The tube insertion order will be updated on March 1, 2021 to add a question for nurse to place KUB if the purpose of the tube is either medication or feeding. 

After the tube is placed, then the nurse would enter a portable KUB order with order mode of written. 

To avoid confusion and follow guidelines, the Coumadin Diet will be removed from Epic as a diet option. A Vitamin K consistent diet is encouraged while taking Coumadin/Warfarin and aligned with both the Warfarin Manufacturer's Patient Information Leaflet and the Patient Education provided by UMMC's Pharmacy Department. Currently, when a Coumadin Diet is ordered, it is essentially the patient's regular diet. There is NO restriction of Vitamin K foods which causes confusion for providers and patients that believe they shouldbereceiving Low Vitamin K foods while on a Coumadin Diet. For those that do prefer to restrict Vitamin K, a low Vitamin K diet will be available. 

Cupid, Epic's cardiology application, is being implemented at UMMC in phases beginning Monday, March1, 2021. Users will see changes to adult echocardiography ordering and reporting. Ordering providers will see a more limited list of available orders for Echocardiography. Imaging orders with options, such as "Echocardiogram Complete with Bubble Study" will no longer be available. Instead, the ordering provider will order "Echocardiogram Complete" and will be able to specify a choice for imaging options such as bubble study, ultrasound contrast, or strain analysis. 

The screen capture below shows order entry for "Echocardiogram Complete." Four options can be specified for this study. Almost all orders will be appropriately made with the default answer, "Allowed, if indicated" giving the echo lab technologists flexibility to apply options as appropriate to obtain the best clinical imaging for each patient. Choose "Requested" to convey your specific request to perform an option. Choose "No" only for rare cases where agitated saline or ultrasound contrast injection is contraindicated. 

The Chart Review > Imaging activity will change (as shown below) to display both the ordered procedure and the procedure actually performed. You will also see a "Has Critical Result" column. Cupid will be used for Echo critical results notification and tracking, but the vast majority of such findings will still be communicated verbally to the ordering provider. 

While format of Echo Reports will change to include additional findings and measurements, they will still be found in the Chart Review > Imaging activity as before. As a reminder, use the Cardiology activity in Epic to view echo reports from prior to March 2020. Echo Reports since that time are found only in the Chart Review > Imaging activity.