Spotlight: DISCHARGE NOTE
Beginning September 1, 2010, conditional discharge orders will no longer be available in CRIS. Instead, Prescribers will enter a discharge progress note which automatically generates a discharge order. To learn more, New Discharge Process (89 KB)
Spotlight: RESEARCH, BLOOD ORDER FORM
Beginning July 6th 2010, the Research, Blood order will be enhanced to provide better definition and tracking of specimen tubes used for research draws. This includes designating specific tube types by means of the order for any of 9 tube types.
Please refer to DLM Website http://intranet.cc.nih.gov/dlm/index.html for further instructions on ordering Research, Blood test in CRIS.
Spotlight:Electronic Documentation in ICU
Flowsheets are available that replaced the fold-out paper flowsheet in the ICU. The current Critical Care Nursing Assessment flowsheet is replaced with 2 new flowsheets: CC Invasive Ventilation and CC Assessment (includes Vital Signs).
These new flowsheets will include some interfaced observations from the Philips bedside monitors and selected RT ventilators and cardiac output devices. Electronic documentation in the ICU will also include the Intake and Output flowsheet.
Additionally, a new Clinical Data Viewer (CDV) tab will be available in CRIS Sunrise to help concatenate data from multiple sources, similar to the current paper flowsheet. In its initial implementation, the CDV will be specific to patients in the ICU and will only display limited information for patients outside that unit.
For more information, see Reference Materials.
A new Medications/Herbal on Admit/Encounter document was deveopled to faciliate more accurate documentation of controlled substances (brought from home) upon admission and returned upon discharge. More information (284 KB).
Spotlight:Nursing Plan of Care - Health Issues
An addition of another type of Health Issue is now available - Nursing. This can be used to communicate the patient's Plan of Care, including problems, goals and plan for the Interdisciplinary team. Nursing Health Issues are available to both clinical research nurses and research nurses. Read more about Health Issues Manager found on the Reference Handouts section → Clinical Documentation → Nursing Plan of Care Health Issues (289 KB).
Spotlight: Advance Directives in CRIS
Effective December 9, 2009, you will be able to view scanned copies of patients' Advance Directives (AD) in CRIS. In order to check whether a patient has a scanned AD document, check the Nursing or Social Work Clinical Summary View. The Advance Directive tile on either of these views will list what AD documents have been scanned and the date the patient signed the AD. To view AD(S), go to the Documents tab. By the date, the AD will display on the date the patient signed the AD. By Category, the AD will display under Advance Directive.
Paper copies of signed Advance Directives (AD) should continue to be sent to the Medical Records Department (MRD) with the medical record after a patient is discharged. MRD will scan and file the paper copy of the AD on patients that have been discharged after December 1, 2009. The images of the scanned AD will be viewable in CRIS within 24 up to 72 hours following a patient's discharge and the receipt of the medical record in the MRD.
For additional assistance with viewing or printing Advanced Directives, please contact the CRIS Help Desk at 301-496-8400 or refer to the following reference handouts:
Spotlight: New SCD Profile
The image and login for the Standard Clinical Desktop (SCD) computers are changing! SCD's are located on nursing units and ancillary departments in designated areas. This change will be a phased roll out beginning on or about April 27, 2010 and will continue for several weeks. The biggest change is that you will no longer have to login to the SCD. The SCD image will automatically login when it is available for use. Additionally, the SCD image will display only three icons: CRIS, Citrix, and SCD Desktop. Learn More (770 KB).
Spotlight: Signed Protocol Consents in CRIS
Signed protocol consents are available in CRIS. The protocol consents must have been signed by the patient on or after May 1, 2009. To access the signed protocol consent, select the Protocol Info tab. Select the signed protocol consent you wish to view. It will be labeled Patient Signed Consent in the Item Detail column. Paper copies of protocol consents signed on 5/1/09 or after need to be sent to the Medical Records Department (MRD) for scanning and filing. Upon MRD receipt of the signed consent, you will be able to view it in CRIS within 24 to 72 hours. If you are not able to view a signed protocol consents in CRIS for patients who have met the criteria of a signature date of 5/1/09 or later please contact: The Help Desk at 301-496-8400.
Spotlight: Tamper-Resistant Prescriptions at NIH
To comply with the new CMS law, all take-home medication prescriptions written as 'Not Required for Study' under the Take Home Medications session type, will print on tamper-resistant paper in the Outpatient Pharmacy. Reference (49 KB).
You will no longer need to print/reprint the prescription to the location at which the patient is located; the prescription will print directly in the Pharmacy.
SIGNATURE & SIGNATURE FORM
Your electronically scanned signature will print on the paper prescription if it is on file. If your signature is not on file, you will have to come to the Pharmacy to sign the prescription.
Your Credentialing Coordinator will contact you to have your signature put on file. Additionally, if needed, access a copy of the signature form (42 KB). Follow the instructions to complete and submit the form.
All controlled substances will be filled by the Outpatient Pharmacy and therefore the patient will not receive a paper prescription.
IMPORTANT NOTE - Prescriptions for Schedule II Controlled Substances will continue to require a signed requisition form. The hard copy order requisition will print out at the assigned patient location noted in CRIS. The signed copy is required to be delivered to the pharmacy prior to medication dispensing.
ORDERS PLACED 'ON BEHALF OF' A PRESCRIBER
Take Home medication orders, 'Not Required for Study' (not filled by the NIH Pharmacy) entered 'On Behalf of' a prescriber are not permitted.
WHY USE TAMPER-RESISTANT PRESCRIPTIONS?
The use of Tamper-Resistant Prescriptions was initiated on October 1st, 2008 by the Clinical Center in order to comply with the Centers for Medicare and Medicaid Services (CMS) law. The law was intended to fight Medicaid fraud and abuse. All written Take Home prescriptions for outpatient medications NOT REQUIRED FOR STUDY (prescription filled off-campus) must be written on tamper-resistant paper.
Spotlight: Viewing Flowsheets From The Documents Tab
To view/retrieve flowsheets from the Documents tab, there is an "Include Flowsheets" checkbox to select. For more information, please see the August CIO Newsletter (258 KB).
Spotlight: Practicing with CRIS
To practice using CRIS with fictitious patients go to https://cccasper.cc.nih.gov/Citrix/scd/default.htm
1. Log on using your NIH credentials.
2. Select the CRIS Practice folder.
3. Click the CRIS PRACTICE icon.
For Prescribers: Name: prescriber01 Password: aaaaaa
For other Staff: Name: chart01 Password: aaaaaa
Spotlight: Interdisciplinary Problem List Flowsheet and Interdisciplinary Care View
The Interdisciplinary Problem List Flowsheet was implemented in CRIS house wide in October 2006. Training material on how to use the Interdisciplinary Problem List Flowsheet and the Interdisciplinary Care View can be found on the CRIS website at: http://cris.cc.nih.gov/cristraining/iptm.html.
Spotlight: Venous Access Device (VAD) Flowsheet
The Venous Access Device (VAD) Flowsheet was implemented in CRIS in October 2007. To access the new VAD Flowsheet , select your patient>>>Flowsheet tab>>>VAD Observations. When you make this selection for the first time on your patient, you must right click in the gray box and select "Add Parameter" in order to pull in the needed Flowsheet. Make the appropriate selection for the type of central or peripheral VAD your patient currently has in place.
Note that directly below is a Flowsheet titled "VAD Observations 1/21/06-10/23/07". This is the former VAD Observation Flowsheet and is available for viewing previous documentation only.
If you have questions about the new Flowsheet, you can either call the CRIS Support Center or you can consult with your PCU's Clinical Nurse Educator.
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