Name of Group/Meeting: Nursing Informatics Advisory
Committee (formerly HED Advisory Committee)
Date / Time / Location: June 6, 2013, 2-3pm, 5053/54, MCE, North Tower
Next Meeting: June 20, 2013, 2-3pm, 5053/54, MCE, North Tower
Chair: Vickie Thompson, Karen Hughart
Attending: Arlene Boudreaux, Elma Bunch, Kathleen Burns, Heather Campbell, Jennifer Campbell, Jennifer Erickson, Karen Hughart, Val Kibler, Abigail
Luffman, Lillian McGehee, Maria Morrissey, Shelly Padgett, Connie Pollard, Nancy Rudge, Martha White,
Meeting Objectives:
1. Information sharing on new features & training and implementation plans if applicable
2. Decision making on new enhancements
3. Begin to identify significant enhancements needed (for future prioritization).
AGENDA
MINUTES
Who/Time
Karen Wilson and
Sub. Comm. ,
R0030266 & other
requests , 5 min.
Topic
Present recommendations for Arterial Line
documentation changes. (see below)
Summary / Decision
Changes approved as presented without change
Next Steps
10N, R0041964, 10
min.
Add an additional column for Bed Number to right side
of Inpt. Whiteboard screensaver (in addition to the
Bed Number that anchors the left side). (see below)
Need feedback from users about desire for change.
Suggestions to consider:
1. Decrease the space required for Attending MD column by
listing just last name, first initial.
2. Decrease the space required for the Orders column by
displaying “Orders” vertically instead of horizontally.
There was concern about adding a column for bed number on the
right side because it would have the unintended consequence of
compressing other columns and there were concerns about difficulty
reading some of the content should this happen. Others felt the extra
column would add safety so if we could create enough space to add
this by making the changes suggested above, there was support for
this change.
Once we determine if
either or both
suggested change is
possible, we will bring
this back to the group
for final approval.
R0041981, Melinda
Cherry, 8N, 15 min.
“…use a prompt to enter blood pressure
measurements and heart rate prior to administration.”
What would be useful - Option for HR for cardiotonic drugs?
Clarifications:
 Only applicable HR/BP entered during the hour a med is being
administered would display.
 The nurse giving the med could either choose to save the value
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Work will now be
needed with Pharmacy
to identify the
cardiotonic and



R0020338,
R0042937
Option for BP for antihypertensives? Which
BP results? Both?
Neither?
(see options attached below)
Need an indicator for status of completion of Nursing
Admission History
Review indicator logic that will soon be put in place-Indicator will display as follows
1, Not started this admission - yellow
2. Started this admission but in draft state - yellow
with "D"
3. Not started this admission or in draft state
greater than 24 hours after admission - red
4. Adm hx form completed this admission - green
R0014780
in connection with the med. administration, enter a new one,
or leave it blank. The field is not required so practice standards
should drive usage.
 These HR & BP fields are shared with Vitals/I&O Tab, Quick
Assess, etc. so that results for these values entered on one of
those other tabs would display on the AdminRx tab (if entered
during the hour the med is administered) and results entered
on AdminRx tab would display on the other tabs were these
results can be documented.
Decision:
 Because all BP types of the longer list are used regularly,
the group decided to make the longer list of HR & BP
results available on the AdminRx tab in association with
Cardiotonic & Antihypertensive meds.
antihypertensives with
which HR & BP entry
fields will be
associated.
Specific BP results to
include:
Additional information:
This is NOT the same indicator we used when StarForm Admit
History was first put in place two years ago. That indicator looked
at every single field and was triggered when required fields in any
section were not completed. This indicator looks at whether an
Admit Hx. Form is started or completed.
Additional Discussion:
The indicator will help but will not solve all the problems. There is
lack of accountability for completing a form started by someone
else. The Immunization screen is not required while patients are in
ICU level of care so almost all pts. coming from those units will have
Admit History forms that are incomplete. The indicator will make it
more visible when a form is not started or not completed but
additional effort will be required to really solve these problems.
We anticipate the new
indicator would be
available within a
month.
Placement of new Sensory section with Eye
Assessment (see proposal below)
There is agreement to place this new Sensory Care Category between
the current Special Neuro and Cardiac Categories on the left side bar
of Assessments & Interventions tabs.
Real Time data entry – what are the barriers?
Examples: Vital signs needed for PEWS; % meal intake
needed to correlate with blood glucose & insulin; etc.
In Acute care:

no computers in rooms
 have to pull a dinamap from room to room so cannot also
pull a WOW
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BP (NIBP)
BP mean (NIBP)
ART BP
ART BP (mean)
ABP
ABP (mean)
Manual BP
Systolc BP

long time to log in
 Decrease Care Partner
In ICUs:
 Decrease in Care Partner ratios
 Balance between providing direct care and documenting often
results in delay
 Long time to log in; more pronounced for ICU pts. with long
LOS due to large amount of data to be loaded with each sign
on.
All
5 minutes
Smart Beds data download to HED –
What is relative priority for downloading available
data?
[List of iBed attributes at bottom of minutes. .]
Clarification:
Only Stryker beds in CCT and a few other places are capable of
capturing and sharing this data. Since we do not use some of the
charting capabilities available on this bed for nurses to enter data, we
think only the data that comes from the bed would be useful.
Group voiced concern that the cables never stay connected and that
this is a known issue in the CCT. Trauma voiced concerns that they
might not even have the wiring capabilities to be able to connect to a
network. Great concerns about how the beds would connect to the
network to input data.
Updates and announcements & questions from
participants.
Brief downtime Sun., June 9 from approximately 6:55 to 7:15am. Email communication has gone out all week. There will be overhead
announcements 1 hr. and 15 min. before the start of the downtime.
Applications will not actually be down but due to maintenance on the
“firewall” (a piece of security that will prevent external hackers from
getting into our sensitive patient data), the connection between
these applications and the users will be severed for a brief time. As
soon as connectivity to the data center is restored, applications will
be instantly available.
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Attributes that would
be helpful if we could
capture them from the
bed:
HOB elevation
Bed position (eg.
Trendelenberg, chair
position)
Weight value
Approved -- Proposed Arterial Line Documentation:
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Deferred for further analysis -- For discussion re: changes to screen saver for Inpt. Whiteboard:
A. Add 2nd Bed Number column on right side of screen.
B. Move Bed number column to center of screen.
Page 6 of 11
Add ability to document HR and limited BP results:
We agreed on this version -- Add ability to document HR and all BP results:
Page 7 of 11
Approved -- Proposed placement for new Sensory care category:
iBed Available Data InTouch and S3
Page 8 of 11
Bed Information

Identification (Bed ID)

Options Available (Zoom, Scale, Bed Exit, Bed Exit Multi-Zone, Awareness)

IP Address

MAC Address
Bed Connection Information

Bed Connection Status

Room Location (Hospital Bed Bay Name)

Last Known Room Location

Room Location Module Connection Status

Room Location Module Battery Voltage

Room Location Module Low Battery Alert
Patient-Centric Information

Current Weight

Last Weight Logged
Bed-Centric Information

Low Bed Height

Brake (On, Brake Alarm Option On, Alarming)

Bed Exit (Armed, Alarming, Zone)

Siderails
o Patient Head Left Siderail Up
o Patient Head Right Siderail Up
o Patient Foot Left Siderail Up
o Patient Foot Right Siderail Up

Fowler (Head Section) Angle

Gatch (Foot Section) Angle

Trend Angle

Foot Angle

Base Angle

Foot End Height

Locks
o Gatch Lock
o Foot Lock
o Bed Height Lock
o Patient Bed Motion Lock
o Patient Bed Height Lock
o Patient Fowler Lock
o Patient Gatch Lock

Awareness
Page 9 of 11
o
o
o
o
o
Awareness Status (Armed, Alarming)
Awareness Monitoring (Low Height, Bed Exit, Siderails, Brakes, Fowler 30 degree Lock)
Awareness Monitoring (Bed Supine, Vascular Position) – InTouch only
Awareness Alerting (Low Height, Bed Exit, Patient Head Left Siderail, Patient Head Right Siderail, Patient Foot Left Siderail, Patient Foot Right
Siderail, Brakes, Fowler 30)
Awareness Alerting (Bed Supine, Vascular Position) – InTouch only
Protocol Reminders (InTouch only)





For all Protocol Reminders: Armed, Alarming, Expiration Time, Repeats
Standard Group
o Medication
o Temperature
o Turn Patient
o Weight Patient
o Check Blood Sugar
o Rotation
o Percussion
o DVT
o Intake / Outtake
o Oral Care
o Hand Washing
Pulmonary Group
o Head of Bed Elevation
o Sedation Assessment
o Daily Sedation Vacation
o DVT Prophylaxis
o Stress Ulcer
o Oral Care
o Rotation / Percussion
o Vibration Times
o Suction
Skin Care Group
o Skin Assessment
o Turning
o Braden Score
Restrain Group
o Release Restraints
o ROM
o Offering Food
o Fluids
o Oral Care
o Toileting
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





Fall Prevention Group
o Fall Risk Score
o Check Bed Status
GI Group
o Head of Bed Elevation
o Check Feeding Tube Placement
o Check Residual
Neuro Group
o Skin Check
o Pupilary Reaction
o Orientation of Patient
o Motor Strength
o Pronator Drip
Blood Glucose Group
o Blood Glucose
Mobility Group
o Head of Bed Elevation
o Turn
o Out of Bed
o Walk
o Chair Position
Patient Weight Group
o Auto-Store Weight
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