So here this, this is going to be a bit confusing to you and I know it's not the prettiest slide, but focus on that that box top left, it says a top of a paper form like this involved the nursing assessment and the cardiovascular parameters including the vital signs blood pressure heart rate. And this was a pre procedure assessment that needed to be documented prior to putting somebody through a sedation procedure, the bottom of the form and sort of the highlighted box on the right was the part by the physician provider. And this was really required, because in the United States, the Centers for Medicare Services deems endoscopy a high risk surgical procedure to the sedation component, not because of the endoscopy component because the sedation component. And the focus of that includes aspects including airway assessment, the melon potty class, the ASA classification, and a sedation plan, most places have moved away from paper documentation although it can be very effective and still use you know sort of in an emergency when your computer system goes down, hopefully that doesn't happen too much. Or when you're in areas where you don't have access to a computer, the computer systems can be great and in prompting you through pathways like you see some of these green arrows that are even some of the quality metrics for some of the things that we do, things like you know what anticoagulation agents are they on or anti clotting agents and are antibiotics appropriate in this case, and that can be used in your pre procedure physical assessment.

pre-procedure assessment

sedation procedures

endoscopy

nursing assessment

cardiovascular parameters