resident:va
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| resident:va [2023/08/22 22:14] – [General Information & Onboarding] haley.d | resident:va [2026/04/17 13:21] (current) – [Clinic] ariel | ||
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| ==== VA Faculty ==== | ==== VA Faculty ==== | ||
| - | [[resident: | ||
| - | [[resident: | ||
| + | [[resident: | ||
| + | [[resident: | ||
| ==== Generic Monthly Schedule ==== | ==== Generic Monthly Schedule ==== | ||
| Subject to change! Melissa Munkwitz can update you on any changes, particularly with OR time. \\ | Subject to change! Melissa Munkwitz can update you on any changes, particularly with OR time. \\ | ||
| - | Hand fellow usually covers Weds hands cases--check weekly with fellow or Melissa. \\ | ||
| + | General Schedule | ||
| ^ ^ Tuesday ^ Wednesday ^ Thursday ^ | ^ ^ Tuesday ^ Wednesday ^ Thursday ^ | ||
| - | |Week 1 - Dr. Mathes |Gordon 8 AM Plastic Clinic (door code is 3-2-4), PM Gordon Hand Clinic | AM Gordon Hand OR (Fellow covers), | + | |Dr. Mathes |AM/ |
| - | |Week 2 - Dr. Gordon| Mathes 8 AM Plastic Clinic, PM Gordon Hand Clinic | AM Gordon Hand OR (fellow), AM/PM Hand Clinic | Gordon Plastic OR - 7:45AM Start | | + | |
| - | |Week 3 - Dr. Mathes | + | |
| - | |Week 4 - Dr. Gordon | Mathes 8 AM Plastic Clinic, PM Gordon Hand Clinic | AM/PM Gordon Hand Clinic | Gordon Plastic OR - 7:45AM Start | | + | |
| - | |Week 5 - Dr. Mathes | Gordon 8 AM Plastic Clinic, PM Gordon Hand Clinic| AM Gordon Hand OR (fellow), AM/PM Hand Clinic | Mathes Plastic | + | |
| ==== VA Templates ==== | ==== VA Templates ==== | ||
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| ^ Phone Numbers ^ Role ^ ^ | ^ Phone Numbers ^ Role ^ ^ | ||
| - | | Vocera | Calling system, return pages | 303 299 8020 | | + | | Vocera | 15239 | 720-857-5239 |
| | IT | 14681 | 8556734357 | | | IT | 14681 | 8556734357 | | ||
| | ED | 16298 | | | ED | 16298 | | ||
| | DJ | Plastics RN | 303 803 5199 | | | DJ | Plastics RN | 303 803 5199 | | ||
| - | | Mary | Plastics | + | | Zeina Omisola |
| | Jenn Hutton | SCI Wound Care RN | 720 469 8217 | | | Jenn Hutton | SCI Wound Care RN | 720 469 8217 | | ||
| | Melissa Munkwitz | Hand/PRS PA | 414 587 8491 | | | Melissa Munkwitz | Hand/PRS PA | 414 587 8491 | | ||
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| VA Prefixes: 720-857-xxxx or 720-723-xxxx. Use this last number to call back pages. ie. 1-2345, call 720 723 2345 skipping the 1.\\ | VA Prefixes: 720-857-xxxx or 720-723-xxxx. Use this last number to call back pages. ie. 1-2345, call 720 723 2345 skipping the 1.\\ | ||
| - | Vocera: | + | Vocera: |
| + | |||
| + | ==== VA APP'S ==== | ||
| + | The VA now has APP's that help manage inpatient needs and consults. There are sometimes gaps in coverage. If you admit a patient, please sign out to them so that they know the plan in case they get called (this limits phone calls to you!) | ||
| + | |||
| + | {{: | ||
| + | {{: | ||
| ==== VA Remote Access ==== | ==== VA Remote Access ==== | ||
| - | Get Card reader either from VA (will loan, but may lock you up if you lose it) or Amazon. Make sure MAC compatible if user\\ | + | Get Card reader either from VA IT (as of June 2024 they don't write down your info and don't care about getting |
| - | https:// | + | https:// |
| - | https:// | + | https:// |
| Make sure you have received Welcome Letter in email giving remote access. IF you have not, email Ashley.Herrera@va.gov \\ | Make sure you have received Welcome Letter in email giving remote access. IF you have not, email Ashley.Herrera@va.gov \\ | ||
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| *You need to be sponsored for a badge, email Ashley.Herrera@va.gov this takes few days -a week. I’d check back in with her after a week and email her again to get scheduled to obtain a badge.\\ | *You need to be sponsored for a badge, email Ashley.Herrera@va.gov this takes few days -a week. I’d check back in with her after a week and email her again to get scheduled to obtain a badge.\\ | ||
| * When you present for your badge, I recommend earlier in day, not lunch hour in order to get both building and computer access as these are 2 separate people and the computer people leave at 3.\\ | * When you present for your badge, I recommend earlier in day, not lunch hour in order to get both building and computer access as these are 2 separate people and the computer people leave at 3.\\ | ||
| - | * OH NO I HAVEN' | ||
| - | * EMERGENT: Call Police Dispatch 720-723-5800 and request reactivation for emergent purposes. This gets recorded in Facility Access Section for follow-up and verification with the supervisor/ | ||
| - | * NON-EMERGENT: | ||
| *Trial & error\\ | *Trial & error\\ | ||
| *Prior to starting VA rotation or taking call, recommend trying badge both for computer & door access during business hours\\ | *Prior to starting VA rotation or taking call, recommend trying badge both for computer & door access during business hours\\ | ||
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| |Men's Locker #59 | 8008 | | |Men's Locker #59 | 8008 | | ||
| |Woman' | |Woman' | ||
| + | |||
| + | ====Expired Badges==== | ||
| + | * OH NO I HAVEN' | ||
| + | * EMERGENT: Call Police Dispatch 720-723-5800 and request reactivation for emergent purposes. This gets recorded in Facility Access Section for follow-up and verification with the supervisor/ | ||
| + | * NON-EMERGENT: | ||
| + | * If you are already on campus when you realize this, use intercom button at entrance of staff garage marked " | ||
| ==== Meals ==== | ==== Meals ==== | ||
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| ==== Clinic ==== | ==== Clinic ==== | ||
| - | Plastics Clinic | + | Hand clinic and Plastics Clinic: |
| - | + | 1st floor, building E. Code 251 enter. On Tuesdays it is you, Mathes, Dr. Tebockhorst | |
| - | Hand clinic: | + | |
| - | 1st floor, building E. Code 154 enter. On Tuesdays it is you, Dr. Gordon | + | |
| Clinic names on CPRS: \\ | Clinic names on CPRS: \\ | ||
| Plastics: Rmr Surg Plastc (MD MPR, MD Oper, MD/PA, MD/PA postop, Md/PA preop, MD/Res Eval) (VVC is video)\\ | Plastics: Rmr Surg Plastc (MD MPR, MD Oper, MD/PA, MD/PA postop, Md/PA preop, MD/Res Eval) (VVC is video)\\ | ||
| Hand: Rmr Surg Hand (MD, MPR, OPer, Md/PA urgent, Pa post, pa screen)\\ | Hand: Rmr Surg Hand (MD, MPR, OPer, Md/PA urgent, Pa post, pa screen)\\ | ||
| - | Make sure if scheduling patient for follow-up via RTC in orders, you select the correct follow-up clinic\\ | ||
| - | For pre-ops, patients need: an H&P ("Surgical Preop-Op H& | + | Note Formats on CPRS:\\ |
| + | I recommend you creating templates for new patients vs. post-ops etc. Go to templates in lower left corner of CPRS, right click "My templates" | ||
| + | When you click "new note" it will pop up with progress note title:\\ | ||
| + | Plastics: PLASTIC SURGERY RESIDENT/ | ||
| + | Hand: Type in Hand --> will pop up options, select HAND RESIDENT CLINIC NOTE\\ | ||
| + | Sign notes by right clicking and selecting "sign note now" | ||
| + | It will show a prompt saying "are you the primary for this encounter" | ||
| + | You have to select encounter type, complexity, add Dr. Gordon, and diagnosis for encounter, then sign\\ | ||
| + | |||
| + | For pre-ops | ||
| + | |||
| + | For pre-op labs: Women <55 need HCG (under pre/post procedure orders-pre-labs-urine pregnancy), pre-procedure (NPO/ | ||
| - | For pre-op labs: Women <50 need HCG (under pre/post procedure orders-pre-labs-urine pregnancy), BINAX (under labs- POC), pre-procedure (NPO/ | + | If ordering studies/labs that require follow-up or change management |
| - | ==== PACS ==== | + | ==== IMAGING |
| - | PACS is IMAGING | + | PACS is IMAGING |
| - | You can also access | + | Access |
| 1. Tools | 1. Tools | ||
| 2. Imaging Apps | 2. Imaging Apps | ||
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| 4. Type in patient' | 4. Type in patient' | ||
| - | ==== Clinic Notes ==== | ||
| - | |||
| - | Make sure you always set up an encounter by right clicking note, select edit encounter and select yourself as a primary provider. Also select billing level of complexity, whether condition is service related, and a diagnosis for the encounter. Then write the note - there are specific plastic surgery headings to select. You can create your own template or use a pre-populated one. When you sign the notes - you are the " | ||
| - | |||
| - | If you are seeing a NEW patient consult: | ||
| - | If you are seeing a patient for follow-up, post-op: | ||
| - | If you are seeing a pre-op: “Surgical pre-op H&P” then follow the prompts and check all the boxes\\ | ||
| ==== Surgery ==== | ==== Surgery ==== | ||
| + | Find surgery schedule by selecting clinic schedule RMR SURG PLASTC MD OPER. All Gordon hand cases are now under this schedule as well\\ | ||
| + | \\ | ||
| + | \\ | ||
| The plastic surgery operating room day is Thursday. The first case is supposed to roll into the room before 08:00 AM to not be deemed " | The plastic surgery operating room day is Thursday. The first case is supposed to roll into the room before 08:00 AM to not be deemed " | ||
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| Prior to procedure, patients need orders, a pre-op H&P (by attending) and a consent. You do not need to write note on day of surgery. It's good practice to double check the charts beforehand to make sure that was all done. You should mark every patient. Dr. Mathes likes you to text him all patient names/last 4 of SSN at the beginning of each OR day so that he can write all his notes in the AM.\\ | Prior to procedure, patients need orders, a pre-op H&P (by attending) and a consent. You do not need to write note on day of surgery. It's good practice to double check the charts beforehand to make sure that was all done. You should mark every patient. Dr. Mathes likes you to text him all patient names/last 4 of SSN at the beginning of each OR day so that he can write all his notes in the AM.\\ | ||
| + | |||
| + | Ordering Tumescent: Go to surgery main menu, order tumescent\\ | ||
| ==== Admitting Patients ==== | ==== Admitting Patients ==== | ||
| - | Under orders, "Write Delayed Orders" | + | Under orders, "Write Delayed Orders" |
| - | "Admit to Plastic Surgery", | + | "Admit to Plastic Surgery", |
| - | Surgery Main Menu - can use general surgery | + | Click inpatient orders for all the below orders, and start by going through all the " |
| - | Go through each tab | + | Next in same menu, click " |
| + | Select NURSING free text (0) for free text wound care instructions\\ | ||
| + | Click " | ||
| + | Labs can be found under own menu listed on left of CPRS\\ | ||
| + | Restarting home meds: click on meds tab at bottom of CPRS--> Select all outpatient meds you wish to restart --> open action menu at top left of CPRS--> select transfer to inpatient.\\ | ||
| + | Vitals and I& | ||
| + | Pre-op attending H&P counts as admission H&P, but you need to write a Life-Sustaining Treatment note to be able to order their code status and admit them. Click New Note and type in Life to find note template. \\ | ||
| + | Can sign a bunch of orders at once by clicking File > Refresh Patient Information.\\ | ||
| ==== Discharging Patients ==== | ==== Discharging Patients ==== | ||
| Admitted patients will go to the Building K - 3rd floor.\\ | Admitted patients will go to the Building K - 3rd floor.\\ | ||
| Prior to discharge INPATIENTS, the patients will need:\\ | Prior to discharge INPATIENTS, the patients will need:\\ | ||
| + | (Clicking discharge menu under orders will walk you through this)\\ | ||
| - Discharge order\\ | - Discharge order\\ | ||
| - | - Discharge Instructions (under Notes-discharge instructions)\\ | + | - Discharge Instructions (under |
| + | - Med rec (Meds tab, under Inpatient Meds. Click on med you want to prescribe and click Action > | ||
| - Pharmacy Consult\\ | - Pharmacy Consult\\ | ||
| - | - Pain medication\\ | + | - place a nurse free text order for drain teaching if applicable\\ |
| - Operative Note must be dictated the same day\\ | - Operative Note must be dictated the same day\\ | ||
| - | - Discharge summary (under D/C Summ tab)\\ | + | - Discharge summary (under D/C Summ tab, click new summary, DISCHARGE SUMMARY)\\ |
| - | (Clicking discharge menu under orders will walk you through this)\\ | + | |
| Prior to discharge OUTPATIENTS, | Prior to discharge OUTPATIENTS, | ||
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| For narcotic prescribing, | For narcotic prescribing, | ||
| + | \\ | ||
| + | Can sign a bunch of orders at once by clicking File > Refresh Patient Information.\\ | ||
| ==== Dictations/ | ==== Dictations/ | ||
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| 1. To access dictation system:\\ | 1. To access dictation system:\\ | ||
| From within the facility, dial x15075\\ | From within the facility, dial x15075\\ | ||
| - | From outside the facility, dial 800-394-3845\\ | ||
| When the call is answered, you will be greeted with a voice prompt which gives you instructions.\\ | When the call is answered, you will be greeted with a voice prompt which gives you instructions.\\ | ||
| 2. Enter your USER ID, followed by the # key. \\ | 2. Enter your USER ID, followed by the # key. \\ | ||
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| SCI - This is the inpatient spinal cord unit (first floor of H). This unit is run by PMNR doctors and wound care. | SCI - This is the inpatient spinal cord unit (first floor of H). This unit is run by PMNR doctors and wound care. | ||
| * There are no longer MDC meetings | * There are no longer MDC meetings | ||
| + | * See Plastic Surgery TEAMS spreadsheet for pending SCI consults. You keep this up to date | ||
| * Whoever you are in clinic or OR that day is who I tend to staff the patient with. | * Whoever you are in clinic or OR that day is who I tend to staff the patient with. | ||
| * Our criteria is that their co-morbidities are relatively well-controlled, | * Our criteria is that their co-morbidities are relatively well-controlled, | ||
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| ==== End of rotation Tasks ==== | ==== End of rotation Tasks ==== | ||
| - | Set up a Surrogate: In CPRS - under “Tools” —> select “Options” —> select Surrogates —> select “Add Surrogate” put in name of next resident coming onto rotation and select start date as your last Friday on rotation (just make sure you clear your inbox your last day of rotation) | + | Set up a Surrogate: In CPRS - under “Tools” —> select “Options” —> select Surrogates —> select “Add Surrogate” put in name of next resident coming onto rotation and select start date as your last Friday on rotation (just make sure you clear your inbox your last day of rotation)\\ |
| + | |||
| + | Make sure TEAMS spreadsheets for SCI consults & Tasks to follow up are updated.\\ | ||
resident/va.1692756864.txt.gz · Last modified: 2023/08/22 22:14 by haley.d