When we went live with POM, we went through the intervention dictionary and made all the ones a physician might order as 'orderable', such as VS, suctioning, etc. We also have an OE Admission order set with Admission assessemnt, VS, HT/WT, etc. which ADM staff enter when the patient is admitted. That way the nurse is ready to go when patient arrives on floor (we are mainly amb surg and had to find ways to speed up process). Marge Usher Clinical Systems Manager The New York Eye & Ear Infirmary 310 E 14th Street New York, NY 10003 212-979-4134 [EMAIL PROTECTED]
________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Discoe-Keough April Sent: Thursday, January 18, 2007 4:00 PM To: [EMAIL PROTECTED]; alidalee gingerich; meditech l list Subject: RE: [MEDITECH-L] nursing orders Hi Can I ask how you handled moving over to CPOE /POM per Meditech; without all possible nursing orders being available or are you not there yet? Thanks April ________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Sunday, January 14, 2007 10:41 AM To: alidalee gingerich; meditech l list Subject: Re: [MEDITECH-L] nursing orders The facility I work for now does not use OE to enter Nursing orders. We have an electronic kardex (a profile in NUR) that autoprints near the end of the shift for the handoff,so in order to make Nursing orders display there, we created an intervention called Kardex with a CDS that is built to enable staff to transcribe orders for Nursing, and that CDS is part of the profile via the SCREEN component. The facility I last worked for used the same kind of kardex in the same way, and also used OE for Nursing orders, but only for very specific, physician-issued, key orders. For example: DNR. Restraints. The entry of these orders added an intervention in Process Interventions. Because only high-risk type orders created an intervention, the intervention list stayed short. These orders didn't have to be transcribed to the Kardex intervention screen; they were included on the Kardex profile using the Order component. More common orders, such as for ambulation, were simply transcribed to the Kardex CDS, and documented on the Ambulation/Transfer/Bed Mobility intervention CDS that was part of every care plan, and used by both Nursing and PT to show compliance to the order, but also to chart additional information that is expected from these disciplines, such as assist devices used, distance walked, activity tolerance, etc. >From following the L for many years, I get the sense that some facilities have many or all physician orders for Nursing set up this way, but have found that it can create a mess for the nurses in Process Interventions. Before you decide on the approach you want to use, you might want to compare common physician orders with the content of the screens for the core interventions you have in every care plan. If, for example, you have a screen for meals/appetite that's part of your documentation standards for all patients, and one of the orders you need to accommodate is "assist patient with eating", that screen might be the place to simply add a query for feeding assistance with a lookup with choices from none to total. The nurses would have to continue transcribing this order to their kardex, of course. If you make every physician order for nurses an OE/NUR intervention order, you could end up with a very congested care plan in Process Interventions, with many screenless interventions that nurses will document only by filing the time & date stamp, and even though there's lots of other information they should chart that's associated with these orders, they won't chart it because they'll feel they've already done all they are expected to do. If you DON'T set up all orders this way, the nursing staff will have to memorize what goes on their Kardex and what goes in OE, which could lead to serious error. Either way could call for a lot of education of the staff. You'll find a happy medium somewhere. A year from now, somebody else will be asking the same question and you can write and let us know what you did and why and how it worked. Good luck! Sharon -------------- Original message -------------- From: alidalee gingerich <[EMAIL PROTECTED]> Questions as to how all are using nursing orders: Who builds them as OE category Nursing, with the type as nursing so they are on the intervention list for the users or Who builds them as just regular orders, not nursing type & the orders do not go to the intervention list? What do you all do for kardexs? We have not been placing our nursing orders into Meditech, but will be changing that process. I wanted to review how others used it since it could be 2 different processes. Thanks much AlidaLee Gingerich RN, BSN Applications Specialist Acute Care Nursing Office 970-871-2452 Pager 970-870-5873 ________________________________ Everyone is raving about the all-new Yahoo! Mail beta. <http://us.rd.yahoo.com/evt=45083/*http:/advision.webevents.yahoo.com/ma ilbeta> ________________________________ BHS CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify Berkshire Health Systems immediately by e-mail at [EMAIL PROTECTED] and destroy all copies of this communication and any attachments.
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