EPIC and the Newborn Nursery: a Tip Sheet

EPIC and the Newborn Nursery: a tip sheet

1. Admissions:

 Add your patient to the NBN Resident shared list.

 Add yourself and the infants PCP to the treatment team from the overview screen.

 Gather information for card: Baby chart (delivery summary baby, flowsheet, labs, meds), mom chart (H&P, delivery note, results review for ultrasounds)

 Go through the sections of the admission navigator on the left to select hospital service, update the problem list, etc. You can enter your orders through the med rec –sign link  new orders  newborn nursery admission orderset. Please uncheck erythromycin and vitamin K as it has already been ordered and given in L&D. Please uncheck human milk. Please change the time for the newborn metabolic screen to a time 24-26 hours of age and ensure it is in for phlebotomy draw.

 After talking to family and examining baby, write admission note using .nbnadmission note template.

2. Interim days:

 Update screenings section with most recent weight, tc bili, spo2, hearing test etc. This is found in the view only doc flow sheet in the infant daily cares tab. These will only be documented if the infant is 24+ hours old.

 Make sure you have the “last filed” button clicked to give you the last filed column on the far right of your screen.

 Update things such as hep b, mothers RPR, tox screen results, etc.

 After examining infant and talking to family, use .nbnpncurrent progress note template. This is bare bones so please feel free to add in any pertinent information. OK to be brief but should include relevant information only.

3. Discharge days:

 Update screenings section with most recent weight, tc bili, spo2, hearing test etc. This is found in the view only doc flow sheet in the infant daily cares tab. These will only be documented if the infant is 24+ hours old.

 Update things such as hep b, mothers RPR, tox screen results, etc.

 Update problem list with new/resolved problems.

 You may choose to start your med reconciliation tab when pre-rounding and sign the order in the room so nursing can start d/c process.

 After examining the infant and talking to family, you may put in d/c order and complete note.

 Use the discharge navigator on the left and click through the sections as needed. The med reconciliation section is required and at the end of that section you enter your discharge order. You may use the newborn discharge orderset. The discharge note template is labeled .nbndischarge. Once note is finished and signed, select it from the list of notes in the ntoes section and click “route” in the upper right portion of the screen. Then click PCP and then send in order to route the note to the pediatrician.

 Once the patient is discharged and your work is complete, you may remove the patient from the shared nbn resident list.

4. Other tips

 Make sure your log in context is 5WH nursery.

 For any pending issues at the end of the day, add the patient to the NBN overnight shared list with a brief history and description of the problem/plan for the hospitalist. For example, following up a CBC, a baby struggling with blood sugars, etc.

 NCCC delivery attendance notes are in baby’s chart, as are circumcision procedure notes.

 Students are not expected to write notes in the nursery; they can be helpful in completing parts of navigators, problem lists, and orders.

 You can save your own version of the order set with defaults as above

 Ask questions. 