Epic MAR

1. Epic MAR

2. Reports Clean Up MAR Schedules Peri-Op Meds MAR Potpourri 10 10 10 10 10 20 20 20 20 20 30 30 30 30 30 40 40 40 40 40 50 50 50 50 50

3. Reports – 10 Points • QUESTION: • This report gives an easy-to-read view of a patient’s active and recently completed medications. It resembles a paper MAR. • ANSWER: • What is the MAR Report (accessed from within the MAR)?

4. MAR Report

5. Reports – 20 Points • QUESTION: • This Patient Summary report includes links to MAR reports that show clinical parameters (ex: pain) along with the related medications given (ex: oral pain meds). • ANSWER: • What is the Index Report?

6. Patient Summary > Index report > Medications

7. Reports – 30 Points • QUESTION: • This report is similar to the MAR Report, but it is organized by Scheduled, Continuous, and PRN meds, AND it includes completed and discontinued meds from the current encounter. • ANSWER: • What is the Medication History report? • Note: Access the Medication History report from a link Patient Summary > Index report

8. Medication History Report

9. Reports – 40 Points • QUESTION: • This report displays medications in the order they are due. It only shows meds due through the end of the current shift. It can be added as a button in Patient Summary. • ANSWER: • What is the Due Meds report?

10. Due Meds Report

11. Reports – 50 Points • QUESTION: • Medications documented by this type of provider only display in the MAR, not in MAR reports. • ANSWER: • What are Anesthesia providers?

12. Other Encounters – Bottom of the MAR

13. Clean Up – 10 Points • QUESTION: • For this MAR button to be a useful tool, medication documentation must be kept up to date. • ANSWER: • What is the Overdue button?

14. MAR Overdue Button

15. Clean Up – 20 Points • QUESTION: • When an infusion is finished running and has been discontinued, use these two functions to remove the infusion group from view on Doc Flowsheets • ANSWER: • What are (right-click) “Complete” and “Hide Comp’d”?

16. Complete a Group / Hide Comp’d

17. Clean Up – 30 Points • QUESTION: • It’s the end of your shift. A one-time IVPB infusion finished running 5 hours ago. You need to document intake, but don’t see the infusion group on the I/O flowsheet. Click this button to view the group and document intake. • ANSWER: • What is Hide Comp’d?

18. Hide Comp’d

19. Clean Up – 40 Points • QUESTION: • This kind of I/O infusion group will NEVER “auto-complete” – even when it was started in Periop and the patient has been transferred to the floor. • ANSWER: • What is a Continuous Medicated Drip IV Infusion Group? • Note: You will need to manually “complete” the infusion group to clean up the I/O flowsheet.

20. Continuous Medicated Drip IV Infusion Group

21. Clean Up – 50 Points • QUESTION: • When an IV piggyback, IV fluid bolus, or IV continuous, titratable med is completed or discontinued, its infusion group on the I/O flowsheet “auto-completes” within this time frame. • ANSWER: • What is 4 hours?

22. Auto-Completed Infusion Group Use right-click > Row Status History of Dose to determine if the row was “auto-completed” (User will be blank)

23. MAR Schedules – 10 Points • QUESTION: • You can use this report to view all active medication schedules (and PRN meds too) with minimal scrolling. • ANSWER: • What is the MAR Report.

24. MAR Schedules – 20 Points • QUESTION: • This Epic activity can show all scheduled meds for all patients on your treatment team. • ANSWER: • What is the Work List?

25. Work List

26. MAR Schedules – 30 Points • QUESTION: • Use this MAR action to shift the schedule for the next dose of a medication given late. • ANSWER: • What is “Due”?

27. MAR Action = Due

28. MAR Schedules – 40 Points • QUESTION: • When you scan a medication outside this time frame, you must enter an Override reason and/or an Off Schedule reason. • ANSWER: • What is 120 minutes before and 120 minutes after the medication is due? • Note: You must follow your organization’s policies and procedures regarding “late” medications. For most institutions, anything beyond 60 minutes is considered late. In Epic, the setting is currently at 120 minutes to make barcode scanning more efficient.

29. Schedule: 120 Minute Parameter Too soon Too late

30. MAR Schedules – 50 Points • QUESTION: • You see an, overdue schedule for a Pre-Op med on the MAR. You want to “clean up” this scheduled med as it is no longer appropriate, because your patient has already returned from PACU. Use this MAR action. • ANSWER: • What is Canceled Entry?

31. Canceled Entry and Not Given Note: For some providers, the connotation for “Not given” may be: “Not given, AND not going to give.”

32. Peri-Op– 10 Points • QUESTION: • This MAR tab displays medications given while the patient was in OR and PACU. • ANSWER: • What is the Peri-Op tab?

33. MAR Peri-Op Tab

34. Peri-Op– 20 Points • QUESTION: • On the MAR “All” tab, to see a medication’s Phase of Care (ex: PACU), you can look here. • ANSWER: • Where is below the box for Last 3 Actions / Next 3 Scheduled?

35. Phase of Care

36. Peri-Op– 30 Points • QUESTION: • If you (an IPRN) see an active order for fentanyl 50 mcg Q5min PRN with a PACU phase of care, you should do this. • ANSWER: • Consult the provider to clarify the order: Discontinue or discontinue and re-order. • Note: During the transfer medication reconciliation process, if a physician orders a PACU med to continue, the phase of care for the medication will remain “PACU”. • Note: If the patient “skips” PACU and recovers on your unit, check with clinical leadership regarding administration/documentation of meds with PACU phase of care.

37. Peri-Op – 40 Points • QUESTION: • When a patient is transferred to Peri-Op, most medications automatically change to this status. • ANSWER: • What is Hold status?

38. Auto-Hold for Transfer to Peri-Op • “MAR hold” begins automatically when patients transfer in Epic to Peri-Op and stops automatically when they transfer in Epic to an inpatient bed. • Post-operatively, go to the Scheduled tab and look for pink “Auto Held” documentation. Those were meds scheduled to be given while the patient was in Peri-Op. Review these meds, and determine with the physician which to give late and which to hold for the day.

39. Peri-Op– 50 Points • QUESTION: • This type of medication does NOT auto-hold when a patient is transferred to Peri-Op. • ANSWER: • What is a continuous infusion.

40. MAR Potpourri– 10 Points • QUESTION: • To associate every IV medication with an IV line on one screen, click this button. • ANSWER: • What is Link Lines?

41. Link Lines

42. MAR Potpourri – 20 Points • QUESTION: • The only time you scan an infusion is to document this action. • ANSWER: • What is New Bag?

43. Action = New Bag

44. MAR Potpourri – 30 Points • QUESTION: • You do a Pyxis override for a med that is on the MAR, but has not yet been verified by Pharmacy. You link the override to the order before performing this action. • ANSWER: • What is “Scan the med”?

45. Order Not Verified – Link Before Scanning

46. MAR Porpourri – 40 Points • QUESTION: • This type of report initially displays on the right side of the screen and is easily accessed from the MAR and Doc Flowsheets. • ANSWER: • What is a Sidebar Patient Summary report?

48. Topic 5 – 50 Points • QUESTION: • Look here to view the IV line an IV med was linked to at any time in the past. • ANSWER: • What is the bottom pane of the MAR Report?

49. MAR Report: View Linked Line