Transcript Meditech Upgrade Online Education

Go-Live is November 17th!
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Go-Live Plan
1. Meditech 5.64 Upgrade is November 17th
2. There will be support from Tuesday thru Saturday evening;
flyers will be posted on the unit prior to Go-Live
Starting November 17th the
Meditech System will
automatically prompt you
into the new 5.64 system.
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Reviewing the Application Menu
Once you are logged into the
system you are at your main
desktop.
The main desktop is no longer
gray, and no longer has the
colorful, picture based icons
that we have grown
accustomed to.
Instead the application menu is
expandable and collapsible.
When there is a black arrow
next to the application name
on the menu that is your
indicator that there is more
information behind that menu
item, and it can be expanded. It
can then be collapsed when
you are finished.
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The Admissions Menu
From the Applications menu, you can click on the first expandable
menu, the admissions menu.
This will open up the Registration Management Desktop for you. As
you can see below.
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The Admissions Menu
continued…..
Clicking the Registration
Management Desktop
gives you the Patient
Transfer/Discharge
functionality
1. In Transfer- is for
transferring Inpatients and
Observation Patients only
2. Out Transfer- is for
transferring SDC or
Outpatients only (Preop &
Pacu areas)
3. Discharge- is for
Discharging Patients (you
select the type of patient
you are discharging from
the hospital from the drop
down menu)
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The Order Entry Menu
Click on Order Entry, since this an expandable menu, a second list will
appear. This is where the Nurse’s Main Desktop is now located.
Here you can access all of your ED Admission Reports, Reported Home
Medication Reports, Census Reports, Downtime Reports, etc.
*There are two new tabs located on the right menu
Recent- Shows a listing of screens you have accessed recently in
your current session
Frequent- Routines that you use most often
Click on PCS Worklist to get to your status board.
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Status Board
*Note- If you document against an assessment before it is due, the pink
will go away…Example- your AM assessment is due at 0800 but you
document against it at 0730, the assessment will not pink up until the
next time that it is scheduled!!
Nothing has change with the method that we add and remove our
patients.
However, our status board does look different in Meditech 5.64. Notice
the new Order column on the far right.
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Order Entry
Changes
Orders Entry is still basically the
same in the new version of
Meditech.
Remember just like in the current
Meditech, in the upgrade Red Print
identifies a duplicate order on the
set, or an active order already
entered on the patient.
However, you will notice some
cosmetic changes to Order Entry
with the Meditech upgrade.
A Red Edit button identifies orders
that need to have further detail
entered before filing
While a Blue Edit button does not
require you to enter anything
additional before filing
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Viewing and Acknowledging Stat
Orders
Let’s ACK orders from the Status
Board against the orders in the
chart (instead of Order History)
1. All STAT orders are listed first
and are Pink
2. To ACK the order click on the
word Stat
3.The Order Detail screen will
open
4. Review the computer entered
order with what the physician has
written and if both match, initial
the order in the chart place a check
mark next to ACK by the Order
Once you have selected the Stat
Order and reviewed click
Acknowledge at the bottom of the
Order Detail screen
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Viewing and Acknowledging Routine
Orders
Let’s ACK more orders from the Status
Board against the orders in the chart
(instead of Order History)
1. Since there are no Stat orders on our
patient now, there is no pink STAT in
the Order column instead there is a
gray ACK to alert you that there are
new orders to be acknowledged
2. To ACK the order click on the word
ACK
3.The Order Detail screen will open
4. Review the computer entered order
with what the physician has written
and if both match, initial the order in
the chart place a check mark next to
ACK by the Order
5. Since we have multiple orders to
review click Select & Next on the
bottom menu
6. Once all orders are reviewed click
Acknowledge at the bottom of the
Order Detail screen
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Acknowledging Orders from the
Status Board
1.
2.
Click the Acknowledge
Orders button at the
bottom (footer) of your
status board screen
This allows you to
acknowledge orders on
multiple patients. If
you use this method all
of orders will display
and be listed next to
the patient’s name
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Viewing Order History
Once all of the orders have been acknowledged then the order
column will be blank. You can click in the empty field (at the top
of the green Order column) and the Order History will
automatically launch
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Caring for a New Patient
1.
2.
New- will appear the first time that
you log onto the patient and shows
previous orders that have been ACK by
the previous RN caring for the patient
(will show the orders placed in Order
Entry in the past 14hrs)
Click on New
*Note- ACK orders screen will open and
allow for viewing the order history/detail.
Once you have reviewed the previously
ACK orders click Close to exit. The New
flag will go away
*Note- You will only see the word “New” if
there are no STAT orders entered on the
patient
*Note -If your patient has a STAT order you
will see the word STAT in place of the word
new
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Viewing Lab Results from the Status
Board
On the Status Board under the Results section, you will no longer
see the purple letters to indicate results. Instead you will see:
1. Pink boxed results are Critical
2. Yellow boxed results are Abnormal
3. Gray boxed results are Regular
Once you click on the Result notification the screen containing the
result will open. Once you exit the screen the notification and color
will disappear. The appearance and disappearance of the status
board notification is completely individual and is linked to your
Meditech login ID.
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Documenting Critical Lab Values
All Critical Lab Values require proper
documentation within 60 mins of the nurse being
notified by the lab of the critical.
The nurse should immediately informed the
physician that ordered the lab of the critical result
and document that the notification occurred
within the 60 min timeframe by using the critical
lab value document which is found on all SOCs.
Nurses must document that they were notified, if
the value was expected ( if it was a comment
about why), and the name of the person they
notified along with the date and time. The exact
critical value and any nurse actions taken as a
result of speaking with the physician is also
required.
Followed prescribed orders is only answered if a
order to address that critical value is already on
the chart otherwise it is left blank.
Unit Secretaries and NSTs cannot complete this
form, nor can they take calls for critical lab values
from the lab.
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Looking at
Medications
from the
Status Board
We can still click under Medications on the
Status Board to see the next 8 hours of
medication orders displayed.
However, now the IV orders display the entire
order, and remember you are able to access the
eMAR from the medications list
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eMAR View
1. Click on the eMAR
tab located in the right
main navigation menu
2. Notice that the font
is larger and that the
Dose
Instructions/label
comments are
collapsible
3. Next drug name,
dose, and dose due is
bolded
4. Click on the +/signs to open and close
the label comments and
dose instructions
*Note- You can also click on
the +/- Admin Instructions
Key to open and close ALL
dose Instructions and label
comments
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Check Interactions Feature in in the
eMAR
1.
2.
3.
Click on Additional
Functions
Select Check Interactions
Click on the Drop Down
Box
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Check Interactions Feature in in the
eMAR
4. Type in a Medication in the
Search field
5. Click Enter
6. Click on a Medication in the
Against Drugs list using the
drop down box
7. Once the Med ID is
highlighted click OK in the
bottom right
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Check Interactions Feature in in the
eMAR
8. The Interaction screen will
display
9. Click Close at the bottom
right
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IV Spreadsheet
1. In the right navigation menu click on IV Spreadsheet
2. Select OK to default the column time to Now
*Note- This is the exact same spreadsheet as the IV spreadsheet
Intervention. You will now document against the IV Spreadsheet
here, it will no longer be part of your SOC and you will no longer
be able to add it to your intervention list
The font and appearance is slightly different.
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IV Spreadsheet
Let’s document IVF intake for a Med Surg
patient
1.
2.
3.
A column is inserted when the bag is
hung and a “0” is placed as the inake
amount , this “0” acts as a
placeholder because our hospital
policy is to only document fluids that
have infused into the patient
Now at the present time you can
document the intake, rate and site.
Our patient was receiving a bolus of
500cc of his IVF over the last hour.
M/S documents lump totals for IVF
intake every 8 hours
*For critical care areas they would enter
the intake and the rate for every hour
versus a lump total every 8 hours
*The zero indicates what time the
IVF/med was hung and the total volume
infused should be entered once the bag
finishes. The time from the “zero” entry to
the total volume is how long the IVF/IV
med took to infuse
4. Click Save in the bottom right hand
corner
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Intake and Output in the EMR
1.
2.
In the right main navigation
menu click on the EMR
Click on I & O
*Note- Remember that the Intake
and Output add up in the
EMR. You can select different
“hour” views for specific
amounts and totals
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Help Key
There is a help key at the bottom right
of the screen that is much more
helpful. When you have a questions
regarding a screen that you are
viewing or documenting against then
you can access the Help key
1. While viewing the I &O screen in
the EMR click on the Question Mark
located in the bottom right menu
2. The Help Screen will open and
contain information regarding the
screen that you are viewing or
documenting against
3. Click the black X at the top of the
screen to exit the Help screen
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Notes
1. Click on Notes located on the
right main navigation menu
2. At the bottom click on Enter
3. The date and time will default to
the present. To change the time
click on the current time (Note the
new Time box).
4. To write your own note, just
move your cursor to the large white
space and begin typing.
5. We now have spell check, just
click on the blue checkmark in the
tool bar.
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Canned Text Notes
1. Click on Enter at the
bottom of the screen
2. Click in the white text
area
3. Add a canned text
note by clicking F5 for
the “get” function
4. Next click F9 for the
“look up” function
5. Choose the Admit To
note by clicking on the
title
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Canned Text Notes
*Note- a note template drops in, and you are still able to fill in the blanks by free texting and also
by choosing from a drop down
1. You are able to free text information into the blanks, or add information as
necessary
2. Click F12 to advance to the next section for completion
3. Scroll through the list and highlight the Stretcher option
4. To Select that as the option click on it when it is Highlighted Green
5. Once you have completed free texting in the fields click F12 to enter the note
6. Click Save in the bottom right corner
7. Click Close in the bottom right corner
Remember you can spell check by using the blue checkmark.
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Care Plans
1.
2.
3.
Click on Process
Plans located on the
right main navigation
menu
Click on Enter at the
bottom of the page
Click on Care Plan
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Care Plans
1.
2.
3.
Click on Process
Plans located on the
right main navigation
menu
Click on Enter at the
bottom of the page
Click on Care Plan
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Care Plans
4. Type in Capital
Letters “MS”
5. Click Enter to add
the Med Surg Care Plan
6. Click Enter Twice to
accept the default date
and time of Today and
Now
7. Click Save at the
bottom of the screen
8. Click Close
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Care Plans
Next, Prioritize your problems in
your care plan, by clicking Edit,
then Prioritize Problems.
Now, you can rank your problems
in the Priority new column. 1 is the
most important problem in your
opinion for this patient. You may
have multiple 1’s or 3’s, etc. Every
problem must be ranked.
Nothing has changed with the way
that we document on our care plan.
We still document against the care
plan under Outcomes just as we
normally would.
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Reconcile Meds
Most of Reconcile Meds is the same in the
Meditech upgrade as it is now.
The cosmetic difference that you will notice
is that once you have added a medication to
your patient and saved, then click on Last
Dose Taken the Last Taken screen is
different. You now have a calendar, a time
calculator. However, the fill in the blank
box for the dose remains the same.
Today’s date and current time will
automatically default on the screen. If you
patient does not know the date, time or
dose, click clear on the bottom left then
type unknown in the dose blank and save.
Otherwise, just change the needed
information so that the screen matches
what you patient tells you, and save.
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This functionality allows you to
compare and trend different
Numerical data…
Toggling for
Graphs
Here is an example…
1. Click on the EMR
2. Click on the Vital Sign’s tab
3. Right Click in the yellow Blood
pressure area
4. Select the Toggle for Graph
option
5. Next click on the I&O tab
6. Right Click in the yellow IV
Total area
7. Select the Toggle for Graph
option
8. Next at the bottom of the screen
select the Graph option
*Click Clear in the upper right hand
corner to remove the toggled
information
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Questions??????????
Contact
Cindy Ellis
[email protected] or 443-849- 6014
Sharon Rowe
[email protected] or 443-849-2515
Lisa-Marie Williams
[email protected] or 443-849-2137
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