Scenario 1: Patient with C



VISN 15 Vendor Oral Presentation ScopeAnesthesia Record Keeper plus PreOperative ScriptVendor _____________________ Evaluator __________________ Scenario: Patient post-op from scheduled Femoral Artery Stent Placement. Patient is to be recovered in the ICU overnight. The patient received antibiotics in the OR. DOB: August 24, 1975Gender: MAllergies: PCNCode Status: Full CodeReligious Preference: CatholicInstructions for VISN 15 Source Selection Team Members: The script evaluation scale to be used is as follows: 0 = Does not meet script requirement, 1= Meets script requirement, 2= exceeds script requirement, 3= substantially exceeds requirement. The category for each line item is identified by the non- shaded area where the score will be recorded. Please use the comments section to list any short comings and or strengths of the performed script. ActivityApplicationEnterpriseTechnicalComments1234Demonstrate the ability to easily connect to external medical devices such as anesthesia machines, IV pumps, cardiac monitors, hemodynamic monitors, ventilators, balloon pumps, CVVHD, pulse oximeter. Demonstrate when data collection begins ie: when connected to external device, when patient selected or when told to begin collection by user. Demonstrate the ability to display the record in accordance with 508 compliance.Demonstrate the ability of the ARK device to include input capabilities from Bar-Code Readers, swipe card readers and/or RFID.Show the pre-built flow sheet elements that are provided with the software purchase. 567891011121314151617181920212223Demonstrate user log-in into the system using Access/Verify. Demonstrate selection of patient and verification of correct patient and procedure. Demonstrate review of DOB, SSN, and general biographic information. Demonstrate how you would reconcile a patient’s profile started without an ADT admission who then gets admitted. Demonstrate the manual entry of a patient when the ARK is not connected to the network.Demonstrate how height and weight are recorded (demonstrate the ability to display in metric units: cm/kg), religious preference, code status, admitting diagnoses, scheduled procedure, health care surrogateDemonstrate the ability to document multiple vital signs ie: arterial BP as well as NIBP or cuff BP.Demonstrate the entry of allergies such as PCN Anaphylaxis within last year, Tylenol Unknown >1 year ago and ASA GI distress >1 year ago, blood type/negative antibodies. Is the entry of allergies into the ARK system bi-directional ie: Are allergies pulled from CPRS into the ARK and if placed into the ARK do they populate the allergy section in CPRS?Demonstrate documentation of anesthesia concerns, e.g. anticipated difficult intubation, risk of aspiration, and recent MI Demonstrate the documentation of special procedures or events such as Swan-Ganz , A-line insertion, medication interactions or bronchospasm. Demonstrate the documentation of Demonstrate your procedure for documenting patient care events prior to room entry such as: anesthesia machine checked, drug availability, airway equipment etc. and customize additional fields as needed.Demonstrate documentation of: ASA status, airway exam, cardiac risk assessment, NPO, informed surgical consent, informed anesthesia consent, blood availability, focused physical exam, correct procedure and correct laterality, site marked, as well as customization of additional fields. Demonstrate the ability to view various assessment elements such as cardiac, neurologic, procedures etc, in a tabbed browsing form or equivalentDemonstrate the collection of I&O information including, IV fluids, blood products, PO, IV drips, parenteral fluid, enteral fluids, as well as the ability to provide continuous shift, 24 hour and LOS totals. Demonstrate how the totals could be reset to start from zero.Demonstrate documentation of anesthesia/drug administration including selection of drug dose and time as well total medication as well as edit drug selection, dose and timing. Demonstrate documentation of IV administration including selection of drug dose and time as well total medication volume infused within the Intake and Output record. Edit drug selection, dose and timing. Also demonstrate how to add a new medication to the system. Demonstrate how the system alerts the user to repeat administration of antibiotics (1 and 3 hour) Demonstrate documentation of universal protocol/ procedural time out.Demonstrate the documentation of an emergency event such as cardiac arrest or death in the OR. Show how the user would add details and narratives after the event is completed. Describe or demonstrate addition of new compliance rules and how documented.2425Demonstrate how laboratory information is viewed. Demonstrate the documentation of blood verification and administration. 26272829Demonstrate the ability for multiple users to document information, and also demonstrate how to edit information entered Demonstrate how you would limit functions by user. (ie: Nursing, Physicians, Respiratory Therapy)Demonstrate the ability to capture and store multi-disciplinary service care. Please demonstrate if your system allows for multiple user log on.30 minutes into the procedure, the anesthesia provider realizes that data is not being recorded. Describe/demonstrate the recovery procedure. 30313233343536Demonstrate the ability to customize the patient flow sheet. Demonstrate process for constructing additional templates, e.g. risk assessment for post-operative nausea and vomiting and cardiac risk assessment?Demonstrate how the user controls the volume of data displayed (e.g. filters), as well as the format of display (numerical vs.graphic).Demonstrate the ability to customize the patient flow sheet once the ARK is in clinical use.Demonstrate the ability to view various sections on the screen simultaneously such as vital signs, vaso-active drips and I&O at the same time. Demonstrate the ability to display and store cardiac and hemodynamic waveforms within the system. Demonstrate how these waveforms can be imported as part of the patient record. Show how data is trended graphically, and how data can be viewed in real time and in selected hour increments (ie: Q4H, Q8H) Demonstrate documentation of compliance with payor rules, e.g. Anesthesiologist presence37383940414243Demonstrate selection of methods of anesthesia and environment (moderate sedation, regional anesthesia, LMA, intubation). Demonstrate the ability to document standard events during the induction of anesthesia such as pre-oxygenation, mask ventilation, and intubationDemonstrate the documentation of specific events associated with: Performance of spinal anesthesia, Insertion of an LMA and IntubationDemonstrate documentation of a difficult intubation Demonstrate workflow and documentation of conversion from regional anesthesia to LMA to general anesthesia with intubationDemonstrate documentation of skin incision Demonstrate the documentation of the patient’s emergence from anesthesia, extubation and egress.44454647Demonstrate how a user would be able to view the ARK record without accessing CPRS. Is this data viewable in real time when accessed remotely?Demonstrate any remote view capabilities. Does the system allow for multiple users to remotely view the record at the same time? Is this data viewable in real time? Can mandatory documentation be required prior to closure of record? Is there a mechanism to override? 484950Demonstrate how the system alerts users of abnormal values and critical lab values. Demonstrate how is the user required to address alerts such as extremity cuff and vascular cross clamps. Is there a timer function to alert the user of time and limits of cross clamps, or out-of-range parameters, BP and lab valuesDemonstrate documentation of patient position and edit of position, and recurring checks of patient position and pressure points5152535455565758596061626364Demonstrate the collection of data elements.Explain how data is collected and stored. Is it stored on a server or locally on the individual PC?Demonstrate how the data is verified, and can the system compute provider concurrency in real time? Demonstrate edit of artifacts. Demonstrate how to edit previously saved information.Demonstrate edit of staff identification in case of erroneous entry or staff changes.Demonstrate printout options and capabilities. Can the anesthesia record be previewed prior to printing without changing the anesthesia environment?Can recovery room staff preview the anesthesia record prior to admission to the PACU?Show the frequency the data is collected and, demonstrate the ability to change frequency “on the fly”. Demonstrate how a coordinator would have the ability to add fields to the flow sheets remotely and can these fields be calculated variables?Explain how long collected information is available, for example does this information reside in a buffer that can be accessed after the information is uploaded to CPRS?Explain how long the data is stored. Demonstrate how to audit the data trail. Is this information editable, and for how long? 6566676869707172737475767778Demonstrate how application software is updated. Can this be pushed to the PCs? Or does it have to be loaded on each individual device?Demonstrate how the record is placed into CPRS, is the record editable after it has been sent, and how long does it remain editable before the document is permanently closed/locked?Demonstrate how the system would collect data in the event of a network failure.Demonstrate the different ways in which physiologic data can be viewed in both numeric and graphical format. What reference materials or cognitive aids are included in your product?Does the system require network access for case startup and closure? If not, what happens in the event of a system lockup? A transient power failure?Describe how the system responds to a mid-procedure network failure? To a mid-procedure power failure? To a mid-procedure workstation failure?Will a server hard drive failure corrupt the system database?Will a workstation hard drive failure lead to loss of data?How many other VA sites have you installed this software?Has your system ever lost data due to a workstation/network failure?Have other sites had unexplained failures? Were they hardware, software or network related? Other causes? Has your system ever been un-installed from a facility? Can icons be added e.g. to a toolbar to display reference materials updated from a central location, e.g. phone lists, call schedules, antibiotic and other drug information and administration protocols, and management of emergencies such as transfusion reactions, malignant hyperthermia, ACLS protocols, etc. ................
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