English French Notes Complete/Exclude Select WARD (or ALL): [Greater than Today?] [Must End after Start] This Report shows the status change on the starting date and on the ending date. Excludes any Admission starting from the starting date. The response must be a number from 3-99 Enter # of Days from Admission: Shows Status Change on Start Date and End Date (Excludes Any Admission from the starting date) BEG STATUS END STATUS I II III IV UNC SAME Days to No status on file for this patient. Select ADMISSION (or C for CURRENT) Starting Date: FIRST// [Must not be before Admission!] Ending Date: LAST// [Must not be before Starting Date!] [Must not exceed the length of stay of this admission!] No Status on file on this Admission. II IV WARD RM Status Level Clinician Who Entered Choose a Nutrition Status Level Current Inpatients At Nutrition Status: Unclassified There are No current inpatients with nutrition status. Ward Room Nutrition Status Average This is a very time consuming report, it must be queued to print. Grand Total Would you like to display ALL monitors How many monitors would you like to display? Inpatient admitted None on file Nutrition Assessments No assessments on file. Recent Assessments: ADT HGT HGP WGT WGP DWGT UWGT IBW XD Usual Wt: Weight/Usual Wt: Ideal Wt: Weight/IBW: Date Taken: Medications No current medications in selected drug classes. No selected laboratory data available last NUTRITION PROFILE Dietetic Encounters Last Three Years No Encounters recorded last three years. Admission Monitors No Monitors on file. Food Preferences Future Clinic Appointments No scheduled appointments. Likes DisLikes No Food Preferences on file 1~All Meals Noon Even Adm. Dx: Current Diet: No current order Comment: Tray Dining Room Expires: Tubefeed Ordered: Total Quantity: Total KCAL: Supplemental Feeding: No Order Reviewed: Print by PATIENT or COMMUNICATION OFFICE or ALL or WARD? WARD// COMMUNICATION OFFICE Answer with P or C or A or W Select COMMUNICATION OFFICE: Select DIETETIC WARD: Admissions since Date/Time: [ DATE CANNOT BE MORE THAN 5 DAYS IN PAST ] Include Nutrition Profiles? (Y/N): S: Chewing Problems: Y N Pre-Admission Diet: Dysphagia: Y N Wt. + - ____ # in last ___ months Appetite: + - Nausea: Y N Vomiting: Y N Feeding Assistance Required: Y N Diarrhea: Y N Constipation: Y N Food Allergies: O: Current Diet: Adm. Date: Prior Assessment: Frame Size: Curr. Weight: Amputation %: Last Weight: Weight Taken: Usual Weight: Ideal Weight: Weight/IBW: A: Nutrition Status Nutrition Education Further Education Required: Y N P: Nutrition Plan Recommendations: NUTRITION SCREENING Press RETURN to continue. Select COMMUNICATION OFFICE (or ALL): Birthday DATE: Select LIST Printer: Room Birthday Enter Month/Year of Cost of Meals Served: You Must enter a Month and a Year. Month/Year must not be in the future. Starting Month/Year: Month/Year Must Start before Current Month/Year! You Must enter a Month and a Year. Ending Month/Year: Month/Year Must be before Current Month/Year. End Cannot be before Start Month/Year. Enter a Month and a Year such as 6 2000, 6/2000, 6-2000, or June 2000. You can even enter T-1 or type in a date. I II III IV V VI COST OF MEALS SERVED WORKSHEET Costs Beg Inv Issue Usage Act Dev Date/Time: [ Date must be in Future ] Enter 1-60 character comment Select CLINICIAN (or ALL): Through Date: Select LIST PRINTER: No Tickler File Entries Consult SF Review Diet Review Tubefeed to exit. Enter Return or Thru: Is Order OK? Y// Disposition (C=Complete, X=Cancelled, R=Reassign, RETURN to bypass): Enter C, X or R or Press RETURN to bypass REASSIGN to Clinician: Current Status: Is Status OK? Y// Action Taken: Required entry: document action (up to 60 characters) or ^ to bypass. SUPPLEMENTAL FEEDING DIETETIC CONSULTATION DIET ORDER Monitor: BMI < 21 Monitor: On Tubefeeding Monitor: On Hyperals Monitor: Albumin < 3.2 Monitor: NPO+Clr Liq > 3 days CLEAR LIQUID CLR LIQ Sort Patients: (A=Alphabetically R=Room-Bed) R// Select Date: Print Three Per Page? N// Select MEAL (B,N,E,or ALL): Select B for Breakfast, N for Noon, or E for Evening or ALL for all meals Print Only Ones With Order Changes related to the Diet Card? N // ALLGS.: Breakfast Noon Evening (More Items Next Pg) No Dietetic Information Available Food Preferences Currently on file: Dislikes Starting Date Dietetic Ward: Room-Bed: Current Diet Order: Current Service: Current Isolation: Current Tubefeed Order: Last Label Ward: Current Supp. Fdg. Order: Last Label Room: No Diet Orders for this Admission No Diet Order Sequence for this Admission Effective: Ordered by: Ordered: Diet: Prod. Diet: Canc. By: Canc. : No Supplemental Feedings for this Admission Menu: Ordered: By: Reviewed: Cancelled: Dietary Therapeutic Diet Associated: No Tubefeedings ordered for this Admission No Consultations ordered for this Admission No Early or Late Trays ordered for this Admission Order # Daily CC's: Daily KCals: Comment: Ordered: Cancelled: Product: Product CC's: Water CC's: Request: Complete Comment: Type: Initial Cleared: Order: Meal: Breakfast Bagged: No Standing Orders for this Admission No Additional Orders for this Admission Order #: All Meals Meals: Order: By: Saved By: Select Patient (Name or SSN): Inp atient Not Selected NOT CURRENTLY AN INPATIENT! FH*5.0*6 ** INACTIVE COMM OFFICE ** Print report for all Communications Offices Y or N: Total All Communications Offices ALL Total Select Communication Offices: Print report all Communications Offices Y or N: Total all Communications Offices All Total All Avg. All % Paid All Adjustment for Unscheduled and Intermittent All UNS/INT Total All Adjusted Measured FTEE All Avg Measured FTEE T O T A L TOTAL ENCOUNTERS ALL COMMUNICATIONS OFFICES Print report for all Communication Offices Y or N: TOTAL ADMISSIONS: TOTAL WITH MONITORS: Percentage of Admissions with Monitors: Dietetics Monitor Report ALL COMMUNICATION OFFICES ALL TOTAL ADMISSIONS: MONITOR BRIEF REPORT Monitor? Select type of movement for this report: TOTAL Percentage of Admissions Discharges with Monitors: ALL TOTAL DIETETIC MONITOR REPORT (Monitoring Communication Offices: NO PATIENTS WITH MONITORS IN GIVEN DATE RANGE ** TOTAL COMMUNICATIONS OFFICE - Admissions.....: Totals for ALL Clinicians.......: Wards............: Monitor: Albumin < 3.2..........: Monitor: BMI < 21...............: Monitor: NPO+Clr Liq > 3 days...: Monitor: On Hyperals............: Monitor: On Tubefeeding.........: *** TOTAL PATIENTS WITH MONITORS ALL COMMUNICATION OFFICES....: TOTAL ADMISSIONS....: TOTAL MONITORS......: PERCENTAGE..........: Albumin #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################