Dream Factory by TruBridge Ideas Portal
Currently if a blood pressure is documented manually by nursing staff in the VS application, the MAP is auto calculated once the systolic and diastolic pressures have been entered. When they're imported from a monitor system (like Mindray), only the systolic and diastolic pressures appear even though the HL7 message contains the MAP value. The programming / logic used in the VS application needs to be updated so it recognizes the mean arterial pressures being imported with the rest of the VS. When providers enter orders for Hemodynamic drugs such as Norepinephrine using an infusion protocol, the order will state the parameters. For example, "Norepinephrine drip, start at 2mcg/min and titrate every 2-5 minutes to desired mean arterial pressure (MAP) of 60 - 65". Documenting this correctly would be greatly improved if the VS imported appear accurately in the EMR. On hectic nursing units in stressful situations, remembering to enter all of the B/P's manually so the MAP is captured is easily overlooked.
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More Information Needed
I put in the Merged idea in September 2022. This issue is a very important one to the ICU staff who are entering BP/HR/MAP every 5 minutes for some medications. Especially when the Provider has ordered the titration to be done according to the MAP. It must be documented so that the medication that is being giving compares to the MAP result. It is extremely time consuming to enter these manually every 5 minutes. Currently our ICU nurses are Importing the BP/HR and then going into the Flowchart to manually document the MAP. Or they are not importing and manually entering the BP/HR in the VS application and letting the MAP be calculated. It is very frustrating because our bedside monitors do send the calculated MAP, but Trubridge does not accept the value.
I saw this was marked as more information needed. Feel free to email me, this is absolutely important for ICU care.
As the person who submitted this idea, I find it hard to understand why it's been nearly 2 years now and the Status is still "Open for Comment". This is an issue that I feel is being ignored and in the meantime is a potential patient safety issue. This should at least be in Product owner review.
This is standard of care for sepsis patients.
Janna Sartin at Girard Medical Center has to do the following with the interfaced Arterial BP- the blood pressure does not come across as showing as Arterial. They currently print he Mindray information and then scan into the patient chart. If the Arterial BP could have its own unique field in vitals, similar to what was done with EtCO2, she feels this would be a good step forward.
Please add CO2 while you are at it. I have a separate Dream Factory idea for this but I'm not going to miss an opportunity to suggest this.. It would be great to be imported with the other vitals but currently there is not even a place to even document it in Vitals. CO2 has been a standard of care for sedation since 2011.
In addition, for those of us who do not have a monitor interface, we need to be able to manually enter MAP instead of having it calculated. There should be a setting where we can turn off the calculated MAP.
Most (maybe all) NIBPs measure MAP and calculate systolic/diastolic based off an algorithm. Often the measured and calculated MAPs match, but not always. It is disturbing to know that clinical decisions are made based off a number that might not be accurate.
We also previously submitted this request back in September. DFE-I-285. It's a real aggravation for nursing that it only calculates for manually entered vitals even though it's on the interface.