EPIC IMP 100

What should you do when all of the teaching points for a topic are complete?

Resolve the topic.

What does the pushpin mean if it is next to a problem in the problem list?

The pushpin indicates that the problem is a chronic problem (an ongoing problem for the patient).

What are two reasons why a nurse might need to pull a medication from an ADS cabinet on override?

-No one has entered an order for the medication into Epic -An order has been entered in Epic, but pharmacy hasn't verified ti yet, so it does not appear on the patient's ADS profile.

What is a SmartText and how can it be pulled in to a note?

A SmartText is a template for writing a note. It can be pulled in from the Insert SmartText field.

How do you know which notes are new?

A clock icon appears in a column next to the note.

How can you tell when a teaching point has been completed?

A green check mark appears next to it.

What is the purpose of a wildcard?

A wildcard, denoted by ***, is intended to provide the clinician with a place to enter free text.

What are the tabs along the left of the screen in a patients' chart called?

Activities

How can you quickly indicate the patient's last dose of all of home medications was today?

Click MARK UNRECONCILED TODAY in the Review Home Medications section of the navigator.

When first opened, for what time frame does the Work List display tasks?

Current Shift

How can a clinician open a patient's chartg?

Double-click the patient from Patient Lists.

What are two ways Education titles can be added to the Education activity?

Education titles can be added automatically if a Care Plan goal or intervention requires teaching, or they can be added manually by clicking ADD TITLE.

Where should a physician go to order a patient's home medication if it wasn't originally ordered during the admission process?

Home Meds tab of the Orders activity -> Reorder Home Meds

As you are writing an order for your patient, your pager goes off. What can you do with this unfinished order?

Pend the order by clicking Save Work.

List at least three pieces of information that can be found in the Details report within the Flowsheets.

The value, comments, time taken, time recorded, user taken, user recorded, show audit.

How do you remove yourself from the treatment team for a patient?

Find the patient in the My Patients lists. Right-click on the patient's name and select END MY ASSIGNMENT.

What can you type in the search field if the patient tells you they are taking a medication but they do not know the medication name?

Type "Help" in the search field to add Unknown to Patient to the med list. (You can also just type "Unknown.") You might need to click the Database Lookup tab to find it.

What happens behind the scenes when you modify the rate of a medication?

The original order is just modified. As a result, only one row appears on the MAR for nurses.

When writing a sticky note, what should you include at the end?

Your name and the date you are writing the note.

What is a system list, and how can it be used to organize patients?

A list of patients that is automatically updated by the system. You can make a shortcut to these lists in a My List.

Why might an Order Set be suggested in the New Orders section?

Based on a diagnosis listed in the patient's Problem List, based on a BestPractice Advisory, or based on the type of navigator.

How can you quickly find a patient's H&P within the Notes activity?

Click the H&Ps. Or, from the All Notes tab, click the Type column header to sort by note type.

What activity should you use to get report at start of shift?

Summary activity

How can you tell if there are values hidden within a time interval in accordion reports?

The abnormal value appears in red.

What is the Principal problem?

The Principal problem is the main reason for the patient's hospitalization.

How do you document a goal that was not met?

Enter "Not Progressing" in the Outcome field. Then, document a variance. Highlight the goal, click ADD VARIANCE and fill in the appropriate fields.

Before a nurse releases signed and held order for a new patient who just arrived on the floor from the ED, what other step needs to be done first? What will happen if this step is not done?

Before releasing signed and held orders, the patient's arrival on the unit must be confirmed in Epic using the Unit Manager activity. If this is not done, the system will think the patient is still in their original unit and orders might be affected (medication might be dispensed to the wrong place, etc).

WHen documenting with a positive/negative button, how can you quickly indicate that the specific condition is absent or negative?

Right-click or click the minus sign.

What does EPIC call the first screen a user sees when they log in?

Startup Activity

True or False? If a clinician closes a patient's chart without clicking File in the Flowsheets activity, any unfiled data in the flowsheet is lost.

False. The system automatically files any pending data when the end user changes flowsheet templates, leaves the Flowsheets activity, closes the patient's chart, or logs out.

True or False. The Work List includes all tasks that a night nurse might have to complete throughout a shift.

False. There are things a nurse is responsible for that are not listed as discrete tasks on the Work List.

In which section of the medication reconciliation navigator do you decide whether a home med should be ordered for this admission?

In the Reconcile Home Medications section, you determine whether the medication should be Ordered, Not Ordered, Replaced, or Discontinued.

What does it mean to release signed and held orders?

Releasing orders means you are making them active. Other clinicians will be notified of the orders and can start acting on them.

How can you most efficiently document several teaching points to several learners?

Select multiple topics or points before clicking Document, or select more than one learner after clicking Document for the appropriate pieces of the patient's education.

True or False? Teaching points are always attached to a teaching topic.

False. A teaching point can be added to a topic or directly to a title. The topic just serves as an organizer for multiple points.

Assume the following scenario: You are searching for an order, and you are unable to find it on your preference list, so you search the facility list and find it there. The next time you search for this same order, you don't want to have to expand your search to the facility list. What can you do?

Add the order to your preference list by clicking the star to the right of the order.

True or False? a note can be signed even if all of the SmartLists have not been completed.

False. All SmartLists and wildcards must be completed before the note can be signed.

What are two ways templates can be added to the Care Plan activity?

Care Plan templates can be added automatically by accepting a recommendation in a BestPractice Advisory or they can be added manually by clicking APPLY TEMPLATE.

How do you add yourself to the treatment team for a patient?

Click Sign In and select your patients from the department list.

What must you do before that unfinished order can be acted upon?

Complete and sign the order.

When searching for a dietary consult order, you enter "con die" in the search field. What search method are you using?

EnRol

How does a nurse document that all values are normal except for a few?

Enter an "X" in the WDL row. (This documents that all values are within defined limits, except...) Then enter the abnormal information in the appropriate rows.

True or False? A Care Plan problem is the same thing as a medical disagnosis on the Problem List.

False. A Care Plan Problem is commonly referred to as a multidisciplinary problem that nurses or ancillaries are caring for. For example, "pain" or "disorientation" are multidisciplinary problems.

On the Add or Remove Buttons from Toolbar window, what is the difference between the Reports and Display Name columns?

In the REPORTS column, you enter the name of the report you want to have as a shortcut on the Reports toolbar. The name in the DISPLAY NAME column is what you actually see on a report's button in Summary.

When documenting with a positive/negative button in the NoteWriter, how can you quickly indicate that the specific condition is present or positive?

Left-click or click the plus sign.

What is the main difference between documenting a PRN medication compared to a scheduled medication?

PRN medications do not have scheduled times that appear on the MAR. To document giving the medication, the nurse clicks anywhere in the cell and documents administering the medication. Scheduled medications appear with a due time in the cell at the time the medication is scheduled to be given. To document administering the medication, click the due time on the MAR.

On which tab can you document progress of education provided to the patient?

The Education tab.

After filing a note to the patient's chart, where in Hyperspace can that note be read?

The note can be viewed from the Notes activity or an encounter report in Chart Review.

When a nurse does into a flowsheet and wants to enter new values, what should be done before documenting any information to ensure the data is entered under the correct date and time?

The nurse should click the Add COl button or the ow hyperlink. This drops a new column with the current date and time. If charging values taken in the past, the Insert Col button should be used.

What happens behind the scenes when you modify the frequency of a medication order?

The original order is discontinued and a new order is entered. As a result, two rows appear on the MAR for nurses.

How can you tell there is an abnormal value within a specified time interval in accordion reports?

There is a red exclamation point next to the value.

Embedded within a SmartText are SmartLists. How can you start filling out a SmartList? Make a selection? Accept your selection?

To start filling out a SmartList using the mouse, use the Next Field option (under the All Other Tools menu). To make a selection, left-click, and to accept your selection, right-click.

True or False? Documenting the patient's vitals in the navigator will also populate the Vital Signs flowsheet template int he Flowsheets activity.

True. All documentation that you complete in a navigator will automatically populate the appropriate places throughout the patient's chart.

True or False? You can add free text to a note in the Note form.

True. You can add additional information to your note by using SmartPhrases or free text in the white space withing the note.

How do values appear prior to filing them to a patient's chart? How doe they appear after they are filed?

Values have a grayed edge in their cell prior to being filed. Values do not have this icon after filing.

Give two advantages of using the Work List instead of the Due Meds report to review your patients' medications. Then give two advantages of using the Due Meds report instead of the Work List.

Work List: Can see ALL medications for ALL patients; can see other tasks at the same time; can document without opening a patient's chart. Due Meds: Can see ALL of one patient's medications due within the current shift; can see last administration time of all meds; can easily see administration instructions.

Can a nurse document giving a medication that has NOT been verified by pharmacy?

Yes. He sees warnings that the medication has not been verified but can continue with the administration.

After creating a User SmartPhrase that includes a SmartText, using the green plus sign, how can you pull the new text into a note to use it for patient documentation?

You have created a SmartPhrase, so you can summon it into your note by typing a 'dot' and the SmartPhrase name or by clicking the List My Phrases (.my?) button.

In the Problem List section of the navigator, how can you indicate what the patient's principal problem is? What must this problem be marked as first?

You select the check box in the Principal column after indicating that the problem is a hospital problem.

How do you document on an ongoing goal?

Highlight the goal and click DOCUMENT. You can mark it as "Progressing" or "Met this Shift" if the goal was met.

You want to Time Mark the new notes for your patient. Will that action Time Mark your patient's notes for anyone else who opens her chart?

No. Clicking Time Mark automatically marks ALL notes as no longer new for the user to Time Marks, but nobody else.

Why are orders signed and held when written for a patient being admitted from the ED?

Orders are held so they are not sent to the ED. They need to be held until the patient arrives in the inpatient unit.

Dr. Asparagus would like to order an acetaminophen-codeine (TYLENOL #3) tablet for his patient. In the search field, he types "T3" and finds the order. Why did Dr. Asparagus find the order after typing, "T3"?

T3 is a synonym for the acetaminophen-codeine (TYLENOL#3) tablet order.

When reviewing ht patient's home medication, what does the house icon indicate?

The house icon indicates that the medication was entered in Epic as an outpatient prescription.

How do medications that are discontinued appear on the MAR?

The medication row appears with all the cells highlighted in yellow.

What types of information can a surgeon gather from reports at the bottom of the startup activities?

Vitals, I/O, Current Meds, and more

What is a My List?

A list of patients that I am following during my shift. I control the columns, the default report, and I manage the list of patients

How can you search for a patient that is not admitted to the hospital?

Click PATIENT LOOKUP to search through the entire database of patients, including those who are not admitted.

True or False? BestPractice Advisories (BPAs) notify clinicians of tasks that they must perform for the patient.

False. BPAs present clinicians with suggestions to do things like add to the patient's care plan or place orders. If clinicians don't agree with the BPA suggestion, they can clear the check box in the BPA before clicking Accept.

True or False? Epic does not have an audit trail for values in Flowsheets that have been edited or deleted.

False. Epic does have an audit trail for edited or deleted data, and any values that have been edited or deleted are flagged.

True or False? When you log out, the system remembers all filters and views that you set on the Work List.

False. The Work List only saves the last view selected by the user. The filter is not saved.

You're about to give a pain medication to a patient. You know the patient hasn't received any doses of this medication, but you'd like to see the last time he received any pain medications over the last 24 hours. How can you do that without having to scroll through multiple shifts of the MAR?

Use the MAR Report in the MAR activity.

True or False? Time Mark means that you have actually read all of the notes in the patient's chart.

False. Time Mark serves as a bookmark and organization tool for you. It simply marks the notes as no longer new.

What does an "!!" icon next to a medication on the MAR mean? How is the administration workflow different for that medication?

The medication requires dual sign-off. Another nurse will need to review and verify the administration and enter his user ID & password when documenting the administration.

If a clinician enters WDL in the "Within Defined Limits" row for a system, what does this mean?

"WDL" means that all values taken within that system fall within the defined range. No other data needs to be entered.

Where can a nurse look to find information on the "defined" values for a given row?

A nurse can view the Row Information in the Details report on the right side of the screen. This gives him information about normal values, possible choices, and the last filed data. If the Details report is hidden, click the left facing arrow in the middle or the right side of the screen to expand the report.

How can you tell if there are values hidden within a time interval in accordion reports?

A plus sign appears next to the value displaying in a given column.

How would you change the Work List to display only medication tasks organized by patient?

Change to Patient View and filter on Medications

How can a surgeon quickly sort her list of patients by unit?

Click the Unit column in Patient Lists.

True or False? The Work List only allows a nurse to view tasks for one patient at a time.

False. If the nurses selects a list of patients and clicks Work List, tasks for all patients on that list appear in the Work List to review.

True or False? When creating a User SmartPhrase that includes a SmartText, a physician should insert the SmartText into the note before clicking the green plus sign.

False. If you are creating a User SmartPhrase that contains a SmartText, click the green plus sign first. Then, pull your SmartText in to your note window. This prevents any patient-specific information from being saved in your template.

When documenting with a positive/negative button, how can you quickly add a comment?

Hover your mouse cursor over the positive/negative button and start typing. Or, double click the positive/negative button to open the comments window and then start typing.

What does it mean to Sign and Hold an order?

It means that the order has been authorized, but it is not released or active until the patient arrives to another location or stage of care.

When reviewing the patient's home medications, what does the person icon indicate?

The person icon indicates that the patient reported taking that medication.

How can you tell if a comment has already been added to a positive/negative button?

The positive/negative button is underlined.