eobservations user guide - ppmsupport.leedsth.nhs.uk · avpu select a consciousness level for the...

PPM+ eObs User Guide v5.0.0b.docx 1 of 19 Last updated: 03/04/2017

Email: [email protected]

eObservations User Guide

Welcome to the PPM+ eObservations User Guide. For further support on PPM+, please see the Help Site: http://www.ppmsupport.leedsth.nhs.uk/

Contents (click on a header to go to that section)

Devices ............................................................................................................................... 2

Access and Login .............................................................................................................. 2

Home Screen and Ward Search ........................................................................................ 3

Ward Screen ....................................................................................................................... 3

Patient Details screen ........................................................................................................ 4

Take Observation ............................................................................................................... 4

Respiratory Rate ............................................................................................................... 5

Oxygen Saturation ............................................................................................................ 5

Respiratory Support .......................................................................................................... 5

Temperature ..................................................................................................................... 6

Heart Rate ........................................................................................................................ 6

Blood Pressure ................................................................................................................. 6

AVPU ................................................................................................................................ 7

Pain Score ........................................................................................................................ 7

Blood Glucose .................................................................................................................. 7

NEWS Summary .............................................................................................................. 8

Counter-signing ................................................................................................................ 8

View Chart .......................................................................................................................... 9

View Table ........................................................................................................................ 10

Adding Intervention ......................................................................................................... 10

Edit Settings ..................................................................................................................... 11

Override O2 Saturation ................................................................................................... 11

View on eWhiteboard ....................................................................................................... 12

Logging Out ..................................................................................................................... 12

Troubleshooting .............................................................................................................. 13

Desktop PCs and WoWs ................................................................................................. 13

Ward Patient List ............................................................................................................ 14

Observation Dialogue Box .............................................................................................. 14

View Table and Graph .................................................................................................... 15

View Audit....................................................................................................................... 16

View Observation Summary Table in Single Patient View .............................................. 16

Printing the Observation Summary ................................................................................. 17

Logging Out ..................................................................................................................... 17

BCP Laptop ...................................................................................................................... 18

Appendix - NEWS Parameters ........................................................................................ 19

http://www.ppmsupport.leedsth.nhs.uk/



Devices

Your mobile devices will be found in the charging cabinets situated on the Ward. Please remember to return the devices to the charging cabinets after use. The devices are:

iPod Touches (pictured left) - advised for taking observations.

iPad minis (pictured middle) - advised for observations and charts.

iPads (pictured right) - advised for viewing charts.

If a device is locked you will have to input a PIN to unlock. Each ward has a unique PIN for their devices. Please see your Ward/line Manager for more details.

Access and Login

First, tap on the eObs icon on the mobile device:

Then login using your network/Novell user name and password, then tap on

. If this is your first login, thoroughly read the Terms and Conditions then tap on

if you accept the terms.



Home Screen and Ward Search

If your ward does not appear when you

login, tap on in the left-hand Menu bar. Your Recently Visited Wards will be displayed for quick selection but if the required Ward is not present, then enter the ward name into the search

bar and tap on . You will then be presented with the search results for selection.

Ward Screen

Once you have selected your Ward you will be presented with the list of inpatients for that Ward. Next to the patient’s name is their NHS number, which bed they’re in, their current (and previous) NEWS and when their next observation is due (or how overdue it is). An arrow will also be displayed to indicate an increased , decreased

or unchanged NEWS. You can sort the patient list by

, ,

or by using the buttons on the left. To take a patients’ observations, view

their charts and tables, tap on .



Patient Details screen

When you have selected your patient from the Ward View by tapping on

you will be displayed with the Patient Details screen. Here you can either

, ,

or by tapping on the buttons (click on the above buttons to take you to that section).

Take Observation

When you tap on the

button you will be presented with the observation form to complete. We can now go through each of the observations to complete and obtain a NEWS score.

Tap on the button if you’d like to go back to the previous screen without saving. Once all the sections are complete, tap

on the button. If you are unable to take a full set of observations and they are due, enter a reason for partial readings at the bottom of the form and then tap on

.



Respiratory Rate

Enter the patient’s respiratory rate and the score for that observation will appear in the right:

Oxygen Saturation

Enter the patient’s O2 saturation and the score for that observation will appear on the right:

Respiratory Support

Select whether the patient is on respiratory support. If the patient is on respiratory support, remember to select the Supplemental O2 from the drop-down box and complete any other fields. The score for that observation will appear on the right.



Temperature

Enter the patient’s temperature and the score for that observation will appear on the right:

Heart Rate

Enter the patient’s heart rate and the score for that observation will appear on the right:

Blood Pressure

Enter the patient’s Systolic and Diastolic BP and the score for that BP observation will appear on the right.

You can also enter the patient’s

Standing BP by tapping on under Add Standing BP?



AVPU

Select a consciousness level for the patient and the score for that observation will appear on the right:

Pain Score

The Pain Score does not add to the overall NEWS but please record when taking observations. An indicator of severity will appear on the right once you have selected the Pain Score for that patient.

Blood Glucose

If a patient has a NEWS of 5 or more or a 3 in one parameter, you will be asked to complete the patient’s Blood Glucose level. If the Blood Glucose monitor displays a value of High instead of a numerical value, please select Yes:



NEWS Summary

Once all fields (excluding Pain Score) have been inputted, you will presented with the final NEWS along with a Graded Response Strategy and the Previous NEWS on the left. NEWS Observation frequency

: Every 12 hours (min)

- : Every 4 hours (min)

- : Every 2 hours (min)

(or in any one parameter)

or more: Every 1 hour (min)

Finally, make sure to in the bottom right.

Counter-signing

If a CSW is performing observations and the NEWS score is 5 or above (or 3 in one parameter) they will need to find a qualified member of staff to counter-sign. Upon review of the observations, the counter-signatory will then enter in their network username and tap on

to validate.

REMEMBER The Observation Frequency can be overridden in the Edit Settings section on a device.



View Chart

When you tap on the button you will be presented with 3 separate charts for that patient. Namely:

NEWS

Body Temperature

Blood Pressure & Pulse (combined).

If you tap on any of the points of the graph, it will let you know the exact score/reading and the date/time taken:

Use the buttons at the side to zoom into the latest 48, 24, 12 or 4 hours of charts. Alternatively, you can use the sliders at the bottom to create a custom time range for your charts. Press and hold your finger on the slider and then drag to the date you would like the custom range to start and finish on. The results for Respiratory Rate (RR), O2 Saturation Rate (O2 Sat (%)), Supplementary O2 (Supp O2), AVPU Assessment (AVPU) and Blood Glucose (mmol/L) are displayed at the bottom of the charts in a table.

Top Tip If you are having trouble using the sliders, zoom in (by pinching out

with your thumb and forefinger) so that the sliders are larger.



View Table

When you tap on the button you will be presented with a breakdown of all the observations and who took them. If you have entered an observation in error you can tap on the upward arrow

icon and select Withdraw Observation to remove/revoke an observation, which will then appear with a strikethrough on the table.

Adding Intervention

If an intervention is required, select the

button from the Ward View (or Add Intervention from the Table View) and you will be presented with documentations needed for respective NEWS score groups:

Low NEWS (Total 1 - 4).

Medium NEWS (Total 5 or more OR 3 in one parameter).

High NEWS (Total 7 or more). If there is an intervention that needs to be recorded, select Yes. You will be presented with additional fields to complete.

Once submitted, you will see a icon under the Ints column for that particular observation on the table.

Top Tip Notice how the table is colour-coded to reflect the severity:

Black Green Amber

Red



Edit Settings

Nurses and Doctors can override the observation Frequency by tapping on

. Observation frequency can be changed by selecting one of the following options. (By default Use NEWS Graded Strategy is selected).

Override NEWS Graded Strategy.

Suspend Observation for 2 hours.

NB: Once you have overridden the observation frequency, this new frequency will remain until you select Use NEWS Graded Strategy If you select Override NEWS Graded Strategy, you will be presented with time period you can delay the observation. (If you select Never, make sure to select override reason).

If you wish to Suspend Observations for 2 hours, make sure to add in the suspension reason

Override O2 Saturation

You can also override the O2 Target Saturation here following consultation with the Medical Team.

Make sure to tap to ensure these target saturations will be noted in future observations. This is also available in the Desktop view.



View on eWhiteboard

Once you have submitted ( ) the observation, they will appear in the eWhiteboard under the NEWS and OBS columns like the example on the right. The time when the observation is due is displayed in black and how long an observation is overdue will be displayed in red. You can view your patient’s Pain Score when you are viewing your Ward on a PC. The Pain Score is not a mandatory column so may not show on your eWhiteboard.

Logging Out

Once you are finished using a device

tap on from the

left-hand Menu bar and return the

device to the charging station.



Troubleshooting

If a device has frozen and it is still fully charged, you may need to perform a restart. To do this, press and hold both the top on/off button and the home button on the bottom centre of the device. Press and hold for up to 5 seconds and the device will restart. If you have been successful in your restart, you will be presented with the apple logo and the device will become operational again after a minute or two.

Desktop PCs and WoWs

Your Ward’s Desktop PCs and WoWs (Workstation on Wheels) are also used in the observations process. Following an observation being taken, please then use a Desktop PC or WoW to:

Print off an observation if required

View Audit. You can also take a full set of observations using a Desktop PC or WoW. Please see below sections for more info.



Ward Patient List

Once you have selected your Ward you will be presented with the list of inpatients for that Ward. Also featured on the Ward Patient List are the columns for the patient’s current (and previous) NEWS, when their next observation is due (or how overdue it is) and their Pain Score. The Pain column will not appear on the eWhiteboard. An arrow will also be displayed in the NEWS column to indicate an increased

, decreased or unchanged NEWS. To take a patients’ observations, view their charts, tables and audit trail, click in the NEWS cell of the patient you would like to update.

Observation Dialogue Box

When you have selected your patient you will be displayed with the observation dialogue box.

Here you can either ,

view (and current

Pain Score), , ,

and . Observations, Table, Chart and Settings work exactly the same as the mobile versions.



View Table and Graph

The and functions work exactly the same as on the mobile devices. Table only shows NEWS only and observations within last 2 weeks by default. Change the Show option to All NEWS scores and interventions to see intervention details. Change the from range option from Last 2 weeks to Since admission to see all the observations recorded since admission. In addition, if required, you can print all available observation results by

selecting in

the tabs.

Top Tip Notice how the table is colour-

coded to reflect the NEWS score: Black Green Amber

Red

Top Tip Before clicking on Print All

Observation Results, make sure the table shows all the

information required. E.g. NEWS and Interventions or NEWS only.



View Audit

When you select the tab, you will be displayed with who has accessed a patient’s record, what actions they have taken and when it was taken. This is currently only available in the Desktop version and cannot be access on a mobile device

View Observation Summary Table in Single Patient View

Another way to view a summary of observations for a patient, is via the Single Patient View.

Click on in the Actions bar for that patient, and click on File

Link next to . The greyed out observations are Withdrawn and will not show on any graph.



Printing the Observation Summary

If there is a requirement, you can print the patient’s Observation summary. Open up the Summary table from the Single Patient View and then click on

the print button ( ) at the bottom of the page to print off the table. Or Right Click on the table and click Print to print the observation summary table.

Logging Out

Once you are finished using PPM+

please ensure you log out by clicking

on underneath your name

in the top-right.



BCP Laptop

If eObs is unavailable, you can access the patient’s last 20 observations to print, via the BCP (Business Continuity Plan) Laptop:

1. To access, you will first need the sealed envelope containing the login details from the Ward Safe.

2. Login to the BCP Laptop

using the details found within the envelope.

3. On the desktop, double-click

on the Offline Client icon (see image 3.)

4. A further box will appear for you to enter your full name and click OK (see image 4.)

5. Image 5. (see opposite) will

appear. Select the ward with the observations you wish to print. Ensure that in the Patients to show section, you have Currently on the Wards selected.

6. You can select all or a

selection of your wards current patients. Ensure Active Document Only is selected and click on

3.

4.

5.



Appendix - NEWS Parameters

eobservations user guide - ppmsupport.leedsth.nhs.uk · avpu select a consciousness level for the...

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