Transcript Adding and Documenting Medications

Anesthesia Manager Training
Adding and Documenting Medications
Date
Presentation Title
Objectives
By the end of this module the participant will be able to:
Be
Be
Be
Be
Be
Date
familiar with the Medications (All) flowsheet
able to add a dose to a default medication
able to add non default medications to the flowsheet
able to modify, delete a dose of medication
familiar with the medication summary
Presentation Title
Medications (All)
Default Flowsheet
Default List of Medications can
be found on:
• Anesthesia Summary Flowsheet
• Medications (All) Flowsheet
Can be organized by:
Organized by
Subheadings
• Subheading
• Alphabetical
List is a compromise with
nursing
• all meds will carry over into the
postoperative period unless
cancelled/discontinued
Date
Presentation Title
Medications (All)
Flowsheet
Organized
alphabetically
Date
Presentation Title
Adding a Dose for a Default Medication
1. Click cursor at desired
time-Document Window
opens
3. Adjust
time if
required
2. Enter dose
4. Change
route if
required
5. Hit
check
mark
Date
Presentation Title
Adding a Dose for a Default Medication
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Standard Option
1. Mouse turns
to hand when
placed over the
“Medications”
title bar
2. Can choose “All
Families” or a
“Specific Family”
•List of drugs appears
“All Families” will list ALL drugs
in the database alphabetically.
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Standard Option
Selecting a family will list ONLY the
drugs specific to that family in
alphabetical order
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Standard Option
Mouse turns to hand
when placed over a
specific Medication
subheading
Date
Only medications
specific to that family
will be listed
alphabetically
Presentation Title
Adding Additional Medications to the Flowsheet
Standard Option
Regardless of option used to
add a new medication, you
can now:
“Add and Document”
• Brings up “document
window” prior to order
appearing on the flowsheet
 Can
 Can
 Can
 Can
 Can
adjust time
adjust volume
enter additives
set pump rate
adjust site
“Add”
• Enters new order onto the
flowsheet
• User must now click on desired
time on the timeline to open the
“Document Window” and enter
information
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Protocol Option
Protocols
• are groups of standard orders
that you can add to the patient
chart in part or in whole
• Anesthesia Manager has been
configured with multiple drug
protocols which classify
medications by families or other
logical means
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Protocol Option
•Selecting any of the
medication protocols will
list:
•Drugs/drug combinations
or infusions specific to that
family rather than just
single drugs as per
previous methods
•Drugs/drug combinations
or infusions that are
commonplace in
anesthetic practice rather
than ALL drugs as per
previous methods
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Protocol Option
•Eg: Selecting the *Anes_Analgesics protocol will list all common
analgesics/analgesic infusions and drug combination analgesic infusions
Date
Presentation Title
Adding Additional Medications to the Flowsheet
Protocol Option
1. Click to select one drug or
multiple drugs
(*no need to hold down shift/control)
2. Hit “Add” button to
include selected
medications in flowsheet
Option 1
Date
Hit the “Add” button to select ALL
drugs/infusions/combinations
Option 2
Presentation Title
Adding Additional Medications to the Flowsheet
CAUTION
DO NOT USE THE EDIT KEY WHILE IN PROTOCOLS
YOU CAN CAUSE REPROGRAMMING OF THE DATABASE
(version bug)
Date
Presentation Title
Let me BE CLEAR
DO NOT USE THE EDIT KEY WHILE IN
PROTOCOLS
YOU CAN CAUSE REPROGRAMMING OF
THE DATABASE
(version bug)
Date
Presentation Title
Documenting a Second Dose of Medication
1. Click on previous doseDocument Window opens
(same time block)
3. Enter additional dose
(default will be previous
value)
4. Hit check
box
2. Click on “Add
Dose”
Date
Presentation Title
Documenting a Second Dose of Medication
(same time block)
Total dose is preceded by an
= sign to indicate divided dosing
Display of Doses given
In real time, you must wait at least 1 minute
before attempting to add an additional dose to
the initial dose
(above example shows 50 mcg at 21:08:10 and
50 mcg at 21:09:40)
Date
Presentation Title
Modifying a Dose
1. Click on dose that
you want to changeDocument Window
opens
3. Modify the
dose
2. Check the time of
dose that you want to
modify
Date
4. Hit OK
Presentation Title
Modifying a Dose
5. Agree to the
modification
Modified Dose appears on flowsheet
Date
Presentation Title
1. Click on dose that you
want to undo/deleteDocument Window opens
Deleting a Dose
4. Agree to the
modification
2. Check the time of
dose that you want to
undo/delete
3. Hit “Undo”
Dose removed from the flowsheet
Date
Presentation Title
Adding a Combined Medication (Bolus)
Combined Medications are found under “Protocols” and can be:
• IV bolus and infusion - Simple (2 drugs)
• IV bolus and infusion - Complex (more than 2 drugs)
• Epidural bolus and infusion
• allows for documentation in one document window rather than multiple
document windows
• Represented by a “pill bottle” icon
 We can’t do anything about the cost prefix
Date
Presentation Title
Adding a Combined Medication (Bolus)
2. Populate dose fields of
the respective meds.
1. Click at desired time
of administrationDocument window
opens
Date
3. Hit check
mark
Presentation Title
Adding a Combined Medication (Infusion)
Date
Presentation Title
Adding a Combined Medication (Infusion)
Bolus infusion
•
represented by
absolute units of
measurement only
 (eg. mg)
1. Click at desired time
of administrationDocument window
opens
Continuous Infusion
•
Date
Represented by units
of measurement/+weight/+- time
 (eg. mg/kg/hr)
Presentation Title
Adding a Combined Medication (Infusion)
Building the Combo
1. Add the drug
masses to your combo
2. Default fluid
volume=20mL.
Adjust if required
3. Enter weight if
required
Build your combo med as if you are filling a syringe with the different amounts of the
respective drugs-entering doses at this point will result in FAILURE.
Date
Presentation Title
Adding a Combined Medication (Infusion)
Building the Combo
4. Either enter in the dose of:
5.
a. ONE of the combo meds
OR
b. the desired Pump Rate.
All other fields will populate
automatically.
Date
5. Hit
“OK”
Presentation Title
Adding a Combined Medication (Infusion)
Building the Combo
Combination Medication appears in both:
-Medications (All) flowsheet
-Med Infusions & Fluids (All) flowsheet
Date
Presentation Title
Adding a Combined Medication (Infusion)
Adjusting the Combo
1. Click at desired time
of administrationDocument window
opens
2. ONLY OPTION
-adjust the flow rate
Date
Presentation Title
Adding a Combined Medication (Infusion)
Adjusting the Combo
Reducing the pump rate by 50% reduces the infusion rate by the same amount
Date
Presentation Title
Medication Summary
Access by pull down menu
OR Medication Summary icon
Total Dose administered
over the current
encounter
Data sorted by
“Administration Time” OR
alphabetically OR by family
Date
Presentation Title
Adding and Documenting Medications: Exercise
Add a few doses of various default medications
Add new Medications to the flowsheet via:
• List of medications belonging to a specific family
• Using protocols
Add a second dose of a medication
Modify a medication dose
Review the medications administered in the Medications Summary
Date
Presentation Title
Questions And
Answers
Date
Presentation Title