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SEIMENS MAK

Medication Administration Check

Always keep your screen protected

from view

To lock screen use the windows key + L

to unlock use ctrl + alt + del password

is nursing

Fair

Warning

DECREASES MED ERRORS ۞ eliminates errors by ensuring the „five rights‟ of medication administration:

right patient, right drug, right time, right dose, and right route.

۞ eases concerns nurses have of making a medication error.

DECREASES UNCHARTED OCCURRENCES ۞ reminds the user that these still need to be charted.

IMPROVES ACCURACY OF CHARTING ۞ flags the user if charting on the wrong occurrence and will not allow

charting data

PROVIDES NURSING WITH ON-LINE DRUG

INFORMATION

MAK – Medication Administration Check System

(Vbradford) NURTEST3

WELCOME ***********

Forget your

badge? Type in your

ID number here

ENTER 9 0‟S BEFORE

YOUR NUMBER IF YOU

HAVE A 105 NUMBER.

0000000001053434 Scan your

badge here

Keep your screen

where you can

view it when

scanning the pt.‟s

armband

VIRGINIA W BRADFORD RN 2E

CENSUS ICON

Place the mouse curser over the

icon to display it‟s meaning

Moves to the next patient

Clinical Alert symbol

Log off

with 1

click

SEARCH

ICON

Headings at top

This is your navigator.

We will be using 3 items here.

1.Chart Select patient by census

2. Chart emergency override

3. Vaccination information statement link

Select Location Census and select the floor

Finding Patients Search

button

Personal Census

Use you Control button on your

keyboard to select the patients from

the Location Census to create your

personal census and use the Add to

Personal button.

Cancel the

screen and click

on OK

Open the search

icon to view

your newly

created Personal

Census

After selecting your floor or personal census using the

Select All button allows you to navigate between patients.

To open your

medications click

on

“Chart – Select

Patient by

Census”

Close will close your patient‟s screen

Quick Review of the Tabs across the top

Med Summary lists all current, active medication orders (white) as

well as medications that have been discontinued (yellow high

lighted meds) in the past 24 hours. Unverified medication orders

cannot be charted. Medications need verification only once.

MED SUMMARY:

All new medication orders automatically display in the MED

SUMMARY folder. New orders are noted by the red pen-tip icon.

White background are active

medications.

Yellow are discontinued

A verbal order taken by

the nurse shows as a

check with 2 pills.

Verbal orders

CPOE (Computerized Physician's Order Entry) orders can be

verified by using OAW (Order As Written) tab.

CPOE Medications that need to

be verified will have the Red

Pencil and also an additional red

symbol in the column to the left

of the pencil.

Active Worklist displays a list of current, active, uncharted

medication orders. Uncharted meds show for 24 hours. Unverified

orders also display here but cannot be given until the verification is

done. Medications are dispensed in the Active Worklist and

verification of meds can also take place here.

Regularly scheduled meds are located on the

top.

PRN‟s are located on the bottom.

Peach colored indicates the

medication is late

Active

Worklist

Clicking on the headings will rearrange the medications

according to that heading.

Time arranges your medications in order of administered time.

Route arranges by IV OR PO, drug name in order alphabetically.

height, Weight, age, Ideal Body

weight, and Body Surface Area.

Demographics

Diagnosis

The most recent lab results are available.

Not all lab work will be listed here.

Only those labs important to the pharmacy.

Lab Results

Allergies

Med Summary

the verification process occurs

The life time cumulative dose

is tracked for selective

drugs. Pneumovax &

influenza.

Interventions

Add an intervention or

e-mail the pharmacy

with a problem

Interventions To search for the correct drug - Enter at least 3

letters into the drug name.

Interventions

Charted List – 1. View the Administered medications under this tab.

2. Adjust the begin / End Dates and times.

2. Revise times and mandatory fields.

3. View History and details.

Charted List

Expand list changes

the time frame to view

several days of

medications.

Located under

Charted list &

Active Worklist

Opens a

calendar

RED PEN - The order requires verification against the physician‟s

written order.

QUESTION MARK - The nurse has sent an RX Message to

Pharmacy to clarify an order.

BLACK PEN -The pharmacy reviewed the order sent by nursing via RX

MESSAGE and has reset the order for nurse verification.

BLUE PEN - The medication to be administered requires a nurse co-

signature. (pediatric IV medications in MAK)

TRIANGLE- More information is available for display – click on the

triangle to open or close the information display.

YELLOW CROSS -Indicates the occurrence was entered by using Chart –

Emergency Over-ride.

YELLOW CAUTION SYMBOL - warning; a need to look at data it is attached

to. You will see this on the „Interventions‟ tab when there are open

interventions and on the „Lab results‟ tab when there are abnormal lab results.

RED STAR – A reminder to follow up within 1 – 2 hours

HISTORY - Indicates there is a history to the charting of the medication.

Click on the and the charting history will display.

1. Pain medication requires effectiveness to be charted

2. The IVF requires an end time to be charted.

3. Influenza & Pneumococcal Vaccinations require follow up using

the comment box “No adverse reaction noted” or free test any

signs or symptoms of a reaction.

4. Follow up on PRN antipsychotics and anti anxiety within one

hour.

Blue Bell - Scheduled Reminder or action required for

Vaccinations and for IV stop times.

zyprexa-

Haldol -

thorazine-

geodon-

risperdal-

seroquel-

ativan-

valium-

xanax

librium

Phenobarbital-

cogentin-

The Green Check next to a drug shaded in green indicates the correct drug

has been scanned.

The Yellow Triangle next to a drug occurrence on the

„Active Worklist‟ indicates the barcode scan over ride was used.

The Red “X” next to the drug shaded in red indicates either the wrong

drug has been scanned, or you have scanned a drug too far past the

ordered administration time.

Medications highlighted in pink are uncharted, past due medication occurrences.

The “N/A” with the drug shaded in blue on the „Active Worklist‟ indicates

this drug has been charted as Not Administered.

When an entire medication order is highlighted in GREEN OR YELLOW

, this indicates the order has been discontinued

TRIANGLE OR CAROTS

Indicates more information is available for display – click on

the triangle to open or close the information display.

sliding scale

QUESTION MARK The nurse has sent an RX Message or intervention to Pharmacy to clarify

an order. The order can not be verified until the pharmacy responds with

a black pencil. Once the order appears with a red or black pen tip icon

in front, it is ready to verify and administer.

BLUE Pen - The medication requires a nurse co-signature

BLACK PEN – Pharmacy has verified the medication in question

Drugs include:

Insulin

Pediatric IV IM

TPN

K+

Pitocin

High Alert Medications • Requires 2 licensed nurses check medication together

with initiation of medication, bag change and change of

shift or level of care.

• Includes:

– Insulin

– Heparin IV

– Weight based Lovenox

– Pediatric medications

– Critical Care Drips including Electrolyte infusions

Drugs requiring a 2nd nurse to scan badge include:

Insulin

Pediatric IV IM

TPN

K+

Pitocin

YELLOW CAUTION SYMBOL - warning; a need to

look at data it is attached to. You will see this on the

„Interventions‟ tab when there are open interventions and on

the „Lab results‟ tab when there are abnormal lab results.

This will also occur when you over ride a medication. The 5

rights have not been checked.

YELLOW CROSS Indicates the occurrence was entered by using Chart – Emergency Over-

ride.

Find Hytone cream

Double click on it on medication or highlight

drug and click on Detail.

Drug information

opens more

information on your

drug

ENGLISH

ENGLISH

Drug information

provides more

information on your

drug

Can be printed

(REPORT) off for

the patient

Questioning Hytone cream After double clicking on it, click on

Intervention to create a message to

pharmacy.

Use the drop down boxes to

find your problem when

sending an intervention and

SAVE or send it to the

pharmacy.

Indicates the order requires verification against the physician‟s

written order. Verification occurs only once until the order is changed.

RED PEN

Verification is the MOST important process in MAK.

If you don’t take the time to check everything in MAK to the doctor’s orders in the chart,

medication errors will occur every time that medication is due until someone picks up that chart

to check it.

You must check all five rights at this time. Right drug, Right

patient, Right dose, Right time, Right route

This Order is a verbal order

(telephone order) taken by the

nurse as seen by the Icon with a

check and 2 pills.

Verbal orders or

telephone orders

Reminder, Verification only is done ONCE

Verify All - will automatically open all of your meds

one at a time.

All medications with red pens will be highlighted.

After comparing the original order on the chart to the

above information and finding that everything is correct,

the five rights are verified, click on the verify button.

Blue (now purple) indicates this is a free text by the

physician. This order happens to be in a Pre-Heart

Cath order set which is a suspended order – (on

HOLD)

Go Ahead and Verify your Meds

Using the Verify All at the bottom of

the screen.

Rx Message

Located on the Active

Worklist tab –

does not keep written track

of your correspondences. It

can be used to let

pharmacy know the rate of

your IV fluid.

2 tablets ordered and

require the scanning of

both tablets. Black

requires the second scan.

Cut the Lanoxin tablet in half

Administering Medications

ACTIVE WORKLIST: Highlight the drug to be

administered & scan the barcode on the medication

package.

Click on ID Patient

& scan the

armband


The screen changes at the top to allow the nurse

to document: Vital Signs & Site location, Blood Sugar, Pain

Assessment , Cream colored indicates the field is mandatory if certain

drugs are being administered such as insulin or demeral.


Note the mandatory fields must be filled

in before charting


Once they are filled in, the nurse can chart

77 7 102


77 7 102

Green highlighted medications with a check in front

indicates the medication is correct and ready to be given


The Red “X” red highlighted drug indicates the wrong

drug has been scanned, or you have scanned a drug

too far past the ordered administration time, giving you

a warning box

Medicare REQUIREMENT FOR REIMBURSEMENT

After IV Medication is “verified” – the following message appears -

IV Stop Time All IV‟s & Piggybacks

require a stop time

Find your Normal Saline from your active

worklist & Administer it.

The blue bell shows up to remind the nurse there is

an IV that the stop time needs to be documented.

In the charted list, right click on the IV and select Document Outpatient

Infusion End Date/Time.

The pop up box defaults to now, but is easily change by clicking the

calendar icon next to the date/time.

The last step is to remove the reminder. Back under the Active Worklist,

click the blue bell and click complete.

If you forget how to do this, you can follow

the instructions written in the reminder.

You can always revise or edit the stop time if needed. Go to the charted list tab

and select the IV that needs documentation and click REVISE. Click the

calendar next to the OP Infusion End D/T. It will default to now, but you can

easily edit it.

1. Scan Medication

2. Scan your

patient‟s armband

TRANSDERM SCOP

3. Use drop down box to place in a

location.

4. Chart the medication.

Enter the lot number, exp. Date & manufacturer

Then click on ID patient & scan the armband.

Scan your Pneumovax vaccine

The VIS # will autopopulate,so it will not have to be entered by the nurse but

is editable if needed..

Mandatory areas: Administration site and Chart reason

Which is the VIS DATE found on the VIS form

4/24/15

Vaccination

Information

Statement Link

connects to the

nursing website

where the VIS link

is chosen.

Copy and paste the VIS

date into the chart reason

window

All mandatory fields must

be filled in before the

information is sent to

GRITS

Revise from the Charted list

Find the RED STAR and

chart effectiveness

Over Riding the barcode for the

medication and the patient‟s

arm band for Remove Patch

Highlight the medication to be over-ridden to click

on the barcode or open the detail box to click on

the barcode.

Highlight & double click on

Remove patch; click the

barcode to over ride

I removed Patch

Type in a reason for

over-riding

IV has no bar code

Type in a reason for over-riding

Over-riding the bar code

Click on the bar code with your mouse.

This drug has 2 tabs.

Over-riding the bar code

Overriding the patient‟s armband

requires a reason.

Barcode torn

OVER RIDE ARM BAND

Scan Digoxin

Scan your patient‟s armband

Fill in a pulse (77)

Chart the medication.

Revise the time of Digoxin to 8AM

Revising a medication


Highlight the

medication in

your charted list

and click on

Revise


Correct the error (time)


Place in a reason for the revision

and Chart


Now the medication has an Hx or

history attached to it

Highlight the med. & right click to unmark an

occurrence such as an NA or an over-ride

Unmark occurrence

1. N/A or not administer the Synthroid in the active work

list by highlighting the medication and click on the

icon

2. Administer it from the charted list

No scanning needed

Choose a reason

use Patient off floor

Not Administer

77 7 102

Not Administered

And CHART

Not Administered

Administered

Highlight the medication with the N/A status under the

Charted list and scan the medication and the pt‟s arm band

then chart it.

Not Administered

Administered

The Medication has a history Hx. Highlight the

occurrence and click on detail to get more explanations

MAK - Changes

Chart - Emergency Override by Census

The wording under Navigator “Chart-

pharmacy review pending by Census” will

be changed to “Chart- Emergency Override

by Census” This change should make it

easier to understand the function. This is

how the nurses are to administer stat

medications that are not profiled yet, or

meds that were held for a

treatment/procedure and are past the

allowed administration time.

Emergency Override –

Administering a medication prior

to pharmacy profiling it.

Emergency Over-ride

• When administering blood, the 500cc bag

of Normal Saline will need to be over-road.

• The medication will be charged to the

patient through MAK.

• If a patient needs a pain medication and

the pharmacy has not profiled it into MAK,

the nurse will need to use the emergency

over-ride in MAK.

• Narcotics removed from the Omni-cell

need to match up in MAK.

After administration is complete, the system creates a

follow-up reminder placing the medication on the active

worklist. The red star reminds the nurse to assess pain 1

– 2 hours after pain medication was administered.

Assess pain

Clicking on the red star prompts the nurse to chart the

effectiveness and pain assessment of the medication.

Assess pain

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