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Tim:

We do not use the worklist, but why not build a valid direction for Q3-4
With Feeds and then PHA can attach it if the order is written that way.
I agree that it would be nice to have all active interventions appear on
the worklist, but if your facility is like all the ones I have worked
at, that worklist would be long.

I chose a patient at random and that patient has 39 active
interventions, 90% without valid directions, either no directions or
.directions.

Interventions                 Sts Frequency            Doc  Src D C/N KI
Prt
 ~~~~~ PATIENT RIGHTS ~~~~~
  -CODE STATUS - FULL CODE L  A                        6h  CP
   DOCTOR'S ORDER DATE:
  -Communication Devices      A                            CP
*
 ~~~~~ DAILY / SHIFT DOCUMENTATION ~~~~~
  -Plan of Care reviewed      A QS                     3h  CP
  -Pain, Evaluation and       A .TIMELY RE-EVAL***         CP
  -Education, Patient/S.O.    A                            CP 
  -Physician notification     A                            CP
  -Physician Critical Result  A                            CP
  -Shift/Patient Evaluation   A QSHIFT                 3h  CP
  -Shift/Summary              A QSHIFT                 5h  CP
  -Dinner Intake              A HS                    16h  CP
 ~~~~~ CLINICAL MEASUREMENT ~~~~~
  -PCA, Pump cleared          A QSHIFT                     CP
------------------------------------------------------------------------
--
As you know only the interventions listed above with the valid
directions appear on the worklist. The worklist is suppose to be a tool
to help the caregiver plan their day and remind them to provide certain
care/treatments/follow doctors orders, etc.

Without a valid direction, as you stated, it could be added to the
bottom of the worklist, but for my facility, you would have 39
interventions on that one patient, including the 3 Admit Assessments
(Meds,Hx and Assessment), that almost no-one remembers to change the
status to complete and they are still on the Process Intervention
Screen....from 3days ago...

~~~~~ ASSESSMENT ~~~~~
 -PLAN OF CARE, Initialized                A                        3d
AS
 -ER Triage Assessment                     A                        3d
AS
 -ADMISSION, Patient Assessment            A                        3d
AS
 -ADMISSION, History                       A                        3d
AS
 -ADMISSION, Home Medications              A                        3d
AS
------------------------------------------------------------------------
--
I know education is the answer, but no matter how many times we teach
the staff or remind them to clean up the patient's care plan and thus
the PI screen would be shorter and easier to document on their patients,
it just does not get done...The staff do not get the big picture for how
it all works and could work better.

Let us all know if you come up with a good work around for this issue.

Good Luck,

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Witt, Sharon L.
Sent: Friday, September 01, 2006 12:56 PM
To: Brady, Tim; [email protected]
Subject: RE: [MEDITECH-L] NUR Worklist and .SIG Orders

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I think the fix for this is in 5.5, sr2.  We have this in test and the
prns appear at the bottom of the worklist.  Do your nurses print the
worklist? Ours have and they were the ones to notice that while the room
# appears on the worklist when viewing, they don't print. Instead the
account # prints.

Of course, Meditech states it is working as designed and there are no
plans on changing it.

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Brady, Tim
Sent: Tuesday, August 29, 2006 2:36 PM
To: [email protected]
Subject: [MEDITECH-L] NUR Worklist and .SIG Orders

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Our nurses love the worklist, but we are ready to turn it off!  We have
several medication orders which do not have specific times and thus do
not appear on the nursing worklist.  An example of such an order is:
(Q3-4 With Feeds).  Has anyone out there had any luck getting these type
of orders to appear on the worklist?  I understand that it can not
appear with times, but even if it could just be listed at the end, it
would be a cue for the nurse to look at the MAR.

Any thoughts/suggestions are appreciated!

Tim Brady
Director of Information Systems
Mt. Washington Pediatric Hospital
(410)578-2676


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