INP402 EpicCare Inpatient Clinical Exam (Latest 2023/ 2024 Update) Questions and Verified Answers| 100% Correct| Grade A
INP402 EpicCare Inpatient Clinical Exam
(Latest 2023/ 2024 Update) Questions and
Verified Answers| 100% Correct| Grade A
Q: Defines the type of information users can document in the row & how they should format it;
determined by the row type.
Answer:
Value type
Q: Where do you link rows to a group?
Answer:
Within the open group/row record (in the doc flowsheet builder).
Q: Where do you link groups to a template?
Answer:
Within the open template record (in the doc flowsheet builder).
Q: Where do you specify all the rows that should normally show up in a group by default?
Answer:
The group form in a flowsheet group record.
Q: How do you have groups added on a template that should not appear by default/added by
clinicians as needed?
Answer:
Start Removed (mark them as start removed).
Q: Organizes similar groups together in the table of contents so clinicians can easily navigate to
that part of the flowsheet template.
Answer:
Topics
Q: In what order should you build a flowsheet?
Answer:
From the bottom up, but with a slight variation:
-at a high level, to build most flowsheet rows:
- Create a placeholder flowsheet group record
- Build all the rows to appear on the flowsheet (build row records & set the group as
“preferred”) - Attach the rows to groups created in Step 1
- Build the flowsheet template & attach groups to it
Q: Where are all flowsheet records built, edited, & accessed?
Answer:
In Hyperspace (in Flowsheets FLT & FLO)
Q: How should you distinguish between groups and rows in the FLO record?
Answer:
Preface all group record names with “G” and preface all row record names with “R.”
Q: When building a basic flowsheet group (aka one not used for LDAs or med intake), what
category of Row Type should you use?
Answer:
A Row Type of Flowsheet Group.
Q: True or False. Updating the Row Type for a record can alter what you can or cannot do
within it.
Answer:
True
Q: Explain the difference between Maximum/Minimum fields vs. Warning Maximum/Warning
Minimum fields.
Answer:
The max/min fields prevent impossible values from being entered; the warning max/warning min
fields help to alert clinicians of abnormal values.
Q: A setting within a row record that indicates what group a row should be added to if the row
is added to a flowsheet on its own; does NOT add the row to the group, just says what group is
should appear in.
Answer:
Preferred group
Q: What happens if the preferred group is left blank?
Answer:
Drops to the bottom of the flowsheet in the OTHER group.
Q: How do you LINK the rows into the group?
Answer:
After all rows are created, you list them within the group record itself.
Q: Because both rows & groups link out to groups, what build is most efficient?
Answer:
Build groups first and add them as preferred groups when building rows.
Q: What are the three (3) main records needed to build a flowsheet?
Answer:
Flowsheet Row
Flowsheet Group
Flowsheet Template
Q: The nurse opens flowsheet template & Add Row; after making a selection, the row he
chooses drops to the bottom under OTHER; why?
Answer:
The group is not listed as preferred within the row record.
Q: Why could a user be unable to add a group using Add Row?
Answer:
The flowsheet has Restrict Rows set within the template record.
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Flowsheets activity
Where do nurse do the majority of their documentation for a patient?
Template (Flowsheet templates, Flowsheet tabs)
Used to organize different types of documentation; seen as tabs within the activity; used to group similar categories of documentation together.
FLT master file
Each flowsheet template is a record in which master file?
FLO master file
Groups & Rows are records in which master file?
Group (Flowsheet Group)
Used to organize individual documentation flowsheet rows; appears as a darker row color/bold font in the flowsheet activity.
Row (Flowsheet Row)
Where data is documented; designed to hold specific data; appears as a lighter row color in the flowsheet activity.
Doc Flowsheet Builder
The administrators home menu when building flowsheets.
Row type
Defines the purpose of a record.
Acuity Calculator
Charge Row
Custom Formula
Data
Flowsheet Group
Infusion Group
Lines/Drains/Airways
Programming Point
Properties
Row types: What are the nine (9) available row types?
Value type
Defines the type of information users can document in the row & how they should format it; determined by the row type.
Blood Pressure
Category Type
Custom List
Date
Height
Numeric Type
Patient Height
Patient Weight
String Type
Temperature
Time
Weight
Value types: What are the twelve (12) available value types?
Details Report
Shows extra information about the flowsheet on the right side; min & max values, who documented, etc.
Table of Contents
To the left of the flowsheet; shows the available templates/tabs.
Within the open group/row record (in the doc flowsheet builder).
Where do you link rows to a group?
Within the open template record (in the doc flowsheet builder).
Where do you link groups to a template?
The group form in a flowsheet group record.
Where do you specify all the rows that should normally show up in a group by default?
Start Removed (mark them as start removed).
How do you have groups added on a template that should not appear by default/added by clinicians as needed?
Topics
Organizes similar groups together in the table of contents so clinicians can easily navigate to that part of the flowsheet template.
From the bottom up, but with a slight variation:
-at a high level, to build most flowsheet rows:
- Create a placeholder flowsheet group record
- Build all the rows to appear on the flowsheet (build row records & set the group as “preferred”)
- Attach the rows to groups created in Step 1
- Build the flowsheet template & attach groups to it
In what order should you build a flowsheet?
In Hyperspace (in Flowsheets FLT & FLO)
Where are all flowsheet records built, edited, & accessed?
Preface all group record names with “G” and preface all row record names with “R.”
How should you distinguish between groups and rows in the FLO record?
A Row Type of Flowsheet Group.
When building a basic flowsheet group (aka one not used for LDAs or med intake), what category of Row Type should you use?
True
True or False. Updating the Row Type for a record can alter what you can or cannot do within it.
The max/min fields prevent impossible values from being entered; the warning max/warning min fields help to alert clinicians of abnormal values.
Explain the difference between Maximum/Minimum fields vs. Warning Maximum/Warning Minimum fields.
Preferred group
A setting within a row record that indicates what group a row should be added to if the row is added to a flowsheet on its own; does NOT add the row to the group, just says what group is should appear in.
Drops to the bottom of the flowsheet in the OTHER group.
What happens if the preferred group is left blank?
After all rows are created, you list them within the group record itself.
How do you LINK the rows into the group?
Build groups first and add them as preferred groups when building rows.
Because both rows & groups link out to groups, what build is most efficient?
Flowsheet Row
Flowsheet Group
Flowsheet Template
What are the three (3) main records needed to build a flowsheet?
The group is not listed as preferred within the row record.
The nurse opens flowsheet template & Add Row; after making a selection, the row he chooses drops to the bottom under OTHER; why?
The flowsheet has Restrict Rows set within the template record.
Why could a user be unable to add a group using Add Row?
When they are ready to be used in production.
When should flowsheet records be released?
To preserve data integrity; altering certain fields would change the fundamental behavior of the row.
Why are some fields uneditable once the row is released?
Min/Max
What setting restricts the end user from entering an out of range temperature such as 200 or 1000?
Create a new version- as long as you do not need to change the row type or value type.
What do you do if you need to edit a released version of a row?
Retire the row & create a new one.
What do you do if you need to change the row type or value type of a row?
Units section
What setting lets the administrator build “per minute” or etc. to be seen when hovering over a value?
Start removed
When checked, indicates groups that are part of the template but only accessible by a manual Add Rows (not provided by default).
Allow remove?
When checked, indicates the user can manually remove the group from the template.
Log completely out of Hyperspace & then back in again.
What do you have to do to update Restrict Rows in Hyperspace?
Flowsheet groups & rows are all records in the same master file (FLO); they begin as “blank” FLO records & only become a group or row when you assign them a row type.
Why use the same field to create both groups and rows?
The Start Removed property
Which property of a flowsheet row takes precedence over its preferred group?
Building the template & adding the appropriate groups; because all groups must be build before a template can be finished.
What is the largest piece of flowsheet build and why?
Preferred Group
The group in which a row should appear if someone adds the row individually to a flowsheet; not the same as attaching the row to the group.
Warning Min/Max
Values below/above these numbers generate a warning flag in the flowsheet cell.
Released
Indicates the record can be used in a production environment with real patient data; causes certain fields to grey out, aka become uneditable.
Cascading
Functionality that automatically adds, or prompts you to add, specific flowsheet rows & groups to a flowsheet template when a value in a row meets a specified condition.
It appears at the bottom under Other.
If NOT in the group record, what happens when you add a row manually to a flowsheet using the Add Rows button?
So users can remove the group if they chose it in error.
Allow remove? and Start Removed usually are selected together: why?
Rows & groups
Which flowsheet records can be released: rows, groups, or templates?
Text-side utility
Used to release records en-masse.
In the row that triggers the cascade.
Where do you configure cascading & the rows that are added?
Charting to a definition (aka charting by exception)
The model of clinical documentation where a clinician records only abnormal values.
Automatic cascades
Add new groups and rows to the flowsheet without additional input from the user; guides the user (disadvantage is use of space).
Prompted cascades
Allow the user to pick which groups and rows to add to the flowsheet; hides items not often needed (disadvantage is popup fatigue/unable to find); best to use when true choices must be made.
You would not see the WDL row.
Why not mark the entire group as Start Removed?
1-Be able to be documented by typing “WDL” or “X”
2-Provide a definition of defined limits for your organization
3-Cause rows to cascade (automatically, if appropriate)
WDL rows that cause rows to cascade should do what?
Allow copy forward
Select this check box if users should be able to right-click the row in Doc Flowsheets & copy a previous assessment to the current time column.
Cross Encounter
Select this check box to allow users to view or copy data in this row from a previous encounter into the current one.
Row information
Include instructions for your end users on how to document in this row; information here appears in the Details report in the Flowsheets activity.
Top table of the Cascading Flowsheet
Section where you specify the condition triggering the cascade.
Bottom table of the Cascading Flowsheet
Section where you list the groups or rows that should appear when the cascade is triggered as well as method in which they will appear (automatically or prompted)
Comparison Operator (equal, greater than, greater than or equal, less than, less than or equal, not equal)
The logical operator to determine if cascading rows are triggered.
Comparison Value
Free text field; not case sensitive.
As the abbreviation.
If you build a custom list with abbreviations, how should you list the value in the comparison value section?
Evaluation Logic
Specifies how the system should determine a cascade trigger.
“(1 AND 2) OR 3” – entered after choosing Custom Evaluation Logic button in the Cascading Flowsheet section
If you have 3 conditions listed & want cascade to trigger if either both lines 1 & 2 are true or if line 3 is true, what (& where) would you enter?
Flowsheets
The Work List
Care Plans
Patient Education
What is the Clinical Documentation install team primarily responsible for?
Clinical Content Build Out (CCBO)
The process in which decisions about build are finalized, implemented in build, & validated by stakeholders.
False
Epic’s Foundation System clinical content is evidence-based.
Charting to a definition
A method of clinical documentation where providers record only the values outside the facility-defined normal limits.
True
True or False: cascading rows always appear in the order they are attached to the flowsheet template record, regardless of how the end user cascades them onto the flowsheet.
Trigger row
The row that causes the cascade to occur.
Calculated assessment scale
A numeric scale representative of a nursing assessment and used as a tool to determine future intervention (exs: Braden, GCS)
Charge row
A row configured to generate a charge; can be done as the end user is documenting in flowsheet; choose it as the row type.
Enter a number as the Abbreviation for the custom list value.
How do you associate a numerical value with the choices in a custom list row?
Charge trigger type
When building a row that files a charge, in which field can you specify how often the charge(s) should be filed?
Charge quantity
The number of charges this row should generate when a value is entered; the default is zero for this field, so if you leave it blank, there will be nothing generated.
Denoted by braces
Record IDs in a custom formula are formatted/identified in what way?
Use 2 semicolons to seperate the record ID from a default value (ex: {record ID;;0}).
How do you make custom formula rows default to a certain number if the values are not defined?
weight- in ounces
height- in inches
temperature- in Fahrenheit
In what units is weight, height, & temperature stored in Epic?
{blood pressure row ID number;D}
To enter values for diastolic blood pressure, what formula would you use?
{5;D}+({5;S}-{5;D})/3 (where ‘5’ is the Foundation record ID number)
How is mean arterial pressure stored in Epic?
{blood pressure row ID number;D} for diastolic; {blood pressure row ID number;S} for systolic (these are stored as 2 values within 1 row)
How is BP built in Epic?
The combination of Started & Discontinued values.
What creates a charge in the system?
By placing a $ symbol in the display name.
How are charge rows identified to the user?
Chargeable procedures
Charge rows must be linked to what?
Each Entry
First Entry Only
On/Off Time Based
Once Per Day
What are the 4 types of charge triggers?
Quantity type
Determines the method by which the quantity of charges for a row will be determined; use the value Qty by Spec Value to specify the number of charges in the record.
Charge procedure
The field that links the flowsheet row to a specific chargeable record in the Procedure (EAP) masterfile; is the actual charge applied to the patient account.
Enter a number as the Abbreviation for the custom list value.
How do you associate a numerical value with the choices in a custom list row?
Required documentation
Helps guide the users to know what documentation is needed.
Required doc report & button
Indicates whether the req doc is complete; nurses can click the links into the chart to finish documentation. When the button is enabled, the required rows appear with icons in the flowsheet.
At the system or department level (typically, the system level is first)
Where can administrators configure the rule for required documentation?
The patient’s current department (not the user login)
Required documentation is controlled by what?
Documentation rules editor
Where the required rows and due times are linked to the documentation rule.
Link to rules
This portion of the documentation rules editor links to rules that specify required documentation.
Define the due time
This portion of the documentation rules editor sets the parameters for when clinicians receive a warning about documentation due soon & when it is flagged as overdue.
Flowsheet links
This portion of the documentation rules editor tells the system which flowsheet to jump to from the required documentation report, and it tells the system which rows to highlight as required when working in the Flowsheets activity.
- Plan- what is required & when should it be documented?
- Create a rule using Rule Editor
- Attach rule to Department Rule Editor or System Definitions
- Test your build
List the required documentation build steps.
Flowsheet row records need to exist first so the rule can include that flowsheet row.
When building out a Required Documentation rule, should you build out your rule first or your flowsheet row records first?
Warning time gives the enduser a yellow circle for documentation needing to be completed soon; due time gives the enduser a red circle to indicate overdue documentation.
Describe the differences between a warning time and due time in Required Documentation.
In the configuration record
Which record do you list the specific flowsheet template when building a new navigator section?
Navigator
A series of sections meant to follow a particular workflow, such as admitting a patient.
Configuration (VCN) record
The powerhouse of the navigator; holds all details of what f/s template to use, whether last filed values will appear, & if completed rows should be hidden.
PAF Column
Record in the census field master file; displays info about records in report results.
If you attach a rule to a department, it affects the documentation requirements that display for patients admitted to that department.
You can attach a rule to a department or to a Systems Definitions level: when is it best to use one over the other?
-when a clinician should be warned of upcoming documentation
-when documentation is considered due
-groups &/or rows that will appear with req doc icons next to them in flowsheet activity
List some details set when rules are attached to a department.
- Plan out your build
- Create a navigator configuration record
- Duplicate/create a navigator section record
- Produce remaining navigator records in Hyperspace using the Navigator Template Editor & assemble the navigator
- Test your work
Steps to build a flowsheet navigator section. - Plan- what flowsheet data should display
- Create PAF columns for those that do not exist in Foundation
- Make columns available to users
-managing column groupers
-adding column groupers to a profile - Test your build
What are the steps to build a PAF Column?
Anything really, but usually used for helping the clinician navigate through requirements such as admission documentation or daily shift workflow items to be documented.
Types of documentation that can be used for Required Documentation.
In Template Editor (LVN) in Hyperspace; go to the navigator link. Also in Text in Navigator, Navigator Configurations (VCN).
Where do you attach a flowsheet & configuration record when building navigator sections?
Rule (CER) record
Used for varied purposes; usually to evaluate info & return a true or false.
It is true when a patient’s documentation is complete.
In required documentation, what is the goal when building a rule?
Because rules are used for more than flowsheets (like BPAs & Care Plans); changes will affect other areas.
Why create/duplicate a new rule instead of editing an existing rule?
Evaluation logic
The logic the rule will apply to the criteria properties listed.
And
Properties listed below will ALL need to be documented upon to satisfy the rule.
Or
Any of the properties listed below can be documented upon to satisfy the rule.
Custom
Allows for the requirement of a combination of properties listed below (ex: “1 and (2 or 3)”); in this logic, the order in which the properties are listed is important.
Flowsheet Row ID
This is the flowsheet group or row you want to evaluate; if a group is entered here, users must fill out every row within that group to satisfy the property.
Operator
The ways to have a record evaluated: equal, greater than, less than, greater than or equal to, less than or equal to, between
Ignore system rules?
If checked, the department rules will override those set at System Definitions; if unchecked, Sys Definition rules will also apply.
Column
This is the record name of the column.
Caption
This is the display name of the column; it is what will appear to users in Patient Lists if they add this column to a My List or System List Grouper; the name will be truncated if too wide to accommodate captions.
Used By
List the applications that use this column; for inpt pt lists this field is required in order for the column to be available.
Field Type
Indicates the type of census field: data item or extension
Data Item
Retrieve information from a master file.
Extension
Used for parameter-based programming points; they are code-containing records and should NOT be edited in production.
Master file
The master file the column’s data comes from.
Text Ext.
Enter an extension record in this field to tell the system where to look for the data to display in this column.
Parameters
Depending on the extension record, you might need to enter the specific record or specific location where the data can be found.
Data type
This tells the system what type of data to expect in the column- numbers, date, time, string (freetext), etc.
No- users are given a subset of the columns from the PAF master file to use; assigned by a Column Grouper record attached to their profile.
Are columns available to all users in Patient Lists?
Default flowsheet
The flowsheet order set in the profile record for the enduser; the tab order can be changed by the enduser if desired.
Template tabs
The flowsheets that appear for an enduser; the template order field in Clinical Administration is where the order is entered.
In Hyperspace, check the template record of the clinician; check the EpicCare form to see if the clinician’s profile is listed in User Profile field.
How can you troubleshoot tabs you cannot see?
- make a plan- decide who needs to see which flowsheets
- create flowsheet templates
- create a preference list
- attach the preference list to a profile, location, service area, or facility record
List the steps to create a flowsheet preference list.
The preference list attached to the most specific place (usually location) takes precedence; location, service area, and facility records are all built in the EAF master file.
How does the system honor multiple facility preference lists?
It attaches the flowsheet templates to a particular preference list as to regulate what the user can select.
How does a preference list affect what an enduser sees in Hyperspace?
In the profile record of text.
Where do you restrict the view of flowsheets for the clinician?
0- no restrictions (if left blank, this is the default)
1- database only
2- facility only (not used often)
3- database & facility (common)
What are the restriction types you can use to limit user searches?
1- the profile preference list must include all templates needed becasue they will not be able to use the Selection button to search
2- if you forget to assign a pref list in their profile, their tabs & default settings are liited; they will likely receive the message “Flowsheet template selection is disabled for this user.”
If you choose to apply both database & facility restrictions, what implications must you consider?
Facilities often have hundreds of flowsheets; limiting available ones to endusers will help decrease search time & make sure they use the flowsheets intended for their work area.
Why should you limit the flowsheets a clinician can access?
Yes- users can create their own flowsheet template tabs by clicking the wrench; the first tab is the default for that user.
Can a default flowsheet set in a profile record be overridden?
In profile records; they are the only ones containing the ‘template order’ of tabs.
Where can you set flowsheet template tabs?
False; a preference list linked to an appropriate record allows the enduser to see it, regardless of release status.
True or False: a preference list must be marked as released in order for an enduser to see it.
- profile record
- location
- service area
- facility records
Where can a preference list be attached/assigned?
Login as administrator, go to User (EMP), check in EpicCare for the template record in the user profile field.
If a user cannot see their preference list, how can you troubleshoot it?
Order Flowsheets button (the wrench): select override template order box & rearrange the order.
Where the enduser can change their own flowsheet template tabs.
Clinical Admin > Mgmt Options > Profiles > Flowsheet; list the f/s templates in the order they should appear in the Flowsheets activity.
Where are flowsheet tabs configured? (aka Set a Default Flowsheet & Template Tabs)
Use the Filter toolbar using pref list; set it to “yes”
How can the user see only the tabs set for them?
Tell the system to which users it should apply; in text > clin adm > mgmt options > profiles >flowsheets – 3
Once a preference list is created, what is the next step?
Only 1 preference list can be assigned.
How many flowsheet preference lists can be assigned to a profile in text?
Clin Adm > Facility Structure > Facility/Service Areas (EAF); enter the list on the screenwith f/s template pref list for either location, service area, or facility record.
What is the path to assign a preference list to a piece of facility structure?
Properties
The values “12/19/13 Left Forearm” are what type of documentation?
Group renaming rows (used to generate the name of the LDA group)
The IV date & location values/properties are in the group name because they were configured as what?
In the LDA group record
Where are group renaming rows configured?
Make all data rows used in an LDA group duplicable.
What must you do when building data rows for an LDA to make sure they can appear in the LDA group?
Rows in Properties record are for one-time documentation & appear in the Properties window, attached to the Properties record of the LDA; the rows attached directly to the LDA group appear on the f/s to be documented over time.
What is the difference between LDA rows in the Properties record and those that aren’t in the Properties record?
700- placement date
701- placement time
702- removal date
703- removal time
Name the 4 standard, Epic-released data rows that must be used in the Properties record of EVERY LDA.
Properties Row Type
Needed by all LDAs; renames the group to identify the LDA; documented on just once.
Lines/Drains/Airways Row Type
Special flowsheet groups to document on all lines drains, airways, incisions, wounds, tubes, & even pain.
Line
Any invasive line inserted into the patient such as peripheral IV, PICC line, A-line, etc; should be documented on a specialized IV Assessment flowsheet template restricted to only line LDAs.
Drain
Any invasive drain or tube inserted in the patient such as NG tube, JP drain, Foley, etc; should be documented on the standard Intake/Output flowsheet template.
Airway
Any invasive airway or opening in the patient such as ETT, tracheostomy, etc; should be documented on either the standard head-to-toe assessment or on a specialized f/s template restricted to airways.
Wound
Should be documented on either the standard head-to-toe assessment or on a specialized f/s template restricted to wound care.
Assessment Row Type
Needed for ongoing documentation on the status of the LDA (ex: skin appearance, dressing status, etc.)
1- Create LDA Property Rows
2- Create the Properties Group record; attach the standard properties plus any additional from step 1
3- Create the Over-Time Assessment Rows used to document ongoing assessments of the LDA
4- Create the LDA Group record; attach Properties record & all of the ongoing assessment rows.
In what order do you build an LDA Group? (*note: shell placeholder groups are not needed)
Allow completion & be duplicable
Every record in an LDA should do what?
Because rows are often shared between many different LDAs; it is impractical to assign them a single default group.
Why is the Preferred Group field in an LDA group not used like in other flowsheets?
Flowsheet
Data
Each property of the LDA must be built as a ____with a row type of _.
In the Properties record
Does the group renaming follow the orders in which the rows are listed in the Group Renaming Rows field or in the Properties record?
Restrict rows
Select this check box to prevent users form adding any groups, rows, or LDAs to the f/s other than those listed in the Group/Row field.
Yes- the user must manually add each LDA
Should the Start Removed? check box always be selected?
1- create or copy the f/s template containing the groups you want to override for certain users
2- open the group & override the rows that will appear for the new template
3- attach the new template to the user’s profile (if this is a default template) &/or add it to the f/s preference list affecting this user
How do you override default rows by user?
You don’t have the option to add rows; you can only remove them.
How can I add rows to a particular Template?