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Open blue Actions tab, under labour heading

Open the blue Oxytocin button.

Add new, fill in details required. This will give you your Oxytocin prescription, this will also have to be prescribed on the paper drug chart.

You can then access this on the Plan, once prescribed it will drop a blue label on the bottom right of the Plan, open this to open your prescription

Open the Commence Infusion and fill in as required.

Can also be accessed via the Oxytocin button in Actions, once prescribed.

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plh-tr.digitalsupport@nhs.net

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Whenever you feel it's appropriate to review care.

However they should definitely be done:

on initial admission to labour ward to risk assess fetal monitoring

hourly (includes routine CTG review)

during ward round

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How to do a SAFERR review (VISUAL GUIDE)

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How to do a SAFERR review (VISUAL GUIDE)

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How do I document a perineal repair/suture?

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How do I document a perineal repair/suture?

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Open the blue Actions button

Under the Management heading open the blue Plans button, this will open the Management Plan wizard

Click on Add New Management Plan, this will give you a list of pre set plans, open the one required and fill in

Once completed it will give you a chronological list of all Plans

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In "actions" choose "labour" then "second stage obs"

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Open the Blue Actions tab

Under the Management heading open the blue Sepsis Six Pathway

Initiate New Instance of Sepsis Six Pathway, fill in form as required, when completed it will show a Sepsis Six Pathway

Click on to the one created, this will open a Sepsis Six Pathway form, click on the red pencils to fill in information required, after each section is filled in, the form will close and take you back to the original screen, where you will have to open again to fill in the next section

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When is the partogram triggered/why can't I see the partogram?

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When is the partogram triggered/why can't I see the partogram?

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By default, the partogram is not displayed until the labour start time has been entered

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Are one of the CTG stickers remaining to go on the CTG machine? 

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Are one of the CTG stickers remaining to go on the CTG machine? 

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Click onto the MOEWS tab

This will then open your MOEWS chart

In the top right hand corner, their is a blue Add MOEWS Obs tab, this will open the wizard to complete your MOEWS observations

Once the wizard is filled in it will the plot the observations onto the MOEWS chart, if the Partogram has started will also pull across to their

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Why are we routinely doing SAFERR reviews hourly?

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Why are we routinely doing SAFERR reviews hourly?

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This is part of updating our practice to ensure we are Saving Babies' Lives (v3) compliant. The new ask is for an hourly holistic assessment of both mum and baby. We're using the SAFERR review to achieve that.

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Yes, until around March 2024. Newly booked women will be given small folders to carry with them, CTGs can be stored in there in the usual envelopes.

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Click onto the Partogram tab

This will open the Partogram

Click onto the FHR (found on left hand side of chart) you want to record

This will then open the wizard for you to fill in the information required.

Once the wizard is filled in, it will plot the FHR onto the Partogram

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Under the "pain management" tab of the actions menu- look for the epidural insertion.

Beside the insertion detail you will see a red pencil and the opportunity to "perform review"

Click through to complete the screens.

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How to document observations of the liquor

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How to document observations of the liquor

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Liquor can be documented via the blue Actions tab

Under Labour - Membranes and Liquor, this will open a wizard for you to document the information

If the Partogram is running it will pull across to the chart, and you can also input information via the Partogram, by clicking on Liquor on the left hand side of the chart

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Complete all information on the outcome screens.

Complete an SBAR.

Complete discharge checklists.

Ensure patient is discharged from ward (see discharging patients guide).

Providing discharge is effectively completed the patient is automatically marked as needing postnatal triage by the community team.

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This is done via a SAFERR review. The suggestion is to use a workstation on wheels.

In Athena, navigate to the inpatient notes from the ward list in "locations."

Under the "management" tab scroll down to "SAFERR review"

Add new

Select the features to review

Complete the wizard

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In Athena, access the patient's notes by going to "locations," choosing the ward they are on and clicking the three dots by their name and selecting "inpatient notes."

Under the "management" tab scroll down until you can see "SBAR"

Select this button and click the red pencil by "add new SBAR"

Indicate where you are transferring from and to

Add the name of the transferring and receiving staff member (this needs to be updated at face to face handover if changed)

Complete the screens and add recommendations where indicated.

In Guardian, choose the "full inpatient notes" grey rectangle at the bottom of the actions menu.

In "Management" scroll down to the SBAR tab. Add SBAR as above.

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How to generate a hospital number/NHS number

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How to generate a hospital number/NHS number

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Please ensure that the baby's ethnicity and place of birth is filled in, as won't generate a number without

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From the main screen choose "locations" and the ward the patient is currently situated on.

Beside their name click the three dots and choose "inpatient notes"

Mum assessments (old purple stickers) are under the "clinical assessment" tab and "midwifery postnatal assessments."

Baby assessments (old lilac stickers) are under the "baby obs" tab and "baby assessments."

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The SAFERR board is on the wall in the CDS handover office.

It takes information from all the portals in the CDS rooms as to the current situation in that episode of care.

It updates in real time and provides insight into deteriorating situations for mother or baby, and external visibility of the plan.

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If your Partogram is running, you will find your Blood glucose on the left hand side of the chart

Click on to Blood Glucose, it will open a screen to record your Blood Glucose.

If the Partogram hasn't been started, open the blue Actions button,

Along the bottom their is a View Full Inpatient Notes button, open this, go to the Observations Tab across the top and the Blood Glucose button will be on the left hand side

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We used to have LSCS/OASI stickers with a pre-prepared plan, how do I do that now?

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We used to have LSCS/OASI stickers with a pre-prepared plan, how do I do that now?

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How to add a reminder to complete an action

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How to add a reminder to complete an action

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Open the Plan tab along the top

In the top right hand corner their is a blue Add Custom Plan Event

Fill in the wizard, once completed it will drop a purple label on to your Plan in the bottom right hand side of the chart

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Why does the system keep reminding me to do things?

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Why does the system keep reminding me to do things?

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The system uses preset care bundles to suggest you actions which it thinks are relevant to the person's care. For example, prompting BPs when an epidural has been recorded as in place. This should never replace your clinical judgement and is intended purely as a guide.

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Under "outcomes" and "baby" and then "baby details" ensure that the box is ticked to say resus was performed.

This opens a resus wizard on the left hand side to document events.

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In the Actions tab select "vaginal delivery scribe"

This wizard does not need authentication after every entry

Use the buttons on the left to add actions

Use the "add note" function to provide additional information

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Open the blue Actions tab,

Under the Labour heading, open the Vaginal Delivery Scribe, on the right hand side their is a Shoulder Dystocia Heading, open this and fill in as required

Under the Labour heading, open the Shoulder Dystocia Scribe, and fill in as required

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How to do mother/baby checks (old lilac/purple stickers)

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How to do mother/baby checks (old lilac/purple stickers)

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If my patient stays on CDS after delivery, do I document in Guardian or Athena?

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If my patient stays on CDS after delivery, do I document in Guardian or Athena?

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Anything you enter in Guardian appears in Athena. Anything you enter in Athena translates to Guardian. For ease you can continue to use the Guardian portal in the room to enter ongoing care details for your patient. In that situation, your portal can basically be used as a laptop. Enter obs, update management plans, record meds and add additional notes, just as you would in labour. All of this information will transfer to the Athena system used if/when the patient is transferred to the wards.

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You can do this in Athena. Go to the patient's record, select the "profile" tab, go to the far right hand side and choose "audit." Then go down that menu and choose "countersign."

In Guardian you can use the "add notes" button to leave a line explaining the period you are countersigning for at any time.

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This is completed under the third stage scribe.

Navigate to "outcomes" then "maternal" then "third stage."

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How to write extra notes for context (beyond what the system prompts you to complete)

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How to write extra notes for context (beyond what the system prompts you to complete)

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Open the Notes tab, along the top, this will open your notes page, any information input into the system will pull across to here and will appear in chronological order.

If you would like to add a free text note, open the blue Add note button on the right hand side, in this page open the blue Free text button, and here you will be able to add your free text note.

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Please continue to complete chronology in the usual way and send these to the safeguarding team/review them from the G Drive. You will still need to complete K2 safeguarding assessments where appropriate.

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Open the CTG tab along the top, to the right hand side their is a blue CTG review button, this will open the CTG review wizard

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Midwife 1 will do the routine review as part of their hourly SAFERR review.

Midwife 2 still comes into the room to review the trace. They complete the Fresh Eyes on the K2 portal.

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In "actions" choose "labour" then the "third stage scribe"

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From 29/11/23 we'll be adding records for new scans onto K2.

You can access them from the "fetal assessment" tab on Athena. Then choose "assessment history" where they will be attached.

All previous scans will be on paper in the handheld notes which women will retain.

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Enter MEWS on the standard chart.

Add notes of additional observations undertaken.

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Please be acutely aware that entering your password incorrectly 4 times will lock you out of the system for 4 hours!!! Please take note of warning pop up and inform Digital Midwifery Team

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On guardian, ensure wizard is fully completed before clicking register under the green baby button

NHS number should then pull through

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If you get an error message informing you 'Woman not linked on PAS' click resolve now and it will match to the hospital record

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What paperwork do I need to do after delivery in theatre?

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What paperwork do I need to do after delivery in theatre?

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You need to work through the outcomes tab.

The key part (at least initially) is to complete the "birth" section (the red pencil which says "delivery") and the "baby delivery information" in the outcome screens.

This sets up the screens the medics need to write their op notes.

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The portal comes with you.

Turn off the screen and unplug the unit.

Plug back in on arrival to theatre.

Document using the surgical scribes (accessible via the Guardian actions menu).

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Enter display settings via right click on desktops or via start menu then settings, system, display

Scale and layout settings, display resolution 1920x1080 , size of text 100%

Check settings each time you sign on to a different laptop, if not correct will effect your screen resolution on Athena

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When the CTG page is open, on the right hand side their is a blue button with Sign Trace, if you click this button it will ask you to authenticate, either by using your thumb/finger print or entering your password