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General
Q:
Can I put the database on my network?
A: You'll have to ask your network administrator if they'll allow you to put it on the network. If they will, you certainly can put it in a shared file, however more than one person cannot enter data at the same time. Q: The database won't load. It says unrecognizable format. A: The
version of the database you must use depends on which version of Access
you have on your machine. If you have Access 97, you need to use the Pain
QI Database 1997. If you have Access 2000, you need to use the Pain QI
Database 2000. There is NO difference in content, each is just formatted
for a specific version of Access.
Q: How do I import the data from my old database into the new version? Q: I've loaded the database and now I can't enter data because it says the database is Read-Only. A: Instructions
were included with the CD on how to make the database not Read-Only. Here's
a repeat of those instructions:
ATTENTION:
The
database as it appears on the CD is Read-Only. In order to make it accessible
for data entry and reporting, you MUST copy it onto your hard drive
using the following steps.
1. Open the CD ROM and find the database in the Database folder. 2. Drag the icon of the database you will be using, either 1997 (Pain QI Database 1997) or 2000 (Pain QI Database) to your desktop or to the folder in which you wish it to be located. 3. Wait for the file to copy. This may take a few minutes. 4. Right click on the database icon that you have copied to your computer. 5. A menu should pop up; choose Properties from this menu. 6. In the Properties screen that appears, uncheck the Read Only box at the bottom. You
are now free to enter data, create reports, and make changes to the database.
Q: I'd like to change the
number fields so that they accept decimal places. How do I do that?
A: Use these instructions. Q: I want to add questions
to the Medical Record Audit. How do I reflect this in the Database?
Q:
I'm concerned that if I make changes in the database, I won't be able to
use any other updates that you might produce, and that my data will be
different from everyone else's so that it cannot be compared.
A: It
is true that people that make changes to their database will not be able
to use the “quick fix” updates that are sent out. In these cases, outlined
instructions on how to make the updates will be given. This database is
a template, so we anticipate and encourage that people make changes to
fit their needs. If you feel that integrating your changes and our suggestions
is to complex, we encourage you to use another method of monitoring your
progress. That brings me to the second point: data submission. Submission
of data is completely voluntary, so we do not expect to get everyone's
data. The data that we do receive will most definitely vary in content,
either because people have made changes to the design of the database,
or because people have interpreted and answered questions differently.
As mentioned in other questions, how you answer some of the questions is
up to you. This will result in many different answers to a single question.
Therefore, when we do collect data, all who submit their data will be asked
to fill out a short questionnaire on how they changes/altered the database,
so we can compare answers and usage.
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A: Medical
record audit data should not be taken from charts older than 12 months
prior to the project start date. Therefore for most of you, “pre” data
should be from charts dated after 6/1/99.
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ID number
Q:
The database is skipping ID numbers when I enter data.
A: The
database assigns an ID number to each new record that is entered, starting
with 1 and continuing on. The only reason it would “skip” a number is if
a record was started and then deleted. This could be accidental. If a record
is deleted, Access will not reuse its ID number. There is no real need
to have the ID numbers in numerical order, however if you'd really like
them to be, there
are a few steps you can take to fix this.
Q:
My ID numbers aren't sequential.
A:
When in the Medical Record Audit Form, place your cursor in the ID field
of the first record that comes up, and press the “Ascending order” button
(has AZ on it and a downward pointing arrow).
Q: On the Medical Record
Audit Summary, what does the number after Count represent?
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Q:
“Code number”- is this my own identification of chart? (Like billing or
medical record number)
A: Yes,
many IRBs won't want you to use medical record numbers or billing numbers
which could be used to identify individual patients, so what we do, and
what I recommend is that you keep a list of MR#s of the patients and assign
a random code like 301, 302, 303, etc. to assure anonymity.
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Age Q: What does the Average on the Medical Record Audit Summary represent? A: The average is the of all numbers entered, including any 0s. The equation for this field is =DAvg("[Age]","Medical Record") |
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Admit or Surgical Date Q:
“Admit/or surgical date” - what it they are not the same day?
A: The
form can be used for Medical or Surgical patients – you may choose to broaden
your scope past just post-op patients and on to medical patients as well.
Some surgical patients may be admitted several days before surgery, so
record the day of surgery for surgical patients and the admit date for
medical patients.
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Ethnicity
Sex
Diagnosis
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Diagnosis Description Q:
How many characters are allowed for the “Diagnosis Description” field?
A: The
field on the original version was limited to 50 characters. This was corrected
in the updated version. If you are still having problems:
1.
Open the MR Tool table in Design View.
2.
Scroll down to the “diagndesc” field, place your cursor in that row, and
look at the boxes at the bottom of the screen. In the “Field Size” row,
change the number to 255.
3.
Exit the table and when prompted, save all edits.
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Q: What do the percentages on the Medical Record Audit Summary represent? A: The percentages are the the count of each answer divided by the total number of records. So, for example, the number of Yes answers divided by the total number of records. The equations for the report are as follows: Yes: =(DCount(“[MD_doc]”,”Medical Record”,”[MD_doc]=’1’”))/(DCount(“[ID]”,”Medical
Record”))
No: =(DCount(“[MD_doc]”,”Medical Record”,”[MD_doc]=’0’”))/(DCount(“[ID]”,”Medical Record”)) To change any of the equations, use these instructions. |
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Q:
The question regarding numeric chart use by MDs always appears with a pre-recorded
'YES' response. When I change the answer, a message says: “MD documentation
question must be answered yes to change this answer (e.g., to change response
from 'yes' to 'no'). Access will make the change for you.”
How do I fix that?
A: The
database is pre-recording an answer for you. To fix this one follow
these instructions.
Q: Should I answer this question if there was no MD documentation?
Q: What do the percentages on the Medical Record Audit Summary represent?
Q: Shouldn't the percentage be not of all the records, but only those
that had MD documentation, since that is what the question asks?
These equations count the records that answered Yes (or No or Pt Unable
to Respond) AND Yes to the MD documentation question, divided by the number
of records that have Yes answered for the MD documentation question. So,
if there are records that have this question answered, but not the previous
one, they will not be included in any of the percentages. This assures
that your percentages will add up to 100%.
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Q:
Some of our documentation is done by LPNs. I’m including these ratings
in with the RN pain ratings. Is this correct?
A: Definitely.
Q: What do the percentages on the Medical Record Audit Summary represent?
Yes: =(DCount(“[RN_doc]”,”Medical Record”,”[RN_doc]=’1’”))/(DCount(“[ID]”,”Medical
Record”))
No: =(DCount(“[RN_doc]”,”Medical Record”,”[RN_doc]=’0’”))/(DCount(“[ID]”,”Medical Record”)) To change any of the equations, use these instructions. |
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RN scale use Q: What do the percentages on the Medical Record
Audit Summary represent?
A: The percentages are the the count of each answer divided by the total number of records. So, for example, the number of Yes answers divided by the total number of records. The equations for the report are as follows: Yes: =(DCount(“[RNrating]”,”Medical Record”,”[RNrating]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[RNrating]”,”Medical Record”,”[RNrating]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Pt Unable to Respond: =(DCount(“[RNrating]”,”Medical Record”,”[RNrating]=’2’”))/(DCount(“[ID]”,”Medical Record”)) To change any of the equations, use these instructions. Q: Shouldn't the percentage be not of all the records, but only those
that had RN documentation, since that is what the question asks?
These equations count the records that answered Yes (or No or Pt Unable
to Respond) AND Yes to the RN documentation question, divided by the number
of records that have Yes answered for the RN documentation question. So,
if there are records that have this question answered, but not the previous
one, they will not be included in any of the percentages. This assures
that your percentages add up to 100%.
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Number of scales Q:
The question about the number of pain ratings that were 0-10 etc. limits
me to the number of ratings taken by the nurse and won't include doctor
documentation.
A: The
question does only ask for the number of scales recorded by RNs. However,
if you would like the field to allow any number of pain ratings please
follow
these instructions.
Q: The database says I
have to fill in the questions about how many numeric pain ratings, highest
score and lowest score. But in the charts where there is no documentation
by a nurse, I don't want to answer those questions.
Q: What does the average
on the Medical Record Audit Summary report represent?
Q: Shouldn't the average
on the Medical Record Audit Summary only include numbers from records where
there was RN documentation?
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Q:
The database says I have to fill in the questions about how many numeric
pain ratings, highest score and lowest score. But in the charts where there
is no documentation by a nurse, I don't want to answer those questions.
A: You're right, you shouldn't fill this in if there was no RN documentation. To stop the database from saying that, use these instructions. Q: What does the average
on the Medical Record Audit Summary report represent?
Q: Shouldn't the average
on the Medical Record Audit Summary only include numbers from records where
there was RN documentation?
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Highest score Q: The database says I have to fill in the questions about how many numeric pain ratings, highest score and lowest score. But in the charts where there is no documentation by a nurse, I don't want to answer those questions. A: You're right, you shouldn't fill this in if there was no RN documentation. To stop the database from saying that, use these instructions. Q: What does the average
on the Medical Record Audit Summary report represent?
Q: Shouldn't the average
on the Medical Record Audit Summary only include numbers from records where
there was RN documentation?
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Lowest score Q: The database won't accept "moderate" as an answer for the question "What was the lowest pain rating recorded?" A: The pain ratings questions (highest, lowest) only accept numbers. In order to find the average of all ratings, the answer must be recorded as a number. Q: The database says I
have to fill in the questions about how many numeric pain ratings, highest
score and lowest score. But in the charts where there is no documentation
by a nurse, I don't want to answer those questions.
Q: What does the average
on the Medical Record Audit Summary report represent?
Q: Shouldn't the average
on the Medical Record Audit Summary only include numbers from records where
there was RN documentation?
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Non-pharmacologic interventions Q: What does the percentage on the Medical Record Audit Summary report represent? A: The percentages are the the count of each answer divided by the total number of records. So, for example, the number of Yes answers divided by the total number of records. The equations for the report are as follows: Yes: =(DCount(“[doc_nonp]”,”Medical Record”,”[doc_nonp]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[doc_nonp]”,”Medical Record”,”[doc_nonp]=’0’”))/(DCount(“[ID]”,”Medical Record”)) To change any of the equations, use these instructions. Heat - Other
Q: Shouldn't the percentages on the Medical Record Audit Summary
report be the percent of those records that had non-pharmacologic interventions,
not the percent of all records.
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IM injections Q: If IM/IV/IVPCA/oral opioids are ordered but not given, should we indicate which drug was ordered? A: This is up to you. Just remember that when the Medical Record Audit Summary report calculates the percentages for these questions, it counts the number of times each drug was chosen as an answer, and divides it by the number of records that answered Yes to the first question in the series. So for example, the percentage for IM Morphine is the number of times Morphine was the answer to that question (Which IM drug was administered) divided by the number of records that answered Yes to the first question in the series (Was an IM injection ordered). So in other words, if your percentages for the IM drug question do not add up to 100% on the summary report, the missing percentage is those records that did have IM injections ordered, but didn't have a IM drug chosen. Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: Regarding the IM question, does the times administered and amount administered parts include Torodol PO, or only IM? A: It
should be just the total IM/IV given on the specific Torodol questions.
Any PO Torodol should be counted on the oral NSAID question (third to last
question set).
Q: The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug list. How do I add it? A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q: What do the percentages on the Medical Record Audit Summary represent?
IM ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[IMopioid]”,”Medical Record”,”[IMopioid]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[IMopioid]”,”Medical Record”,”[IMopioid]=’0’”))/(DCount(“[ID]”,”Medical Record”)) IM PRN/Scheduled: the count of each answer for records where the previous question (IM ordered) is also answered Yes, divided by the number of records that had an IM opioid ordered (IM opioid question is answered Yes). PRN: =(DCount("[IMprn]","Medical Record","[IMprn]='1' AND [IMopioid]='1'"))/(DCount("[IMopioid],"Medical Record","[IMopioid]='1'")) Scheduled: =(DCount("[IMprn]","Medical Record","[IMprn]='2' AND [IMopioid]='1'"))/(DCount("[IMopioid],"Medical Record","[IMopioid]='1'")) IM times administered: the average of all numbers entered for this question. =DAvg("[imop_adm]","Medical Record") IM amount administered: the average of all numbers entered for this question. =DAvg("[imop_amt]","Medical Record") IM drug administered: the count of each answer divided by the number of records that had an IM opioid ordered (IM opioid question is answered Yes). Morphine: =(DCount("[IM_drug]","Medical Record","[IM_drug]='Morphine'"))/(DCount("[IMopioid]","Medical Record","[IMopioid]='1'")) Dilaudid: =(DCount("[IM_drug]","Medical Record","[IM_drug]='Dilaudid'"))/(DCount("[IMopioid]","Medical Record","[IMopioid]='1'")) Demerol: =(DCount("[IM_drug]","Medical Record","[IM_drug]='Demerol'"))/(DCount("[IMopioid]","Medical Record","[IMopioid]='1'")) Other: =(DCount("[IM_drug]","Medical Record","[IM_drug]='Other'"))/(DCount("[IMopioid]","Medical Record","[IMopioid]='1'")) To change any of the equations, use these instructions. Q: I want to change the averages so that they show averages/percentages
of only those records that had an IM opioid ordered, not of the whole population.
If you are afraid that data entry will be done incorrectly and IM drugs
will be chosen when an IM opioid was not ordered, you can limit the percentages
for the IM drugs as well. Change them to look like the example below, replacing
the drug names:
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Ketorolac Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: What do the numbers on the Medical Record Audit Summary represent? A: The percentages/averages and equations are as follows: Ketorolac ordered: the the count of each
answer divided by the total number of records. So, for example, the number
of Yes answers divided by the total number of records.
Yes: =(DCount(“[Ketorola]”,”Medical Record”,”[Ketorola]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[Ketorola]”,”Medical Record”,”[Ketorola]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Ketorolac PRN/Scheduled: the count of each answer for records where the previous question (Ketorolac ordered) is also answered Yes, divided by the number of records that had ketorolac ordered (ketorolac question is answered Yes). PRN: =(DCount("[ket_prn]","Medical Record","[ket_prn]='1' AND [Ketorola]='1'"))/(DCount("[Ketorola],"Medical Record","[Ketorola]='1'")) Scheduled: =(DCount("[ket_prn]","Medical Record","[ket_prn]='0' AND [Ketorola]='1'"))/(DCount("[Ketorola],"Medical Record","[Ketorola]='1'")) Ketorolac times administered: the average of all numbers entered for this question. =DAvg("[ket_adm]","Medical Record") Ketorolac amount administered: the average of all numbers entered for this question. =DAvg("[ket_amt]","Medical Record") To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had ketorolac ordered, not of the whole population.
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Demerol Q:
The Demerol question - is this intramuscular (IM)?
A: Can
be IM or IV, but NOT PO. PO would be picked up on the oral opioid questions.
Remember that the IM route is not recommended.
Q:
The drug amounts administered won't accept decimal places.
A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: If a drug was ordered but not administered, should I enter 0 in the amount administered and number of times administered boxes or should I leave them blank? A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: On the meperidine question
and the Acetaminophen question, the times administered and amount administered
averages are the same and they shouldn't be.
Q: What do the percentages on the Medical Record
Audit Summary represent?
A: The percentages and equations are as follows: Demerol ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[Demerol]”,”Medical Record”,”[Demerol]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[Demerol]”,”Medical Record”,”[Demerol]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Demerol PRN/Scheduled: the count of each answer for records where the previous question (Demerol ordered) is also answered Yes, divided by the number of records that had Demerol ordered (Demerol question is answered Yes). PRN: =(DCount("[dem_prn]","Medical Record","[dem_prn]='1' AND [Demerol]='1'"))/(DCount("[Demerol],"Medical Record","[Demerol]='1'")) Scheduled: =(DCount("[dem_prn]","Medical Record","[dem_prn]='0' AND [Demerol]='1'"))/(DCount("[Demerol],"Medical Record","[Demerol]='1'")) Demerol times administered: the average of all numbers entered for this question. =DAvg("[dem_adm]","Medical Record") Demerol amount administered: the average of all numbers entered for this question. =DAvg("[dem_amt]","Medical Record") To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had Demerol ordered, not of the whole population.
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Q:
Regarding the PCA question - We clear PCA machines at 6 am each day. I
don't know a total for 24 hours.
A: We
have a similar problem here, not because of the way we clear the machines’
memory, but because the nurses are more attentive to volume than dosage
in their documentation, which to me is problematic. It's so important to
know how much drug a patient received particularly when you're converting
back to PO, is there any way you can figure out how much they got from
the PCA flowsheet or the medication kardex in which the syringes or PCA
bags are signed out? If you can't find this information then you've already
highlighted an area to target improvements in practice. LINK
TO PCA REFERENCES
Q:“PCA
initiated dose” - Is this patient dose?
A: Yes.
LINK
TO PCA REFERENCES
Q:“PCA basal rate” - Is this continuous drip? A: Yes,
“basal” rate means continuous infusion and you can check this box in the
PCA question for patients who have a continuous infusion WITHOUT PCA as
well. LINK
TO PCA REFERENCES
Q:“RN bolus” - Is this like a loading dose? A: No,
this is an EXTRA ORDER that is ongoing, such as “patient initiated dose
1.0 mg, lockout 6 minutes, no basal, prn RN bolus 2 mg q 1 hour.” It is
part of the usual regimen. LINK
TO PCA REFERENCES
Q: In our charts, IV opioid amounts are charted per shift. How should we determine the amount of opioid given if the 24 hour period ends mid-shift? A: Doesn't
make a huge difference as long as you set a rule and do all the charts
the same. Since there is a fairly large difference in opioid requirements
in individuals the total amount of drug used, although good to track, doesn't
need to be precise; just make sure the data collection methods are. Is
there no way to use the pain flowsheet to get a more precise handle on
how much was left in the syringe when the 24 hours was up? I guess I would
divide each shift into amount given per hours and add it up that way.
Q: If IM/IV/IVPCA/oral
opioids are ordered but not given, should we indicate which drug was ordered?
Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug list. How do I add it? A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q: What do the percentages on the Medical Record Audit Summary represent? A: The percentages and equations are as follows: IV PCA ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[IV_pca]”,”Medical Record”,”[IV_pca]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[IV_pca]”,”Medical Record”,”[IV_pca]=’0’”))/(DCount(“[ID]”,”Medical Record”)) IV PCA basal rate: the count of each answer for records where the previous question (IV PCA ordered) is also answered Yes, divided by the number of records that had an IV PCA ordered (IV PCA question is answered Yes). Yes: =(DCount("[Basal]","Medical Record","[Basal]='1' AND [IV_pca]='1'"))/(DCount("[IV_pca],"Medical Record","[IV_pca]='1'")) Noc Only: =(DCount("[Basal]","Medical Record","[Basal]='2' AND [IV_pca]='1'"))/(DCount("[IV_pca],"Medical Record","[IV_pca]='1'")) No: =(DCount("[Basal]","Medical Record","[Basal]='0' AND [IV_pca]='1'"))/(DCount("[IV_pca],"Medical Record","[IV_pca]='1'")) IV PCA pt initiaited dose: the average of all numbers entered for this question. =DAvg("[pca_dos]","Medical Record") IV PCA basal rate: the average of all numbers entered for this question. =DAvg("[bas_rate]","Medical Record") IV PCA lockout: the average of all numbers entered for this question. =DAvg("[lockout]","Medical Record") IV PCA RN bolus: the average of all numbers entered for this question. =DAvg("[RN_bolus]","Medical Record") IV PCA amount administered: the average of all numbers entered for this question. =DAvg("[PCA_amt]","Medical Record") IV PCA drug administered: the count of each answer divided by the number of records that had an IV PCA ordered (IV PCA question is answered Yes). Morphine: =(DCount("[PCA_drug]","Medical Record","[PCA_drug]='Morphine'"))/(DCount("[IV_pca]","Medical Record","[IV_pca]='1'")) Dilaudid: =(DCount("[PCA_drug]","Medical Record","[PCA_drug]='Dilaudid'"))/(DCount("[IV_pca]","Medical Record","[IV_pca]='1'")) Demerol: =(DCount("[PCA_drug]","Medical Record","[PCA_drug]='Demerol'"))/(DCount("[IV_pca]","Medical Record","[IV_pca]='1'")) Fentanyl: =(DCount("[PCA_drug]","Medical Record","[PCA_drug]='Fentanyl'"))/(DCount("[IV_pca]","Medical Record","[IV_pca]='1'")) Unable to Determine: =(DCount("[PCA_drug]","Medical Record","[PCA_drug]='Other'"))/(DCount("[IV_pca]","Medical Record","[IV_pca]='1'")) To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an IV PCA ordered, not of the whole population.
If you are afraid that data entry will be done incorrectly and IV PCA
drugs will be chosen when an IV PCA was not ordered, you can limit the
percentages for the IV PCA drugs as well. Change them to look like the
example below, replacing the drug names:
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Q: If IM/IV/IVPCA/oral opioids are ordered but not given, should we indicate which drug was ordered? A: This is up to you. Just remember that when the Medical Record Audit Summary report calculates the percentages for these questions, it counts the number of times each drug was chosen as an answer, and divides it by the number of records that answered Yes to the first question in the series. So for example, the percentage for IM Morphine is the number of times Morphine was the answer to that question (Which IM drug was administered) divided by the number of records that answered Yes to the first question in the series (Was an IM injection ordered). So in other words, if your percentages for the IM drug question do not add up to 100% on the summary report, the missing percentage is those records that did have IM injections ordered, but didn't have a IM drug chosen. Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug list. How do I add it? A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q: What do the percentages on the Medical Record Audit Summary represent? A: The percentages and equations are as follows: IV opioid ordered: the the count of each
answer divided by the total number of records. So, for example, the number
of Yes answers divided by the total number of records.
Yes: =(DCount(“[IVopioid]”,”Medical Record”,”[IVopioid]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[IVopioid]”,”Medical Record”,”[IVopioid]=’0’”))/(DCount(“[ID]”,”Medical Record”)) IV opioid PRN/Scheduled: the count of each answer for records where the previous question (IV opioid ordered) is also answered Yes, divided by the number of records that had an IV opioid ordered (IV opioid question is answered Yes). PRN: =(DCount("[IV_prn]","Medical Record","[IV_prn]='1' AND [IVopioid]='1'"))/(DCount("[IVopioid],"Medical Record","[IVopioid]='1'")) Sched: =(DCount("[IV_prn]","Medical Record","[IV_prn]='0' AND [IVopioid]='1'"))/(DCount("[IVopioid],"Medical Record","[IVopioid]='1'")) IV opioid times administered: the average of all numbers entered for this question. =DAvg("[ivop_adm]","Medical Record") IV opioid amount administered: the average of all numbers entered for this question. =DAvg("[ivop_amt]","Medical Record") IV opioid drug administered: the count of each answer divided by the number of records that had an IV opioid ordered (IV opioid question is answered Yes). Morphine: =(DCount("[ivop_drug]","Medical Record","[ivop_drug]='Morphine'"))/(DCount("[IVopioid]","Medical Record","[IVopioid]='1'")) Dilaudid: =(DCount("[ivop_drug]","Medical Record","[ivop_drug]='Dilaudid'"))/(DCount("[IVopioid]","Medical Record","[IVopioid]='1'")) Demerol: =(DCount("[ivop_drug]","Medical Record","[ivop_drug]='Demerol'"))/(DCount("[IVopioid]","Medical Record","[IVopioid]='1'")) Other: =(DCount("[ivop_drug]","Medical Record","[ivop_drug]='Other'"))/(DCount("[IVopioid]","Medical Record","[IVopioid]='1'")) To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an IV opioid ordered, not of the whole population.
If you are afraid that data entry will be done incorrectly and IV opioid
drugs will be chosen when an IV opioid was not ordered, you can limit the
percentages for the IV opioid drugs as well. Change them to look like the
example below, replacing the drug names:
|
|
Q:
There isn't a separate question regarding intrathecal catheter. A lot of
our patients receive this instead of an epidural catheter. Should we record
this in the epidural space?
A: I
would count them the same. In other words, patients with either of these
are both receiving neuraxial or spinal analgesia which count the same when
considering a multi-modal approach. If for your own purposes you would
like to keep them separate,
you
can add a new question.
Q:
The use of epidural narcotics, whether continuous or with the patient controlled
feature – there is no accounting for this under the epidural questions.
How should this be handled?
A: You
may want to
add
this question into the database
if you are concerned about it. However, what you're really trying to get
a handle on is what percentage of patients is being offered a multi-modal
approach that includes an epidural route. Whether the epidural is administered
as repeat MD boluses, continuous or PCA doesn't matter much for POP.
Q: What do the percentages on the Medical Record Audit Summary represent? A: The percentages and equations are as follows: Epidural ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[spinal]”,”Medical Record”,”[spinal]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[spinal]”,”Medical Record”,”[spinal]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Epidural PCA/bolus/Continuous: the count of each answer for records where the previous question (epidural ordered) is also answered Yes, divided by the number of records that had an epidural ordered (epidural question is answered Yes). Coninuous: =(DCount("[cont_spi]","Medical Record","[cont_spi]='1' AND [spinal]='1'"))/(DCount("[spinal],"Medical Record","[spinal]='1'")) PCA: =(DCount("[cont_spi]","Medical Record","[cont_spi]='2' AND [spinal]='1'"))/(DCount("[spinal],"Medical Record","[spinal]='1'")) Bolus: =(DCount("[cont_spi]","Medical Record","[cont_spi]='3' AND [spinal]='1'"))/(DCount("[spinal],"Medical Record","[spinal]='1'")) To change any of the equations, use these instructions. |
|
Oral Opioids Q:
“Oral opioid” - Darvocet is not listed. What if they are on it?
A: Well,
I guess technically that counts as an oral opioid and you mark “Yes” if
the patient is on oral opioids and then indicate how many times it was
administered and the amount of mg administered. You'll have to leave the
box empty or write “Darvocet.” If you are using a lot of it I would see
if you could get someone from your information system department to modify
the Access Database file to add Darvocet to the drug list.
This may also spark you to perform a separate drug utilization review on
Darvocet as this is a drug that should rarely be used anymore. We knew
we probably would not be able to design a form and database that would
meet everyone's needs and formularies. And there is a lot more detail on
the Medical Record Form than you probably care to look at anyway. You'll
still be able to see the percentages of patients who get PCA vs. oral vs.
IM, etc. LINK
TO DARVOCET REFERENCES
Q: If IM/IV/IVPCA/oral
opioids are ordered but not given, should we indicate which drug was ordered?
Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q:
The drug amounts administered won't accept decimal places.
A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug list. How do I add it? A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q:
When looking at the Medical Record Audit Summary, both “Oral Opioid 1”
and “Oral Opioid 2” have prn and scheduled as the same percentage and they
add up to more than 100%.
A: The
database is counting the same answer twice instead of counting the two
different answers. This should have been fixed in the update of the Medical
Record Audit Summary, however you can change it yourself by using
these instructions.
Q: What do the percentages on the Medical Record
Audit Summary represent?
A: The percentages and equations are as follows: Oral opioid ordered: the the count of each
answer divided by the total number of records. So, for example, the number
of Yes answers divided by the total number of records.
Yes: =(DCount(“[po_opioid1]”,”Medical Record”,”[po_opioid1]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[po_opioid1]”,”Medical Record”,”[po_opioid1]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Oral opioid PRN/Scheduled: the count of each answer for records where the previous question (oral opioid ordered) is also answered Yes, divided by the number of records that had an oral opioid ordered (oral opioid question is answered Yes). PRN: =(DCount("[po_prn1]","Medical Record","[po_prn1]='1' AND [po_opioid1]='1'"))/(DCount("[po_opioid1],"Medical Record","[po_opioid1]='1'")) Scheduled: =(DCount("[po_prn1]","Medical Record","[po_prn1]='0' AND [po_opioid1]='1'"))/(DCount("[po_opioid1],"Medical Record","[po_opioid1]='1'")) Oral opioid times administered: the average of all numbers entered for this question. =DAvg("[po_adm1]","Medical Record") Oral opioid amount administered: the average of all numbers entered for this question. =DAvg("[po_amt1]","Medical Record") Oral opioid drug administered: the count of each answer divided by the number of records that had an oral opioid ordered (oral opioid question is answered Yes). Codeine: =(DCount("[po_drug1]","Medical Record","[po_drug1]='Codeine'"))/(DCount("[po_opioid1]","Medical Record","[po_opioid1]='1'")) Hydrocodone: =(DCount("[po_drug1]","Medical Record","[po_drug1]='Hydrocodone'"))/(DCount("[po_opioid1]","Medical Record","[po_opioid1]='1'")) Oxycodone: =(DCount("[po_drug1]","Medical Record","[po_drug1]='Oxycodone'"))/(DCount("[po_opioid1]","Medical Record","[po_opioid1]='1'")) Morphine: =(DCount("[po_drug1]","Medical Record","[po_drug1]='Morphine'"))/(DCount("[po_opioid1]","Medical Record","[po_opioid1]='1'")) Oral opioid combination product: the count of each answer divided by the number of records that had an oral opioid ordered (oral opioid question is answered Yes). Yes: =(DCount("[pocombo1]","Medical Record","[pocombo1]='1'"))/(DCount("[po_opioid1],"Medical Record","[po_opioid1]='1'")) No: =(DCount("[pocombo1]","Medical Record","[pocombo1]='0'"))/(DCount("[po_opioid1],"Medical Record","[po_opioid1]='1'")) To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an oral opioid ordered, not of the whole
population.
If you are afraid that data entry will be done incorrectly and oral
opioid drugs will be chosen when an oral opioid was not ordered, you can
limit the percentages for the oral opioid drugs as well. Change them to
look like the example below, replacing the drug names:
|
|
Oral Opioids 2 Q: There are two “oral opioid” questions? Are the two questions the same? A: Yes, it's a repeat because some patients may be on more than one oral opioids, like Oramorph and Percocet. Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q:
The drug amounts administered won't accept decimal places.
A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug list. How do I add it? A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q:
When looking at the Medical Record Audit Summary, both “Oral Opioid 1”
and “Oral Opioid 2” have prn and scheduled as the same percentage and they
add up to more than 100%.
A: The
database is counting the same answer twice instead of counting the two
different answers. This should have been fixed in the update of the Medical
Record Audit Summary, however you can change it yourself by using
these instructions.
Q: What do the percentages on the Medical Record
Audit Summary represent?
A: The percentages and equations are as follows: Oral opioid ordered 2: the the count of each
answer divided by the total number of records. So, for example, the number
of Yes answers divided by the total number of records.
Yes: =(DCount(“[po_opioid2]”,”Medical Record”,”[po_opioid2]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[po_opioid2]”,”Medical Record”,”[po_opioid2]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Oral opioid PRN/Scheduled 2: the count of each answer for records where the previous record is also answered Yes, divided by the number of records that had an oral opioid ordered (oral opioid 2 question is answered Yes). PRN: =(DCount("[po_prn2]","Medical Record","[po_prn2]='1' AND [po_opioid2]='1'"))/(DCount("[po_opioid2],"Medical Record","[po_opioid2]='1'")) Scheduled: =(DCount("[po_prn2]","Medical Record","[po_prn2]='0' AND [po_opioid2]='1'"))/(DCount("[po_opioid2],"Medical Record","[po_opioid2]='1'")) Oral opioid times administered 2: the average of all numbers entered for this question. =DAvg("[po_adm2]","Medical Record") Oral opioid amount administered 2: the average of all numbers entered for this question. =DAvg("[po_amt2]","Medical Record") Oral opioid drug administered 2: the count of each answer divided by the number of records that had an oral opioid ordered (oral opioid question is answered Yes). Codeine: =(DCount("[po_drug2]","Medical Record","[po_drug2]='Codeine'"))/(DCount("[po_opioid2]","Medical Record","[po_opioid2]='1'")) Hydrocodone: =(DCount("[po_drug2]","Medical Record","[po_drug2]='Hydrocodone'"))/(DCount("[po_opioid2]","Medical Record","[po_opioid2]='1'")) Oxycodone: =(DCount("[po_drug2]","Medical Record","[po_drug2]='Oxycodone'"))/(DCount("[po_opioid2]","Medical Record","[po_opioid2]='1'")) Morphine: =(DCount("[po_drug2]","Medical Record","[po_drug2]='Morphine'"))/(DCount("[po_opioid2]","Medical Record","[po_opioid2]='1'")) Oral opioid combination product 2: the count of each answer divided by the number of records that had an oral opioid ordered (oral opioid 2 question is answered Yes). Yes: =(DCount("[pocombo2]","Medical Record","[pocombo2]='1'"))/(DCount("[po_opioid2],"Medical Record","[po_opioid2]='1'")) No: =(DCount("[pocombo2]","Medical Record","[pocombo2]='0'"))/(DCount("[po_opioid2],"Medical Record","[po_opioid2]='1'")) To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an oral opioid ordered, not of the whole
population.
If you are afraid that data entry will be done incorrectly and oral
opioid drugs will be chosen when an oral opioid was not ordered, you can
limit the percentages for the oral opioid drugs as well. Change them to
look like the example below, replacing the drug names:
|
|
NSAIDs Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: What do the percentages/averages on the Medical
Record Audit Summary represent?
A: The percentages/averages and equations are as follows: NSAID ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[nsaid]”,”Medical Record”,”[nsaid]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[nsaid]”,”Medical Record”,”[nsaid]=’0’”))/(DCount(“[ID]”,”Medical Record”)) NSAID PRN/Scheduled: the count of each answer for records where the previous question (NSAID ordered) is also answered Yes, divided by the number of records that had an NSAID ordered (NSAID question is answered Yes). PRN: =(DCount("[nsaid_pr]","Medical Record","[nsaid_pr]='1' AND [nsaid]='1'"))/(DCount("[nsaid],"Medical Record","[nsaid]='1'")) Sched: =(DCount("[nsaid_pr]","Medical Record","[nsaid_pr]='0' AND [nsaid]='1'"))/(DCount("[nsaid],"Medical Record","[nsaid]='1'")) NSAID times administered: the average of all numbers entered for this question. =DAvg("[nsaid_adm]","Medical Record") To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an NSAID ordered, not of the whole population.
|
|
Acetaminophen Q:
If a drug was ordered but not administered, should I enter 0 in the amount
administered and number of times administered boxes or should I leave them
blank?
A: Again
this is up to you. If you want to know the average amount administered
whether it was 0 or 100, enter a zero. However, if you are only concerned
about those people that actually received the drug, leave it blank.
Q: The drug amounts administered won't accept decimal places. A: This
has been fixed in the updated version of the database. If you are still
having problems, see the section
on changing data features.
Q: On the meperidine question
and the Acetaminophen question, the times administered and amount administered
averages are the same and they shouldn't be.
Q:
Every time I try to enter data for the Tylenol question, I get an error
message that says Microsoft Access can't find the Macro NOP3.
A: A
macro isn't working correctly here. The solution requires you to carry
out a few easy steps.
A: Use these instructions. Q: What do the percentages on the Medical Record
Audit Summary represent?
A: The percentages and equations are as follows: Tylenol ordered: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[Tyl]”,”Medical Record”,”[Tyl]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[Tyl]”,”Medical Record”,”[Tyl]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Tylenol PRN/Scheduled: the count of each answer for records where the previous question (Tylenol ordered) is also answered Yes, divided by the number of records that had Tylenol ordered (Tylenol question is answered Yes). PRN: =(DCount("[Tyl_prn]","Medical Record","[Tyl_prn]='1' AND [Tyl]='1'"))/(DCount("[Tyl],"Medical Record","[Tyl]='1'")) Sched: =(DCount("[Tyl_prn]","Medical Record","[Tyl_prn]='0' AND [Tyl]='1'"))/(DCount("[Tyl],"Medical Record","[Tyl]='1'")) Tylenol times administered: the average of all numbers entered for this question. =DAvg("[Tyl_adm]","Medical Record") Tylenol amount administered: the average of all numbers entered for this question. =DAvg("[Tyl_amt]","Medical Record") To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had an NSAID ordered, not of the whole population.
|
|
Q:
Regarding a “change in analgesic order”- what if they change drugs?
A: Yes,
that is a change in the “analgesic order” but I guess I would leave the
“increased” and “decreased” box empty unless it is clear from the rest
of the documentation they were changing because of unrelieved pain. The
typical reason to change would be side effects.
Q: On the last question of the Medical Record Audit Tool if the order was changed, but the dose wasn't increased or decreased, should I leave the question blank? A: Yes,
leave that part of the question blank. On the Medical Record Audit Summary
report, the patients who had an order change but no dose change is the
remainder of 100% minus the increased doses percentage minus the decreased
doses percentage.
This
question was added because if you pick up all the different drugs ordered/administered
in the previous questions, it is difficult to know if they were all ordered
at once or in anticipation of a change in PO status after surgery or if
an order change occurred during this first 24 hours and if so you could
determine overall why and in which direction.
Q:
The last question regarding order changes increasing or decreasing doesn't
reflect what I calculate as the correct percentages.
A: Make
sure the correct expressions are being calculated. Use the equations below.
Q: What do the percentages/averages on the Medical
Record Audit Summary represent?
A: The percentages and equations are as follows: Change in orders: the the count of each answer
divided by the total number of records. So, for example, the number of
Yes answers divided by the total number of records.
Yes: =(DCount(“[orderch]”,”Medical Record”,”[orderch]=’1’”))/(DCount(“[ID]”,”Medical Record”)) No: =(DCount(“[orderch]”,”Medical Record”,”[orderch]=’0’”))/(DCount(“[ID]”,”Medical Record”)) Change increased/decreased: the count of each answer divided by the number of records that had a change in orders (Change in orders question is answered Yes). Increased: =(DCount("[ch_direct]","Medical Record","[ch_direct]='1'"))/(DCount("[orderch],"Medical Record","[orderch]='1'")) Decreased: =(DCount("[ch_direct]","Medical Record","[ch_direct]='0'"))/(DCount("[orderch],"Medical Record","[orderch]='1'")) Why change in orders: the count of each answer divided by the number of records that had a change in orders (Change in orders question is answered Yes). Side effects: =(DCount(“[ch_se]”,”Medical Record”,”[ch_se]=’1’”))/(DCount(“[orderch]”,”Medical Record”,"[orderch]='1'")) Pain not controlled: =(DCount(“[ch_noctr]”,”Medical Record”,”[ch_noctr]=’1’”))/(DCount(“[orderch]”,”Medical Record”,"[orderch]='1'")) Patient's PO status changed: =(DCount(“[ch_po]”,”Medical Record”,”[ch_po]=’1’”))/(DCount(“[orderch]”,”Medical Record”,"[orderch]='1'")) Unable to determine: =(DCount(“[ch_nodet]”,”Medical Record”,”[ch_nodet]=’1’”))/(DCount(“[orderch]”,”Medical Record”,"[orderch]='1'")) Other: =(DCount(“[ch_oth]”,”Medical Record”,”[ch_oth]=’1’”))/(DCount(“[orderch]”,”Medical Record”,"[orderch]='1'")) To change any of the equations, use these instructions. Q: I want to change some of the numbers so that they show averages/percentages
of only those records that had a change in orders, not of the whole population.
These equations change the numerator to include only those records to
include records that have both the particular question answered AND the
Change in orders question answered Yes.
|
|
Q:
What if patients have a Duragesic patch - should they be included in this
study?
A: DEFINITELY,
remember, this is QI and you're trying to get a handle on analgesic prescribing
practices for your postoperative patients and many patients do come to
us with chronic pain, cancer pain, etc. And many folks will use the Medical
Record Audit and Database to audit/examine medical patients as well. You
can add
a new question
to track Duragesic use. LINK
TO DURAGESIC REFERENCES
Q:
On the Medical Record Audit Tool, there is no allowance for the subcutaneous
(SQ) route of opioid administration, which is routinely ordered. Should
this be accounted for with the IM route?
A: Yes,
SQ if given as intermittent injections should be considered IM. SQ tends
to have the same problems as IM (hurtful administration and erratic absorption).LINK
TO SQ REFERENCES
Q: Under the treatment section there is a question that asks about IM analgesics. We have had a couple of records that gave IM Demerol with Vistaril? How do we capture that and is it important for POP. A: We
do not need the information about Vistaril for POP, but I would expect
you would want to internally track this to try and diminish its routine
use. You can do this by adding
a new question.
Vistaril does not enhance the analgesic effects of opioids and the IM route
is very painful. LINK
TO VISTARIL REFERENCES.
LINK
TO IM REFERENCES.
Q:
There isn't a separate question regarding intrathecal catheter. A lot of
our patients receive this instead of an epidural catheter. Should we record
this in the epidural space?
A: I
would count them the same. In other words, patients with either of these
are both receiving neuraxial or spinal analgesia which count the same when
considering a multi-modal approach. If for your own purposes you would
like to keep them separate,
you
can add a new question.
Q:
The drug I need for IM opioid/IV PCA/IV opioid/PO opioid isn't on the drug
list. How do I add it?
A:
Unfortunately we couldn't list every possibility. To add a drug to the
list, follow
these instructions.
Q:
The use of epidural narcotics, whether continuous or with the patient controlled
feature – there is no accounting for this under the epidural questions.
How should this be handled?
A: You
may want to
add
this question into the database
if you are concerned about it. However, what you're really trying to get
a handle on is what percentage of patients is being offered a multi-modal
approach that includes an epidural route. Whether the epidural is administered
as repeat MD boluses, continuous or PCA doesn't matter much for POP.
|
|
Data Entry Form Q:
When I click the buttons at the top of the screen for previous record,
new record, etc., nothing happens.
A: If
the buttons at the top of the screen don't work, use the buttons at the
bottom of the screen.
<Previous
record
|<First record >Next
record
>|Last
record
>*New
record
Q:
When I try to go to the next record it reads “Data Set Full.”
A: There
are two options with this problem.
1.
First try using the buttons at the bottom of the screen to move from record
to record instead of the buttons at the top (see previous question).
2.
If that doesn't help things, it could be that your computer doesn't have
enough memory to support the program. Check with your I/S department.
Q: I've entered all my records and now I can't go back and edit them. A: There
are two possible solutions to this problem:
1.
The buttons at the top of the screen that help you move between records
aren't working properly.
If
this is the case, the correct number of forms will appear after the “of”
at the very bottom of the screen.
2.
If the correct number of forms does not appear at the bottom of the form
(like below)
there is probably a filter that has there is probably a filter that has accidentally been turned on. Make sure the funnel-like commands at the top of the screen (like those at the right) aren't punched in. If they are, click on them again and all your records should come back. 
3. Use the buttons at the bottom of screen to move from record to record. |
|
Q:
My percentages add up to less than 100%.
A: This
means data entry wasn't done correctly. Go back and make sure all those
answers that were supposed to be filled in are filled in. Make data entry
changes as needed. Don't fill in drug choices or amounts administered if
a drug wasn't ordered. NOTE:All questions on page 1 should be filled in.
On pages 2 and 3, all questions regarding the ordering of drugs should
be answered either yes or no, HOWEVER specifics about drug orders should
only be answered if the drug was ordered. For example, only answer the
prn/scheduled question regarding Demerol if Demerol was ordered.
Q: My percentages add up to more than 100%. A: This
means that there are answers in some boxes that shouldn't have answers.
The most common place this will occur is in the prn/scheduled questions
regarding drug orders. For example, if your ketorolac prn/scheduled percentages
add up to over 100, some records that did not have ketorolac ordered have
the prn/scheduled question answered. Go back and check: if ketorolac wasn't
ordered, nothing should be filled in for the proceeding questions about
ketorolac. This includes prn/scheduled, amount, number of times administrated,
etc.
Q: The average on my drug amounts/times administered don't add up to what I calculate. A: The averages are of all records that have a number entered into that space, even if it is a zero. If you don't want the records with zeros counted in the average (they do make quite a difference) remove them and leave the space blank. Q: On the meperidine question and the Acetaminophen question, the times administered and amount administered averages are the same and they shouldn't be. A: Use these instructions. Q: When looking at the Medical Record Audit Summary, both “Oral Opioid 1” and “Oral Opioid 2” have prn and scheduled as the same percentage and they add up to more than 100%. A: The
database is counting the same answer twice instead of counting the two
different answers. This should have been fixed in the update of the Medical
Record Audit Summary, however you can change it yourself by using
these instructions.
Q: The NSAIDs scheduled
answer should be _% and instead it said 0%. What's wrong.
Q:
The last question regarding order changes increasing or decreasing doesn't
reflect what I calculate as the correct percentages.
A: Make
sure the correct expressions are being calculated. Check
above for the correct equations.
To change any of the equations, use these instructions. |
|
Quality Indicator Report Card Q:
I have concerns that Quality Indicator #5 does not reflect the treatment
the patients receive because even if a non-opioid was ordered, it doesn't
always get administered.
A: Yes,
this is a consideration. Remember that this database and the graphs in
it are just a template. You CAN manipulate your data to show whatever you
are looking for. Or you may want to simply count the number of people to
come up with your own statistics. We suggest asking your IS department
for assistance.
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