Published Oct 14, 2009
jjjoy, LPN
2,801 Posts
Hi there! I've got a question for those who work with a system like MacLab in their cath lab.
How do you use the Event Log? For what? Certain time-stamp items need to be entered (eg, pt arrives, MD arrives, case start, case end), but what about the rest of the info recorded there?
The reason I ask is that our lab's Event Log is incredibly long recording the procedure step-by-step (though not always exactly consistent with the eventual dictation) and ends up being 3-4 pages long all by itself.
Maybe we shouldn't even include the Event Log in the printed report (goes into patient's med record) and use a different MacLab function if pieces of that info need to go into the patient's medical record.
Anyone into this at all??
dianah, ASN
8 Articles; 4,503 Posts
We use the MacLab but print out two reports.
One is the RN documentation, which contains all the VS and all the elements that fulfill the Moderate Sedation policy requirements for our facility.
A copy of this goes into the pt's chart, and one is sent for scanning into the electronic chart.
Runs 4 pages long.
The other is the Event Log (RHC, LHC, Device Implant, etc), which is printed out for the Cardiologist's reference for his documentation.
This does not go into the chart.
Runs 7-9 or more pages, with pressure tracings etc.
Thanks for sharing!!! First off, I love the idea of not including the Event Log in the med record, and actually only including a few sections to keep it relatively short and relevant. I'll have to ask around if we can split the report similarly to yours. : )
How about meds used? How are they signed off? Our report includes the meds administered during the case (time, dosage, who administered it, etc). The physician signs off on the printed list at the end of the case.
Thanks again for sharing!! : )
Report includes meds given: time, dosage, route,who gave, and MD who ordered.
MD and RN sign the chart copy of the RN Report (the Moderate Sedation record).