Medication Administration Handheld Device
Most departments in ProMedica use a full screen application to scan and document medication administration. The application is called AdminRx. In a few areas, a full computer screen cannot be seen from the patient’s bedside. In those areas, a smaller hand held device is used to scan and document medication administration. It is still called AdminRx, but has several differences from the full screen version. These slides will help you understand the basic use of the handheld and some of the differences.
Handheld Scanner Reboot Button
Stylus
Buttons for scanning
Handheld General Information • The hand held has a built in scanner for administration • The term “Tap” means using the stylus to touch the screen (Do NOT use pens/pencils. This will damage the screen) • If the handheld needs a Reboot, use stylus and press red button in upper right corner for 3 seconds. The handheld will start the reboot process.
Handheld General Information • All medications should be confirmed in the Full Screen application. The process is quicker and easier to complete in full screen than the handheld. • If a medication is documented in one application, it will display as documented in the other application (full screen- handheld). • If a medication requires a co-signature, the co-signature must be completed in the Full Screen application. If co-signature is completed in handheld, it will not carry over to full screen application.
Access and Login Handheld Screen
Tap the McKesson AdminRX button To access the login application
Access and Login •Tap the User ID field •Enter User ID or scan ID badge •Tap Password field •A keyboard will show up where you can enter your password by tapping the letters and numbers •If keyboard does not automatically display, tap on keyboard icon at the bottom of the screen. •Enter Password •Tap Login User ID and Password will be the same as for the full screen application (Use iCare password)
Census Screen • After your initial login, the first screen you will see is the department census screen
Census Screen • Department-shows the current department/unit • User Name-Tapping the name will allow you to choose a department • Search-The search tab is used to execute a patient search by name or ID/visit number User Name Department Search
Census Screen • • • •
Tap on User Name Default Unit form populates Tap on drop down arrow for Unit selection will display Tap Submit when correct Unit has been selected User Name
Unit Drop Down
Submit
Unit Drop Down List The second column identifies the specific unit.
The first number listed indicates the specific facility ID.
Facility ID Key 3 = BayPark 4 = Flower Hospital 9 = Toledo Hospital 10 = St. Lukes
Action Tabs •
Census-Tapping the Census tab allows you to toggle between ‘My Assignments’ and the ‘Unit Census.’ (The handheld does not support assignments at this time).
•
Add Med-Use the Add Med tab to view the formulary (when selected from the census screen) or select a medication from the formulary (when selected from the patient profile). Add IV
Census Add Med
Log Off
Action tabs must be white in order to be active
•
Add IV-Use the Add IV tab to view floorstock IVs and/or select an IV from the formulary. Type in the fluid name and click search.
•
Log Off-Tap the Log Off tab to exit the application. If there are pending medications that have not been fully charted you will receive a warning.
Action Tabs •
Validate-The Validate tab will become active (turns yellow) when a patient is selected and medications are scanned for administration. Tapping the Validate button will prompt you to scan the patient ID band.
•
Chart-The Chart tab will become active (turns yellow) when administrations have been validated. Tapping the Chart tab will prompt you to scan your ID badge. Medication administrations will be saved to the MAR.
MAR
Validate Chart
•
MAR-Tapping the MAR tab will take you to the electronic Medication Administration Record for reviewing and editing administrations.
•
Help-Use the Help tab for instructions and assistance with the application.
Help
Tabs •
N-numbers in this column represent new orders, tapping this will sort patients by new orders.
•
D-numbers in this column represent due and overdue orders (overdue meds are in red). Tapping here will open up the due list. D
N
Bed ID •
Bed ID -Tapping on the Bed ID tab will sort the list by ascending or descending room and bed number. Tap the magnifying glass in the census screen to access patient demographics.
•
Patient -Tapping the patient tab will sort the patient list alphabetically by last name.
Patient
Due Medication Tab •
Tapping an underlined number for a specific patient in the D column displays Due and Overdue meds.
• Overdue meds appear in red.
Patient Demographics Screen •
Tapping the magnifying glass takes you to the patient demographics and allergy screen
Icon List The eye icon signifies a medication to be cosigned. A red A signifies that the patient has an allergy. This icon appears next to the patient’s name. A hand with a pen signing a piece of paper denotes medications that need to be confirmed. This icon indicates an overdue med. The same icon in yellow indicates a due med. This blue icon with an “i” indicates that there is more information in the order info screen.
This icon denotes a medication that was omitted.
Medication Administration •
Note-The terms Validate and Chart used in the Handheld are equivalent to the Save and Save and Confirm functions on the Full Screen application.
•
From the census screen, scan the patient’s wristband to open up the Due Medication list.
•
Review the desired Medication Lists by selecting from the dropdown menu.
Orders Dropdown List
Medication Administration •
Scan the medications for administration
•
The scanned medication is matched to an order and any associated warnings are displayed in red in a pop-up dialogue box. Tap OK to proceed or CANCEL if you do not wish to administer the med.
•
After scanning medications and clicking OK, you are taken back to the Medication screen. Matched orders appear with a checkmark next to them.
Order matching dialogue box for a late med
Due Medication list showing a matched order
Medication Administration •
Continue scanning medications and/or tap the yellow Validate button when scanning is complete to continue the documentation process.
•
Address any variations from the MAR associated with the med administrations by selecting override reasons. If the same override reason is valid for all administrations, select the Apply to All checkbox beneath the override dropdown. Note: Acknowledge if note says ‘one or more medications remain on the due list’
•
Tap SUBMIT when completed. You will be prompted to scan the patient wristband.
•
Scan the patient wristband or provide an override reason if the wristband is not scanned.
Medication Administration •
After scanning the patient wristband you will be taken to the Pending list.
•
Administer the validated medications.
•
Finish the medication administration process by charting the validated meds. Tap the yellow Chart tab to save the med administrations to the MAR (scan your ID badge). Tapping the checkmark next to a med before charting will allow you to cancel or modify the documentation. Review the MAR by clicking on the Mar tab
Tapping here will allow you to cancel or modify the documentation
Medication Administration Administering Med with Dose Range
Medications with a Dose Range Administered Dose has to be documented • Scan the medication for administration • Indicate the amount being administered • Chart towards the administration being charted on. • Click OK
Indicate administration being charted on
Type Administered dose
Medication Admin Non-barcoded • •
Tap the name of the medication on the due/overdue list to open the Orders Details Screen. From the Order Details screen, tap the NON-BARCODED button.
• • •
Verify that the medication will be Administered without scanning the barcode. Click OK.
• •
Validate, Chart, and review the MAR like any other med administration.
Order Detail Screen
Non-barcoded button Non-barcoded prompt
Medication Admin Non-barcoded Cont. Non-Barcode Reasons • If unable to scan barcode, notify and return to pharmacy • If no Barcode Available, notify and return to pharmacy • Patient Home Meds- administering meds patient brought from home • Patch Removal- example nicotine patch, duragesic patch • Reminder Message- Coumadin PT/INR reminder • Other- all other reasons
Medication Admin-Omission •
From the Order Details screen tap the OMIT button if a medication is not going to be given. Note: the OMIT function is equivalent to ‘Not Given’ in the full screen application.
•
Verify that the med will be omitted.
Omit medication prompt
Medication Admin-Omission • • • •
Select Validate from the Pending list. Note: Omitted medications appear with the icon next to the med name. Select a reason for omitting the medication- Use prepopulated drop down Tap the SUBMIT button. Pre-populated Tap the Chart button, address any overrides, scan your ID badge.
down
Tapping here will allow you to cancel the omission
Drop
Medication Admin-Editing • •
From the Pending Medication work list, select a medication to edit by tapping the checkmark next to the med name. Edit the med administration from the Edit Record screen. Address admin status, dose, site, and/or comments.
• • •
Record an observation by tapping the RECORD OBSERVATION button. Basic Observations carry over to Horizon Expert Documentation: Vital Signs, Blood Sugars Tap the SAVE button, record more observations, or tap SUBMIT to complete the observation.
Observation entry screen
IV Administration •
From the Census screen, scan a patient wristband to open the Due Medication list.
•
Scan the IVs to be administered or select the desired IV from the IV Ordered Bottles work list.
•
Review Ingredients and/or Order Details for specific IVs by clicking the SHOW INGRED or DETAILS buttons at the bottom of the screen.
IV Administration •
Chart patient weight for medicated drips, infusion rate, and/or site. Enter comments in the Nsg Note field. See Order Details by tapping the IV Detail button.
•
When charting is completed, tap the SAVE button, Tap the Validate button then scan the patient ID band
•
Address any overrides
•
Tap the Chart button and scan your ID badge
Medicated Drip Considerations Note The Dosing Weight governs automatic calculations of the infusion rate if a dose is entered, and vice versa. Changing the Dosing Weight field will result in re-calculation of the infusion rate and will affect all medicated drips for that patient.
Manage a Hanging IV •
From the Census screen scan a patient wristband to go to the Due Medication list.
•
Select IV Hanging Bottles from the dropdown list and tap the desired IV. Enter new information such as Rate, Dose, Site, or Comments.
•
IV Bottles can also be ended from this screen. After entering Total Infused, tap in the checkbox next to END. Note: The SAVE button must be tapped for charting to be saved to the database. Make necessary changes in IV Manage and tap SAVE.
Don’t forget to scan your ID badge to save the changes
Admin Rx Full Screen
How to Access Admin Rx Full Screen 1. Launch McKesson on PC 2. Locate the patient in Unit Census 3. Go to Chart/Launch HED (found on top tool bar) 4. Click on ALL MEDS (left column) 5. Listed meds- medications administered during this visit 6. Admin button- click to administer meds 7. Review Med Orders- list of all active ordered medications
Admin Rx Full Screen Patient Name Chart Tab
Launch HED
Admin Rx Full Screen List of All medications given
All meds
Review Meds: List of all ordered medications
Admin: Click here to administer meds
Admin Rx Full Screen ( ) Indicates there were modifications to the administration;
Regular med administration
Admin Rx Full Screen
Recordable Observations. Note: Vital Signs & Blood sugars carry over. PT,PTT,INR do not carry over
Yellow Sticky Note: any comments entered
Handheld
The End