<< Click to Display Table of Contents >> Navigation:  Reviewing/Editing Orders > Pending Order Review Screen > Selecting and Editing Items > Pharmacy Order Review > Pharmacy Non-IV

Pharmacy Non-IV items will display in the order in which they were selected by the provider on the Pending Orders screen.

 

•Items will be preceded with the Clinical Monitoring or required Clinical Monitoring icon if any results have populated. These may be viewed/addressed by selecting the button from either the action bar on the Pending Orders screen or from the Non-IV Medication Order Edit screen. These results must be viewed before the provider can sign the orders.

 

 

Select Order Entry > Review.

 

Order Review

 

•The following information will display for the order:

 

oLine 1 - Any Clinical Monitoring notifications will display first, followed by the item description in bold, the Dose, Unit, Route, Frequency, and Start Date/Time. If the order was placed as STAT, this will also display.

oLine 2 - If any instructions were entered on the item, they will appear on the last line.

 

•To edit the item, the provider may either double-click the item in the list or select to highlight and select the Edit option. Required fields that are unaddressed will appear in red. The provider may make any necessary changes to the item and then select Update to hold the changes. Once Update is selected, the provider will be returned to the Pending Orders screen.

 

 

Select Order Entry > Review > Select item > Non-IV Medication Order Edit

 

Non-IV Medication Order Edit

 

 

•The item fields will populate as follows:

oIf the item is selected from an Order Set, the predefined values will pull into the fields depending on how the item was saved in the Order Set setup.

oIf the item is selected from an Order List, the predefined values that were saved by the user that created the Order List will populate.

oIf the item is selected from the Departments listing, the predefined values in the Item Master will populate.

 

•The Non-IV Medication Order Edit Screen will appear in the following order:

 

oMedication Name: The medication name from the item long description will display in bold. The description functions as a hyperlink that, when selected, will open the Drug Monograph screen. Information such as the NDC Number, Drug Notes, Package-Product Information, UltiMedex/Company Information, Ingredients, Class Information, and Patient Specific Dosing will be available from this option.

 

oDose/Unit: The dose/unit will populate with the following hierarchy:

▪Order Set/Order List/Protocol Setup

▪Predefined Doses

▪Other Units (from Pharmacy item "Other Units" fields)

▪Alternate Doses (from Pharmacy item "Alternate Doses" fields)

▪Each (EA) will always be included in the Units drop-down so that items that are not set up with alternate units (Tab) or are predefined may be ordered as 1 EA.

 

oRoute: The drop-down will display the predefined route for the medication set up in the Pharmacy Info table. If the item has been selected from an Order Set or Order List, the route will pull based on how the item is set up in the set/list. The pharmacy route table is also available and can be accessed by selecting the magnifying glass icon next to Route. (NOTE: If the Pharmacy Control table switch "Only Allow Predefined Routes in OE" has been checked, the Route lookup will not be available and the user must choose from the predefined frequencies for the selected medication.)

 

oFrequency: The drop-down will display the predefined frequencies set up in the Pharmacy Info table. If the item has been selected from an Order Set or Order List, the Frequency will pull based on how the item is set up in the set/list. The pharmacy frequency table is also available and can be accessed by selecting the magnifying glass icon next to Frequency.

▪Standard: The standard times will pull from the Pharmacy frequency table.

▪Non-Standard: This option allows providers to manually enter frequency times outside of the standard times. This option will assist providers in setting the correct frequency for continued Home Medications that may have an infinite combination of frequency times. This option will be disabled if a X1 or PRN frequency has been selected in the frequency field. It will also be disabled if the frequency field is left blank.

 

oTimes: The administration times will default based on the selected frequency.

 

oDuration: This field is a free-text field. If a number of doses is entered, it will automatically fill a stop date/time based on the selected frequency.

 

oStat: By checking this field, a STAT order will be created as well as a Routine order (the routine order will display in Pending Orders).

 

oFirst Dose Date/Time: Indicates when the first dose will be given to the patient. If the "Require First Dose Entry" switch is selected in the Pharmacy Control Table, the field should auto-populate with the current time as the Start Date/Time. If the field is cleared, the provider may enter a different time. If it is cleared and no time is entered, it will repopulate to the Start Date/Time field as it is required and cannot be left blank.

▪The system uses both the date/time entered via the Set Start/Schedule Date button as well as Discontinue Days set up to calculate the correct First Dose date/time, Start date/time, and Stop date/time. This should apply only if the order is added to pending after the user changes the date/time via Set Start/Schedule Date.

▪The system uses both the date/time entered via the Set Start/Schedule Date button as well as X1 functionality to apply the correct First Dose date/time, Start date/time, and Stop date/time. This should apply only if the order is added to pending after the user changes the date/time via Set Start/Schedule Date.

▪The system uses both the date/time entered via the Set Start/Schedule Date button as well as the frequency set up on the item within the Order Set/Order List/Protocol to calculate the correct First Dose date/time, Start date/time, and Stop date/time. This should apply only if the order is added to pending after the user changes the date/time via Set Start/Schedule date.

▪The system uses both the date/time entered via the Set Start/Schedule Date button as well as the Days from Now set up in Order Set/List/Protocol maintenance to determine the Nursing order start date/time. This should apply only if the order is added to pending after the user changes the date/time via Set Start/Schedule Date.

▪The system uses both the date/time entered via the Set Start/Schedule Date button as well as the Start in Days from Now set up to calculate the correct First Dose date/time, Start date/time, and Stop date/time. This should apply only if the order is added to pending after the user changes the date/time via Set Start/Schedule date. NOTE: If the item is set up with Discontinue Days, this will need to be incorporated as well to determine Start Date/Time information.

 

oStart Date/Time: This field will default to the time the item was selected during the ordering process. It may be changed if the medication needs to be administered at a later time.

 

NOTE: If an order is placed with a First Dose Date/Time that is prior to the Start Date/Time of the order and the selected Frequency results in a dose that would be in between the First Dose Date/Time and the Start Date/Time, there is potential for a dose to be missed. If this occurs and Update is selected from the Medication Edit screen, the following warning message will appear. Selecting Yes will proceed with scheduling the medication as the user has ordered it. Selecting No will return the user to the Medication Edit screen so that the setup may be adjusted.

 

Warning Message

 

oStop Date/Time: If the medication has a predefined stop date/time, this field will auto-populate. This field may be addressed if the medication needs to be stopped at a certain time.

 

oIndication: The Indication of Use or Reason a patient is being administered a medication. This field will default to blank. If it is red, it will be required to address prior to updating the item. Up to 20 predefined reasons may be listed in the drop-down, based on the category information associated with the medication's classification.

oThe field will display a magnifying glass lookup option to allow the users to launch the indications/reason table. The indication may be searched for by description. If an indication is selected from the table, the field will read "OTHER - (selected indication)."

oThe Indication List will use the current HLI lookup for SNOMED/ICD-10 and pull the user-defined description and association ICD-10 and SNOMED codes.

oTo make the field required, the item itself will need to have "Indication Required" checked on pg 2 of Pharmacy Information.

 

NOTE: This is needed for Antimicrobial Stewardship, but may be set up for any medication.

 

oInstructions: These are free-text fields where up to 130 characters may be entered. Some items may have pre-defined instructions as set up in the Pharmacy Info table.

 

oPatient's Own Medication: In the instance that the patient is being given a med that the patient has brought from home, there is a box to indicate "Patient's Own Medication," which will prevent the pharmacy from filling an order of the medication, but will allow the order to show on the MedAct for administration purposes.

 

•Both the Route and Frequency fields have a magnifying glass icon that will direct the provider to a screen of hospital defined routes and frequencies.

 

 

Select Order Entry > Review > select medication item > Route Binocular Icon

 

Route Table

 

 

Select Order Entry > Review > select Medication Item > Frequency Binocular Icon

 

Frequency Table

 

 

•The route/frequency may be changed by selecting the description and then selecting the Select button. Select the option or double-click the description. Once selected, the user will be redirected to the medication edit screen.

oThe blue back arrow will direct the provider back to the Search Options screen without saving any changes if it is selected first. If the changes are saved and it is then selected, it will return the provider to the Search Options screen with the saved changes on the medication.

oThe Update option will save all changes made to the medication.

oThe Save to List option will allow a provider to save an edited item to one of their Order Lists. This will open the Order List Setup screen so that the provider may add the item to one or more existing lists or create a new list for which to add the item.

 

NOTE: The Dose, Unit, Route, Frequency, Stat (if selected), Protocols (if applicable), and Special Instructions fields will save to the List.
 

•The Remove option will remove the medication from the Pending Orders list.

 

•The Address Clinical Monitoring option will allow the user to individually address Clinical Monitoring on the item, if present.

 

•The Dose Information option will open a MicroMedex screen in the web browser to give additional information about the medication.

 

•The Dose Calculator option provides the ability to calculate an administer dose and administer amount for non-IV medications. See Non-IV Dose Calculation.

 

•To change a frequency to a non-standard, time, select the drop-down and select Non-Standard.

 

 

Select Order Entry > select Medication

 

Non-IV Medication Order Edit

 

 

The Non-Standard Frequency screen will open where the specific Times, Hours Between Doses, or Days of the Week may be indicated. Once entered, select Update to save the changes. The new administration times will then be reflected on the Non-IV Medication Order Edit screen.

 

 

Select Order Entry > select Medication > Non-Standard

 

Non-standard Frequency

 

 

To add an indication, select the drop-down box to see preselected answers for that medication.

 

 

Select Order Entry > select Medication > Indication

 

Non-IV Medication Order Edit

 

 

Select Order Entry > select Medication > Indication

 

Indication List