ieMR Quick Reference Guide Insulin Administration ... · Insulin Admin – Subcut Carb Counting...
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ieMR Quick Reference Guide Insulin Administration – Subcutaneous Carb Counting Paediatric PowerPlan - Nursing Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019 Townsville Hospital and Health Service Page 1 Review Orders 1. Navigate to the Orders tab to view the PowerPlan and associated orders. 2. The PowerPlan will contain Patient Cares, Medications, Consults and Referrals. Document BGL 1. Select the BGL Monitoring task from CareCompass. This will take you to Activity View. 2. Navigate to the Document button at the bottom of the screen. 3. Document the patient’s BGL in the Blood Glucose Capillary data cell. 4. Select the green tick to verify and sign. Note: You can click on the blue hyperlink to see the reference text. Document Carbohydrate Intake 1. Navigate to Paediatric Systems Assessment in Interactive View 2. Select the Activities of Daily Living sub- heading and scroll down to the Nutrition section QGEA-PUBLIC
Transcript of ieMR Quick Reference Guide Insulin Administration ... · Insulin Admin – Subcut Carb Counting...
ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 1
Review Orders
1. Navigate to the Orders tab to view the PowerPlan and associated orders.
2. The PowerPlan will contain Patient Cares, Medications, Consults and Referrals.
Document BGL
1. Select the BGL Monitoring task from CareCompass. This will take you to Activity
View.
2. Navigate to the Document button at the bottom of the screen.
3. Document the patient’s BGL in the Blood Glucose Capillary data cell.
4. Select the green tick to verify and sign.
Note: You can click on the blue hyperlink to see the reference text.
Document Carbohydrate Intake
1. Navigate to Paediatric Systems Assessment in Interactive View
2. Select the Activities of Daily Living sub- heading and scroll down to the Nutrition
section
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ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 2
3. Double click the cell beside Meal and choose the matching selection i.e. Breakfast
4. Document the carbohydrate intake in the Total Carbohydrate cell
Obtain Phone Order for Insulin Dose
1. Review the insulin order and insulin subcutaneous dose check order on the MAR.
Note: To view the PowerPlan orders easily, select Plan View on the MAR.
2. Hover over the orders to view any special instructions. This includes reviewing the carbohydrate to insulin ratio and correct factor that is required for the patient according to their BSL. The two nurses will manually calculate the required amount of the insulin
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ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 3
3. Call Medical Officer (MO) to obtain/ verify the correct insulin dose to be
administered.
4. Navigate between iView and MAR to provide relevant information (BGL, Total
Carbohydrate) to inform dose confirmation.
5. You will need a nurse witness to verify as per phone order process. The doctor will
use the information documented in the Comments field, in addition to the patient’s
BGL and intended carbohydrate intake (and clinical judgement) to prescribe a dose.
At the bedside with your nurse witness:
6. Navigate to the Medication Wizard.
7. Perform PPID and barcode scanning.
8. Select the check box beside the insulin order and click the Result column.
9. An alert will fire indicating that the nurse must refer to the Order Comments for
dosing instructions – select OK to open the Administration Window.
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ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 4
10. Once the administration window is open review the order comments by right clicking
on the blue order heading and selecting Order Info.
11. Select the Comments tab to review the specific instructions.
12. Select the blue door icon to exit the Order Info window and return to the
administration window.
Enter the following details in the administration window:
• If a BGL has been documented in iView within the previous 30 minutes, select
the Acknowledge checkbox to acknowledge this value.
• Document the prescribed dose in the Insulin dose field, e.g. 2 units. *Also
document in this field if dose is administered by the child or parent.
13. Enter your nurse witness details.
14. Select Comment tab to document the name of the prescriber and select OK.
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ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 5
15. Nurse witness to enter password and select OK.
16. Primary nurse to select Sign on the MAW. Navigate to MAR and refresh screen QGEA-PUBLIC
ieMR Quick Reference Guide
Insulin Administration – Subcutaneous Carb
Counting Paediatric PowerPlan - Nursing
Insulin Admin – Subcut Carb Counting Paeds PowerPlan - Nurse, V1.0, MA016, 28/08/2019
Townsville Hospital and Health Service Page 6
17. Navigate to the Diabetes-Endocrine iView band to view the documented
information.
DO NOT GIVE RAPID ACTING INSULIN MORE REQUENTLY THAN 2 HOURLY
Insulin may not be required for carbohydrates (CHO) less than 15grams at snack
times. Contact MO for insulin requirement advice if:
• BGL is outside target range (greater than 15mmol)
• Ketones greater than 0.6mmol and/or
• Child plans to eat more carbohydrate than documented carb ratio for snacks.
18. If the child does not have a snack/supper/meal or they have a snack/supper/meal that contains less carbohydrates than the documented carbohydrate ratio for that time and no insulin is required, navigate to the MAW, click not given and add Comment (i.e. low carbohydrate content)
Standard practice will be to treat mild hypoglycaemia with hypo packs from the ward (i.e. juice popper and biscuits)
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