<p> Toolbox Questions – Answers - References REF # QUESTIONS ANSWER REVIEWED BY DATA OR NUMBER OF REFERENCE/SOURCE DATE (TASKFORCE MEMBER) EVIDENCE? RESPONSES 1 Is ‘copy forward’ allowed? Copy forward may be used very carefully. Clear policies covering Melissa Barthold Evidence and http://journal.ahima.org/2 April, this use should be available. Lisa Bove data- 008/06/04/an- 2009 Jim Cato appropriate-use-of-copy- When making this decision, the following should be considered: Brenda Kulhanek forward-with-a-caveat/ Survey Stakeholders in the decision: CNO’s, Practice Councils, Risk Results: Discussion on CARING list Management, Legal department. (date)</p><p>Review of software to determine functionality – clinical IT and clinicians</p><p>Is ‘copy forward’ present in any application currently?</p><p>What data is copied forward – and what is not allowed to be brought forward?</p><p>Is there a standard in place?</p><p>How is validation accomplished? How the caregiver is assured that the data is not simply copied forward, but is reviewed prior to storing the data? 2 How is the electronic signature defined? 3 Should physiologic data Any physiological data imported from monitors into an electronic Brenda Kulhanek Data- Discussion on CARING list imported from monitors be documentation system must be approved or validated by the nurse Lisa Bove validated before data is it prior to its storage in the EMR. Melissa Barthold CARING llist stored in the EMR? Portia Towns Issues: Validating that data is correct coming across an interface Ensures clinician evaluation of the data prior to storage and provides the ability to observe trending or to correct technical issues, such as lead artifact or monitor/interface issue. 4 How do you define what data should be included in documentation? – When making this decision, the following should be considered: Build documentation that reflects best practice and standards’ 5 How do you show documentation in error/ or changed documentation?</p><p>Page 1 of 5 Toolbox Questions – Answers - References REF # QUESTIONS ANSWER REVIEWED BY DATA OR NUMBER OF REFERENCE/SOURCE DATE (TASKFORCE MEMBER) EVIDENCE? RESPONSES “Error explanations– changes – how much should be in strikethrough format? Or should it be in that format?” 6 What are the best device When making this decision, the following should be considered: configurations that support nursing workflow? Do you support point of care (real-time at the patient’s side) charting?</p><p>What applications are currently in use and what are planned?</p><p>If you are using electronic medication records with bar coding, do you need a place to store individual medications? 7 Are mobile carts (COW’s, To be considered: Brenda Kulhanek Data CARING list July 2009 WOW,s, etc.) allowed in the Instruct staff to move mobile devices from hallways into alcove or Lisa Bove hallway? nurses’ station to comply with fire/state regulations. Melissa Barthold For design/redesign, consider creating elevated floor with outer Portia Towns perimeter docking or alcoves that includes power/network drops. Consider wireless. How are devices flexed in response to staff or patient census. What area is available for parking the devices to maintain power? Place outlets/network drops at an ergonomic height. 8 How do you maintain the charge on mobile devices? 9 How do you determine the number of devices needed? 10 How is ‘timeliness of When making this decision, the following should be considered: charting’ defined?” Is timeliness defined in other applications? 11 Are ‘default’ answers in When making this decision, the following should be considered: forms permitted? Do you allow defaults on paper forms or in other applications? 12 ‘During a downtime, what do you use to document?’ 13 ‘Once the system is back up, what downtime documentation is entered into the system? Is there a time frame associated with Page 2 of 5 Toolbox Questions – Answers - References REF # QUESTIONS ANSWER REVIEWED BY DATA OR NUMBER OF REFERENCE/SOURCE DATE (TASKFORCE MEMBER) EVIDENCE? RESPONSES this? If down < 2 hrs, or > than 4 hrs or?’ 14 What is current practice for communication of downtimes to clinical areas? 15 ‘What is current practice on communication of system changes (enhancements, etc.) 16 ‘Does charting-by-exception "Ladies & gentlemen support best practice? Is it of the jury, I present... legally defensible? the nursing documentation".Full Text Available (includes abstract); Austin S; Nursing, 2006 Jan; 36 (1): 56- 64 (journal article - case study, CEU, exam questions) ISSN: 0360-4039 PMID: 16395021 CINAHL AN: 2009089387 17 ‘What is current practice on prioritizing of enhancements? (Clinical requests being analyzed by a technical person) How is clinical impact of these changes included? 18 What documentation by non- licensed staff is permitted in the EMR? If it is done, should the RN co-sign the documentation? 19 What is current practice on Page 3 of 5 Toolbox Questions – Answers - References REF # QUESTIONS ANSWER REVIEWED BY DATA OR NUMBER OF REFERENCE/SOURCE DATE (TASKFORCE MEMBER) EVIDENCE? RESPONSES managing clinical students’ access to clinical systems? 20 How is the future state included in current implementations/enhanceme nts? How do you avoid making technology decisions that negatively impact future enhancements/building? How far in the future can we look – what is reasonable? 21 What is current practice in training/ SuperUsers? How is this resource continued and best utilized? 22 What QA is necessary for electronic systems? Who should do QA? 23 How do you ensure standardization of practice? 24 Has anyone converted paper to electronic in their psychiatry units? 25 How does your organization handle EHR training for ancillary departments? 26 What is the best practice for configuring (keyboard covers) and cleaning computers used for documentation in patient care areas 27 What is the best way to handle ongoing change management between IT and the clinical areas. 28 29 30 Page 4 of 5 Toolbox Questions – Answers - References REF # QUESTIONS ANSWER REVIEWED BY DATA OR NUMBER OF REFERENCE/SOURCE DATE (TASKFORCE MEMBER) EVIDENCE? RESPONSES 31</p><p>Page 5 of 5</p>