e-mar ltc requirements document

E-Mar Long-Term Care (LTC™) System

Requirements Document

(January 2006)

LifeCare Technologies, Inc.™

E-Mar Long-Term Care (LTC™) System Requirements Document

Contents 1 Document Profile.................................................................................................................... 6

1.1 Purpose of this Document........................................................................................................... 6 1.2 Scope and Layout of this Document .......................................................................................... 6 1.3 Who Can Use this Document? ................................................................................................... 7 1.4 Document Format ....................................................................................................................... 7

2 System Login........................................................................................................................... 8 2.1 Logical Specifications ................................................................................................................. 8

2.1.1 First Login ...............................................................................................................................................9 2.1.2 Login After Step Away............................................................................................................................9

2.2 Data Specifications.................................................................................................................... 10 3 The Dose Alert Screen (Tiled View)..................................................................................... 11

3.1 Logical Specifications ............................................................................................................... 11 3.1.1 The Residents Tiles................................................................................................................................11 3.1.2 The Global Command Bar.....................................................................................................................13

3.1.2.1 The Menu Button ..........................................................................................................................13 3.1.2.2 The Med Pass Button ....................................................................................................................13 3.1.2.3 The View Button...........................................................................................................................14 3.1.2.4 The Census/Tiled Button ..............................................................................................................15 3.1.2.5 The Help Button............................................................................................................................15 3.1.2.6 The Step Away Button..................................................................................................................15 3.1.2.7 The Log Off Button.......................................................................................................................15

3.1.3 The MAR Control Buttons ....................................................................................................................15 3.1.4 The Resident Identification Window .....................................................................................................16

Approvals: Project Lead _______ B.A. ________ Development Lead _______ Final Review _______

Release 1.0 – E-Mar LTC System Requirements Document 2 of 105

E-Mar Long-Term Care (LTC) System

3.2 Data Specifications.................................................................................................................... 17 4 The Resident Census Screen ................................................................................................ 25

4.1 Logical Specifications ............................................................................................................... 25 4.1.1 Adding Observations .............................................................................................................................26 4.1.2 Adding an Image....................................................................................................................................30 4.1.3 Census List Options ...............................................................................................................................30 4.1.4 The Once Dose Feature..........................................................................................................................31

4.2 Data Specifications.................................................................................................................... 33 5 The Resident MAR Screen ................................................................................................... 51

5.1 Logical Specifications ............................................................................................................... 51 5.1.1 Resident MAR Banner...........................................................................................................................52 5.1.2 Medication Order Area (Order Tiles) ....................................................................................................52

5.1.2.1 Status Button Selections................................................................................................................53 5.1.3 Due/Chart Tab .......................................................................................................................................54

5.1.3.1 STAT Order Options.....................................................................................................................54 5.1.3.2 Due or Past Due Order Options ....................................................................................................54 5.1.3.3 Charting Options...........................................................................................................................55 5.1.3.4 Outcome Options ..........................................................................................................................55

5.1.4 Routine Orders Tab................................................................................................................................55 5.1.5 PRN Orders Tab ....................................................................................................................................56 5.1.6 All Orders Tab .......................................................................................................................................57

5.1.6.1 Order List Section .........................................................................................................................57 5.1.6.2 Order Details Section ....................................................................................................................58 5.1.6.3 Order Rules Section ......................................................................................................................58 5.1.6.4 Order History Button ....................................................................................................................58 5.1.6.5 Control Buttons .............................................................................................................................58

5.1.7 Unverified Orders Tab...........................................................................................................................58 5.1.8 History Tab ............................................................................................................................................59

5.1.8.1 Filters Section ...............................................................................................................................60 5.1.8.2 Dose Documentation Details Section............................................................................................60 5.1.8.3 Print MAR Button.........................................................................................................................61 5.1.8.4 Additional Functions.....................................................................................................................61

5.1.9 Global Command Bar ............................................................................................................................61 5.2 Data Specifications.................................................................................................................... 61

6 Order Verification................................................................................................................. 78 6.1 Logical Specifications ............................................................................................................... 78

6.1.1 The First Dose........................................................................................................................................79 6.1.2 The Schedule Page.................................................................................................................................80 6.1.3 The Confirmation Page..........................................................................................................................81 6.1.4 The Dose Confirmation Window...........................................................................................................83

6.1.4.1 The Progress Bar...........................................................................................................................84 6.2 Data Specifications.................................................................................................................... 84

7 Barcoding and System Messages ......................................................................................... 90 7.1 Logical Specifications ............................................................................................................... 90

7.1.1 Dose Confirmation.................................................................................................................................90 7.1.2 Barcode Scanning ..................................................................................................................................91 7.1.3 Med Not Due .........................................................................................................................................91 7.1.4 Wrong Resident .....................................................................................................................................92 7.1.5 Minimum Time Between Orders ...........................................................................................................92



7.1.6 Order On Hold .......................................................................................................................................93 7.1.7 Order Discontinued................................................................................................................................93 7.1.8 Resident Record Locked........................................................................................................................94 7.1.9 Similar Name Alert................................................................................................................................94

7.2 Data Specifications.................................................................................................................... 95 8 Using the E-Mar LTC System .............................................................................................. 96

8.1 Logical Work Flow ................................................................................................................... 96 8.1.1 Quick Admit ..........................................................................................................................................96 8.1.2 Dose Administration..............................................................................................................................96

8.1.2.1 Due or Past Due Doses..................................................................................................................96 8.1.2.2 Dosing PRN Orders ......................................................................................................................97 8.1.2.3 Early Doses ...................................................................................................................................97 8.1.2.4 Once Dose.....................................................................................................................................98 8.1.2.5 Bypass a Dose ...............................................................................................................................99 8.1.2.6 Injections.......................................................................................................................................99 8.1.2.7 Sliding Scale .................................................................................................................................99

8.1.3 Orders ..................................................................................................................................................100 8.1.3.1 Routine Order Verification .........................................................................................................100 8.1.3.2 Reject an Order ...........................................................................................................................100 8.1.3.3 Order Discontinuation.................................................................................................................100 8.1.3.4 Order Hold/Resume ....................................................................................................................101

8.1.4 Modify an Order ..................................................................................................................................101 8.1.5 Frequencies ..........................................................................................................................................101

8.1.5.1 Daily (one or more per day) ........................................................................................................101 8.1.5.2 Range (hours, days, weeks or months between doses)................................................................102 8.1.5.3 PRN.............................................................................................................................................102 8.1.5.4 Mapped Frequencies ...................................................................................................................102 8.1.5.5 Add a Frequency .........................................................................................................................103 8.1.5.6 Unsupported Frequencies............................................................................................................103

8.1.6 Adding Observations ...........................................................................................................................103 Index ........................................................................................................................................... 104



All materials in this specification documentation are confidential to LifeCare Technologies, Inc., and cannot be disclosed to anyone outside of the company without specific permission from authorized management.

The methodology, formats and business applications used herein are copyright protected products of LifeCare Technologies, Inc. Their use by persons or for purposes not authorized in writing by LifeCare Technologies, Inc. is unlawful.

Photocopy duplication and distribution is limited to LifeCare Technologies, Inc., and their legal assignees. All rights to electronic duplication, distribution, or alteration are strictly limited to LifeCare Technologies, Inc.

This document identifies the Logical Design Requirements for the E-Mar Long-Term Care™ (LTC) System. The information in this document is subject to change. LifeCare Technologies, Inc. may occasionally issue revisions to advise of changes and/or additions.

© Copyright 2006 LifeCare Technologies, Inc.™ All rights reserved.

LifeCare Technologies, Inc. 4710 Eisenhower Boulevard

Suite A-10 Tampa, FL 33634

(813) 886-7500 www.lifecaretech.com


http://www.lifecaretech.com/


1 Document Profile

1.1 Purpose of this Document The purpose of this document is to identify the System Requirements for the long-term care (LTC) version of the E-Mar system. This document is intended to provide the Logical Design necessary to pilot the Physical Design and Development phase of the E-Mar LTC product. This document takes into account material accrued from earlier product phases, identifies any additional system objects, determines operations and data structures for all objects, validates relationships and interactions between objects, and prototypes actor interface objects. The ultimate goal of this document is to identify specific actor actions that will result in predictive outcomes when utilized by users of the E-Mar LTC product.

Note that this document does not attempt to limit design choices based on any platform or language decisions that were made in previous product phases. Any constraints that resulted from such platform or language decisions will be dealt with during the Physical Design phase.

1.2 Scope and Layout of this Document This document contains instructions for the E-Mar LTC System, including:

• administering physician-ordered medications by pre-authorized personnel,

• managing the dosing schedule by providing real-time reminders that an action is required,

• accessing a resident’s complete MAR from multiple locations,

• ensuring the right resident, drug, dose, route, and time,

• documenting the administration of administered medications,

• charting of observations, assessments, outcomes and other dose-related information.

Both the end-user software, and the administration software, must be installed and the associated servers set up before the instructions in this document can be applied.

Because all activities in the system are performed via displays on the monitor screen, all instructions in this document are associated with those particular screens.



1.3 Who Can Use this Document? This document is intended for use primarily by the LifeCare Technologies, Inc. development staff as a general guide in the creation of the Physical Design of the E-Mar LTC (End-User) system. However, senior management and/or the marketing staff may elect to use some edited version of this document for new-client presentations or RFP/RFI applications, as desired.

1.4 Document Format This document uses a combination of grammatical and graphical formats, that is, narrative text combined with screen views, window views, and tabled data. A red highlight or underline indicates that a data field or some process requires editing or a definition of what’s being described. These pending issues will be dealt with during the Physical Design phase of the project, and reflected in a later, revised version of this document.

This requirements document can be viewed as a two-part logical overview of the LTC system:

• Part I – Chapters 2 through 7 of the document cover the general layout and design of the system. After describing the initial login procedure (Chapter 1), the next six chapters cover the three main “views” of the E-Mar LTC system:

• The Dose Alert Screen or Tiled View

• The Census View

• The MAR Screen Also, order verification process, barcoding, and related system messages are covered.

Chapters 2 through 7 are also organized into two main sections

• Logical Specifications: This section covers the logical application of the topics covered in the particular chapter, using narrative text and screen/window views as mentioned earlier.

• Data Specifications:

This section maps all of the fields (i.e., entry vs. display) in Chapters 2 through 7 only. These “data maps” – which are organized in tabled format – include the Field Name, Length, Type, Data Type, Required Fields, Related Fields, Duplicates Allowed, and Related Source(s) for every field on all the screen/window views.

• Part II – Chapter 8 of the document covers the practical application of the LTC system, such as working with barcodes, Quick Admits, Dose Administration, Orders, Recording Observations, and all of the related functions and views used by the actor to manage the dispensation of orders to the residents under the actor’s defined area of responsibility.

The electronic version of this document features extensive hyperlinks that allow the reader to navigate among the various topics, and to access cross-references embedded in the text. These links are color-coded and underlined wherever they appear within the document.



2 System Login

2.1 Logical Specifications All actors must use a valid User Name and Password combination in order to log into the E-Mar LTC system. Access to the system should be available only to authorized actors who have been previously identified in the system.

If an actor does not have the appropriate security level defined in the system, an “Invalid User or Password” message is displayed. The access table (to be defined) should identify the actor’s:

• User Name,

• Password, and

• the level of security and privileges for which the actor is authorized.

Figure 2-1 E-Mar LTC Login window

Once the actor enters a valid User Name/Password combination in the appropriate fields, the

actor clicks on the arrow key to display the Dose Alert Screen (tiled view).



Figure 2-2 E-Mar LTC Dose Alert Screen (tiled view)

Prior to software delivery, some actors are set up with various levels of security privileges based on input received from the facility. Additionally, some facilities support scanning which enables the actor to login by scanning an ID tag and typing a password.

2.1.1 First Login When the actor logs into the LTC system for the first time, a disclaimer information window is displayed. The actor acknowledges the agreement by clicking on the appropriate button and then OK. Note that this is a one-time-only function. Once the actor accepts the disclaimer terms, the window does not display again for subsequent sessions by the same actor.

2.1.2 Login After Step Away When doses of medications are prepared for dispensing, the actor clicks on a Step Away button

in the lower right corner of the Dose Alert Screen to log out of the E-Mar systemtemporarily while administering the medication. When this action is taken, all

resident-specific

entification (with the exception of the room number and bed) is hidden. id



To l b w, the actor:

2. ouble-clicks on the User in the window below to fill the User Name field,

og ack into the normal vie

1. Scans an ID badge, or

D

3. Types the Password in the appropriate field, and

4. Clicks on the arrow key to re-displayed the normal tiled view.

2 D S ific on

.2 ata pec ati s

Field Name

Length Type Data Type

Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

User Name

Un-defined

Entry Alpha- numeric

Y Password Y ?

Edit Validation cLogi : Act el o y and pr eges a must t be established in the sy c a dite g both pha an aracters.

or’s levnd une

f securitd, acceptin

ivil al

uthorizationd numeric ch

firsstem. Field is dynami

Password Un-defined

Entry Alpha-numeric

Y User Name Y ?

Edit Validation Logic: Ac el o and pr eges auth ust t be established in the system Field is dy ic a acters.

tor’s levnd unedited,

f securityaccepting both alpha and numeric char

ivil orization m firs. nam

OK n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on t onfirm a pend Global functihe button to c ing action. on.

Step Away n/a Button Action Y n/a N System Config.

Edit Validation Logic: Allows the actor to temporarily log out of the system while administering medication to a resident. Actor must log back into the system to re-display the normal view.



3 The Dose Alert Screen (Tiled View)

3.1 Logical Specifications The Dose Alert Screen always defaults to the tiled view at the start up of the LTC system. Each location is represented by a Resident Tile. The Dose Alert Screen changes depending on whether or not someone is logged in. When no one is logged in, resident locations are displayed on the Resident Tiles as Occupied, instead of by the resident’s name, to ensure privacy.

3.1.1 The Residents Tiles Information on the Dose Alert Screen tiles is communicated to the actor via verbal, graphical, and color-coded means. The resident’s Name is displayed at the top of the tile. If two residents have similar names , a warning icon is displayed. The location is defined by the Room Number and Bed. The Next Dose Due is displayed as a date/time stamp. The Med Status area displays icons that indicate if a dose is due or overdue, if charting is needed, or if an outcome must be documented. No symbol indicates that the actor does not need to take any action.

The areas of the residents tile are discussed further in the Data Specifications section of this chapter. The table below defines the icons, color coding, and watermarks used in the tiled view.

RESIDENT TILES “STATUS ICONS”

Located to the left of the resident’s name Indicates that there are residents with similar names. (color-coded purple.)

Located in the Med Status area of tile. Indicates resident has one or more medication doses due. (Color-coded green.)

Located in the Med Status area of tile. Indicates resident has one or more medication doses past due. (Color-coded red.)

Located in the Med Status area of tile. Indicates resident has one or more medication doses that require charting or assessment. (Color-coded orange.)

Located in the Med Status area of tile. Indicates resident has one or more medication doses with an outcome that needs to be documented. (Color-coded light blue.)



RESIDENT TILES “COLOR CODES”

White or light gray Some action is required as indicated by icons and watermarks.

Teal The resident has unverified orders.

Pink The resident has a STAT dose due.

Medium Gray Normal. No dose is due.

RESIDENT TILES “WATERMARKS”

No watermark shown on tile. Normal condition.

The resident has one or more doses that are due immediately (STAT).

The resident has one or more unverified orders.

TL

he resident is on a leave of absence from the TC facility.

The resident has one or more medication doses past due.



3.1.2 The Global Command Bar The bar at the bottom of the Dose Alert screen is comprised of several command buttons.

Figure 3-1 Global Command Bar

3.1.2.1 The Menu Button The actor clicks on the Menu button to display the following drop-down list of options:

• Administration Tools… This selection enables the actor to navigate to the Administration Tool where various set-up tables are maintained. The actor can then add, modify, or delete table data.

• Quick Admit… This allows the actor to admit a resident on an emergency basis. (See the section on Quick Admit for further information.)

• View View enables the actor to open a window to set filters and other options controlling the residents included in the view. The two drop-down selections under View – View and Census – operate the same as the View or Census buttons on the Global Command Bar.

• Minimize E-MAR The actor clicks on this button to reduce the screen view to a button displayed in the lower left corner of the computer screen. Double-clicking the button restores the previous view.

• Exit the Application The actor shuts down the E-Mar LTC system completely with this selection

3.1.2.2 The Med Pass Button The actor clicks on the Med Pass button to filter the resident tiles on the Dose Alert Screen to those residents assigned to a particular area. Med Pass is present in the tiled and census views but not on the MAR screen. Clicking on the Med Pass button displays some previously selected Med Passes. The actor clicks on Select to show a complete list of all available Med Passes. The actor can select any Med Pass that is on the list.



Med Pass is set up using the E-Mar LTC Administration Tool. The actor selects the Med Pass Function from the Administration Tool system to add, edit, or delete Med Passes. The actor can designate any Med Pass identifiers desired, according to the facility’s protocol.

3.1.2.3 The View Button The actor clicks on the View button to filter, sort, and organize the display of residents on the Dose Alert Screen, for both the tiled and the census views.

Figure 3-2 Select View Settings window

When the actor selects Resident on Unit, a drop-down list is available that allows the actor to indicate the particular unit. The actor can filter the view further by selecting Due Orders, Unverified Orders, or Charting Required. The actor can sort the view by Last Name or Room. Additionally, the actor can select the Unverified Order, STAT Orders, Doses Due, or Charting Required radio buttons to organize the screen view by urgency of dose dispensation. Residents requiring no action are placed at the end of the listing, along with any actions that are not checked on the Select View Settings window. When the actor selects Set As Default, those radio buttons selected for filtering and ordering become the default settings.

Drop-down list displays units when

Resident on Unit selected.



3.1.2.4 The Census/Tiled Button The actor clicks on the Census/Tiled button to toggle between the tiled and census view of the Dose Alert Screen. (See Chapter 4 on The Census View for further information about this view.) The MAR screen provides separate tiled and census buttons.

3.1.2.5 The Help Button The actor clicks on the Help button to display the online Help Contents screen. The actor can also click on F1 on any field to display the Help relating to that screen.

3.1.2.6 The Step Away Button The actor clicks on the Step Away button to temporarily log out of the system when administering medications. The actor later logs back into the system by following the procedure described in Chapter 2 under Login After Step Away. (In some facilities the actor can scan their ID to log back into the system.) If the actor steps away from the E-Mar system for longer that the time permitted by the facility, the actor is automatically logged off.

3.1.2.7 The Log Off Button The actor clicks on the Log Off button to completely log off the system. The actor logs back into the system by following the procedure described in Chapter 2 under System Login.

3.1.3 The MAR Control Buttons When the actor clicks on a resident’s tile and Select from the Resident Identification window, a new set of control buttons are displayed at the bottom of the screen.

Figure 3-3 MAR control buttons

The Menu and Help buttons function the same on the Dose Alert Screen. The actor clicks on the Census or Tiled buttons, depending on the screen view desired.



3.1.4 The Resident Identification Window The actor can click on any resident panel in the tiled view of the E-Mar LTC system to display the Resident Identification window.

Figure 3-4 Resident Identification window

Display-Only Areas

Action Buttons

The window can also be displayed by scanning the resident’s barcoded wrist band.

The Resident Identification window displays resident-related information that the actor has already entered in the census view of the system. Additionally, the actor can perform certain actions by clicking on any of the four buttons in the lower left side of the window.



The information, or actions, available from the Resident Identification window include:

• The resident’s name and ID number.

• An image of the resident. (See the section on Adding an Image for further details.)

• The resident’s location (Facility-Unit-Room-Bed).

• Observations relating to allergies, diagnosis, notes, and complaints.

• The MAR screen of the medications prescribed for the resident. (The actor clicks on the Select action button.)

• The Once Dose window, which enables the actor to administer a single medication. (The actor clicks on the Once Dose action button.)

• The Resident Observations window, which the actor uses to record resident data. (The actor clicks on the Observations action button.)

• The Cancel action button, which stops a pending action.

3.2 Data Specifications

Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

“RESIDENTS TILES” SECTIONRoom n/a Display Alpha-

numeric Y Bed N Facility-Unit-

Room-Bed (Admin. Tool)

Edit Validation Logic: Field defined in the E-Mar LTC Administration Tool during the normal ADMIT process. Field is dynamic and unedited, accepting both alpha and numeric characters.

Bed n/a Display Alpha-numeric

Y Room N Facility-Unit-Room-Bed

(Admin. Tool)


Date/Time Stamp

(Next Dose Due)

10 + 5 Display Numeric Y n/a N Internal to E-Mar/DBase

Edit Validation Logic: Field on Dose Alert Screen tile that indicates when the resident’s next dose is due. If no doses are past due, then the date/time of the oldest dose is displayed. If none is scheduled, then the area of the tile is blank.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Last Name n/a Display Alpha-numeric

Y First Name N Residents (Admin. Tool)


First Name n/a Display Alpha-numeric

Y Last Name N Residents (Admin. Tool)


Location n/a Display Alpha-numeric

Y Room, Bed N Facility-Unit-Room-Bed

(Admin. Tool)


Med Status n/a Display Icons Y Doses N ?

Edit Validation Logic: Icons display if the dose is due or overdue, if charting is required, or if an outcome needs to be documented. No icon displayed means no action is required. (See the Residents Tiles section.)

STAT n/a Display Color + W-mark

Y ? N Item/Formulary (Admin. Tool)

Edit Validation Logic: Resident’s tile color (on Dose Alert Screen) turns pink, and the STAT watermark displays, indicating that the resident has one or more doses due immediately.

UNV n/a Display Color + W-mark

N n/a N n/a

Edit Validation Logic: Resident’s tile color turns teal, and the UNV watermark displays, indicating that a new order(s) has been received from the pharmacy to the facility’s E-Mar system that requires review and verification.

LOA n/a Display Color + W-mark

Y ? N Residents (Admin. Tool)

Edit Validation Logic: Resident’s tile color turns gray, and the LOA watermark displays, indicating that the resident is away from the facility on a Leave of Absence.

“GLOBAL COMMAND BAR”MENU n/a Button Selection Y n/a N n/a

Edit Validation Logic: Actor clicks on the button to access (1.) Administration Tools, (2.) Quick Admit, (3.) View, (4.) Minimize E-MAR, and (5.) Exit the Application. (See the The Menu Button section also in this chapter for further information.)



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

MED PASS n/a Button Selection Y n/a N n/a

Edit Validation Logic: Actor clicks on button to filter residents according to a selected Med Pass. This function is present in the tiled and census views, but not on the MAR screen. Med Pass is set up on the E-Mar LTC Administration Tool. (See The Med Pass Button section also in this chapter for further information.)

Select n/a List Func. Selection Y Med Pass N n/a

Edit Validation Logic: Actor clicks on Select to display a complete list of available Med Passes.

— (Fields under the “View” button on the Global Command Bar) —

VIEW n/a Button Selection Y n/a N n/a

Edit Validation Logic: Enables actor to open the Select View Settings window to set filters and other options that control how residents are displayed in both the tiled (default) and census views. This function is not present on the MAR screen. (See The View Button also in this chapter section for further information.)

All Residents

n/a Radio Button

Action Y n/a N Med Pass (Admin. Tool)

Edit Validation Logic: Actor filters all residents to be viewed on the Dose Alert Screen view.

Resident on Unit

n/a Radio Button

Selection List

N n/a N Med Pass (Admin. Tool)

Edit Validation Logic: Actor filters only those residents to be viewed on a particular unit. A drop-down list enables the actor to select a unit to enter in the field. The field is validated by the E-Mar LTC Administration Tool.

Due Orders n/a Radio Button

Selection N n/a N n/a

Edit Validation Logic: A filtering selection, enabling the actor to map the Dose Alert Screen view as desired.

Unverified Orders

n/a Radio Button


Edit Validation Logic: Both a filtering and hierarchical selection, enabling the actor to map the Dose Alert Screen .

STAT Orders

n/a Radio Button

Selection N n/a N Items/Formulary (Admin. Tool)

Edit Validation Logic: A hierarchical selection, enabling the actor to organize the Dose Alert Screen.

Doses Due n/a Radio Button



Charting Required

n/a Radio Button


Edit Validation Logic: Both a filtering and hierarchical selection, enabling the actor to map the Dose Alert Screen.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Set As Default

n/a Button Action N All on “Select View

Settings”

N n/a

Edit Validation Logic: When the actor selects Set As Default, all radio buttons selected for filtering and ordering become the default settings. (See the section on The View Button also in this chapter for further information.)


Edit Validation Logic: Actor clicks on this button to confirm a pending action. Global function.

Cancel n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to stop a pending action. Global function.

— (End of fields under the “View” button on the Global Command Bar) —

CENSUS n/a Button Selection Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to switch to the census view. Both the tiled and census views are present on the MAR screen. (See The Census/Tiled Button section also in this chapter for more information.)

HELP n/a Button Selection Y n/a Y Help Module

Edit Validation Logic: Allows actor to display the online Help Content screen. (See The Help Button section also in this chapter for further information.)

STEP AWAY

n/a Button Selection Y n/a N n/a

Edit Validation Logic: Allows the actor to temporarily log out of the system while administering a medication. Actor logs back in by following the procedure described in Chapter 2 under Login After Step Away.

LOG OFF n/a Button Selection Y n/a N n/a

Edit Validation Logic: Actor completely logs out of the system. Actor logs back into the system by following the procedure described in Chapter 2 under System Login.

— (Fields relating to selections under the “View” button only) —

Admin-istration

Tools

n/a Menu Selection

Navigation Function

Y n/a N n/a

Edit Validation Logic: Actor navigates to the E-Mar LTC Administration Tool system where various set-up tables are maintained. The actor can then add, modify, or delete the table data as necessary. (For detailed information on E-Mar’s table functions, see the “Administration Tool User Manual.”)

Quick Admit

n/a Menu Selection

Data Entry Window

Y n/a N n/a

Edit Validation Logic: Actor uses this function to quick-admit a resident to the facility on an emergency basis.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Load Image

n/a Button Action N n/a N ?

Edit Validation Logic: Actor can import an image of the resident into the LTC system, if capability is available.

Gender 1 Entry Selection List

N n/a N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s gender. Field is validated in the Administration Tool.

Birth Date 10 Entry Numeric N n/a N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s birth date, using an online calendar function.

Resident ID

8 Entry Numeric N ? N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s ID. The field is validated in the Administration Tool. However, the field is dynamic and unedited, accepting both alpha and numeric characters.

MR # TBD Entry Numeric N ? N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s Medical Record number. The field is validated in the Administration Tool. However, the field is dynamic and unedited, accepting both alpha and numeric characters.

Acct. No. TBD Entry Numeric N ? N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s Account Number. The field is validated in the Administration Tool. However, the field is dynamic and unedited, accepting both alpha and numeric characters.

SSN 9 Entry Numeric N Resident Name

N Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s Social Security Number in this field. Field is dynamic and unedited, accepting both alpha and numeric characters.

Similar Name Alert

n/a Radio Button

Y / N N Resident Name

N Residents (Admin. Tool)

Edit Validation Logic: Actor clicks on radio button to indicate if there is another resident in the facility with a similar name. This feature is validated by a one-character field (Y/N) on the Administration Tool.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Use Alias n/a Radio Button

Y / N N n/a N Residents (Admin. Tool)

Edit Validation Logic: Actor clicks on radio button to indicate if the resident has used an alias during the normal ADMIT process. The feature is validated by a one-character field (Y/N) on the Administration Tool.

Email to Pharmacy

n/a Radio Button

Y / N N n/a N n/a

Edit Validation Logic: Allows the actor to send an email notice to the pharmacy serving the LTC facility of the emergency admission

Admit n/a Button Action Y n/a N n/a

Edit Validation Logic: Actor clicks on button to quick-admit a resident to the LTC facility on an emergency basis.

Reset n/a Button Action N n/a Y n/a

Edit Validation Logic: Allows actor to clear all previously populated fields on the Quick Admit window.



View (under Menu

button)

n/a Menu Selection

Selection Y n/a N n/a

Edit Validation Logic: View selection enables the actor to open Select View Settings window to set filters and other options that control how the residents are displayed in both the tiled and census views. The census selection displays the census view. This selection operates the same as the View button on the Global Command Bar.

STAT Orders

n/a Radio Button

Selection N n/a N Items/Formulary (Admin. Tool)


Doses Due n/a Radio Button



Minimize E-MAR

n/a Menu Selection

Formatt-ing

N n/a N n/a

Edit Validation Logic: Actor clicks on this button to reduce the Dose Alert Screen to a button displayed in the lower left corner of the computer screen. Double-clicking on this button restores the screen view to its original size.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Exit the Application

n/a Menu Selection

Action Y n/a N n/a

Edit Validation Logic: The actor clicks on this selection to completely exit the system.

— (End of fields relating to selections under the “View” button only) —

“RESIDENT IDENTIFICATION” WINDOWFacility n/a Display Alpha-

numeric Y Unit, Room,

Bed N Facility-Unit-

Room-Bed (Admin. Tool)


Unit n/a Display Alpha-numeric

Y Facility, Room, Bed

N Facility-Unit-Room-Bed

(Admin. Tool)


Room n/a Display Alpha-numeric

Y Facility, Unit, Bed


(Admin. Tool)



Y Facility, Room, Room


(Admin. Tool)


Allergies n/a Display Alpha-numeric

N n/a ? Allergy Type (Admin. Tool)

Edit Validation Logic: Field defined in the E-Mart LTC Administration Tool during the normal ADMIT process. Field is dynamic and unedited, accepting both alpha and numeric characters.

Diagnosis n/a Display Alpha-numeric

Y Resident ID Y Resident Diagnosis (Admin. Tool)

Edit Validation Logic: Field displays the resident’s diagnostic data as entered on the Resident Observations window.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Notes n/a Display Alpha-numeric

Y Resident ID Y n/a

Edit Validation Logic: Field displays the actor’s notations as entered on the Resident Observations window.

Complaints n/a Display Alpha-numeric

Y Resident ID Y n/a

Edit Validation Logic: Field displays the resident’s complaints as entered on the Resident Observations window.

Select n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to navigate to the MAR screen of resident medications.

Once Dose n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to open the Once Dose window. This enables the actor to administer a single dosage of a medication that was not received by the E-Mar system from the pharmacy.

Obser-vations

n/a Button Action Y n/a Y Residents (Admin. Tool)

Edit Validation Logic: Actor clicks on this button to display the Resident Observations window, where resident-related information such as vitals signs/history, diagnosis, allergies, and dietary data are entered.





4 The Resident Census Screen

4.1 Logical Specifications

The actor clicks on the Census button on the Global Command Bar to change from the tiled view to the Resident Census Screen below.

Figure 4-1 Census View screen

ree sections:

ion Pane

ents

Current Residents Section

Total Orders Section

Resident Identification

Pane

The census view is divided into th

• Resident Identificat

• Current Resid

• Total Orders



The Resident Identification Pane displays the resident’s name, an image of the resident (if available from the LTC facility), allergies, diagnostic information, notes and any resident complaints. (For information on how to add an image a resident’s image to the top of the pane, see the section on Adding an Image.)

The Current Residents section displays the resident’s name, next dose due, and the locatioas well as the relevant icon for each resident. The actor double-clicks on a re

n, sident line to

open that resident’s MAR. When the actor right-clicks on a resident a list of functions idisplayed. (See the section on

s Census List Option. for further information.)

The Total Orders section displays all the orders or medications for a selected resident.

4.1.1

► The actor clicks on Add after entering the required data on any window, No longer required

For definitions of the fields under each tab, as well as their parameters (i.e., data type, length, related fields, etc.), refer to the Data Specifications

Adding Observations The actor can add resident-related observations to the E-Mar LTC database by clicking on the Observations button on the Resident Identification Pane to display the Resident Observations window. Resident Observations is comprised of seven tabs (entry windows) for entering a range of data, including: Vitals, Vitals/History, Diagnosis, Allergies, Complaints, Notes, and Dietary.

to clear the data for a selected date/entry, Print Report, or Close to exit an entry window.

section in this chapter.

Figure 4-2 Resident Observations tab for entering Vitals data



Figure 4-3 Resident Observations tab for entering Vitals/History data

Figure 4-4 Resident Observations tab for entering Diagnosis data



Figure 4-5 Resident Observations tab for entering Allergies data

Figure 4-6 Resident Observations tab for entering Complaints data



Figure 4-7 Resident Observations tab for entering Notes data

Figure 4-8 Resident Observations tab for entering Dietary data



4.1.2

The a cility has To add an image to the census view, the actor:

tification Pane to display the

Adding an Image ctor can add the resident’s image to the Resident Identification Pane, if the LTC fa

configured the system to use the feature.

1. Clicks on the Image button in the Resident Idenform_ImageProcessing window,

Figure 4-9 form_ImageProcessing window

2. Clicks on the Load Image button (for a new image ), or the Reset Image button (to update an existing image),

3. Selects an image from the window that opens, then

4. Clicks on OK to insert the image in the Resident Identification Pane.

4.1.3 Census List Options The actor can right-click on any resident line in nts section of the census view

display the Census List Options window (shown on the next page). the Current Reside

to



Figure 4-10 Census List Options

The actor clicks on:

to go to the Unverified Orders in MAR,e O go to e/Chart tab in MAR, ports to list reports that can be printed, ce Dose to open the Once Dose

• View MAR to display the MAR screen of the E-Mar system, • Unverified Orders• Du• Re• On

tab rders to the Du

window, and • Resident Observations to open the Resident Observations window.

Definitions of the , as rameters for the fields under the Once DoseReports well as pa and Resident Observations windows, are provided in the Data Specifications section.

tor can cess the ose rom:

• The Census List Options in the census view,

ny resident tile in the tiled view.

Once Do indow t pag

4.1.4 The Once Dose Feature The ac ac Once D function f

• The All Orders tab or the Unverified Orders tab on the MAR screen, and

• The Resident Identification window, by clicking on a

(see se w on nex e)



Figure 4-11 Once Dose window

t was not inally rece d by the syst e pharm . (See the section on Once Dose

The actor uses the Once Dose feature to administer a one-time dosage to the resident thaorig ive E-Mar em from th acy fofurther information.)

r



4.2 Data pec ti S ifica onsField Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

“RESIDENT IDENTIFICATION PANE”— (Fields under “Resident Observations” window, Resident Identification Pane) —

Obser- n/a Button Action Y n/a Y Residents v (A l) ations dmin. Too


Report Date Range

10 + 10 Entry Numeric Y n/a Y

(Start/End)

n/a

Edit Validation Logic: Actor enters start/end observations dates, using the online calendar function.

Temp (F) 5 Entry Numeric Y n/a Y Resident als (Adm(under

“Vitals” tab)

Vitin. Tool)

Edit Validation Logic: Actor enters the resident’s temperature (in Fahrenheit) in this field.

Heart Rate 3 Entry Numeric Y n/a Y Resident als (Ad ol)

Vitmin. To

Edit Validation Logic: Actor enters the resident’s heart rate in this field.

Respiration 3 Entry Numeric Y n/a Y Resident ls (Ad l)

Vitamin. Too

Edit Validation Logic: Actor enters the resident’s respiration in this field.

Intake 5 Entry Numeric Y n/a Y Resident Vitals (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s intake of fluids. Dro isplay its in ccp-down list d s un and mm.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Outtake 5 Entry Numeric Y a n/ Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Actor enters the resident’s output of fluids. Drop-down list displays units in cc and mm.

Saturation Y a 3 Entry Numeric n/ Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Actor enters the resident’s pulse/oxygen ratio as a percentage.

Blood Pressure

Y a 7 Entry Numeric n/ Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Actor enters the resident’s systolic/diastolic blood pressure in this field.

Weight 5 Entry Numeric Y a n/ Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Actor enters the resident’s weight (in pounds or kilograms) in this field.

Height 3 Entry Numeric Y a Resident Vitals

n/ Y

(Admin. Tool)

Edit Validation Logic: Actor ente side ht (in inches or centimeters) in this field. rs the re nt’s heig

Physical Obser-

250 max. Entry Alphanumeric N n/a Y

vation

Resident Vitals

(Admin. Tool)

Edit n Log Validatio ic: Freeform wi r to en clinical observations of the resident’ . area, allo ng the acto ter s condition

Clear n/a Button Action Y n/a Y n/a

Edit Validation Logic: Allows actor to clear all populated fields under the Vitals tab.

Add n/a Button Action Y n/a Y Admin. Tool

Edit Validation Logic: Actor clicks on this button to add all vitals entries to LTC system, as well as the Administration Tool simultaneously, since all resident data resides on a common database.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Close n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on this b ose the Resident Observationsutton to cl window. Global function.

Date

Hi )

10 + 8 Display Numeric Y n/a Y Resident (under “Vitals/

Vitals (Admin.

story” tab Tool)

Edit Validation Logic: Date/time stamp indicating when the resident’s vitals were entered under the Vitals tab.

Blood 7 Display Numeric Y n/a Y Resident

Tool)

Pressure Vitals (Admin.

Edit Validation Logic: Resident’s res ered b e actor un he Vitals blood p sure as ent y th der t tab.

Body Temp. 5 Display Numeric Y n/a Y

dmin. Tool)

Resident Vitals

(A

Edit Validation Logic: Resident’s mp entere the actor er the Vita b. body te erature as d by und ls ta

Heart Rate 3 Display Numeric Y n/a Y Resident Vitals

(Admin. Tool)

Ed n Loit Validatio gic: Resident’s ate a by the or unde heart r s entered act r the Vitals tab.

Saturation (%SaO2)

3 Display Numeric Y n/a Y

(Admin. Tool)

Resident Vitals

Edit Validation Logic: Resident’s xyg as entered by the actor er the Vital . pulse/o en ratio (percentage) und s tab

Initials 2 Display Alpha Y User Name Y ResideVital

(Adm

nt s in.

Too.)

Edit Validation Logic: Actor’s initials are automatically entered in field following logging into the system, and addin under the ls tab, esid rvationg data Vita on the R ent Obse s window.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Physical 25 x. Resident Obser-vations

numeric Vitals (Admin.

0 ma Display Alpha- N n/a Y

Tool)

Edit Validation Logic: Physical observations as entered by the actor under the Vitals tab. Freeform field.

Height 3 Display Numeric Y n/a Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Resident’s height as entered by the actor under the Vitals tab.

Weight 3 Display Numeric Y n/a Y Resident Vitals

(Admin. Tool)

Edit Validation Logic: Resident’s weight as entered by the actor under the Vitals tab.

Intake/ 5 + 5 Display Numeric Y n/a Y Resident

Tool)

Outtake Vitals (Admin.

Edit Validation Logic: Resident’s ak t as en ed by the actor under the als tab. flue int e and outpu ter Vit

No Longer Required

n/a Button Action N n/a Y n/a

Edit Validation Logic: Displays a Confirm window. Actor clicks on Yes to clear the resident’s vitals information for the selected date. r clicks to indow d retain th ries unde Vitals taActo on No close the w an e ent r the b.

Print Report n/a Button Action N n/a Y n/a

Edit Validation Logic: Actor clicks on this button to print a report of the resident’s vitals data.


Ed on Loit Validati gic: Actor click is bu lose the sident Ob ationss on th tton to c Re serv window. Global function.

Date (under

“Diagnosis”

10 + 8 Display Y n/a Y

( Tool) tab)

Numeric Resident Diagnosis

Admin.

Edit Validation Logic: Date/time stamp showing when the diagnostic data were entered under the Diagnosis tab.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)


Dia is Resident Diagnosis

Y gnos Y

(Admin. Tool)

Edit Validation Logic: Field disp ent he Diag is line wh e actor clicks on the Addlays data ered on t nos en th button.

Initials 2 Display Alpha Y User Name Y Resident Diagnosis

o.) (Admin.

To

Edit Validation Logic: Actor’s initials are automatically entered in the field following logging into the system, and ata under the Diagnosis tab, on th ent Obs tionsadding d e Resid erva window.

Type n/a Entry Selection Y n/a n/a Resident Diagnosis (Ad in.

Tool) m

Edit Validation Logic: Actor enters the diagnosis type from the pull-down list under the Diagnosis tab.

Classification n/a Entry Selection Y n/a n/a Resident Diagnosis (A in.

Tool) dm

Edit Validation Logic: Actor enters the diagnosis classification from the pull-down list under the Diagnosis tab.

Diagnosis 250 ax. numeric

R t Re nt Diagnosis

m Entry Alpha- Y esidenID

Y side

(Admin. Tool)

E Lodit Validation gic: Freeform f tor e e diagno under the gnosis tabield. Ac nters th sis Dia .

No Longer n/a Button N n/a Y n/a Required

Action

Edit Validation Logic: Disor cli

plays a window. Actor clicks on Yes to r the diagn ic data for ts The act cks on ose ow and etain the es under t iagnosis ta

Confirm No to cl

cleaentri

osthe D

he b. elected date. the wind to r


Edit Validation Logic: Actor clicks on this button to print a report of the resident’s diagnostic data.

Add n/a Button Action Y n/a Y Adm in. Tool

Edit Validation Logic: Actor clicks on this button to add diagnostic entries to the LTC System, as well as the Administration Tool simultaneously, since all resident data resides on a common database.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)


Edit Validation Logic: Actor clicks on this button to close the Resident Observations window. Global function.

Date 10 + 8 Display Numeric Y n/a (under

“Allergies” tab)

(Admin. Tool)

Y Resident Allergy

Edi ogt Validation L ic: Date/tim di data were entered under the Allergies tab. e stamp in cating when the allergy

Notes n/a Display Alpha- Y Allergy Y Resident lergy min.

Tool)

numeric Al(Ad

Edit Validation Logic: Field displays data entered on the Allergy line when the actor clicks on the Add button.

Initials 2 Display Alpha Y User Y ResName

ident Allergy (Admin.

Tool)

Edit Validation Logic: Actor’s initials are automatically entered in the field following logging into system, and a de s ta e Resident Observationsdding data un r the Allergie b, on th window.

Type n/a Entry Y n/a n/a Resident Allergy (Admin.

Tool)

Selection

Edit Validation Logic: Actor enters the allergy type from the pull-down list under the Allergies tab.

Severity n/a Entry Selection Y n/a n/a Resident Allergy (A .

Tool) dmin

Edit ation Logi Valid c: Actor ent lerg ty level the pull n list under the Alleers the al y severi from -dow rgies tab.

Allergy 250 max. Entry Alpha-numeric

Y n/a n/a ResAl

ident lergy

(Admin. Tool)

Edit Validation Logic: Freeform field. Actor enters allergy information under the Allergies tab.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

No Longer Required


Edit Validation Logic: Displays a Confirm window. Actor clicks on Yes to clear the resident’s allergy data for the selected date. The actor clicks on No to close the window and to retain the entries under the Allergies tab.


Edi tion Logit Valida c: Actor cli s b rint a report of the resident’s allergies data. cks on thi utton to p


Edit Validation Logic: Aim

ctor cli s bu add aller entries to C System s well as theAd ion Tool s ultaneo e al t data resides on a c database

cks on thiusly, sinc

tton to l residen

gy the LTommon

, a.

ministrat



Date (under

c

“Complaints” tab)

10 + 8 Display Numeri Y n/a Y ?

E n Logidit Validatio c: Date/time dic en com nt data we ntered und he Complaints tab. stamp in ating wh plai re e er t


Y Com-plaints

Y ?

Edit Validation Logic: Field sho nte mp ts box wh e actor clicks on the Add on. ws data e red in the Co lain en th butt

Initials 2 Display Alpha Y User Name

Y ?

Edit ation Logi Valid c: Actor’s in au lly entered in the field following logging into itials are tomatica the system, and adding data under the Complaints tab, on the Resident Observations window.

Complaints 1000 max. Entry Alpha- Y n/a n/a(box) numeric

?

Edit Validation Logic: Freeform field. Actor enters the resident’s complaints under the Complaints tab.

No LoRequired

/a nger n/a Button Action N n/a Y n

Edit Validation Logic: Displays a Confirm window. Actor clicks on Yes to clear the resident’s complaints dafor the selected date. The actor clicks on No to close the window and to retain entries under the Complaints tab.

ta


Edit Validation Logic: Actor clicks on this button to print a report of the resident’s complaints data.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Add n/a n n Butto Actio Y n/a Y Admin. Tool

Edit Validation Logic: Actor clicks on this button to add the complai the LTC SystemAdministration Tool simultaneously, since resident data reside on same database.

nts entries to , as well as the


Edit tion Log Valida ic: Actor this button to close the Resident Observations clicks on window. Global function.

Date (under

10 + 8 Display Y Y

“Notes” tab)

Numeric n/a ?

Edit Validation Logic: Date/time stamp indicating when the notations were entered under the Notes tab.

Notes n/a y a-c

Displa Alphnumeri

Y Notes Y ?

Edit Validation Logic: Field displays data entered in Notes box when the actor clicks on the Add button.

Initials 2 Display Alpha Y User Y ? Name

Edit ation LogValid ic: Actor are ally entered in fiel g loggi o theadding data under the Notes tab, on the Resident Observations

’s initials automatic d followin ng int system, and window.

Notes (box) 1000 max. Entry Alpha-numeric

Y n/a n/a ?

Ed on Logit Validati ic: Freefo Act s notatio ab. rm field. or enter ns under the Notes t

No Longer n/a Button N n/a Y Required

Action n/a

Edit Validation Logic: Displays a Confirm window. Actor clicks on Yes to clear the resident’s notations for the se The a click close the window and to retain s under Notes tablected date. ctor s on No to the entrie the .

Print Report n/a Button N Y Action n/a n/a

Edit Validation Logic: Actor clicks on this button to print a report of the resident-related notations.


Edi tion Logt Valida ic: Actor this button to add the notations stem s well as the Administration Tool simultaneously, sinc ent data resides on a common database.

clicks on to the LTC Sy , ae all resid





Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Date (under

10 + 8 N

“Dietary” tab)

Display umeric Y n/a Y ?

Edit Validation Logic: Date/time tered under the Dietary tab. stamp indicating when the dietary data were en

Notes n/a Display A N lpha-numeric

Y otes Y ?

Edit Validation Logic: Field displays data entered in the Dietary box when the actor clicks on the Add button.

Initials 2 Display Alpha Y User Name

Y ?

Edit Validation Logic: Actor’s initials are automatically entered in field following logging into the system, anadding data under the Dietary tab, on the

d Resident Observations window.

Dietary 1000 ax. n/a (box) m Entry Alpha-numeric

Y n/a ?

Edit Validation Logic: Freeform field. Actor enters dietary data under the Dietary tab.

No Longer Required


E n Logdit Validatio ic: Displays window. Actor clicks on Yes to clear the resident’s dietarthe selected date. The actor clicks on No to close the window and to retain the entries under the Die

a Confirm y data for tary tab.


Edi tion Logit Valida c: Actor cli print a report of the resident’s dietary ta. cks on this button to da

Add n/a Button Y n/a Y AAction dmin. Tool

Edit Validation Logic: Actor clicks on this button to add the dietary entries to the LTC System, as well as the Administration Tool simultaneously, since all resident data resides on a common database.


Edit ation LogiValid c: Actor cli close the sident nscks on this button to Re Observatio window. Global function.

— (End of fields under “Resident tions” window, R dentification PaneObserva esident I ) —

Image n/a Button Action N n/a N LTC ty facili

Edit Validation Logic: Actor can include an image of the resident on the Resident Identification Pane, if the capability is available from the LTC facility. (See section Adding an Image in this chapter for more information.)



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Facility n/a Display Alpha-numeric

Y Unit, Room, Bed


(Admin. Tool)

Edit Validation Logic: Field defined in the Administration Tool during the normal ADMIT process. Field is dynamic and unedited, accepting both alpha and numeric characters.

Unit nnumeric

Fa , Room, Bed

F -/a Display Alpha- Y cility N acility-UnitRoom-Bed

(Admin. Tool)

Edit Validation Logic: Field defined in the Administration Tool during the normal ADMIT process. Field is d cters. ynamic and unedited, accepting both alpha and numeric chara

Room n/a Display Alpha- Y Facility, N l)

numeric Unit, Bed Room-Bed(Admin. Too

Facility-Unit-

E n Logdit Validatio ic: Field th tration l during th rmal ADM rocess. Field is d cters.

defined in e Adminis Too e no IT pynamic and unedited, accepting both alpha and numeric chara


Y Facility, Room,

N Facility-UnRoom-Be

Room

it-d

(Admin. Tool)


Allergies n/a D A isplay Alpha-numeric

N n/a ? llergy Type(Admin. Tool)

Edit Validation Logic: Field defined in the Administration Tool during the normal ADMIT procedynamic and unedited, accepting both alpha and numeric characters.

ss. Field is

Diagnosis n/a D numeric

Re t ID

Res nt Diagnosis

(Admin. Tool)

isplay Alpha- Y siden Y ide

Ed on Logit Validati ic: Field di resident diagnostic data as entered on the Residen ervatsplays t Obs ions window.


Y Resident ID

Y n/a

Edit Validation Logic: Field displays resident notations as entered on the Resident Observations window.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Complaints play -numeric

Y ident ID

Y n/a n/a Dis Alpha Res

Edit Validation Logic: Field displays resident complaints as entered on the Resident Observations window.

“CURRENT RESIDENTS” SECTION Status n/a play Y /a Y Dis Icon n ?

Edit Validation Logic: Field displays the same status icons as on the residents tiled view. (For mon the status condition associated with each icon, see The Residents Tiles

ore information section in Chapter 3.)

Last Name n/a Display Alpha- Y First Name N Residents in.

Tool) numeric (Adm

Ed ion Logit Validat ic: Field d in t tration ol during ormal AD T process. Field is dyn d unedited, accepting both alpha and numeric characters.

efined he Adminis To the n MIamic an

First Name n/a Display Alpha- Y First Name N Residennumeric

ts (Admin.

Tool)

Edit Validation Logic: Field defined in the Administration Tool during the normal ADMIT process. Field is d unedited, accepting both alpha and numeric characters. ynamic and

Next Dose 10 + 5 Display eric Y n/a N Base Due E-Mar/D

Num Internal to

Edit Validation Logic: Indica ate he resi t’s next dose is to be adm stered.tes the d and time t den ini

Room n/a Display Alpha- Y Unit, Bed N d numeric Room-Be

Facility-Unit-

(Admin. Tool)


Bed n/a lay -ic

Y Facility, om,

Room

N

Tool)

Disp Alphanumer

Facility-Unit-Room-Bed

(Admin. Ro




Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)


Y ity, Room, Bed

min. Tool)

Facil N Facility-Unit-Room-Bed

(Ad

Edit tion Log Valida ic: Field th ocdyn d unedited, accepting both alpha and numeric characters.

defined in e Administration Tool during the normal ADMIT pr ess. Field is amic an

Resident ID 8 Display Numeric Y n/a Y Residents (Admin. Tool)

Ed on Logit Validati ic: Actor e r D. Fiel validate Administration Tofield is dynamic and unedited, accepting both alpha and numeric characters.

enters th esident’s I d is d in the ol. However, the

View MAR n/a Display Selection N n/a n/a Residents (Admin. Tool)

Edit Validation Logic: This s is accessed from the Census List Options and allows the acelection tor to display the resident’s MAR screen.

Unverified Orders

? n/a Display /a Selection N n/a n

Edit Validation Logic: Orders awaiting review, verification by the actor. Also displayed on the MAR screen.

D Selection /a ue Orders ? n/a Display N n/a n

Edit Validation Logic: The number of currently due orders. Also displayed on the MAR screen.

— (“Reports” under Census List Options, Current Residents section) —

Resident LOA

/a

n/a List Selection N n/a n Residents (Admin. Tool)

Edit Validation Logic: Actor prints a report of the resident going on a Leave of Absence (LOA).

Resident /a ?n/a List Selection N n/a nMed Orders

Edit Validation Logic: Actor prints a report of all medication orders for the resident.

Resident Event

a Resident Event (Admin. Tool)

n/a List Selection N n/a n/

History

Edit tion Log Valida ic: Actor rep ent ev such as ion or in ation added ord. prints a ort of resid ents admiss form to rec

Resident Medication

n/a List Selection N n/a n/a ?

Event History

Edit Validation Logic: Actor prints report of medication events such as an order given, verified, or discontinued.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Resident n/a List N n/a n/a ?Override/

Bypass

Selection

Edit ation LogiValid c: Actor pri ort o verride bypas includ the date/tim nts a rep f order o or s events, and es e, themedication, and the operator who recorded event.

Operator-Resident

Event

n/a List Selection N n/a n/a Operators (Admin. Tool)

History

Ed on Logiit Validati c: Actor pri rt es that the operator has performed in the systemmedication dosed for a particular resident or a discontinued order.

nts a repo of activiti , i.e.,

30-Day MAR

n/a List Selection N n/a n/a ?

Edit Validation Logic: Actor prints a report of the MAR screen for the current month or the previous month.

— (End of “Reports” Residents section) — under Census List Options, Current

— (Fields un r “Onc i sus L ptions, C ent Reside sectiode e Dose” w ndow, Cen ist O urr nts n) —

Physician n/a Entry Selection Y n/a Y Pool) List (Admin. T

hysicians

Edit Validation Logic: Actor sel si cation to iven from op-dowects a phy cian who orders medi be g a dr n list.

Search Drug n/a Radio Button

Selection Y n/a Y Ite(Ad

ms/Formulary min. Tool)

Edit Validation Logic: Actor clicks on either the (brand) name or generic name of the medication to be given.

E-kit Only n/a Radio Button

n/a Y Item (A

Selection Y s/Formularydmin. Tool)

Edit Validation Logic: Actor clicks on the E-kit button to limit the drug search to only those medicati ons that arenormally kept on-site, at the facility, which have not been specified for a particular resident.

Drug Search n/ En Y n/a Y Item (A

a try Selection s/Formularydmin Tool)

Edit Validation Logic: Actor types the first few characters of the medication name in the field until thin

the field the actor double-clicks on the selection, or presses ENTER, to po te the Drug escriptio

e medication is displayed. (Actor can also scroll down list.) When the medication and dosage level are displayed

pula D n box.

Name n/a Display Alpha-numeric

Y n/a Y Ite(Ad

ms/Formulary min. Tool)

Edit Validation Logic: Field displays the name of the medication selected by the actor.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

G c numeric

n Y Item (

eneri n/a Display Alpha- Y /a s/FormularyAdmin. Tool)

Edit Validation Logic: Field indicates the generic equivalent of the medication selected by the actor.

Dose ? Display Alpha- Y Name Y numeric

Items/Formulary (Admin. Tool)

Edit Validation Logic: Field indicates the unit of measure (mg, ml, etc.) that the selected medication comes in.

Measure ? Radio Button

Numeric Y Dose Y Items/Formulary (Admin. Tool)

E ion Logdit Validat ic: Clinical specialis what t utton is fot uncertain his b r.

None ? Radio ? ? ? ? Item y (Admin. Tool) Button

s/Formular

Ed tion Logit Valida ic: Clinical specialis what t utton is fot uncertain his b r.

Dose Given (first field)

4 Entry Numeric Y Name Y Ite(A

ms/Formulary dmin. Tool)

Edit Validation Logic: Actor enters the actual dosage of the medication administered to the resident.

Dose Give (second field)

Na Y Item (

2 Display Alpha Y me s/FormularyAdmin. Tool)

Edit Validation Logic: Field indicates the units of the medication administered, i.e., mg, ml, cc, etc.

Route n/a Entry Selection Y n/a List

Y Route of Admin. (Admin. Tool)

Edit Validation Logic: Actor selects the means by which the medication was administered from a drop-down list.

Frequency 4 Entry Selection Y n/a Y ?

E n Lodit Validatio gic: tor se

Acto s wh e medica was adm red as a on me dosag( ). Ac lects y f This field affects the view and t AR s

r indicate frequenc

ether throm a list.

tion inistetiled

e-tihe M

e or STAT creen. immediately

Instructions n/a Entry Alpha-numeric

N n/a n/a n/a

Edi ation Lot Valid gic: Freef . F the act o enter not out dispen order to a resident. orm field ield allows or t es ab sing

Find n/a Radio Selection Y Name n/a substitution

on E-kit Button

n/a

Edit Validation Logic: This allows the actor to substitute a medication ordered by the physician, but that has not yet been sent by the pharmacy, with an equivalent or near-equivalent medication from the E-kit.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Cancel /a n on n Butto Acti Y n/a Y n/a

Edit Validation Logic: Actor clicks on th to stop a pending action. Global function. is button

OK n/a Button Action Y Frequency Y n/a

Edit Validation Logic: Actor clicks on bu onfirm a pending action. In the event nce Dostton to c of O e function, screen. If the red clock icon.

once the actor clicks on OK in hange o e resident’ d view and MARfrequency selected by the actor was STAT, the tile changes to pink with a STAT watermark and a

the status dicators c n th s tile the

If the frequency was once, the tile is colored green, the watermark reads DUE, and the clock icon is green.

— (End of fi unde Dose” window, Cen List Options, Current Residents secelds r “Once sus tion) —

Resident Obser- (Admin.vations

n/a Display Actioin Y n/a Y

Residents

Tool)


“TOTAL ORDERS” SECTION Routine 2 Display Numeric Y n/a Y

ity-based armacy

Meds (Active)

facilph

Off-site or

Ed tion Loit Valida gic: Indicates the num -PRN, non-STAT me tions order or the resideber of non dica ed f nt.

Routine Treatments

(Active)

2 Display Numeric Y n/a Y Off-site or facility-based

pharmacy

E on Lodit Validati gic: Indicates the num -PRN, non-STAT treatments ordered for the reber of non sident.

PRN 2 Display Numeric Y n/a Y Off-sifacility-based

pharmacy

te or

Edi ation Lot Valid gic: Indic um be administered e resident as ded. ates the n ber of medications ordered to to th nee

STAT 2 Display Numeric Y n/a Y Off-site or facility-based

pharmacy

Edit Validation Logic: Indicates the number of medications ordered to be administered to the resident at once.

Charting Required


pharmacy

Edit Validation Logic: Indicates the number of medications that require charting.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Due 2 Display Off-site or -based

Numeric Y n/a Y facility

pharmacy

Edit Validation Logic: Indicates the number of medications currently due to be administered.

Unverified c facility-based

pharmacy [UNV]

2 Display Numeri Y n/a Y Off-site or

Edit Validation Logic: Indi num rders aw ng review, ication by the actor. cates the ber of o aiti verif

Rejected [RE]


pharmacy

Edit Validation Logic: Indi nu ected orders. cates the mber of rej

DC’d Orders

2 Display Numeric Y n/a Y Off-site or

[DC] facility-based

pharmacy

Edit Validation Logic: Indicates the number of discontinued orders.

On Hold [HD]


pharmacy

Edit Validation Logic: Indicates the number of orders currently on hold status.

Order # 8 Display Numeric Y ? N Off-site or facility-based

pharmacy

Edit Validation Logic: Unique identifier for a medication or treatment, as entered into the E-Mar system.

Dispensed n/a Display Alpha-numeric

Y n/a N Internal to E-Mar/DBase

Edit Validation Logic: Indicates all medications, treatments administered by the actor to a particular resident.

Dose n/a Display Alpha-numeric

Y n/a N Unit of Measure

(Admin. Tool)

Edit Validation Logic: Indicates the dosage level of the medication, treatment that was administered by actor.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Route n/a Display Alpha- Y n/a N numeric

Route of Admin.

(Admin. Tool)

Edit Validation Logic: Indicates how the medication, treatment was administered by the actor.

Freq./Rate 6 Display Alpha- Y numeric E-Ma

n/a N Internal to r/DBase

Edit Validation Logic: Indicates the frequency or rate at which the medication or treatment was administered.

Order Status

n/a Display Alpha Y n/a N Internal to E-Mar/DBase

Edit Validation Logic: Indicates if the medication was Active, Unverified (UNV), Rejected, or Discontinued.

Order Date 10 Internal to E-Mar/DBase

Display Numeric Y n/a N

Edit Validation Logic: Not sure if this indicates when order is administered or when it is received in E-Mar.

Next Dose 10 + 5 Display Numeric Y n/a N Internal to E-Mar/DBase

Edit Validation Logic: Indicates the date and time that the next dose is to be administered by the actor.

Menu n/a Button Selection Y n/a Y n/a

Edit Validation Logic: Actor clicks on button on the Global Command Bar to access (1.) Administration Tools, (2.) Quick Admit, (3.) View, (4.) Minimize E-MAR, and (5.) Exit the Application. (See the The Menu Button section in Chapter 3 for further information.)

Med Pass n/a Button Selection Y n/a Y MedPass (Admin. Tool)

Edit Validation Logic: Actor clicks on button on the Global Command Bar to filter residents according to selected Med Pass. Function is present in tiled and census views, but not on MAR screen. Med Pass is set up on the Administration Tool. (See The Med Pass Button section in Chapter 3 for further information.)

View n/a Button Selection Y n/a Y n/a

Edit Validation Logic: Enables the actor to open Select View Settings window to set filters and other options that control how the residents are displayed in both the tiled (default) and census views. This function is not present on the MAR screen. (See The View Button in Chapter 3 section for further information.)



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Tiled n/a n/a Button Selection Y n/a Y

Edit Va alid tion Logic: Actor clicks on this button to display the residents tile view, comprised of various conditio n t’s medication status. (See

n i dicators, including color-coding, icons, and watermarks, which indicate each residenThe Residents Tiles section in Chapter 3 for further information.)

Help Help Module n/a Button Action Y n/a Y

Edit Va alid tion Logic: Allows the actor to display the online Help Content screen.

Step Away n/a Button Action Y n/a Y System Config.

Edit Validation Logic: Actor clicks on this button on the Global Command Bar to temporarily log out owhile administering medication to a resident. Actor logs back in by following the p

f the system rocedure described in Chapter 2 under Login After Step Away.

Log Off n/a Button Selection Y n/a Y n/a

Edit Validation Logic: Actor completely logs out of the system. The actor logs back into the system by following the procedure described in Chapter 2 under System Login.



5 The Resident MAR Screen

5.1 Logical SpecifThe resident’s MAR screen is a graphical represe n individual resident’s medication ad inistra rs. The screen is d

ications ntation of a

m tion record, which provides the tools for documenting doses and managing ordeivided into several sections:

Resident MAR

Banner

Filter Tabs

Medications Order Area

GlobaCommand

Bar

l

Figure 5-1 Sa tab selected) mple Resident MAR screen (Due/Chart



5.1.1 Resident MAR Banner The Resident MAR banner area is present in all views of the Resident MAR, and includes.

• An image of th

The resident’s name, sex, weight, DOB, SSN, ID, location, and primary physician.

e resident (if the LTC facility utilizes this feature).

•

• Any notes that the actor entered on the Resident Observations screen, Notes tab.

• Any allergies, diagnosis, dietary data, or complaints, also entered by the actor on the Resident Observations screen, per the associated tabs on this screen.

The actor clicks on the bar between the image and the resident data to return to the tiled or thecensus view, depending on which view was

used to navigate to the MAR screen.

5.1.2 MAR screen include the:

Medication Order Area (Order Tiles) The filter tabs that the actor can access order tiles from on the

• Due/Chart,

• Routine Orders, and the

• PRN tabs.

1 2

3

4

5

g with dosing data, the date the as been specified it will also be

AT, Past Due, Chart, Chart-STAT, Outcome, Scheduled, or PRN, depending on the type of order

Figure 5-2 Sample order tile

1. The medication name is listed at the top of the order tile, alonorder originated, and a prescription number. (If a stop date hdisplayed here.)

2. The status/action button indicates ST. The actor clicks on the action button to display drop-

down windows, providing various functions, depending on the order type and status.

3. A status icon is displayed if necessary.



4. A schedule area displays the schedule for today and yesterday, and the initials of the person

who administered the dose. If the dose was bypassed the initials are circled in red.

is shown as a day, date, and time.

ning of each:

5. The last dose charted

The table below depicts the order status icons and explains the mea

ORDER STATUS ICONS

Icon Meaning

Indicates resident has one or more medication doses due. (Color-coded green.)

Indicates resident has one or more medication doses past due. (Color-coded red.)

Indicates residenassessment. (Co

t has one or more medication doses that require charting or lor-coded orange.)

Indicates resident has one or more medication doses witdocumented. (Color-coded light blue.)

h an outcome that needs to be

Figure 5-3 Order Status Icons

The tile colors convey information and are configured by the LTC facility. The table below lists the default colors. (Orders on the PRN tab are always colored white.)

ORDER TILE COLORSColor Meaning White Scheduled, On Hold, or PRN. Pink STAT order. (See watermarks also.)

Green Due or Past Due. Blue Outcome required.

Figure 5-4 Order Tile Colors

5.1.2.1ow

Status Button Selections When the actor clicks on the status/action button on any order tile, a drop-down selection windis displayed, as shown below.

Figure 5-5 Sample selection window



Note that the particular window, and selections displayed, depend on the order type.

The Due/Chart tab is the default view when the actor selects the MAR screen. 5.1.3 Due/Chart Tab

Figure lt view

on Order Area (Order Tiles)

5-6 Filter abs with Due/Chart tab as the defau

The Due/Chart filter tab view is the most commonly used when administering routine medications. This view gives the actor an overview of all the orders for a resident that are STAT, Past Due, Due, and/or require charting, assessment, or outcome documentation. (See the Medicati section in this chapter for further information on the

e, Charting Required, and

5.1.3.1

isplayed.

scanner is not available, or if it is malfunctioning, at the LTC facility. This allows the actor to prepare a dose without scanning it. If the actor overrides the dose a reason must be entered in an Override Reason window.

The actor uses the Dose Documentation selection to record any notes, in addition to prompted assessments and outcomes associated with a particular dose. Notations can be entered at any point during the dispensing process.

Both the Discontinue Order and the Hold Order selections prevent the actor from administering the medication. If the actor scans the medication package, either an Order Discontinued or Order on Hold warning is displayed and the medication cannot be prepared.

5.1.3.2 Due or Past Due Order Options When the actor clicks on the status/action button on a Due or Past Due order, the drop-down window at right is displayed.

The actor selects Bypass Dose to skip a dose that is due. If the actor bypasses a dose a reason must be entered in a Bypass Reason window. The actor can also select Dose Documentation

formatting of this view.) Orders are sorted by STAT, Past Due, DuOutcome Required. Additional sorting within each of these group creation-date in the E-Mar LTC system.

is determined by the order

STAT Order Options When the actor clicks on the status/action button on a STAT order, the drop-down selection window at right is d

The actor selects Administer-Override Scan if a barcode

to add any documentation that is currently due. (Refer to the sections on Due or Past Due Doses and Bypass a Dose, for further information on these functions.)



5.1.3.3 Charting Options When the actor clicks on the status/action button on an order where

the drop-dow

ottom of the MAR screen to chart more than one order at a time.

The actor selects Undo Prepare in order to reverse the dose preparation. (This would be done if the dose was delayed or refused after the dispensing process was already started. The actor would select Undo Prepare also select Dose Documentation

charting is required, n window at right is displayed.

The Chart As Given selection allows the actor to chart the dose as given. The actor selects the Chart All as Given button at the b

and then Bypass it.) The actor can to entation to the currently prepared dose.

5.1.3.4 Outcome Options hen the actor clicks on the status/action button on an Outcome

Due order, the drop-down selection window at right is displayed.

t Outcome to record the outcome of a

add docum

W

The actor selects Documenan administered medication after a certain period of time has elapsed. The actor can also select Dose Documentation to add documentation on the currently prepared dose.

5.1.4 Routine Orders Tab

b All scheduled medications are displayed on the Routine Orders ta , which

of th by the order-creation date in the E-Mar LTC sy

Not

down selection window at r

ar se enables ugh it is not yet time for it. An Early Dose Documentation window displays when this selection is chosen,

a reason for the early dispensing. Dose Documentation

provides an overview of all the orders scheduled for a particular resident. Orders are sorted by STAT, Past Due, Due, Charting Required, and Outcome Required. Additional sorting within each

ese group is determined stem. If no activity is scheduled the tiles are colored white.

ice that the status/action button is now displayed as Scheduled for routine orders. When the actor clicks on this button, the drop-

ight is displayed.

E ly Do the actor to administer a dose even tho

prompting the actor to record , Discontinue Order, and Hold Order (all covered earlier in this chaprecord documentation, or to prevent the medication from

ter) are also available to allow the actor to being administered.



5.1.5 PRN Orders Tab

The format for PRN orders , or orders that are administered only as needed, differs fromthat of the first two tabs, as shown below.

Figure 5-7 Sample order tile for PRN orders

The sorting order for PRN tiles is Charting Required, Outcome Required, and Available for Dosing PRN. Within these groups the tiles are sorted by the order-creation date in the E-Mar LTC system.

PRN tiles are always color-coded white. However, it charting or outcomes are required they will have the standard Status Icon for those activities and status/action button will be labeled according to the order’s current status.

When the actor clicks on the status/action button on a PRN order, the drop-down selection window at right is displayed. (Each of these selections is covered earlier in this chapter.)

(See the section on Dosing PRN Orders for further information.)



5.1.6 All Orders

The All Orders tab

Tab

displays a list of all the orders for a resident, along with individual tiles for each order which provide detailed information about the orders. The All Orders filter also shows all discontinued orders. The actor can modify orders as necessary.

Order List

Section

Order ls

Figure 5-8 All Orders tab format

5.1.6.1 Order List Section The order list section provides a line-item list of all resident’s orders. Contents of the list include order number, dispensed item, dose, route, frequency/rate, order status, order date, and next dose.

DetaiSection

Control Buttons

Order History Button

Order Rules

Section



5.1.6.2 Order Details Section

The Order Details section of the screen is divided into four parts:

• Frequency: Prescribed Drug (if different), Dispensed Drug, Generic Name (if supplied by the pharmacy), and Route.

• Info: Order Date, Prescribing Physician, Entered By, Pharmacy Verified By, Verified By (E-Mar LTC user), Hold Date, Resume Date, and Discontinue Date.

• Schedule: Dose, Frequency, Duration, Start Date, and Stop Date.

• Instructions: Physician and Pharmacy Instructions.

5.1.6.3 Order Rules Section The Order Rules section is divided into several parts:

• Minimum Time Between Doses: This can apply to any order and provides notification to the actor in the event a dose is given within the specified minimum time since the last dose.

• Assessment: The required assessment for each dose for this order.

• Outcome: The required outcome for each dose for this order.

Additional available modifications include the Injection Site and Sliding Scale options. These are viewable once the actor selects the Modify button. (See the section Modify an Order for details on working in this area.)

Any modification affects only future administration of the medication and not past history.

5.1.6.4 Order History Button The actor selects the Order History button to access history specific to the order selected and not

e dosing history. The selection provides details on the order and the resident. It also provides a table listing each event associated with the order, sorted by date. Additional information includes

e source of the event, and the name of the individual recording the event.

5.1.6.5

th

the status, the event, th

Control Buttons Both Observations and Once Dose control buttons are available on the tab.

Unverified Orders Tab 5.1.7

The layout for the Unverified Orders tab is basically the same as the All Orders tab, and lists all unverified orders for the selected resident. The actor uses the tab mainly for verification. The two areas of the tab that differ from the All Orders tabs are (1.) the control buttons and (2.) the lower right corner.



Figure 5-9 Unverified Orders tab control buttons

Figu Low t co eri rs

The actor can take tw the order. (See the chapter on Order Ver

re 5-10 er righ rner of Unv fied Orde tab

o actions with an unverified order: verify of rejectification for information on processing verified orders.)

5.1.8 History Tab

The History tab lists all the doses administered to the resident identified in the banner part of the screen. The History tab provides the dosing history associated with a specific dose or a

p of doses.

The actor has the capability of selecting a specific dose from the filters section of thet the

See the next page for the History tab format for the MAR screen

grou

screen, and reviewing detailed information about the dose in the Dose Documentation Details section abottom of the MAR screen.



Figure 5-11 History tab format

5.1.8.1 Filters The filters section enables the actor to select specific orders/doses to view. The Show

ns . The

can b set to ou Range ( or all dat he actorick on the Given outside prescribed limits, Bypass, and Given by (a particular perso

5 ose um n D SectioThe Dose Documentation Detail section provides the actor all the available documen

Assessments and Outcomes. Note that incomplete doses (doses for which documentation has not been completed) will not be displayed on this view.

Section pull-down

menu allows the actor to select all orders or a specific one. The actor clicks on the radio buttoto the right of View Only to further refine the view to Routine, STAT, PRN, and One Timedatecl

e Last 24 H rs, Date calendar function), es. T can also n) radio

buttons to filter the view even further. (Given by requires a user’s initials.)

.1.8.2 D Doc entatio etails n tation for the

selected order. When all required documentation has been completed, the notes are sent to this view. Available documentation includes Prepared, Charted As Given, and if defined,

Filters Section

Dose Documentation Details Section Additional

Functions

Print MARButton



5.1.8.3 Print MAR Button

is b ws r to e a p fo nt last

Functions This is another place where the actor can access the Once Dose

Th utton allo the acto generat rinted MAR r the curre month or for month.

5.1.8.4 Additional and Observations fun

5.1.9 BaSee the section on the Global Command Bar

ctions. (See these sections in Chapter 4 for detailed information on their use.)

Global Command r in Chapter 3 for detailed information on

the use of the various functions associated with the command bar.

5.2 Data Specifications

Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

“RESIDENT MAR BANNER” SECTIONImage n/a Button Action N n/a N LTC facility

Edit Validation Logic: The actor can include an image of the resident in the Resident banner, ifcapability is available from the LTC facility. (See

this Adding an Image section in Chapter 4 for more details.)

Sex 1 Display Residents ol)

Alpha Y n/a Y (Admin. To

Edit Validation Logic: Resident’s gender, entered by the actor during the normal ADMIT process.

Weight 5 Display Resident Numeric Y n/a Y Vitals (Admin. Tool)

Edit Validation Logic: Resident’s weight, entered by the actor during the normal ADMIT process.

DOB 10 + 2 Display Numeric Y n/a Y Residents (A ) dmin. Tool

Edit Validation Logic: Resident’s date nd age, entered by the actor during the ADMI of birth a T process.

SSN 9 Display Numeric Y n/a Y Residents (Admin. Tool)

Edit Validation Logic: Re oc ty Num , enter tor dur the ADMsident’s S ial Securi ber ed by the ac ing IT process.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Resident ID

N 8 Display umeric Y n/a Y Residents (Admin. Tool)

Edit Validation Logic: Actor enters the resident’s ID. Field validated in the Administration Tool. Field is dynamic and unedited, accepting both alpha and numeric characters.

Facility n/a Display numeric

Y Unit, Room, Bed

N R

ol)

Alpha- Facility-Unit-oom-Bed

(Admin. To

Edit Validation Logic: Fie in inistration Tool during the normal ADMIT procdy nd unedited, accepting both alpha and numeric characters.

ld defined the Adm ess. Field is namic a


Y Facility, Room, Bed

N Facility-UnitRoom-Bed

-

(Admin. Tool)


Room n/a Display Alpha-numeric

Fa , Unit, Bed

Fa

min. Tool)

Y cility N cility-Unit-Room-Bed

(Ad

Edit Validation Logic: Fie in inistrat Tool duri e normal A IT p unedited, accepting both alpha and numeric characters.

ld defined the Adm ion ng th

DM rocess. Field is dynamic and


Y Facility, Room,

N FaciRo

Room

lity-Unit-om-Bed

(Admin. Tool)

Edit Validation Logic: Field defined in inistration Tool during the normal ADMIT pr the Adm ocess. Field is dynamic and unedited, accepting both alpha and numeric characters.

Physician n/a Display Alpha- Y n/a Y Physiciannumeric

s (Admin. Tool)

Edit Validation Logic: This field displ ysician who ordered medications for the residays the ph ent.

Resident Button Alpha- N n/a Y Notes numeric

Residents (Admin. Tool)

Edit Validation Logic: Displays any notes entered by the actor on the Resident Observations window.

Allergies n/a Button Alpha- N n/a Y Resident numeric Allergy

(Admin. Tool)

Edit Validation Logic: Displays any allergy data entered by the actor on the Resident Observations window.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Diagnosis n/a Button Alpha-numeric

N n/a Y Resident Diagnosis

(Admin. Tool)

Edit Validation Logic: Dis gno a entered the actor on the Resident Observationsplays dia stic dat by window.

Dietary n/a Button N n/a Y Resident Dietary

dmin. Tool)

Alpha-numeric

(A

Edit Validation Logic: Dis tar ered by actor on esident Observationsplays die y data ent the the R window.

Com-plaints

n/a Button Alpha-numeric

N n/a Y ?

Edit Validation Logic: Dis p red by actor on t esident Ob vationsplays com laints ente the he R ser window.

“FILTER TABS” SECTIONDue/Chart n/a Button Selection Y n/a N n/a

Edit Validation Logic: Ac on n to display all of th ident’s me ation ordtor clicks this butto e res dic er tiles.

Routine n/a Button Selection Y n/a N Orders

n/a

Edit Validation Logic: Actor clicks on this button to display the resident’s routine orders tiles.

PRN n/a Button Selection Y n/a N n/a

Edit Validation Logic: Actor clicks on button to display the tiles of orders to be administered as needed.

— (Fields under “All Orders” AND “Unverified Orders” tabs, Filter Tabs section ) —

Order # 8 Display Numeric Y ? N Off-site or facility-based

pharmacy


Dispensed n/a Display Alpha-numeric

Y n/a N Off-site or facility-based

pharmacy

Edit Validation Logic: Indicates the me or administered to the resident. dication that the act

Dose n/a Display Alpha- Y Dispensed N Unit of numeric Measure

(Admin. Tool)

Edit Validation Logic: Indicates the unit of measure of the medication administered to the resident.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Route n/a Display Alpha-numeric

Dose RoY N ute of Admin. (Admin. Tool)

Edit Validation Logic: Indicates how the medication, treatment was administered to the resident.

Freq./Rate numeric

Dis ed

pharmacy

n/a Display Alpha- Y pens N Off-site or facility-based

Edit Validation Logic: Ind fre or rate at which the medication was given to the icates the quency resident.

Order n/a Display Y n/a N E-Mar/Dbase Status

Alpha Internal to

Edit Validation Logic: Ind ed was Active, Unverified (UNV), Rejected, or Discicates if m ication ontinued.

Order 10 + 5 Display Y n/a N E-Mar/Dbase Date

Numeric Internal to

Edit Validation Logic: Not thi hen o r is administered or when it is receive sure if s indicates w rde d in E-Mar.

Next Dose 10 + 5 Numeric Y n/a N E-Mar/DBase

Display Internal to

Edit Validation Logic: Indicates the date and time the resident’s next dose is to be administered.

Prescribed n/a Display Alpha-numeric

N n/a N Items/Formul(Admin. To

ary ol)

Edit Validation Logic: In medication ordere the physician for a particular residendicates the d by t.

Dispensed n/a Display Alpha- N n/a N I in. Tool) numeric (Adm

tems/Formulary

Edit Validation Logic: Indicates the m actuall ministere he residen ia the phE-kit) if the original medica der hysici as unavai and a sub ute was

edication ed by the p

y adan w

d to tlable

t (vstit

armacy or the ordered. tion or


Y Dose N Route of(Admin

Admin. . Tool)

Edit Validation Logic: Indi w tion, tr ment was given to the resident. cates ho the medica eat

Order Date

10 + 5 Display Numeric Y n/a N InteE-Ma

rnal to r/DBase

Edit Validation Logic: No his when o r is administered or when it is recet sure if t indicates rde ived in E-Mar.



Field Name


Required Fields?

Related Fields

Duplicates Allowed?

Related Source(s)

Physician numeric (

n/a Display Alpha- Y n/a N Physicians Admin. Tool)

Edit Validation Logic: Name of the physician who ordered the medication administered to the resident.

Entered n/a Display By

Alpha- Y n/a N n/a numeric

Edit Validation Logic: Name of the pharmacy that filled the medications ordered by physician.

Pharmacy n/a Display Alpha- Y n/a N n/a numeric

Edit Validation Logic: Nam ph here the resident’s medications were filled. e of the armacy w

Verified by

n/a Display Alpha-numeric

Y n/a N Internal E-Mar/Dbas

to e

Edit Validation Logic: Name of actor who verified rece of the me ion(s) from e pharmacy, dat time ord eceived LTC facil

ipt by

dicatity.

thincluding the e and that the er was r

Hold Date 10 + 5 Display Numeric N n/a N Internal to E-Mar/DBase

Edit Validation Logic: Indicates when an order was put on hold. The actor selects Hold Order from a drop-down window under Due he date and time. /Chart tab for Due or Scheduled orders. The system stamps t

R Date

10 + 5 Display Hold Date esume Numeric N n/a Internal to E-Mar/DBase

Edit Validation Logic: Indicates when an order was taken off hold and is resumed. The actor clicks the On Hold button under the Routine Orders tab, enters the data requested by the Resume Order Wizard, then clicks on Resume Order. System stamps date/time on All Orders and UNV Orders tabs on MAR screen.

Discontin-ued date

10 + 5 D Internal to E-Mar/DBase

isplay Numeric N n/a N

Edit Validation Logic: Actor clicks on the status/action button from the pull-down selection window under the Due/Chart, Routine Orders, or PRN tabs and selects Discontinue from the pull-down window. A confirmation window prom act on Yespts the or to click .

Dose n/a Alpha- Y Prescribed N Internal to e

Display numeric E-Mar/DBas

Edit Validation Logic: The dosage level (ml, capsules, etc.) of medication scheduled to be administered.

Frequency n/a Display Alpha-numeric

Y Dispensed N Off-site or facility-based

pharmacy

Edit Validation Logic: Frequency or rate at which a scheduled medication is to be administered.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Start Date/Time E-M

10 + 5 Internal to ar/DBase

Display Numeric Y n/a N

E iondit Validat Logic: Da at d med ion is to b inistered to the resident. te/time th a schedule icat e adm

Stop Date/Time E-Ma

10 + 5 Display Numeric Y n/a N Internal to r/DBase

E tiondit Valida Logic: Da at d med ion is to b ontinued. te/time th a schedule icat e disc

Physician n/a Display Alpha- Y n/a N Internal to E-Mar/Dbase numeric

Edit Validation Logic: Name of the ph ho ord the medication(s) for the resident. ysician w ered

Pharmacy n/a Display Y n/a N Internal to E-Mar/DBase

Alpha-numeric

Edit Validation Logic: Na ph the ordered medications was filled. me of the armacy where

Specify

between

n/a Radio N n/a N Internal to E-Mar/Dbase minimum

time Button

doses

Selection

Edit Validation Logic: This button enables the actor to indicate a different minimum time between doses other than the time receive ar rom the pharmacy. U what cond ns is this used by E-M system f nder itio d?

Min. Time 10 + 5 Calendar Selection N n/a N Internal to E-Mar/Dbase

Edit Validation Logic: Allows the actor to set a minim ate/time en dose istration. um d betwe admin

A n/a Entry Selection List

N n/a N Internal to E-Mar/Dbase

ssess-ment

Edit Validation Logic: Actor clicks on Modify to display a drop-down selection list of Assessments.

Outcome n/a Entry Selection List

N n/a N Internal to E-Mar/Dbase

Edit dation Vali Logic: Actor clicks on Modify to disp drop-do ection li utcomeslay a wn sel st of O .

Order History

n/a Button Review N n/a N Resident Eve(Admin. Tool)

nt

Ed ation it Valid Logic: Actor clicks on ng the

O Histor w the M tion Ev tory scree he res ncludi orde ering ian, medication, dos

rder physic

y to vie edicaage, event date, and the status.

ent His n for tident, i r #, ord



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Verify n/a Button Action Internal to E-Mar/DBase

Y n/a N

Edit Validation Logic: Featured on UNV Orders tab only. (For detailed information on this function, see Chapter 6 on Order Verification.)

Reject n/a Internal to E-Mar/DBase

Button Action Y n/a N

Edit Validation Logic: Featured on UNV Orders tab only. (For detailed information on this function, see Chapter 6 on Order Verification.)

O Residents (Admin. Tool)

bser-vations

n/a Button Action Y n/a Y


Once Dose n/a Button Action Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to open the Once Dose window. This enables the actor to administer a single dosage of a medication that was not received by the E-Mar system from the pharmacy.

— (End of s un Or ND “Unverified Ord tabs, Filt abs sec field der “All ders” A ers” er T tion ) —

— (Fields under “History” tab, Filter Tabs section ) —

Show n/a List Selection List

Y n/a N Items/Formu(Admin. To

lary ol)

Edit Validation Logic: Actor clicks on the arrow to the right of the drop-down list to select ALL orders, or a specific order only, that ha administered to the resident. Selected order data are displayed in the Filter section below.

ve been

View Only n/a Radio Selection N n/a N n/a Button

Edit Validation Logic: This button allows the actor to refine the view in the Filter section to include Routine, STAT, PRN, and/or One Time orders as desired.

Date n/a Radio Button


Edit Validation Logic: The actor can set the date for the last 24 hours, by Date Range (selected from the Start/End calendar box below) or All Dates. The actor ecting the rab ow: G outs rib bypass d Given rticular person). Note that the “Given by” selection requires the actor’s initials.

can filter the view further by, an

sel dio uttons bel iven ide presc ed limits, by (a pa

Due Date 10 Display Numeric Y n/a N n/a

Edit Validation Logic: The date that the selected (filtered) order was administered to the resident.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Time 5 Display Numeric Y n/a N n/a

Edit Validation Logic: The time that the selected (filtered) order was administered to the resident.

Prepared 10 + 5 Display Numeric Y n/a N Date

n/a

Edit Validation Logic: The date and time that the order was prepared by the actor, if not bypassed.

Charted Date

10 + 5 Display Numeric Y n/a N n/a

Edit Validation Logic: d. The date and time that the order was charted by the actor, if require

Item n/a D

N n/a isplay Alpha- Y n/a numeric

Edit Validation Logic: The name of the medication administered by the actor.


Y n/a N n/a

Edit Validation Logic: The dosage level of the medication administered to the resident.

Init. 2 Display Alpha Y n/a N n/a

Edit Validation Logic: The initials of the actor administering the medication. Required if “Given by” filter radio button is selected.

Type ? Display Alpha N n/a N n/a

Edit Validation Logic: Indicates the type or order, i.e., PRN, STAT, etc.

Done (Assessme

nt & Outcome nformatioI

TBD TBD TBD TBD TBD

n windows)

TBD TBD

Edit Validation Logic: Non-functional. ALL documentation – assessments, outcomes, etc. – appear in the “Additional Notes” window at the bottom of the MAR screen. Nothing displays in either of these windows.

By TBD TBD TBD TBD TBD TBD TBD

Edit Validation Logic: Non-functional. cumentation – asses , outcom etc. – appear in the ALL do sments es, “Additional Notes” window at the bottom of the MAR screen. Nothing displays in either of these windows..

Date TBD TBD TBD TBD TBD TBD TBD

Edit Validation Logic: Non-functional. ALL documentation – assessments, outcomes, etc. – appear in the “Additional Notes” window at the bottom of the MAR screen. Nothing displays in either of these windows.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Additional Notes

TBD TBD TBD TBD TBD TBD TBD

Edit Validation Logic: Non-functional. ALL documentation – assessments, outcomes, etc. – appear in the “Additional Note ndow bo R scre Nothing in either these windows” wi s at the ttom of MA en. displays of s.

Additional ? Display Alpha- N n/a N n/a Notes (box)

numeric

Edit Validation Logic: Presently, ALL documentation relating to order administration displays here.

View Notes

n/a Button Alpha-numeric

N n/a N n/a

Edit Validation Logic: This displays the Dose Detailed Notes window that allows the actor to review any do tion re to th d o as an a ment or an outcome. cumenta lated e selecte rder, such ssess

Once Dose n/a Button Action Y Y n/a n/a

Edit Validation Logic: Actor clicks on this button to open the Once Dose window. This enables the actor to a single dosage icat as not ived by th ar system m the pharmdminister a of a med ion that w rece e E-M fro acy.

Obser-vations

n/a Button Action Y n/a Y Residents (Admin. Tool)

Edit Validation Logic: Actor clicks on this button to display the Resid bservationent O s wry

indow, whered information such as vitals signs/history, gnosis, alle s, and dieta data are ente

e red. resident-relat dia rgie

Last onth

MAR M

n/a Radio Button

? ? ? ? ?

Edit Validation Logic: ???

Scan override

n/a Display Alpha N n/a n/a n/a

Edit Validation Logic: This field indicates if the scanned order dispensing data was overridden.

Print MAR

n/a Button Action N n/a N n/a

Edit Validation Logic: Actor clicks on this button to print out the currently displayed MAR screen.

A n Anumeric

N Route N n/a dmin. Site

/a Display lpha-

Edit Validation Logic: Indicates where a certain medication was applied on the resident, such as ointment.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

B 10 + 10 N N N nypass Date

Display umeric n/a /a

Edit Validation Logic: Date and time stamp of when a scheduled order was bypassed by the actor.

Bypass reason

D An

N n/a N n/a n/a isplay lpha-umeric

Edit Validation Logic: Displays reason entered in “Bypass Reason” window why medication was not given to the resident. Function is av om wn list, when the status/action but is clicked onailable fr the drop-do ton .

— (End of fields under “History” tab, Filter Tabs section ) —

“MEDICATIONS ORDER AREA” SECTIONMedica- n/a Display Alpha- Y Resident Y Item

tion Name IDs/Formulary

(Admin. Tool) numeric

Edit Validation Logic: This area at the top of the order tile indicates the medication name, dosing data, date the ord ted, resc mb top date been spec it is displa here also. er origina and p ription nu er. If a s has ified yed

— (Fields under “Status/Action button,” Medications Order Area section ) —

Status/ Action Button

n/a Button Selection Y n/a N n/a

Edit Validation Logic: This button in the top right corner of the order tile displays STAT, Past Due, Chart, chart-SAT, Outco Sche PRN, depending on order type. Various functions are available via me, duled, or thedrop-down selection windows, depending on the order type and status.

Code (Administer-

Override Scan

selection)

Y Na N n/a 1 Display Alpha me

Edit Validation Logic: When the actor clicks on the status/action button and then selects Administer-Overridefrom the drop-down list, the Override Reason

window is displayed. Selection A indicates that a wrist-band

ner i ava ndi t the scanner is malfunctioning. The scanner (if availa the LTC facility) is used to verify that the m order being sent to the E-Mar system from the pharmacy barcode scan s not ilable; B i cates tha

edicationble at

filling the order is being associated with the correct resident.

Name n/a Display Alpha Y Code N n/a

Edit Validation Logic: Depending on wh e LTC f ity has arcod anner capability, the ether th acil wrist-band b e scactor selects either (A) that the scanner is not available, or (B) that the scanner is malfunctioning.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Notes n/a Entry Alpha-merinu c

Y Name, Code

N n/a

Edit Validation Logic: The actor enters the reason for overriding the scanner process on this line.

Select n/a Button Selection Y Name, Code

N n/a

Edit Validation Logic: The actor clicks on this button to display the Past Due Order Documentation window, OK

the Dose Confirmation w at fo N ord ers order s. Also, the PRN Dose Confirmation winrequires the actor to enter documentation relating to the order being ad stered – depending on the type – such as Assessment or Outcome. The ation entered on this screen is displayed under the History

and enters the reason the dosage is being administered late in the appropriate space. The actor then selectsto proceed to the Dose Confirmation window, or Cancel to stop the process. (Note that

indow form r PR ers diff from other

document

type dow ordermini

filter tab, for the particular medication that is administered.)

Cancel n/a Button Selection Y Name, Code

N n/a

Edit Validation Logic: The actor clicks on this button to stop a pending action. Global function.

Prepare n/a Button Action Y n/a N n/a

Edit Validation Logic: The actor clicks on this button to open the cart drawer and to administer the medication t. The actor clicks on the Step Away button to hide resident information. to the residen

Documen-tation Result

n/a Entry Alpha-numeric

N n/a N n/a

(PRN Orders)

Edit Validation Logic: The actor selects the result (for PRN orders only) from a drop-down list. The result can be for an Assessment or an Outcome. When the actor clicks on Prepare, the status/action button on the ordetile indicates that charting is required for the medication being administered to the resident.

r

Additional Dose Notes

(PRN numeric

Orders)

n/a Entry Alpha- N n/a N n/a

Edit Validation Logic: Freeform field. The actor enters additional PRN order documentation in this field.

Code 1 Display Alpha Y Name N n/a (B s ypas

selection)

Edit Validation Logic: When the actor clicks on the status/action button and then selects Bypass Dose from the drop-down list, the Bypass Reason window is displayed. Several selections are available that allow the actor to indicate the coded reason why an order was not administered to the resident as scheduled.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Name n/a Display Alpha Y Code N n/a

Edit Validation Logic: The actor selects a reason from the Bypass Reason window as to why an order was not ad d to the resident as originally scheduled. ministere

Notes n/a Alpha-numeric

Y Name, Code

N n/a Entry

Edit Validation Logic: The actor enters the reason for bypassing the dosage on this line.

Select n/a Button Selection Y Code, Name,

N n/a

Reason

Edit Validation Logic: The actor clicks on this button to select the bypass code, name and reason.

Cancel n/a Button Selection Y n/a N n/a

Edit Validation Logic: The cks tton to stop a pending action. Global function. actor cli on this bu

Drug n/a Display Alpha- Y n/a N n/a (Dose

Documen-

tation selection)

numeric

Edi dation Lt Vali ogic: Nam dica r, as list t the top o Dose Deta d Notes winde of me tion orde ed a f the ile ow.

Dose Date 10 Display Numeric Y n/a N n/a

Ed tion Lit Valida ogic: The date that the dose is scheduled to be administered by the actor.

Dose Time 5 Display Numeric Y n/a N n/a

E ion Ldit Validat ogic: The t the schedule o be admin ed by the actor. time tha dose is d t ister

Date 10 + 5 Display Numeric N n/a N n/a

Edit Validation Logic: The date/time stamp that the actor entered comments in the documentation box at the b e Dose Detailed Notes window. ottom of th

Dose Notes n/a Display Alpha-numeric

N n/a N n/a

E tion Ldit Valida ogic: The ts th tor ente in the doc tation box at the bottom of the Dose Detailed Notes window.

commen at the ac red umen

Initials 2 Display Alpha N Dose Notes N n/a

Edit Validation Logic: The initials of the actor who entered the comments displayed in the Dose Notes field.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Note Type Selection Doc n-tation

Internal to E-Mar/DBase

n/a Entry List

Y ume N

Edit Validation Logic: The actor clicks on this drop-down list to select the type of notation to be entered in the Note Type field, such as assessment, outcome, bypass, etc.

Print Date n/a Radio Selection N n/a N Range

n/a Button

Edit Validation Logic: The actor clicks dio button to indicate that a selected date range of dose on this radocumentation, relating to the specific order, is to be printed from the E-Mar database.

Start date Calendar 10 Entry Function

N n/a N n/a

Edit Validation Logic: The actor selects the start date from a calendar for the documentation to be printed.

End date 10 Entry Calendar N n/a N n/a Function

Edit Validation Logic: The actor select ate from a calendar for the documentation to be printed. s the end d

Print n/a Button Action N Print Date N n/a Order

Dose Notes Start Date, End Date

Range,

Edit Validation Logic: The actor clicks tton to erate a print out of all the documentation/notes entered into the E-Mar system for the date range indicated in the Start Date and End Date fields.

on this bu gen

Add Notes n/a Button Action N Documen- N n/a tation

Ed n Lit Validatio ogic: The actor clicks on this button to add the notation entered in the Documentatio x to E-Mar. The dose notation, date, time, and actor’s initial are displayed at the top of the Dose Detailed Notes window. All notes for a pre-defined date range can be printed out via Print Order Dose Notes.

n bo

Close n/a Button Action N n/a N n/a

Ed tion Lit Valida ogic: The actor clicks on this button to se the disp dow. Global function clo layed win .

Documen-tation

1000 Entry Alpha-numeric

Y n/a N n/a

Edit Validation Logic: The ter comme and obser ns about th ose in this boactor en s all notes, nts vatio e d x.

Yes (Discontin-

ue Order selection)


Edit Validation Logic: The actor clicks on this button to confirm discontinuing the selected order.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Cancel n/a Button Action N n/a N n/a

Edit Validation Logic: The actor clicks tton to stop a pending action. Global function. on this bu

Do Not n/a Radio Selection N n/a N Know

n/a

When to Resume

(Hold Order

selection)

Button

Edit Validation Logic: When the actor puts an order on hold, the resumption of administration defaults to this condition unless otherwise indicated. (See Resume On Date selection below.)

Resume n/a Radio Calendar N n/a N On Date Button Function

n/a

Edit Validation Logic: Actor selects a date from a calendar when administration of the order is to resume.

Notes ? Entry Alpha- N n/a N numeric

n/a

Edit Validation Logic: A freefor detailing why the order was placed on Hold status. This ept ned nu r of chara .

m field box acc

that allows the actor to enter cos an undefi

mments ctersmbe

OK n/a Button Action N n/a N n/a

Edit Validation Logic: The actor clicks on this button to confirm a pending action. Global function.



Chart As n/a Button ActioGiven

(Charting selection)

n N n/a N n/a

Edit Validation Logic: This selection allows the actor to chart the dose . NOTEas given : A r at

Chart All as Given button at the botto f the ree he actor to chart mor n one orde a time.m o MAR sc n enables t e tha

Undo Prepare


Edit Validation Logic: The actor selects Undo Prepare in order to reverse the dose preparation. (This would be done if the dose was delayed or refused after the dispensing process was already started. The actor would select Undo Prepare and then bypass it.)



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Drug (Document Outcome selection)

numeric n/a Display Alpha- N n/a N n/a

E tion Ldit Valida ogic: This ic g for which an outco field ind ates the dru me is required (PRN orders).


N n/a N n/a

Edit Validation Logic: This field indicates the dosage level of the drug that was administered.


N n/a N Route of Admin.

(Admin. Tool)

Edit Validation Logic: This field indicates how the medication, treatment was administered by the actor.

Freq. n/a Display Alpha-numeric

N n/a N n/a

Edit Validation Logic: This field indicates the schedule for administering the drug, as received by E-Mar.

Time 5 Display Numeric N n/a N n/a

Edit Validation Logic: This field indicates the time of day that the drug was administered.

Dose Amount

? Entry Alpha-numeric

N n/a N n/a

Edit Validation Logic: This field indicates the dosage amount, i.e., 1 caplet. Field is dynamic and unedited, accepting both alpha and numeric characters.

Chart (or

Prepare)


Edit Validation Logic: This button displays as Chart when documenting an outcome, or as Prepare when charting an order, on the Dose Confirmation window.



Documen-tation Result

n/a Entry Selection List

N n/a N n/a

Edit Validation Logic: The actor selects the resident’s “pain level” from a drop-down list.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Additional n/a Entry Alpha- N Dose Notes numeric

n/a N n/a

Edit Validation Logic: The actor can enter additional dose-related notations, comments on this line.

— (End of fields under “Status/Action Button,” Medications Order Area section ) —

Status Icon n/a Display Graphical Y Resident ID Y n/a

Edit Validation Logic: An icon is displayed only if necessary. (See the section on Order Tiles, also in this chapter r, fo a detailed explanation for each icon type.)

Schedule Are

Resident ID Y n/a 5 + 5 Display Numeric Y a

Edit Va alid tion Logic: This area displays schedule for today and yesterday, and the initials of the actor who administered the dose to the resident. If the dose was bypassed, the actor’s initials are circled in red.

Last DCharted

ose 10 + 5 Display Numeric Y Resident ID Y n/a

Edit Validation Logic: This area displays the day, date, and the time that the last dose was charted.

“GLOBAL COMMAND BAR”Men n/a u n/a Button Selection Y n/a N

Edit Validation Logic: Actor clicks on this button to access (1.) Administration Tools, (2.) Quick Admit, (3.) View, (4.) Minimize E-MAR, and (5.) Exit the Application. (See the The Menu Button section in Chapter 3 for further information.)

Census n/a Button Se Y n/a lection Y n/a

Edit Validation Logic: Actor clicks on this button to switch to the census view. (See The Census/Tiled Button section in Chapter 3 for more information.)

Tiled n/a Button Selection Y n/a Y n/a

Edit Validation Logic: Actor clicks on this button to switch to the tiled view. (See The Census/Tiled Button section in Chapter 3 for more information.)

Help Y Help Module n/a Button Selection Y n/a

Edit Validation Logic: Allows the actor to display the online Help Content screen. (See The Help Button section in Chapter 3 for further information.)



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Step Away n/a Button Selection Y n/a N n/a

Edit Val ioidat n Logic: Allows the actor to temporarily log out of the system while administering a medication. back in by following the procedure described in ChThe actor logs apter 2 under Login After Step Away.

Log Off n/a Button Selection Y n/a N n/a

Edit Validation Logic: The actor completely logs out of the system. The actor logs back into the system by following the procedure described in Chapter 2 under System Login.



6 O

6.1 Logical Specifications The essential goals of routine order verification

rder Verification

are to ensure that:

• The resident receiving the medication is correct,

• The medication being administered is correct,

• The dosage being administered is correct, and

• The route and time the medication is administered are correct.

Orders originate from the pharmacy provider and are typically received in the E-Mar system via an electronic interface. Before the order can be administered to a resident it must first be verified.

The Resident Tile’s “unverified” status (shown below) alerts the actor that a UNV order has been received from the pharmacy. The actor specifies the first dose, establishes the proper schedule, and defines additional rules such as the Assessment or Outcome, as required along with other related information. These activities are all performed using the Order Verification Wizard.

Unverified, or UNV, orders are displayed on the E-Mar tiled view as shown below.

Figure 6-1 Unverified order tile

n the MAR screen, the actor selects the Unverified Orders filter tab O to list selects a specific unverified order

Wizard shown on the next page. all of the UNV orders for the selected resident. The actor thento display the Order Verification

To display the first page of the Order Verification Wizard, the actor:

Orders filter tab on the MAR screen, then

een. (The actor can also double-click on the selected

1. Highlights the order on the Unverified

2. Clicks on Verify at the bottom of the scrorder to display the first page.)




Figure 6-2 Order Verification Wizard for a UNV order, “First Page”

6.1.1 The First Dose The actor uses the first dose page of the Order Verification Wizard to specify an immediate first dose, or a later dose, as desired. (Note that the first dose page is not required for PRN orders.)

The actor should always refer to the frequency, physician and pharmacy’s instructions, when setting up the first dose in the E-Mar system.

The default date and time that the first dose may be given is shown under the “First Dose to be Administered on” section o

f the window.

Figure 6-3 Setting the time for the first dose to be given

Actor uses the arrow keys to reset the first

dose time.


The actor has three choices for administering the first dose to the resident:

e “First Dose to be Administered on” section by

the first dose at the next scheduled dosing time.

6.1.2 The Schedule Page Once the first dose time i he second page of the wizard. The actor uses the second page of the wizard to define the dosing schedule for an order. The actor pecifies the next dose or the first dose (depending on the option selected on the first page), and

1. Accept the current dosing time indicated in thclicking on Immediately. (If this is selected, the dosage is given as if it is a PRN order.)

2. Change the dosing time (with Immediately still checked) by clicking on the up-and-down arrows in the “First Dose to be Administered on” section. (Note that military time is used.)

3. Click on Later to administer

s set, the actor clicks on Next to display t

sthe times that the order will become due in the future.

1 2

4

3

Figu rder Verification Wizard, Schedule or “Second Page”

1. A list of day elect the next dose”

re 6-4 O

s/dates/times for the next dose are displayed in the “Please sbox. If it is the first dosage is to be given, and then clicks o o go to the next orde ification page.

acceptable, the actor clicks on the default day/date/time that n Next t r ver



2. However, if the actor desires a different schedule than what is shown, the list of

The actor then clicks on A ange t times di n the d date/timactor then highlights the desired first dose day/date/time and clicks on Next.

inut he actor selects the dose schedule in the da time box, then clicks

6.1.3 The Confirmation Page

times displayed in the right box allows the actor to select a different dosing schedule. (For QD scheduling, one time must be checked; for BID, two times must be checked, etc.)

3. pply to ch he splayed i ay/ e box. The

4. The actor can also change the time intervals in the dose scheduling under the “Modify dosing times” section. Once the actor clicks on the desired radio button (Hour, 30 Minutes, 15 M es), t y/date/ on Next.

The actor uses the third and final page of the Order Verification Wizard to specify additionalrequirements for actions to be taken during the administration process of an order.

12

3

4 56

Figure 6-5 Order Verification Wizard, Confirmation or "Third Page"

The various actions taken on the confirmation page include:



• Assessments and outcomes

nje and sca

inim ime dos

• Duration of the order (i.e., stop date)

rst the n ose, osi s.

The actor should always refer to the frequency, physician and pharmacy’s instruc

he se ns he verification pages are displayed on this page.

e actor records any documentation required for assessment and/or outcomes.

3. The actor clicks on a radio button to indicated the Medication Type.

inim between doses sure.

he actor clicks fy Order to finally accept the order, close the verification wizard, d to move the UNV order on the resident’s MAR screen under the All Orders filter tab.

ed as sliding scale. Example: If the dose is 1-2 tablets, the slidi ale r tton checked. When minis the dose, thactor must also make an assessment so that the dose given can be recorded.

• I ction site sliding le

• M um t between es

Also, the confirmation step allows the actor to review the previously defined frequency, the fidose,

ext d and the d ng time

tions, when establishing the rules for an order.

1. T

2. Th

lectio made on t previous

4. The actor can record a duration (in days), to automatically create a stop date for that order.

5. The actor can specify

6. Tan

a m

on Veri

um time as an added safety-check mea

A range dose must be verifing sc adio bu should be the actor ad ters e



6. e Dose Confirmatio indoenever se is d fo stration hether the dose is a routine or PRN ord

s, as well as prompts the actor for additional require es,

1.4 Th n W w Wh a do prepare r admini – w er – the Dose Confirmation window is displayed. This function provides various safety check

d documentation such as assessments, outcomand sliding scale. injection site,

1

2

4

Figu Conf ation wind

ord s alw luded at the top of the Dose Confirmation window.

2. Dose information is also pr Prepare and a Cancel button. The only time as been defined as sliding scale cess under the All Orders tab.

The A sment Required tab is displayed only when an assessment was selected as a “required option” in the Or on Wizard, or in the change order process under the

ration Site drop-down selection list is displayed at the bottom of the Dose Confirmation window. The actor chooses from a facility-defined list

re 6-6 Dose irm ow

1. The original er tile i ays inc

esented, along with a the actor can edit the Dose Amount field is when the order hin the Order Verification Wizard, or in the change order pro

3. ssesder Verificati

All Orders tab. Note that the actor types in Additional Dose Notes as desired, whereas the actor selects documentation Results from a drop-down selection list.

4. If the order is for an injection, the Administ


3


of injection sites for the current dose, and a window in which the site of the previous injection is d The injection s or t th en.

e Pr essThere may be a progress bar di n the Dose Confirmation window if “auto preup for the LTC facility. If so, there is a period of time (also established by the LTC faci

aiting, the pre me has elaps d, ose be ; it

6 a

isplayed. ite must be selected pri o charting e dose as giv

6.1.4.1 Th ogr Bar splayed o pare” is set

lity) after which the dose is automatically documented as prepared. During this period, a bar is drawn across the bottom of the window (from left to right). To prepare the dose without wactorthe d

sses ENTE cannot

R, or pauses by canceled

pressing any can only be “Unprepared.”

other key. When the period of ti e

.2 D ta Specifications

Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

“ORDER VERIFICATION WIZARD” (Fist Page)Dose n/a Display Alpha- Y n/a Y Items/Fo lary

(Admin. Tool) rmu

numeric

E ion Ldit Validat ogic: This is the dosage level of the medication that the actor is to give the resident.

Route n/a Display Alpha- Y Dose Y Off-site or ed

numeric facility-baspharmacy

Edit Validation Logic: The means by which the actor is to give the medication to the resident, i.e., oral, IV.

Frequency numeric

Y Dose Y Off-site r facility-based

n/a Display Alpha- o

pharmacy

Edit Validation Logic: This field indicates how often the actor is to administer the medication to the resident, i.e., QAM (once in th s a day), etc. e morning), BID (twice a day), TID (three time

Order # 8 Display N Y N f

umeric n/a Off-site or acility-based pharmacy


Start Date 10 Display Numeric Y n/a N Off-site or facility-based

pharmacy

Edit Validation Logic: The date that the actor is to begin giving the medication to the resident.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Physician n/a Display Alpha-numeric

Y n/a N Physicians

Edit Validation Logic: Name of the physicians authorizing the order scheduled for the resident.

Physician n/a Display Alpha- N n/a N Instructions

Off-site or f numeric acility-based

pharmacy

Edit Validation Logic: Displays any special instructions (to the actor) from the physician authorizing the order, as regards the administration of the dose to the resident.

P y Instructions

harmac n/a Display Alpha-numeric

N n/a N Off-site or facility-based

pharmacy

Edit Validation Logic: Displays any special instructions (to the actor) from the pharmacy filling the orders, as regards the adm tratioinis n of the dose to the resident.

Immediately (Give the

n/a Radio Button

Y First Dose N

First Dose)

Selection n/a

Edit Validation Logic: The actor clicks on this radio button to indicate that the medication is to be adm ed to the resident right away. inister

Later (Give the

n/a Radio Button

Y First Dose N

First Dose)

Selection n/a

E ion Ldit Validat ogic: The actor clicks e res

on this raure day/date/ti

dio button to indicate that the medication is to be ad d to th iden fut m be dete . ministere t at some e, to rmined

First Dose to be Adminis-

5 Entry Numeric Y n/a N n/a

tered on

Edit Validation Logic: This function allow the actor to change the dosing time (with the Immediately radio b hecke y clic the wn arr s in the “F ose to be Administered section on the first page of the Order Verification Wizard. (Note that 24:00 hours, m ary time, is used.)

utton still c d) b king on up-and-do ow irst D on” ilit

Next n/a Button Action Y n/a Y n/a

Edit Validation Logic: The actor clicks on this button to go to the next page of the verification wizard.

Reject n/a Button Action Y n/a Y n/a Order

Edit Validation Logic: The actor clicks on this button to stop the order verification process.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)


Edit Validation Logic: The actor clicks tton to stop a pending action. Global function. on this bu

“ORDER VERIFICATION WIZARD” (Second Page)Please

select the next dose

3/10/5 List Dose Selection N N n/a

Edit Validation Logic: If it is acceptable, the actor clicks on the default day/date/time that the first dosageto be given, and then clicks on Next to go to the next order verification page.

is

Modify

Selection N dosing times

n/a Radio Button

n/a N n/a

Edit Validation Logic: The actor can change the time intervals in the dose scheduling by clicking ondesired radio button. The actor then selects the dose schedule in the day/date/time box and clicks on

the Next.

Apply n/a Button Action Y n/a N n/a

Edit Validation Logic: The actor clicks on Apply to change the times displayed in the day/date/time box. The actor then highlights the desired first dose day/date/time and clicks on Next to go to the next page.

Previous n/a Button Action Y n/a Y n/a

Edit Validation Logic: The actor clicks on this button to go back to a previous page of the O/V wizard.

“ORDER VERIFICATION WIZARD” (Third Page)Assessment Required


N n/a Y Internal to E-Mar/Dbase

Edit Validation Logic: The actor records any required assessment via this drop-down list.

Outcome Required


N n/a Y Internal to E-Mar/Dbase

Edit Validation Logic: The actor records any required outcome via this drop-down list.

Injection n/a Entry Radio Button

N n/a N n/a

Edit Validation Logic: The actor clicks on this button if the method of

Sliding Scale

n/a Entry Radio Button

N n/a N n/a

Edit Validation Logic: A “range” dose must be verified as sliding scale. (Example: If the dose is 1-2 tablets, the sliding scale radio button should be checked.) When the actor administers the dose, the actor must also enter an assessment so the dose given can be recorded.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Frequency n/a Display Alpha-numeric

Y Dose Y Off-site or facility-based

pharmacy

Edit Validation Logic: This field indicates how often the actor is to administer the medication to the resident, i.e., QAM (once in the morning), BID (twice a day), TID (three times a day), etc.

First Dose 10 + 5 Display Numeric Y Dose Y n/a

Edit Validation Logic: This field indicates the date/time that the first dose is to be given to the resident, as previously defined on the previous Order Verification Wizard pages.

Next Dose 10 + 5 Display Numeric Y Dose Y n/a

Edit Validation Logic: This field indicates the date/time that the next dose is to be given to the resident.

Dose Times 10 + 5 Display Numeric Y Dose Y n/a

Edit Validation Logic: Times of day that the dosage is to be given to the resident. The numeric formates do not follow the standardized hh:mm format used throughout the rest of the system.

for these tim

Specify Minimum

Time Between

Doses

n/a

5

n/a

Button

Entry

List

Selection

Numeric

Selection

N n/a N n/a

Edit Validation Logic: The actor can specify a minimum time between doses as an added safety check. Note that there are three entry field for this function: a button, numeric time, unit of time. The five-character time field is not edited for numeric characters only, but will also accept alpha entries.

Verify Order

n/a Button Action Y Dose N n/a

Edit Validation Logic: The actor clicks on Verify Order to accept the order, close the verification wizard, and to move the unverified (UNV) order on the resident’s MAR screen under the All Orders filter tab.

“DOSE CONFIRMATION” WINDOW

Order Tile n/a Display Alpha-numeric

Y Dose Y Off-site or facility-based pharmacy

Edit Validation Logic: The order tile displaying all relative dosing information, as received by E-Mar from the pharmacy, or as set up on the Order Verification Wizard by the actor if the order was a UNV order.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Dru n/a Y Off-site or facility-based

pharmacy

g n/a Display Alpha- Y numeric

Edit Validation Logic: The medication to be administered to the resident by the actor.

Dosnumeric facility-based

pharmacy

e n/a Display Alpha- Y n/a Y Off-site or

Edit Validation Logic: The dosage level of the medication to be administered to the resident by the actor.

Rou f-site or facility-based

te n/a Display Alpha-numeric

Y n/a Y Of

pharmacy

Edit Validation Logic: The means by which the actor is to give the medication to the resident, i.e., oral, IV.

Freq ite or sed

pharmacy

. n/a Display Alpha- Y n/a Y Off-snumeric facility-ba

Edit Validation Logic: This field indicates how often the actor is to administer the medication to the , i.e., QAM (once in the morning), BID (twice a day), TID (three times a dresident ay), etc.

Dose Amou

or ased

acy nt

n/a Display Alpha-numeric

Y n/a Y Off-sitefacility-b

pharm

Edit Validation Logic:

Prepare n/a Button Action Y Drug Y n/a

Edit Validation Logic: The actor clicks on this button to administer the medication to the resident. A, all required verification and safety steps should have been performed by the actor.

t this juncture


Edit Validation Logic: The actor click on this button to stop a pending action. Global function.

Documen-tatioResu

n/a Entry N n/a n lt

List Selection N n/a

Edit Validation Logic: The Assessment Required tab is displayed only when an assessment was selected as a required option in the Order Verification Wizard, or in the change order process under the All Orders tab.



Field Name


Required Field?

Related Fields

Duplicates Allowed?

Related Source(s)

Additional Dose Notes

n/a Entry Alpha-numeric

N n/a N n/a

Edit Validation Logic: Freeform field. The actor types in additional notes as desired.

Adminis-tration Site

n/a EntryList

N/ n/a Selection N n/a

Edit Validation Logic: If the order is for an injection, the Administration Site drop-down selection list is . The actor chooses from a facility-defined list of

h the site of the previous injection is displayed. The inje

displayed at the bottom of the Dose Confirmation windowinjection sites for the current dose, and a window in whic

ction site must be selected prior to charting the dose as given.

LasAdmin.

Site numeric

n/a t n/a Display Alpha- N n/a N

Edit Validation Logic: This indicates the admission site for the last dose administered by the actor.



7 ystem Messages

7.1 Logical Specifications The E-Mar LTC system has several built-in safety features designed to reduce risks to both the residents and the actor.

7.1.1 Dose Confirmation

Barcoding and S

Whenever a dose is prepared for administration (whether a routine or a PRN dose), the Dose Confirmation window is displayed.

Figure 7-1 Dose Confirmation window

The above window displays the same safety checks as provided during the order verification process, such as ensuring that:



• The resident receiving the medication is correct,

• The medication being administered is correct,

orrect, and

also prompts the actor for additional required documentation such as assessments, outcomes, injection site, and sliding scale. (See the window description under Dose Confirmation

• The dosage being administered is c

• The route and time the medication is administered are correct.

The window

for further information.)

7.1.2 Barcode Scanning The E-Mar LTC system fully supports barcode scanning for LTC facilities that have this capability. The actor can utilize barcode scanning in any of three ways:

• Resident wrist bands or barcoded identifiers can be scanned to ensure that the right patient is being selected.

• Medication orders can be scanned to ensure that the right medication is being prepared.

• Actors can scan their own identification badges for fast access to the E-Mar system during sign-in and after returning from Step Away.

While barcode scanning improves safetyhis following sections cover how these risks are handled by the system.

overridden due to scanning difficulties, sch as a l.

7.1.3 the actor scans a medication that is not yet due to be administered, the warning below is

displayed, and the actor is prompted to confirm whether or not it is to be administered.

on most systems, it can also create its own set of risks. T

These safety features sometimes apply to situations where barcode scanning may not be used or where the scanning function is damaged barcode labe

Med Not DueIf

Figure 7-2 Medication Not Due Yet warning

If the actor clicks on Yes must be entered before it can be prepar n on administering a dose early.)

, a reason for administering the medication off schedule ed. (See the Early Doses section for further informatio



7.1.4 Wrong Resident

If the actor accidentally scans a medication ordered for a different resident, the system message below is displayed and the actor clicks on OK to acknowledge that the action is disallowed.

Figure 7-3 Do Not Administer system message

7.1.5 um Time Between Orders If the actor tries to adm d the Minimum Tim een Dos set in the Order Minim

inister a ose with e Betw es Verification Wizard, the Dose Interview Warning system message below is displayed.

Figure 7-4 Dose Interval Warning system message



package, the Order Is On Hold warning is displayed and it cannot be prepared.

7.1.6 Order On Hold The actor cannot administer a medication that has been put on hold. When the actor scans the

Figure 7-5 Order on Hold warning

If the actor is using the order tiles, there is no selection for administering the dose that is on hold.

7.1.7 . When the actor annot be prepared.

Order Discontinued If an order has been discontinued, the actor cannot administer the medicationscans the package, the Order Was Discontinued warning is displayed. and it c

Figure 7-6 Order Discontinued warning

If the actor is using the MAR screen, it is listed only on the All Orders tab.



7.1.8 Resident Record Locked hart a

dose a ly mode. If an actor has a resident’s record open and an activity is in-progress (i.e., prepare a dose, c

s given, observation, verification, etc.), the record is locked and in a view-on

Figure 7-7 Resident Record Locked system message

Once th

7.1.9 SimilIf the S tration Tool

e actor returns to the tiled or census view, the resident record is then unlocked.

ar Name Alert imilar Name Alert has been set (on the Adminis ) when the resident was first

admitted, the icon will appear on the Resident Tile.

Figure 7-8 Similar Name Alert, with tile icon shown



7.2 Data

Specifications

Field Name


Required Fields?

Related Fields

Duplicates Allowed?

Related Source(s)

Y n/a es n/a Button Action Y n/a Y

Edit Validation Logic: The actor clicks on this button to confirm a pending action. This is a global function.

No n/a Button Action Y n/a Y n/a

Edit Validation Logic: The actor clicks on this button to stop a pending action. This is a global function.


Edit Validation Logic: The actor clicks on this button to acknowledge a system message. This is a global function.



8 U tem

8.1 Logical Work Flow Care system.

8.1.1 utomatically via electronic

ity itself. The resident must be ived and charted.

ives in need of immediate medication, the actor can use the Quick

(including STAT or First Doses) within the same MAR. The actor:

1. Selects Quick Admit from the menu button at the bottom of the screen to display the uick Admit window,

8.1.2 Do must be displayed before the actor can administer a dose. There are

three way

1. he Dose Alert Screen (tiled view), then clicks on ication window.

2.

sing the E-Mar LTC Sys

The following sections cover the day-to-day use of the E-Mar Long-Term

Quick Admit Ordinarily residents are added to the E-mar LTC system atransfer of data from the pharmacy or from the LTC faciladmitted on the E-mar system before any medication orders can be rece

If a new resident arrAdmit function (without waiting for an external source) to maintain the resident’s medication history

Resident Q

2. Enters all the required resident data on the Resident Quick Admit window,

3. Clicks on Admit to add the resident’s data to the E-Mar database.

se Administration The resident’s MAR screen

s for the actor to open the MAR screen.

The actor clicks on the resident tile on tSelect on the Resident Identif

On the census view, the actor double-clicks on the resident’s Name under Current Resident.

lect on the

8.1.2.1 Due or Past Due Doses

3. The actor scans the resident’s barcoded wrist band, if available, then clicks on SeResident Identification window.

To administer a Due or Past Due dose, the actor selects the Due/Chart tab on the resident’s MAR

:

screen. The actor then:

1. Prepares the dose either by scanning each medication package, or by clicking on the Due Administer-Override Scan, button on the order tile then selecting

2. Confirms the dose by

• Scanning the barcode on the label a second time,



• Clicking on Prepare, or

• Waiting for automatic preparation (if enabled),

If an click on Cancel until the progress bar has finished. After that the actor will have to use Unprepare.

3.

the actor decides not to prepare the dose, the actor c

Clicks on Step Away while administering the dose to the resident,

4. Charts the dose.

When the actor has finished giving medications to a single resident, the actor return from Step Given if

m , the system prompts the actor to make the required entry.

8.1.2.2

1. ning the medication package, or by clicking on the PRN cting Administer-Override Scan,

e section on Barcoding Scanning

Away and charts each one individually by clicking on the Chart button, or Chart All as all edications can be charted at one time. If documentation is required for a particular order

Dosing PRN Orders To administer a dose PRN (as needed), the actor selects the PRN tab on the resident’s MARscreen. Then, for each dose, the actor:

Prepares the dose either by scanbutton on the order tile then sele

2. Confirms the dose by:

• Scanning the barcode on the label a second time. (See th in Chapter 7 for further information),

are, or • Clicking on Prep


3. Prepares the dose, or clicks on Cancel until the progress bar has finished,

4. Clicks on Step Away while administering the dose to the resident,

5. Charts the dose.

8.1.2.3 ro administer an early dose, the actor selects the Routine Orders tab

If documentation is required, the system prompts the actor to make the required entry.

Ea ly Doses T on the resident’s MAR

ning the medication package, or by clicking on the PRN

, a confirmation window opens notifying the actor that the dose is not

screen, then the actor:

1. Prepares the dose either by scanbutton on the order tile then selecting Administer-Override Scan,

• Scans the packagedue. The system prompts the actor to confirm that the dose is to be given now, and to document why.



• Clicks on the Schedule button, the actor selects Early Dose from the list. A confirmation

hat the dose is not due, and prompting the actor to now, and to document why.

led),

3. he progress bar

window opens notifying the actor tconfirm that the dose is to be given




• Waiting for automatic preparation (if enab

Prepare the dose, or clicks on Cancel until t has finished,

4. Clicks on Step Away while administering the dose to the resident.

5. Charts the dose.

If documentation is required, the system prompts the actor to make the required entry.

8.1.2.4 the Once Dose function. The Once

three different sources:

• The Resident Identification screen

s tab

Once Dose The actor can administer a single dose of a medication usingDose function is accessible from

• The Unverified Order on the MAR screen

• The All Orders tab on the MAR screen

At the bottom of any of these screens, the actor clicks on the Once Dose button at the bottthe screen to display the Once Dose window. The actor then:

om of

2.

given, selects the Route and the Frequency (STAT, Now, or Later), and enters any Instructions,

he MAR screen opens with the Once Dose showing as an order tile.

e order displays on the resident’s MAR screen as a

ing on the Status/Action button on the order tile then selecting Administer-Override Scan,

6.

3. Clicking on Prepare, or

1. Selects the Physician at the top of the window,

Selects the drug search criteria (Name or Generic Name),

3. Enters the Dose

4. Clicks on OK. T

• If the frequency selected was STAT, the order shows on the resident’s MAR screen as a pink order tile with a STAT watermark and a red clock icon.

• If the frequency selected was Once, thgreen order tile with a DUE watermark and a green clock icon.

5. Prepares the dose either by scanning the medication package, or by click

The actor confirms the dose by:




4. Waiting for automatic preparation (if enabled),

Prepares the dose, or7. clicks on Cancel until the progress bar has finished,

8. Clicks on Step Away while administering the dose.

9. Charts the dose as given.

d.

8.1.2.5

eason in the Bypass Dose Reasons window,

4. Clicking on OK.

T edule area of the order tile displays the actor’s initials, with a red circle indicating that the

8.1.2.6Inje erence is in the charting. The actor selects the

1. e Due selecting Administer-Override Scan. If the dose is past due, the reason,

notices the site of the previous injection,

selects Chart As Given.

8.1.2.7ilar way to

e appropriate tab on the resident’s MAR screen then:

ach medication package, or click on the Due button on the order

The system prompts the actor if additional documentation is require

Bypass a Dose The actor can bypass a scheduled medication dose by:

1. Selecting the order tile for the medication to be bypassed from the resident’s MAR screen (Due/Chart tab),

2. Clicking on Due or Past Due, then selects Bypass Dose,

3. Selecting a facility-defined r

he schdose was bypassed.

Injections ctions are prepared like other doses. The diff

appropriate tab on the resident’s MAR screen. Once done, the actor:

Prepares the dose either by scanning each medication package, or by clicking on thbutton on the order tile then actor is prompted to enter a





3. Enters the Assessment (if known), and

4. Clicks on Step Away while administering the dose to the resident,

5. Records the injection site of the dose just given and

Sliding Scale Sliding scale doses (such as 1-2 tablets) are handled by the E-mar LTC system in a siminjections. The actor selects th

1. Prepares the dose, The actor can either scan e



rile and select Administer-Override Scan. If the dose is past due, the system prompts the actor to enter a reason.


• Scanning the barcode on the label a second time, or

• Clicking on Prepare,

3. Checks the Assessment documentation for the dosage criteria,

4. Clicks on Step Away while administering the dose

5. Charts the dose, records the assessment details and the amount of the dose, then clicks on Chart As Given,

6. Documents the outcomes at the appropriate time, per the LTC facility’s procedures.

8.1.3 rem. Prior to

an order becoming active on a resident’s MAR screen, the actor must first verify the order and rules, and certain safety precautions.

8.1.3.1

O ders Orders are added to The LTC system via electronic data transfer the pharmacy’s syst

content, the first dose, schedule

Routine Order Verification See Chapter 6, Order Verification, for detailed instructions on verifying orders with the E-Mar

stem. Chapter 6 also provides tabled definitions (Data SpecificationsLTC sy ) of all the fields isplayed on the windows used in the order verification process.

8.1.3.2 Reject an Order At any point in the order verification process, the actor can reject the order by clicking on the Reject Order button in the lower part of any of the order verification windows. The actor is prompted to provide a reason as to why the order is being rejected. Once an order is rejected, an email is sent to the pharmacy, and will display as rejected under the All Orders tab on the MAR.

8.1.3.3 Order Discontinuation The actor can discontinue orders from either the MAR screen’s Due/Chart, Routine Orders, or PRN filter tabs. Once an order is discontinued, it is listed on the All Orders tab as discontinued.

Orders requiring charting, assessment, or an outcome cannot be discontinued.

The actor can add documentation for a specific dose of a discontinued order from the History tab. To discontinue an order, the actor:

1. Clicks on either the Due/Chart, Routine Orders, or PRN tabs, then on the order’s action/status button,

2. Clicks on Discontinue Order on the action/status button to open a confirmation window,

3. Then clicks on Yes to complete the process.

d



8.1.3.4 Order Hold/Resume

In order to pu

1. Selects t

t an order on hold, the actor:

he order tile for the order to be put on hold, from the Due/Chart or Routine Orders tabs on the resident’s MAR screen,

Due or Scheduled, then clicks on

ow When to Resume or

if Resume on Date is selected,

red notes, the clicks on OK.

ill appear in the All Orders list w tation under Status, and also Hold showing on the

dd Dose tinue, or Resume. (See

2. Clicks on Hold Order,

3. Selects Do Not Kn Resume on Date,

4. Adds the date

5. Adds any requi

A Hold order w ith On Hold as a noin Routine Orders with On order tile and its upper right corner controlbutton. Options from that button are to a Documentation, DisconOrder Discontinuation for furth

To resume an

er information.)

1. Clicks the On Hold button on the order tile on the MAR screen, Routine Orders tab,

s requested by the Resume Orde

sume Order.

Order modified only through the All Ord . Modifications only

entation and have no effect o he actor:

dify in the lower right corner o Order ion window (see next page),

ons to Assessm um Time ion Type. (No the Physician

OK.

ncies are defined in the E-mar LTC system e unit or cart level. When

is received from the pharmacy, E-mar g imes for the order based by the pharmacy.

frequency of dose corded. The following rted, as well as the

ne or more per day) osing is on a daily basis, whether it is onc ther

y, the actor indicates this

order, the actor:

2. Enters data a r Wizard,

3. Clicks on Re

8.1.4 Modify anOrders can be ers tab on the MAR screenaffect future docum n past documentation. T

1. Clicks on Mo f the screen to display the Modify Documentat

2. Makes the required modificatind Medicat

ents, Outcomes, Duration, MinimBetween Doses, a

, changes can be made to

Instructions.)

3. Clicks on

8.1.5 FrequeFrequencies by the facility, at than order enerates default dosing ton the frequency indicated

Once an order is verified, the the suppo

administration is then reexplanations cover unsupported, frequencies.

8.1.5.1 Daily (oIf the d e a day (QD), twice a day (BID), or onumber of times per da during the Order Verification process by:



1. Selecting the order on the Unverified Orders tab, and clicking on Verify, to open the Order

information on all three “pages” of the Order Verification Wizard,

Verify Order.

rs, days, weeks or monthhe dosing has a period of time between doses ex s, or months –

18 hours (Q18H), every other nd very month on the 12th (Q the Order

Verification Wizard,

2. Entering the required

3. Clicking on

8.1.5.2 Range (hou s between doses) If t pressed in hours, days, weekwhether it is every day (QOD), every Monday, Wednesday aFriday (QMWF), or e M), the actor indicates this duringVerification Process by:

rder on the Unverified Orders open the Order zard,

red information on all three “pages” of the Order Verification Wizard,

y Order.

8.

1. Selecting the oVerification W

tab, and clicking on Verify, toi

2. Entering the requi

3. Clicking on Verif

1.5.3 PRN Orders that are prescribed as PRN mbetween dose

ay be purely a minimum time ds this d fication

as needed, or there may bes specified. The actor recor uring Order Veri by:

g the order on the Unverified Orders , to open the Order (Confirmation page ),

. Entering the Assessment and Outcome Required, medication type, and minimum time between doses fields as indicated in the physician’s or the pharmacy instructions,

3. Clicking on Verify Order.

8.1.5.4 Mapped Frequencies Sometimes an order may come from the pharmacy with a frequency that the E-mar LTC system does not recognize. In this case the frequency must be “mapped.” When the actor clicks on Verify on the Unverified Orders tab (resident’s MAR screen), an information window is displayed. When the actor clicks on OK Map Frequency button is displayed. The actor can click on the button or you can reject the order.

If Map Frequency is chosen, the actor reads the order to determine how often the dose is to be administered. The actor maps the order frequency by.

1. Clicking on the Map Frequency button, (The E-Mar Frequencies window is displayed.)

2. Typing in the Latin abbreviation to displayed a list of possible descriptions,

3. Selecting the correct one (double-clicking the arrow to the left of the description),

4. Clicking on Apply, then

5. Restarting Order Verification for that order, once the window has closed.

1. Selectin tab, and clicking on VerifyVerification window

2




8.1.5.5 Add a Frequency If there is no equivalent frequency in the E-mar LTC system the actor can either HTUreject the orderUTH and request an order from the pharmacy (with a valid frequency) or contact LifeCare Technologies, Inc. to request that a frequency be added.

8.1.5.6 Unsupported Frequencies Sometimes an order may come from the pharmacy with a frequency specified in terms that E-mar LTC system cannot support. The types of frequencies not supported by the system include schedules within a schedule, different doses for different times, and non-PRN orders with no specified schedule.

Examples:

• Give for 4 days every month

• Give 2 cc for 7 days, then 4 cc for 14 days

• Add to all liquids for nectar thick consistency using Pre-packed Thick and Easy

8.1.6 Adding Observations See Chapter 4, HTUAdding ObservationsUTH, for detailed instructions on verifying orders with the E-Mar LTC system. Chapter 4 also provides tabled definitions (HTUData SpecificationsUTH) of all the fields displayed under the various entry “tabs” on the Adding Observations window.



Index Adding an Image, 30 Adding Observations, 26, 103 Additional Functions, 61 Admin Log-In window, 8 Administration Tools, 13 All Orders Tab, 57 Barcode Scanning, 91 Barcoding and System Messages

Logical Specifications, 90 Barcoding and System Messages Data

Specifications, 95 Barcoding and System Warnings and Messages,

90 Bypass a Dose, 99 Census List Options, 30 Census View screen, 25 Charting Options, 55 confirmation page, 81 Control Buttons, 58 Document Format, 7 Document Profile, 6 Dose Administration, 96 Dose Confirmation, 90 Dose Confirmation window, 83 Dose Documentation Details Section, 60 Dose Interview Warning, 92 Dosing PRN Orders, 97 dosing schedule, 80 Due or Past Due Doses, 96 Due or Past Due Order Options, 54 Due Orders, 31 Due/Chart Tab, 54 Early Doses, 97 E-Mar LTC Dose Alert Screen, 9 E-Mar LTC Login window, 8 E-Mar LTC System Safety Features

Data Specifications, 95 Exit the Application, 13 Filters Section, 60 first dose, 79 First Login, 9 Global Command Bar, 13, 61 History Tab, 59

Injections, 99 leave of absence, 12 Load Image button, 30 Logical Design, 6 Login After Step Away, 9 MAR control buttons, 15 Med Not Due, 91 Medication Order Area (Order Tiles), 52 Minimize E-MAR, 13 Minimum Time Between Doses, 92 Minimum Time Between Orders, 92 Modify an Order, 101 Once Dose, 31, 98 Once Dose window, 32 Order Details Section, 58 Order Discontinuation, 100 Order Discontinued, 93 Order History Button, 58 Order Hold/Resume, 101 Order Is On Hold, 93 Order List Section, 57 Order On Hold, 93 Order Rules Section, 58 Order Status Icons, 53 Order Tile Colors, 54 Order Verification, 78

Data Specifications, 84 Order Verification Wizard, 79 Order Was Discontinued, 93 Orders, 100 Outcome Options, 55 Physical Design, 6 Print MAR Button, 61 PRN Orders Tab, 56 progress bar, 84 Quick Admit, 13, 96 Quick Admit window, 96 Reject an Order, 100 Reports, 31 Reset Image button, 30 Resident Identification window, 16 Resident MAR Banner, 52 Resident MAR screen, 51



Resident Observations, 31 Resident Observations window, 26 Resident Record Locked, 94 Routine Order Verification, 100 Routine Orders Tab, 55 Select View Settings window, 14 Similar Name Alert, 94 Sliding Scale, 99 STAT, 12 STAT Order Options, 54 Status Button Selections, 53 Step Away button, 9 System Login, 8

Data Specifications, 10 Logical Specifications, 8

The ‘Once Dose’ Feature, 31 The Census/Tiled Button, 15 The Confirmation Page, 81 The Dose Alert Screen (Tiled View), 11

Data Specifications, 17 The Dose Alert Screen (Tiled View) Logical

Specifications, 11 The Dose Confirmation Window, 83 The First Dose, 79 The Global Command Bar, 13

The Help Button, 15 The Log Off Button, 15 The MAR Control Buttons, 15 The Med Pass Button, 13 The Menu Button, 13 The Progress Bar, 84 The Resident Census Screen, 25


The Resident Identification Window, 16 The Resident MAR Screen, 51


The Residents Tiles, 11 The Schedule Page, 80 The Step Away Button, 15 The View Button, 14 Unverified Orders, 31 Unverified Orders Tab, 58 Using the E-Mar LTC System, 96

Logical Work Flow, 96 View, 13 View MAR, 31 Wrong Resident, 92

e-mar ltc requirements document

Documents

logical specifications

data specifications

view button

menu button

censustiled button

help button

system login

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