ORHub Nurse Training - Knees

This course is designed to train nurses in the use of ORHub for orthopedic knee surgery. Upon completion of this course, nurses will be prepared to use ORHub immediately.

ORHub is meant to be used primarily by nurses and vendor representatives in the operating room, as well as procurement agents, patient billing, and materials management to manage the resulting purchase orders. Surgeons will also review and sign off on case details.

You will take quizzes after each section, and a final course evaluation at the end of the course. If you need to take a break or finish the course later, you can click the "Take a Break" button at any time. To return to where you were in the course, log back in using your email address and the password you created.

Case Flow

Nurse Workflow in ORHub

Typical Case Workflow

Below is an illustration of how a case should flow using ORHub. The various steps will be highlighted throughout the course to show which steps you have completed, and which steps are yet to be completed.

Getting Started

Learning Objectives

Learning Objectives

Upon completion of this section, you should feel comfortable with the following:

  • ORHub Terminology
  • Creating an Account and Logging In
  • General ORHub Navigation
  • How to navigate to and update your Profile

At the end of this section you will take a short quiz to assess what you have learned. You can take the quiz as many times as you need to get 100%. 

Terminology

ORHub Concepts

What is a case?

A case refers to an instance of a surgery with a specific patient, surgeon, and procedure(s).

What is a tray?

A tray is a container for a collection of implants, tools, etc. that have the same sterilization information.

What is a material?

A material refers to one of the following: implant, biologic, medication, tool, or disposable.

What is an implant?

An implant refers to any material installed in the body during surgery.

What is a biologic?

A biologic refers to any material containing human anatomy.

What is a medication?

A medication refers to treatment used during surgery that is absorbed into the patient tissue.

What is a tool?

A tool refers to an instrument used during the surgery that can be sterilized and reused.

What is a disposable?

A disposable refers to a single usage tool or instrument that is discarded after use.

What is an explant?

An explant is any material removed from the patient’s body during the surgery.

Who should use ORHub?

ORHub is meant to be used primarily by nurses and vendor representatives in the operating room, as well as procurement agents, patient billing, and materials management to manage the resulting purchase orders. Surgeons will also review and sign off on case.

Creating an Account and Logging In

Creating an Account

Nurse accounts will be created by hospital admin or ORHub admin. The first time you login, you will need to change your password. See the instructions below to learn how to reset your password.

Logging In

To log in to ORHub, visit app.orhub.com in your browser, or click on the ORHub icon in the taskbar of your computer.

  • Click Login
  • Fill in your Email and Password. Your email will be your hospital email address. Your temporary password will be emailed to you.
  • Click the Log In button

Change your password

Once you’re logged in you can change your password at any time. When users are registering or changing their password, they will see a rating of their password strength. They can also click "Show" to verify the password they entered.

  • Navigate to My Profile in the sidebar menu
  • Click Go to My Profile Details
  • Enter your old and new password information
  • Click Save Changes

Reset your Password

If you forget your password, you can reset it at any time.

  • Enter your Email on the login page
  • Click the Forgot Your Password? link
  • Enter your email address and click Email Link
  • Check your email for steps to follow to reset your password.

Navigation

Navigation

Once in the ORHub application, you can navigate between dashboards at any time. The features you will use most often are on your Home Screen, any additional features are available through the Navigation Menu.

Home Screen

When you first log in, your home screen will appear with the most popular navigation options. From here you can Start a Case, Open a Case, Print an Implant Record, or Logout. If you are searching for a different option, expand the navigation menu to show all options.

Click the "i" buttons below to learn what each button on this screen does.

Navigation Menu

Click on the Menu icon in the upper left hand corner of the screen to show the Navigation Menu. Click Home to return to the Home Screen.

Updating Your Profile

Profile

To get to your profile, select My Profile From the Navigation Menu. From your profile you can:

  • View your Hospitals 
  • View, add or delete Contacts
  • Manage your Account Details such as your password, notification settings, and contact information.

Assessment

  • Case
    An instance of surgery with a specific patient, surgeon, and procedure(s)
  • Tray
    A container for a collection of implants, tools, etc. that have the same sterilization information
  • Material
    Either an Implant, Biologic, Medication, Tool, or Disposable
  • Implant
    Any piece of equipment or biologic used in a surgery
  • Medication
    Treatment used during surgery that is absorbed into the patient tissue.
  • Tool
    An instrument used during the surgery that can be sterilized and reused
  • Disposable
    A single usage tool or instrument that is discarded after use
  • Explant
    Any material removed from the patient's body during the surgery

Starting a New Case

Learning Objectives

Learning Objective

Upon completion of this section, you should feel comfortable with:

  • Starting a New Case
  • The Nurse Task List
  • Creating the Patient Label
  • Admitting Other Users to a Case
  • Loading and Editing a Tray
  • Entering Sterilization Details

At the end of this section you will take a short quiz to assess what you have learned. You can take the quiz as many times as you need to get 100%. 

Starting a New Case

Starting a New Case

You will start each case by creating a New Case. This case will be specific to this particular surgery and may encompass multiple procedures. Upon creating a new case, an ORHub PIN will be assigned to the case and will be valid until the case is closed. The PIN is a quick and easy way for nurses and vendors to pull up a case without entering the entire Hospital Case ID.

Create Case

Click Start a New Case

  • Select Knee from the surgery drop down list 
  • Start typing the surgeon’s name to select from the drop-down, or fill in free-form if the surgeon’s name is not available
  • Fill in the hospital’s case number
  • Describe the procedure that will be performed during the case (you can copy and paste from another application) 
  • Press Begin The Case

Case Details

When you create a case, the ORHub system will take the Procedure Description and populate a more granular description of the procedure automatically from key words in the description.

You should see the information you entered populated on the Case Details screen. 

Procedures

  • Verify or correct the details of the procedure
  • You can add procedures by clicking the Add Procedure button

Click the "i" buttons below to learn what each button on this screen does.

Nurse Task List

Nurse Task List

The nurse task list is a feature for nurses to see what critical information is still missing from a case. As tasks are completed, the items are crossed off but still visible to the nurse. The nurse can click the down arrow to display the spine graphic if desired.

Incomplete Nurse Task List

Completed Nurse Task List

Patient Label

Patient Label

The Patient Label will print on the Implant Record after the case is closed.

Patient Label

 To create the patient label, click on the Patient Label button and fill in all of the fields.

  • All fields must be filled in for the patient label to save.
  • If you forget to enter the patient label in this step, you will get an alert when you go to close the case.



Admitting Other Users to a Case

Admit Vendor Rep to Case

Admitting Vendor Rep to Case

Once you have created a case others can join your case by referencing either:

  • ORHub PIN Number
  • Hospital Case Number

When another user joins your case, you will see a notification pop up in the upper right hand corner telling you that a user is waiting to be admitted to the case. You can admit the user by clicking Admit to Case.

Loading and Editing Trays

Add Trays

Loading Trays

If you have sterilized trays of implants for the case, you can load them into ORHub after you open the case. Nurses and Vendor Reps can both load trays into ORHub. Your hospital may establish a procedure as to who is responsible for loading trays.

  • Navigate to the Trays tab
  • Click Load Tray

Build Tray for Case

Either the Nurse or the Vendor Rep can build trays for the case. The Vendor Rep will only be able to see trays for Vendors he represents. Nurses will be able to see all trays in the case.

  • Select the Vendor from the drop down menu
  • Fill out the Tray Label
  • Enter or scan in the Tray ID
  • Click Next

Edit a Tray

If you need to change any tray label or sterilization information, you can edit a tray at any time. 

  • Navigate to the Trays tab
  • Click Edit and change the details you wish to edit

Sterilization Details

Sterilization Details

Once the sterilization details for the tray are entered, any materials added to the tray will have the sterilization details preloaded.

  • Select the type of sterilization: Steam, Sterrad, Manufacturer, or None/Not Sure
  • Fill in the required fields
  • Click Add the Tray

Click the "i" buttons below to learn what each button on this screen does.

Assessment

  • Nurses must admit other users to the case before they can see any case information.
  • Only nurses can load trays.
  • Once you have created a case, you cannot edit any case information.
  • You can edit tray label and sterilization information at any time by navigating to the trays tab and clicking "edit tray."
  • If you forget to add the Patient Label, there is no way to catch it and enter it later.
  • You can add procedures as the case progresses.
  • A rep can join a case using the Hospital Case ID or ORHub PIN

Managing Materials

Learning Objectives

Learning Objectives

Upon completion of this section, you should know how to:

  • Add Explants
  • Add Implants and Materials
  • Add Implants and Materials not from a tray
  • Group Materials by View
  • Add Custom Implants
  • Edit Implants

At the end of this section you will take a short quiz to assess what you have learned. You can take the quiz as many times as you need to get 100%. 

Adding an Explant

Adding an Explant

All explants used in a case can be tracked using ORHub. You can add explants from the Case Details screen, or from the Implants and Materials screen. You can edit or delete an explant the same way as an Implant.

Adding an Explant from the Case Details Screen

  • Navigate to the Case Details screen
  • Select the Procedure in which the explants are being removed
  • Click the Explants link below the procedure
  • Click Add Explant
  • Fill in as much of the explant details as possible.
  • Click Save & Close

You can edit or delete an Explant the same way as an Implant.

Hover your mouse over the "i" icons to view additional information on these buttons.

Adding an Explant from the "Implants and Materials Screen"

  • Navigate to the Implants and Materials screen
  • Click the Explants link at the bottom of the screen
  • Click Add Explant
  • Fill in as much of the Explant details as possible.
  • Click Save & Close Window

Adding Implants and Materials

Managing Materials

All materials used in a case can be tracked using ORHub. Materials may include Implants, Explants, Tools, Disposables, Medication and Biologics.

Add Materials

Adding Implants and Materials

After you have loaded the trays required by the procedure, you can add implants or materials in 1 of 2 ways:

  • Click the Add Implants or Materials tab which opens up the specific Materials page. If you chose to add implants and materials using this button, you will have the option to select which tray it came from, or choose no tray if it did not come from a tray.

-or-

  • Click Add Implant from this Tray from within the correct tray. If you chose to add implants and materials using the Add Implant from this Tray option, the implant or material will automatically be added to that tray.

Search for Implants and Materials

To search for implants and materials, you can add filters for Vendor, System, or Category to narrow your search. To add filters, click the down arrow under the filter you would like to add, and select an option from the drop down menu. To clear the filters simply select "No Filter" from the drop down menu.

  • Start typing to the left of the Search button to initiate a search for implants. You can search by:
  • A catalog number
  • Any part of the implant description (ex. graft or 50cc)
  • Any part of the category (ex. anterior)
  • Click Add Implant

Implant Details

  • Fill out implant Quantity, Lot Number, Expiration Date, and Billing Type (Vendor Owned or Hospital Owned). The system will automatically select the type of material that we believe it to be, however you should verify and make any corrections as necessary. Implants, disposables, biologics, and medication will be visible on the Implant Record, however tools will not.
  • If you added the implant from the tray, you’re done – click Add Implant
  • If you added the implant from the Add Implant button, click Next
  • Select the procedure for which you are using this implant.
  • Click Next which will bring you to the Sterilization Details page.
  • Select what tray the Implant is from, if it not from a tray select Not From a Tray
  • Choose a sterilization method (Steam, Sterrad, Manufacturer, None)
  • Fill out the sterilization details for the method you chose
  • Click Add the Implant

Material Category

Material Category

Depending on what type of material will be used in the procedure (Implant, Disposable, Tool, Biologics or Medication) the user will be prompted to fill out Material SubCategories and a Modifier.


Implant Category

Edit Description, Type default, and Category In-Case

Changes are allowed and remembered, they are also tracked and audited. Changes for Catalog Number, Size & Description, Vendor, Material Category (Implant, Disposable, Tool, Medication, Biologic), Subcategory, and Modifier.

Any time a field is changed, all information regarding the change will be tracked for auditing purposes. ORHub will track the user making the changes, the old and the new data. The history of a material can be viewed by Procurement personnel. 

Hover your mouse over the "i" buttons below to learn what each button on this screen does.

Adding Materials Not from a Tray

Adding Materials Not from a Tray

Materials that are not from a tray could be prepackaged tools, medications, biologics, or disposables.

  • Navigate to the Implants and Materials tab
  • Click Add Implants or Materials button 
  • Add implants from the selection, or search for implants using the search box in the upper left hand corner
  • Click Add Implant
  • Fill in the required fields and click Next
  • Select the procedure and click Next
  • Select Not from a Tray from the drop down menu
  • Enter the sterilization information, and click Add the Implant

Hover your mouse over the "i" buttons below to learn what each button on this screen does.

Sterilizing Materials/Implants 

Pick from one of the 4 sterilization methods:

  • Steam, Sterrad, Manufacturer, None / Not sure
  • Input the required fields once you have selected the sterilization method
  • To finish click Add The Implant

Group by Views

Group by Views

You can view the implants and materials that have been added to the case from different views – by Tray, by Sterilization, or by Procedure. This is a quick way to verify that all implants and materials have sterilization information entered, and have been assigned to the correct procedure and tray.

  • Tray: Organizes the implants/materials used based on the Tray they came from
  • Sterilization: Organizes the implants/materials based on the type of Sterilization they received
  • Procedure: Organized the implants/materials based on which Procedure they are to be used in

Adding a Custom Implant

Adding a Custom Implant

 If you can’t find the implant you’re looking for, you can add a custom implant:

  • Click the Add Implants or Materials button
  • Click Can’t find the implant you are looking for?
  • Fill out the required fields and select Next
  • Select what Procedure the material will be used in then click Next
  • Select what tray the Material came from then click Add The Implant

Once you have added a custom implant once, you can enter just the catalog number in the future and the rest of the fields will populate.

Editing Implants

Mark an Implant or Material as Waste

If a used implant or material must be discarded for any reason, it can be marked as Waste.

  • Navigate to the Implants and Materials screen
  • Click the three horizontal dots on the right-hand side of the implant line item you want to Mark as Waste
  • In the menu bar that opens, click Mark 1 as  Waste

View/Reload Wasted Implants or Materials

You can view or restore any implants marked as Waste during a case. 

  • Navigate to the Implants and Materials screen
  • Right below the list of Implants, click 1 Implants Marked as Waste
  • Review and Reload any implants you want from the list that pops up
  • By selecting Reload Implant the implant gets placed back on the tray

Edit an Implant

You can edit the lot number of any implant or material, the sterilization information of an implant or material that is not from a tray, and all the fields associated with a custom implant or material.

  • Navigate to the Implants and Materials screen
  • Click the three vertical dots on the right-hand side of the implant line item you want to copy
  • In the menu bar that opens, click Edit Implants
  • Follow the prompts to edit the relevant information
  • Click Save & Close Window when finished

Copy an Implant or Material to a Different Tray

You can copy any implant or material to another tray. The original implant or material will remain in the original tray, and a new implant will be copied to the new tray.

  • Navigate to the Implants and Materials screen
  • Group by: Trays
  • Click the three vertical dots on the right-hand side of the implant or material line item you want to copy
  • In the menu bar that opens, click Copy to Tray
  • Select the destination tray from the list of trays that pops up

Assessment

  • All implants, explants, biologics, tools, and medication used in a case can be tracked using ORHub.
  • Once you have added an Implant to a tray, there is no way to edit the details.
  • If you can't find the Implant you are searching for, you should just leave it out of the case.
  • You can add all Explants for a procedure in the same text box.
  • You can view the implants and materials that have been added to the case from different views – by tray, by sterilization, or by procedure.
  • Materials tracked in ORHub include Implants, Explants, Tools, Disposables, Medication and Biologics.
  • Once you waste an Implant from a tray, there is no way to restore it.
  • When adding Implants, it is important to select either Vendor Owned, or Hospital Owned.

Signing and Closing a Case

Learning Objectives

Learning Objectives

Upon completion of this section, you should know how to:

  • Verify that a case was performed to consent
  • Verify case details and procedures
  • Download the Implant Record
  • Gather signatures from the Vendor Rep(s) and Surgeon
  • Sign and close the case

At the end of this section you will take a short quiz to assess what you have learned in this section. You can take the quiz as many times as you need to get 100%. After completing the section quiz, you will have the opportunity to leave feedback on the course. Please take the time to leave any suggestions or comments. ORHub will use this feedback to improve this course and other training materials. Upon completion, please be sure to submit your results so we can track who has completed the course.

Closing a Case

Closing a Case

When the case has been completed and all Implants and Materials have been recorded, the case should be signed and closed. The Nurse, all Vendor Reps, and the Surgeon should all sign the case.

  • You can close the case by clicking the Sign & Close Case button in one of two places.
  • The first is positioned by the Waiting Room button towards the top part of the page. 
  • The second option is to go to the Implants & Materials page, then scroll down to select the Sign & Close Case button at the bottom of the page.

Case Performed to Consent

Case Performed to Consent

Verify if the case was performed to consent. 

  • Select Yes or No
  • If you select No the case was not performed to consent then you must describe what changed with the case and why.

Verifying Case Details and Procedures

Verify Case Details

Verify Case Details

Prior to closing the case, verify that all information in the Procedures, Implants, Waste and Explants sections have been entered in correctly.

View Case Receipt

View Case Receipt

From the Case Summary screen, a nurse can click the Case Receipt button on the right hand side of the page to view a case receipt for the surgeon to review the cost of their case. The case receipt specifies the cost of implanted and used items, as well as wasted items so a surgeon can see the cost of the materials used in a case immediately after the case.

Surgeon Sign Off

  • The surgeon must sign off on the case receipt
    • Note: the Surgeon's signature will show up automatically on the case receipt page if he/she has already signed off on the Sign & Close Case page

Case Receipt

Download the Implant Record

Preview the Implant Record

  • From the Sign-off & Close Case screen, click the Download the Implant Record button.

Review the Implant Record

Review the Implant Record for accuracy. If you need to make changes before signing off on the case, click cancel and make any changes. 

Print the Implant Record

You can either print the Implant Record immediately after signing and closing a case, or at a later time. You only need to know the Hospital Case Number in order to pull up the Implant Record. To print the implant record:

  • Expand the Navigation Menu
  • Click Print Implant Record
  • Enter the Hospital Case ID number and click Implant Record
  • Print the Implant Record

Note: A list of recent cases will show up when you click Implant Record. If you recognize the details of the case, you do not need to enter the Hospital Case Number to access the case and can simply select from the list of recent cases.

View and Print Implant Record

Gather Signatures

Sign and Close Case

Gather Signatures, Save and Close Case

  • Gather Signatures from the Vendor Rep and Surgeon.
  • Click Save and Close Case 

From the nurses screen, both the Surgeon, Rep and Nurse can sign their names. From the Representatives screen only the surgeon and the rep can sign their names. If anyone needs to make changes, the Nurse can clear signatures. No one can make changes when the nurse is in the summary screen. The nurse must exit the screen before other users can make changes. Once the nurse clicks Save and Close Case, no one can make any additional edits to the case. 

Assessment

  • You do not need to verify that the case was performed to consent prior to signing a case and closing.
  • Once a rep has signed a case, there is no way to go back and clear the signature.
  • Surgeons can sign off a case on either the nurses screen or the reps screen.
  • Nurses can preview the implant record prior to closing the case.
  • The nurse is responsible for verifying case details and procedures prior to signing and closing a case.
  • The Nurse, Surgeon and Rep can all sign off on the Case receipt.

Course Feedback

Course Feedback

Please provide feedback on the content of this course. ORHub will use this information to make improvements to this training. We value your opinion and hope you will take time to share your thoughts and suggestions with us! Thank you!

Frequently Asked Questions

FAQ's

How do I name a tray when it is a peel pack?

You can name a tray however you want, the name is not used except for you to be able to identify the tray. Our recommended format is Vendor-Material Category-Number.


Why does the Vendor Rep screen say the case is locked when I am not in the summary screen?

Clear the Vendor Rep's signature to unlock the case for the Rep.

How do I record drill bits?

Drill bits should be recorded as disposables. 

How do I change the procedure a Material or Implant is recorded under?

Select Group by:  Procedure in the Implants & Materials tab. Click the three vertical dots to the right of the implant or material you would like to move to expand the menu. Click Edit Implants. On the next screen click Edit. Verify the information for the implant or material is correct, and click Next. Select the procedure the implant or material should be recorded under, and click Next


How do I know what materials made it onto the Implant Record?

All implants and materials recorded in a case will be visible on the Implant Record.

How can I switch the nurse in the middle of the case?

If the nurse on a case needs to log out (end of shift, lunch break, etc.) another nurse may take over the case. The first nurse who originally opened the case can simple click the person icon in the upper right hand corner to expand the menu, and click Switch Nurse.

Once the first nurse clicks Switch Nurse, the second nurse can log in as usually and the case will pick up right where the first nurse left off.

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Add a Frequently Asked Question

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