copyright 2004, Welford Medical Computing, Inc. All rights reserved

USING A FLOWSHEET (User's Manual, pgs. 857-862)

1. Press View\Flowsheets\Use.

2. For Title, type in Thyroid, or choose it from your list of Flowsheets

3. For Start Date, enter the earliest date of data you wish to see. For most situations, you will probably want to set this to be about 3-6 months earlier that today's date, so that you can see recent trends without being overwhelmed with a lot of older data. However, you may wish to set it to a different interval depending upon the nature of the test. For example, for thyroid tests, you might want to set it back 1-2 years. For tests in the hospital that are ordered daily, you may wish to set it back only 3-7 days. The factory default is to only show today's values. However, you can change this default by pressing Options and setting Open back to a value other than 0.

4. Enter the name of the patient whose Thyroid Flowsheet you wish to use (e.g. Kelly Erickson).

7. Either double-click on the TSH box up in the grid, or click on the TSH box on the Tests tab in the editor at the bottom. (Either way you end up at the same box). Type in a TSH value of "9".

8. Notice that the "9" automatically appears now up in the grid in the TSH column. Note also that this value will get automatically stored in this patient's Lab Book when you store this Flowsheet.

9. Now <tab> or click on the "Free T4" box on the Tests tab and enter a value of "0.4".

10. Since you have no Thyroid Ultrasound report, leave it blank.

11. Note that the Drugs column is blank, as is the Current Doses tab, because the patient is not yet on any thyroid medication.

12. Either double-click on the New Doses column in the row with today's date, or click on the New Doses tab in the Editor, or press <Pg Dn> in the Editor until you reach the New Doses page.

13. Click on the Start New Drug bar. This opens a Medication\Add window for this patient.

14. For Drug, type in "levothyroxine"

15. For Instruction, type in "0.1 mg po qam".

16. Leave the Date start as today and the Date end as blank and press Ok.

17. Note that this medication is now stored not only in the patient's Medication Editor but also now appears in the Flowsheet and as its own bar on the New Doses page in the Editor.

18. Double-click the Assessment box in the row with today's date, or click on the Assessment tab in the Editor, or simply press <Pg Dn> in the Editor to move to the Assessment page.

19. In the free text box on the Assessment page, type in "thyroid is underactive". Note that as you type, the text is copied automatically into the grid as well.

20. Double-click the Advice box in the row with today's date, or click on the Advice tab in the Editor, or press <Pg Dn> in the Editor to move to the Advice page.

21. In the free text box, type in "start on medication". Note that this is copied automatically in the grid.

22. Move to the Next Tests page.

23. Keep TSH checked but uncheck the other choices. Note that as you check and uncheck choices, these changes are automatically reflected up in the grid. Note that you can add other tests to the grid by typing them into the Test to add or change box.

24. Move to the Repeat In page.

25. Change the setting to read 6 weeks.

26. Note that at this point, if you wish, you could press Jump\Flowsheet Editor and change the characteristics of this Flowsheet. For example, if you realize now that you would like "start on medication" to be one of the Advice choices in the future, you could edit the Flowsheet, adding this Advice to the list.

27. Suppose you wish to send this Flowsheet now to the In-Box of your secretary, Suzy Secretary. When she receives it, she will see it in her In-Box, call the patient up, tell her to start the medication, call in the prescription, and then go to the Notified page of the Flowsheet and enter the Date Notified, Time Notified, Notification Method, and any optional Comment about what she told the patient or what the patient told her. Her name will be automatically stored in the Notified by field, and all of this will be stored along with this line in the Flowsheet. To send this Flowsheet to Suzy, press the red Send button . Then, check Suzy Secretary's Name from the list and click Ok.

28. At this point, you could press Store to store this Flowsheet information. You would mainly do this if you wish to then edit another Flowsheet (on this patient or some other patient) before leaving Flowsheets. However, if you would rather leave Flowsheets and return to the Main Menu, press Ok instead.

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