1. Downtime Quick Reference Medipac, HEO/Wiz, HED, Admin-Rx, StarPanel, Network 1.Post DT notices & remind staff time DT is starting 2.Check DT kits & fill to par levels (for each form par level = # of beds on unit plus 5 additional copies) 3.Listen for overhead announcements for start of DT  MEDIPAC: Print Patient List /Charge Nurse worksheet from HEO/Wiz  HEO/Wiz: Print COS on all patients for RNs  HED : Addressograph both pages of DT flowsheet & place in pt’s chart  Admin-Rx : Retrieve MARs from designated printer & distribute. Prints to (CCT on each unit, VUH on south side, VCH on B pods, MCN on each unit, VPH adult units on ADL1, peds on ADOL) For new admissions, stamp interim MARs and place in chart.  StarPanel: RN: Print “Overview of Patient Care” (OPC) & address outstanding Inpt Whiteboard (Inpt WB) indicators while information still current( VAP, Falls)  Lab Computer System: call center # 322-1164  Network: All of the actions above  MEDIPAC: track admissions/transfers/discharges (ADT) on Patient List/Charge Nurse Worksheet (VPH done by Respond)  HEO/Wiz: See COS & StarPanel for orders entered prior to DT MD should write orders on Physician Order sheet, print & sign name, write pager #, & then give to MR A copy of each POS is tubed to Pharmacy The MR transcribes new, modified, & discontinued orders to the paper MAR RN’s verify transcription is correct & signs MAR MR completes DT requisitions for labs, ancillary depts & blood bank (one requisition per dept)  HED: Nurses document on manual flowsheets & should NOT use HED even if it appears to be available  Admin Rx: Meds are documented on paper MARs. MR transcribes new, modified, & discontinued orders to paper MAR (some areas nurses do this) RN’s verify transcription is correct and signs MAR RN checks StarPanel e-MAR for previous med admin times & verifies schedules are correct on paper MAR  StarPanel: Print Nursing Admission History from e-docs Lab will contact unit with STAT results Indicators on Inpt WB will not receive updates  Network: All of the actions above Preparing for Scheduled Downtime(DT) During Downtime(DT)

2. Workstations on Wheels (WOW) and scanners are unavailable. Use DT procedures for Admin-Rx and locate hardwired computer for other tasks. Downtime Quick Reference Medipac, HEO/Wiz, HED, Admin-Rx, StarPanel, Network Listen for overhead announcements for end of DT  MEDIPAC: From ADT Tracking List, MR Discharge pts who left during the DT Transfer pts to correct locations Continue to track new admissions & calls Admitting Dept (Respond in VPH) if pt not on census in one hr  HEO/Wiz: MR back-enters all on-going non-med orders Pharmacy enters all on-going med orders  HED: RN enters cumulative I&O  Admin-x: RN Confirm ed orders & schedules in Care Organizer are correct (allow time for PHM to catch-up) Note overdues and document as “already given-see MAR” if administered & charted during DT  StarPanel: RN: print new OPC if needed and address indicators Alert banner displays with start/end times of DT & instructs staff to see paper documentation  Network: All of the actions above All paper documentation is a permanent part of the medical record. MR should restock DT kit to par level ASAP. Preparing For DT  MR Print ED Order Summaries on every pt in treatment area 15 minutes prior to scheduled DT or at beginning of unscheduled DT & place on pt’s clipboard Stamp & place on clipboard: Physician Order Sheet (1), DT reqs (2), Facility Charge Form (1)  Charge Nurse: Initiate manual whiteboard During DT Maintain accurate census on manual whiteboard Recovery From DT Charge nurse performs DCRN function to update census on WB using the Facility Charge form Recovery From Downtime(DT)Emergency Departments Whiteboard (WB) Wireless Network DT V:downtime/1.7.2009DT Quick Reference