| These tips are a compilation from many nurses working with Meditech. Some I received from site visits to facilities in California, some from general discussion at MUSE meetings and some from Marianne Keane at HealthNet Consulting. Many thanks to Louis Rotondo at Little Company of Mary Hospital, Ron Rutherford at Citrus Valley, Bruce Mathias at Bakersfield for hosting a visit from myself and my coworkers. If you have any more tips I will be happy to add them, just email me at debk@olypen.com. |
| 5.4 Go Live Issues -
We went live with 5.4 June 2, 2004, here are some issues we found
in test and live.
Corruption on CDS with multiple queries. MIS 6820 Symptom: In my NUR cds’s where I had a multiple type query…particularly our Allergy query…it was dropping the first letter of the prompt. So, I saw LLERGIES instead of ALLERGIES
CDS screen corruption when using Recall (F5) function MIS 6884 Symptom: In my NUR cds’s where I had a multiple type query and I pressed F5…..of course, you would have had to fill it out once already….lots of screen corruption noted on screen when pressing F5 on a multiple type query
Kicked to code from List Note Category Dictionary NUR 6862 Symptom: Upon listing the note category dictionary, got kicked to goodbye
NUR Charges not crossing to BAR Charges I had set up in NUR to go to OE then BAR where not going….I have an OE fix in test 8772….supposed to fix it…will find out tomorrow. My advice is be sure to test carefully and see that any charges you have set up in NUR get all the way to BAR.
NUR new parameter for DI Default I like this one and just wanted to tell you about it. You can now set the default for where the cursor stops when you use DI from the Process Interventions screen. You can set it to stop at Date, Time or OK. I set it at Date because with DN they really only need to use DI when they need to change the date or time.
OE using consult category and OECONS query not working Symptom: We have a category to enter a consult and use the OECONS query. It is not working. We use this a lot to essentially open the record for physician office staff. It is not working. No fix just yet.
OE Patient Not Found flag is not appearing OE 8528 We did not notice this in testing, it is one of those subtle things you have a hard time realizing what is going on. Symptom: In OE, at the patient prompt, when
I enter a patient that is not in the system, I do not get the PATIENT
NOT FOUND flag. I get it in 4.9 test as usual but it
OE Not getting File Verified Y/N when filing orders Again, one of those subtle things we did not notice at first. Symptom: Enter orders and press F12….they just file…you do not get File Y/N. In looking at our task, I do not see a dts number associated with this, it just says “Fix for File Verified flag”.
OE Getting Press Return to Continue and should not In cds’s attached to OE procedures we are getting “Press Return to Continue” when we do not think we got it before. It seems to be happening on a procedure cds where the last query has an attribute, best I can tell at this point. Have not heard from meditech on this one and am not sure if it is a problem or WAD.
SCH to OE Link printing orders when it should not This is intermittent. In a SCH CLI status, order paperwork is printing when the appointment is booked. Typically, it printed when we pre reg’d the patient. That is how we want it to keep working. In most cases it does but not in all. Have not figured this out, nor has meditech responded.
PCI – they changed a little of how the esign prompts function You can now press Spacebar to check off all reports to sign them. That is good. If you just want to sign one report and have it highlighted, you now get a prompt Sign and Exit or just Exit. X is what you enter to Sign and Exit…if you use oldie. If you use NUI, it looks great.
PCI – discharged patients not disappearing from list Some docs are complaining that their discharged
patients are not disappearing from their list in PCI…like they
used to. I have not got enough info to figure this out just yet.
In talking to meditech, there are some changes in the lists but
I still do not understand it just yet and I read all the enhancement
data….I will be investigating this one further but it is somehow
affecting how docs lists appear…not sure which lists just yet.
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| Shared queries problem fixed in 4.8!! In the profile dictionary for screen component types that are set as historical, there is a new element in your popup box called USE DATA FROM, you can select PCI or NUR. PCI works the same as before, NUR pulls just data entered on that cds in the nursing module. It works great!!(added 6/19/2001) |
| Click here to see our IV Start screen. Site is required. For multiple sites, the user should enter multiple DI times and enter the appropriate site for each start time. Click here to see our IV site maintenance screen. The reason they are separate is because our charge for IV starts is attached to the IV start intervention. (added 6/9/2001) |
| Multidisciplinary screening. Click here to see a screen shot of our multidisciplinary screening tool that is at the end of our assessment. Each department submitted the questions they needed answered to perform a screening. These are then sent via an NPR to the appropriate departments and they determine if the pateint needs further evaluation by their department. (added 6/9/01) |
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Departmental Tips & Tricks CLICK HERE Handout from MUSE 2001 presentation on departmental reports. added 6/3/2001 |
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The Nurse Lookup. If the nurse has created her patient list, she can use the nurse lookup in the Process Intervention screen much like the location lookup is used. At the patient prompt, type N, space, NURSESMNEMONIC, then enter selects the first patient on your list. Once you exit this patient, your next patient appears. You can press F9 instead of enter and get a lookup of just your patients. added 6/3/2001 |
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FINAL PRINT FROM NUR Create 2 profiles. One is ASSESSMENTS, the other PROCEDURES. Classify your interventions to place in these profiles. Organize the profiles in the order in which you want to see the data. I try to do this logically, like a paper chart would have been. Then, create a multiple print format to include these 2 profiles and notes. I set mine to include all. Our final chart is then printed by medical records after the patient is discharged. The graphic flowsheets are printed daily on the floor and remain with the final record. Finally, include a summary that captures all edits of any intervention. We did this with a npr customized by Bobcat Software. Our charts now show a logical, chronological format of nursing documentation for the patient's stay. added 2/27/00 |
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DOWNLOAD A CDS You can download a cds and email it to a friend. Use the List cds function in MIS. Then, at the Print On prompt, type in DOWNLOAD. Save it to your drive. Then, attach it in an email. It can be opened in Wordpad and looks much like the printed version from Meditech. Added 2/27/00 |
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4.71 NUR Problems - We went live August 4, 1999. Canned Text - When entering a patient note and then get canned text, some sort of corruption any time you try to go beyond one line of text that wraps to the next line. You get odd characters or no characters or backwards typing. When you get back to the green screen, body of the note, you can edit it but meditech is working on a fix for this. Flowsheet Printing - If from the NUR Main Menu, I go to #19. Flowsheet (Format) and print a custom I created for a patient, then go back and print #14. Flowsheet (standard)....it prints the same custom that I did in #19. If I just print #14 for a patient and never printed #19. it prints fine. Meditech fixed this. Also, the flowsheet was printing some goofy characters where it usually printed the triangle, circle, etc. Meditech fixed this also. Flowsheet header - The room number and admission date were missing from the #14. Flowsheet (Standard) when we printed it. Meditech has a fix for this. |
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NIC could be used within Meditech by using DOMAINS as headers, INTERVENTIONS as interventions and placing all ACTIVITIES within the protocol dictionary. Added 8-25-98 |
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Consider using the JCAHO Standards as Intervention Headers. Added 8-25-98 Marianne Keane, RN |
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The protocol dictionary can be used to house policies & procedures, standards or protocols. Preface the description with PP, ST or PR...to identify what type of supportive documentation is included. Added 8-25-98 |
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Use the online documentation (Shift F8) to place standards of care at the nurses' fingertips. This can include practice standards and/or definitions of parameters used within a CDS. Added 8-25-98 |
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Create a PCI Query group just for anesthesia. Pull in info they want to see at a glance for a preop patient. Added 8-25-98 Marianne Keane, RN |
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Create a "Shift Report" screen in PCI using query groups. Can give report right from the computer with up to date info easily readable. Added 8-25-98 Marianne Keane, RN |
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Identify interventions that have a charge component with a ~ or some other special character. Nurses then know that they must only document when they want to charge, and they must use the edit or undo feature in the event of a mis-documentation. Added Feb. 21, 1998 Pat Korolog, Clinical Informatics |
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Problem: I cannot see the patient name in the Handheld device. Solution: At any point, you can press the RIGHT CIRCLE to see what patient you are working on. |
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Problem: The doctor wants to see the graphic sheet just like he did on paper. It was a concise format with important information all in one place. Solution: Create a "Clinical Data Summary" which includes all of these specific parameters. This can be done in a profile or created through an NPR. Many thanks to Nancy at Sierra Nevada for this idea. It has been very well received. |
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Your LookUp Tables (or Group Responses) can be set to either 10 or 21. Check with your IS department. It is done per user menu. Added 8-24-97 |
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Think carefully about how many shared queries you want to have. Plenty of us have found that sharing queries causes reams of paper to print--every place that query appears. Added 8-24-97 |
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You can identify which interventions have CDS's attached, that require staff to complete the screen, by indicating them with an asterisk at the end of the intervention description or typing that description in caps. Added 8-24-97 |
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Put some thought in how you want to organize your mnemonics and descriptions throughout the NUR module. It is helpful to define which numbers belong to which clinical areas. When organizing your CDS's, it is a good idea to name the queries similar to the CDS, name the group response the same as the query. Consider one group response per query, instead of sharing group responses. Then, when you make a change in a group response, you do not have to worry about what other screens it is going to affect. Added 8-24-97 |