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Sunrise Downtime Information and Procedures November 6-7, 2015 The Soft Laboratory Information System implementation will begin on Friday, November 6, at 1730. Sunrise downtime is required to complete this implementation. Sunrise will be unavailable beginning Friday, November 6, at 1800 until approximately 0100, Saturday, November 7. Lab order entry via Sunrise will be available at approximately 0700 Saturday, November 7. Please see below timeline and procedures for this implementation: Soft ID/TX Implementation Timeline: November 6 1730 - Order Entry will be turned off in Sunrise 1745 - Pharmacy will complete verification of all medications that are pending 1745 - E-link connection will be closed so Vitals can no longer be downloaded 1800 - Sunrise system downtime in effect, Nursing to begin printing kardex and lab/rad reports from Delsol November 7 0100 - Sunrise system available for clinical documentation. Order Entry will be available for pharmacy, radiology and nursing orders. NOTE: LAB ORDER ENTRY WILL NOT BE AVAILABLE. CONTINUE WITH PAPER LAB REQUEST PROCESS 0700 - Soft system live and Lab order entry available via Sunrise Physician Procedure: Sunrise will stop processing orders at 5:30 p.m. and paper charting will be employed until the system is back online. Providers will use paper forms to chart assessments, notes, and orders. Nursing staff will have the paper forms available. Lab Results during Sunrise downtime will be available via Clinical Inquiry. You will need to call the Help Desk 358-4059 for your password if you need one. Call the Help Desk for password assistance prior the system downtime so you are not waiting in a queue. All nurses will have access to this system with their User ID. Medication orders will be restricted to one time orders or the number of doses needed for the seven hour downtime period. The Pharmacy / PYXIS interface will remain up so the patient profile should remain intact in PYXIS. New medication orders will not appear in the PYXIS profile if placed during downtime. Nursing Procedure: Printing before downtime for each patient: All pertinent Tasklists Medications o Do not print prior to 1530: Ensuresrecently placed medication orders appear in your task list. History and Physical I&O for last 24hours Page 1 of 4 Source: Information Services, Created 10.16.15 Sunrise Downtime Information and Procedures November 6-7, 2015 Vital Signs for last 8 hours To print I&O and VS go to Clinical Summary tab and select Downtime Information from drop down list Last full provider note entered Consultation notes for last 24 hours Sunrise Downtime Forms and Charting: Flowsheets – for I&O, vitals, weights, assessmentsMAR – IV, Regular, Stat, PRN administration sheets Notes Orders Lab order forms Nursing History and related admission documents Radiology order forms (BC# 757-A Radiology Order) Any other forms unique to the unit Remember: the person writing an order must date, time, and sign. Refer to Policy 10.03 “Medical Records”, page 7. Referencing data during downtime: http://delsol/ (Type this address in your browser line on the UHS Homepage) o Radiology, Lab, and Medication orders entered prior to Sunrise downtime o Task Lists prior to Sunrise downtime Clinical Inquiry o Lab Results prior to and during Sunrise downtime o Access from UHS Intranet homepage under “Clinical Apps” o Call the Help Desk 84059 for password reset if needed Support Service Departments: Lab: Use UHS Lab forms. Do not pre-print Sunrise lab requisition slips for labs to be drawn after 1800 on November 6. Ask providers to restrict orders to one time or the number of tests needed for the downtime period. Once Sunrise is back online, all pending labs that have been done on paper should be cancelled in Sunrise by Nursing. DO NOT mark tests as collected - use the DC/Cancel choice on the orders tab: a. Cleans up the duplicate tests on the task list and orders tab b. Updates the record of what labs were ordered and have been done. Blood Bank: The Blood Transfusion Justification Form (BCHD #789) form is used to request units of blood. If the unit does not have a form available, they may call the Blood Bank at 82800 and one can sent to them in the tube system. The Blood Component Dispensing Request (BCHD #7-120-5) is used when the blood is picked up. Radiology: a. Fax completed orders to: All tests (Diagnostic, CT, MRI, US, NM): 3 6009 Stat / Critical Tests: 8 4751 Interventional Radiology: No fax number. Provider ordering IR must contact the radiologist. b. Results will be available through Synapse (PACS) or Clinical Inquiry. Page 2 of 4 Source: Information Services, Created 10.16.15 Sunrise Downtime Information and Procedures November 6-7, 2015 Medication Administration Process: a. All Pyxis access will be in override mode (If patient not listed in Pyxis, manually enter the patient information, please enter Visit Number as the patient ID) b. Paper pharmacy orders faxed to Pharmacy (8-8780) c. Ask providers to restrict orders to one time or the number of doses needed for the downtime period. The Pharmacy / PYXIS interface will remain up so the patient profile should remain intact in PYXIS. d. Missing dose slips/MAR/Order Form to be used for all medications not available in Pyxis e. Phone communication to Pharmacy for STAT items (please limit calls for true emergencies) f. Transcription of all medications to paper MARS Required Data Entered by Nursing Staff after Sunrise downtime: Dietary orders Consultation orders Medications – both new medications and any administered doses of those ordered prior to downtime (Pharmacy staff to assist PRN) Radiology exams to be done in the future Patient Profiles I&O totals will have to be entered so that fluid balance stays correct for those areas where patients on are strict I&O Labs – discontinue labs entered prior to downtime (DO NOT use the “d/c reorder” feature) and place new order for labs to be drawn after Sunrise is back up DO NOT need to enter Admission, Discharge and Transfer orders IDX, Lab, and Radiology will take about an hour to update admissions, transfers and discharges as well as the laboratory and radiology exam results. Other Cleanup: The Task Lists and Orders will need to be cleaned up so that there are no red boxes. Lab and Radiology orders that were scheduled to occur during the downtime will need to be discontinued/canceled. When the results for these orders come into the chart, they will auto create an order, which will be quite confusing if the lists are not cleaned up. Medication Reconciliation for discharged patients will need to be done using the paper discharge orders. You will need to search for the patient as they will be off of your census. All paper forms will be collected and placed in the patient’s hard chart for collection by Medical Records at discharge. Page 3 of 4 Source: Information Services, Created 10.16.15 Sunrise Downtime Information and Procedures November 6-7, 2015 Post Soft Implementation, Clinical Inquiry will be replaced by our HIE (dbMotion): After the SOFT implementation is complete. Lab results, radiology results and patient documentation will be available via our HIE (dbMotion). In the event of a Sunrise outage, all of this information is available from the UHS Intranet Page. 1. Find the Clinical Views – HIE link on the UHS Intranet Page 2. Use UHS Network login and password 3. Patient Search, use name or MRN 4. Click the Results tab, then Lab Results History Page 4 of 4 Source: Information Services, Created 10.16.15