CARE PARTNER/MEDICAL RECEPTIONIST
New Employee Orientation 2014
Setup PRIOR to Class: Enter pre-orders for number of students in the class for 7N census or census for
the room the class is being held.
Enter Pre-Orders on training pts for # of learners expected plus 2 (for late comers,etc.)
1. How to Enter Pre–orders
a. Signon with provider ID: TRAIAKO, password: sss003 (look on website at Training ID
Information for current passwords)
b. Select a training patient then Click Manage Pre-Orders
c. Open dropdown box and Select Surgery/Procedure
d. Click Create
e. Open order set for lap choley
f. Enter these 3 orders:
,
,
g. Click Done
h. Type lap choley, Click Max, Click Today, Click Save Signed pre-Orders
2. Turn on LCD, set up Microphone, check CWS
3. Open SSS Website to Training, CP/MR NEO Class.
4. Instructor signs-on with MR TRAINING ID.
5. SUPPLIES
a. Trainer’s Manual and Roster
b. Laminated Documents: POS, Lab & RT req,
c. Print Patient List for 7N for each student
d. Staple together, VCWS set up, Systems Access Checklist, Abbreviations, Tip Sheet, MR
Dashboard, Create and End Assignment
e. Downtime Kit stocked
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Getting Started:
Welcome

Introductions with explanation of CAPs role

Restrooms

Length of class is 4 hours with 1 break.

Explain handouts
Previous Experience
Trainer: Get an idea of who your audience is

Who is new to Vanderbilt?

What’s your previous work experience?

Who is being cross trained as an MR?

Do you know medical terminology and abbreviations?
Your job as a Care Partner and/or a Medical Receptionist will vary based on your specific unit.
Today you will learn about patient care applications as they related to your job.
For class today, everyone will be using a Training ID. Your permanent ID and systems access
will be set up by your security manager (on most units, the AA). A checklist is provided for
things that need to be done to complete your systems access and set up your Virtual Clinical
Workstation.
StarPanel:
Trainer: Show Companion PPT slide 1 and explain StarPanel is the electronic medical
record and StarBrowser is the inpatient view of StarPanel designed for inpatient clinicians
Inpatient Whiteboard:
1. Press Spacebar…sign-on
2. Explain VCWS
Practice in StarPanel:
1. Set up user preferences for frames. Explain users will need to do this once with their own
ID and instructions are located on the Systems Access checklist.
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a. Click on Customize, then Preferences on the Black menu bar
b. Scroll down and find Show numeric frame sub tabs. Click on no and it will change
to yes. This only needs to be done once.
2. Users can also Resize the upper frame … drag or double click white spot
3. Locate patient’s name on Patient List and find patient on census list…may need to scroll
or resize to locate
4. Click MR# to load patient’s entire chart
5. Click Pt List to view full census for unit
6. Click ACTIONS to the right of your patient’s name
7. Click CHANGE
8. Select Medical Receptionist’s Menu
Actions Menu:
Trainer: Review most frequently used functions by MR from Actions menu
1. Click AllDocuments – this contains a record of any document that pertains to a
patient’s medical history at Vanderbilt University Medical Center.
Frame below census opens with all of the documents in the pt’s chart
a. Type “Property” in the Title search field
b. Press ENTER
c. Click on one of the Property Records
Frame below AllDocuments opens with a scanned document of the property the pt had with
them at admission.
2. Click Appointments: If the pt has upcoming appointments, they will display here
3. Click Consent Documents
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a. Open Surgical Consent document
b. Scroll to view scanned in consent document. Many consents are now being
collected electronically.
4. Click Demographic. Insurance and patient contact information displays in frame below
5. Click e-Docs
a. Type Downtime. 2nd document listed Downtime and Code Req
b. Right of document, Click glasses to view. When HEO/Wiz, the order entry system
goes down, this document used to order labs, blood products and other tests.
6. Click ED Docs. List of all documents done while pt was in ED
7. Click OPC
a. Overview of Patient Care
b. Printed by MR for nurses prior to shift change
c. Nurses use to give and receive report… Handover tool
d. Pt information from orders, test results, nursing & MD
Point out the following as learners locate
Situation:

Team Team Page can be done from here

Patient Contact Information… phone # nurse collected

Synopsis: Residents note if what brought patient to the hospital

Alerts: Allergies, Isolation, Fall,

Advance Directive: end of life document
Background: past medical/surgical history
Assessment: Nursing documentation
Recommendations: Orders from HEO Wiz
8. Print OPC for nurses prior to shift change
a. Click Actions
b. Click OPC
c. Note Print button - DO NOT click
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d. Note Next Patient till entire census prints
9. Print CarePartner Snapshot prior to shift change…same steps as OPC
a. Click Actions Menu
b. Click CP Snapshot
c. Note Print button and Next Patient - DO NOT click
10.
Print Charge Nurse Snapshot prior to shift change
a. Click Print. One document prints with all patients listed
MR Dashboard:
1. The MR dashboard is located under the Dashboards list in the black menu bar of
StarPanel. Click Ancillary dashboards to expand the list and select MR-Ancillary.
2. Show class how to Drag and drop MR Ancillary in the Favorites list for easy access.
a. MR’s should be set up to use their MR-Ancillary dashboard by clicking “show this
dashboard after login” at the bottom of the dashboard. Then setup their Inpt wb
to show in favorites and select their floor – but do not set it up in preferences to
show on sign on. It won’t work if they have selected “show this dashboard after
login”. CP’s crosstrained to MR should use whichever is their primary role to
determine which to set up.
b. Demonstrate how to drag and drop Inpatient Whiteboard census in Favorites. This
will allow them to easily toggle between MR Ancillary and Inpatient Whiteboard.
3. Show the dashboard by clicking on MR Ancillary
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4. Click on Change Panel
5. Trainer selects 5N (this will take you into the live region).
6. Have students select the unit they will be working on. Show them how to select
multiple units.
7. Click OK
8. Point out the indicators. Currently there are indicators for RT, EKG and Discharge
Appointments.
9. The dashboard is a view of the unit census with columns to show:
a. Pt. demographic information ( including security codes)
b. Ancillary Orders – initially just RT and EKG
i. RT – green is a routine order and red is for STAT. From the MR Dashboard,
click on the order indicator. Review the order and click “Acknowledge
orders” to acknowledge you have seen the order. A hollow box indicates
the order has been acknowledged. By acknowledging, you are showing you
saw the order and it is the electronic equivalent of picking the paper
requisition up off of the printer. An automatic page is sent to RT for STAT
orders.
ii. EKG – the indicator colors are the same as RT’s but the process for notifying
EKG will be specific for each unit. There is no automatic notification for
EKG orders.
c. In the notes column, click in the bland space to make notes for MR or Charge RN.
For example, this is a way to track Consents, pt specific data from shift to shift
and contact precautions, etc.
d. The Discharge Appointment indicator provides notification of any follow0-up
appointments made since admission. If the indicator is white, no appointments
have been scheduled and follow up is needed with the patient’s RN.
TRAINER: Refer to handout on MR Dashboard and explain it is on the SSS website.
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HEO/Wiz:
Show the objectives on Companion PPT slide 2.
1. Double click on Green Wizard to open HEO/ Wiz Training region
Confidential Status

N= pt requested no info be given out

G= general info such as room number can be given out

U = unknown

NS = No info and Security Risk , i.e, Victim of violent crime
Other Things from Census View

Search for patient. Type Ztest

Printouts button

Refresh(refreshes the census after a Medipac transfer/discharge)
Printouts Button:
2. Practice printing a patient list from Printouts button – Don’t print
3. Practice printing Wiz labels- Don’t print
Diet List is printed (for Adult Units) prior to the arrival of the food cart in Adult Hospital. Print
Diet list from Actions menu in StarPanel
Pre-Orders Playback:
Trainer: What did the purple P indicate to the left of a pt’s name?
Preorders are entered by a provider and stored prior to the patient being placed in a Medipac
bed. A purple “p” alerts medical receptionist to activate the orders. Orders can be played
back from either HEO/Wiz or StarPanel.
1. Double click on your same patient
2. Click Manage PreOrder (list of preorders with today as playback date will be displayed)
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3. Verify the correct preorder set is selected
Trainer: Do NOT Attempt to playback Unsigned orders-check with Charge Nurse for date to
playback.
4. Click Playback. Preorders load
5. Scroll to bottom and click next. The orders will load & flash across the screen
6. Click Next. The preorders report will be displayed. This document is also sent to StarPanel
and if Wiz were down during the time you needed to playback the orders you could access this
document in StarPanel, print it and use for downtime orders.
7. Scroll to bottom of the View/ Playback orders screen
8. Click Playback Orders
9. Click Yes to “Are You Sure?” HEO closes once orders are played back. POS and Reqs print
1. Click REFRESH - Purple P goes away
Some units get more preorders than others. Dialysis orders are only played back by Dialysis
Staff
Reprint Requisition:
1. Click on Patient’s name
2. Select Reprint Req…Reqs can be printed for yesterday, today, tomorrow
3. Reprint “cbc/plt/diff in 0500 – prints to closest printer on unit
Why would you reprint a req? Lost, damaged, need early
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Processing Orders:
Trainer: When orders are entered directly by a provider or nurse or playback by the MR, a
hard copy of the orders print on the inpt units.
HANDOUTS: POS and REQs …. Review laminated sheet
Computerized Physician Orders
pages 1 and 2
► Generally print to Medical Receptionist’s printer when orders entered in HEO/WIZ and the
MR’s either distribute them to the bedside or keep them at a central location. You will
learn what your unit does from your preceptor.
RN’s will acknowledge orders online
Patient information and MD who authorized order at top
Each order has a number
STAT orders display bold … see page 2
Start & stop times (right side of page)
 Open-ended orders (continuous) display start time. Remain until deleted or pt
discharged – see #10 NHO
 One-time orders - see #13 culture urine bacteria
 Timed orders – See #23 (pg 2) Morphine. 72 hrs stops
Far right column provides a place for MRs to note when dept called, etc
When orders are processed and verified, MR & RN initials are required during a downtime
Computerized POS is not a permanent chart document
Shredded after replaced
Requisitions: Lab pg 3
► Reqs print on unit if procedure or test done on unit. The MR either distributes the req to the
bedside or places it in a central location. You will learn what your unit does from your
preceptor.
► Other Reqs print in performing department, i.e. Radiology, Nutrition Svc.
► Lab Reqs are bar coded:
 2 barcode above double line are patient information
 Barcodes below line defines tests
 Lab scans Req when specimen is received
► Multiple tests print on same Req if tests can be run in same dept (CBC and PCV)
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► Full signature, VUNet ID, dates & time from person collecting specimen.
► Text in center section gives directions on how to collect specimen, color of tube
► If test ordered STAT, MR calls the performing department, except for Labs.
► Batch Reqs print after midnight if the test is to be done after MN, ie, next day’s labs
Medipac:
Trainer: Show Objectives in PPT slide 3
Trainer: Whiteboard unit’s census is managed in 3 ways via the Medipac system:
a. Admitting department admits a new patient into Medipac
b. Unit staff discharge patients in Medipac when they leave VUMC
c. Unit staff transfers patients in Medipac to a different location
When a change is made in the Medipac system, the census is changed in StarPanel and in
other applications. Maintaining an accurate unit census is one of the most important
aspects of the Medical Receptionist’s job.
Trainer: Find your patient on the patient list, use MR training ID TRAIURV, nurse___ so your
screen matches the students.
Review Patient List from laminated packet

Snapshot of current census at the time it is printed

Headers across top: unit, bed, pt’s name, age, sex, admission status (all here are
inpts (IA), MR#, Case #, date admitted and Attending

At the Beginning of shift, print a Patient List.

Will Use this list to practice transfer and discharge

Case # = Account # - always use this account #, not blue card
Trainer: Show Medipac Keyboard Tips and Pavillions in PPT slides 4, 5
What unit is your patient on? 7N(or census for the room training is being held)
What Pavilion is 7N in? Heart and Vascular institute – pavilion 4
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1. Click Go to Desktop… 2nd icon from black bar
2. Double click Medipac Icon
Medipac & StarBrowser display lower tool bar
3. Click Medipac…rsf from lower tool bar to view the application
4. Tab to MEDP3M
5. Type A at the white square
6. Press ENTER. Patient management menu displays
Change Pavilions: Transfer to PAV 4
Trainer: Turn over your training card and practice transferring a patient from 7N to the
unit and bed listed on the card (MCE5 Cardiac Short Stay MCE or 5S)
What Pavilion displays? Pavilion 1
1. Tab to PAV
2. Shift /tab.. practice going back one space
3. Tab back to PAV
4. Type 4
5. Press Enter… Note Message “Pavilion change accepted”.
If the pavilion had not been changed, would the patient be available for transfer? NO
6. Tab to Nurse unit Transfer (NXFE)
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7. type A & press Enter
8. Press TAB key until the white box stops to the right of the Account #
9. Type the number zero
10.
Locate your pt’s case # on the laminated sheet
11.
Following the zero, Type the 12 digit case #
12.
Press Enter
Trainer:
 Always confirm that the name in the top left corner matches the name on the Patient
List.
 Transfer Date and time defaults to current time. If the patient leaves the unit earlier, be
sure to Type over date and time, shown in red, to reflect actual time left.
 F8 turns page forward
 F7 goes back a page
 Pause/Break goes back to the home screen
 Tab goes forward
 Shift Tab goes backward
 If you see the stick man, press Esc
13. Tab to PAV. The patient is transferred within Pav so no Pavilion change is needed
14. Tab to LOC
15. delete red text
16. Type ??
17. Press Enter
18. Review the list of locations patient can be transferred to
19. Turn your patient card over and see what unit your patient is being transferred to
and find it on the list and type in the appropriate line number
20. Press ENTER
Trainer: A list of available beds display, have students assign their patient to bed on the back
of their patient card. No two people should select the same bed.
21.
Locate line number and bed on the Patient List
22.
Type LINE # …be careful to select correct bed for your pt
23.
Press Enter
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24.
Confirm Medipac bed matches what’s on the Patient List
25.
Note Message …Transfer complete
Transfer Back to Home Unit:
Trainer: When the patient returned to the unit from surgery or other areas, the MR should
transfer the patient immediately to their unit’s census.
1. Tab to Account #
2. Type zero
3. Type the 12 digit account number
4. Press Enter
5. Tab to LOC
6. Delete Red text
7. Type ??
8. Select 7N… the pt’s home unit
9. Type line number for the original bed, based on the pt list
10. Press Enter. Transfer complete displays at bottom left screen
Additional Transfer Information:
 Transfer Notice will print
 When transferring to the OR, CCL or other procedure areas, select any available
bed.
 When transferring to unit, select actual room pt is going in to
Discharge for IA:
Trainer: Practice discharging your SAME patient. All patients should be back on 5N
1. Press Pause/Break to get out of transfer function
2. Tab to NDSC “Nurse Unit Discharge”
3. type A
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4. Press Enter
5. Tab to Account #
6. Type zero
7. Type account #
8. Press Enter
9. Type over date /time if not time patient leaves unit
10. Tab to disposition code
11. Type E
12. Press Enter
13. Press Enter again after message -Warning, pt inhouse on this day
14.
message at bottom left
Additional Discharge Information:

What admissions types are discharged, IA or OT? IA…on Patient list

Use Patient List for account number, not the blue card

Never perform the medipac discharge or transfer function until the patient physically
leaves the unit
o Transfer complete displays at bottom left screen
o Admitting department must cancel all discharges… i.e., patient is leaving unit but
collapses at elevators and MD decides not to discharge

Is there urgency in getting a discharge cancelled if pt didn’t leave? Yes, orders are
lost in 4 hours and no new orders can be entered until patient is back in Medipac.

What happens if disposition code 7 is selected instead of E? Pt will not have MR # to
schedule clinic visits/hospital readmits.
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If you correctly typed in the acct #, but get message “Pt not in this Pavilion”,

what’s the problem? Change pavilion
Departure for OT: Trainer Demo Only
Nurse Unit Departure is similar to Discharge (NDSC) except Departure is for Outpatients (OT).
Watch the screen to observe how a Departure is done
1. Press Pause/Break to return to Patient Management menu
2. Confirm PAV 1 Displays
3. Select NDPT, Nurse Unit Departure
4. Type this case #: 000503212-0298 - ZTRAINSSS10SD, ANDRE
5.
Departure time should match time
patient physically leaves the unit
6. Disposition – E
7.
8. Press Enter… departure complete
Instruct learners to close out Medipac
9. Press Pause/Break and F3 until back to signon screen
10. X out of Medipac so that Desktop displays
Break 15 Min
(during break, trainer’s need to cancel discharges from
Medipac)
1. Cancel Discharges…a 2 step process… use your own ID, not training ID
A. Step 1: Compare CENI Medipac list with 5N training patient list
a. Patient Management Menu
b. Select PAV 4
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c. Select CENI
d. Type 5N location – Press ENTER
e.
Either print all census pages (F8 to go to next page)
A. Step 2: Cancel discharge on any patient not in Medipac
f. Press Pause/break to select Discharge Cancel (DSCC) in Pav 4
g. Type Ztrainsss5N, space first name
h. Select line number of the case that was discharged last
i. Press F9 to cancel discharge
j. Continue until all discharges cancelled
k. Check Wiz train census to confirm all display... click refresh several times
2. Cancel Departure (DPTC): Ztrainsss10SD, Andre, case # 000503212-0298, Pav 1
a. Change to Pav 1 if needed
b. DPTC function
c. Type name: Ztrainsss10SD, Andre
d. Enter
e. Select correct date (usually the first one ) to cancel departure
f. F9 to cancel
g. Check Wiz Census to confirm Andre is on 10SD census – May need to refresh 2-3 times
before appears on census
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Trainer: Show Companion slide in PPT slide 6 to outline next few items to be discussed.
Scanning Documents:
1. Explain there needs to be a current patient label affixed to each side of the
document.
2. After the scanning process is complete, put a yellow highlight check mark on the page
to indicate completion.
3. The type of documents needing to be scanned varies by unit. Please ask your
preceptor or CAPS person for further information.
Hardware Checks:
Have learners walk to printer and trainer ask questions below and practice opening all parts
of printer to troubleshoot.
1. What printer is termed “Critical? Order’s printer
2. Do critical printers look any different than demand printers?
No, but they are
monitored by the HD and unit will be notified if a problem
3. Electronic Script Printer, locked and has special paper
4. Is it your job to make sure all printer on your unit function properly at all times? Yes
5. What should you do if you find a printer or a CWS that isn’t working? troubleshoot
6. What kind of problems can happen to a printer that you can solve?

Jam - Off line

Out of paper – Unplugged -Out of toner
7. If unable to solve the problem what should you do? Turn off and back on
Trainer: Notify the HD: by phone for Critical printers, Prescription printers and Zebra
printers. The HD should replace the printer very quickly.
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Paper Documents are being scanned into the medical record and your unit also has a
Scanner, copier, and fax all in one. Issues with the scanning equipment should be called
into the vendor. Check with your AA for your unit’s process.
Open HELP Desk Ticket:
Trainer: When you find CWS or a demand printer that doesn’t work, it’s your responsibility to
get it fixed. First reboot the CWS and do routine printers checks. If that doesn’t work, notify
the HD by placing a self-service ticket.
1. Click Starbrowser on lower tool bar
2. Click HD icon left of black bar
3. click Here to open Pegasus
4. Enter VUNET ID and Password
Trainer: Click Communications then Click Self Serve to view what MRs see
7. Type Title and Description and add any attachments
8 Click ADD
Downtime:
Trainer: Show PPT slide 7
Downtime can occur with any of the systems we have learned about. Generally speaking:

StarPanel: seldom goes down

Medipac: has scheduled DT for Maintenance and Upgrades

HEO/ Wiz and HED: scheduled DT for Maintenance and upgrades and sometimes
unscheduled DT.
1. Email announcement are posted around unit if DT is scheduled
2. Overhead announcements are made prior to DT(if scheduled), start of DT and at end of DT
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3. Downtime Kit for ALL types of Downtimes: MR’s job to keep stocked . E-docs is where
documents can be found for the downtime kit. SSS website is a good resource for
information.
4. Each patient room must have a blue chart for downtime documents as needed.
DEMO kit:
a. Black Laminated on each unit & some units have multiple kits
b. Point out “Quick Reference” laminated sheet describing what EVERYONE on unit
should do during DT
c. Mention Policies
c. Refer to example of completed POS (for HEO/Wiz DT) for Providers to hand-write
orders and manually process (unit has supply). Fax Pharmacy a copy to enter meds
when system back up
d. Mention Peds / adult packets (critical & general care) to their specific area Flowsheet (for HED DT)- for nurses and CP to document patient care (from e-docs)
e. MAR: (for Admin-RX DT) –Pharmacy will print computer generated MARs for
scheduled and unscheduled DT for nurses to document medications on during the DT.
If Pharmacy can’t print and admin-Rx is down, a paper MAR can be printed from edocs.
Trainer: tell learners to check with their preceptors to find out where their unit DT
computer generated MARs print.
A Closer Look at Downtime when HEO/Wiz is down:
Handouts: POS and DT Req
Trainer: POS
 Which orders are ongoing… that means not a one-time order
 Locate the code column… what code is in this column for on-going orders? DT –
these orders must go in computer after DT is over: Bedrest, full liquid diet
 Which orders need to go to someone other than the nurse? Full Liquid diet
(nutrition svc), PRBC (BB), Aspirin and Metoprolol to (Phm)
 What code is placed next to these types of orders? Req except for Medications.
Phm will receive a copy of the entire order
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Signoff on POS
 Sign full name, role, date /time
 Mark large X through any unused area on sheet
 Fax 2nd sheet to Pharmacy
 Code with Req and DT
 Tear off unit copy and give to CN for back-entering orders
 Place original in chart
 Flag orders for nurse. Inform of STATs
 RN should verify orders were processed accurately and signs full name, date/time
at bottom.
Requisitions
Trainer: Review DT Req’s 4 sections are completed. Send a req for each dept
 Section I - Lab: MR completes this portion and gives to phlebotomist to finish
 Section II- Lab: Based on orders from Order sheet, Glucose and
CBC/Platelets/Diff req is sent to lab
 Section III -Ancillary Depts: Nutrition and other ancillary depts. need a req to
know of the change.. “Full liquid diet” note other departments on form and each
dept will receive their own req
 Section IV -Blood Bank: 1 Units PRBC… symptomatic anemia .. send unit now
End of DT:
 HEO/Wiz: On-going orders back-entered by Charge Nurse, CSL or Provider
 Medipac Down: Reconcile census … Discharge, Transfer out and transfer in new
admissions
 HED: Place in blue chart the computer generated MARs that nurses documented on
and flowsheets (depending on the length of the downtime, documents may be
scanned instead of placed in the chart)
Play Game Show
Dismiss Medical Receptionists and Crosstrain CPs (have
roamer assist students doing Class Evaluation)
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Care Organizer/HED:
I. Objectives for Care Partners - Trainer: PPT Slide 8
II. Refer to Systems Access Checklist and show them how to find Create Assignment under
Links in Care Organizer and HED.
HED Charting VS/I&O:
Vanderbilt is not totally paperless but most of your work is charted in HED
I. NAVIGATING HED – Click on HED from Care Organizer screen
A. Initial Screen
 HED defaults to the unit the computer is on, this room is 7N
 Change the census by clicking on the unit dropdown box
 Opens to VS/I&O Tab. More tabs in train than you will actually see
 Care Assistant tab is next to VS/I&O tab.
B. Main Screen
 Read from left to right.
 Pt name- click on down arrow to change to a different pt
 Allergies are imported from HEO/Wiz
C. Toolbar above pt name
 Review documentation
D. Left Menu Bar… jump to correct area
1. Click Output to navigate to that category in the column to the right.
2. Click Critical Result to navigate back to the top of the left menu
E. Vertical Columns
1. Note DATE and TIME column is documented
2. Scroll down and Left & Right to view all info
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3. Click arrows to go back & forward in time.
II. SHOWALL
Trainer: HED opens in display mode. NO boxes to enter data- only see data previously entered
1. Click Chart
Trainer: White boxes appear for data entry
 Chart opens to current date and time
 Save button lower right
 SHOWALL: HED displays only categories & items that have been charted.
2. Click SHOWALL in left menu bar. Displays entire list of items in menu, not items
previously charted. Notice CT levels
3. Click SHOWALL for Vital Signs: Displays all items in Vital Signs category not just the
ones that have been charted on.
4. Click SHOWALL again. Show all is a toggle- expands & collapses.
Trainer LEAD: Data to chart… 30 minutes ago you collected the following info
 101.4 oral
 Radial pulse 112 … enter comment “Nurse notified”
 Pulse Ox 98%
 O2 @ 2L/min per NC… pt resting
 BP: 144/90 R arm
 Intake 60ml
 Output 300ss urine – clear amber urine
 Emesis x1 large amount
III. DOCUMENT VS
1. Click the blank temp box, type 101.4. F is the default.
2. Click oral from the drop down box
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3. Click exclamation point. Highlight the value in red, making it a “significant finding”
toggles on and off
4. Click heart rate/DAS. Cursor is placed in box & line is highlighted in yellow
5. Type 112.
6. Click Radial from the drop down box
7. Click Post it Note. Type short comments “notified nurse”
8. O2 Sats = 98 on Oxygen
9. O2 Liter flow = 2 per nasal cannula
10. NBP = 144/90 right arm
Intake section on the Left bar
12. Type 60 - no need to type ml or what type of liquid consumed
Trainer: Jump to Output on the Left bar and click SHOWALL
1. Urine: Type 300
2. Emesis: Type 1 in blank box for emesis (o). (1) Occurrence, unable to measure, similar
to typing x1 on paper.
Important to chart accurately so the computer will add the I&O accurately
3. Annotate with sticky note details, i.e. large amount
4. Change time to 30 min ago.
a. Double click in time box until it turns dark blue
b. Type time. Can also click on the arrows
Trainer: Document in REAL time. Remember, clinical decisions are made based on the
nursing Flowsheet in StarPanel that providers are checking frequently. Do not wait until end of
shift to input data.
IV. SAVE DATA
1. Yellow check mark on the Vital I&O tab
2. Click Save
3. Review data entered, time and date. Could change on this screen
4. Click Confirm
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5. View now collapsed to what has been documented.
6. Point & hover to see annotation info
7. Notice yellow check mark gone
8. Click “Show All” to display categories.
9. “Show All” for each system 1X per shift to not miss anything
HED Charting VS/I&O:
LCD 9 PPT V/S & I&O data return demo
Trainer: Enter information from the PPT slide. Raise your hand if need help.
Temp 99.8
 Pulse radial 98
 Respirations 18 visual
 Pulse ox 98% on room air
 BP = 122/68 left arm
 Weight 188 lbs
 Intake 400
 Foley output 300
 Stool X 1
Trainer Debrief:
o What did you learn new?
o What was hard?
o What was easy?
HED Charting:
Trainer: Data to chart
 50% Breakfast
 Clear liquid diet
 Mouth care
 OOB to chair with assist of 2
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 Thigh high Sequential Compression Devices applied
 Elevate HOB 45%
 Incentive Spirometer 800 ml
VIII.
INTERVENTIONS and ADL
1. Click Nutrition By Nursing in left menu bar
a. Click Patient Diet. Clear Liquid
b. Click Breakfast. Type 50% of meal consumed.
Trainer: Where would you enter patient consumed 120 ml of juice? I&O tab.
5. Click Activity of Daily Living
a. Mouth Care: check done
6. OOB to chair. It takes 2 people to get patient up. (Assist 2)
7. SCD: thigh high applied
8. Elevate HOB: 45 degrees
9. Incentive Spirometer: Trainer: Where is Incentive Spirometer? Jump to Pulmonary –
Show ALL. 800 ML X 6
Trainer Debrief
o What did you learn new?
o What was hard?
o What was easy?
Practice (15 minutes):
LCD 10 PPT Interventions Return Demo
Trainer: Enter information from the PPT slide. Raise your hand if need help.
 Ambulated patient with assist of 1 X 150 feet
 Bathed patient with moderate assistance (annotate)
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 Positioning Care – click Done
 Full liquid diet for lunch – consumed 75%
 Intake 240 ml (V/S&I&O tab)
 Foley Output 300
 Stool X 1
Trainer Debrief
o What did you learn new?
o What was hard?
o What was easy?
HED Charting – Making Changes and Corrections:
IX. CORRECTIONS
Trainer: CHANGE TEMP TO 102.4 and add a comment “Nurse notified”
1. Click VS Tab
2. Click 101.4
3. Click blue boxes
4. Type 102.4. Other fields can be modified from this window
5. Click Save
Trainer: What Changed? Parenthesis around the value
Trainer: Time Limits on Making Changes
 72 hours on admitted pts to correct mistakes
 48 hours on discharged pts.
 Only Information YOU enter
X. ADD TO PREVIOUS TIME SLOT Respirations, 24, add to first timeslot
1. Click chart
2. Change the time to previously charted timeslot
3. Type 24 under respirations
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4. Choose visual from second drop down box. Note data entered earlier in timeslot
5. Save
6. Confirm
LCD 11 PPT communication scenario
LCD 12 PPT communication answers …show this slide after they discuss what should be
communicated
Communication
Communication between the RN and CP is very important.
CP QUESTION
You are working with a new RN, right out of school today.
Your patient (Mr. Jones) had a lengthy ICU stay, isn’t
eating much and IVs are infusing. Your RN partner tells
you she is concerned about this patient’s nutritional status
and overall condition.
What should you communicate to the Nurse?
V/S and I&O
 Let you know if decreased output, even though
he/she charts it
 Food eaten
 Skin
What should the Nurse communicate to you?
 Strict I & O, V/S.
 If pt given Lasix or IV Bolus
 Discuss at beginning of shift
Play HED Game Show (time permitting)
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Evaluate class
Instruct learners to go to SSS web site and complete MR evaluation
Class Stops here for now
End of Class Duties
3. Update Amanita (if student is in there):

Remove Training Flag

Comments: Trained MR Class (date/yr)
4. Add New MR to SSS distribution list in the correct location (VCH or VUH) – Julie to do
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