Version 20.10

Overview

Nurse only visits are documented as Encounters and can include appointment reasons such as Shots, Labs, Weight Checks, Rechecks, etc. Always follow your practice's policy on what information is documented for a Nurse Visit.

Document a Nurse Only Visit

1. Navigate to Tracking, and click to select the patient you will be working with.
2. Change the Visit Status by clicking the Visit Status field and selecting the status from the drop-down.
3. Select a room from the Room field drop-down to display the room where the patient will be seen.
4. Right-click on the highlighted patient, and select Open encounter.
5. A confirmation window is displayed asking you to confirm the template for the visit. Click Yes to use the listed template.
6. Review or change information in sections of the note.
7. Click the Orders button.
8. Follow the steps below for the tabs commonly used for Nurse Visits:

• Order Immunizations

1. Click into the Vaccine Name field or click the Add button , and enter the name of the Vaccine.
2. Select a vaccine from the list, and confirm there is an Active status.

3. Confirm there is stock available to administer the vaccine by reviewing the VFC and Priv columns.

4. (Optional) Add Special Instructions.
5. Click the Department drop-down arrow, and select the Department that will complete the task.
6. Confirm the Tdy radio button is selected.
7. Click the Save button  to save.
8. Repeat the above steps for additional Vaccines.
9. Once all vaccines have been added, click the Create button.

• Order Labs

1. Click into the Diagnostic Test Name field or click the Add button , and enter the name of the Diagnostic Test.
2. Select a test from the list.
3. (Optional) Add Special Instructions.
4. (Optional) Add the Dx code.
5. Click the Department drop-down arrow, and select the Department that will complete the task.
6. Click the Save button  to save.
7. Repeat the above steps for additional Diagnostic Tests.
8. Once all diagnostic tests have been added, click the Create button.

1. Click the X button to close the note.
2. Click the Save button in the Confirmation window.
3. Complete the tasks from the Tracking window.
4. Complete the visit by following the steps below.

1. Right-click on the nurse visit and select Open encounter.
2. Click the Summary and review the visit note.
3. Click the Finalize button.
4. Click the OK button on the Confirmation window.
5. From the Tracking window, select Nurse: Finished from the Visit Status drop-down. 

Version 20.8

Overview

Nurse only visits are documented as Encounters and can include appointment reasons such as Shots, Labs, Weight Checks, Rechecks, etc. Always follow your practice's policy on what information is documented for a Nurse Visit.

Document a Nurse Only Visit

1. Navigate to Tracking, and click to select the patient you will be working with.
2. Change the Visit Status by clicking the Visit Status field and selecting the status from the drop-down.
3. Select a room from the Room field drop-down to display the room where the patient will be seen.
4. Right-click on the highlighted patient, and select Open encounter.
5. A confirmation window is displayed asking you to confirm the template for the visit. Click Yes to use the listed template.
6. Review or change information in sections of the note.
7. Click the Plan/Orders button.
8. Follow the steps below for the tabs commonly used for Nurse Visits:

• Order Immunizations

1. Click into the Vaccine Name field or click the Add button , and enter the name of the Vaccine.
2. Select a vaccine from the list.
3. (Optional) Add Special Instructions.
4. Click the Department drop-down arrow, and select the Department that will complete the task.
5. Confirm the Tdy radio button is selected.
6. Click the Save button  to save.
7. Repeat the above steps for additional Vaccines.
8. Once all vaccines have been added, click the Create button.

• Order Labs

1. Click into the Diagnostic Test Name field or click the Add button , and enter the name of the Diagnostic Test.
2. Select a test from the list.
3. (Optional) Add Special Instructions.
4. (Optional) Add the Dx code.
5. Click the Department drop-down arrow, and select the Department that will complete the task.
6. Click the Save button  to save.
7. Repeat the above steps for additional Diagnostic Tests.
8. Once all diagnostic tests have been added, click the Create button.

1. If the practice will charge for the Nurse Visit, click Coding and select Use Suggested.
2. Click the X button to close the note.
3. Click the Save button in the Confirmation window.
4. Complete the tasks from the Tracking window.
5. Complete the visit by following the steps below.

1. Right-click on the nurse visit and select Open encounter.
2. Click the Summary and review the visit note.
3. Click the Finalize button.
4. Click the OK button on the Confirmation window.
5. From the Tracking window, select Nurse: Finished from the Visit Status drop-down.