Childrens Hospital eChart

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Childrens Hospital eChart
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Log-on Procedure

• Enter username and password then click OK.

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Log-on Procedure

• BioLogon screen will appear, place fingerprint on
  scanner.

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Patient Census Screen
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Select your unit from the Current List drop-down
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Flags

• Flags appear on the patient census screen.
• Information about new orders or new results can
  be found by double clicking on the flags.
• Green flags are routine orders or normal lab
  results.
• Red flags are stat orders, alerts, or abnormal
  results.

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Flags
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Viewing Orders

• Highlight patient on the census screen and click
  on the Orders tab
• All active orders from the start of admission
  will appear.
• Orders are categorized under Pharmacy, Lab,
  Nursing, etc.
• Some orders may have a symbol to the left to
  indicate the type of order. Ex) STAT, Held, PRN

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Viewing Orders
Click to highlight pt.
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Icons

• A blue question mark next to the order indicates
  that the order is Conditional, and a condition
  must be met for activation of the order.
• A red hand means the order is Suspended.
• A red circle with a line means the order is on
  Hold. (Seen in patients transferred from the ED
  or PACU.)
• As needed orders will have PRN next to them.
• A yellow clip board indicates there is a timed
  reoccurrence, such as a lab ordered every 12
  hours.
• Urgent orders will have STAT next to them.

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Filtering Orders

• Several filter options are available to help sort
  orders
• Date Range- shows orders by their date
• Order Status- shows orders by status, ex) Active,
  Discontinued, Completed, etc.
• Order Selection- shows orders from just one
  department, ex) Lab, Pharmacy, Nutrition, etc.
• Requested by- allows you to look at orders in
  historical view

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Lab Results and Diagnostic Tests

• Click on the Results tab to view
• Select a category and then double click on the
  box for that result/report
• To view multiple results, hold down the left
  click button on your mouse and drag it across all
  data you want to capture
• Click Report by Order
• Click Summary to return to the main results
  page

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Results
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Allergies

• You can locate allergies via the Patient Info
  tab.
• Notice if the allergy has a yellow H or i just
  double click on the allergy to see all the
  information. is for the history of the
  allergy and is for the description of the
  reaction.

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Allergies
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System Safeguards (FYI)

• Allergies are added by the physician upon
  admission of the patient. They carry forward to
  future charts as the patient is re-admitted.
• The system will alert the physician to medication
  allergies or improper doses.
• The system also does alerts to remind physicians
  to reorder restraints.

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Alerts (Under Patient Info Tab)
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Significant Events

• Significant Events are located under the Patient
  Info tab.
• These carry forward from chart to chart and are
  entered by the RN.
• Items that are entered include GT placement to
  custody issues.
• This item gives the admitting nurse immediate
  information on the patient.

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Patient Summary

• Click on the Summary tab to see pts Allergies,
  Health Issues, Significant Events, and Orders.

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Temporary Location

• When a patient goes off the unit for example, to
  the OR or Dialysis, they need to be placed in a
  temporary location.
• This allows all departments to know where the
  patient is and enables them to receive pharmacy
  orders and lab labels.
• You will see this temporary location on the
  header bar. Ex) PACU.

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Documentation (SCC)

• Click the wrench icon to toggle to the
  documentation side of the system

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The Wrench
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Basic SCC Lingo

• SCC is not a windows based program-so double
  clicking does not work. Just point and click
  using your mouse. You will also be able to use
  the function keys at the top of your keyboard or
  at the bottom of the computer screen.
• You will need to sign data that you enter prior
  to moving on to the next page of data. Unsigned
  data appears in purple. In order to sign, just
  click on the word Sign in the lower right hand
  corner and enter your password.
• Sections and forms are at the top of the screen.
  Each section will bring you to a different set of
  forms.
• The first form you will cross to from CPOE is
  always Vital Signs.

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Vital Signs

• Done every 4 hours or more often if
  ordered/indicated
• Click on the Flowsheet Section, and on the
  Vital Signs Form
• Along the left hand side of the screen will be
  the name of the parameter such as BP,
  temperature, respirations, etc.
• In order to chart on that parameter you will need
  to go to the blank space under the correct time
  column.
• Type in your data and select from pop-up box if
  present.
• At the end, click the Sign button.

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Vital Signs

• Under correct time, point and click on the
  temperature cell and type in temperature.
• A pop-up box will appear, click the appropriate
  data.

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Treatments

• From Flowsheet Section, click on Treatments
  Form
• This flowsheet is for things that you do to your
  patient.
• Click appropriate treatments and add data in time
  columns
• Safety Checks, Fall Risk Assessment, IVs, and
  Cares are done every hour
• Review IV Assessment tool on this page
• note students will view, but not document IVs
  in this area
• Sign when finished

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Treatment Flowsheet
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Treatments

• An asterisk found to the left of an item
  indicates details/references to this item.
• Left click to highlight the box, right click on
  show and then right click on show reference

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Intake and Output

• From the Flowsheet Section, click on I/O Form
• I/O Totals are located at the top of this form
  and are automatically calculated under shift and
  daily total columns. It wont allow you to chart
  in these areas.
• Intake Select the row for the appropriate type
  of input Ex) Oral, IV, etc. then type in amt.
  under correct time
• Output Select parameter under the correct time
  column and enter amount
• Remember to sign all data!

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I/O Flowsheet
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Corrections

• Select the data cell that needs to be corrected
• Click on F3 Correct Parameter
• Type over the incorrect data with the correct
  data
• Click OK and Sign
• A red C will show in the cell to show that the
  data was corrected

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Labs

• Labs can be viewed on both SCC and CPOE.
• In SCC simply click on the lab tab and choose
  your lab category to view.
• In CPOE click on the results tab and then choose
  the result you want to view. Double click on the
  flag to view that lab result.

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Labs Review from SCC
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Assessments

• Assessments are done daily on all units at 0100.
• At the beginning of every shift you will need to
  review the 0100 assessment
• Then enter a note to verify whether you agree or
  disagree with that assessment.
• You will enter a new note under the Notes
  Section. Use Topic- Summary with the Subtopic-
  Shift Change.

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Notes

• Go to Notes section, click F5 to enter new
  note
• Will default to current date and time, change if
  needed
• All notes must have a topic. Click in the text
  box next to topic to see a list of options.
  Choose a sub-topic.
• Either free text your note or select from the
  list of drop-down options which will form your
  note for you.
• Write entered by, name, SN at the end of your
  note.
• Leave your note incomplete by clicking on the
  yes in the bottom left hand corner and change
  it to no
• The instructor will then review the note,
  complete it, and both names will appear on the
  note.

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Notes
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Medications

• Click on the Medications Section and the Meds
  Due form
• The list of meds due on your shift will then
  appear

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Medication Documentation
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Medications

• To document a medication administration, place
  the cursor on the text box next to the dose.
• Click F6 Enter Detail
• Verify administration time. Type in correct time
  if a correction is needed.
• Students should enter Checked with and type in
  the instructors name with whom the medication
  was checked in the Comment field.

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Medication Administration
Administration time
Click OK and Sign
Checked with
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PRN Medications

• PRN medications can only be signed off from the
  medication form.
• Select the medication and go to the time column
  of the time the medication was given. Click in
  this space.
• Again use the F5 Enter Detail to chart on this
  medication.

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Plan of Care/Teaching Record

• Plan of Care is created within 24 hours of the
  patients admission. The teaching record is a
  multidisciplinary form used by everyone.
• In order to chart on either form you will need to
  F10 Add Time. This creates a column for you
  to chart in.
• Each parameter has a pick list to chart from it.
• You can write a note in any of the boxes that you
  are charting in simply by clicking on F5 Enter
  Note. This will place a green n in that box.
  
• You have to write a note if there is an exception
  to the plan of care.
• Always remember to sign.

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Function Keys

• F2-Show Detail To see more detail in the cell.
• F3-Correct Parameter To change any previously
  entered data.
• F4-Enter Comment To add a comment of up to 26
  characters to any cell. Ex) patient crying.
• F5-Enter Note To enter a note from any cell.
• F7-Highlight To highlight pertinent data in
  red.
• F9-Modify Form To add a new row to the form.
• F10-Add Time To add a new column with the
  current time or a time from the past.
• F12-Print To print off parts of the chart as
  needed. Ex) OR Report

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Function Keys
Sign button
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Return to the Order Entry side by clicking on
either of these icons
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Click Logoff when finished at the computer.
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Desktop Features

• On the desktop, click on the Drug Card Database
  or CHI Formulary to look up a medication.
• Click on the Laboratory Guide to Services to find
  out detail about various labs.
• Click on Childrens Hospital Intranet and Policy
  Manuals and Standards of Conduct tab to look up
  hospital policies.