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ED Phase 3 Training for Nurses

ED Phase 3 Training for Nurses. Should be documented within the Triage Screen. On the Allergies/Home Meds tab Computer Based Trainings:. Home Medications. Home Meds Questions?. OM Ordering for RN’s Order Source: Either Verbal or Med Exec Approved

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ED Phase 3 Training for Nurses

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  1. ED Phase 3 Training for Nurses

  2. Should be documented within the Triage Screen. On the Allergies/Home Meds tab Computer Based Trainings: Home Medications

  3. Home Meds Questions?

  4. OM Ordering for RN’s • Order Source: Either Verbal or Med Exec Approved • Order Source of Med Exec Approved should be utilized for RN Protocol Order Sets • Order Source of Verbal should be used in emergent situation only (use your professional discretion)

  5. Ordering IV Fluids

  6. Select New Meds Select New Meds to order IV fluids

  7. Search for IV fluids using the type ahead look-up. Place a check mark next to the fluidyou want to order Click Next to continue. Search for IV Fluid by Name

  8. Select the volume you want to administer Note the OK is not lit Click on the blue edit to enter the rate Select the Volume to Infuse

  9. Titrate defaults to No Type in the rate mls/hr defaults in the units field Click OK > Save Enter Rate and Units ml/hr

  10. Order Sets

  11. Click on New Sets House sets on the left; specialty sets on the right Click on the + to expand the ED RN Protocol sets Check the order set (s) you need ED RN Protocols

  12. Order set expands to a pick list w/scroll bar on the right to scroll down the list Check all the orders you need: NEW status Note orders that have already been ordered Click Edit all to complete required fields > OK > SAVE Order Set View

  13. If you need an order that is not contained in the set click on Any Order Any Order

  14. Any Order, continued You can add orders, meds, or sets. This example shows adding a Rapid Group A Strep which was not part of the order set The order will show at the bottom of the set under “Additional Orders”

  15. Code Orders Major Trauma Restraints Stroke STEMI Blood Product Request for Transfusion What Stays on Paper

  16. eMAR/BMV Training Session

  17. Introduction eMAR/BMV MAR Layout ACK Orders from RN Tracker and MAR Prerequisite CBT Viewing: Agenda

  18. The ED Physicians will be placing order in CPOE (computer provider order entry) this will now include medication orders RN’s will be documenting and scanning the Medications through scanning/BMV (bedside medication verification) on the eMAR (electronic medication administration record) Introduction

  19. Medication Administration Record (MAR)

  20. MAR Layout EMR, PCS, & OM Routine Buttons Inclusion Criteria MAR Headers Footer Functions

  21. MAR Headers • Clickable & Sort able • Start/Stop • Status • ACK Status • Medication • Route • Scheduled times

  22. Time Column • Time Column • Scheduled times • Last administrations

  23. Start and Stop Date and Time Please note: Once and One Time Medication will automatically stop one minute after being ordered. This does not mean that they can not be documented against.

  24. Active Order is active and available to administer Discontinued Order has been discontinued Canceled Order has been cancelled MAR Order Status

  25. Unacknowledged Acknowledged Rejected ACK Status

  26. Medication Information Jump to the next slide to review the information in the med order info cell.

  27. Medication Order Cell Generic Name Dose Route Frequency Schedule Trade Name Rx Number Symbols: Addl Info Give Field: How much of the dispensed dose to give. More about the Give Field on the next Slide… PRN Reason

  28. MAR Symbols Associated Data Titration Drug Monograph Special Instructions Assessment Protocol Co- Signature

  29. Clickable & Sortable: Symbols Links Co Signature Titration MAR Symbols: Clickable

  30. GIVE FIELD Ordered Give Dispensed Give Field: How much of the dispensed dose to Give to Pt ie: Give 2 Tabs of the (dispensed) 325 mg tab 2 Tabs x 325 mg (dispensed) = 650 mg (ordered)

  31. GIVE FIELD: Split Tab Give Give Field: How much of the dispensed dose to Give to Pt ie: Give 1/2 Tabs of the (dispensed) 50 mg tab 1/2 Tabs x 50 mg (dispensed) = 25 mg (ordered)

  32. GIVE FIELD Give Give Field: How much of the dispensed dose to Give to Pt ie: Give 6 ml of the (dispensed) 100 ml/4 ml suspension 6 ml (admin) x (100 mg/4ml) (dispensed) = 150 mg (ordered)

  33. GIVE FIELD: Partial Injection Give Field: How much of the dispensed dose to Give to Pt ie: Give 2.5 ml of the (dispensed)5 mg/5 ml Ampule 2.5 ml (admin) x (5 mg/5ml) (dispensed) = 2.5 mg (ordered)

  34. GIVE FIELD: Multi Dose Container • Give Field: Does not appear • Dose Instructions indicate Multi Dose Container • Order Indicates amount to administer & units as appropriate

  35. Viewable Dates • Viewable Dates • Currently: Yesterday & Today • You can manipulate the display to determine appropriate viewable date range

  36. Refresh: Refresh new data manually Change View: Changes the view of data displaying on the MAR Document: Document an administration (manually-not using scanning) Not Recommended! Document Unscheduled: Document an administration that is not scheduled Document Assess: Document an MAR assessment Detail: View the detail of the MAR Order Manual Barcode: Enter Medication Barcode Manually Renewal: Will not be utilized Schedule Comment: Enter a comment for a medication schedule MAR Layout Footer Functions

  37. Medication Detail Screen

  38. Medication Detail Panel Includes Many Tabs of Order Information • Med Detail Info Tabs • Detail • MAR Detail • History • Audit Trail • Flowsheet • Assessment Documentation • Associated Data • Related Queries, Labs, etc • Protocol/Taper • As Indicated • Order Detail • Audit

  39. Medication Detail: History Tab Order Information Audit Trail Line Items Audit Trail Detail

  40. Medication Detail: Flowsheet Tab Flowsheet Documentation as associated to the Medication

  41. Medication Detail: Monograph Tab Order Detail • Medication Monograph • Viewable • Print-able • English/Spanish

  42. Medication Detail Associated Data Tab Order Detail • Associated Data • Query Documentation • Lab Results

  43. Medication Detail: Protocol/Taper Tab Order Detail • Associated Data • Query Documentation • Lab Results Protocol or Taper as Indicated

  44. Order Detail Order Detail Fluid Volume Info Titration Info & Protocol ACK Audit Trail

  45. Medication Detail Panel Review All of the info just covered, is viewable from the MAR Detail Tab • Med Detail Info Tabs • Detail • MAR Detail • History • Audit Trail • Flowsheet • Assessment Documentation • Associated Data • Related Queries, Labs, etc • Protocol/Taper • As Indicated • Order Detail • Audit

  46. Questions on MAR Layout?

  47. Next, topic: Acknowledging Meds • Two Methods to Ack Meds • RN Tracker • MAR

  48. Acknowledging Orders • Two places to Acknowledge Med Orders • MAR Ack Routine • RN Tracker Ack Routine Acknowledging Orders from the RN Tracker will Auto - Ack on the MAR!

  49. To Acknowledging from the RN Tracker: Click on the ACK prompt from your Tracker RN Tracker ACK

  50. List of Medication Orders and Status of Each Place a checkmark to the left of the first Order RN Tracker ACK

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