Clinical Information System scheduled maintenance (downtime)

30 minutes prior No additional electronic orders are entered. 15 minutes prior Verify downtime reports have an Information as of

time within the last 30 minutes. Email ITSERVICE@gru.edu as soon as you are able to access your

correct/current CPOE and eMAR downtime report. Use the subject line only to enter message i.e. 5West (your unit) downtime report is correct/current.

If you have problems accessing your downtime reports call the ITS Service Desk at 1-7500.

15 minutes prior All personnel should complete work in Cerner. Begin sending 6 demographic labels per patient to the lab with each group of specimens submitted.

Additional labels may be printed from Forms on Demand. 10 minutes prior All personnel should exit Cerner applications (PowerChart) Information Technology Services will post updates on the PAWS intranet home page, paws.gru.edu

to communicate downtime status How to run a Downtime CPOE Report/MAR For the scheduled monthly maintenance downtime, begin this procedure at 2145 (9:45pm) Please make sure the printer has an ink cartridge installed and paper in the tray. The Downtime Report application should be open and minimized at all times. Maximize the application by clicking on the appropriate notification in the tray. The patient roster will populate the screen. As a double-check that the most recent information is viewable, refresh the screen by clicking the

Refresh button located in the upper left of the screen. Email ITSERVICE@gru.edu as soon as you are able to access your correct/current CPOE and eMAR

downtime report. Be specific in the subject line i.e. 5West downtime report is correct/current or 4CMC downtime report is correct/current. Do not type anything in the body of the email.

If you have any problems with the downtime report i.e. did not update or all of your patients are not included, call 1-7500 and do not email ITSERVICE@gru.edu.

To view or print the eMAR for a single patient, select (click) the Mortar and Pestle/Clock icon in the MAR column next to the patients name to open the Downtime MAR.

The MAR opens in .pdf format (Note: The information as of date and time displays at the bottom of each page)

To print the eMAR choose FilePrintOK (Verify that the appropriate printer is selected) To print the eMARs for the entire nursing unit, select the drop down arrow next to the Print icon

in the tool bar. Choose Print All MAR. A prompt will ask, Are you sure you want to print all MAR reports? Answer Yes and printing will begin.

To view or print the CPOE record for a single patient, select the Chart icon next to the patients name. This report should not ordinarily be printed just viewed in the electronic format.

The Downtime Report will open in .pdf format (Note: The information as of date and time displays at the bottom of each page)

To print the CPOE record choose FilePrintOK (Verify that the appropriate printer is selected) To print the CPOE records for the entire nursing unit, select the drop down arrow next to the Print

icon in the tool bar. Choose Print All CPOE. A prompt will ask, Are you sure you want to print all CPOE reports? Answer Yes and printing will begin.

Begin downtime procedures--as soon as the system is unavailable

Lab and Radiology Results posted prior to the downtime: Are available in the HealthQuest system. Do not call the laboratory for history results. HealthQuest has a nightly downtime from 12 mid - 2:30 AM During this time; HealthQuest is be

available for view only. Lab and Radiology Results that become available during downtime: Blood Bank (1-2731) will be answering their phones as usual. Microbiology should be paged (6427) from 12 MN to 4AM Calls to SCC Lab, Chemistry Lab, Hematology Lab, Blood Gas Lab need to be directed to pager 9191. Communication needs to be limited to urgent or emergent requests. Lab staff will call Critical results to the appropriate ordering unit. All other labs will be faxed to the Nursing units. Laboratory will begin entering downtime results

when the system becomes available; however, the timeframe to complete entry of results will be approximately equal to the length of the downtime. Please maintain the faxed results until entries are available in PowerChart.

Radiology images are available in the Kodak Browser. The Radiologist will not dictate during downtime. New results will be communicated verbally or by

hand written form. Specimens sent to lab during downtime: Send 6 labels per patient for every group of specimens transported to the lab Nursing Documentation: Downtime < 4 hours All documentation will be entered into PowerChart when the system is available Downtime > 4 hours Downtime forms are available in Forms on Demand. Use the appropriate Downtime Forms for your

area. If your area has BMDI functionality, manually enter any items that do not flow in once the system becomes available.

All documentation will be on downtime forms and placed in the paper chart Medication administration, Documented Medication by Hx (if your unit is performing electronic

medication reconciliation), I&O, Allergies, initial or updated height and weight, and Vital Signs MUST be entered into PowerChart when the system is available.

If paper downtime forms are to be part of the patients paper medical record, the caregiver will document yes on the downtime documentation question once the system becomes available.

This will denote that some documentation may not be a part of the electronic record due to downtime. Exception: Clinician shift ends during downtime Downtime forms are available in Forms on Demand Care provided must be documented on paper downtime forms and placed in the paper chart Medication administration, Documented Medications by Hx (if your unit is performing electronic

medication reconciliation), Allergies, I&O, initial or updated height and weight, and Vital Signs MUST be entered into PowerChart when the system is available.

If I&O, Documented Medication by Hx (if your unit is performing electronic medication reconciliation), and Vital Signs to include height and weight documentation are electronically entered by a staff member other than the individual making the original downtime entry, the individual entering the data will sign the proxy signature on the downtime form to be placed in the patients paper medical record

If medication administration documentation is electronically entered by a staff member other than the individual who administered the medication, the individual entering the data will enter the administering individuals name into the performed by window in the EMAR task.

If paper downtime forms are to be part of the patients paper medical record, the caregiver will document yes on the downtime documentation question once the system becomes available. This will denote that some documentation may not be a part of the electronic record due to downtime.

CPOE Orders Management Downtime Process All processes revert to paper. All paper orders (except for Lab orders) will be communicated via

OrderComm to the appropriate departments. Lab orders will be transcribed to the paper requisitions and sent with the specimen and

six demographic labels to the lab. When a printed Cerner lab label is available it should be used if the specimen is sent to

the lab during downtime. Routine collection labels may print prior to scheduled time depending on downtime processes.

AcuDose will be on override. All physician orders are to be written on the paper Physicians Order sheet. Physicians are

encouraged to only write orders that are required for the immediate care of the patient. These orders would be written as one-time orders.

Recovery Process One-time orders that have already been completed will not be entered into the electronic system. If the physician wrote paper continuing or future orders, or performed Medication Reconciliation,

he/she will be responsible for entering those orders and Medication Reconciliation into the electronic medical record.

Problems experienced during this time should be reported to the ITS Help Desk (721-7500).