Tips & Tricks COMPASS Improvements

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1 Tips & Tricks COMPASS Improvements Coming on Nov 26 and Dec 3, 2012 Information for All Medical Practitioners Regardless of Specialty... 1 Changes to Spine Surgery Pre, Post and Discharge order sets on Nov Turning off Auto Verify for Medications Ordered from Day Surgery Locations on Dec Enteral and Oral Dietary Formulary Changes to Generic Product Names on Dec Information for Allied Health Practitioners Addition of PowerNotes to Allied Health Position on Nov Information for All Medical Practitioners Regardless of Specialty Changes to Spine Surgery Pre, Post and Discharge order sets on Nov 26 Rationale: Clinician request and process review of the Spine Surgery Admit Orderset Key Points: Change from 1 orderset into 3 ordersets o Spine Surgery PreOp (Paper) o Spine Surgery PostOp Admit o Spine Surgery Discharge Summary of Change: Pre Op: Orderset Name: Spine Surgery PreOp All pre op orders have been removed from the orderset and will be ordered on PAPER o Orders can be found through the Pre printed Orders database o Used for patients seen through a Pre Admission Testing visit

2 Orders that will be used on the day of surgery will be transcribed into COMPASS on the day of surgery by the Pre Op nurse o Orders will be placed in the generic PreOp orderset o Post Op: Orderset Name: Spine Surgery PostOp Admit Removed Telemetry Tier I, II and III from: o Admit to o Observe to o Transfer to Removed Physician Transfer of Patient Care order Removed pre check from Patient Condition order Addition of Diagnosis/Condition Instructions order Changes to Vital Signs order details Pre checked and changes to Neuro Check order details Removed Pulse Oximetry order Pre checked and changes to Pulse Oximetry Continuous order details Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

3 Removed Weight and Height/Length orders Reorganization, removal and additions to Activity section Changes to NPO order details Addition of Communication Order for link to Clinical Pathway Removed Routine Intake + Output order Addition of Dressing orders Removed Saline Lock Insertion order Pre checked Saline Lock Conversion order Addition of Bulb Suction Management and Surgical Drain Site Care orders Reorganized Urinary Catheter orders Addition of Notify Provider orders Reorganization of Continuous Infusions section Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

4 o o o o Addition of Medication Instruction order Addition of LR order Addition of D5LR order Change in IV Infusion rate default to 75ml/hr Reorganization, removals and additions to Antimicrobial section Reorganization, removals and additions to Analgesics section Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

5 Reorganization, removals and additions to Muscle Relaxants section Removed Protonix order Addition of Maalox Plus order Addition of Phenergan 25mg Rectally order Addition of Milk of Magnesia and Fleets Enema orders Addition of Decadron order Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

6 Addition of Benadryl 25mg IV Push order Removed Sleep and Anxiety section of orders Removed Vitamin section of orders Addition of Insulin Scheduled and/or Correctional Scale for Diabetes sub phase Reorganization, removals and additions to Laboratory section o Stat labs are available in the ellipse option of the Routine orders Addition of Consult orders for other providers o Persistent Note added as reminder to call consulting provider Removed Consult Wound Ostomy Continence Nurse order Change in Oxygen order details Addition of Cough + Deep Breathe order Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

7 Removal and additions to Radiology section Discharge: Orderset Name: Spine Surgery Discharge Turning off Auto-Verify for Medications Ordered from Day Surgery Locations on Dec 3 Rationale: Currently all medication orders placed in the Day Surgery COMPASS location auto verify and bypass pharmacy review. In order to maintain compliance with Joint Commission regulations and enhance medication safety practices, pharmacy must review orders placed in surgical areas. Summary of the Change: Medication orders placed by medical provider for a patient in a Day Surgery location will be sent for pharmacy review. Key Points: Medical Practitioners may receive phone calls from pharmacists to clarify ambiguous orders. Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

8 The Joint Commission allows the first dose of medications to be given in surgical areas prior to pharmacy review. Once pharmacy has reviewed and verified the medication orders, the mortar and pestle icon will disappear. Enteral and Oral Dietary Formulary Changes to Generic Product Names on Dec 3 Rationale: Transition to generic enteral and oral diet formulas in COMPASS supports the 12/3/12 vendor change. Summary of the Change: Seton s transition to a new enteral and oral diet product vendor requires COMPASS to revise the enteral and oral formula names in COMPASS. Clinical nutrition is recommending a switch to a more generic naming convention to support future maintenance. Transition Plan: Orders will transition in COMPASS, December 3, 2012 at Patients with Oral supplements or enteral tube feeding orders placed in COMPASS prior to 0600 will have new orders placed using the generic naming convention. The oral supplement / enteral tube feeding orders under the brand naming convention will be canceled/discontinued by nutrition services using the communication type: Per Standard of Care, Other: conversion to generic terms. After the transition of active orders, clinicians will see new oral supplement / enteral tube feeding orders with generic terms Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

9 Key Points: Formula names will switch from brand based to generic. Order names will NOT change. Clinicians will search for orders in the Find window using current search terms. Search by diet tube or by tube feeding or by enteral tube feeding Search by adult oral supplements or pedi oral supplements The nutritional supplement choices within the order details change. Before After Before After Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

10 The formula choices within the order details change. Before After Before After Before After Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

11 Before: Order Sets view After: Order Sets view Refer to the reference text icon to select the hyperlink on the enteral / oral nutrition orders to review crosswalk of current brand names to future generic formula names OR Selecting the icon, opens the Decision Support window: Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

12 Selecting the hyperlink opens the crosswalk document Adult Oral Supplements Generic Term for COMPASS Old Product New Product High Cal High Protein age 17+ y.o. Boost Plus Ensure Complete High Calorie Pudding Boost Pudding Ensure Nutritional Pudding Diabetic Supplement Boost Glucose Control Glucerna Therapeutic Nutritional Shake Clear Liquid Supplement Boost Breeze Ensure Clear Renal Supplement Novosource Renal Nepro with Carb Steady Wound Healing Supplement Resource Arginaid Juven Concentrated (2 cal/ml) Supplement Nutren 2.0 Two Cal HN oral supplement Peptide Oral Supplement N/A Pediasure Peptide 1.5 (flavored) Tube Feeding Adult Generic Term for COMPASS Old Product New Product 1.2 cal Standard with fiber Fibersource HN (standard w/ fiber) Jevity 1.2 cal 1.2 cal Standard without fiber Isosource HN (standard without fiber) Osmolite 1.2 cal 1.2 cal Diabetic Diabetisource AC (diabetic) Glucerna 1.2 cal Concentrated Renal Dialysis Novosource Renal (renal) Nepro with Carb Steady 2 cal Concentrated formula Nutren 2.0 (concentrated) TwoCal HN 1.2 cal Peptide immune mod elemental Impact Peptide 1.5 (immune modulating Peptamen AF (sepsis/ards/ali) Vital AF 1.2 cal 1.5 cal Peptide elemental Peptamen 1.5 (immune modulating) Vital 1.5 cal 1.5 cal Peptide high protein Peptamen Bariatric Pivot 1.5 cal Vivonex RTF Vivonex RTF Vivonex RTF Pediatric Oral Supplements Generic Term for COMPASS Old Product New Product Pedi Standard Supplement Boost Kid Essentials Pediasure Pedi Clear Liquid Supplement Boost Breeze Ensure Clear Pedi Standard 1.5 cal Supplement Boost Kid Essentials 1.5 cal Pediasure 1.5 cal oral Pedi Standard 1.5 cal Supplement N/A Pediasure 1.5 cal oral with fiber w/fiber High Cal High Protein Supplement Boost Plus Ensure Plus High Calorie Pudding Boost Pudding Ensure Pudding Amino Acid age 1+ y.o. Flavored Elecare Vanilla (hypo allergenic) Elecare Jr. (vanilla) Pedi Renal Supplement Novosource Renal Novosource Renal (flavored) Pedi Peptide 1.0 cal Supplement N/A Pediasure Peptide 1.0 cal oral supplement Pedi Peptide 1.5 cal Supplement Peptamen Jr 1.5 (pediatric peptide Pediasure Peptide 1.5 cal (flavored) based) Pedi Peptide 1.5 cal Supplement N/A Pediasure Peptide 1.5 cal with fiber Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

13 w/fiber (flavored) Health Shake Health Shake Health Shake Health Shake sugar free Health Shake sugar free Health Shake sugar free Scandishake Scandishake Scandishake Concentrated (2cal/mL) supplement Nutren 2.0 Two Cal HN oral supplement Pediatric Tube Feeding Formula 1 10 years Generic Term for COMPASS Old Product New Product Pedi Standard 1.0 cal Nutren Junior Pediasure Enteral Formula 1.0 cal Pedi Standard 1.0 cal with fiber Nutren Junior with fiber Pediasure Enteral Formula 1.0 cal with fiber Pedi Renal Novosource Renal (renal) Novosource Renal (unflavored) Pedi Peptide 1.0 cal Peptamen Junior 1.0 (pediatric Pediasure peptide 1.0 (unflavored) peptide based) Pedi Peptide 1.5 cal Peptamen Junior 1.5 (pediatric Pediasure peptide 1.5 (unflavored) concentrated peptide based) Pedi Peptide 1.5 cal with fiber N/A Pediasure peptide 1.5 with fiber (unflavored) Amino Acid age 1+ y.o. Unflavored Elecare Elecare Jr. (unflavored) Pediatric Tube Feeding Formula 11+ years Generic Terms for COMPASS Old Product New Product 1.2 cal Standard with fiber Fibersource HN (standard with fiber) Jevity cal Standard without fiber Isosource HN (standard without Osmolite 1.2 fiber) 1.2 cal Diabetic Diabetisource AC Glucerna 1.2 cal Pedi Peptide 1.0 cal Peptamen Junior 1.0 (pediatric Pediasure peptide 1.0 peptide based) Pedi Peptide 1.5 cal Peptamen Junior 1.5 (pediatric Pediasure peptide 1.5 concentrated peptide based) Pedi Peptide 1.5 cal with fiber N/A Pediasure peptide 1.5 with fiber Pedi Renal Novosource Renal (renal) Novosource Renal 1.5 cal Peptide elemental Peptamen 1.5 (immune modulating) Vital 1.5 cal 1.5 cal Peptide high protein Peptamen Bariatric Pivot 1.5 cal 1.2 cal Peptide immune mod Impact Peptide 1.5 (immune Vital 1.2 AF elemental modulating Amino Acid age 1+ y.o. unflavored Elecare Elecare Jr. 2 cal Concentrated formula Nutren 2.0 (concentrated) TwoCal HN Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

14 Information for Allied Health Practitioners Addition of PowerNotes to Allied Health Position on Nov 26 Rationale: To allow allied health providers with prescriptive authority the ability to document in COMPASS using PowerNotes. Summary of the Change: 1. Allied health providers who function to support physicians at Seton Healthcare Family will see a new menu item on their chart navigator. It will be labeled: PowerNote. 2. Only those practitioners at Seton Medical Centers Williamson and Hays are permitted to document using PowerNote at this time. 3. Only those trained in the use of PowerNote should document using this function. 4. Contact Cyndi Barbour at cbarbour@seton.org to enroll in training classes. Seton Healthcare Family COMPASS Tips & Tricks Nov 19,

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