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Interactive View Instructions DEFINITION.......................................................................................................................................... 2 NAVIGATOR ........................................................................................................................................ 2 IVIEW TOOL BAR ................................................................................................................................ 3 VIEW PANE .......................................................................................................................................... 3 CHARTING ........................................................................................................................................... 4 BACK CHARTING ................................................................................................................................ 4 CORRECTING CHARTING ERRORS .................................................................................................. 4 COPY DOCUMENTATION ................................................................................................................... 6 CHARTING DYNAMIC GROUPS ......................................................................................................... 6 CUSTOMIZING ................................................................................................................................... 10 SETTING USER PREFERENCES ...................................................................................................... 11 CHANGING NAVIGATION BANDS ................................................................................................... 12 FILTER AND FLOWSHEET SEEKER ............................................................................................... 12 SEARCH CRITERIA BAR .................................................................................................................. 14 TIMESCALE ....................................................................................................................................... 14 GRAPHS............................................................................................................................................. 15 I&O BAND .......................................................................................................................................... 17 NA I&O ............................................................................................................................................... 18 CHARTING IV VOLUMES .................................................................................................................. 19 CHARTING MEDICATION DRIP RATES ........................................................................................... 19 CHARTING FREQUENT IV MEDICATION DRIP CHANGES ............................................................ 20 DISCONTINUED IVS. ......................................................................................................................... 20 Page 1 of 20 Definition Interactive View (hereafter referred to as IView) is a tab in Powerchart that allows the user to chart and organize patient data in a meaningful manner. There are 3 main sections: Navigator, View Pane and Filter and Seeker. Seeker Filter and Navigator View Pane Navigator The Navigator is made up of a number of bands and sections. Click the band to open to the defaulted view. Click the sections to open a specific section of the band. Indicates data is charted. Indicates a critical value. The sections are color-coded. Bands Sections Blue means the section will default open when the band is clicked. Yellow indicates the section displaying at the top of the flowsheet. White indicates sections that are not defaulted open. Click the section to open. Page 2 of 20 IView Tool Bar Collapses the Navigator allowing more room for the View Pane. Splits the window to view data from 2 different bands. Hides or shows empty rows and columns. Signs charting. Cancels charting. Associates monitor in PowerChart. Used in the critical care units only. Creates a label for a new Dynamic group Actions- Duplicates entered data or clears unsigned data Opens the Add Order window (A future function.) Open the Orders for Signature window. This button is active when you click the Sign Later button on the Orders window. (A future function.) View Pane The view pane is used for charting and viewing patient data. The flowsheet view is determined by location and/or user position. The display can be customized to fit the patient. View Pane Tool Bar Customizes the flowsheet. Inserts columns for back charting. Changes start time of I&O totals. Indicates an order in the section that is associated with a task. Indicates a calculated result. Hover to view contributors. Indicates the value requires manual recalculation. Page 3 of 20 Charting 1. Double-click the time cell to activate charting in all the sections open on the flowsheet. Double-click the section header to activate just one section To chart in one cell only: right-click and select Add Result. 2. Use the keyboard instead of the mouse for easier and quicker charting. Press the Tab key until you reach the correct cell and enter data. Use the Arrow key to select an option from a drop-down menu. Use the Space bar to select options with a check box. Or use the Tab key with the mouse. 3. To enter a comment, right-click on cell and select Add Comment. 4. Review charting. 5. Click the Sign icon. Double-click the time cell to activate all the sections. Double-click the section header (blue or yellow) to activate one section. Back Charting 1. 2. 3. 4. 5. 6. Click the Insert Column icon. Right-click the new time cell. Click Change Date/Time. Enter correct time. Chart patient information. Click the Sign icon. Correcting Charting Errors If patient information was charted by a form through Ad Hoc Charting or PAL, go to Forms to make corrections. 1. Right-click the data to be corrected. 2. Select Modify, Unchart, Change Date/Time or Add Comment. 3. Unchart is used for duplicate charting or charting on the wrong visit or patient. Modify 1. Select Modify. 2. Enter correct information in the cell. 3. Click the Sign icon. Page 4 of 20 Unchart 1. Select Unchart. 2. Click the yellow Reason field or the Reason field in the lower window and select an option. 3. Click Sign. Select a reason from either field. Reason is required as indicated by the yellow field and the dithered Sign button. Change Date/Time 1. Select Change Date/Time. 2. Enter correct date/time. 3. Enter a comment. 4. Click the Sign icon. Add Comment Comments can be added prior to signing and after signing. 1. Select Add Comment. 2. Enter data. 3. Click OK. Note: Uncharting and Change Date/Time allows multiple cells to be changed simultaneously. Depress the Ctrl key while clicking the cells to be changed. Right-click on any one of the cells and select an option. Correcting Calculations When you modify a contributor, the calculation will automatically recalculate unless the contributor values are from outside IView. The system will notify if a manual recalculation is needed with the icon. To manually recalculate: 1. Right click on the cell. 2. Click Recalculate. 3. Click OK. Page 5 of 20 Copy Documentation 1. Find the time header for the documentation that you want to copy. NOTE: Do Not highlight a column with another disciplines data. 2. Click blue (label) section header o Column becomes highlighted 3. Click Actions icon on tool bar 4. Click Duplicate Results 5. Enter Date/Time of documentation and click OK 6. Results populate new column. 7. Click in cell to make additions and subtractions as needed. 8. SIGN Charting Dynamic Groups 1. Select the desired band To chart wounds select Assessment & Interventions band To chart IV’s, arterial lines, chest tubes, drains select Lines/Tubes/Drains band Page 6 of 20 2. Click the “Add a Dynamic Group” icon to create a label if not present The new subsection or placeholder displays 3. Click the label placeholder to define the label 4. Define the label by selecting the appropriate options Yellow indicates the field is required Scroll to view all choices 5. Verify Label is correct 6. Click “OK” to close the window 7. The label is displayed inside brackets until it is signed. 8. Click Sign Page 7 of 20 To Unchart a Dynamic Group Once the label is signed it cannot be modified, however it can be uncharted. All results within that subsection must be uncharted from each cell. 1. Make sure all data has been uncharted from each cell 2. Right-click the dynamic group label 3. Click Unchart 4. Select a reason from the Unchart window 5. SIGN 6. The uncharted label will display as “In Error” and the section will be dithered. 7. Once data is Uncharted the subsection cannot be Reactivated. The user needs to create a new label. To Inactivate and Activate a Dynamic Group Always chart “discontinue” and then inactivate a dynamic group subsection when it is no longer needed, such as when a drain or tube is removed or an IV is discontinued. When a label is incorrect and multiple staff have already documented on it: 1. Right-click in the Activity field 2. Click “Inactivate-site clarification 3. Sign 4. Follow steps below to then Inactivate incorrect label To Inactivate a subsection 1. Right-click label to be inactivated 2. Click Inactivate 3. Inactivating a group will dither entire section Page 8 of 20 To reactivate a subsection that has been accidently inactivated: 1. Right-click label 2. Click Activate Page 9 of 20 Customizing You can customize the display for the patient that affects all clinicians who chart. The display can also be altered for the current charting session only. (Settings return to the default when the chart is closed.) To customize for the patient (changes retained after chart is closed or refreshed): 1. Click the Customize View Icon. 2. Select and de-select the items by clicking the check boxes. 3. Click OK. Click the Default Open box to display the section on the flowsheet when IView is opened. Checking On View puts the section on the Navigator and leaves it closed on the flowsheet. Shaded boxes cannot be deselected. Use this field if looking for a specific item. It’s easier to find a section if you click Collapse All. When the section with data has been deselected, the Navigator will have a checkmark indicating data is present. Click the section on the Navigator to view. To customize on the flowsheet : 1. Right click on section or item. 2. Select option. Collapse: Collapses section for current session. Close: Removes section from View Pane and leaves section name on Navigator for current session. Remove: Removes section from View Pane and Navigator for all users and retains the change after closing the chart or refreshing. To Split the window to view data from 2 different bands: 1. 2. 3. 4. Click the Split Window icon. Click within the 2nd window to highlight. Click the 2nd band. Click the section to display in the 2nd window. 5. Click to remove the split. To hide empty rows/columns 1. Click the Show Empty Columns/Rows icon. Page 10 of 20 Setting User Preferences The user can change preferences, such as search criteria or the I&O display. Changing Preferences is user specific and for all patient charts. 1. Click the Customize View icon. 2. Click the Preferences tab. 3. Make changes in the All My Views or the current view column. For example, to change the search criteria, click the drop-down arrow on Default Retrieval Type and select an option. 4. To change the defaults for just one band: a. Click the band on the Navigator. b. Click the Customize View icon. c. Click Preferences tab. d. Make changes in the middle column with the band name. Make changes in this column to affect all the bands. The current band column. Change options in this column if you want just the one band affected. This column is the system default. Changes cannot be made here. Click the Reset System Defaults to restore the original defaults. 5. Click OK. 6. It is not recommended to change: Encounter Filter -defaulted to current encounter Display Rule - defaulted to last charted value Reverse Chronological order, unless changing all bands Order Statuses - defaulted to discontinued and ordered Page 11 of 20 Changing Navigation Bands To add a band or change the order of the bands on the Navigator: 1. Click View on the Menu Bar. 2. Click Layout. 3. Click Navigator Bands. 4. To add a band: a. Click the band in the Available Document Types window. b. Click the arrow pointing right. 5. To change the order of the bands on the Navigator: a. Click the band to be moved in the Current Document Types window. b. Click the up or down arrow. 6. Click OK. Click the band to be added in the Available Document Types window. Click the arrow pointing right. To change the order of the bands, click the band to be moved. Click the up or down arrow. To remove a band, click the band in the Current Document Types window. Click the arrow pointing left. After clicking OK on the Navigator Documents window, this alert displays. Do not exit PowerChart. Close and re-open the patient’s chart. Filter and Flowsheet Seeker The Filter and Seeker are used to quickly find results. Page 12 of 20 The Flowsheet Seeker (This function was removed in 2008 but may be activated in the future.) The Flowsheet Seeker pane displays a map of the flowsheet that is color-coded by result status (critical, high, low, etc.) The display is based on the search criteria and sections that are opened. 1. Click and drag the black box to the color-coded results. The Filter The Filter pane is used to search for a specific result or result status of critical, high, low and abnormal. To search for a specific result: 1. Enter the name in the Find field. 2. Select the correct item. 3. Click the result to move the result into view. The result cells will turn green. To search by result status: 1. Click the check box next to the status. Click the result to move the flowsheet. The result cells will turn green. 2. Page 13 of 20 Search Criteria Bar The Search Criteria Bar determines time frame for the data. Change the bar to view different data by one of the following: 1. Click the arrows at either end of the bar. 2. Right click and select an option. Timescale The time columns can be set for actual or time increments from q30 sec to q120hrs. 1. Right click on the date or time cell. 2. Click one of the options. Changes can be made to the Search Criteria Bar and the Time intervals that are specific to the user and affect all patient charts. Go to Setting User Preferences on page 7. Page 14 of 20 Graphs IView has a Graphs band that has prebuilt graphs, and also allows the user to build graphs. To build a graph: 1. Click the New Graph Icon. Graph Tool Bar 2. Enter a name for the graph. 3. Select a type of graph; Standard or BMDI (Bedside Monitoring Device Information – INet). 4. Click Next. Enter a name. Select one of the options. Page 15 of 20 5. 6. 7. 8. 9. Enter item in Search Item field. Click Search. Click an item from the Search Results field. Click Move. Click Finish. Click Symbol to change to a line graph. 10. Click the Save icon . The graph will save to Favorites folder. The graphs you created will be available for any patient chart. Graphs can be modified, such as adding components. Click the Modify icon. To delete a graph, click. To close the graph, click the Close icon. Page 16 of 20 I&O Band The band’s Navigator and View Pane function the same as the other IView bands: Click on a section in the Navigator to open or move it to the top of the flowsheet. Double-click the section header or time cell to activate charting. Right–click to Modify, Add a Result, Unchart, Change Date/Time, Add a Comment and View Result Details. Add items to the I&O band by clicking the Customize button. For example, to enter blood product volumes go to Transfusions section on the Customize window. Additional functions and fields: Summary of today’s and yesterday’s I&O are at the top of the flowsheet. Fluid Balances are listed at the bottom of the flowsheet. Shift and 24 hour total columns display corresponding totals Intake-No Longer used and Output-No Longer used sections: Do not use these sections for charting. The sections are present for historical data from the old I&O. The Continuous Infusions rows are created by IV orders entered into PowerChart. Drip and Continuous IV volumes will automatically populate when the cell is activated. Rightclick and select Modify to change the volume. The Medications section is created when an IVPB is charted. Diluents will be used for IVs that pharmacy does not enter. The band allows textural documentation such as urine color. Page 17 of 20 NA I&O Nursing Assistants document I&O on the Nursing Assistant Monitoring band. The I&O sections work the same as the other sections, such as Vital Signs. Page 18 of 20 Charting IV Volumes Once a continuous IV or a medication drip has been scanned, the rate will default to I&O when the time column is activated. The rate defaults as a volume. If the Begin Bag is not done, the volumes will not default to I&O (inpatient units chart in CareMobile, ED chart on the MAR). 125 and 5.25 auto- populated the cells when the column was activated. Charting Medication Drip Rates Charting medication drip dose/rate and changes on IV Drips section will auto-calculate the volume on I&O when the column is activated. IV drip rates are to be charted hourly. Rate changed on IV Drips section of the Monitoring band. The charting must be signed before it will populate I&O. After refreshing the I&O band, the new volume auto-populated the I&O when the time column is activated. Page 19 of 20 Charting Frequent IV Medication Drip Changes Multiple rate changes within one hour will auto-calculate the volume correctly when entered on the IV Drips section. 1. If your flowsheet is set to 1 hour increments, click the Insert Date/Time Icon to add a current time column . You will not need to change the time. 2. Enter the changed rate/dose and sign. Actual time. Dose changed from 4 to 6 mcg/kg/min. Rate was auto-calculated with rate change. The next hour, the volume defaulted from the last rate entered. 6mcg/kg/min = 15.75 ml/hr Discontinued IVs. Discontinued IVs, including medication drips will not auto-populate I&O. A volume may be entered manually. Manually enter a volume when charting has not been completed prior to pharmacy discontinuing the IV. Page 20 of 20