Cerner Bedside Monitor Documentation Change

Go Live: November 5th

Documentation change

An update is coming with how results from associated devices are interfaced into Cerner's Interactive View (I View)

Info

Demo

Documentation change

Cerner is requiring an enhancement in an effort to improve the accuracy of documentation of results from devices associated with the patient's chart in Interactive View (I View)

When "pulling" vital signs into Cerner from the bedside monitor, Cerner will document the most recent data communicated from the monitor in its own specific time column.

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Practice Makes Perfect

The best way to understand how these changes will impact your practice, is to see for yourself

Let's walk through a demo of different scenarios you may encounter after this change in how Cerner is interfacing data from the bedside monitor

Open Chart

In this scenario, the time columns are set to q15min. & we are "back charting"

13:42

(documenting after the timeframe we are charting in)

Click the 12:30-12:44 time column to "pull over" vital signs

Cerner will pull in the most recent data sent from the monitor for the time-range you are charting in

13:42

When back-charting in a time range, the most recent data for the continuous parameters (HR, RR, SPO2, Art BP) will be the last minute of that time range

Click the highlighted areas to learn more

Next

In this scenario, the time columns are set to q15min. & we are charting for the time range we are currently in

13:43

Click the 13:30-13:44 time column to "pull over" vital signs

Cerner will pull in the most recent data sent from the monitor

When charting in a time range column that includes the current time, the most recent data will be what was last sent from the monitor

13:43

*in real-time, there is approx. a 1-2 min. delay*

Click the highlighted areas to learn more

Next

With this change, the most accurate format to view and document vital signs in is "Actual View" instead of time range columns

13:36

Let's set our default format for the Adult ICU Quick View to "Actual View"

Click: "Customize View"

With this change, the most accurate format to view and document vital signs in is "Actual View" instead of time range columns

13:36

Let's set our default format for the Adult ICU Quick View to "Actual View"

Click: "Preferences"

With this change, the most accurate format to view and document vital signs in is "Actual View" instead of time range columns

13:36

Let's set our default format for the Adult ICU Quick View to "Actual View"

Select the drop down arrow highlighted

With this change, the most accurate format to view and document vital signs in is "Actual View" instead of time range columns

13:36

Let's set our default format for the Adult ICU Quick View to "Actual View"

Select "Actual"

With this change, the most accurate format to view and document vital signs in is "Actual View" instead of time range columns

13:36

Let's set our default format for the Adult ICU Quick View to "Actual View"

Select "OK"

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click next to the time to Insert a new Date/Time

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Select "Insert Date/Time"

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to type in the 1145 time

Enter the time you wish to chart vitals for

1145

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to pull in the 11:45 vital signs

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Great! Now click to insert another Date/Time

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Select "Insert Date/Time"

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to type in the time the next set of VS should have been taken

Enter the time you wish to chart vitals for

1200

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to pull in the 12:00 vital signs

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Great! Now click to insert another Date/Time

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Select "Insert Date/Time"

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to type in the time the next set of VS should have been taken

Enter the time you wish to chart vitals for

1215

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Now lets chart some post-procedure vital signs for our patient

The first set of vitals were taken at 11:45

Click to pull in the 12:15 vital signs

Now your "Adult ICU Quick View" navigator band will always open in "Actual View" instead of time range columns

13:36

Awesome Job!

Notice there was an additional column generated at 12:17 with new arterial line BP results

Next

In some instances, the vital signs we chart are related to regulatory requirements.

13:36

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

Notice the NIBP for our pt's 12:30 vitals pulled in 1 min late

Next

In some instances, the vital signs we chart are related to regulatory requirements.

13:36

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

Click to manually enter the NIBP in the 12:30 column

In some instances, the vital signs we chart are related to regulatory requirements.

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

13:36

Click to manually type in the SBP

Enter the SBP result

119

Enter the DBP result

62

Enter the MAP result

83

In some instances, the vital signs we chart are related to regulatory requirements.

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

13:36

Click to manually delete the 12:31 DBP

In some instances, the vital signs we chart are related to regulatory requirements.

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

13:36

Click to manually delete the 12:31 MAP

In some instances, the vital signs we chart are related to regulatory requirements.

If the noninvasive BP pulls over into a time column a minute later than when the measurement started, this could cause us to fall out of compliance

13:36

Now Compliant!

Next

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"The secret of change is to focus all of your energy not on fighting the old, but on building the new"

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Morgan Swearingin

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Clinical Informatics

Go Live: November 5th

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Go Live: November 5th

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Since arterial lines measure BP continuously, the most recent data for this parameter within the timeframe is the same as the HR & RR, 12:44

Intermittent paramenters (like noninvasive BP) will pull in for the time that the measurement completed

This pt's BP started taking at 13:30 but didn't complete until 13:31 due to movement

The most recent SPO2 data interfaced to Cerner from the monitor was at 12:34. The patient removed the pulse ox

Intermittent paramenters (like noninvasive BP) will pull in for the time that the measurement completed

This pt's BP started taking at 12:30 but didn't complete until 12:31 due to movement

Since HR, RR, & SPO2 are continuously monitored parameters, the most recent data sent from the monitor was from the minute before, 13:42 If we were documenting at a time outside of this range, it would be 13:44

Since arterial lines measure BP continuously, the most recent data for this parameter within the timeframe is the same as the HR, RR, & SPO2 - 13:42

Since HR & RR are continuously monitored parameters, the most recent data will be for the last minute of the time interval. In this instance that is 12:44