Know and Go PowerChart Tips Jan 2008 boo… · Know and Go PowerChart Tips Jan 2008. page 2 page 3...

Know and GoPowerChart Tips

Jan 2008

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The symbol at the end of the title signals content for Physicians

Table of ContentsAdvAnced direcTives _________________________________ 5

Finding a previous Advanced directive ____________________ 5ciTrix server ________________________________________ 6

Finding your citrix server number _____________________ 6Acis/Powerchart citrix session TimeOut ________________ 7

dOcumenTs __________________________________________ 8document report dual Page __________________________ 8ed Triage Form as a Text document ______________________ 9document search _________________________________ 10dual Page view ___________________________________ 11Opening multiple documents ________________________ 12resizing and/or moving a document window ______________ 14Save Work during Inbox Document Modification _____________ 15

encOunTers ________________________________________ 16selecting a patient previous encounter ________________ 16

LOgin ______________________________________________ 17Login and Password for Acis __________________________ 17Quick and easy Login ________________________________ 18Log out with exit and ready ___________________________ 19

PATienT LisTs _______________________________________ 20creating a Location List: ________________________________ 20creating a visit relationship List: _________________________ 22customizing columns ______________________________ 25Options for printing a List _____________________________ 26Proxy your Patient List _____________________________ 30

PrivAcy sTATus ___________________________________ 32POwerchArT TAbs ___________________________________ 33

discharge document Tab ___________________________ 33navigating the document/reports Tab ___________________ 34

resuLTs viewing ____________________________________ 39blood bank results __________________________________ 39customizing the search criteria default _______________ 40setting your default Flowsheet view __________________ 41what does the mOre button do ________________________ 42Printing Lab results with reference ranges ____________ 43

TOOLs ______________________________________________ 44clinical calculators ________________________________ 44Launching other Applications through Powerchart! _________ 45what is contained within the TAbs of Powerchart? _______ 46reduce number of click to search Policies ________________ 47

APPendix ___________________________________________ 49cerner Learning manager: web based Training (wbT) ______ 50hybrid medical records _______________________________ 52documents - Powerchart document categories ____________ 53categories of documents Types standardized Full _____________ 54Powerchart document categories chart Order _____________ 56Powerchart document categories Alphabetical ____________ 58

TesT yOur POwerchArT knOwLedge ___________________ 61Powerchart Quiz #1 _________________________________ 62Powerchart Quiz #2 _________________________________ 63Acis Powerchart crossword (Quiz #3) ___________________ 64competency Test ____________________________________ 65Powerchart Quiz #1 Answers __________________________ 69Powerchart Quiz #2 Answers __________________________ 70crossword Answer ___________________________________ 71

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basic Concept of Locating a Previous document The search criteria must include the date of service – the date the test was performed or

the date the old chart was scanned. A discharged chart is scanned to the date of dc. The Ad can be found under the All results Tab or the documents-reports Tab.

Locating a Previous Ad in PowerChart scenario – Ad has been copied during a previous admission – unknown date. you must check across ALL admissions [a.k.a. encounters]

Open the Patient chart and click on the Location to see the visiT LisT

double click on the earliest encounter. click yes, then close the window [Ok or exit].

There may be a hesitation in loading the information if the patient has many inpatient admissions.

From any Flowsheet Tab, select the ellipse button. [This is a search feature]your view might be better with the grOuP view if there are many Ad entries. note – this search will only return documents within the search criteria dates listed in the green bar [default is 24 hr. PreAdmission to current]. Type in “Adv” and enTer:

select either option by double clicking or highlight and click Ok. you will only see Ad related forms – summary and scanned Advanced directives.

AdvAnCed direCTives•Finding a previous Advanced directive

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CiTrix server•Finding your Citrix server number

ACis/PowerChart Citrix session TimeOut

To maintain the ACis/Cerner Application response Times, the Applications will CLOse after 60 minutes of nO ACTiviTy.

it should not log you out while using any Cerner ACis program.

Continue to leave the Log-in screen up and ready for the next user – do not cancel out of the login screen, unless you intend to close the program completely.

remember, when you exit PowerChart from the Organizer using the “x”

in the upper right corner, the screen will be ready for the next user. The Log On box will automatically appear.

Login time is as quick as you can type your login username and password.

Reminder – close all patient charts before exiting

if you select “CAnCeL” when this log on box appears, the PowerChart connection is closed and the next login will take much longer.

If you experience any slow responsiveness or if you are kicked out of Cerner ACIS applications while being used,

Please notify the IT HelpDesk, 2249.

ACis Cerner Applications include: PowerChart [Core Chart] Firstnet [ed] Profile / Provision / mrP [him / medical records]

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dOCumenTs•document report dual Page

go to document/reports Tab click on icOn at bottom of window select enable dual Page view select or de-select any other options desired.

in the documents-reports Tab, i have opened a group of scanned Orders. it has 129 pages. i have enabled duAL PAge vieWer to more quickly page through the group of documents. i have checked all boxes. i can use the small teal arrows below to move through 2 pages at a time. i can zoom the pages if desired, using the magnifying glass + or -.

To reverse – i just uncheck the first item “enable dual page view”. The other items can remain checked to make it a quicker selection next time.

Printing Tip: you must use the Print icon at the bottom window – be sure to select page(s) and not print ALL!

ed Triage Form as a Text document

Additional report eFFecTive 5/3/06

On the FLOWsheeT view, if you double click on ed nursing record you will see the text document and can print from there.

Also available On the dOCumenTs/rePOrTs tab

WhAT This meAns TO yOu: • you can now view the

form as it looks printed. • you can tell who modified

what and when. • you can print the text

document without going to form browser!

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dual Page view

document search

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Opening Multiple Documents in a Patient’s ChartThere is new functionality after the ACIS Upgrade that allows you to open more than one document in apatient’s chart from the Documents/Reports tab. You can either open additional documents one at atime or open multiple documents at once.

“Open Additional Document” – Opens the document in a separate window foreasier viewing. If you keep selecting this option with other documents, youwill have more than 1 document opened at the same time.

1. Open a patient’s chart to the Documents/Reports tab.

Reminder: Make sure your search criteria is set to include the documents you are looking for. To changeyour search criteria, right click on the green bar and select Change Search Criteria.

2. Navigate to the document you would like to open and single click to select/highlight that document inyour list. You can expand document folders by single clicking on the plus sign next to the folder.

3. Right click on the selected document and choose Open Additional Document.

This will open the selected document in a separate window. Once the document is open, you canresize or move the window around for easier viewing.

4. Continue to open additional documents in this manner one at a time until all the desired documentsare open. To open more than one document at once, see the next page.

IMPORTANT: Once a document is open on the right hand pane of the Documents/Reports tab (ifyou double click on the document instead of right click), it cannot be opened in a separate window atthe same time. You would need to navigate to a different document, and then go back to thedocument you would like to view, right click and select Open Additional Document. For bestresults, do not double click on any documents!

Opening multiple documents

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Opening Multiple Documents at one time in a patient’s chart

1. Open a patient’s chart to the Documents/Reports tab.

2. Navigate to the first document you would like to open and single click to select the document.

3. Navigate to the additional document you would like to open, hold down the Ctrl key on your keyboardand single click to select the document. Continue to select documents in this manner until all thedocuments you would like to open are selected (highlighted blue).

4. Right click on any one of the selected documents and choose Open Multiple Documents.

This will open each selected document in a separate window. Once the documents are open, you canresize or move the windows around for easier viewing.

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SaveWorkduringInboxDocumentModification resizing and/or moving a document window

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Once a document is open in a separate window, you can move, resize, minimize, maximize or close that window. each of the following steps corresponds to the numbered boxes on the image below.

1. The blue title bar at the top of the document window allows you to do the following actions:

minimize restore maximize Close

2. To move a window, click and hold on the blue title bar at the top of the window then drag to move to the desired location.

3. The document window for scanned documents has 2 panes (transcribed documents only have one), the document viewer (upper pane) and the document information (lower pane). To resize the panes to allow for better viewing of the document, hover your mouse pointer over the line separating the panes, click and hold with the left mouse button, then drag up or down to resize the panes.

4. To resize a window, hover your mouse curser over any one of the 4 corners of the window. your curser will change to a 2-headed arrow. Once this happens, click and hold with the left mouse button then drag to resize the window.

2.To move the window, click and hold on the blue title bar with the left mouse button, then drag the window to the desired location.

4.To resize the window: hover your mouse pointer over the corner of the window. Then click and hold with the left mouse button and drag to resize the window.

3.To resize the document pane: hover your mouse pointer over the line between the two panes of the window. Then click and hold with the left mouse button and drag to resize the pane.

1.To minimize, maximize or close the window, use the corresponding buttons on the blue title bar.

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LOgin•Login and Password for ACis

For first time log in, first login after a password reset and expired password notification.

when prompted to change your password, you must change the password to something that you have not previously used. you are no longer able to re-use passwords in Powerchart.

if you need to change your password for security reasons at a time between scheduled changes (every 180 days) – go to Task menu > ChangePassword.

First TimePassword –1. might be reset to the same as your user name[ex. “greenejs”] 2. –or as instructed, ex. Password1

The password you just used to login.

yOu create your password – At least 2 numbers and 4 letters. [ex. 12remember]

retype the password you just created to validate – make sure you didn’t have a typing error.

enCOunTers•selecting a patient previous encounter

1. click on the LOCation in the banner bar 2. double click on the encounter you want to open. click 3. yes and 4. Ok to close the windows.

how selecting a past encounter affects what is seen in the tabs

default search Criteria = All documents from selected encounter [only shows documents from the encounter you select] document/reports Tab discharge documents

default search Criteria = 24 hour Prior to Admission to Current – will show all documents from the past encounter admission to today’s date [includes all encounters in between the admission date of the selected encounter to present date] Quick view Lab rad All results

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exit Functionality set to decrease Login Times

when you exit PowerChart from the Organizer using the “x” in the upper right corner, the screen will be ready for the next user. The Login screen will automatically appear.

Login time is as quick as you can type your login username and password.

All shared, general use workstations [ex. those in the nurses station] will be set to exit in this manner when exiting using the upper left “X” in the Organizer.

Reminder – close all patient charts before exiting

if you select “cAnceL” when this log on box appears, the Powerchart connection [citrix] is closed and login will take longer.

The citrix connection will time out after 60 minutes or inactivity [no user activity] and close the PowerChart connection.

Only for private, single user computers: you need to change the default setting if you do not want the Powerchart Login screen to appear each time you exit.

Please go to TAsk menu > select exiT and this dialog box will appear. chose your default setting and select yes.

exit and shut down the application – closes it out completely check “save as the default choice” check “don’t ask me this again”

OTher OPTiOn meAnings: Exit application, with screen ready

for next user = the way all shared, general use computers will exit.

Have a new user take over application in its current state = same as change user – will be useful in Phase ii with co-signing functions.

Log out with exit and readyQuick and easy Login

unit secretaries– yOu CAn heLP

Take a few minutes before high volume

times to make sure allof your nursing

station and Physician AreaComputers are

powered on, open the desktop ACis iCOn

and then the PowerChart iCOn so

it will be up and running and ready for

access.

LimiTATiOn: The citrix session expires after 60 minutes of inACTiviTy.This means, if this sits untouched for 60 minutes – it closes.

FACT: initial login into Powerchart may take up to 20 – 30 seconds as it establishes a ciTrix connection to denver, cO [national Offices].

FACT: you do not have to wait that long every time!

when you exit Powerchart, the login screen pops back up, making it reAdy FOr The nexT user.

Please dO nOT CAnCeL and close Powerchart completely.

Logging in at this point is immediATe upon typing in your name and password.

if you want it to be out of your way…place cursor on the

screen, hold the left mouse button and drag the screen off to the corner of your desktop

display.

sTOP WAiTing and Access Patient information

immediATeLy!

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select List maintenance from Patient List menu or use icOn

select neW

select Location type of list

Location – Follow steps in screenshot below

refresh the organizer to see new Location List

Call Paula @ 4776 or eula @1863 with issues with Artromick CartPlease give us objective feedback on carts, things that would help you etc. as we do this evalution. Clean these carts with the Anti-microbial wipes frequently!!

PATienT LisTs •Creating a Location List:

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Creating a visit relationship List:

select List maintenancefrom Patient List menu or

use icOn

select neW

select visit relationship type of list

visit relationship – based on yOur Powerchart position/relationship select yOur relationship change the Title of the List, if desired click Finish make the list ACTive Patient charts you have viewed will post to the list refresh the organizer to see patients of newly opened charts

select yOur relationship – your position in POWerChArT

Check yOur relationship

you can change the name to whatever you like.

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Customizing Columns

From the PowerChart Organizer – select the patient list you want to customize. go to Patient List in Task bar and

select Customize Columns.

3. sortuse this arrow to move the selected column to the position you desire

1. Available Columns highlight the

column you want to add from the Available column box on the left

2. existing Columns use the teal arrow

to move it to the existing columns box on the right

4. sAve when completed– and close out using

if you want to delete a column – highlight the selected column name and click here

The new column should appear once you close the customize columns window. use the “As Of” button to refresh data is needed.

Columns Available:*AdmittedAdmitting Physician *Age*Attending Physicianconsulting Physician *dOb*dischargedexpiration date *FinLeave status^

Length of stay *Location*mrnmedical service *name*new resultsnote^

Primary care Physician Priority^

Privacy status [Opt Out]

sec^

*sexTemp Location^

viP code visit reason visitor status^

*default

^disclaimer: not all column data may be sent at this time. A visit relationship List has a few more options.

select nexT – Filters if you do not want to see discharged patients, select nOT disChArged.

select nexT - PrOxy you can set PrOxy if desired – see other tip sheet for instructions Otherwise, select Finish. you will need to move it from Available Lists to Active List to view in the

Organizer.

Available: “Waiting in the Wings” - List that are made, but not viewed in the organizer.

Active: List that you see in the organizer. You can change the order – highlight and use the arrows to the right to move up or down in the order.

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Patient ListClick on “Patient List” to show options in the box to the right.Select the list you want to print from the drop-down box.Select your Sort PriorityClick Execute

Select the list youwant to print from thedrop-down menu

You have the option tosort by Name or byLocation.

Then click EXECUTE.It will not take long foryour list to appear in anew window.

Options for printing a List

start the explorer menu from the Powerchart Organizer by clicking on the icOn

Types of Lists are Available:

Patient ListThis provides a different print layout of yOur Patient Lists [Only lists yOu have created under your login] if you print the Patient List from the Powerchart Organizer – it prints

exactly like it appears on the screen. if you select one of your patient lists from the explorer menu, it will be

formatted on two rows with space in between each patient name row.

The Patient List report Contains: Patient name, Privacy status, Location, Age/sex, dOb, mrn, Fin, Admit, dc, Attending md and Patient Type.

station Census The station census provides a printed list based on a patient care location. The list can be printed non-spaced [single spaced] or spaced [a few rows in-between each patient name, separated by a line]

The station Census report Contains: room-bed, Patient Type, Account, Privacy status, Patient name, service, Age, sex, and Attending Privacy status is abbreviated – only “do no” is seen for “do not Publish” =

no information Patient

double-click to Open “main menu”

click the “+” to Open the Powerchart Audits menu [or double-click]

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Station CensusSelect MBO – LEX, only choiceSelect FacilitySelect Unit [you can select more than 1, and they will page break between units]This report takes longer to execute than the Patient List – may take 20-30 seconds – or

more if multiple units have been selected.

The report appears in a new window. Use the print ICON to start printing. NOTE: Theasterix before the patient name signifies an OPT OUT choice of privacy – do notgive out any information on location or condition – treat as if this person is not onthe list.

Once you haveopened thereport, it will belisted in this“recentPrograms” folder

Select MBO – only 1choice - LEX

CheckFacility

Check Unit

ChooseSpacing

The report appears in a new window. use the print icOn to start printing.

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Proxy Your Patient List

Select the list you want to proxy to another provider:

Select PROPERTIES from Patient List Menu or ICON :

Select PROXY Tab.Select NEW.Select PROVIDER.Enter a provider name –

it will auto-search formatches.

For multiple matches –click the address bookICON

Select ACCESS –Important! READ is best.

Full Access would allow the proxy to DELETE your list!

Proxy your Patient List Proxy Your Patient List

Select a stop date andtime if desired. This willautomatically removethe Patient List from theProxy.

Click APPLY. The Proxyname must be in the leftbox.

The Provider must activate the Patient List through list maintenanceto see the tab in their Patient List.IT will stay in the Available lists column until needed or until itexpires.

Select LIST MAINTENANCE.Move the list from AVAILABLE LISTS to ACTIVE LIST using the arrow.Click OK.

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POWerChArT TAbs•discharge document Tab

ContentCategories: Face sheet h&P consult Orders Progress note Operative report Procedure record heart cath report cardiac Procedure ekg echo stress dc Plan PFTcardiac Other

A new Powerchart Tab for Physicians, nurses and him staff.

PurPOse: To assist with discharge summaries and for quick past visit review. in the same layout as documents/reports Tab Filter shows All documents from the selected encounter includes limited categories defaults to show documents “by encounter” hover above categories to see details of document name

Positions with the new Tab:

dbA mbO core Analyst Pathnet: Pathologist Physician e-signature Physician no e-signature Physician Assistant e-signature Physician Assistant no e- sig nurse Practitioner e-sig nurse Practitioner no e-sig nurse rn Physician office staff Provider co-signature him:Analyst him:coders him:emPihim:managers

double-click to see document

move page to page settings – look

here to set dual Page view seen in this example

hover shows document name

Arrows expand folder and select nextdocument

Sept.

7th

200

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Clicking into Safety

PowerChart can now be thePrivacy Source of Truth

In STAR, when patients are registered, they are asked if they want to Opt Out of theCensus. It is entered in STAR if they say YES, I want to Opt Out or NO, I don’t want to OptOut. If they choose to OPT OUT – this means they want they stay to be private andNO INFORMATION should be given out… even their presence in the hospital shouldnot be revealed. If you receive and inquiry, you should say “They do not appear on ourhospital census.” You should not have the computer screen where others can see it.

In the STAR station census, it is designated by an * before their name.

In PowerChart, it is designated by “Do Not Publish” if they chose to OPT OUT – or- “na”if it is Not Applicable and they chose No, they are OK with the standard level of HIPAAprivacy.

You will see this in a NEW Column in the Patient List – “Privacy Status”. It also appearson the Visit History Tab [Under the Patient Information Tab] and the Face Sheet.

If you have used the “Customize Column” feature to add/delete columns, you will need toadd this column manually since your personal settings have priority over global settings.

PrivACy sTATus •

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navigating the documents and reports Tab

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categories to their maximum, showing the document in the window.

if you hover your mouse pointer over the form category name – you see the entire entry – showing the “name of the document”

you may prefer “by encounter” to see 1 list of ALL document types.

navigating the document/reports Tab

you can use the green arrows at the lower left to easily expand the

Current search Criteria is set to All documents from selected encounter. To change search criteria - right mouse click on the green search range bar.

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making the view larger: move window border – hover over border until -||- appears, hold down

mouse button and drag.

you can expand your view somewhat by going to view and deselecting (clicking each one) demographic bar, Toolbar and status bar to help minimize your up and down scrolling to view the entire document.


3

To access the Progress notes/Orders, click the documents and reportscategory and expand to see all categories within. select / go to Physician Orders. [you can double click on a category or form to expand or you can use the green arrows]

ideally, ALL orders / progress notes are under one heading of “Orders”. some orders are scanned in separate if the paper chart is not complete when sent to medical records.

use the small green arrows in the lower portion of the document window to move through the pages from admission to discharge.

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resuLTs vieWing•blood bank results

blood bank results in PowerChart

new result navigator Panes may be seen in PowerChart:[category types are only seen if your patient has results posted to the chart for the category]

1. blood group and Type 2. Antibody screens 3. hemolytic investigation 4. Antigen information 5. Crossmatch results6. Therapeutic Phlebotomy 7. rh immune globulin investigation 8. Transfusion reaction results

example: Crossmatch results - for each blood product prepared for transfusion, up to 6 fields will be sent to Powerchart

1. Product id – Type of product [ex. Platelets, cryoprecipitate, red blood cells, etc.] 2. unit number – assigned by the collecting / processing facility 3. Crossmatch result – if applicable 4. status info – ready, issued, Transfused, canceled 5. Product Code – corresponds to the product barcode on the blood product label 6. unit Type – the blood type of the product [ex. O Pos, A Pos, etc.

each “set” of result codes will be prefaced by a numerical identifier, e.g. 01, 02, 03, etc. where the 01 is the first unit, 02 the second unit, etc.

status info messages for crossmatched products will be sent to Powerchart immediately at the completion of the crossmatch. status messages for FFP, Platelets, and cryoprecipitate will not be sent until the product is ready to release, i.e. thawed, pooled, etc.

The crossmatch specimen expires in 3 days. until expired as shown here, it will show a date in this format: yyyymmddhhmm [year, month, day, hour, minute]

status: ready, issued, Transfused, cancelled

each product is designated by 01, 02, etc.example: All information for the first unit is designated by “01”


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holding your place while you double check a result if you come across a Progress note that makes you want to check a Lab result or an OP note, use the tabs of the chart to navigate to those documents (like the Allresults tab) and you will not lose your place in the Progress notes when you navigate back to the documents/reports tab.

1. you may want to change the view on this screen and can easily do that by selecting the grOuP radio button to group items by date and make your scrolling up and down only. This view is a nice way to see Trending.

2. you can use the navigator bars to quickly pull the category to the top of the window – click once on the navigator bar category [example coagulation].

3. you may want to change the seArCh CriTeriA to view more results [right click green bar – select a date range or admission to current]

4. you can then view labs or other transcribed reports, radiology results, etc… and still return to the documents/reports tab and not lose your place.

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setting your default Flowsheet view

setting your favorite Flowsheet view as the default view

setting your Favorite Flowsheet vieW as the default view

example:you want to always see your Powerchart Quick view flowsheet in grOuPview

1. Open a patient chart Quick view flowsheet and set it to grOuP view

2. go to OPTiOns in the menu bar – select PrOPerTies

a. select the deFAuLTs tab

b. click sAvec. click yes

This is set per flowsheet.

Customizing the search Criteria default

This will set your personal default properties for the Flowsheet you have selected [ex. Quick view, Lab, rad, All results].

As a default setting, you will see your search criteria every time you open a chart.

each Flowsheet Tab default is set individually.

Open a patient chart. select the Flowsheet Tab on which to set defaults.

go to OPTiOns in menu and select PrOePrTies.

select defaults Tab

choose your defaults and select sAve*.

“yes” to are you sure?

And Ok to exit the window.

your default view will be set. you must close the chart and reopen to see your changes.

*if you are setting your flowsheet view to Table, group or List,select the desired view, and go to the default tab and select sAve. There is not an item on the defaults tab window to select.

similar settings for other tabs can be found: documents/reports Tab: go to “document” > “Options” > select “index defaults” Forms browser Tab: go to “Options” > “Properties”

This sets criteria for the arrows on each end of the search criteria bar – how many days it skips forwards and backwards.

days for “clinical/Posting range”

Or results for “result count”

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Printing Lab results with reference ranges What does the mOre button do

A cap to the number of results that are returned in Powerchart has been set to help maintain system performance. This is set to 1000 results per cerner’s recommendation.

Only the first 1000 will be returned regardless of what the search criteria is set to. if you want to see all of the results, you have to click on the mOre button. clicking the mOre button will return all results for that patient (nOTe: you could experience a slight delay if a patient has a lot of results).

you will encounter this using the Flowsheet Tabs [Quick view, Lab results, and All results, which contain large amounts of information]. For these tabs, the default search range is set to 24 hours Preadmit to

current date. if you select a previous encounter this search range might span several month to years of encounters.

it is easier to click mOre than to alter the search criteria.

If you see the MORE button active [bold, not grayed out]; click it before looking through the chart.

grayed out = all results are showing

bold = results are capped to show only 1000 – click to see ALL resuLTs

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in Acis/Powerchart, click on the WhiTe iCOn in the toolbar – you can select Lex intranet or Chi micromedex.

From the intranet – you can connect to UpToDate and search for the latest ebP information on diagnosis, Treatments and drugs!

All clinicians have access to this new resource from any sJhc/chi computer. For more information on upTodate – click on the FAQ

link in the “what’s new” section on the sJhc intranet.

Launching other Applications through PowerChart!TOOLs•

Clinical Calculators select the icOn to launch the Clinical Calculator functions.

select the desired calculation from the drop down menu. enter the data and the result will automatically calculate.There is a basic calculator that can be accessed in the lower left of the window if desired.below are the available calculations:

Calculation Formulabody mass index english [(weight)/(height*height)]*703body mass index metric [(weight)/(height*height)]*1000bsA sqr [(ht x wt)/3600] mostellar formulacardiac index cO/bsAcardiac Output hr x sv (stroke volume)ml per hr (mcg desired x wt x 60)/(concentration of drip)celsius to Fahrenheit 32 + [(9/5) x c]centimeters to inches cm/2.54

coronary Perfusion Pressure diastolic bP – PwP (Pulmonary wedge Pressure)

estimated creatinine clearance < 17 yo (0.48 x ht x bsA)/(s.cr. x 1.73)

estimated creatinine clearance men (140 – age) x wt / (72 – s.cr.)crockcoft-gault formula

estimated creatinine clearance women (140 – age) x wt / (72 – s.cr.) x 0.85 [crockcoft-gault]

Fahrenheit to celsius (F-32) x (5/9)ideal body weight (ibw) < 60” child (ht^2) x 1.65/1000ideal body weight (ibw) > 60” Female child 42.2 +2.27 x (ht – 60)

ideal body weight (ibw) > 60” male child 39 + 2.27 x (ht – 60)

ideal body weight (ibw) male 50 + 2.3 x (ht – 60) devine 1974ideal body weight (ibw) Female 45.5 + 2.3 x (ht – 60) devine 1974inches to centimeters inch x 2.54ivF rate (ml x drop factor) / timekg to Lb kg x 2.2Lean body weight (Lbw) male 1.10 x wt – [128 x{(wt^2 / (100 x ht)^2}]

Lean body weight (Lbw) Female 1.07 x wt – [148 x{(wt^2 / (100 x ht)^2}]

mcg / kg / min (ml x concentration of drip) / (60 x wt)mcg / min (ml x concentration of drip) / 60Lb to kg Lbs / 2.2Pulmonary vascular resistance [9mean PAP – PwP) / 60] x 80stroke volume cO / hrsystem vascular resistance [(mAP – mean rAP) / cO] x 80Total Pulmonary resistance mean PAP / cOTotal systemic resistance mAP / cO

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Only Lab

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everyth

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under

docu

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orts Tab

Transcrib

ed d

ocu

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h&

P, consu

lts, Op reco

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Proced

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sum

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h&

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will co

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clin

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to

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ates [d

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eport

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reduce number of Click to search Policies

page 49

APPendix•

page 51

The Cerner Learning Manager home replaces Mymeded. Several Cerner WBTs are available to CHI employees. You may complete as many as you would like but Cerner does not keep a record or provide documentation of completion.

Steps to Access Cerner WBTs: 1. Click here to log into Cerner Learning Manager. The Welcome to Cerner

Learning Manager login window displays.

2. Register in Cerner Learning Manager. Even if you have a Cerner.com account,

you must create a new account to access the WBTs that can be accessed by CHI.

a. Click the phrase Click Here to Register. The Self Registration window displays.

b. In the Registration Key field, type CHI011808. You must enter this key to access the CHI WBTs.

c. Complete all required fields (*). If you already have a Cerner.com account, you must choose a different username.

d. Click Submit.

e. Click Login. The Welcome to Cerner Learning Manager! window displays.

Note: You will use your username and password when you log into Cerner Learning Manager in the future.

3. Click My Learning in the upper left corner. All Cerner WBTs available to CHI display on your My Learning Plan tab. You may also see the status of your progress for each WBT ( Enrolled, In progress, Completed).

My Learning Plan tab displays all available WBTs.

4. To begin or resume a WBT, locate the WBT name.

5. Scroll to the right and click Begin or Resume on the line with the appropriate WBT name. A window displays with the name of the WBT or the components WBT.

6. Click the name of the WBT or a component to launch it.

If you need assistance or have problems with your account, please contact:

Kristi Blazek Catholic Health Initiatives ∞ ITS-Denver ACIS Cerner Training Coordinator [email protected] (720)874-1195 – office

Cerner Learning manager: Web based Training (WbT)

page 53

CATegOries dOCumenT TyPesdisChArge-FACe sheeT

Face sheetdischarge summarycoding summarycancer staging FormsProblem List

AdvAnCed direCTive Advanced directive-Living will

hisTOry and PhysiCAL-COnsuLTATiOn

h and PPrenatal recordconsults

emergenCy

ed recorded Physician recorded nursing record

PhysiCiAn Orders

Ordersrestraints

PrOgress nOTes

Progress notePhotos

OPerATive - PrOCedure rePOrTs

Operative reportProcedure recordAnesthesiaOperative documentation

LAbOrATOry rePOrTs

blood AdministrationLaboratory documentPathologyreferral LabPku

diAgnOsTiC imAging

radiologynuclear medvascular diagnosticscT Artery

CArdiAC

cardiac Procedureekgecho-stresscardiac Other

mOniTOring sTriPs monitoring Forms

TeCh serviCes Tech service reports

grAPhiCs graphic

mediCATiOn reCOrds

mArmAr-diabeticmAr-Anti-coagulantmAr-Other

nurses nOTes

AssessmentFlowsheetsnursing notesPlan of carePathwayscare record

PsyCh AssessmenT Tx PLAn

Psych Assessment Psych Treatment PlanPsych Therapist notes

disChArge PLAnning

Transfer Formdischarge Planinstructions

PATienT eduCATiOn Patient education Forms

CLiniCAL AnCiLLAry

respiratoryPulmonary Function TestPT-OT-speechnutrition Other Ancillary

COnsenTs

consent Formsspecial consents

OTher-misCeLLAneOus

Legal documentsPatient rightsmiscellaneousrOiOther Facility

CAre CenTer care center records

documents - PowerChart document Categorieshybrid medical records

We are living in a hybrid world –how do paper and electronic mix?

electronic Paper

during admission – does not contain progress notes, orders, mArs, nursing notes, ancillary evaluations and progress notes.

during admission may contain most all records – but may not, it depends on printing and associate management of the chart.

dictated reports – viewable immediately upon transcriptiondictated reports – viewable immediately upon completion of dictation when physicians use Powerscribe and self-edit.

dictated reports - print out upon completion of transcription, but must be physically retrieved by an associate, chart located and placed [ranges from a few minutes to never making it to the chart]

Lab results – viewable immediately upon completion

Lab results - print out upon completion, but must be physically retrieved by an associate, chart located and placed [ranges from a few minutes to never making it to the chart]. Final lab summary not in the paper chart.

viewable from any computer – unit, hospital, office, home.

viewable only in the nursing unit

viewable by many clinicians at the same time

viewable by 1 clinician at a time

record complete with paper records scanned 24-48 hours post dc

record never complete

updates continue post dc [physician signatures, etc]

is never updated post dc

during admission - Legal medical record [hybrid during admission]

during admission - Legal medical record [hybrid during admission]

Post dc – Legal medical record Post dc, nOT the legal record – interfaced documents removed and destroyed, other documents moved off site immediately

page 55

HIM

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TO

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S

DEFICIENCY ANALYSIS

Signature Required

Co-signature Required

Allow multiple

anticipated documents

Match anticipated do-cuments with

physician

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page 57

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page 61

TesT yOur POWerChArT knOWLedge•

page 63

PowerChart Quiz #2PowerChart Quiz #1

Answers may be found on page 64!

True/False:

1. True or False: The following picture depicts the desktop icon i need to click on to access Power chart.

2. True or False. i have successfully logged on to Power chart at least once in the last week, and have been able to access a patient chart. i am using my own user id and password to get into Power chart.

Fill in the blanks:

3. List at least 2 super users in your department:

__________________________________________

__________________________________________

4. List two (2) ways you can locate a patient, to gain access to a patient’s electronic chart in Power chart.

___________________________________________

___________________________________________

referring to the picture of the “tabs” available in Power Chart, answer the following questions:

5. under which “tab” will you find the scanned paper charts (old charts)?

_______________________________________

6. under which “tab” will you find a patient’s encounters?

________________________________________

referring to the picture of the “icons” available in Power Chart, answer the following question:

7. scenario: i’ve been logged into Power chart for 20 minutes. i’m looking for a radiology result that i know was “resulted” within the last 10 minutes, but i can’t find the result in Power chart. i should click on which icon to “refresh” my view in Power chart and obtain the most recent results since i logged in.

___________________________________________

Answers may be found on page 65!

using the picture below, answer the following question:Print Icon #1

Print Icon #2

1. To print a copy of this scanned document, which print icon should be used (Print icon #1, #2, or #3)? Print icon #_____

2. what is the “official” name of the mystery area?? _____________________

3. what action do i take to change the range described in this mystery area? ___________________________________________________________

4. what does the “x” in the red square indicate? This document is ______________. what is one reason for this document being assigned this indicator? ____________________________________________________________

5. what “domain” was accessed in the picture above? buiLd, PrOd or TrAin?? ___________

6. how do you know this? ________________________________________________________

Mystery Area

What does the X indicate? Question #4

Print Icon #3

page 65

ACis PowerChart Crossword (Quiz #3)

name: _________________________ department: _______________

directions: Please complete this crossword puzzle and return to the designated super user in your department. This person is _________________________________. Answers may be found on last page!

Crossword Puzzle:

ACrOss1. ___ bar - contains basic demographic information.3. each nursing unit has a default ___ patient list.6. marks new results as “viewed.”7. Function used to create “drawing” of discreet results.9. critical results display in ___.10. ___ List - patients in a physician group.11. new results display in ___.14. ___ bar - shows every result category.15. system prompts you to change this every 180 days.16. ___ List - can include any patient, and is built by the user.

dOWn2. “refresh” information.4. initial screen obtained when logging into Power chart.5. name of “live” domain.8. ___ summary - names of anyone who has accessed a patient’s chart.12. relationship not being used.13. Patient information organized in ___.

1. The As OF icon on the toolbar is used for:

A. Searching for a patienta. Refreshing the screen and showing changes in the chartb. Reviewing old recordsc. Exiting the systemd.

When logging out of PowerChart, you can:1.

Use the Exit Icona.

Use the Change User Iconb.

Use the “X” in the upper right hand cornerc.

or use All of the Above d.

The All Results tab is:2.

Best overall viewa. Contains every resultb. Lab, Radiology, Documents/Reportsc. All of the aboved.

The Orders Tab is non-functional in this phase:3.

Truea. Falseb.

6. It is ok to look up any patient records, including your own, a family member or friend:

Truea. Falseb.

By right clicking on the Green Search Bar, you can change the search criteria:8.

Truea. Falseb.

Competency Test

page 67

It is not recommended to print results or old charts?9.

Truea. Falseb.

You will need to double-click on a Lab Result to display the normal ranges and 10. view any

comments that may be present:

Truea. Falseb.

A Final Report is:11. A Discharge Summary1. A transcribed document 2. that has been electronically signed by a physicianThe final results of a lab 3. test

12. If a document is multiple pages, to view the other pages, you can:

a. use the scroll barb. Use the arrowsc. Enter the page #d. a & ce. b & c

13. To print this document, which printer icon will you use:

A. TOP B. MIDDLE

C. BOTTOM

Under the Patient Information Tab, which tab will show you the movement 14. of a patient from unit to unit (per Bed Control) for the current visit or most recent visit?

a. Patient Demographics b. Visit List c. PPR Summary d. Visit History

page 69

Under the Patient Information Tab, under which tab will you locate insurance 15. information?


Under the Patient Information Tab, under which tab will you locate the 16. patient’s previous visit information?


In PowerChart, Lab Results are displayed:17.

a. When they are orderedb. When they are received in

the Labc. When they are drawnd. When they are resulted

or completed

The Navigator Panel shows:18.

Everything that has been done and completed in c. Patient’s chart.The items that have been ordered onlya. A list of only the important items on a patientb.

The Visit Reason lists the diagnosis of the patient:19. Truea. Falseb.

The Form Browser Tab is used to find:20. a. Patient medsb. Emergency Dept visits.c. Patient Demographicsd. Patient diagnosis

Answers:

1. True or False: The following picture is the desktop icon i click on to access Power chart.

Answer: FALse – the Acis icon looks like this. it should be found on each Pc and/or wyse/winterm terminal in your department.

if you find a Pc or wyse/winterm terminal that is missing this icon, please call the heLP desk at 313-2249.

2.True or False. i have successfully accessed Power chart at least once in the last week. i am using my own user id and password to get into Power chart

Answer: hopefully, True! if you have not, please work with your super user to practice logging on to Power chart at least once a week! if your login and password don’t work, please call the heLP desk at 313-2249!

3.List at least 2 super users in your department: if you could do this, great! if not, please speak to a member of your management team. They should be able to direct to a list of super users in your area!

4.List two (2) ways you can locate a patient, to gain access to a patient’s electronic chart in Power chart.

•you should be able to find a patient on a patient list – nursing units should have a “default” patient list that should be specific to that nursing unit, and have a list of that unit’s patients on it. if you double click on a patient name on that list, the electronic chart should open up for you!

•use the Find Patient icon or select Task – Find Patient from the menu bar.

5. under which “tab” will you find the scanned paper charts (old charts)? documents/reports

6. under which “tab” will you find a patient’s encounters? Patient information

7. i should click on which icon to “refresh” my view in Power chart and obtain the most recent results since i logged in. The “As Of” button!

PowerChart Quiz #1 Answers

page 71

Answers:

1.if you’re in the document/reports tab, you need to print using Print icon #2at the bottom of the screen. in this tab, if you print using the icons on the top of the screen (Print icons #1 or #3), you will just get a blank page! scanned document pages are the only pages with 3 print icons!

On non-scanned document pages (i.e. transcribed reports – h&P) in the document/reports tab, there are 2 print icons (1 and 3) at the top of the screen. both of these will print the document!

2.search range bar

3.using your mouse, you need to point to the search range bar, and perform a righT CLiCk. A little box will display that says “change search criteria.” After clicking on this box, another window will display with the options available in that tab to change search criteria ranges.

4.This “x” indicates that this box is in errOr. various reason for this exist:

a.This document may have come down with the paper chart and had the incorrect patient’s name addressographed on the paper form

5.The domain used was the TrAindomain.

6.you know this because the screen tells you (refer to the area circled in red at the lower right corner of the screen).

nOTe: you should glance at this area after you sign into Power chart, just to make sure you are in the domain that you intended to access!!

PowerChart Quiz #2 AnswersCrossword Answer

Know and Go PowerChart Tips Jan 2008 boo… · Know and Go PowerChart Tips Jan 2008. page 2 page 3...

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