Nova StatStrip Downtime Override

We allow downtime override all over the hospital.  Sometimes when patients get moved the adt doesn’t catch up like surgery to sicu.  So we allow anyone to use it.  Though we train to double check what you scan vs what it should be before overriding.   We also have our middleware hold results if an id was used for someone discharged. 

We allow users to override. Currently we are facing an unresolved issue dealing with overrides. The majority of Patient testing will require the user to perform a New Patient Override even though they are in the system. Once the override is accepted, all results flow over to the EMR as they should. This is extremely aggravating because the users believe all overrides are due to this issue. 

Andrea, will you elaborate on "the ADT doesn't catch up". Is your system doing the same thing that I have explained above? 

We only use the downtime override function in the ED and Labor/Delivery since there may be a need to test before the patient gets an armband/ID.  They will enter a fake ID, such as 9999999999.  They are then to complete a name verification form and send to us, within their shift, so that we can reconcile the result in RALS and release to the EMR.  

POCT Name Verification Form__blank_copy_id_4930858.pdf

We do a similar thing as Deborah.  We go one step further and have a barcode on the verification form that allows are end user to scan the same number.  They send the verification form for us to reconcile the result in Telcor QML for us to release to the EMR.  

Ashley yes it is the same issue.  Where the information getting to meter is slowed down that they need to override and then the result crosses through to the patient chart just fine

Thank you Andrea! 

Our process is the same as Andrea's...

We do the same as Andrea. We allow the use of the meters during code blues which could be on an employee or adult with no ID. They have no choice but to put in a fake number. We also have some departments that see a mix of inpatients and outpatients and the meter can only be programmed to grab from one of those ADT "buckets". The users in these areas know that and have been trained to double and triple check the ID and use downtime override. These results still go to the chart since it is a correct MRN. 

Thanks everyone!  We currently allow the users to scan a "Non-admit" form and send to us as well to correct and post to the chart once the patient has been registered.  Sounds like we will need to allow this option across the health system to ensure we can still obtain glucose results.

We use "Downtime Override" at all locations.  Somehow the ADT is slow catching up with the patient after they were moved from one location to another.  But if more than one patient in one location requires Downtime Override, the unit usually let me know. Sometimes registration make a mistake, then I have to investigate why that patient number require Downtime Override.  
It is a necessary feature especially if the patient require a glucose STAT. 

In all areas we use both overrides  "new patient" and "downtime"  as choices to select.  We did update the message in NovaNet. Hated the wording Invalid Patient ID. If PPID does not display - the scanned number shows in red and comment reads in red  " Validate Patient ID - Check against the armband"  Teach in class that if  patient is wearing an HIS armband and # displays in red - press back and rescan OR match each digit to the armband before pressing override -  that is the only way it will chart.  If does not match print a new armband.  If an emergent need they use 911 and send email to our shared POC inbox or in secure EPIC chat.  We have very few inpatient overrides and track these as a PI. 

Patsy  - that is great to know! I had no idea that the comments could be manipulated that much. I will definitely have to think about changing that in the future. You're right - the operators freak out when they see "invalid patient". They always think the meter is broken. 

For those of you that use the downtime override option on the glucose meter - do you track them for PI or compliance?  If you review them, how are you checking them to ensure its not end user behavior versus an ADT issue?