Answers to Questions from Staff Members

Question: Amphotercin B was a scheduled order on the ‘Active Worklist’. The MD then discontinued the medication. After the d/c’d order was written, the dose remained on the ‘Active Worklist’. The RT clarified the order and documented ‘Not Admin’ with the Admin reason of ‘Med Discontinued’. How can this be prevented in the future so it does not show as a ‘ding’ against the RT’s?

Answer: Medications appear on the ‘Active Worklist’ 2 hours prior to the administration time. If the scheduled dose was due at 0900 and the MD then wrote a DC order after the scheduled time i.e. 0915, the medication would still appear on the “Active Worklist’. (This is the same as it was on the paper MAR.) Respiratory Therapists should always check the Med Summary tab prior to medication administration to review and determine if any medications have been discontinued. If the medication is discontinued there may still be one dose remaining on the ‘Active Worklist’. The therapist would then document Not Admin with the reason of Med discontinued as this person did. There is no ‘ding’ against the therapist. RT’s and nurses need to simply document that the medication was Admin or Not Admin.

Question: When giving a small volume nebulizer with Albuterol/Atrovent, could the RT give the small ampule of Albuterol, i.e. 2.5 mg with no saline when mixing Atrovent to shorten the time of the treatment?

Answer: Sue Herzog from the Respiratory Department and Ziband Zelazny from Patient Information Systems are working on changing the orders in PCIS so the MD’s can select this order. Currently you would not be able to scan this order as it is not entered this way. You would have to enter a new order.

Question: A reason is required to be entered when administering a prn medication. Could there be selections added for wheezing and shortness of breath in the drop down reason field?

Answer: Yes! These reasons have been added. If you have any additional requests of this nature, please contact Patrice Slojkowski at pslojkowski@ucsd.edu
or Kathy Swasey at kswasey@ucsd.edu.

Question: If the system goes down, is there a backup for MAK?

Answer: Information is saved and MARS can be printed in the event of a System Downtime. If there is a planned or unplanned downtime, please refer to the MAK binder on the nursing unit or in your department for details on how to proceed. The HELP desk will be able to offer direction and contact the necessary individuals in the event of an unplanned downtime.

Question: Can the MDI orders be reconfigured to permit a text box so protocol doses can be entered instead of having to scan for each puff?

Answer: Yes. This can be changed for protocol orders only. (This will require a request from your department to the IS department to change the programming in PCIS). For a routine treatment where the MD has ordered a specific number of puffs, to give a different dose you will need to obtain a new order.

Procedure for cleaning the scanner: The scanner can be wiped down with Sani Cloths located on the nursing units. If the lens becomes soiled, use water with a soft cloth or tissue to remove soil. If needed you may use soap and water on the lens. If you use soap, be sure to wipe with a soft cloth moistened with water to remove any film from the lens.

Coordination of Care: It is very important to have good communication with the nursing staff to coordinate care. Nurses and Respiratory Therapist must work closely to ensure the patient receives the treatments needed and to clarify who will administer the treatments. All respiratory treatments administered by RT’s must be documented in MAK by the RT’s. When the care is transitioned to the nursing staff, please be sure to communicate this to them.