ensure
119. ding phase are an exact copy of the patient s earlier lab tests Including all instructions Click the button as per previous instructions followed by the button to review all the orders Once reviewed click the button The desired phase is now ordered and the Lab labels will print Completing Recurring Multiphase PowerPlans Once the last set of labs has been done on the stop date of the timing order the plan may be completed It is important to discontinue the Timing phase when the plan is completed to ensure that the recurrent PowerPlan does not continue past the intended duration of treatment 1 To discontinue the plan right click on the Timing phase and select Discontinue from the shortcut menu Activate Discontinue Replicate Copy Plan Information Add Comment A Discontinue dialog box opens and displays the timing orders being discontinued Do not check the box preceding the order in the Keep column as orders selected will not be discontinued 7 P Discontinue COMMON Recurrent Outpatient Labs Timing Keep Component Status Order Details A Timing Of Laboratory bei On Outpatient Labs Phase weekly for 26 week On Mondays old Cancel Click the button Click the button The amp indicates that order details are incomplete gem E Y Order Name Status Start Details 4 Future A Mon Categorized EDU Timing Oflaboraton Cancel So Click the amp icon A cancel reason
120. dtimgadgllio duci tid i oH N 125 Select Returm DOTE uoi o n AA ue ea 125 SCO CUNT Phases este aded tica oa 126 Follow UbAbDbolntment LADS Phase t ti pier te bo doo SAA AAA As 127 Return to Clinic With Diagnostic Imaging Required eese nnne nnne sn ashes saa assess asses 128 Ortho PowerPlans not Processing Due to Missing Date for a Routine Xray T 1 for Post Op Day 1 130 rip ep PR 130 REASON Sede E EN HN eR E NEM INNEN oM contu tem mat mel adito uade et 130 SOIL BO eaters elas tro uo uut iu t pou eet ulpa uu ciet ee 130 PowerPlansun Planned Stile euni tdt dd incida 130 STOP NOUMEALIONS ss aether a 131 SOLE stop Noticas e Rma aedbctasa tod etel esa Palau etidm tul tesko aolcad 131 AE SLOP NOU ICON ETT D o OI LS waa oars OE 134 Proposem OA a D ws 135 Exisung Proposed Orders asar a 135 HP A 135 OrderPlaced DY SMN 136 Tasks Firing to Nursing and Unit Clerk Task List oooccccccoccnnnnccnnncnocnnonononcnnnnonononnnnononononnnnnnnnnnnnnnnananononos 136 Proposed Order Alertsin Arteta 136 Proposed Ordene aa 136 Quick Check Box Tor Proposed OTE AN ri 137 Quick Orders P3BeUsc ie ous dd e vacui eosdem iv div nM er de mdi Seed eis 137 Ordering Recurrent Transfusions in Outpatient Settings ccooocccnncnnccnnonanonnnonaconnnnaconnnnaronnonanonnnnnaoos 139 Adding tie Pla da ido cdi 139 Timing ANG Parameters PNAS Cass e O e 140 I
121. e is only as good as the list of documented medications The greater the accuracy of the BPMH the easier it will be to complete reconciliations e Choosing a drug with an associated dosage in the title but changing the dosage in the order details can be confusing and will not translate properly across the reconciliation eg Venlafaxine 150mg tab 125 mg oral daily It is appropriate in these cases to choose medications that have no dosage information associated with them e g choose NONE option e The BPMH MUST be completed prior to reconciliations Without them the task is impossible to complete e Not every Med History or Reconciliation will be presented to you in a clear concise manner For example the pateint may be confused or unable to speak and no family is present e When the patient leaves your care the information you ve provided in your Discharge Reconciliation will become the new Medication History on their next encounter This tells the provider on the patient s next encounter what medications they were on when they left the hospital Medication History When a medication history is unknown or non existent the proper method for indicating this is found in the upper left hand corner of the window as Add Medi cati eee No Known Home Medications Unable To Obtain Information Use Last Compliance No Known Home Medications Only available if the patient has not had any medications entered into the system in
122. e Plan Review the Plan favorite for the identified modifications Ensure the new order is either included or excluded as desired and complete order details All other orders will remain unchanged from the previous plan favorite Laboratory Y Group and Screen LHSC SJHC Timed Blood A Complete GOO COUN and Dimerenmtial CBCD Timed Blood Frequency ONCE CA INRPTT Timed Blood Frequency ONCE In this example the LAB Group and Screen Module was replaced with the Group and Screen single orderable Resaving the Plan After reviewing the new plan select to resave this plan The Save as My Favorite dialog box will display with the current Plan Favorite Name Save as My Favorite Flan Favarite Mame ONE Return to Clinic Chemotherapy BR cane The same plan name may be used when resaving personal favorites A Save as My Favorite alert window will notify you that the previous plan favorite will be lost Click to complete the saving of your new favorite plan Save as My Favorite ij 1 A plan favorite already exists with the same name Do you want to A overwrite the existing plan favorite Removing Favorite PowerPlans If a PowerPlan favorite is no longer needed it may be removed from the My Favorite Plans Folder From the Add Order window click the icon and select My Favorite Plans UE Contains oo Type da Ambul Favorites Search within ll EET ILC My Favorite Plans AITIDUTdLOTy IIT U
123. e lowest effective dose especially in patients over age 65 CT acetaminophen 325 mq tab ORAL ONCE O 4 diphenhydrAMINE C A diphenhydrAMINE 25 ma tab ORAL ONCE PostT ransfusion Lo Furosemide should be ordered for patients with significant fluid balance concerns C Ei furosemide 20 ma tab ORAL on CALL post transfusion of first unit of PREC C Ei furosemide furosemide injection 20 mg injection IV on CALL post transfusion of first unit of PRBC Completing the PowerPlan Once all information has been completed click the button and click the button The plan phases should display as below COMMON Recurrent Packed Red Blood Cells and Platelets Multi phase Timing and Parameters Future Laboratory Planned LAB G roup and Screen VH Parkwood LRCP Module Planned B Packed Red Blood Cells Planned BLOOD TRANSFUSION Packed Red Blood Cells PRBC Full Protocol LHSC UH VC PW SJH LRCP Planned Platelets Planned BLOOD TRANSFUSION Platelets PLT Full Protocol LHSC UH VC SJH LRCP Planned View Planned PowerPlan If you are looking for planned orders open the Orders page They will be displayed at the top of the View section under Plans You may need to click the plus signs beside Plans to be able to see all plans ORDER ALERT In the current configuration of HUGO more than one provider was able to enter orders on a patient s chart at the same time We had put this pref
124. eason IL L L d j You may at this point choose to accept or decline the substitution and have the patient take their own supply of medications Patient s Own Meds You may choose to order a non formulary medication for a patient for various reasons If it s the patient s own medication you must indicate this 1 In Details click Yes for Patient s Own Meds e bn T Order Mame Status Start Detail W AED Pod A 6 VISIT 422352338 Admit 2014 05 09 08 59 00 EDT E Medications RRS 1 Order 2014 06 13 8 13 Requested Start Date Time 2014 06 13 8 13 Pantoloc Details for pantoprazole Pantoloc PES Details 32 Order Comments 55h Diagnosis T t li Duration Unit Requested Start Date Time 2014 06 13 813 Stop Date Time 4 gt First Dose Priority Routine Possible Error Messages When using the Reconciliation windows you may get various error messages Discern 1 of 2 E DISCERN ALERT Cerner _ _ _ O O o o o This patient does not haye allergies documented Please document prior to placing an order Document Allergy Alert An Allergy Status notification is no longer a Hard Stop alert It will now allow you to proceed past the warning If you wish to enter an allergy from this warning you may continue to do so 1 From the Discern Alert window select the option to document an allergy You will be taken to a new pop up window
125. elvic Ultrasounds LNMP field OB Ultrasounds tab Date and Time for Orders Please add the date of the last known menstrual period in the Please add the estimated date of birth into the Order Comments When completing an order ensure that the start date and time of the order is appropriate For example an order for bedtime placed in the morning should start at 2200 hours not today and now 1 In the Details for the order click the drop arrow for Requested Start Date Time 2 Enter the new date and time nj Ens w Rd E 5 eaa ones arare Fk ec hew p ai PINC1187 03 ES Dedem Dcdo Lud A E eek Era A Irene dar MeT ur S THLE IKEA WERT AAA A View ern Dose Unit Route of Administration PRN 9 2014 04 30 Infuse Over 2014 04 30 Duration 2014 04 29 17 00 Requested Start Date Time 3 Click the button 4E rna js lhr wi at mnata alise Gil estere Hes Alergia Het Reser apesta tert Dubai dar r3 dt w rrr a Presa hat ia ent Pains E uen crams Arie engem a unm pr Pana rr YY chetuleg Aporrea ck Meti a 6 i aca 0 11 A A Bpqueted at ae lene el Serio He pde rati hor Vez Dope Prine aa JE vo Mext administration Skip administration Following administration ECG Orders Reoccurring ECG Orders 1 When the provider would like ECGs ordered with a frequency they are instructed to use the orderable ECG Nurse order when
126. en amp 50 mq 1tab ORAL BID Discontinn O N metoprolol metoprolol tartrate 50 1 tab ORAL BID 60 tab Documen e 7 7 Discontine O O y nicotine nicotine 14 mq 24 hr trans 1 patch transDERMAL Documen amp Ndi Tem PR Di z O Eh E ranitidine ranitidine injection 50mg 98 hours Discontinn O p risperiDONE Risperdal 2 mq 1 tab ORAL daily Ordered O fa risperiDONE Risperdal 2 mg 1 tab ORAL daily Ordered y risperiDONE Risperdal 2 mq oral tab 1 tab ORAL daily 60 tab Documen Eb sitaGLIPtin 50 mq 1 tab ORAL daily Ordered o O Eb sitaGLIPtin 50 mq 1 tab ORAL daily Ordered 4 sitaGLIPtin Januvia 50 mq oral tablet ORAL Documen E IV Solutions lactated ringers 1 000 mL 125 mL hr IV continuous Ordered 9 O Eb 5 lactated ringers 1 000 mL 125 mL hr IV continuous Ordered Transfer Medication Reconciliation Transfer medication reconciliation is to be completed each time a patient moves from one level of care to another e g critical care to inpatient unit pre op to post op or inpatient unit to long term care etc Please revise per Lori O Brien s email This is an excellent opportunity to refresh the patient s medication regime to reflect their current and sometimes drastic changes in condition The Transfer Med Rec is almost identical in appearance to the admission Med Rec Complete Transfer Reconciliation 1 Access transfer medication reconciliation from the Reconciliation
127. en caf y Metoprolol metoprolol Documented 1 tab ORAL daily do not chew or break tablets 30 tab 0 tartrate 200 mg oral tablet Refill s 2014 06 12 12 41 Maintenance w dion digoan 125 meg Documented 1 tab ORAL daily 30 tab O Refills 2014 04 28 22 49 0 125 ma oral tablet Maintenance tartrate 5 stable E Prescription Moddy Dp digoxin digen n 250 mes Suspend 30 tab O Refill s 2014 06 12 12 43 0 25 mg oral tablet Complete Dp metoprolol metoprolol 60 tab O Refill s 2014 06 12 12 43 tartrate 50 mg oral tablet Cancel DC o acetaminophen caffeine Delete vars PRN pain 120 tab O Refill s deme acetarninaphen Add Modify Compliance Order Information Reference Information Y Disable Order Information Hyperlink A 4 Choose a Cancel Reason from the drop menu Details E Order Comments Diagnosis Sh 3 Cancel Reason EA Cancelled by physician Duplicate Request Patient Discharged Patient Refused Patient too ill Cancelled by Nurse Cancelled by Provider Patient Transferred Transcription error System troubleshooting Order details changed Referral ordered in error 5 Once the details have been completed to your satisfaction you can again minimize the details window once again with the small black arrow in the upper left hand corner Duplicate or Similar Orders Duplicates or similar entries can be challenging to spot
128. en until you get to the Results section and click it Here you can exclude or include items from the Events section in the middle of the screen You can also include or exclude encounter types on the right hand side of the screen Setup for WET Test HUGO Physician Configuration Behaveur Frets Manage Fook Manage Frowy FYI Result Subscnpibruri Time Range 60 00 Days Summary Vise Caleqery _ Secure Messages Asseciated hers Column O Medicatinns 7 eRe Suspect Matches Ahnnrmal Results Details Patient Mame Rx Renewals rticas Re sults Encounter Type Abnormal V1 eRe Mon Matches Emoni Results Outstanding Orders Remove satus amp Rx Mon Mate Fiother Result To Result Type eRe Rowling Errors Type Result Status CI Ta Messages Fram IE Results Notiferation Canmrment F Other Subject Il Normal Create Date ivi Nome Update Date Iv Cortical Assigned 9 Abnormal Results FYI 1 Other Aucending 9 Descending erra 2 Critical i EX Abnormal nric unters Work Remis amp Include F Saved Docurments E 7 P Based Diercumerits ee eo M meum Dictate z Eemeye Patient s Reminders Cine Day Stay Incomplete Order Dutpatient F Consult Orders PreReg Inpatient z m PreReg Cine Day Stay PreReg Outpatient Key Motilecations 3 max Referred In Shiller Abrev Ge View name Telephone Carnmunication Order Orders E Add Event Remove Event Messa Messages Chi C
129. ent List dialog box opens 7 Click the plus sign in front of Locations Location Patient List IE Locations w x Locations Groups Encounter Types Care Teams Relationships C Time Criteria Discharged Criteria C Admission Criteria Please note that you can also choose Locations Groups to generate a list of patients admitted to a specific location within a predefined location e g J Colp Clinic We won t be doing that in our example 8 Click the plus sign in front of the appropriate site location e g LHSC UC ocation Patient List L Locations Medical Services Encounter Types Care Teams Relationships LC Time Criteria Discharged Criteria Admission Criteria Eep Four Counties Health Services Elh LHsc uc c b LHSC VC p Listowel Memorial Hospital a El LRCP Pe Mount Hope Campus Bele Old LRCC Pe Parkwood Campus fe RMHC London i Elp South Huron Hospital Association i Elp Southwest Centre for Forensic Mental Health Care p St Joseph s Campus D St Thomas Elgin General Hospital oy Middlesex General Hospital Locations Medical Services Encounter Types Care Teams _ Relationships LC Time Criteria Discharged Criteria Admission Criteria Finish Locations 0 56 Alexandra Hospital i Sala Four Counties Health Services 3 8 LHsc uc a pe Fowler Kennedy Sport Clinic UC CES Lindro
130. entries cannot be added or removed from the list 1 From the Patient List toolbar click the List Maintenance icon Patient List eH SO e The Modify Patient Lists dialog box opens It displays Available lists on the left an Active lists on the right To create a new list click the button The Patient List Type dialog box opens Double click Medical Service po o x S Patient List Type Select a patient list type Location Medical Service Personal Custom Provider Group Relationship 6 Click in the appropriate checkbox for the medical service you require Medical Service Patient List Medical Services Urology C Transplant Surgery C Locations Encounter Types _ Trauma Non Brain Injury 7 Trauma Non Spinal Cord Injury Care Teams C Traumatic Brain Injury _ Relationships C Traumatic Spinal Cord Injury LC Time Criteria C Traumatology Discharged Criteria 7 Unknown C Admission Criteria 7 Vascular Surgery u Veteran Dementia Care Veteran Physical Rehab Veteran Respite WCW Affective Social Enter a name for the list Limited to 50 characters Urology 7 Click the button 8 The Modify Patient Lists dialog box displays 9 Click to highlight the new list name in the Available lists pane and then click the blue arrow to move the name to the Active lists pane IP Modify Patient Lists Availab
131. ents tab allows the provider to add parameters around the medication administration e g Hold if SBP is less than 80 Do Not Use the Orders Comments Tab Do Not Use the Order Comments Tab for adding stop dates dose increases or direction to add extra orders Help Finding a Medication Pharmacy can help identify if a medication is available to order in the system or if it needs to be entered as a non formulary drug If you need assistance in placing the medication order you need to ask a SuperUser or colleague Medications from Pharmacy Even though orders are sent to pharmacy instantly they still need time to process them Please be patient Medications cannot be dispensed from Pharmacy until they have been verified by a Pharmacist You will know a medication has been verified when the mortar and pestle icon disappears Additional Precautions Any health care professional can initiate additional precautions for identified or suspected infections and conditions and precautions should be initiated as soon as symptoms of an infection are noted Appendix B of the corporate Additional Precautions policy outlines some clinical syndromes requiring the use of controls pending diagnosis Infection Prevention and Control or the Infectious Diseases Consultant should be contacted if clarification regarding initiating precautions is required Adult vs Paediatrics If your site has both paediatric and adult patients please select your
132. erPlans Find periop cn Contains a tt ce LA B SS PAED PERIOP Pre Admission Clinic EMPERIOP Day of Procedure Pre Op EMPERIOP Diabetes Management Module EMPERIOP One Day Stay Post Op EMPERIOP Pre Admission Clinic Find ortho eh Contains Ti tal ve La Ga idi Search within S ORTHO Admission Pre Op ORTHO Day of Procedure Pre Op ORTHO Hip Fracture Post Op Multi Phase ORTHO Hip Fracture Pre Op SS ORTHO Lower Limb Past Op Multi Phase ORTHO Lumbar Surgery One Day Stay Post Op SSIORTHO One Day Stay Post Op GORTHO Pre Admission Clinic ORTHO Spine Surgery Post Op Multi Phase G ORTHO Suggested Orders ORTHO Total Joint Replacement Post Op Multi Phase ORTHO Total Joint Replacement Pre Op ORTHO Upper Limb Post Op Multi Phase ORTHO Venous Thromboembolism VTE Prophylaxis Module 4 Click to select either the PERIOP Pre Admission Clinic PowerPlan or ORTHO Pre Admission Clinic PowerPlan it will turn bold and blue 5 Click the button 6 Select the orderables that are appropriate for the procedure by clicking the check boxes to left of the orderable 7 Ensure that you have included the following a Diagnostic tests including blood work and x rays for Ortho patients use the ORTHO Pre Admission Clinic PowerPlan and you will find all the x rays listed b Anesthesia and Medicine consults with reason included 4 E ae Add to
133. erence in place to reduce frustration among providers if there is simultaneous ordering activity taking place e g MRP and consulting services However we have found that with a simultaneous order when you place an IV order the system does not perform allergy checking for the IV medication This means if a patient was allergic to morphine and a morphine IV infusion was ordered there would be no allergy checking As a patient safety precaution we have turned the setting that allows simultaneous provider order entry OFF This will enable allergy checking but only allows one person in the chart at a time P Patient Profile Is Reserved Purple Pumpkin O Another user Test HUGO Phys2 Cerner is currently manipulating LE pharmacy orders on this patient s profile You may complete the details for this action and the system will notify you when the action may be signed Purple Pumpkin 1187 19 96 Proceed and Notify Cancel You may see the above warning appear if you are attempting to enter orders on a patient s chart at the same time as someone else This is a safety feature of the system and helps us to ensure that two people are not entering orders at the same time which could result in dual orders for the same item If you click on Proceed and Notify the system will allow you to continue adding orders to the scratchpad or adding details to a PowerPlan but will not allow you to sign those orders until the firs
134. ering the medication signing However you may be required to sign off medication that you as a provider have given 1 Click MAR from the table of contents menu 2 Find the medication order on the MAR 3 Click the blue box if scheduled or the green box if PRN in the administration column of ondansetron 4 The Chart Details dialog box opens Here we can see the full order It defaults today and now and the person logged in 5 Click the Sign L X icon to document and close the dialog box 6 The administration box turns grey and displays the word Complete 7 Refresh the screen and the administration is now documented under the appropriate time with that medication on the administration line MEDICATION RECONCILIATION Medication reconciliation allows the clinician to document a patient s historical home medications and reconcile medications Online medication reconciliations are to be performed by providers only Medication reconciliation is accessed from the Orders or Medication List components of the table of contents menu The phases to online medication reconciliation 1 Medication History Document by Hx 2 Admission Medication Reconciliation 3 Transfer Medication Reconciliation 4 Discharge Medication Reconciliation Initially the status of the three phases will show incomplete as evidenced by blue exclamation marks Each new encounter will reset this status bar Status a Meds History o Adm Meds
135. ery Monday Requested Start Date Time 2014 07 14 Future Order Indicator Yes No Outpatient Lab Phase 1 In View section click the next phase of the PowerPlan Outpatient Labs Initiated Pending Orders for Signature E Plans Ei Medical mit 2 Checkthe appropriate orders ee Component Hematology Complete Blood Count CBC Coaqulation INRPTT INR International Normalised Ratio PTT Activated Partial Thromboplastin Time General Chemistry Electrolytes Serum Plasma LYTE Creatinine CRE Urea U Glucose Fasting GLUA Glucose Random GLUR Glucose PC GLUP Alanine Aminotransferase ALT Aspartate Aminotransferase AST Alkaline Phosphatase ALP Lactate Dehydrogenase LD Albumin Serum Plasma ALB Protein Total PR Amylase Total AMY Bilirubin Total BILT Bilirubin Direct BILD Calcium Serum Plasma CA Magnesium Serum Plasma MG Creatine Kinase CK Gamma Glutamyl Transferase GGT LIPIDS Chol Trig HDL LDL Phosphate PHO Urate UR amp J amp J amp J NS SNS NA ON e B 0000000000 LLL COMMON Recurrent Outpatient Labs Outpatient Labs Initiated Pending mW Details Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Ro
136. ethod 2 When a Patient Chait is Open ii caters adio tn d ea ede aah oa dat eto Hd Na 164 Method 3 Add From Another Patient EISU oa eto ote ana d a Stra a a te cda re d add Pe ETE eaa 164 Remove a Patient Trom a CUSTOMISE oy edo aoctor rb A dde are Ru es th drea eae 164 PRT ES Ciro ID E RR UT DIT UU 165 PowerPlan Favorites cccccssccccccsscccccccscccccccsceccccesceccacescecccsccecccseusecccssascecessenceeceneateeeens 165 Notification of Plan Modifications ccccccccsssccccesececeesececceecceeeusececeusececcencesseeecessusecessuneceesegeeetes 165 REVIEWING the Plan canes 166 RES AV IMG the tono 167 Removing Favorite POWeFP larns 4o oret A oe ae cet 167 Mice To RN mM 168 Do Not Print a Duplicate Prescription for the Chart ccccscccccsssecccesseceecesecceseeseceseeeceeeeeeceesegeeeenas 168 Non Medication Template Prescription ure eer E e Pre eet bees ei Pe Eo ve eive ia 168 Previous NonsMedicatior Template nia Cheer a rep Deest bre ee ta Un erm e Ep Py ERR REX VIRI CON IER 168 New Non Medication Template t oett e a t he a et Emi et divus ei ae ied e nt du D E a M EEN 169 Specific Non Medication Template ee ot ee eva pes Dn ave iia 169 Narcotic PrescrIDEIOTIS vaioudeu ciui eri om a QU eut debo adobe oo nie IQ koe duo Medos D Fon AIR lee EUR RE DUE EN 171 Placing an Ambulatory Medication Order as a Prescription ccccccsseccesececescecenceceeceeeeceeenceeseeseneeeeeecenes 171 Prescription on DISCD
137. ext clinic visit The lab order is entered electronically changing the Future Order field to Yes in the Details tab 4 D OR Details Era Order Comments Priority Routine Specimen Type Future Order amp Yes No The lab order will appear on Orders profile as Future On Hold Display All Active Orders gu BR 7 Order Name Status H Active El Complete Blood Count and Future On Hold Differential CBCD CBC and Di Clinic provides patient with a card with the instructions to go to Lab Test Centre before next clinic visit Ambulatory PowerPlan E 2 3 4 5 6 Patient seen in clinic Provider determines labs to be done later before next clinic visit The lab order is entered electronically in a planned state as a Planned PowerPlan From the Add Order window change the Type to Ambulatory In the Find field type COMMON Outpatient Click the COMMON Outpatient Labs PowerPlan Find common outpatient ph Contains Advanced Options ow Type Ambulatory Ti tal ww la a Search within l a COMMON Outpatient Labs Click the button Click the checkboxes to add the lab tests that you would like to order ae Add to Phase A Check Alerts JComments Start Now si Duration dev Component Status COMMON Outpatient Labs Planned Pending E Laboratory Details S Hematology A Complete Blood Count CBC Lo Coaqulation x Routine T M Blood
138. f ordered on an ambulatory encounter see tip above Multi Phase Outpatient Labs PowerPlans 1 In the Find field type common re 2 Click to choose the COMMON Recurrent Outpatient Labs PowerPlan Find common rel a ns Advanced Options Type Ambulatory a Gt x la Ea Search within l Atlocation COMMON Recurrent IVIG i Phase 553 COMMON Recurrent Outpatient Labs Apple Brenda 1194 00 14 Done 3 The Add Plan window opens 4 Change Confirm Outpatient Labs Start Date Time date to the date you would like to begin the labs 5 In the Confirm Phase Action section click the drop arrow in the Action column and change the Outpatient Labs to Order Now P Ambulatory Practiced Add Plan Bex COMMON Recurrent Outpatient Labs Confirm Outpatient Labs Start Date Time 201 4 07 11 4 Confirm Phase Action Start Date Time Action 2014 07 14 09 39 Important Do not modify the Action field of the Timing phase This is required to ensure the plan will be available on the next visit 6 Click the L__ button to close the Add Plan window 7 Click the button to close the Add Order window Reviewing the Plan The Common Recurrent Outpatient Labs plan has two phases within it The phases are Timing Future Pending and Outpatient Labs Initiated Pending The phases of the plan can be found in the View section of the Orders page COMMON Recurrent Outpatien
139. fer ReconciliatiOnsS oooocconccononcnnnnnonanonnnnnonanonos 47 Admission Reconciliatio N dar A A da 47 TransrerRecohcilldti bi na ld a ac 47 Transfer Medication ReconciliatiON ooccooccnnccnnononoconocanoconoconoconoconoronoronaronoronoronnronnronnronnrcnnccnnaconos 47 Completenranster RecobcllidtiORi sio votos a to nbn d ir reus a toteluo ema us s Debnr Ede er eur ote duse ott ber ut 48 Transfer to Discharge Reconciliation tdi iii 48 Discharge Medication RecoricillatlOTi ii RE rere EY irre dan acer c dee epe a VE CHE DER 48 Complete Discharge ReconetHlatiOTisi cid 49 Acute Versus Maitena coo 50 Admissions From Home or a Non Cerner Facility ooocccoooccnnonaccnnonanonnnnnaconnnnnronnonononnnonaronnonaonnos 50 REDNINE ash FESEMID LON T T I T TEE 50 View ReconcilatloD HIsSEOFE Vita 51 Message Contra 51 PLOXVJACCOSSU o decides 51 Grant Proxy to DNS 51 Accessing an Account to Which You Have Proxy ACCESS cssseccccssseccceesececeeecceeeeseceseeecessueceesegeeeetas 54 Orders and Results in Message Cente r ccccsssssccccccsssseccccceeseececeseensecccssuunsececssuauseceeseuaueecesesuaaeeeeeeaas 54 Order rc I 54 ZiYololqo ctm C 54 RI ECT ROT NR RP E E 55 View Order Proposals Before Approving or Refusing the Order ccccccccsssseccecsssecceceeecceeeaeeeceeseeeeeeesseees
140. ferrals Task List of the allied health professional Placing Diet Orders Use Drop Down Fields Not Order Comments Issue Dietary order information is not being transferred from PowerChart to the dietary software Reason Users are typing dietary information in the Order Comments tab instead of using drop down fields in the Details tab Text typed in the Comments tab does not get transferred to the dietary software Solution 1 Do not use the Order Comments tab when ordering diets These comments are not transferred to the dietary software 2 Usethe dropdown qualifier fields on the Details tab to add details to the dietary order See below Regular Diet Regular Order 2014 05 04 08 22 Start 2014 05 04 08 22 Diet LHSC Details for Regular Diet Regular Diet LHSC Details E Order Comments v teo lii Diet Order Start Date Time 2014 05 04 a 0822 2 Cultural Food Practices Fluid Type Amount Consistency Texture Diabetic Fat Fibre Protein Sodium Potassium Minerals Condition Procedure Test Placing Orders on the Correct Encounter Important Itis important to choose the correct encounter to ensure that orders are placed to the correct encounter and eliminates the need to cancel and reorder orders placed on the wrong encounter 1 The Demographic bar displays the patient s location and encounter type c
141. ff Special Instructions RSV Precautions Contact precautions MRSA v Patient Attributes v Special Unit Needed Quick Inpatient Registration 1 Close the patient s chart 2 Ensure the patient s name is highlighted on the Patient List Tak Ede Wes Patert Chart Links Patier list Help d Patient Lint al Muki Patient Task Lit Scheduling Message Center fy Home Tracking Board E Test Comer 4 In Bes E Quick Orders Configuration AOL Rp Medication Information E PawerC hart Info and Training CE B Change Ti suspend Al c nm Calculator E Scheduling Appointment Book E Explorer Menu Y Patent Locator Bj dioc am PM Conversation A Conversation Launcher Mil Medication Adrranistration le Depart Add Bh Encos Patient List Ai xsweeemagmeeseimms il M Palull Emergenmy All Patents V Adult Emergency nzam Bea Name Pod A What 5 Up Pod tenth pirk Poda That 12H tesipabient allan ET Testing Tena Pod C 1 RWR Testing Suran Peters ingestion jPod a 7 Testing Me Testing Chartatte Testi Alyson Testing Allan tat TestDi n ev beii ihe q Angn Fei Age 1167 21 52 AB ye re Mal 1187 12 83 33 years Male 1187 21 53 37 yeart Female 11567 1213 38 years Male 11H 14 73 58 yeart Female 1107 12 1B 59 year Female 1187 06 49 49 yeart Male 1187 12 34 30 years Female 118 12 16 49 yeart Female 1187 123 19 years Male 1187 1584 40 yenrt Male 1187 0
142. for printing Priority options include Collection date and time Default in ambulatory areas Collection date time will be set to today s date and the current time Label will print immediately For inpatient areas Collection date time will be set to today s date and the current time Label will print for next hour lab collection time e g if order placed at 0805 label will print at 0815 Order placed at 0825 label will print 0915 Only for medical emergencies Collection date time will be set to today s Default in Emergency date and current time departments Lab labels have STAT printed on them and are processed by the lab as a STAT priority Use for tests that need a specific Collection date time will be entered to the time for their draw for successive time that is requested draws or for a label that is required Frequency Duration and Duration Unit today and now on the inpatient can be completed to identify recurring blood draws To print a label immediately for a non stat laboratory order use the priority of Timed with T N Labels Do Not Reprint Old Labels Please do not print old labels and put on new blood work The blood work associated with these old labels has already been resulted and this is causing issues in our lab Ensure that you are printing new labels for new blood work so that proper results can be completed on your patient Labels Printing Solution for Future Lab Orders Some facility
143. globin less than or equal to 80 Then transfuse 1 unit packed red blood cells rij Conditional If Then If platelets less than or equal to 10 Then transfuse 1 adult unit platelets CT Conditional If Then If platelets less than or equal to 15 and patient is bleeding Then transfuse 1 adult unit platelets If the required parameter is not available right click on Conditional If Then order and select Modify Conditional If Then E Conditional If Then Conditional If Then pamaco ess than or The parameters in the If Then fields can be changed to meet the patients required transfusion parameters Details for Conditional liffhen Details H2 Order Comments CE Offset Details Diagnosis If hemoglobin less than or equal to 70 Then transfuse 2 units packed red blood Important All parameter instructions for Nursing or Laboratory staff are to be communicated through the Timing and Parameters phase Please do not enter Nursing transfusion parameters in other phases of the plan Laboratory Phase The laboratory phase contains a Group and Screen and Complete Blood Count and Differential to be completed prior to each transfusion COMMON Recurrent Packed Red Blood Cells and Platelets Multi phase v Eb LAB Group and Screen VH Parkwood LRCP Module M Y Complete Blood Count and Differential CECD If additional blood work is required select Add to Phase and Add Order to search for required blood work
144. gnature e v Component Plans MED Admission Planned Pending B e Medical Resuscitation Status 3 MED Admission Planned Pending BA Please ensure paper resuscitation form is completed reviewed erts Somes a a VTE Prophylaxis Moc TEREE MED Admission Planned Pending m fe a 2 Click Add to Phase and then click Add Order to open the Add Order window 3 Search for and select the order and click Done 4 Enter the order details and Sign and Refresh If you have generated your lab labels and you require an additional lab test you must contact the Lab Department They will guide you on how to enter the additional test Blood Transfusion PowerPlans Once the last product associated with a BLOOD TRANSFUSION PowerPlan is infused nurses need to discontinue the PowerPlan to discontinue the remainder of the orders e g the continuous IV order Blood products are only available to order within the BLOOD TRANFUSION PowerPlans Providers may choose to use the Full Protocol or the Product Only Using the PowerPlan will task the transfuse order to the nurse Blood Transfusion PowerPlan have been added to the Blood Tissue products order folder To view pending blood product orders and or product availability click Blood Product Information on the Table of Contents menu in the patient s chart This is new for Albumin IVIG and Rh Immune Globulin e The Blood Transfusion Lab will assign the total number of vial
145. gs saved successfully message given proxy to including the new resident Setup for Test HUGO Phys17 Configuration Behavior Prefs Manage Pools Given Proxies Given by Me FYI Result Subscriptions r Cancel Under the Proxies Given by Me section you can now see the accounts you have Proxies Taken from Me Begin Date End Date User WBT Test HUGO Resident 2014 05 06 13 39 00 2014 06 06 13 39 00 New User Begin Date End Date Accessing an Account to Which You Have Proxy Access 1 2 Click the Proxies tab Click the Proxy drop arrow to choose an account if you have proxy access to more than one account All Granted Items will be available Pl Powerchart Grpesirer fce WET Tert HUGO Reuidera Tori Dither 8 LT breed Docormenti Paper Bases Decus Decret Lo Dime Fere de POT WTR 06 Man mdi 1252 Orders and Results in Message Center Orders 1 All verbal phone and proposed orders entered with your name as ordering provider will appear in your Orders section of your Message Center Inbox Inbox Items 19 Documents Orders to Approve 11 11 2 This is for new cancelled discontinued and modified orders that are entered with the communication type of Verbal with Readback Phone with Readback and Proposed orders 3 You can single select or multi select patients 4 Right click over one of your selected patients 5 To clear these order
146. gy Category Multum Drug Name Vocabul Code Principal Types Lasix Multum D d00070 Generic Name El Lasix Special Multum D d00070 Generic Name 2 Reaction type Alleray iR reactions mediated by the immune system 3 Reaction symptoms 4 Allergy details Status Active V Mark As Reviewed 5 Click the Search tab and type in the substance name 6 Double click on the found substance to move it to the Substance section PKWD Learn Practice64 MRN P104169 Add Allergy Adverse Effect es Ee Je My Favorites Search c mc Search metoprolol ENS 1 Substance required Search bv Search for erae text Name Code Substance Reaction NKA metoprolol EI P A ee text Category Drug For items with these vocabularies principal types Vocabularies SNOMED CT Principal Types All Principal Types 2 Reaction type Name Vocabul Code Principal Types Allergy gt ee reactions mediated by the immune system 3 Reaction symptoms 4 Allergy details Status Active y V Mark As Reviewed Reviewed 2014 04 17 11 32 Severity Do Not Use Y Recorded on behalf of Info source Not Specified Onset lt notentered gt notentered y 5 Comments 7 The Reaction type will default to Allergy 8 Click the drop arrow beside the Reaction type field if the type needs to be changed 10 11 12 1 Substance required
147. harge is for a future date then the Requested Date Time can be changed to reflect the desired discharge date as shown below gt Order Name Status Start Details Discharge Patient Order 2014 05 04 15 57 Details for Discharge Patient Details j Order Comments fs Diagnosis Requested Date Time UL su Discharging to bi Special Instructions Discontinue PowerPlans 1 When discontinuing PowerPlans right click on the desired plan and select Discontinue Copy Plan Information Add Comment Save as My Favorite 2 The Discontinue dialog box opens identifying the order to be discontinued 3 Checkthe boxes beside the order you want to keep or leave them all unchecked to discontinue the entire plan B Discontinue PERIOP Day of Procedure Pre Op Keep Component Status Order Details Diet O 7 Communication Order Ordered Keep patient NPO for procedure Vital Signs EF vital Signs Ordered ONCE Patient Care E A Peripheral IV Insertion Ordered No Preference IV Solutions r1 Y lactated ringers 1 000 Ordered 1 000 mL IV continuous Start date 2014 04 23 15 28 75 mL hr Total volume mL mL 1 000 Medications A ceFAZolin Ordered 1g 50 mL injection IV on CALL infuse over 30 min order duration 1 dose Requested Start Date Time 2014 04 23 16 00 For patients with weight less than or equal to 80 kg start 0 60 minutes prior to procedure r
148. harmacy for further assistance Add Non Formulatry Medication Using the Template 1 Click Medication List on the table of contents menu 2 Click Document Medication by Hx t Medication List The Document Medication by Hx window opens Click the icon The Add Order window opens 2E IMS E Type medication template in the Find field Find medication template Contains Type 4f Document Medication by Hx 7 Click medication template from the list of results 8 Click the button 9 Complete the details accordingly there are no mandatory fields 10 Click if you need to add more medications or click the button if all medications have been documented Ordering a Medication when the Medication Cannot be Found in Order Catalogue 1 Click Add beside Orders on the table of contents menu Orders 2 Type nonformulary in the Find field Find nonformulary en Contains Advanced Options 3 Click nonformulary 4 The following message regarding Interaction Checking appears Interaction Checking Interaction checking cannot be performed for nonformulary Please click OK to continue placing the order 5 Click the button to continue 6 Click the button 7 In the Details fill in all mandatory fields Y Details for NONformulary Details is Order Comments js Diagnosis
149. hematuria Urology 255 3 Days Build a Provider Group List 1 eS n9 From the Patient List toolbar click the List Maintenance icon Patient List e 8 B amp eg The Modify Patient Lists dialog box opens It displays Available lists on the left an Active lists on the right To create a new list click the button The Patient List Type dialog box opens Double click Provider Group Anon Age t Note Attending Physician Visit Reason Medical Service LOS Leave Status Admitted 2013 09 06 14 52 2013 09 04 22 27 2013 08 29 10 48 2013 08 29 10 52 2013 09 03 10 26 Discharged Patient List Type Select a patient list type Location Provider Group Patient List Provider Groups Thoracic C STEGH Paeds Group Encounter Types T STEGH Psychiatry Group Medical Services C STEGH Urology Group Locations C Strathroy Medical Clinic C Time Criteria T System Support Group _ Admission Criteria Talbot Creek Midwives _ Discharged Criteria J TDMH Family Physicians _ Use Best Encounter Y Thames Valley Midwives Theracic Surgery Group gt Urology Group L C VFMC Physician LU Vic Medical Consults 2 Victoria Family Medicine Group Enter a name for the list Limited to 50 characters Thoracic Surgery Group 7 Next click Encounter Types on the left hand side of the dialog box There will be no checkmark initially 8
150. hrology Cardiology Attending Admitting Assigned Subscriptions Emergency Attending Admitting Emergency Copy to Hugo Subscription Inpatient Copy to Inpatient Attending Admitting One Day Stay Copy to One Day Stay Attending Admitting Outpatient Copy to Outpatient Attending Admitting Delete 10 Configure your own subscription based on your specific needs including Lifetime or Encounter Relationships Event Types Lab Radiology Pathology etc and the Encounter Types 2T Test HUGO vsician Configuration Behavior Prefs Manage Pools Manage Proxy Available Subscriptions Ambulatory Public Nephrology Cardiology Attending Admitting Subscription Details Filters Lifetime Relationships Description Encounter Relationships Birth Physician Care Coordinator Case Management Assistant Case Manager Life Death physician Dentist Family Physician OB GYN Physician Other Override Medical Student n Patient Care Case Management Administrator Override Infection Control Practit T Administrative Functions Administrative Support Admitting Physician AH External Reviewer 01 AH External Reviewer 02 Allied Health Anaesthesia Consultant Art Therapist
151. hysician Billing Patient Review Physician Billing Patient Services Thoracic DAF Physician Billing _ TTH I Physician Billing F Cancel Automatic Fax An automated fax with the appointment details will go to the ordering physician s office or the clinic space if the order is scheduled more than 48 hours in advance If the order is scheduled less than 48 hours in advance the Central Bookings office will contact you directly with the appointment date and time No Auto Notification Auto notification of appointments is not set up for Interventional Radiology VH UH The Booking Clerks in each of these areas will call with the appointment date and time DI Order Changes St Joseph s With HUGO you no longer complete paper requisitions for radiological tests performed at St Joseph s and Parkwood This includes Ultrasound Nuclear Medicine CT MRI Fluoroscopy Interventional BMD Mammography and General Radiology These orders will be entered electronically The exception is PET which has to be ordered using the Provincial paperwork and remains on paper RMHC and SWFMH stay on paper for all diagnostic imaging tests Mount Hope is out of scope for HUGO Requested Hospital Field 1 In the order details Parkwood can change the Requested Hospital field to St Joseph s Main for DI order not done on site Parkwood Main RMH London 5 Satellite Imaging South Huron St Josephs Main aT St
152. ial Instructions type in here something to the effect take mg x duration then decrease or increase to mg on date w Details for haloperidol haloperidol 1 mg oral tablet v Send To RP1031 on LHPRNI1 Ih tvh ca from QCP387 in session 11 v lau Details j Order Comments Es Offset Details ls Diagnosis Dose Route of Administration Frequency Duration Dispense 39 99 Refill 1tab ORAL d TID le 60 day 180 tab le 0 PRN Y Special Instructions take mg x duration then Type Of Therapy Acute decrease or increase to mg on O Mea Select Prescriber Address date CURE e Samples Y Drug Form tab Commen t Text 1 XX Initiate Sign Add Outcome Intervention Add Prescription 17 In the Add Order window change the Type field to Ambulatory Meds as Rx You have to change the Type field every time to Ambulatory Meds as Rx 18 Complete again steps 9 15 changing the doses the duration and the dates and message in special instructions 19 For the last decrease include in the special instructions when to discontinue Before initiating and signing click the button at the bottom Make sure you change the name of it to reflect what it is for example Titrating Quetiapine WR 2014 03 04 Adding your initials and the date can help you identify that this is the PowerPlan that you c
153. ication A Provider can generate a prescription for an inpatient medication order without going through discharge medication reconciliation Important discharge medications By generating the prescription in this manner the patient s discharge medication reconciliation will not necessarily be reflective of all of his her menu ogram _ Messa 0 Order 1 es M Tear Off ad Attach 6 Chan Weight 65 kg Sex Female Order N acetyls oral tal benseri 25 mg furoser furoser EP Detan 9 r im Order Comments of Dag Ce 1b onu FER Type CH Therapy L dt BE Masteanze tamp Route of Admini iratis Renew Modify Copy Cancel Reorder Suspend Activate Complete Cancel DC Delete Convert to Prescription Reschedule Administration Times Medication Request Add Modify Compliance Order Information Comments Results Ingredients Reference Information Print Advanced Filters Disable Order Information Hyperlink Open the patient s chart to the Medication List component of the table of contents Right click on the inpatient medication order and choose Convert to Prescription Curate e m peral Insincere Hhirquency d dub ect Porucribe Adres ra Perro tab Send Toc FAA pe LAER tros fron QRO RE in eto I Dispone 20 90 Lera n th eo E I Strep Data Tirar 28046010 dE a Comerant
154. ies 2 From the Catalog tab expand the folder for No Known Allergies Unable to Obtain CO Common Drug Allergies 41 Common Food Allergies ea noun Allergies Unable to Obtai NEDA No Known Environmental Allergies Ma Known Food Allergies Unable to O btan Collect ommon Drug Allergy Categories ommon Environmental Allergies 3 Double click to choose the no known allergy e g NKDA No Known Environmental Allergies No Known Food Allergies 4 The Substance field will display the no known allergy that was selected 1 Substance required MIKA LR Hi 5 Click the drop arrow beside the Category field and choose the associated category e g Drug Environment Food Category Environment Drug Environment Food znat entered Other 6 Click the drop arrow and choose the correct Info Source the person who provided the allergy information Info source Patient 7 Click the button to apply this allergy information to the patient s chart 8 To add more allergy information click the button 9 When all three categories of allergies have been documented click thel 1 button to return to the patient s chart Modify an Allergy Entry 1 Double click the substance in the allergy record 2 The Modify window opens allowing you to make any necessary changes 2 Train Betty MRN RL69073 Modify penicillin My Favorites Search Catalog Substance History 1 Substance required N
155. igoxin digoxin 250 m 1 tab ORAL daily 30 t Documen digoxin 250 mcq 1 tab ORAL Ordered ibuprofen 50 mq CHEW after br Prescribed ibuprofen 50 mq 0 13 tab CHEW Ordered rosuvastatin Crestor 1 ORAL Documen rosuvastatin Crestor 10 mq 1 tab ORAL da Ordered warfarin warfarin 4 m 1tab ORAL daily 30 t Documen warfarin 4 mq 2 tab ORAL daily Ordered B ications finasteride 5 mg 1 tab ORAL daily Ordered furosemide 40 mg 1 tab ORAL Bl Ordered acetylsalicylic acid As 1 tab ORAL daily Documen clopidogrel Plavix 75 1tab ORAL daily 90 t Documen ondansetron ondanse 1 tab ORAL ONCE 3 t Documen acetaminophen caffei 2tab ORAL q4 hours Prescribed digoxin digoxin 250 m 1 tab ORAL daily 30 t Documen ibuprofen 50 mg CHEW after br Prescribed rosuvastatin Crestor1 ORAL Documen warfarin warfarin 4 m 1tab ORAL daily 30 t Documen O O O O O O O o9 0000000000 OOO e Y a Wu OO OOOOOOOOOO OOO 0 Missing Required Details All Required Orders Reconciled Dx Table l Reconcile And Sign Cancel Complete Discharge Reconciliation 1 Access discharge medication reconciliation two way a From the Reconciliation drop down list and select Discharge or F Add 4 Document Medication by Hx Reconciliation Check Interactions Admission Medi
156. ime Continuous Infusions HOLD NIGHT ECT a divalproex sodium A Future PRN Discontinued Scheduled ET PRN Discontinued Unscheduled BEE coe itime PRN for Discontinued PRN posers CELTS SE b deos gies Meike nities irs HOLD NIGHT ECT ee lORazepam mg PRN 7 5 mg 1 tab tab ORAL bedtime PRN for HOLD NIGHT ECT zopiclone Favorites Check Your Favorites As you have become more familiar with the process of ordering this might be a good time to revisit any favorites that were saved early on to ensure that the order details have been completed correctly When accessing shared favorites you need to review the order details before saving to ensure that they are ordered correctly The following PowerPlans are available 1 LAB Group and Screen STAT UH 2 LAB Group and Screen STAT VH Please take the necessary steps to ensure providers are aware of these new PowerPlans Favorites Do Not Save a Modified Continuous IV within a PowerPlan as a Favorite If you modify continuous IV solutions the modifications do not carry across when you have modified them and save as a favorite The issue arises when you try to use this saved favorite with the modified continuous IV infusion on an ambulatory encounter Here is the problem 1 You modify the continuous IV solution in a PowerPlan and then click the button ae Add to Phase y Check Alerts J Comments Star Now El Duration Mone P ae Y Component D
157. immediately Keep in mind that the Documented Meds by Hx list will populate medications by category first i e home meds the prescriptions then by alphabetical order Important Please note that if a patient has Lasix and Furosemide entered in their history they will both appear The task of finding duplicates is not always an obvious one In that same respect if a patient has a Lipitor prescription and home med they too will appear in each section of the Documented Meds by Hx as in the case below Medication History No Known Home Medications Unable lo Obtain Information Use Last Compliance Add b Document Medication by Hx ES Order Name di Status Details Last Dose Dat ww Last Documented On 2014 06 12 12 43 Tesi EB Documented Medications by Hx 4 acetaminophen caffeine co Documented 2 tab ORAL q4 hours PRN for pain 0 Refill s deine acetaminophen caf a digoxin digoxin 125 mcg Documented 1 tab ORAL daily 30 tab 0 Refill s 2014 04 28 22 49 0 125 mal oral table Maintenance a metoprolol metoprolol Documented 1 tab ORAL daily do not chew or break tablets 30 tab 0 tartrate 200 mg oral tablet Refill s 2014 06 12 12 41 Maintenance lt y metoprolol metoprolol Documented 1 tab ORAL BID 60 tab 0 Refill s 2014 04 28 22 49 tartrate 50 mg oral tablet Maintenance ablet Prescription i Be acetaminophen caffeine co F 1 tab ORAL q6 hours PRN pain 120 tab 0 Refill s deine ace
158. indicator bottom left will display with the count of unreconciled orders 3 The Order Reconciliation window opens and there are two sections a Medications Prior to Admission historical medications and prescriptions b Medications after Admission Reconciliation inpatient medications 4 Take the appropriate action on each medication listed Continue or Do Not Continue gt Continue Do Not Conti Note Continued or Reconciled medications can still be modified to suit the needs of the patient s plan of care 5 When all medications are reconciled and order details are complete click Reconcile And Sign Formulary v Non Formulary Medications In the event that the patient is on a medication that is not stocked at your facility a red diamond will appear beside the medication if when you choose to continue it It will generate a new pop up window that may provide you with some alternatives or options in ordering a replacement Drilling down through these folders may yield a variety of options that you may find suitable as a replacement for the medication in question e Green Circles indicate that it is a formulary or in stock choice e A Red Diamond indicates a non formulary choice e Some medications have no replacement options at all Orders to Convert Available EM M eiie Conversions for nicotine 14 mg 24 fer transdermal fim IESU IEN m extended release nicotine nicotine 14 1 patch transDE
159. ion Patient Appointment Itinera v Transfer Medication Administration Select all reports From To 2014 05 26 2014 05 26 Printer destination ahrp3inp02 ch SetasDefaut Cancel Print 7 Click the button Transfer Between Campuses Transfer to LHSC UH and Transfer to LHSC VH has been built in the system This order is to be used by providers to alert nursing and unit clerks to an impending transfer VIEW LABORATORY GUIDES AND TESTS 1 Click Manuals and Guides on the LHSC Intranet site Programs amp Services Staff Central Manuals amp Guides ft Home 2 Type lab in the Filter field 3 Click Laboratory Test Information Guide LHSC Manuals amp Guides 5 Click on the test LA London Health Sciences Centre Qs JOSEPH CARE NDON Pathology and Laboratory Medicine Details for Electrolytes Plasma Test Name Alternate Name s Laboratory Specimen Type Collection Information Requisition Laboratory Test Information Guide A Jot Venture of London Health Seiences Centre and St Josephs Health Care London Electrolytes Plasma Sodium Potassium Chloride CO2 GAP Core 4 5 mL Green Lithium Heparin top Vacutainer Pediatric 0 2 yrs 0 5 mL Green micropick tube 2 10 yrs 2 mL Green top Collect blood aseptically in a Vacutainer tube Avoid hemolysis Serum from a 5 mL Gold top or 6 mL Red top is also accepta
160. k Add in the Orders component of the table of contents menu Orders 2 The Add Order window opens 3 In the Find field type periop to see the PERIOP PowerPlans or ortho to see the ORTHO PowerPlans Contains Ph periop Find a tt ce LA B SS PAED PERIOP Pre Admission Clinic EMPERIOP SMPERIOP EMPERIOP SMPERIOP Find a ortho m ou Day of Procedure Pre Op Diabetes Management Module One Day Stay Post Op Pre Admission Clinic Contains Advanced Op e 43 Search within S ORTHO ORTHO ORTHO S ORTHO ORTHO SSORTHO ORTHO S ORTHO amp ORTHO ORTHO S ORTHO ORTHO Total Joint Replacement Post Op Multi Phase ORTHO S ORTHO Venous Thromboembolism VTE Prophylaxis Module Admission Pre Op Day of Procedure Pre Op Hip Fracture Post Op Multi Phase Hip Fracture Pre Op Lower Limb Post Op Multi Phase Lumbar Surgery One Day Stay Post Op One Day Stay Post Op Pre Admission Clinic Spine Surgery Post Op Multi Phase Suggested Orders Total Joint Replacement Pre Op Upper Limb Post Op Multi Phase Click to select either the PERIOP Day of Procedure Pre Op PowerPlan or ORTHO Day of Procedure Pre op PowerPlan it will turn bold and blue Click the button Select the orderables that are appropriate for the procedure by clicking the check boxes to left of the orderable En
161. king notas Patient only take a half tab daily prescribed Choose the correct function Convert to Prescription or Convert to Inpatient Order Cancel Reorder Resend allows you to re print the prescription and choose another printer if required Complete to remove medications from the list When documenting med history it is important to put in the Last Dose in the Order Details When completing the Med Rec and converting orders you need to look at the schedule click Review Schedule and pick the next scheduled dose to be given as directed a bedtime Y Details for fUr OS bedtime alternate days fe Details Order d before breakfast before breakfast amp lunch t st amp si DR ot supper Review Schedule Relhai ing Administrations 0 Stop Unknown before lunch Dose before lunch and supper Dose Unit mg v before meals amp bedtime QID before supper Drug Form Route of Administration ORAL v BID after food Frequency v PRN Yes 6 No PRN Reason Y Infuse Over Reconcile And Sign Cancel Patient Taking Medication More than Once Per Day with Different Doses If a patient takes 2 pills one 18 mg and one 3 mg you must document the medication per dose in the patient s medication history with one showing the 18 mg and one showing the 3 mg This will facilitate proper admission medication reconciliation by the provider HYDROmorphone Hydromorph Contin 18 mq 1 cap ORAL before supper
162. ky Notes Patient Management Conversations 10078 10 Method 3 Add From Another Patient List Right click on a patient on another list and choose Add to a Patient List and click the desired custom list If you have more than one list Practice HUGO 11870354 68 years Male Practice HUGOS 1157 03 55 12 months Male Patient Snapshot Provider Information Visit List Inactivate Relationship Add View Sticky Notes Sort Hide Customize Columns Add to a Patient List Copy Ctrl C Remove a Patient from a Custom List You cannot add or remove patients to Location or Medical Service list types 1 Open the patient list 2 Select the patient s name to be removed from the list 3 From the Patient List toolbar click the Remove Patient icon Patient List d e F 4 The patient s name is no longer displayed on the patient list Print a Custom List 1 From your custom list click the Task menu on the menu bar 2 Click Print and then click Print Screen PowerChart Organizer for WBT Test HUGO Physicia Ip eee Eatient Chart Links Notif Change Passwort jScheduling Messag SM UN Sticky Notes Tear O Suspend Reports MRP Print Print 3 Make sure the correct printer is selected and then click OK POWERPLAN FAVORITES When modifications are made to a PowerPlan you will be prompted to resave your favorite plan This guide will assist with the resaving of a
163. le lists P Modify Patient Lists Available lists Us Active lists Active lists Urology 10 Click OK to return to the Organizer screen 11 The new list now appears as its own tab with all patient names automatically generated for that medical service Build a Personal Custom List A Personal Custom list might be helpful to follow up on patients It is also useful for inpatient nurses so they only display their patient assignments on the Patient Access List PAL 1 From the Patient List toolbar click the List Maintenance icon Patient List The Modify Patient Lists dialog box opens It displays Available lists on the left an Active lists on the right To create a new list click the button The Patient List Type dialog box opens Double click Personal Custom prt e m 19 Patient List Type Select a patient list type Location Medical Service Personal Custom Provider Group Relationship 6 The Custom Patient List dialog box opens 7 Type a name for the list and specify a filter type if applicable e g My Follow up List My PAL Custom Patient List Care Teams _ Locations Medical Services C Encounter Types _ Relationships Admission Criteria _ Discharged Criteria _ Use Best Encounter Enter a name for the list Limited to 50 characters My Follow up Lis 8 Click the button 9 The Modify Patient Lists dialog box displays 10 Click t
164. lease page your team to make them aware of the order s We are working on an alert that will fire when a patient has a proposed order This alert also fires a task to nursing and unit clerks to remind them to make sure the order s is addressed by the MRP team Existing Proposed Orders Task 1 When a proposed order has occurred the nurse will receive a notification saying that there is a proposed order that needs to be reviewed This task will stay on the chart even after the provider has reviewed and accepted or rejected the proposed order 2 To verify whether a proposed order has been reviewed or not go to the Orders page and look for any orders that have a blue question mark icon and in a Proposal status 3 If there is still a proposed order on the chart investigate if the team has been alerted If they have not been alerted then alert the team of the presence of the proposed order Leave the existing proposed order task in a pending state 4 fthere is no proposed order to be found on the Orders page then the proposed order has already been reviewed and addressed Complete the existing proposed orders task so that it may fire again when new proposed orders are placed From a Consultant Proposed orders from a consultant will now show in a Proposal status on the Orders page Customize View Status lose Details Ordered 2 g injection IV q24 hours infuse over Requested Start Date Time 2014 04 18 1 Ordered 80 mq
165. mg Details Ii Continuous Details iz Order Comments Diagnosis Wr ivan fange fd rio ange Unt 7777777777 T9 Route of administration N continuous v Duration O O Duration unit v First Dose Priority Y Requested Start Date Time 2013 11 08 1330 Stop Date Time 777 Maintain SBP Greater Than O OE Maintain SBP Less Than OE Maintain DBP Greater Than sd Maintain DBP Less Than i Maintain MAP Greater Than Maintain MAP Less Than si Hold if HR Greater Than o Hold if HR Less Than ss 2 Missing Required Details Dx Table Orders For Cosignature 8 Click the Sign button and then click Refresh Placing TPN Order Initial TPN Orders Search and select the COMMON Total Parenteral Nutrition TPN Module COMMON Total Parenteral Nutrition TPN Module Changing an Existing TPN Order Search and select the TPN Fluid Adult order TPN Fluid Adult Important DO NOT change the TPN medication order DO NOT enter as a Communication Order The TPN Adult PowerForm will open and the yellow fields must be completed PN Adult Education Tracey Y E G FI ume Performed on 2014 04 20 M 1035 By Test HUGO Phys17 X TPN Adult Adult Total Parenteral Nutrition TPN TPN iett od O fused via central line catheter O nfused via p 4 25 Amino Acids 10 Dextrose Region 5 Amino Acids 10 Dextrose 5 Ami
166. mplement any additions changes or cancellations to orders 2 Consult amp Suggest Assess the patient and suggest any additions changes or cancellations to orders Consult to Physician Nurse Unit Clerk Workflow When the provider places a Consult to Physician order it will task to nurses and unit clerks to contact the appropriate provider 1 Nurse unit clerks see the task on their task list 2 Consult the on call list to determine the correct provider to contact 3 Contact the provider that is being consulted to inform them of the request for consult 4 Modify the Consult to physician order as follows a Navigate to the Orders page Ev b Right click on the order and select Modify chewable nene y D EN 5 eiiim Modify oral cApsule y furos mide La y furos nide La uspend y HYDRDmorph ie extenffed relea Complete in HYDRDmorph Cancel DC extenffed relea Delet y ibupriffen ibu FCR lule Task Times b Y S m insulill regular ompliance Y LORallepa b v4 amp pm Order Information y mediation ter y mediation ter Results Laboratory Reference Information Active i a Y dg Compete Blod Print E E Advanced Filters A Disable Order Information Hyperlink BB Y c Consult to Physician Or c In the Ordering Physician dialog box enter the name of the provider ordering the consult in the Physician name field and select Electronic or Non Provider as the Communication type
167. n D3 Q vitamin A Q vitamin E Vitamin A Level Serum VITA Vitamin E VITE Vitamin A D and C oral liquid Q Vitamin K1 Vitamin B Complex with C and Folic Acid oral tablet 4 Find vitamin oD Starts with y Advanced Options Type gb Inpatient v a A aaa Search within AlI Atlocation LHSCVC D vitamin A D vitamin E Vitamin A Level Serum VITA Vitamin E VITE Vitamin A D and C oral liquid Vitamin Kl Vitamin B Complex with C and Folic Acid oral tablet Vitamin B Complex with C oral tablet Vitamin B1 Vitamin B1 Level Serum VITB1 Vitamin B12 Vitamin B12 Serum VTB12 Vitamin B6 Vitamin B6 Level VITB6 D Vitamin C Vitamin C Level VITC Vitamin D 125 Vitamin D2 Vitamin D3 Please remember to change back to Contains on your next order PowerPlans e Do not choose a label printer e Batching of blood work can only be done after you have initiated the orders e Be mindful of the date when ordering labs for AM Routine as they will be scheduled to print for tomorrow s date e g watch to see if it is after midnight or before midnight Add an Order to a PowerPlan with Add to Phase NOT Add 1 When adding an order to a PowerPlan prior to placing it in a Planned state be sure to click Add to Phase icon and not the Add icon ft Orders 6 Check Interactions F Add to Phase jd Comments Start Now i Duration None fa Q Orders for Si
168. n Profess Cd E Creatinine CRE Ordered Timed 2014 07 16 08 34 Blood until 2014 07 16 08 34 T E Electrolytes Seru acl Timed 2014 07 16 08 34 Blood until 2014 07 16 08 34 ma LYTE WT S ew Urea U Ordered Timed 2014 07 16 08 34 Blood until 2014 07 16 08 34 e Call 52580 at VH or 35787 at UH to reach the lab e Call 64261 to reach the Specimen and Receiving Core Lab at St Josephs Lab Order Add on Blood Work If a blood sample has already been sent down and you would like to order more blood work you need to call the Lab to find out if the blood work can be added on the samples already collected This will decrease the number times a patient is picked Do NOT enter these add on orders in PowerChart the Lab will enter them If it s not possible to add on to existing samples you will be asked to enter the order as a new sample will be required from the patient Lab Order Batching Lab Orders 1 In the Find field type the desired lab test 2 Select the lab test which will turn blue after it has been selected Starts with y Advanced Options Type Eh Inpatient Search within il Allocation LHSCUC CBC and Diff CBC Nurse order when 3 f another test needs to be order click in the Find field and type in the desired lab test 4 Click the button when all tests have been ordered 5 To change the default priority or collection time on all orders click on the first order hold your
169. n session 10 v Dose Route of Administration Frequency Duration Dispense 20 90 Refill 2tab J ORAL 4 q4 hours 360 tab ec y PRN for pain y Special Instructions Type Of Therapy Acute Stop Date Time 77 777 Sir e E 0 Maintenance Select Prescriber Address Samples 10 Click the button and refresh your screen Important Once you click the button the prescription is printed to your default printer Prescription on Discharge The Special Instructions field in the Prescription details is a field that allows you to add details on the prescription instructions You can add instructions such as e Instruction for the pharmacist filling the prescription such as holding a prescribed medication until it is approved by family physician e Instructions to be added to the medication label such as detailing the range dosing of medication 1 to 2 tabs Dekada los Dose 1tab onu Route of Administration AN Duel adis M Order Comments Diagnosis Frequency Duration d daily PRIM Type Co Therapy C Acute 9 Maintenance Samples Select Prescniber Address Drug Form Send Ta VIC TAISEEI on thee from PROSS m ten 1 Dispense 50 gg Reti 20 tab 40 i p Sep Gute Tene TT T G 9 ou Tab v Commera Text 1 Print a Prescription for an Inpatient Med
170. nce Comments Status Order Comment Details Dose Adjustment Add gt Ordering Physician Stop Start Last Updated By Last Updated lt Remove Select how pon want to group amp sort orders Group orders by Clinical Category Sort orders by Type Then by Venue Ascending amp Descending uw 2 Click the drop arrow beside the Group orders by field and change to Clinical Category 3 Click the drop arrow beside the Then by field and change to Venue 4 Click the drop arrow beside the Sort orders by field and select Type and then click the Descending radio button Select how you want ta group amp sort orders Group orders bw Clinical Category Sort orders by Type 4 4 d Ascending amp Descending Of 5 Click the button to save these settings Column Information When you make Type the first column it shows you icons as a visual expression of the order type Here are some examples Inpatient order Home medication Ele Prescription Quick Discontinue allows you to see if the order is active checkmark in grey box Click once on a checkmark in the Quick Discontinue column to discontinue the order The Notifications column needs to be close to the front because this is where there nurse will see nurse review Gd The Order Name Status and Details columns are usually grouped together Sizing Columns Remember you can adjust the column width by selecting
171. nd Lt Routine Hand Rt Routine acetaminophen 575 mg tab ORAL ONCE acetaminophen 1 00 0 mg tab ORAL ONCE acetaminophen oxyCODONE 325 mg 2 5 mg oral tablet 1 tsb tab ORAL ONCE acetylsalicylic acid 80 mg CHEW tab ORAL ONCE azithromycin 250 ma tab ORAL ONCE cephalexin 500 mg tab ORAL ONCE dimenhyDRINATE so mn tah ORAI ONCE Inpatient y mcg 50 mcg inhalation powder 1 la ss New Orde ff INHALE BID TUI publidshare 180 ea Advair Diskus 500 Favorites mcg 50 mcg Imadi ging inhalation powder 1 puff INHALE BID J IV Fluids 180 ea g Labs amoxicillin 500 mg J Meds oral capsule 1 cap My Plan Favorites ORAL TID X 7 day 21 cap F amoxicillin clavulanate 500 mg 125 mg oral tablet 1 tab ORAL q8 vJ Xx 4 J Patient Care H0207 HFNMDLDN 22 January 2014 15 48 1 Click the Quick Orders component of the table of contents menu 2 Define your view the first time by clicking the down arrow beside View Selector and clicking the correct view depending on patient type View Selector Mon ts A air Diskus 250 i ED View Adr ED View Adult Paeds Oncology ED View Paeds Orthopedics 4 Click to place a checkmark in front of the desired orders in any of the available components e g ED Laboratory Investigations Adult
172. nding the patient to the non invasive diagnostic cardiology department Leaving it as an active order will page the ECG tech to come to your location FH Other Diagnostic Testing Treatment v Details for ECG 12 Lead Details j Order Comments Portable Location Requested Hospital VH Main v Visit Type Inpatient Comment Missing Required Details l Orders For Nurse Review EMG Order The electronic order is now available When ordered it will route to the EMG department for scheduling The paper forms still need to be completed and sent to the department Heparin Order Placing the Order 1 Open the patient chart to Orders 2 From the table of contents menu click Add 3 The Add Order window opens 4 Search for heparin 5 Select the COMMON IV Heparin Module PowerPlan 6 The orderable will turn bold and blue Find d Contains y Advanced Options w Type gp Inpatient a ff w Ca Ga Search within Al Atlocatic 55 COMMON IV Heparin Module Discontinue Heparin when D heparin heparin 20 000 units in 500 mL dextrose 5 heparin 20 000 units in 500 mL sodium chloride 0 heparin 20000 units in 500 mL dextrose 5 premix heparin 40 000 units in 500 mL dextrose 5 heparin arterial line flush Heparin Assay HEPA heparin flush d Heparin Induced Thrombocytopenia HIT Heparin Lock Flush No Heparin or Low Molecular Weigh
173. no Acids 16 6 Dextrose O 7 Amino Acids 17 Dextrose O 20 Lipid Ot ipid C Other Amino Acid Dextrose Infusion Rate Do 8m Lipid Infusion Rate Total TPN Infusion Rate Length of Infusion Maximum infusion time 24 hours TPN Infusion Instructions mmol l The standard electrolyte concentrations will automatically be defaulted in These concentrations can be modified if required Chloride and Acetate amounts will be adiusted hu Pharmaru gt In Progress The TPN Fluid order will show up in the Diet section of the Orders page This order tasks to a Pharmacy task list for them to enter the order in PharmNet It will not immediately show up as a medication on the MAR NPO NPO HUGO Ordered TPN Fluid Adult Ordered Priority Routine This order has an associated PowerForm that can be viewed in the Clinical Documents Reports and in Form Browser from the table of contents menu Sort by Encounter Date B l FO All Forms 5 H Inpatie 13 09 03 10 26 lt No Discharge date gt 3 45 Sunday April 27 2014 16 13 TPN Adult Auth When the task is completed by Pharmacy its status will change to Completed and the order will not show on the All Active Orders list Once the TPN order is entered in PharmNet the medication will appear on the Orders page under the IV Solutions section E IV Solutions H Active Ela M Bun amino acids dextrose variable concentration 1 000 mL Ordered
174. o highlight the new list name in the Available lists pane and then click the blue arrow to move the name to the Active lists pane P Modify Patient Lists Available lists Active lists My Follow up List V Zone C Level 5 100 Cancel P Modify Patient Lists Available lists Active lists V Zone C Level 5 100 My Follow up List Cancel 11 Click the button to return to the Organizer screen You can modify the order of the lists using the up 4 and down arrows 12 The new list now appears as its own tab but no patient names are generated You need to add the patients to a custom list Patient List P E t 4jtwt B5 8 mma B V Zone C Level 5 100 My Follow up List PIN Name Anon Age Sex Jay Note Attending Physician Visit Reason Medical Service LOS Leave Status Admitted Discharged Visit Add a Patient to a Custom List You cannot add or remove patients to Location or Medical Service list types Method 1 Patient Search 1 Make sure you have clicked your custom patient list tab 2 From the Patient List toolbar click the Add Patient icon Patient List Fa Bla EE B 3 The Patient Search window opens 4 Enter the appropriate search criteria and click Search to retrieve matching entries AS Patient Search eeu PIN PIN Name Sex BithDate Age HCN Version Family Physician Phone Address Address 11870503 411870503 Cl DocMed Female 1949 05 17 64
175. ome from or how they were generated Each medication will have an icon associated with it for that purpose Some medications may have multiple icons If you are unsure what an icon respresents hover the pointer of your mouse over the icons on the left to display a text box describing the icon la i diphenhydrAMIME 50 mq 2 tab ORAL q4 hours PRM emtricitabine tenofovir emtricitabine tenofovir 200 mg 300 mg oral tablet 1 tab ORAL daily Ordered E This order is part of the plan COMMON Body Fluid Exposure Module Ha i acetaminophen BCG BCG 600 000 000 units intravesical injection Type AL Inpatient Inconsistencies in Medication History You may need to makes changes to the history when there are inconsistencies between the history provided by a patient or care giver and what is on record in our online Medication History How to Look for Inconsistences 1 Review each medication listed in the Medication History Example a patient indicates a med is a maintenance medication ie Beta blocker vs acute med prescription for antibiotics Medication Histo Add No Known vui Medications Unable To Obtain Information Use Last Compliance Document Medication by Hx E Order Name Status Details Last Dose Dat iP Last Documented On 2014 06 12 12 43 Tes E Documented Medications by Hx y acetaminophen caffeine c Documented 2 tab ORAL q4 hours PRN for pain 0 Refill s odeine acetaminophen c
176. on Ordered ebsuomide 500 ma 2 cap ORAL dady Ordered dle ccelel 125 ma ORAL ONCE Ordered GO GGG 06000 ipai 10 mg ORAL daily Ordered retoprelel metoprelel tartrate 25 1 tab ORAL EID 60 tab Prescribed ramapnil ramipril 10 mig oral tablet 1 tab ORAL daily 3 tab Presonbed Notice that the icons now reflect that these are Inpatient medications e Once the medication appears in the right hand column highlight it and the order details will appear in the lower half of the screen You may need to increase or improve the visual field of this window by dragging the margin upwards e From here incomplete order details or details that you need to modify can be done so easily e Work your way down the list keeping in mind that choosing to continue a medication is in no way an indication that you are committing to that historical dosage schedule or even route Complete Admission Reconciliation 1 Access admission medication reconciliation from the Reconciliation drop down and select Admission Check Interactions Transfer Discharge Add 4 Document Medication by Hx Orders Medication List Note Providers cannot reconcile a patient s admission medications until the historical home medications have been documented updated 2 The providers will have a visual indicator Ll orange star next to the medication indicating the medication has not been reconciled Also a numeric
177. ons diagnostic or medication imaging tests that are available when searched as they do not link with the department or existing orderables Consult Orders Inpatient vs Outpatient Consult Referral Inpatient Outpatient Consulting a Physician Consulting a Physician e Use the Consult to Physician e Use the Outpatient Clinic Referral Order Order e Call that physician Nurse Sec Unit Clerk will print and send to referred Physician Placing an Allied Health discipline referral Placing an Allied Health discipline referral e Enter the individual referral order e Use the Outpatient Allied Health e Allied Health discipline will receive Referral order an automatic notification of the Nurse Sec Unit Clerk will print and referral through PowerChart send to referred Allied Health Consult Provider Consult Order Process e Consults between services involve providers working together to provide the best possible care for our patients To facilitate this process we have a Consult to Physician order that helps to relay the pertinent information and directions to the consulting service so that they know how the attending physician would like to proceed with any consult orders e When a consult is requested the admitting team will enter the Consult to Physician order and contact the provider service they want to consult e Two options are available for the consulted service 1 Consult amp Implement Assess the patient and i
178. op down or free text the dose 5 The Special Instructions field is a required field Free text the desired additional information for the prescription y Details for non medication template ankle foot orthosis y Send To RP1395 on Ihprni1 from WDP932 in session 7 Details 35 Order Comments a Diagnosis Dose Dispense See Instructions tions See Instructions See Instructions Start Date Time 2014 07 10 Type Of Therapy V cure Stop Date Time Maintenance Select Prescriber Address Samples O Missing Required Details Important The Dispense field is no longer a mandatory field but may be required for insurance purposes depending on the item 6 When all order details are complete click the button and refresh the screen 7 When a specific orderable non medication template is used the printed prescription now appears as the following ul PF London Health Sciences Centre Patient Name Ambulatory Practiced ii es Birihdate 12 17 1627 Age Bo Years Sex Female Location U DODOD HCH Other ID Type iy Allergies NKA Pharmacist please note Allerey list may be incomplete Patient Address 9 McHappy Stree Honre Phone London Ontario Wark Phone TOOL OU Prescription Details Date Issued 2014 07 10 1 ankle foot orthosis Refills 4 See Insbructiians Instructions For left leg
179. or ORAL Documen O 0000 OOOOOO 00 OLJOOOO OOOOOO OO OOOO OOOOOO OO Discharge Medication Reconciliation Three 3 different sections may be displayed a Home Medications This section shows home medications that have not been ordered as inpatient medications b Continued Home Medications These are medications that were documented Home Medications and were continued as Inpatient medications c Medications These are new medication orders started in hospital Please note PRNs and regularly scheduled meds are grouped on the same list Order Reconciliation Discharge Testing Andrew c le Se Testing Andrew PIN 1187 09 03 Allergies Not Record Inpatient 2014 05 23 10 14 lt No Discharge date gt Weight 98 kg 98 kg VISIT 422352701 Location V C63 C6 305 A Age 37 years Sex Male Provider Test Doc DOB 1977 04 04 Discharge Status Red Status Add M PI E tm wW Meds History 3 Adm Meds Rec o Disch Meds Rec gt E Y Order Name Details Status gt B Es E Y Order Name Details Status Contin Create Do Not amp Home Medications 3 acetylsalicylic acid As 1 tab ORAL daily Documen 3 clopidogrel Plavix 75 1 tab ORAL daily 90 t Documen y ondansetron ondanse 1 tab ORAL ONCE 3 t Documen E Continued Home Medications Ge acetaminophen caffei 2 tab ORAL q4 hours Prescribed acetaminophen caffei 2tab ORAL q4 hours Ordered d
180. ose Details PERIOP One Day Stay Post Op Planned Pending E Activity v Y Activity as Tolerated E Vital Signs M Y Vital Signs H IV Solutions Iv Ki lactated ringers 1 000 mL per protocal 1 000 mL IV continuous Routine 175 ml e Trail rm EGIT Details for lactated ringers 1 000 mL Details Tf Continuous Details E Order Comments CE Offset Details Diagnosis Base Solution Infuse Over 1000 mL 8 hr Additive Dose Mormalized Rate Delivers Occurrence 2 You open a patient s chart on an ambulatory encounter this does not occur on inpatient encounters 5 Ambulatory 3 You open the Orders page and find your favorite 4 When you go to sign the order you will notice the line with the continuous is blank ae FP Component Status Dose Details Cont IV solution Planned Pending E Activity v Y Act E Vital Signs per protocol Important If you modify a continuous IV solution within a PowerPlan do not save as a favorite modifications will NOT carry across Favorites Save PowerPlans as Favorites 1 It is not recommended that providers save prebuilt PowerPlans at this time as they are subject to changing in the early days of the conversion 2 However if you do alter and save a PowerPlan you must be mindful when you reorder it that you are on the correct encounter type Example When altering the continuous infusion rate on a PowerPlan it will not sign correctly i
181. osign Cancel Cytology Orders When entering a Cytology order it is important to choose the correct Order Sentence Do not choose None If you choose None no labels will print Find d f ww o a 3 es CYTOLOGY Suggested Orders Ed Cytology Endobronchial Ultraso d Cytology Endoscopic Ultrasound d cytology Endoscopic Ultrasound EA cytology Esophageal Gastrointe Ed cytology Fine Needle Aspiration Ed cytology Fluid CYTOF Ed cytology Gyn CYTOGYN Ed Cytology PAP CYTOPAP Ed Cytology Respiratory CYTORESHF Ed Cytology Urine CYTOU B P Order Sentences Type Catheter Type Cystoscopy Bladder Urine Type Cystoscopy Bladder Washing Type Ileal Conduit Type Kidney Urine left Type Kidney Urine right Type Kidney Washing Left Type Kidney Washing Right Type Miscellaneous Type Neobladder Type Post Cystoscopy Voided Type Renal Pelvis Washing Left CYTOLOGY Suggested Orders d cytology Fluid CYTOF d cytology Gyn CYTOGYN Ld Cytology PAP CYTOPAP d Cytology Urine CYTOU ES Cytology Endobronchial Ultraso EJ Cytology Endoscopic Ultrasound Cytology Endoscopic Ultrasound d Cytology Esophageal Gastrointel Ld cytology Fine Needle Aspiration E Cytology Respiratory CYTORESR Order sentences for Cytology Urine CYTOU None Type Catheter Type Cystoscopy Bladder Urine Type Cystoscopy Bladder Washing Type Ileal Conduit Type Kidney Urine left
182. osteopenia osteoporosis rickets renal disease malabsorption syndromes medications affecting vitamin D metabolism olr Vitamin D 25 Hydroxy Uninsured Not available for the facility of the active encounter Patient is responsible for payment Geel Y olr Other Test Y olr Other Test A ol Other Test Y olr Other Test G olr Other Test A Details Dx Table Orders For Cosignature Save as My Favorite Orders For Sig 7 Click Sign if do not want to change the printer 8 If you want to change the printer click on olr Printer 9 In the Details click No and enter the correct printer into the REROUTED PRINTER field 10 Click Sign 61 Order Name Status Stat Details O E W D52 D5 203 A VISIT 422351974 H Laboratory al olr PRINTER rt Order 2014 05 22 13 37 Ontario Lab Requisition click to change from la E olr Sodium Order 2014 05 22 13 32 Ontario Lab Requisition dla E olr Potassium Order 2014 05 22 13 32 Ontario Lab Requisition Details for Olr PRINTER rt click to change from default Details ig Order Comments ED Offset Details 2h h Route to Default Pinter D Yes 8 No uU REROUTED PRINTER Po How to Complete Other Tests This is to be used for orders not found on Ontario Lab requisition 1 Click Other Test 2 Click the button NF Other rii olr Other Test Y olr Other Test r Other Test
183. ow to provide notifications specific to your plan choices Review the plan in its entirety M otifications 2014 06 25 13 18 a 5wapped Maxeran SC for PO k Continue Load standard catalog plan Cancel 10 When re saving your favorite plan you will receive a dialog box that says there is already a plan that exists do you want to override 11 Make sure you click the button Hard Stop Notification 1 The PowerPlan Orderset team made a hard stop change to metoclopramide ORAL Plan Favorite Notification The system administrator has made changes to the standard catalog plan and has disallowed use of this plan favorite A new plan favorite can be created for this standard catalog plan Do you want te load the standard catalog plan m 2 Click the button and you will be taken out of the Add Order window and back to current Orders page 3 Click the button and the PowerPlan becomes the blank standard plan again and the Favorite plan is unrecoverable Proposed Orders As an alternative to Suggested Order PowerPlans providers have been given the ability to propose orders Proposed orders will appear with an amp icon and the status of Proposal Proposed orders will also show up in Message Center of the provider it is directed to Order Name Status Bj ud Glycated Hemoglobin GLYHB Proposal If you see these orders please keep a watch to ensure the MRP team addresses them If the order is urgent p
184. owerChart 2 Find and touch and hold the medication Reprint a Prescription To reprint one or more prescriptions 1 Highlight the prescription medication in the Home Medications widget of the Summaries ViewPoint Patient Sum de all Veit All Visits NKDA Home Medications 2 All Visits Rx acetaminophen oxyCODONE Percocet 5 325 oral tablet 2 tab ORAL q6 hours PRN pain May take 1 2 tabs q4 6 hours 60 tab 0 Refills other 60 tab 0 refills Hx digoxin digoxin 250 mcg 0 25 mg oral tablet See structions 54 ORAL 0 Refil s 2014 05 03 18 34 FayRenew 2 Cancelfoc Complete Routing 2 Click the button and select the Routing to pick an appropriate printer Routing RP1031 on LHPRHNI11 Ih tvh ca from QCP387 in session 5 3 Clickthe button Patient Sum Discharge Su All Visits NKDA Home Medications 2 All Visits FY acetaminophen oxyCODONE Percocet 5 325 oral tablet 2 tab ORAL q6 hours PRN pain May take 1 2 tabs g4 6 hours 60 tab 0 Refills other 60 tab 0 refills VHC3205RP1 on Ihprint2 from GKX953 in session 3 Hx digoxin digoxin 250 mcg 0 25 mg oral tablet See Instructions 54 ORAL 0 Refills 2014 05 03 18 34 Maintenance 0 refills Routing VHC3205RP1 on Ihprint2 from GKX953 in session 3 4 Click Medication List from the table of contents menu
185. p Appointment Labs Future Pending Click the appropriate diagnostic imaging and complete all the required details El 7 CT Abdomen Pelvis El Y CT Head FA Y CT Pulmonary nqio El Y CT Thorax El A CT Thorax Abdomen CT Thorax Abdomen Pelvis MRI x El A MR Head Y MR Rectum Nuclear AO qagaaad In the details select the appropriate clinic for the appointment notification to be sent Details for CT Thorax Abdomen Pelvis Details lt Order Comments eu Offset Details ej Send Appt notification to if not Orderin LREP Clinic 1 Clinical Indication for Scan Reason for Exam 7 Complete the Follow up Appointment Labs Phase as per previous instructions 8 When complete click the L Orders E button to review all the selected orders 9 If all orders are correct click the button d PowerPlans not Processing Due to Missing Date for a Routine Xray T 1 for Post Op ay Issue Ortho Order Sets are not processing because the Requested Date Time field for a Routine xray T 1 for Post Op Day 1 in the Order Set has been left blank Reason This is occurring because the Requested Date Time field is not yellow required Users do not realize that it is a required field because it is filled white instead of yellow and do not enter a date and time When users sign the Order Set without entering a date and time for tomorrow s date they receive an error message similar to the one below
186. q oral tablet Document 1 tab ORAL daily 30 tab 0 Refill s 2014 02 22 9 39 Details for digoxin digoxin 125 mcg 0 125 mg oral tablet ES Details 35 Order Comments Dose Route of Adminis Frequency Duration Dispense Refill mm ora 4j daily 30 tab eo PRN v Special Instructions Type Of Therapy Acute Stop Date Time e y Select Prescriber Address G e Print DEA Number Yes 8 No Samples v Performing Location v Order Output Destination v Drug Form tab Y Comment Text 1 Leave Med History Incomplete Finish Later Document History Cancel 2 Defaults to Still taking as prescribed 3 f you change the compliance to Still Taking Not as Prescribed you must enter a Comment title will flash e g Still taking but only every second day or only a pill Y Details for furosemide Lasix 20 mg oral tablet Details l Order Comments 24 Compliance Status Information source Still taking not as prescribed di Patient Comment Still taking but only taking 1 2 a pill Compliance should NEVER be entered in the Details tab or the Order Comments tab Y Details osemide Lasix 20 mg oral tablet A 4 NO der Comments 0 Compliance Cleaning Up a Documented Medications by Hx Expired Prescriptions It is not uncommon to find expired prescriptions on a patient s list of medications Try to remove the defunct prescription
187. quency ql hour v PRN Yes No PRN Reason symptoms of alcohol withdra T Infuse Over Infuse Over Unit v Duration Duration Unit LY Requested Start Date Time 2014 05 01 15 16 v Stop Date Time 77 777 a First Dose Priority Ly Rate Rate Unit v Patient s Own Meds Yes No Medication Order Dose Times Associated with Hourly Frequencies LHSC A reminder about dose times associated with several of these hourly frequencies These are not new frequencies and apply to LHSC They intentionally skip dose times overnight q1 hour while awake 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 skips doses from 23 to 07 q2 hours while awake 06 08 10 12 14 16 18 22 skips from 24 to 04 q3 hours while awake 06 09 12 15 18 21 skips doses for 24 and 03 q4 hours while awake O6 10 14 18 22 skips 02 dose q6 hours while awake 06 12 18 skips 24 dose If wanting to give a medication around the clock ATC but ok to skip if sleeping then these frequencies should NOT be used as they will skip doses and are not ATC frequencies For medications wanted ATC use q2 hours q6 hours etc and put info about holding during sleep in the Order Comments This gives the RN a dose to document against ATC and the ability to give or hold the dose during the overnight hours depending on whether the patient is sleeping or not Medication Order Saline Lock Flush If a patient has a saline lock
188. r sess r resa rie 30 Recobciliatton deOLiS iaces leido te As decena dolar acte latet Ao o ALT Cp LE Leo E EC LA Ate NA cera OE Co tanos lor ended de Le rado 30 Accessing Medication Recontlliatiolissesuesosct pet irse Sun etes ti Ue Eun E E uet vi estem iN rds 31 Order a a Medication List Pm 31 Best Possible Medication HIS tO Viana 31 PRC CU gc ro ee rM M P Em 31 Medication HISTO rad ri 32 Order Catalogue when Adding Medication to BPMH ccconcccnnonoccnnnnnncnnnnnaronnnnnnonnonononnnonaronnonanonnnnanoss 32 Add ia Mealcationin theBPMIPliu cea sues eiecti talas 33 eese C TT 34 Cleaning Up a Documented Medications by HX ccccccssseccccesscceceeseccceeeceeeeeseceseeseceeseneceesegsecessgaeees 34 Expired PreScHDEIOLS i sibus eite d edita alus en diste pen boei D besten oE pee Db se Moni sese docs 34 Deciphering The RECOMCIATIOMN sud po v A oe oe ERE HEU sucess audae Na pet ides entia e RU MEA LAE eaheateows 35 Inconsistenciesdn Medication AUS TO a 35 alearga e AIEE E P ET ED om aN oe oo tue E hae a 36 HOW ToEx IncohsistellCeS sn essentia d edoR E Pan PsC vais OE Ora d can a OR OUR uu e Pa oda AA AA 36 AGING AMECA Clone Mov tb d e b nba dio Gd AAA 36 MODAN COI CODO ADA eher vea RUM Dai e PIRE Maa T BRUM OE Depp rP Geena i Del Ed 36 Canceling A Medica ON Hoe n 37 DUbIICHte OF SIMIA FOSA obtu up cl e cen Ma t pte le duet 38 Patient Compliant ess SA re Lora bh erat pu ed Neu cM Nr
189. ral tal Ingredients benser 25 mg Reference Information furoser Print furoser Advanced Filters Disable Order Information Hyperlink fend Tee PEGE on LHPEREI hoe from QUP ETT a seneni EN Details H Order Comments G Dugnas Diit Route ol Admiral Frequency Duiatiees hpr Jal s Rem ta dp cau j diiy gt mm 14138 m PEN Special instruction Type Di Therapy ham Shen Cate Tere SMD jm Ieee UE Merterance y Taled Brescribus Addresc Samples Deeg Porres tab w Comment Tex 1 10 Make sure that the Send To field is displaying your default printer Send To RP534 on LHPRNI11 Ih tvh ca from QCP387 in session11 m Important Providers should convert all the medications they want on the prescription first and only click the button when they are done so all the medications are batched together 11 Click the button 12 Click the button and refresh your screen Important Once you click the button prescription is printed to your default printer Print a Prescription Through Juniper In most cases printers directly connected to external computers with a Windows 7 or Windows XP operating system are accessible from a Juniper Citrix Cerner session Print a Prescription Using a Tablet You will need to convert the medication to a prescription and then setup the printer on the tablet Convert and Print Prescription 1 Using the tablet open the patient s chart in P
190. ransfusion PowerPlans occcccoconnoncccoonnononononononononononononononononconnonononnnonnnaronnnnnanenss 115 ECT POW Gini Gli eaae isves iio 115 Favorites Check YOUFE3VORIt6S euo todos decade titesuc ai 117 Favorites Do Not Save a Modified Continuous IV within a PowerPlan as a Favorite 118 Favorites Save PowerPIahs as EaVOFIEeS uo set aesiu au erst a EE a 119 Multi Phase Outpatient Labs PowerPlans ccccssssccccssscccesececceececsenseccseuecessusccsseecessueeesseaeceesaseesaaeeeesanees 119 aa A sco t din aps 120 Completing Orders within the Phases d tse i Lieber AAA d vH at A RA 120 TIBUS ssec tasse eut fetu asesd needs mie EO Dp EIN D LU matos rM anota ME ame eue 120 Qutba tient tab Phases iiri adeo a AN Ma MICI MUR 121 PEVCA dol a BITTE EO TED TRIES 122 Initidtinog Recurring PANAS ie uo e eee GE orb o iei t asia re ur crap vas seu b cid nct ecu 122 FS LODO GTO V aras N e ET RM LUE CL IS LC AIC 123 SUDSEQUERt LAOS o iai p ES DER MINI ue Den e A eT qEIE MUNI Dos M anes rop MEI UM nq Dus MOS I IUE M 123 Completing Recurring Multiphase PowerPl lls t tort e buc t be e b dat tbe an bea t i ate b ER a n 123 Multi Phase POWeFPIGES 2 25 50 A eisdem vetta a LL LM MCI DM D UL INDE Ld eMe EIU ODE 125 No Proposing Furictlornality o ecetees verte ene die ER n e aed i ERR de e Na lodi ue EE ee 125 Oncology Return to Clinic PowerPlabi oss ioo Rr a ror e RN ebat NUR cas 125 Retorn to Chime Witho
191. reated in order to find it next time 20 Click the L amp 21 Click the button 22 Click the button Important When you click the button it automatically prints Medication Order When Ordering any Medication The provider needs to pay attention to the Requested Start Date and Time You need to assess the date and time and adjust to Requested Start Date Time to the Next administration if required Dose Unit Route of Administration PRN Infuse Over Duration Requested Start Date Time Requested Start Date Time First Administration y 1700 2014 04 29 Mext administration 2014 04 30 Skip administration Following administration 2014 04 29 17 00 Orders that Do Not Fire to your Multi Patient Task List Not all orderables are set to fire a task The following do not e Dressing changes e Vital signs e Central Venous Pressure did but we have removed the tasking e Future lab orders e Future MRI Ultrasound CT Nuclear Medicine General Xrays e Planned PowerPlans you can view them in the patient s chart Orders that Fire to Multi Patient Task List for Ambulatory e Return to clinic e OP Allied Health referral referral to OT or PT e OP Clinic referral referral to another clinic e g Respiratory e Labs if they are entered as today and now can be found on Specimens to collect tab Important Outpatient Allied Health Referrals do not fire a task to the Re
192. ritical m 4 m D OK cel 6 To modify the Results FYI section click on the FYI Result Subscriptions tab Setup for WBT Test HUGO Physician Configuration Behavior Prefs Manage Pools Manage Proxy f FY Result Subscriptions E Configuration Belaveor Pres Manage Pooks Manage Proy FYI Result Subscriptions Available 5ubserintinns Assigned Subsrriptians formbulabory Pubie Fiepnluniiepy Cardiology Attending Admitting Emergency Attending admitting Emergency Lary bo Hugo Subscnptian inpatient Lopy En Inpatwnt Attending Admitting Dine Chay Stay Copy te One Day Stay Attending Admitting Outpatient Copy ta Outpatient Attending Admitting 7 From here you can Unassign the subscriptions that you no longer want by clicking on the subscription on the right and clicking the L button Assigned Subscriptions Public Emergency Attending Admitting Emergency Copy to Hugo Subscription Inpatient Copy to Inpatient Attending Admitting One Day Stay Copy to One Day Stay Attending Admitting Outpatient Copy to Outpatient Attending Admitting 8 You can also create your own subscriptions if you want to be very specific regarding what orders come to your Results FYI inbox 9 Todo this click on the button Setup for WB est HUGO Physician Configuration Behavior Prefs Manage Pools Manage Proxy Available Subscriptions Ambulatory Public Nep
193. s grams that were requested in the physician s order e The order will be completed because the blood product is now available for pickup e The nurse needs to send a PickUp order for the appropriate time and NO more than 1 days worth of albumin or IVIG should be requested at one time This change to Albumin IVIG and Rh Immune Globulin will now be consistent with ALL other blood products In the Blood Product Information BPI page there will be either a e Pending Order or e The product will be assigned to the patient and be viewable in the Available Section of this page Important For infusion details like rate of infusion frequency etc the order itself will need to be reviewed and when appropriate copied onto the Kardex and or scratch pad day s worksheet CareSet and PowerPlan Orderset Caresets 9 are a set of orderables usually lab and radiology placed together for ordering convenience An Orderset PowerPlan E is a more robust set or orderable including medications patient care orderable labs and radiology and referrals Find med eh Starts with Advanced Options w Type fF Inpatient zn l AS Search within M Atlocatic SMED Acute Respiratory Distress m Medicine Thoracentesis Care Set BEMED Acute Respiratory Infection de Medrol EMED Admission medroxyPROGESTERone SMED Alternate Level of Care ALC SE MED Influenza Outbreak Prophylaxi MED Influenza Treatment Module
194. s Legacy Research DEJ 5iebens Drake Research Institute AE UH Main fel CIES UH Satellite Outpatient p LHsc vc xli Listowel Memorial Hospital xls LRCP xlii Mount Hope Campus Bp Old LRCC Pe Parkwood Campus E lb RMHC London Enter a name for the list Limited to 50 characters Finish 10 Click the checkbox for desired nursing unit location or ambulatory location Locations U 8 Medical Services LC Encounter Types Care Teams Relationships C Time Criteria _ Discharged Criteria Admission Criteria 0 US OPD Enterstomal Therapy Clinic _ amp U 8 Outpatient Plastics 8PL O06 U 8 Outpatient Surgery amp U 8 Outpatient Wound Clinic Pt U 8 Sub Acute Medicine Unit 1 U 8 Surgery Clinics BOP O06 U8 Urology Procedures CI uo PES U9 ED Decant Unit amp U 9 Metabolic Day Unit O06 U9 OPD IVF One Day Care amp U9 OPD IVF One Day Care LE b U9 Outpatient Gynaecology BGYN E E Enter a name for the list Limited to 50 characters ug 3 denotes nursing unit location E denotes ambulatory location 11 Click the button 12 The Modify Patient Lists dialog box displays 13 Click to highlight the new list name in the Available lists pane and then click the blue arrow to move the name to the Active lists pane Modify P Te Lists Available lists Active lists U8 Thoracic Surgery Group Dr Test Patients H WBT Test
195. s been documented about a patient s allergies it does not mean that all information has been documented The second icon means no allergy information has been documented Double click on the icons to review or enter information O Allergy documentation a No allergy documentation Add an Allergy 1 Open the Allergy window 2 Click the Add icon 3 Ensure Category is set to the allergy you are entering Drug Food Environment 4 Click the Search tab e The Catalog tab contains folders of common allergies as well as common allergic reactions It is important to remember that if you do not find what you are looking for in the Catalog tab use the Search tab e Please ensure that you exhaust all search options to select the correct substance reactions from the database e From the Search tab if you are unsure of a spelling start by typing just a few letters when searching If you still have questions ask a colleague Google check Micromedex or call Pharmacy e For non medication allergies try using existing substances and adding comments For example green apple allergy Substance of apple with Comments green 0 PKWD Learn Practice64 MRN P104169 Add Allergy Adverse Effect My Favorites Search Catalog Substance Search lasix 1 Substance required Search bv Search for 0 Name Code 9 Substance Reaction For items with these vocabularies principal types Vocabularies Allergy Multum Aller
196. s from your Inbox you have two choices Approve or Refuse 2014 04 25 09 18 10 s 7 Forward Only 2014 04 25 03 18 09 Approve no dose range checking 2014 04 25 09 14 25 m 2014 04 15 22 43 21 le 2014 04 15 22 05 51 Assign Item 2014 04 15 22 05 51 ance Unassign Item Approve Please select Approve for any orders that you authorized or would like to accept as proposed orders Refuse Please only select Refuse and complete the Reason if it is not your patient the order was placed on the incorrect patient or the order was incorrect View Order Proposals Before Approving or Refusing the Order 1 Double click on the order On the Order Proposal tab review the order information Click Accept or Reject button If the Reject button was selected fill in all required fields Click Sign P PowerChart Organizer for Test HUGO Phys17 es JE Jew Task Edit View Patient Chart Links Notifications Inbox Help es A N aj Home Patient List a Scheduling Message Center 33 Multi Patient Task List Q Medication Information QFRED Q Microbiology Antibiogram Q Criti 1 E 84 Change Hil Suspend AL Exit A Calculator Si AdHoc Ld Documents Patient Locator EF Label Reprint 2 Inquiry E Scheduling Appointment Book Es Links z Finance Two gig Recent IMRN Mer Message Center K 3 minutes ago Inbox Summary Orders X Order Proposal Finance Two X A Forward Only Y Summary View Finance Two PIN
197. s if you feel like it would help to clean up the Documented Medications by Hx oF HYDROmorphone Documented 8 mg ORAL q12 hours 0 Refill s Hydromorph Contin 6 mg ip paliperidone Invega Documented 150 mg IM 0 Refill s 2014 05 05 00 29 Maintenance Sustenna 150 mg 1 5 mL i A Prescription A dalteparin Prescribed 18 000 units SUBCUTANEOUS daily Supply 7 dose 0 Refill s 2014 05 06 03 25 Do Mot Use given to patient de hydrOXYzine hydrOxWYzine Prescribed 1 tab ORAL TID PRN agitation or restlessness 30 tab 0 hydrochloride 25 mg oral c Refill z 2014 05 07 12 49 Maintenance In the above image only 7 doses of Dalteparin were dispensed well over one month ago but the prescription remains The Dalteparin should be removed or updated to reflect changes that might have been made at a follow up visit See Cancelling a Medication to remove a home medication Below that order thirty Hydroxyzine tabs were dispensed but in contrast the ordering details for this medication were specified as being a Maintenance dose The hydroxyzine needs to be reviewed to ensure that the patient has either stopped taking this medication or that it need to be renewed or modified Deciphering the Reconciliation Due to the workflow of some areas a patient may have initiated orders for their encounter prior to having had their Admission Reconciliation In these cases it is important for you to know where these orders c
198. sation B CI Shari List flag Recent Name Q CI Shari PIN 1187 10 87 Emergency 2014 01 02 9 44 No Discharge date Fin 42234 Visit 422348049 Location V AED Pod C 2 RAZ Allergies Age 43 years Sex Female DOB 1970 06 30 Menu q Provider Emergency Physic ft Quick Orders AD ABIAJ OOR Quick Orders and Charges Print 0 minutes ago Flowsheet ED Summary Triage Summary A and I ED UCC View Selector ED View Adi v ED Common Orders Scripts A Quick Orders Advair Diskus 250 MAR MAR Summary Medication List Allergies Infection Control Clinical Documents R MicroViewer a Add a Add E Add Assessment Monitoring Form Browser Blood Product Information Patient Information Patient Schedule Chemotherapy POC Blood Glucose POC Urinalysis Complete Blood Count and Differential CBCD Electrolytes Serum Plasma LYTE Creatinine CRE Urea U Glucose Random GLUR F Calcium Serum Plas ma CA Magnesium Serum P lasma MG M Phacnhate PHN Abdomen 1 view Abdomen Series Ankle Lt Routine Ankle Rt Routine Chest PA Lat Chest AP Portable CT Abdomen Pelvis CT Head CT Spine Cervical Elbow Lt Routine Elbow Rt Routine Foot Lt Routine Foot Rt Routine Ha
199. sician dialog box opens Complete the physician name field and choose Electronic as the Communication type P Ordering Physician Physician name WBT Test HUGO Physician Order Date Time 2014 05 26 Sm 1154 Communication type Verbal with Readback Phone with Readback Medical Directive Initiate Orderset signed Paper Order Conditional Non Provider Fax Electronic Cancel Click the button In the order details set the Collection Date Time field for the next day Collection Date Time Click the button You will see both the cancelled order and the new order on the scratch pad Orders for Signature 7 EL Wr Order Name Status Details E W C51 C5 104 C VISIT 422346058 H Laboratory Die aL CBC Complete Blood Count Order 2014 05 28 3 00 AM Routine 2014 05 28 3 00 Blood and Differential CBC 10 Click the button and refresh your screen Important Make sure you destroy the old labels Lab Order Insufficient Volume If the lab calls and asks a nurse to redraw a sample due to insufficient volumes the nurse must enter an order for that test and in the Ordering Physician dialog box choose Electronic as the Communication type and include the admitting physician in the Physician name field IP Ordering Physician Physician name Test Doc Order Date Time 2014 05 06 a 0828 Communication type Verbal with Readback Phone with Readback Medical Directive Initi
200. st M a 7 AddtoPhase jComments Start 2014 05 30 08 11 Stop None e View Eredia w Details for ECT Lead Placement MENT HLTH Electroconw COMMON Recurrent Ou Details Jis Order Comments P Offset Details Timing Future Outpatient Labs Plannec lin MENT HLTH Electrocony _ MENT HLTH Electrocony Requested Date Time 2014 05 30 Number Of Treatments 1 MENT HLTH Electrocony COMMON Recurrent Ou ECT Lead Placement Bi Frontal Placement Special Instructions Treatment 1 of 12 Consented Timing Future d Total Lifetime Treatments 24 Outpatient Labs Initiate Outpatient Labs Plannec Outpatient Labs Plannec Orders Admission Resuscitation Status 4 Alerts Orders For Nurse Review Save as My Favorite 7 Click the 3 Initiate button 8 Click the button 9 Click the button to initiate the orders and refresh the screen Orders For Signature 10 Review patient medications 43 Q O Addto Phase jComments Start 2014 05 3008 11 Stop None l xy Component E Details Last updated on 2014 05 30 08 11 by Harloff Krista B Patient Care Y 4 v a ECT Lead Placement Ordered 1 Treatments 12 20 24 as found on pink sheet Bi Frontal Placement E Medications 9 Hold Benzodiazepines Anticonvulsants Diuretics lithium and zopiclone the night before treatment Discontinue monoamine oxidase inhibitors t
201. sure that you have included the following IV insertion order with the appropriate limb selected or no preference IV fluid order with desired rate c IV antibiotics with Send to OR or Start on Transfer from PREP to OR in the Order Comments tab Vital signs and NPO are pre selected Intraoperative Portable is used when you require an xray s in the room during a procedure such as fluoroscopy A down arrow in the middle of the page means that there are various order sentences that you can choose to complete your order i e IV rate drug dosing E W Solutions sodium chloride 0 9 Y lactated ringers A dextrose 5 sodium chloride 0 45 000 Er Iv PEE 75 mL hr 1 000 mL IV continuous 125 mL hr Add an Order to a PowerPlan i If an order does not exist in the PowerPlan add single orders by selecting Add to Phase Click Add to Phase and then click Add Order to open the Add Order window qiu Q F Add to Phase Add Order Consider which of the following types of orders it may fit a Is there an actual orderable that matches i e medication or lab test b Is ita Communication order In the Find field type communication and select Communication Order Type the exact words of the order in the Enter verbatim order field of the Order details Y Details for Communication Order Details b Order Comments Es Offset Details l Diagnosis Y Requested Start Date Time 7777 7 jg Enter verba
202. t not just for a few weeks or months set your date to 2100 01 01 and a time of 2359 New Given Proxy User WBT Test HUGO Resident Additional Users E a 1318 Begin Date 2014 05 06 End Date 2014 06 09 La Su Mo Tu 12 3 8 9 10 15 16 17 22 23 24 29 30 11 12 18 FE 10 11 12 Available Items 19 2 25 26 27 Inbox Items Messages i CC Messages Consumer Messages General Messages 1 Renewal Requests Orders Orders to Approve Renewal Orders E Results L Abnormal Critical L Normal Other a Documents Forwarded Documents to Sign L Review Baciilec EVI Grant All gt gt Grant gt Revoke lt lt Revoke All To grant access to all items click the Grant All button Click the Accept amp Next button Granted Items To grant access to a specific item click the item and then click the Grant button Click the OK button if you are finished granting proxy access Messages CC Messages Consumer Messages General Messages Renewal Requests Orders Orders to Approve Renewal Orders Results Abnormal Critical Normal Other Documents Forwarded Documents to Sign Review Sign Results FYI Abnormal Critical Normal Other Reminders Documents to Dictate Paper Based Documents Saved Documents Notify Receipts Trash Sent Items 4 13 14 Click the OK button to close the Settin
203. t Heparin 4 m p Practice HUGO9 1187 03 56 Done 7 Click the Done button 8 Select the orders you need by using the checkboxes on the left hand side of the screen including either the Hematology or Cardiac Care ft Orders gt 28 minutes ago Add Document Medication by Hx Reconciliation g Check Interactions Status 0D Meds History s Adm Meds Rec Disch Meds Rec Orders Medication List d d T C9 Add to Phase Check Alerts 0 Comments Start Now m Duration None Status Dose Details Patient Care Notify Provider Hemodynamic Measures In the event of significant bleeding and stop heparin IV Solutions 7 dextrose 5 in water hd 1 000 mL IV continuous 100 mL hr Medications Review continuation of medications Acetyl Salicylic Acid NSAIDS Ticolpidine Clopidogrel Oral anticoagulants 4 Discontinue IM injections Cardiac Care For Cardiac Care Use select loading dose PRN bolus and continuous infusion orders below Maximum dose for bolus is 5 000 units Recommended starting infusion rate is 12 unit kg hr 0 3 mL kg hr 7 heparin heparin loading dose 60 unit kq injection IV ONCE infuse over 10 min Maximum dose 5 000 units Dil 7 heparin heparin bolus 60 unit kq injection IV as directed PRN for Other See Comments infuse over 10 7 heparin 20 000 units in 500 mL dextrose 5 500 mL IV Adjust heparin infusion as per following nomogram PTT Bolus Hematology L
204. t Labs AE Timing Future Pending _ Af Outpatient Labs Initiated Pending Completing Orders within the Phases 1 The PowerPlan will open with the first phase of the plan Timing Future Pending 2 Check Timing of Laboratory m Us Diagnoses Add to Phase A Check Alerts 1 Comments Est Start 2014 07 14 09 39 m Duration ge Y Component Dose Details COMMON Recurrent Outpatient Labs Timing Future Pending Iv e 4 Timing Of Laboratory Outpatient Labs Phase 3 The amp indicates that order details are incomplete 4 Right click on the order and click Modify dev Component COMMON Recurrent Outpatient Labs Timing Initiated Pending d i 5 Complete order details as described below Timing Phase If the PowerPlan will be used across multiple encounters it will have a section that provides direction on the frequency and total duration of the labs The Timing phase provides these instructions to the unit for the duration of the testing of labs 1 Select the appropriate timing details for the Frequency and Duration of the order 2 Type any additional details in the Special Instructions field 3 The example below shows the patient needing blood work weekly for a total of 26 weeks on Mondays y Details for Timing Of Laboratory dem 5 Order Outpatient Labs Phase Frequency weekly EL wewo S Duration Unit week v Special Instructions Ev
205. t from the Emergency Department When the admit decision is made enter the Admit To order on the Emergency encounter Then complete Quick Inpatient Registration and complete your admission orders on the new ED inpatient encounter The Admit To order has been modified for patients in the Emergency Department to gather the information needed to communicate bed request This communicates your intention to admit the patient to the Emergency Department staff as it appears as an icon on the tracking board Two new required fields and one optional field have been added e Precautions e Patient Attributes e Special Unit Needed optional field When selecting Precautions or Patient Attributes you can multi select by holding down the CTRL key and clicking the relevant options Details for Admit To Details 8 Order Comments y Requested Date Time 2014 04 14 Special Instructions Precautions Patient Attributes Special Unit Needed E U ER Pod A Visit 422350914 Admit 2014 04 01 15 23 00 EDT E Admission aX Admit 1 e m 14 17 22 Contact precautions MRSA Query CDiff No Known Precautions Acute respiratory illness ARI Airborne precautions C DIFF Contact precautions Y Details for Admit Droplet precautions Details 6 Order Co Proplet Contact precautions MDRO o MRSA Influenza Parainfluenza F Requested Date Time Query CDi
206. t have a specific template already pre built that is suitable for use Search non medication a G 5 la Ea non medication template Y Details for non medication template y Details E Order Comments l Diagnosis Dose Route of Administr Frequency Duration Send To IRP1395 on Ihprn11 from WDP932 in session 7 v m Dispense Device Special Instructions Type Of Therapy Acute 0 Maintenance oS e Start Date Time 2014 07 10 Stop Date Time TAA Select Prescriber Address Samples Specific Non Medication Template Currently seven new templates have been set up for common non medication prescriptions 1 Crutches Wig Glucometer Physiotherapy Syringes Wheel chair 7 Ankle foot orthosis puo ue a 59 If you search by a specific orderable i e ankle foot orthosis you will get the new template that appears on the printed script and is easier to understand for the patient 1 Search for the specific orderable name and click the appropriate orderable it will turn bold and blue Note When searching for these new templates the orderable is indented ea Contains Air Splint Ankle charge Aircast Ankle Boot charge ankle foot orthosis 2 Click the button 3 The eo indicates incomplete order details 4 The Dose field is a required field Select See Instructions from the dr
207. t user has either signed their orders or left the scratchpad Please note we are working on the solution to this issue which will be included in the system when we upgrade the Cerner system in the fall ORDERS PAGE It is recommended that users keep the View pane open in their Orders page This allows for quicker viewing of PowerPlans available on the patient and order categories for quicker navigation of the orders page Add 4 Document Medication by Hx Reconciliation 6 Check Interactions Orders Medication List ME Orders E Print 0 minutes ago Status f Meds History i Adm Meds Rec sf Disch Meds Rec GPlans Medical Suggested Plans 0 or upper outer arm Each patch should be applied to E Orders Communication Order Ordered Contact appropriate health care provider to initiate View Display All Active Orders Customize View 8 Order Name Status Dose Details COMMON Leave of Absence COMMON Nicotine Replace eb B cc LAB Urines Module Initiat COMMON IV Heparin Modi COMMON Endoscopy Discc Leave of Absence Ordered E Patient Care E Active Communication Order Ordered Apply nicotine patch to clean dry skin on the upper b Admission Smoking Cessation Program Resuscitation Status Notify Provider Ordered if patient continues to have urges to smoke and or Alerts withdrawal symptoms are not controlled within 12 hc J Diet Notify Provi
208. tails tab displays the frequency of the labs and includes the stop date for the recurring testing B Ambulatory Practice Order Information for Timing Of Labo gt E E Task View Help AL Original order entered and electronically signed by WBT Test HUGO Physician on 2014 Patient Care Department Timing Of Laboratory Additional Info Details History Comments Ingredients Pharmacy Details Order Outpatient Labs Phase Frequency Duration Duration Unit Scheduled PRN Special Instructions Requested Start Date Time Future Order Indicator Stop Date Time H0207 WBTPHYSICL Do not click the button of the Timing phase This phase must remain in a Future status to be viewable on the patient s return visit First Laboratory If this is the first lab initiate the Outpatient Labs phase of the PowerPlan as per previous instructions Subsequent Labs For subsequent labs the desired phase will need to be copied prior to being initiated 1 2 6 7 Find the appropriate plan in the View section of the Orders page Right click the Outpatient Labs phase that is required and click Copy from the shortcut menu Discontinue Replicate Plan Information Add Comment Save as My Favorite A second phase in a Planned Pending status is now available COMMON Recurrent Outpatient Labs Timing Future Bi Outpatient Labs Planned Pending All orders in the copied Planned Pen
209. tart date will automatically populate PracticeOncology Patientl Add Plan ONC Return to Clinic Select Visit and Start Time This Visit Estimated Start Date of Schedulinq 3 Future Inpatient Visit In Day s Future Outpatient Visit In Week s amp In 3 Month s Est start 2014 07 02 Confirm Phase Action Phase Start Date Time Action Scheduling 2014 07 02 08 00 EA Order now x Diagnostic Imaging 2014 07 02 08 00 H Order now Follow Up Appointment Labs Est 2014 07 02 08 00 Es Order for future visit PracticeOncology Patientl 1187 05 71 3 If Diagnostic Imaging is not required change the Phase Action from Order Now to Do not order by clicking the down arrow 4 Click OK In 3 Month s Est start 2014 07 02 Confirm Phase Action Phase Start Date Time Scheduling 2014 07 02 08 00 amp amp Order now Diagnostic Imaging D o not order Follow Up Appointment Labs Est 2014 07 02 08 00 PracticeOncology Patientl 1187 05 71 Scheduling Phase 1 The PowerPlan will open to the Scheduling Phase 2 Click the appropriate return to clinic disease site T te Add to Phase UJ Comments Start 2014 07 02 08 00 Duration None dev Component Status Dose Details Return to Clinic Scheduling Initiated Pending LRCP Return to Clinic BMT LRCP Return to Clinic BR LRCP Return to Clinic CNS LRCP Return to Clinic GI LRCP Return to Clinic GU LRCP Return to Clinic GY LRCP Re
210. te a new list click the button 5 The Patient List Type dialog box opens Double click Relationship Patient List Type Select a patient list type Location Medical Service Personal Custom 6 The Relationship Patient List dialog box opens 7 Typea name for your list in the Enter a name for the list field Relationship Patient List C Relationships x Visit Relationships Encounter Types H x Lifetime Relationships Locations Medical Services C Care Teams Time Criteria C Admission Criteria _ Discharged Criteria _ Use Best Encounter Enter a name for the list Limited to 50 characters Dr Test Patients Choose Visit Relationships 1 Next click the plus sign in front of Visit Relationships to expand this 2 From the Visit Relationships list click in the checkbox to choose your relationship e g Admitting Physician and Attending Physician E Relationship Patient List Relationships Admitting PI x Visit Relationships Encounter Types _ All Visit Relationships _ Locations Patient Care Medical Services 2 _ Administrative Functions C Care Teams _ Administrative Support LC Time Criteria 3 2 Admitting Physician C Admission Criteria 7 AH External Reviewer 01 Discharged Criteria C Use Best Encounter 3 Enter a name for the list Limited to 50 characters Dr Test Patients Choose Encounter Types 1 Next click
211. ted but will fire again if the proposed order is still in place Patient Care E Active Eb Ea ba Proposed Order Exists Ordered A Proposed order exists and requires attention by the MRP 2014 0 Tasks Firing to Nursing and Unit Clerk Task List This task is meant to alert nurses and unit clerks to notify the admitting team of the proposed order It is recommended that the task is marked as complete after the physician accepts rejects the proposed order Task retrieval completed Task Status Scheduled Date Time Task Description Order Details Provider Name Ir Pending 2014 04 27 17 52 Proposed Order Exists A Proposed order exists and requires attention by the MRP System System Please check with the MRP for the Proposed orders on this chart Proposed Order Alerts in FirstNet When a proposed order is placed on a patient s chart in FirstNet the Proposed Orders Exist order will be placed by the system and a Proposed Orders icon i will appear in the To Do section on the tracking board Pu Bed Status TLOS A Name Age All Patient Reason for Visit Direct To Comment To Do Lab Rad Meds NR Pod A7 EN Another Test py o E test IP ene 9 0 4 0 14 T mud Le Nursing will be responsible for completing the icon after the proposed order is accepted rejected This will complete the Proposed Order Exists order Proposed Order Reminder 1 When opening a chart that has a proposed order the following alert will fire 2 Click OK to cle
212. ted during the PACU phase of the patient s care Phase 1 PACU Stage One will be discontinued by the PACU nurse once the patient has met the criteria Phase 2 amp 3 will be discontinued by the APS team pain when they are finished following the patient Important If the PACU phase has not been discontinued before the patient is transferred to the post op area the inpatient nurse must do so Ortho PowerPlans not Processing Due to Missing Date for a Routine Xray T 1 for Post Op Day 1 Issue Ortho PowerPlans are not processing because the Requested Date Time field for a Routine xray T 1 for Post Op Day 1 in the PowerPlan has been left blank Reason This is occurring because the Requested Date Time field is not yellow required Users do not realize that it is a required field because it is filled white instead of yellow and do not enter a date and time When users sign the PowerPlan without entering a date and time for tomorrow s date they receive an error message similar to the one below Order Service o The system is unable to save changes to plan orders Retry Cancel Solution When ordering Routine xray T 1 for Post Op Day 1 ensure you select tomorrow s date and time in the Requested Date Time field as shown below Details EF Order Comments eu Offset Details T Priority Routine Requested Date Time 2014 05 04 peno Send Appt notification to if not Ordering Physician Copy to Physician
213. the IV solution should be 5 SAVING PowerPlans as favorites can help streamline your workflow However if changes are made to the base PowerPlans your favorite could change or be unavailable and need to be recreated 6 Just to clarify any plans in a planned state for patients are NOT affected NEVER EVER click the X iie button to initiate the PowerPlan click the button only to put the PowerPlan into a Planned state TRANSFERS If a patient from a Cerner hospital is transferred and does not have a Patient Summary printout with them alternate print outs are available Print the Transfer Medication Administration Report 1 To find the previous encounter for the patient click the Location link on the Demographics Bar Inpatient 2014 02 25 00 00 Mo Location 5DA AAMA 1 Provider Fullerton Gary M 2 Double click on the desired encounter and click the button P Custom Information St Joe s Learn Practice51 Selected Visit Type Visit Reason Service Admit Date X Inpatient General Medicine 2014 02 25 00 00 00 ee GENERAL INFORMATION Reo ones meme 3 Click the Task menu and then click Reports Refresh Exit 4 Check off the Transfer Medication Administration 5 Complete From and To date and time 6 Select Printer destination P Reports C Discharge Medication Plan C Leave of Absence Medication Chart C Diet Worksheet C Diet Worksheet TVHPP C LOA Prescript
214. the past or the patient has no known home medication Unable to Obtain Information If you are unable to obtain medication information The nurse will try to gain information within 24 hours and if that time passes a system generated reminder to readdress BPMH will appear the next time you log into PowerChart Use Last Compliance Only available if the patient has had a prior encounter with entries made and the medications are unchanged since the last encounter Order Catalogue when Adding Medication to BPMH This medication catalogue includes e Medications generic and trade names currently in use in Canada e Vitamin and mineral options and e Many of the frequently used herbals This medication catalogue does not include any homeopathic remedies and research medications If you are having difficulty searching a medication please use the following strategies e Check your spelling e Use the generic name as this will yield better results as well as a better translation of doses and schedules through all types of reconciliation e Call your pharmacist for help e Search and use the nonformulary medication order only when unable to find the medication Search and use medication template only when unable to find the medication or to use as a placeholder while investigating exactly what the patient is taking e g I take a pink pill for blood pressure Medication template cannot be Continued when performing medication reconcili
215. tim order Type exactly what you want the orde c Is it a Conditional If Then order In the Find field type Conditional and select the Conditional If Then order Complete the required If and Then fields conditions Y Details for Conditional If Then Details 32 Order Comments Es Offset Details l Diagnosis p sese e foo Requested Start Date Time an d Isit a Notify Provider order In the Find field type Notify Provider and select the appropriate Notify Provider order and completed the order details Notify Provider CSF Notify Provider Hemodynamic Measures Notify Provider Laboratory Results Notify Provider Vital Signs Urine Output Y Detais lo Notify Provider Vital Signs Urine Output ES Details IE Order Comments C Offset Details y Diagnosis Requested Start Date Time pear icr end q Special instructions Temperature greater than Temperature less than Temperature Increases Ldegree higher than previous reading C ves C No Heart Rate greater thare Heart Rate less than Systolic Blood Pressure greater thanx 5ystol Blood Pressure less than e Is it diabetic orders PPO from UH Use a combo of the above and add a Communication Order to see paper orders 4 DO NOT SAVE a PowerPlan as a favorite with the IV solution included unfortunately this is broken functionality and will just result in a blank line item where
216. turn to Clinic HN LRCP Return to Clinic LE LRCP Return to Clinic LU LRCP Return to Clinic LY LRCP Return to Clinic MYELO LRCP Return to Clinic ME REP Return to Clinic PAIN 1 limic PAL LRCP Return to Clinic LRCP Return to Clinic SK dHaummaammmummadnmmms INNA INN IN 3 Type the Reason for Exam Visit in the scheduling order Details tor LACP Return to Clinic LU Details E Order Comments eu Offset Details Requested Date Time 014 0702 a 0800 Followup Diagnostics required Yes No MEN Reason For cami Attending Physician Follow Up Appointment Labs Phase 1 Click the Follow Up Appointment Labs Phase from the Orders View Orders Medication List Dacument In Plan Orders for Signature E Plans Medical 5 ONC Return to Clinic 3 Scheduling Initiated Pending if Follow Up Appointment Labs Future Pending 2 Click the labs you would like completed at the next follow up appointment ONC Return to Clinic Follow Up Appointment Labs Future Pendinq E Laboratory Hematology and Coaqulation Eb LAB Group and Screen VH Parkwaod LRCP OOOO iO mrtometry FLOW Eb LAB ProteiPEgetrophoresis Module Ely LAB Folate Level Vf Chemistry A Protein Total PR Albumin Serum Plasma ALB Calcium Serum Plasma CA Glucose Random GLUE Bilirubin Total BILT Y Aspartate minotransferase AST A Alkaline
217. utine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood Routine T N Blood g e Diagnoses S AddtoPhase A Check Alerts UR Comments Start 2014 07 14 09 39 m Duration Noi A Details Dx Table Orders For Cosignature Save as My Favorite Orders For Signature 3 Complete any incomplete order details as required Review Your Orders 1 In View section click Common Recurrent Outpatient to review all orders for the plan at once Medical MS COMMON Recurrent Outpatient Labs Af Timing Future Pending XKOutpatient Labs Initiated Pending Important The Timing phase will stay in a Future Pending state for the duration of treatment 2 Once all orders are complete click the button 3 Click the button and refresh your screen 4 Orders are now dispatched Initiating Recurring Plans 1 First confirm that the lab testing is required based on the Timing of Laboratory instructions ge x Component Status Details A COMMON Recurrent Outpatient Labs Timing Initiated 2014 07 07 10 23 Last updated on 2014 07 07 10 42 by LON Physician HUGO Train 1 o LA Timing of Laborator Ordered 2 Right click the Timing of laboratory order and select Order Information 3 The De
218. wo weeks prior to treatment A Details Orders For Nurse Review Save as My Favorite Orders For Signature 11 Right click on medications that you want to put on hold due to ECT and select Modify 12 Under the Order Comments tab of the medication type instructions for holding that medication due to ECT in all UPPER CASE LETTERS fi Medication List Print 0 minutes ago Status Add Document Medication by Hx T r ji O Meds History Adm Meds Rec Disch Meds Rec Orders Medication List M Display My view y ua Customize View Order Name Dose Details Start Ordering Physician Status Complia Cor f divalproex sodium 250 mg 1 tab EC tab ORAL bedtime Requeste 2014 05 30 21 00 Test Doc HUGO Modify c y Details for divalproex sodium Details GP Order Com ments Order comments HOLD NIGHT ECT Displayed All Active Orders 4 More Order Orders For Nurse Review Orders For Signature 13 Once you have added the comment to all medications that you want on hold click the button 14 Click the button and refresh your screen Important Add these comments to any medications that are order after initiating the Power Plan as well 15 Nursing will now see your order comments on the MAR zo1ayos727 nias SEE Scheduled Scheduled Unscheduled werd i c A CR sodium PRN 250 mg 1 tab EC tab ORAL bedt
219. y To add a new prescription that is not on the medications list click the L dd button in the upper left corner and complete the order details for the new prescription When all medications are reconciled and order details are complete click Reconcile And Sign Acute versus Maintenance If the radio button for Maintenance is selected you can avoid entering a stop date time on the medication you are prescribing This means that if the prescription becomes invalid expired or discontinued it will need to be removed from the Medication History manually If the Acute button is selected once you have entered a date and time for the medication to stop the prescription will automatically fall off the Medication History Admissions From Home or a Non Cerner Facility 1 2 Using the list of medications on paper sent from another facility or brought by the patient nursing or Pharmacist completes Documented Medications by History and reviews with the patient family This list needs to reflect the medications the patient was on at home prior to the hospital admission Compliance information needs to be documented during this step Pharmacy can be consulted to review verify this list if any problems arise The Provider performs Admission Medication Reconciliation assessing the need for each medication by selecting Continue or Do Not Continue The provider then activates these admission orders by selecting the button
220. y and now 1 In the Details for the order click the down arrow for Requested Start Date Time 2 Enter the new date and time Requested Start Date Time First Administration 2014 05 06 Mext administration 2014 05 07 sg o Following administration 3 Click the button 4 Click Refresh Minutes ago Placing Vitamin Order E 1745 E Skip administration When ordering vitamins change from the defaulted Contains to Starts with to limit your search results to orderables that start with the word vitamin as opposed to orderables that contain the word vitamin See examples below Find vitamin an Contains Advanced Options Type p Inpatient v a y aa Search within l Y Atlocation LHSE VL 1 25 Dihydroxy Vitamin D Serum 125VITD Vitamin B Complex with C oral tablet 25 Hydroxy Vitamin D Serum 25VTD Vitamin B1 B Complex 100 Vitamin B Complex with C oral tablet extended rel Vitamin B1 Level Serum VITB1 calcium carbonate 1500 mg vitamin D3 400 units vitamins miner Qj Vitamin B12 Multiple Vitamins oral tablet chewable Vitamin B12 Serum VTB12 multiple vitamins pediatric oral liquid Q9 Vitamin B6 multivitamin additive Vitamin B6 Level VITB6 multivitamin in 1000 mL sodium chloride 0 9 Q Vitamin C multivitamin with iron Vitamin C Level VITC multivitamin with minerals Vitamin D 125 multivitamin prenatal Vitamin D2 Prenatal Multivitamins oral tablet Vitami
221. y o Palm Medi Rec eo Dich Meds Rex ders Medicatian List H Display Ai Active Orden ad FECE Orders for 5i Problems and Diagnoses Plans Histenes Medics CRIT CAF Quick Orders Orders Alber gies Danse Details sliding scale SUECUTAMELC Blood Glucose Range men Clinical Document F Add Suggested Pl Documents Orders Clinical Notes Viewer il i Complete Blood Count CEC Ordered AM Routine 20040500 0 estaca Scheduled 03 00 aliado dai TAa C Creatinine CR Ordered AM Route 2014 05 01 0 Medicatina List Dies p Scheduled 02 00 MAR Surnrmary m An I Es Wital Sia duc I MAR Fi Patient i H IMRPTT Ordered AM Routine 4114 05 01 0 m Ta 1 7 FU Transplant Lab HLA Iv Sobuti P Urea U CU Urea 2M Tena 2014 05 01 0 Pi Medi d Blood Product information E Laborat Infection Corral Dignes da Oaks Bank aerated Oncology Es Uv Pil rts v S _ Consult s m i Chematherapy Summar 7 Allee H APT Redestion Therapy Summary Patent bali Lab Order Request for Repeat Collection or Appended Addition Laboratory Request for Repeat Collection Scenario Sample clotted hemolysed insufficient quantity tube broke in centrifuge 1 2 Lab notifies unit which specific sample lab order needs to be redrawn Lab cancels current order sample Nurse enters the new order for the repeat draw of specific sample lab order entering the original ordering physician name and communi

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