Hi there! There are some questions I have about EPIC and acknowledging orders.
If the patient came to the floors at say 4pm, but an EKG was ordered at 1pm, but the ER nurse never acknowledged it, who has to do it?
The nurses on the floor are saying since the order was written while the pt was in the ER during that time, the ER nurse should do.
Another disagreement happens during shift change. Our doctors will round and write order between 0630 and 0700. My shift ends at 0645. I do not acknowledge orders because then I would have to carry them out, right? I would also be responsible if an order is wrong or inappropriate.
I've gotten into a few arguments about this with day shift nurses. They are saying since it occurred when I was there, I should acknowledge them.
One solution is to use the "Phase of Care" feature. Orders are written for specific areas and procedures. The orders are placed in the "Signed and Held" tab on the order screen. The orders are release when the patient arrives on the unit. Most nurses pick this up fast. Occasionally, someone releases the wrong order set and that created chaos. I think our facility was not planning to use "Phase of Care" but I am glad decided to use it.
We taught staff to acknowledge orders right away (although by policy they have 4 hours). This means reviewing them BEFORE releasing them. Invalid orders should be left on hold and brought to the attention of the provider.
The "Brain" feature keeps track of things that need doing so acknowledging isn't a problem like it was.
Yes but the doctor writes the order at 0650 and my shift ends at 0645. Technically, my shift is done and I don't look at the orders at that time. Im usually finishing up on my notes. Am shift is supposed to be here at 0645 and getting report from 0645 until 0715. Technically I don't leave until 0715
Pt care is 24/7, orders are to carry on and rendered to next shift. If the order was placed early enough at the ER, it should be done at the ER. If the order was placed at the end of your shift it passes on to next shift
Specializes in ED & Critical Care CEN, TCRN, CCRN, CFRN, CTRN.
EKGs are usually stat! If ordered at 1pm and now 4pm, chances are it was cancelled or ordered by accident. EKGs are a big deal. Trust me, ED docs expect them to be done fast (under 10 min). We (ED RNs) don't release admission orders, unless we are boarding them for an extended period of time. Admission orders are usually placed early.
Sorry, but just acknowledge that darn orders! They can be discussed in report. Unless it is something that needs to be done STAT, it doesn't matter who acknowledges them. alot of times, there are orders for urine tests in the ED, but the pt doesn't void, it has to continue to the floor. If a pt needs an EKG, acknowledge the order and then the techs can find the pt.
Not sure why this is an issue.
It is an issue because where I work nurses do the EKG, blood draws, start our own IV, etc. There is one CNA for 20 tele patients. We don't have ancillary staff like others do. There is no tele tech. There is no pharmacy in the building from 10pm to 8am. We have to call an overnight pharmacy to verify medications.
On thing we were taught about acknowledging orders is that "the nurse saw the order and will carry it out." In other words, like signing a check to pay for something. But as mentioned, the work list has taken some of the fear out of acknowledging orders.
chrisf92262
5 Posts
One solution is to use the "Phase of Care" feature. Orders are written for specific areas and procedures. The orders are placed in the "Signed and Held" tab on the order screen. The orders are release when the patient arrives on the unit. Most nurses pick this up fast. Occasionally, someone releases the wrong order set and that created chaos. I think our facility was not planning to use "Phase of Care" but I am glad decided to use it.
We taught staff to acknowledge orders right away (although by policy they have 4 hours). This means reviewing them BEFORE releasing them. Invalid orders should be left on hold and brought to the attention of the provider.
The "Brain" feature keeps track of things that need doing so acknowledging isn't a problem like it was.