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Discussion

It's that time of year again!!!

Daylight savings!!! Who is ready for med schedules and hourly charting to get all jacked up?!? :wacky:

My hospital's entire internet network (including Epic) decided to crash unexpectedly, which should add a whole new level of crazy to this already interesting night...

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    Well, my EMR hasn't imploded so far.

    At least I'm getting an hour of OT thanks to the "fall back" :)

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    Well, my EMR hasn't imploded so far.

    At least I'm getting an hour of OT thanks to the "fall back" :)

    Kudos to that. Meanwhile, I'm trying to figure out how one gives an IV pain med at 1:45 and reassesses at 1:15, lol. Maybe next year I'll just try to avoid doing anything between the hours of 0100 and 0200.

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    • Experts
    Daylight savings!!!

    should add a whole new level of crazy to this already interesting night...

    attachment.php?attachmentid=23356&stc=1

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    • Experts
    Kudos to that. Meanwhile, I'm trying to figure out how one gives an IV pain med at 1:45 and reassesses at 1:15, lol. Maybe next year I'll just try to avoid doing anything between the hours of 0100 and 0200.

    I know...I had to rig a few things and some of the paperwork to accommodate this extra hour. Fortunately, no one wanted meds between 0100 PDT and 0200 PST :D

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    attachment.php?attachmentid=23357&stc=1
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    I don't know how, but I've avoided ever being in the hospital when the magical repeat of an hour occurs. I can say that I think my hospital does things weird with surgical timing- if we have a case that runs across that hour, we have to change our times for "proper time in OR billing". Instead of the patient leaving the OR at 0230, we document it as 0330. I get they want to get paid for the time in the OR, but why not put that on the shoulders of those responsible for billing rather than making the OR nurse document a false time and then write a note explaining the documentation of a false time?

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    I don't know how, but I've avoided ever being in the hospital when the magical repeat of an hour occurs. I can say that I think my hospital does things weird with surgical timing- if we have a case that runs across that hour, we have to change our times for "proper time in OR billing". Instead of the patient leaving the OR at 0230, we document it as 0330. I get they want to get paid for the time in the OR, but why not put that on the shoulders of those responsible for billing rather than making the OR nurse document a false time and then write a note explaining the documentation of a false time?

    I wouldn't even begin to know the "process" for documenting for cases the time changes during. I *think* if I remember right, we paper document or just document times for the entire case on the same "time" that the case started on (as in you chart as if the change didn't happen...don't jump forward or fall back). I think we still chart a note that says that the case spanned a time change...and that's how billing deals with it. I mean, think about what a mess transplant charting would be - if you account for the time change during the case you then, therefore could have a time for a procedure event before an event preceding it. :eek: :sarcastic: Or even not just transplants - get a patient in the room at 0145 and have time out or incision at 0115 (0215 if not for a change in time)...

    I've only ever worked over the "spring forward" time change. Even then, I was an assistant, and we were on paper charting. Watching the clocks (the wall clocks sped through all 60 minutes of the hour that gets skipped) was entertaining...

    Man am I glad that while I was on call this weekend, my call didn't start until 0700 Sunday.

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    • Experts

    Our EMR automatically attaches Daylight Savings or Standard Time to every entry. So when I had to chart at 0100 that night, it asked if it was 0100 PDT or 0100 PST. I had to chart a lot at both 0100s :D

    For any written documentation, I included PDT/PST behind the time for all entries that night, even if it wasn't charted at 0100. I only do that on the nights that the time changes.

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