New Tools, Updates & Reminders
New Tools: I bought a head-light as well as a set of tools and have stocked them in the Pyxis at both FEDs. So if you need a headlight for sutures, ear exams, nose exams, vaginal exams, etc - just have the nurse (or you!) pull it from the Pyxis under “Head Lights”. Additionally, the “Tools” are under “Tools” in the Pyxis - different size/type of pliers and other tools.
TeleProvider Surge Process: We need to utilize this! I am very excited and thankful to announce that Nichole Campbell, NP, has agreed to be the TeleProvider Point Person for this process.
UMC Burn Center Transfer Protocol: PLEASE REVIEW!! UMC has reached out and requested that we review their transfer protocol. Note they want LR fluids, not NS. They are NOT using the Parkland formula - basically use the ½ parkland formula. They do NOT want us to give antibiotics. Electrical burns are special and do use the higher fluid Parkland formula. Note that Fluid time starts at time of burn, NOT time of arrival
Click here to review the UMC Burn Center Transfer Protocol (also now pinned on the main page!)
Signing Up For Patients: don’t forget to sign-up for patients on the board AFTER you see the patient. Only AFTER you have seen the patient, “Assign” yourself to the patient on the Tracking List.
This is the trigger to let Registration clerk know that you have seen the patient and they can then go discuss billing collection with the patient. Note: per EMTALA, registration cannot discuss billing until the physician/apc has seen the patient.
When starting your note in Cerner, the “Date & Time Seen” is timed from when you lay eyes on the patient – even if they are walking by the desk. The goal is to ‘see’ all patients within 15 minutes of arrival.
Click here to review the ‘Seeing Patients’ process in the Provider Manual.
Open Fractures: don’t forget that even open finger fractures fall under this category and we need to ensure we are giving appropriate antibiotics within 60 minutes for any open fracture.
Decision to Admit: don’t forget to enter this order AS SOON AS YOU THINK A PATIENT MAY REQUIRE ADMISSION. This is a metric we are measured by and need to make sure we are making this decision within 150 minutes of arrival.
Calls for admission and consults: document ALL calls - even if you page or leave a message - in the “Calls-Consults” section under the “Impression and Plan” in the note. For more than one call, right-click on ‘(repeat)’ and select ‘repeat’ to document multiple calls/consults.
Residents and Students: don’t forget we have residents as well as students. Residents can and are expected to do notes, but students are not. Watch Video Below on putting the “Attestation” for staffing residents notes
Macros: see the video below on how to create macros in Cerner - useful for creating standard physical exams, and the “Attending Attestation” for supervising residents. This video is also available in the Cerner Training Videos (click here to go to the page).
