MTW IT Service Desk

Step

Tips/notes

Note - Please refer to ‘Flowsheets – Key Points’ quick reference guide and/or video for more information on how to use and manage Flowsheets.

Flowsheets can be viewed by all staff with the appropriate access rights on Sunrise.

Note – If the Flowsheet needs to be Counter signed, which is the last section on the Flowsheet, please see separate Quick Reference Guide on ‘Counter Signing Documents and Flowsheets’

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From the ‘Tracking Boards’ tab, choose the adult ward from ‘Department’ list and select required patient.

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With the patient selected and displayed in the patient banner, select the Flowsheets tab

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With the Flowsheets tab open, in the Options Panel on the left-hand side of the screen, select the required Flowsheet from the ‘Flowsheet Selection’ area at the bottom. To add observations, select ‘FS Clinical Observations Adult’

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Check the Flowsheet Criteria at the top, ensuring the Chart Selection and Date Range are correct.

Note - ‘This Chart’ will automatically be selected and will show clinical observations only from the current attendance. Adjust the date range to suit your requirements

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The Flowsheet will be displayed in the main screen and the NEWS2 Parameter will automatically be open

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To add Clinical Observations for the patient, click on the ‘Add Time Column Options’ icon on the tab toolbar

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From the menu options, select ‘Add Single Time Column’

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Note - the Start Date and Time will default to the current time but can be amended if required. Click ‘Ok’

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The added time column will display

You can now record the set of Clinical Observations

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Note - the padlock icon on the column heading.

This shows you are currently entering data into that time column so the column is locked to other users until the flowsheet is saved.  This means that no-one can see the data you have just entered until it has been saved.

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At the top of the NEWS Parameter there are two coloured NEWS2 sections

Each colour represents the NEWS2 Scores from the data entered into the Clinical Observations cells. A score of 1 will show in the amber section whilst anything scoring 2 or 3 will show in the red section.

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Within the time column, click into each cell to start adding data, some cells will require manual input whilst others may have pop-ups for you to select your answer

Important Note – You need to answer the first question, ‘NEWS2 or Interim Obs?’ before entering any data

If NEWS2 is selected, the mandatory fields will highlight within the cells, showing a red square with an asterisk in, which must be completed in order for the NEWS2 score to calculate and to be able to save the Flowsheet time column.

If Interim Obs is selected, no mandatory fields are highlighted, just record what is required and save the Flowsheet.

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In the top right corner of the time column within the Clinical Observations section, an ‘r’ icon may display.

If you hover over the ‘r’ icon, it tells you to ‘Please consider completing a Neurological Assessment on the patient’.

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Once all the clinical observations are entered, this will allow the NEWS2 score underneath to automatically calculate and a message will appear. Click ‘OK’

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The coloured NEWS2 sections at the top will then auto-populate

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The flowsheet contains many data collection and assessment parameters, or sections, that can be used as required. Open each parameter by clicking the ‘+’ icon

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Note – If you use the Stool Chart parameter, there is a link to the Bristol Stool Chart, through the Tools menu at the top of the screen

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Note – For the Point of Care Testing parameter, please see separate Quick Reference Guide

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Remember you do not need to fill in every cell, in every parameter, in every column, it all depends what needs to be recorded

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Some parameters have been omitted from the default view but can be added if required.

Either click on the ‘Row Actions’ icon from the tab toolbar and select ‘Add Parameter’

Or right click on the main column heading and choose ‘Add Parameter’ from the menu options

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The Add Parameter screen will display

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Click the ‘+’ icon from the catalogues listed, to select the parameter you require. Once selected, click on the ‘Add’ button to move it across to the right-hand side

Then click ‘Ok’

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The added parameter will be displayed at the bottom of the flowsheet

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Note - with the additional parameter added make sure you are inputting the data into the correct date & time column heading, not past columns which are shaded out.

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Once all data required is entered on the Flowsheet, click the ‘Save’ button, in the top right corner of the Flowsheet to update the results for that time column

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Note – An Alert Detail pop-up may appear, depending on the NEWS2 score calculated. Please read through and choose an Acknowledgement Comment, then click ‘Proceed’

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Important Note – if you decided not to save the clinical observations or other entries and moved away from the flowsheets tab within the same patient to input other details, the clinical observations will still be there. However if you move away from this screen to another patient, a message will appear that entries will be lost unless you return and save.

If you click ‘Delete’ on the message, the clinical observations just entered will be lost, so the correct option should be ‘Return’ and then ‘Save’.

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On the ‘Tracking Boards’ tab, click the ‘Refresh’ icon from the main toolbar to review the most updated information that has been completed on the Flowsheets for the patient in context

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Vital Signs Column

The Vital Signs icon will display

The ‘Vital Signs’ icon with a green symbol shows that the patient’s test results are at normal levels.

The ‘Vital Signs’ icon with a red symbol shows that the patient’s test results have abnormal levels.

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To acknowledge the Vital Signs, hover over the Vital Signs icon for the patient in context. A pop-up tool tip will appear with a green header. Review the vital signs and click on ‘Acknowledge Vital Signs’ button

Note – If you hover over another patient’s vital signs icon, you will get an alert symbol and red header, to notify you that you are not reviewing the vital signs for the patient in context

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Once you have acknowledged the vital signs, the symbol within the vital signs icon on the tracking board will have disappeared

Note - When the next set of Clinical Observations are taken, the symbols will populate on the vital signs icon, ready for you to review and acknowledge

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NEWS2 Column

The NEWS2 Score will populate in the NEWS2 Column on the tracking board, with different colours representing the level of escalation (Red is a score of 5 and above, Amber is a score between 1-4 and Green is a score of 0)

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Special Observations Column

For more information, please refer to the separate quick reference guide and/or video for ‘IP Special Observations Orders’

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NEWS2 Frequency Column

The NEWS2 Frequency column on the tracking board will display the Observations Frequency Timer – a countdown timer identifying the amount of time required before the next set of clinical observations need to be taken.

Note – The frequency shown on the timer will depend on the NEWS2 score.

Once the clinical observations are drawing closer, the cell will turn Green

When the clinical observations are overdue the timer will go into a negative and the cell will turn red

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This table shows the timing for the Adult Wards NEWS2 Frequency Column

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NEWS2 Comments Column

To add a comment for the NEWS2, click into the cell first then double click and a dropdown box will appear. Select the pre-defined comment you require from the list