Starting a Labor Encounter & Flow Sheet

1. Once you have searched the name of your client and clicked into their chart, click 'Encounters' in the menu to the left. 

   

2. Click the green 'Add an encounter' button at the top-right of the screen. You will now have the option to choose which type of encounter you would like to add (e.g. Prenatal, Postpartum, etc.). You will also need to select the place and type of visit along with any notes you would like to add.

   

3. The Labor flow includes additional options for entering Initial Labor notes under 'Encounter notes,' documenting the Planned Site of Delivery, and checking off items in the To-Do Lists. Initial Labor notes can be edited in the Labor flow as well.
4. When you select this type of encounter, you will notice that you have the option to 'Start labor flow sheet' or 'Skip to Immediate Postpartum.' Click 'Start labor flow sheet' if you want to begin adding detailed labor information. 

   

5. Within the Labor Flow Sheet, you can add clinical notes by clicking "Add a labor update" in the top left corner. 

   

   

6. You also have a list of Actions to the right that allow you to set timed reminders and give you shortcut options to enter as updates on the labor flow. 'Labor Milestones' is one example. Select the type of milestone you want to add from the drop-down list and add additional comments if relevant. You can add multiple entries here by clicking 'Add another Milestone' under your previous entry. The two milestones 'Start of Labor' and 'Start of Pushing' will populate the times of each stage of labor in the Care Summaries. 
7. Any labor update or milestone can be signed with the initials of the User who records it. Clicking into the initials box will give you a list of Users to choose from and will filter them as you start typing characters.
8. After adding this to your 'Labor Flow Sheet', you will see that the information is automatically added at the time that the milestone is recorded. 

   

9. Recording the people present for the labor can also be done here. You can add the name, role, and arrival and departure times. Add more people by clicking the 'Add another person' link. This information will also be added to the labor flow sheet. 

    

10. In the event that you would need to record a birth quickly, return to Step 3 (click 'Add new encounter' > select 'Labor, birth, & immediate postpartum' from the drop-down menu) and scroll down to click 'Skip to immediate postpartum' instead. You will have the option to enter the information about the birth and include the User's initials. 

    

11. You will then be taken to an overview of basic information about the birth. Add additional information to the maternal postpartum or newborn flow sheets by clicking the 'Add' button in the appropriate section and selecting the type of update.