CPRS Tips and Tricks – Inpatient



263H: CPRS Tips and Timesavers – Inpatient

Room Assistant Guide and Outline – Rev 8.7.07

Prashant V. Phatak, MD

Presentation: Wednesday August 22, 2007 @ 13:30

0. Have user sign on to CPRS – Remind audience to hold questions till end of presentation – hand in 3x5 cards for any questions.

1. Navigation and Sign-on

a. Sign-on quickly by typing access and verify on same line using semicolon (CPRS Login Screen i.e. ##VEHU;VEHU##). Remember for workstations 1-9 to add a ‘0’ to make it a two digit number

b. Resizing and sorting the view alerts (Patient selection screen – use file >> select new patient)

i. Sorting view alerts: Click on patient, message, notification to sort view alert (notifications)

ii. Resizing windows for patient selection box / view alerts

iii. Use Forward button to forward alerts

iv. Use Next button (Double click on any abnormal results (not informational alert) for a patient view alert – once in the chart right click on Next button in button right corner and choose forward)

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v. Setting up clinic/ward/ team defaults on pt selection box (i.e ward ( 3north ( save OR clinic ( 20 minute primary care ( Save)

c. Tabbing around using (CPRS Tabs at bottom) – select a patient and then use the following keyboard shortcuts to move around the chart

i. CTRL-S (Coversheet), O (orders), N (Notes), L-ab, R-eports, T-consults, U-surgery, D-discharge summary.

ii. In the notes tab - Using arrow keys and plus/minus keys.

iii. Universal windows shortcuts: Cut (CTRL-X), Copy (CTRL-C), Paste (CTRL-V), Undo (CTRL-Z), All text (CTRL-A)

2. Options and Preferences

a. Creating a personal team list

i. go to Tools ( Options ( Lists/Teams ( Personal Lists

ii. Create a new list : Wards-## where ## is the name of your station

iii. Select provider ( Provider, eighty and add all.

iv. Select provider ( Provider, eighty-five and add all. Press OK, OK to exit

v. Patient selection box

vi. go to Tools ( Options ( Lists/Teams – select combination and appointment date, and set Start=Today and Stop today +1)

vii. Source combination ( select name of the list you created above and also clinic: general medicine. Press ok and ok

viii. File ( Select new patient to see our new default list.

b. Setting default date range for meds & radiology

i. Helpful as one student couldn’t find an MRI done 5 yrs ago due to a setting problem and meds from last admission hard to find.

ii. Meds: Tools ( Options ( General ( Other Parameters. Start date for meds : type t-100. Stop date okay as is.

iii. Radiology : Tools ( Options ( Reports ( Set individual Reports. Choose ‘Imaging’ from the list. Type Start date: type 1/1/1999. Stop date okay as is. Avoid setting all reports to this value as this may cause CPRS to run slower.

iv. See how it looks now under reports tab ( Clinical Reports ( Radiology Imaging and also under meds tab (expired medications from June should be visible).

c. Default note title and co-signer (if student).

i. Tools ( Options ( Notes ( Notes – review autosave and could change default co-signer here if needed. OK to ext

ii. Tools ( Options ( Notes ( Document titles – click on two note titles on right to remove and add the following: admit (add), h&P (add), general (add) and generic consult note (add). Use the up and down arrows to the right to sort the order the notes selected. Then Save Changes / OK to exit.

d. Setting alerts to inform when consult completed / lab results.

i. Tools ( Options ( Notifications –

1. Can change various alerts here – i.e. lab results (turn on), mammogram results (turn on). Abnormal labs on by default.

2. Surrogate settings: select provider, eight. Start date 8/22/07 and stop date 8/25/07 using calendar tool.

3. Remove surrogate button

3. Labs tab

a. Labs Status to see if collecting, pending, vs. looking at orders tab. Select patient Twentytwo,Patient ( Lab ( Lab Status ( All results – use scroll feature to see “Test Complete”, “On collection List”, “Collected” and “Routine Requested” –

b. Creating worksheet “panels” (i.e. Iron Panel, Cholesterol Panel). Select Twentytwo,Patient ( Lab ( Worksheet. Type the following and add to right: Cholesterol, LDL Cholesterol, HDL, Triglyceride, PSA, HgbA1c, Occult Blood. Then click on new at top right and yes to save.

i. Similarly can create: Iron panel, dementia panel, hypogonadism workup, hepatitis panel, etc.

ii. Can also use dropdown box at top to look at worksheet panels other providers have created.

c. Graphing: Select Twentytwo,Patient ( Lab ( Graph. While holding control button, click on cholesterol, LDL and HDL. Let go of the control button and uncheck the “individual Graphs checkbox” and set the date range to six months. Use select/define to save current items as a personal “view” ( Select/Define ( ( Click Double Arrow >> ( Save Personal ( “lipid graph”

4. Reports Tabs

a. Clinical reports and the ability to Sort Medications and see all medications used.

i. Select Twentytwo,Patient ( Reports ( Clinical Reports ( Pharmacy ( All outpatient – click headings at top to sort

ii. Select Twentytwo,Patient ( Reports ( Clinical Reports ( Pharmacy ( All IV – click headings at top to sort

iii. Select Twentytwo,Patient ( Reports ( Clinical Reports ( Pharmacy ( unit dose – click headings at top to sort

b. BCMA Logs

i. Select Twentytwo,Patient ( Reports ( Clinical Reports ( Med Admin Log OR can get some of the same information by double clicking a med in the meds tab (more on that later)

5. Orders tab

a. Using custom views to find specific orders (Select Twentytwo,Patient ( Orders ( View ( Custom Orders. Click on All on left and pharmacy ( intpatient medications. Could specify date range (leave as is)

b. Current order view vs. active order (View ( Active orders)

c. Using Auto-DC/Release Event (to find “lost” orders – i.e. observation patient past 24 hrs and readmitted, or transferred pt before delayed orders were written). Then using copy-to-new order to save time.

d. Alert when results

i. Useful if test ordered by someone else, but you also want to be notified (better than waiting for view alert to be forwarded to you).

ii. Existing labs: Select HgA1c in orders tab (under lab heading). Click on it and then go to the Action Menu ( Alert when results. Choose “provider, eight” and OK

iii. Newly ordered labs: Select Orders Tab ( Inpt Labs routine menu – order a chem. 7. Then choose Action( Alert when results. Choose “provider, eight”. Finally File ( Review sign changes (or right click and choose sign) and sign the order using your signature code VEHU##

e. Creating personal quick orders - must be done on the orders tab first.

i. Orders Tab ( Inpatient Medication ( Acetaminophen ( Double click – 650 mg q6h PRN. BEFORE hitting accept, go to options ( save as quick order. Name it something and press ok.

ii. Order tab ( Inpatient medications ( you’ll see the quick order you created. These are also available on the meds tab.

6. Meds Tab

a. Meds can be entered here and personal quick orders will also show up here.

b. Transfer to inpatient and outpatient – Click on a outpatient medication in the Meds tab and transfer to inpatient – hit accept. Vice-versa also true to copy to outpatient.

c. Double clicking an inpatient medication med order to see admin history

i. Nurses initials

ii. Dose given – and whether “G”-iven, “H”eld, and admin times.

7. Notes tab

a. Changing views

i. Using Custom View to view by category, location, (Notes Tab ( View ( Custom view – Group by : Title from the dropdown box)

ii. Going back to see all notes (Notes Tab ( View ( Signed notes all)

iii. Using Custom view to “highlight” notes from Clinic, etc. (Notes Tab ( View ( Custom view – At the bottom check “title” and type General Medicine in the free text box)

b. Authoring Notes

i. Change to date/time of the note (useful if this is a late entry to ensure it lines up correctly in notes tab or for “late entry” – don’t worry timestamp still shows when note really signed). (Notes Tab ( New Note ( Change date/time)

ii. Changing the author of the note. (Notes Tab ( New Note ( Change author to provider,eight)

c. Searching for keywords in all notes by (Right-clicking “all notes” header in left side, search for text – type “diabetes”).

d. Searching for keywords in a specific note. (Select general medicine note and right click on the edit box and find in select note – enter diabetes, press enter.)

e. Right-click while editing note to check spelling (Notes Tab ( New Note ( select a note title and press ok ( Right click in edit box to check spelling). Be sure to use lowercase letters as spellcheck doesn’t check UPPERCASE.

8. Templates

a. Options ( Edit templates – New template – name it something. Edit below and use CTRL-I to select a patient data object. For additional information on creating templates, refer to class 160H and 257H at VEHU.

b. Tools ( Export template ( save it to your desktop

c. Tools ( Import template ( It’s now added to your templates

9. Consults tab

a. Select Twentytwo,Patient ( Consults ( Action ( Consult Tracking and Add comment or resubmit

b. Clinical procedures available on this tab at some VA’s

10. Problems Tab

i. Clicking new problems will bring up “Problem Cateogories” – if not available at your VA, Inquire with your ITS dept (CAC’s).

Any questions?? Thanks for attending.

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