1. Critical Care Indicators (CCI) MRSA, VRE, C-Diff and MDRO Notification Presented by: Janice Lisee, RNC, BSNFrederick Memorial Healthcare System Senior Systems Analyst Frederick, Maryland

2. Previous Process Reports from Microbiology Reports from Microbiology Reports based on nurses Admit HX Reports based on nurses Admit HX Relied on registration/bed management to contact nursing unit Relied on registration/bed management to contact nursing unit Used comment line on VIP screen Used comment line on VIP screen Inconsistent wordingInconsistent wording Used by more than one deptUsed by more than one dept Does not inform nurses, doctors or departments who treatDoes not inform nurses, doctors or departments who treat

3. Goals For New Processes Gather information at patient’s point of entry Gather information at patient’s point of entry Notify staff as soon as possible Notify staff as soon as possible Notify treating departments Notify treating departments Bring information forward to next registration/admission Bring information forward to next registration/admission Keep access to ENTER information limited Keep access to ENTER information limited

4. Points of Entry Emergency Room Emergency Room Same Day Surgery Same Day Surgery Direct Admissions Direct Admissions

5. ED RN – View and/or Enter

6. Info Screen from F8 FCL1=%MIS.SCREEN.display.doc("NUREDAS.0000010","EDCCI_INFO")}

7. Pre-Admission and General Nursing Staff on Admit History Display ONLY These go to Follow-Up Reports

8. CCIs Available in Reg Routines Not Seen In Transfer Routines

9. Information is seen in PCI (but not easily in Clinical Review)

10. Information Shared on Reports & Requisitions Daily Follow-Up Report for IC Staff Daily Follow-Up Report for IC Staff Same Day Surgery Standing Orders Same Day Surgery Standing Orders Nursing Shift Reports Nursing Shift Reports 24 Hour Summary (SBAR) 24 Hour Summary (SBAR) Admission Report (Admit Interventions) Admission Report (Admit Interventions) Radiology Requisition Radiology Requisition Wound Center OE Consult Wound Center OE Consult Request for Bed (admit or transfer) Request for Bed (admit or transfer)

11. Infection Control Staff Access

12. Implementation Started with MRSA and VRE Started with MRSA and VRE Added C-Diff and MDRO Added C-Diff and MDRO Edited 11 reportsEdited 11 reports Edited Allergy FragmentEdited Allergy Fragment Edited 16 screensEdited 16 screens

13. Post Live Review Well received by staff Well received by staff IC pleased with reports IC pleased with reports Need to “fix” Clinical Review Need to “fix” Clinical Review Would like to flag MDs during POM Would like to flag MDs during POM

14. Knowledge Base Articles 410 (MRI) 410 (MRI) 14568 (PCI) 14568 (PCI) 17450 (MIC) 17450 (MIC) 24652 (NUR) 24652 (NUR) 31686 (PCI) 31686 (PCI) 11816 (PCI) 11816 (PCI)

15. Questions??