Nutrition Orders Redesign Learning Module. One patient/one Order

Transcription

1 Nutrition Orders Redesign Learning Module One patient/one Order

2 Learning Objectives One patient/one order Understand why changes in Nutrition orders are happening Learn how to enter a Nutrition order Learn how to make a patient NPO Understand the process of modifying nutrition orders to prepare a patient for a test Retain the concept of One patient/one order

3 Why the need for Redesign Revisions are needed after 6 years of active use of CPOE To incorporate knowledge-based advances in nutrition-related nomenclature To remain compliant with regulations and standards.

4 Anticipated Improvement Outcomes Offer clarity to the nutrition order Enhance provider satisfaction by improving ease of use Improve patient safety and satisfaction Align nutrition orders with Nutrition Care Manual(s) providing a more evidence-based foundation Add transparency when transitions in nutrition orders are necessary during the patient s hospital experience Decrease duplication of nutrition orders and over-use of restrictions

5 Placing the Diet Order One patient/one Order

6 Concept: One Diet Order will follow the patient through the entire hospital stay. This one order will be modified as needed during the admission, and not discontinued until discharge.

7 Choose main Diet Type from List You may choose more than one - e.g. Cardiac Diet, and No Caffeine This is the only required piece in the order. Additional Details/Modifiers are available.

8 Choose Meal to Start Breakfast, Lunch or Supper Send Tray Now? Yes/No

9 Choose Dietary and Beverage modifiers, Fluids permitted, and Dietary Supplements. You may select more than one choice. None of these are required elements. Dietary modifiers Beverage modifiers Fluids Supplements

10 Dietary snacks and Special Instructions Enter free text here for snacks and other special instructions

11 Making the patient NPO One patient/one Order

12 Modify the diet order to NPO (or NPO after midnight if indicated) DO NOT DISCONTINUE THE DIET ORDER. Right click on the order and select MODIFY.

13 Select NPO after midnight from the Diet type choices. Do NOT deselect the original components of the diet.

14 Notice that the original diet pieces remain intact on the order while the patient is NPO

15 When the patient is no longer NPO, MODIFY the order. Click on NPO after Midnight to deselect it. This will resume the original Regular/Unrestricted diet.

16 The order detail will display in the order that changes are made. The most current order will display last. In the example below, NPO after Midnight is the most current diet order.

17 You may also right click on the order to verify. Select Order Information, then the History tab. The most current order will display at the top.

18 A requisition will print to Nutrition Services when the Diet Order is initially placed AND each time it is modified. The last modification ordered is what will be delivered to the patient (or not if they are NPO). This header indicates to Nutrition Services that the original order has been MODIFIED.

19 Advancing the diet (as tolerated) One patient/one Order

20 Advance Diet as Tolerated Search and select the Advance Diet as Tolerated Powerplan. This will be included as a subphase in other PowerPlans with advance diet orders.

21 Clear liquid diet is pre-selected for one meal. One of the other choices may be selected, and modified. The final diet is ordered using the same process as shown earlier (right click and Modify the planned Diet order. The offset time of when to begin this diet may be adjusted.

22 Remember to Initiate the plan once details have been completed. A PowerPlan Alert will open as a reminder to activate the orders. Remember to Initiate and Sign the plan.

23 Pre-procedure diets in PowerPlans One patient/one Order

24 PowerPlan Pre-procedure Diets Certain Cardiology, IR, Surgical, GI and Nuclear Med plans will contain a Procedure diet task. When the plan is initiated, this task will appear for nurses and unit secretaries, who should then modify the diet order according to the instructions in the task.

25 From the task list, right click on the task, select Order Info for detail on how the diet needs to be modified prior to the procedure.

26 Once the diet has been modified, the task should be Charted as done. After the procedure or testing has been completed, remember to Modify the diet order again (back to the original order or with changes if necessary).

27 This concludes the Nutrition changes tutorial. Remember: One Nutrition order follows the patient through the entire stay. This order is modified as needed for testing, procedures or changes in condition.