The Tool Bar-Macro Toolbar The Tool Bar is designed to help users easily access functions in the application they most commonly use. MACRO TOOLBAR The Macro Toolbar is responsible for adding a series of one or more key events to the Event Log Designed to help the end user document key events from start to finish Designed to follow a typical timeline from start to finish A more detailed discussion on “Events” is to follow

MACRO TOOLBAR “Anesthesia Start” 1. Hit the “Anesthesia Start” icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Anesthesia Start” Places an “S” on the timeline Running cursor over the letter “S” will bring up the event descriptor Adds event descriptor to the “Event Log”

MACRO TOOLBAR “Equipment Check” 1. Hit the “Machine Check” icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Equipment Check” Places a “C” on the timeline Running cursor over the letter “C” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “Patient Assessment” 1. Hit the “Patient Assessment” icon MACRO TOOLBAR “Patient Assessment” 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Patient Assessment” Incorporated into the program to deal with concerns of the CPSO Typically, a repeat anesthesia evaluation is performed and transcribed on the written record despite the fact that a patient may have been seen in the PAU Our concern was that there was going to be duplication of effort as well as 2 electronic preoperative assessments on a patient in this scenario After considerable discussion with an Anesthesia Auditor who was not able to give any specific direction (new territory for the CPSO) We elected to incorporate an Event Set titled (A010_Preop Evaluation) which should address the concerns of the College: that certain aspects of the Preoperative Assessment has been reviewed that an A/W exam be conducted by the anesthesiologist of record

MACRO TOOLBAR “Patient Assessment” 3. Event Set Dialogue Box opens. 4. Click on A010_Preop Evaluation 5. Select relevant descriptors and hit > 5. Select relevant descriptors and hit > Click on the Preoperative Assessment QA Indicator and the following will appear. Check the relevant boxes 6. Hit OK

MACRO TOOLBAR “Patient Assessment” Places a “P” on the timeline Running cursor over the letter “P” will bring up the event descriptor Adds event descriptors to the “Event Log” Once you’ve confirmed the time, the following will occur: QA Indicator Check Box with two separate assessments (CPS0 Requirement) The following events will be entered automatically

MACRO TOOLBAR “Regional Start” 1. Hit the “RA” (Start Regional) icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Regional Start” Places a “R” on the timeline Running cursor over the letter “R” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “GA Start” 1. Hit the “GA” (Start General) icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “GA Start” Places a “G” on the timeline Running cursor over the letter “G” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “MAC Start” 1. Hit the “MAC” (Start MAC) icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “MAC Start” Places a “M” on the timeline Running cursor over the letter “M” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “Antibiotic First Dose” 1. Hit the “Hourglass T” (Antibiotic(s)-first dose give) icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Antibiotic First Dose” Places a “A” on the timeline Running cursor over the letter “A” will bring up the event descriptor Launches a timer (count up) - reminder to administer a subsequent dose of antibiotic Adds event descriptors to the “Event Log”

MACRO TOOLBAR “End Surgery/Confirm Procedure” 1. Hit the “Suture/Thread” (End Surgery/Confirm procedure) icon 2. Adjust the time as required, hit OK 2. Adjust the time as required, hit OK

MACRO TOOLBAR “End Surgery/Confirm Procedure” Demographics Navigation Bar is launched Are all required events documented? Any item in RED requires ATTENTION prior to transfer Anesthesia Case Start (S) Anesthesisa Case Finish (F) QA Indicator Anes: Anesthesia Type Anes: Positioning Anes: Equipment Check/ Preinduction Anes: Peripheral IV Access Anes: Airway/Intubation (if relevant) ASA/Medical Team/Surgical Procedure 3. Complete as required

MACRO TOOLBAR “End Surgery/Confirm Procedure”” Places a “E” on the timeline Running cursor over the letter “E” will bring up the event descriptor Adds event descriptors to the “Event Log”

Macro Toolbar “Bag Level” 1. Hit the “Bag Level” (Fluid Balance) icon, Window opens

Macro Toolbar “Bag Level” “Please enter bag levels for all cumulative fluids”

Macro Toolbar “Bag Level” “Fluids IN/OUT” need to be documented at end of surgical procedure This will require validation of the respective “Fluid(s) In” This will require documentation of cumulative fluid(s) out To be discussed in future lecture

MACRO TOOLBAR “Emergence-End GA” 1. Hit the “End GA” icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Emergence-End GA” Places a “g” on the timeline Running cursor over the letter “g” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “Transfer to PACU/SDCU” 1. Hit the “PACU/SDCU/ICU” icon 2. Adjust the time as required, hit OK 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Transfer to PACU/SDCU” Demographics Navigation Bar is launched Are all required events documented? Any item in RED requires ATTENTION prior to transfer Anesthesia Case Start (S) Anesthesisa Case Finish (F) QA Indicator Anes: Anesthesia Type Anes: Positioning Anes: Equipment Check/ Preinduction Anes: Peripheral IV Access Anes: Airway/Intubation (if relevant) ASA/Medical Team/Surgical Procedure 3. Complete required information 3. Complete required information

MACRO TOOLBAR “Transfer to PACU/SDCU” Places a “T” on the timeline Running cursor over the letter “T” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “Transfer to PACU/SDCU” ADT Dialogue Box opens to provide “Transfer” option. If all required information not completed, you can CANCEL at this point 4. Hit Transfer

MACRO TOOLBAR “Transfer to PACU/SDCU” Places a on the timeline Running cursor over the will bring up the event descriptor Adds event descriptors to the “Event Log” Notice Timeline divided into the various sessions Before Admission GA (Anesthesia Standard) GA Transfer

Macro Toolbar “Report” 1. Hit the “Report” (PACU-SDCU-ICU) icon. Event Set Window will open Macro Toolbar “Report” 2. Choose A005_PACU-SDCU-ICU Report When you arrive in the PACU, the patient will be transferred by the nurses into the PACU template Monitors will be attached and real time variables will be captured (post op vital signs) You now document your handover 3. Choose appropriate descriptors 4. Hit the > button

Macro Toolbar “Report” 5. Hit OK Adds event descriptors to the “Event Log”

Macro Toolbar “Finish” 1. Hit the “Finish” (Anesthesia Case Finish Time) icon Macro Toolbar “Finish” 2. Adjust the time as required, hit OK

Macro Toolbar “Finish” Print Dialogue Box Upload to vOacis Print hard copy May have to adjust “STARTING” and “ENDING” time

Macro Toolbar “Finish” Places a “F” on the timeline Running cursor over the letter “F” will bring up the event descriptor Adds event descriptors to the “Event Log”

MACRO TOOLBAR “Discharge to Other” 1. Hit the “X-SIMS” icon 2. Adjust the time as required, hit OK

MACRO TOOLBAR “Discharge to Other” Demographics Navigation Bar is launched Are all required events documented? Any item in RED requires ATTENTION prior to transfer Anesthesia Case Start (S) Anesthesisa Case Finish (F) QA Indicator Anes: Anesthesia Type Anes: Positioning Anes: Equipment Check/ Preinduction Anes: Peripheral IV Access Anes: Airway/Intubation (if relevant) ASA/Medical Team/Surgical Procedure

MACRO TOOLBAR “Discharge to Other” Used when NOT transferring patient to PACU or SDCU (Stage I or II) Typically, this would be the ICU They do not have the SIMS system

Viewing Options The upper left corner of flowsheets contains controls for changing the the way data is displayed: Resolution: Allows you to change the viewing resolution. Show only rows with data: Eliminates rows with no data. Show subheadings: Adds rows with subheadings showing family names. Restore: Reapplies flowsheets defaults and returns to current time view. Freeze/unfreeze: Turns autoscrolling on and off. Go to column: Allows you to go directly to the column closest to a specific date and time. Order filters: Allows you to activate and clear filters for discontinued and canceled orders. d e f g a b c Freeze button very useful, make sure your users know how to use this button. One minute chart data interval, every one minute the screen has to refresh. If user has scrolled back, they will be taken up to the current time each minute. Freeze holds you to where you have scrolled to until you unclick it. Freeze doesn’t allow a refresh to happen. Refresh button will take you back to the current time column. Can keep Freeze/unfreeze button clicked and then click refresh to update data. How Show Only Rows with Data can be a problem: Show only rows with data is a good way to eliminate all the variables that are not really used. Do not see a manual data row unless there is data in the viewing time frame. Lose the variable for daily weight. The Order Filters button (fourth from the left) is only available on flowsheets that are configured to display order-based data such as medications and fluids.

Viewing Options Resolution Resolution changed from 5 minutes to 1 hour Each flowsheet has a default viewing resolution (5 minutes) Changing resolution has NO effect on data collection from devices or how data is stored in the patient record. Blue triangles in flowsheet cells means you need a higher resolution to view all data samples. Further discussion on this topic will take place in an upcoming lecture 03:00 value of 64 is last value in that time period, at 03:00. 48 hour resolution can be removed from the OR template. 10 sec may not be helpful in the ICU. Training Tip: Right-clicking time or date cell in time bar is shortcut for zooming to a higher/lower resolution.

Viewing Options “Order Filters” Filters allow you to eliminate orders that were never administered (canceled) and orders that were partially administered (discontinued). Check mark on button indicates that one or more filters are active. Only flowsheets that contain order-based items such as medications and fluids. Hide cancelled and discontinued orders: Canceled orders were terminated before any documentation. Discontinued orders were terminated after documentation started. Can apply to all flowsheets or only current one.

Viewing Options “Order Filters” Normal Saline and Propofol discontinued Apply Filter Normal Saline and Propofol disappear

Pull Down Menus “Function Keys”

Pull Down Menus “Function Keys”

Pull Down Menus “Function Keys”

Pull Down Menus “Function Keys”

Pull Down Menus “Function Keys” Toolbar, Macrobar, Navigation Bar, Patient Information Band Removed Additional screen real estate recruited when all supplemental menus and bars are removed

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