Vitals

Vitals is available in the following encounter types: Exam, Historical, Immunization, Multi-System, Procedure, Telephone, Reconciliation, and Urgent Care.

• The vitals sort order, encounter note display format, Time default, and default graph time frame can be set by the Clinic Administrator in Vitals General
• The vital sign fields available for documentation and vital sign units of measurement can be configured by the Clinic Administrator by going to Tools > Preferences > CLINIC > Vitals > Configuration
• The high and low range for vital sign readings can be defined by the Clinic Administrator by going to Tools > Preferences > CLINIC > Vitals > Parameters
• Selection list items for blood pressure reading Location, last menstrual period Status, O2 saturation Source, and peak flow Status can be customized. Clinic Administrators can edit the list items by going to Tools > Preferences > CLINIC > Clinic Wide Form Data > Begin Edit and selecting Vitals from the Tab list
• Clinic Administrators can enable Vitals Alerts and BMI Quality Measure Alerts in Clinic Settings: Alerts/Reminders/CDS

• Select any component in a vitals column to display the entry details

  

• To sort the vitals data columns from oldest to newest or from newest to oldest, click the sort button

• Select the Include in Note checkbox to add the vitals data to the encounter Note Display

1. Go to Encounter > Vitals
2. Click Add Column
3. Optional: update the Time field, if needed
4. Document vital signs in the appropriate fields
   1. If the patient's height was previously documented, clicking Last will populate the Height field with the last recorded value
   2. If the patient's height and weight are documented, the patient's Body Mass Index (BMI) and Body Surface Area are automatically calculated upon saving vitals
   3. If the date or status of the patient's last menstrual period were previously documented, clicking Last will populate the Last Menstrual Period and Status fields with the last recorded values
5. Click Save

Vital sign data can be changed prior to finalizing the encounter.

1. Select the vital sign component to edit and click Change
2. Edit the appropriate field(s)
3. Click Save

Individual vital sign entries can be deleted prior to finalizing the encounter.

1. Select the vital sign component
2. Click Delete
3. Click Yes to confirm decision to delete

The entire vitals entry column can be deleted prior to finalizing the encounter.

1. Select the vitals column to delete
2. Click Delete Column
3. Click Yes to confirm decision to delete

All data in the vitals entry will be deleted and cannot be restored

Clinic Administrators can enable two types of vital sign alerts:

• Vitals Alert: creates an encounter alert when a patient's vital signs are outside of the clinic-defined normal parameters.
• BMI Quality Measure Alert: creates an encounter alert when a patient's BMI is outside of the clinic-defined normal parameters. The alert instructs the user to complete a BMI follow-up plan from the Standard Flowsheets tab.

These alerts will display upon saving vitals or when opening an encounter if the any of the patient's vital signs are outside of the normal parameters.

The following growth charts based on CDC guidelines can be generated for patients up to 20 years of age:

• Patients 0–36 months: Length/Height, Weight, Weight for Length, Head Circumference, and BMI
• Patients 3 years up to 20 years: Height, Weight, and BMI

Click a growth chart button to generate the chart. Selecting a plot point on the graph displays the values entered and the calculated percentile.

1. Go to Encounter > Vitals
2. Click Graph
3. Select and populate a Time Frame for the vitals data
4. Select one or more vitals to graph or select the All checkbox
5. Click Display