I hope that everyone had a wonderful Thanksgiving. All good things must come to an end and so it is with holidays; we are now back to work.
Post-op Order Sets
This is a reminder that in order to help both our physicians and Covenant Health comply with the SCIP Guidelines, antibiotic duration on the post-op order sets is defaulted to 24 hours (typically 1-2 doses).
There are times however, when a patient has a known infection (for example, a perforated viscus) and requires more than antibiotic prophylaxis. If you use one of the post-op order sets to choose an antibiotic, and a patient needs more than 24 hours of treatment, you must Edit the duration of therapy of that antibiotic(s).
The screenshots below, taken from the GI Surgery Post-op set, demonstrate this:
Choosing the edit button brings up the following screen:
In this Post-op order set, the duration is set at one dose, which is not adequate to treat an active infection.
In order to adjust the duration of post-op antibiotics, change the parameter in this box by erasing it (backspace) and the duration of post-op antibiotics becomes open-ended, as shown below.
One of the areas in MEDITECH that deserves repeating is medical record signatures. The EHR does not eliminate the need to complete our documentation/dictation and to sign our documents and orders. At this time, if you completed everything in HPF, then no new orders or dictation will appear in HPF for signature. The only things that will appear in HPF for signature are scanned paper documents, such as written or printed office H&Ps and written orders sent in with a patient. Deficiencies for missing dictation will also appear in HPF.
MEDITECH is where you will sign all orders, dictated reports and reports that are created in MEDITECH. Reports created in Provation, ProSolve, Synapse, etc. still need to be signed in these applications.
In the MEDITECH Desktop view the "Sign" button in the right lower portion of the screen is "live" if you have dictation and/or signatures to complete. The screenshot below indicates that there are pending signatures:
Starting on Tuesday, December 2nd, a number of outside support personnel joined us at CH to supplement our onsite Clinical Informatics and Physician Liaison staff. They will be here for the next few weeks to provide "at the elbow" help and to support our Regional Clinical Informatics staff. They will be divided between the CH Ministries and should help significantly with our ability to provide support for our physicians and staff.
As always, if you have any questions or concerns, please contact me at 725-0265.
Until next week,
Lawrence Martinelli, MD, FACP, FIDSA
Chief Medical Informatics Officer
Medical Director, Case Management/Utilization Review
3615 19th Street
Lubbock, Texas 79410