Powerforms

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Infectious Disease Documentation and Alert Updates

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TLTR: On July 30th there will be an update to the current infectious disease nursing intake screening. It will include an expansion of the current Ebola and Zika alerts as well as integration of Tuberculosis, Yellow Fever, and Measles as well as the ability to assess outbreaks within the United States.

Infectious Disease Documentation and Alert Updates

After a systematic assessment of workflow and clinical decision support (CDS) related to infectious diseases documentation in PowerChart, it was found that an enhancement was needed. This enhancement includes updating existing nurse intake documentation and development of new alerts for nursing staff and providers. It was developed with several goals in mind:

  • ·         Improving patient AND staff safety
  • ·         Preparation for emerging AND re-emerging infectious diseases (i.e., the recent resurgence   
  •           of Ebola)
  • ·         Preparation for contagious diseases re-emerging within the United States (i.e., Measles and
  •           Mumps due to anti-vaccination movement)
  • ·         Standardize forms between inpatient and outpatient

To prepare, as well as to align ourselves with the national Centers for Disease Control and Prevention (CDC) initiative (CDC, 2018), we had round-table discussions with subject matter experts and selected several disease processes found to be either underdeveloped or non-existent in the system that needed the highest attention:

  • ·         Ebola (exists, undergoing update)
  • ·         Zika (exists, undergoing update)
  • ·         Yellow Fever (new build)
  • ·         Tuberculosis (enhanced build)
  •           MERS (new build)
  • ·         Measles (new build)

The existing PowerForm, Infectious Disease Screen, has been updated to aid in easing the transition for the nursing staff. It is the same form currently used, only with upgrades and modifications.

As of July 30, 2018, if applicable algorithms are met, an alert will be fired for Ebola and Zika (already exists), as well as Yellow Fever, Tuberculosis, and Measles and MERS (new). Other disease processes will be added later as the need arises or by subject matter expert request.

Continue to rely also on your clinical critical thinking skills when working with potentially infectious patients; always follow your institutional protocol. Clinical decision support provides guidance, but your clinical expertise will aid in whether the situation calls for further action or not.

 

 

References

Centers for Disease Control and Prevention. (2018). Adapting clinical guidelines for the digital age. Retrieved from https://www.cdc.gov/ophss/WhatWeDoACG.html

Centers for Disease Control and Prevention. (2018). CDC travelers’ health, 2018. Retrieved from https://www.cdc.gov/ncezid/index.html

Infectious Disease Intake Updates

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Powerform - Documenting Lab Results From Other Facilities

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Powerforms for documenting lab results from another facility are being introduced and will replace some existing forms. Results documented on these forms will display in the patient flowsheets in Powerchart and are readily identified as coming from an outside source. The name of the facility that processed the lab is a required field and the form cannot be completed without this field. The forms are similarly named "Outside Lab..." followed by the type of results that the form entails (CBC, Chem, FOB, HIV Screen, etc).

Lab results that are not available on these forms will continue to follow the same process previously defined by your clinic (i.e. scan into chart, reviewed by provider, etc).

These forms can be found in your Ad Hoc folders begining May 23, 2018.

Automation of Bedside Sedation Process

Starting 4/3/2018, the bedside sedation process will become electronic

The following plans will be available for your use and should be placed prior to using sedation for a procedure at the bedside.

You will notice the plans have four phases.  The Provider will ONLY complete the FIRST THREE phases. (Pre, Intra, Post-Procedure).  Nursing will complete the Fourth phase.

The first order is the Sedation History and Physical Update Order and this order has a form attached to it that the physician will complete after signing the powerplans.

Once the plan is signed by you, the following form will appear.  This form must be completed by the physician. 

There will also be two new PowerNote Templates available for use with this process.

  1. UMC Pediatric Sedation Brief H&P (This note is specifically used for sedations done in PICU)
  2. UMC Procedural Sedation Note (this will also be available to Insert as a Sentence in any existing note that has a Procedure Paragraph (Ex: Central line Procedure Note)

 

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Fecal Occult Blood (FOB) Outside Source Powerform

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Fecal Occult Blood (FOB) Outside Source section has been added to the Basic Labs Outside Source Ad Hoc form to document FOB results a patient may have received from a provider other than UMC, UMCP, or TTP. This section can be accessed from the Basic Labs Outside Source form or from the Health Maintenance tab under Colorectal Cancer Screening. Results will satisfy HM for 365 days.

The Performed on date should reflect the date the test was resulted, not the day it is being charted in Powerchart.