SPACELABS CLINICAL ACCESS 1. Log In to Clinical Access  Set printer default (first time)  Select a Patient

2. Analyze  Click the Waveforms or the Arrhythmia folder (Top of screen)  Analyze (upper right hand corner of the screen)* must be done every time you log in on each patient  Choose Duration every 8 hours or greater  Click OK  Wait for the message box that states “Analysis has been completed” then “OK” *The timeline (bottom) will turn green for the amount of hours that were analyzed **This must be done every time you log in for each and every patient.

3. Chart Strips at Admission, **Go to Settings bar first to remove the Respiratory wave form if desired Beginning of shift & As Needed  Click the Waveforms Folder for the patient  Click Calipers  Click on the word Rate to turn on Calipers.  Click within the 6-second strip to obtain the rate. Set beginning and end of the 6-second strip  Click on the letters QRS, find a complex within the 6-second strip and click on the beginning of the QRS wave and then click on the end of wave (<.06-.10)  Click on the letters QT, find a different complex within the 6-second strip and click on the Q wave and the end of the T wave. This will also calculate your QTc interval (>0.5 for adult)  Click on the letters PR, find a different complex within the 6-second strip and

click just before the P wave and at the beginning of QRS for the PR interval

(0.12-20)  Click Save,  in the Title Section type: rhythm, initials of first name and full last name/title  (Example: NSR, J. Cool, RN)  Type pertinent information in the Comments Section  Check “Print while saving” and then OK to print the strip now  Place the strip in the patient’s chart  All saved/printed Strips are sent to “Saved Events” folder and can be printed later and placed in the chart.  Multiple saved strips can be printed from the saved folder at one time. Approximately 2-3 strips will print on an 8X11 page depending on whether the Respiratory wave form is included or if the event is >6sec.  Saved Folder events are stored for rolling 72h, and are not part of the patient eHR unless printed and placed in the patient chart.

4. View the Arrhythmia tab and **Save/Print in Clinical Access to document Arrhythmia or alarm in pt. chart SPACELABS CLINICAL ACCESS Alarm tab at the beginning of **remember to Analyze prior to folder review every shift and as needed Arrhythmia tab (stores for rolling 72 hours) throughout shift.  Click Home  Click Thumbnails view button  Choose an Arrhythmia that needs to be viewed (if no arrhythmias are present, always reanalyze to verify there are not arrhythmias present)  Once an arrhythmia is chosen it defaults to the thumbnail view  Click in the thumbnail box to open into Strip view  Click the drop down Arrow underneath the list to scroll through all arrhythmias that have been recorded for the patient in the analyzed time  Click Home to return to all arrhythmias for the analyzed timeframe  Check box of arrhythmia thumbnail(s) to save/print (to chart if appropriate) include: rhythm type, then initials of first name and full last name/title *Can save arrhythmia events, but cannot remove from them Arrhythmia folder

Alarms tab (stores for rolling 72 hours)  Click Thumbnails  In right lower corner of the screen check High and Medium  Select the Dropdown list and change the time to view the specified time of alarms (EX: 8 hours)  In the time line (bottom screen), move the orange bar all the over to the right  Or use the vertical alarm bars if to take a closer look at the alarm  Review alarms that are a significant change for the patient  Once alarms are reviewed, chart what is needed.  Click Save to save in “Saved Events” folder. Complete information in the Title Section and Comments sections as you did for strips and arrhythmias.

 Print to document in the patient’s chart

5. How to Document for a Code  Click Waveforms or Arrhythmia tab Blue / long arrhythmia event  Click Analyze choose Duration (ex: Previous 2 hours)

 Find the arrhythmia event and change to Waveforms tab if not there already

 Click Compressed (top of tab)& change the minutes to either 1,2,3,4 or 5 for the amount detail for the waveform data that you want to see

 Locate the event: Scroll the timeline (bottom screen), to obtain the beginning and end of the arrhythmia event

 Click Save

 Click on the start of the arrhythmia event and then the end of the arrhythmia.

 Label the title and add comments SPACELABS CLINICAL ACCESS  Choose “Strip” vs. “Compressed” in the Save window

 Click Print While Saving, then OK. Once printed, label the strips printout, with barcode sticker #365 (centered at the bottom of the page) and add to patient’s paper chart