EDM Overview of 6.07

EDM Overview
of 6.07
A new red edit button indicates required
The Type, Severity, and Reaction fields
can be edited from the front screen
Allergies are sorted by Type, where Allergies
display first, then Adverse Reactions. Both are
sorted by Severity.
Home Med Entry
Two new statuses; No Home Meds & Unobtainable
Default to New tab to quickly enter multiple meds
The names of Free Text Meds (“Little Blue Pill”) can
be edited once they are identified
Enter name of drug only = unconfirmed status
Enter name and tablet strength = unconfirmed
Enter full details = confirmed status and can be
reconciled to inpatient
Like Allergies, No Home Meds or
Unobtainable can be entered with one click
System auto-defaults to New tab to
allow quick entry of multiple meds
Free Text Meds, like “little blue pill for
blood pressure” can now be edited to
the correct med once known
Enter name of med only and the 1st
tier is confirmed; overall status of med
is unconfirmed
Enter name & tablet strength but no
route and frequency; 2nd and 3rd tier
status will be unconfirmed
Enter name, dose, route and
frequency; 1st and 2nd tier show and
med status is confirmed
? indicates more info is needed to
confirm home med
New Home Medication Indicator
Home Medications Indicator Scheme
• If the Home Medications have been confirmed, a
green check will appear.
• If there are no known Home Medications, the
text ‘No Known’ will display.
• If the Home Medications are not confirmed, a
Red X will appear.
• If the Home Medications are not updated it will
display ‘Not Updated’.
• If the Home Medications are unobtainable,
‘Unobtainable’ will display
When you click on the Notes field off the tracker
you are presented with the following comment
screen. In order to save the typed entry one can
now press ‘ENTER’.
Within the Orders routine the lookup field auto
clears once you check the order.
There is now a larger character font for the
Public Tracker
A new Detail button is available on the Worklist.
Clicking it allows one to view further details of
the Assessments and/or Treatments
By clicking on the detail button you are shown the
Detail, History, and the Flowsheet of what was
Administration Process
Scan the Patient’s Wristband
Scan the vaccine
A screen displays showing the Vaccine Order
Click Ok
The screen defaults to the Protocol Tab
– View the Eligibility queries associated as protocol to the order
Click Flow sheet tab
– New queries
Click Admin Tab
– Error message indicating the VIS publication date is required if you
do not go to the Admin tab
Enter information into the New Immunization Medication Administration
Ok to File
The administration screen is different. The required fields are
the VIS publication date, Eff Dose, Dose, Injection Site, Lot
Number, and Expiration Date. The Eff Dose, Dose and VIS
Publication Date will automatically default in.
Within the Summary Panel in the EMR you can
see the Immunization that was administered.
If you click the Immunization within the Summary Panel
you are presented with the details of the
administration. You can also click the History Report
button to run a report on the Immunizations.
Helpful Reminders
Indicator color schemes
RAD Indicator:
If you placed an order in the category of Ultrasound , Radiology
MRI, and CT the indicator will show as follows if the order is in
the following status:
Taken = Cyan
Ordered = Magenta
Completed = Green
If you placed an order in the category of Imaging and X-Rays the
indicator will show as follows if the order is in the following
Taken = Cyan
Received = Yellow
Ordered = Magenta
Incomplete = Red
Completed = Green
LAB Indicator:
If you placed an order in the Microbiology category
the indicator will show as follows if the order is in the
following status:
Normal = no color
Critical = Red
Abnormal =Yellow
If you placed an order in the Laboratory category the
indicator will show as follows if the order is in the
following status:
Normal= no color
Critical= Red
Medication Indicator
• If a medication has been ordered but not
documented or administered than it will show
up as the following:
• Not Documented = Red Check
• Not Administered = Red Check
ED Downtime Procedures
Before Downtime begins the ED Summary
should be printed on any patients in the ED.
This should be started at least 60 minutes
prior to downtime and report placed on
• From the Tracker, click on Patient Reports
• Click the check in the upper left corner to
select all patients on the Tracker.
Click the Report button at the bottom of the
Type ED in the Patient Report Format field and
hit Enter
Choose ED Order Summary, ED Summary and
add Home Medication Downtime Report
The reports will populate the field. Click OK to print
the ED Order Summary, ED Summary and Home
Medication Downtime Reports for all the patients in
the ED.
Next, go to Clinical Custom Reports on your menu, then HFH Nursing Reports,
then Downtime Reports, and print the following:
Downtime MARs for all the patients on the floor
New Meds/Signature sheets
Unit Census
• To print Meditech Downtime Reports:
– Unit Census: Just click and print
– New Meds\Signature Sheet: Enter your Location and print
– Downtime MAR(format EMAR for Downtime):
• Enter:
• Location: Enter Hospital location (example: ED.HF)
• Start Date: T
• Start Shift: 1
• Alternate MAR Format: EMAR
• Alternate Printer: Enter your unit’s printer name
• Print Blank Pages: Y
**The printer name has to be entered or the MARs
will not print. It will not default in**
All documentation done during downtime remains on paper
Upon completion of a Downtime, the following should be entered
Pt’s that were in dept. prior to Downtime:
1. The last set of Vital Signs
2. Any I&O
3. A Downtime Note
Pt’s arriving in dept. during Downtime (Pt Access will place on Tracker.)
1. Enter Chief Complaint.
2. ESI Triage level
3. HT/WT
4. Allergies
5. Home Medication List
6. The last set of Vital Signs
7. I&O
8. A Downtime Note
•Nurses will need to reconcile the medications on the eMAR that were
given during downtime. On the eMAR, select the medication, then click
Not Given and give the reason for the non-admin as "Downtime-See
Paper Documentation".
Discharge Date and Time
End of Visit Time = Discharge Time
The End of Visit Time should
be the time the patient
actually left the Emergency
The End of Visit Time is the
time that should be entered
as the Discharge Time.
How to continue documenting after
the End of Visit time has been entered
•From the Charge Nurse Tracker, highlight
the patient and click on Add to My List
When a patient is leaving the Emergency Department
the Physician or Nurse should be putting the patient to
a status of ‘End of Visit (Final)’.
From the Charge Nurse Tracker, change
the Status to End of Visit (Final)
• This should be done when the patient
physically departs the Emergency Room
• The time entered should be the time the
patient physically departed the
Emergency Room
Complete documentation from the
RN Tracker
• Click on Lists
• Click on RN Tracker
The patient will remain on the RN
Tracker for you to document on
• The patient will remain on the RN Tracker after
discharge until you click Remove from My List
The Unit Secretary can then go into Find
Account to find the patient and click the
Open Chart button.
Once in the Open Chart routine the Unit Secretary can
go into the ED Visit Data button and click the Activity
tab at the top to see what time the Nurse or Physician
placed the patient to an ‘End Of Visit (Final)’ status.
The Unit Secretary then inputs the ‘End of Visit (Final)’
date/time into ADM Discharge. Discharge Date/Times
must be consistent between ADM Discharge and the ED
Nursing Disposition Documentation.
Documenting IV Start and Stop
All IV medications administered in the ED need
to have a Start and Stop time and the amount
infused documented.
The most efficient way to document these
values is to wait until the medication infusion is
complete and document all of these values at
the same time.
After an IV infusion is complete:
 Go to the IV Assessment/I & O
 If an IV medication is ordered, it will be listed under IV Medication
 Each medication should have the following documentation:
 Infusion Start Time
 Infusion Stop Time
 IV Intake
How to Document Titrations
Scan Patient
Highlight the medication
Click on Document Unsched
Initial Titration Screen
Initial Titration Screen displays for the initial administration only
•Enter Dose
•Enter Units as ML/HR
Must be in upper case
•Rate defaults in
•Click OK
Medication Administration Screen
The Medication Administration screen defaults to
the Prot/Taper tab
Flowsheet Tab
•Click on the Flowsheet tab
•The Rate values default in
•Enter the medication Dose
•Click Ok
Administration Screen
•The Administration screen will display
•Check that the rate is correct
•Click Ok
Summary of Medication
•The Summary of Medication
Administration Session displays for you
to confirm the final documentation
•Click Save
To titrate or change the rate
•Click on titration symbol
Document Titration Values Into Flowsheet
•Enter the Rate in ml/hr and Dose and Save
•Increase or Decrease will default in
according to the change in the rate