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EHR Inpatient Quick Orders. March 2010. Inpatient Quick Orders. Naming Conventions/Recommendations: PSJ = Inpatient Unit Dose Meds PSJIV = IV Piggybacks PSIV = IV Fluids/Infusions Add a “Z” to the end to denote local quick orders Add an “M” to the end to denote a menu.

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inpatient quick orders
Inpatient Quick Orders
  • Naming Conventions/Recommendations:
  • PSJ = Inpatient Unit Dose Meds
  • PSJIV = IV Piggybacks
  • PSIV = IV Fluids/Infusions
  • Add a “Z” to the end to denote local quick orders
  • Add an “M” to the end to denote a menu
inpatient med quick orders psj
Inpatient Med Quick Orders (PSJ)
  • Majority of things fall under this category
  • Unit dose oral meds
  • Creams, Eye Drops, single injections, etc
things to think about
Things to think about
  • Remember, quick orders are made from Orderable items
  • Think about how the order will display on the computer generated MAR (ie “1 tablet” vs “5/325mg”)
  • Dosages available controlled in drug file – marked as “I” or “O” or both
  • IV File Clean-Up
  • Communication with Providers
quick order menu
Quick Order Menu
  • EHR – BEH – ORD – MNU – QOC
  • Order Menu Management
  • ACT Create/Modify Actions
  • DIS Enable/Disable Order Dialogs
  • GEN Create/Modify Generic Orders
  • LST List Primary Order Menus
  • MNU Create/Modify Order Menus
  • OIC Create/Modify Orderable Items
  • PAR Menu Parameters ...
  • PMT Create/Modify Prompts
  • PRI Assign Primary Order Menu
  • PRT Convert Protocols
  • QOC Create/Modify Quick Orders
  • QOR Create/Modify QO Restrictions
  • SET Create/Modify Order Sets
  • SRC Search/Replace Components
  • SRO Search/Replace Orderables
slide7
TYPE OF QUICK ORDER: ?

Answer with DISPLAY GROUP NAME

Do you want the entire DISPLAY GROUP List? Y (Yes)

Choose from:

ACTIVITY

ALLERGIES

CONDITION

CONSULTS

DIAGNOSIS

DIET ADDITIONAL ORDERS

DIET ORDERS

DIET ORDERS(WR)

EARLY/LATE TRAYS

GENERAL RADIOLOGY

IMAGING

INPATIENT MEDICATIONS

IV MEDICATIONS

LABORATORY

NURSING

OUTPATIENT MEDICATIONS

PRECAUTIONS

PROCEDURES

SUPPLIES/DEVICES

TUBEFEEDINGS

UNIT DOSE MEDICATIONS

VITALS/MEASUREMENTS

type of quick order
Type of Quick Order
  • Unit Dose and Inpatient Medications behave the same. Just pick one and go with it
  • IV Medications type behaves very differently
iv piggybacks which type
IV Piggybacks – Which Type?
  • The TYPE of quick order for IV Piggybacks is Inpatient Medications
  • The TYPE of quick order for IV Piggybacks is Inpatient Medications
  • The TYPE of quick order for IV Piggybacks is Inpatient Medications
slide12
Why?
  • Providers want to order schedules for these drugs
    • Cefazolin 1gm IVPB Q8H
    • Ertapenem 1gm IVPB Q24H
  • Pharmacist will finish the order and add:
    • Rate of Infusion
    • Solution for the Additive
    • Other Print Info
why cont
Why? (cont…)
  • In the order dialog for IV Medications type of quick orders, there is no schedule, only a rate
  • Don’t want ordering providers changing which fluid the piggyback is in
time out to talk about drug file
Time out to talk about Drug File
  • Implications of what Pharmacy Packages the drug is marked for
  • Implications for how the dosages are marked –

I, O, or Both

  • Individual UD drug file entries?
pharmacy packages
Pharmacy Packages
  • O - Outpatient
    • if you use the drug for outpatients
  • U - Unit Dose
    • Anything besides IV that you use in inpatient (creams, eye drops, etc)
    • Must be marked as this in order to make an inpt quick order from the drug
  • I - IV
    • Just items that are additives or solutions
examples
Examples
  • Floxin Otic drops
      • Outpatient
      • Unit Dose
  • Hydrocortisone cream
      • Outpatient
      • Unit Dose
  • Cefazolin 1gm Vial
      • Outpatient
      • Unit Dose
      • IV
separate drug file entries
Separate Drug File Entries
  • Do you order unit dose medications from the manufacturer?
  • If yes, then you’ll have a separate drug file entry
    • Lisinopril 10mg
    • Lisinopril 10mg UD
two entries
Two Entries
  • Lisinopril 10mg tab
    • Marked for Outpatient
    • Dosages marked for Outpatient only
  • Lisinopril 10mg UD tab
    • Marked for Unit Dose
    • Dosages marked for Inpatient only
  • Both entries tied to same orderable item – LISINOPRIL TAB
one drug file entry
One Drug File Entry
  • If you unit dose a bulk medication yourself for inpatient use:
  • Will only be one drug file entry, marked as
    • Outpatient
    • Unit Dose
  • Dosages will need to be marked I and O
dosages
Dosages
  • By marking the dosages for either Inpatient, Outpatient, or Both, you control which dosages you have to choose from in different packages
back to quick orders
Back to Quick Orders
  • “Inpatient/Unit Dose” Type of Quick Orders
    • majority of quick order building
  • “IV Medications” Type of Quick Orders
    • This happens after IV Files are cleaned up and marked accurately (See PDM Presentation)
    • Standardized IV Pre-Mixes (NS, NS w/20mEq of KCL, D5W, etc.)
    • Standardized IV Infusion List (P&T approved?)
order sets
Order Sets

Order Menu Management

ACT Create/Modify Actions

DIS Enable/Disable Order Dialogs

GEN Create/Modify Generic Orders

LST List Primary Order Menus

MNU Create/Modify Order Menus

OIC Create/Modify Orderable Items

PAR Menu Parameters ...

PMT Create/Modify Prompts

PRI Assign Primary Order Menu

PRT Convert Protocols

QOC Create/Modify Quick Orders

QOR Create/Modify QO Restrictions

SET Create/Modify Order Sets

SRC Search/Replace Components

SRO Search/Replace Orderables

common combos
Common Combos
  • EX: Promethazine IM/PO/PR
  • Make a quick order for each
  • Put together in a set
psjz promethazine po pr im
PSJZ PROMETHAZINE PO/PR/IM
  • NAME: PSJZ PROMETHAZINE 25MG PO/PR/IM Replace
  • DISPLAY TEXT: Promethazine 25mg PO/PR/IM q6h prn Replace
  • DESCRIPTION:
  • No existing text
  • Edit? NO//
  • ORDER SET COMPONENTS:
  • 1 PSJZ PROMETHAZINE 25MG TAB
  • 2 PSJZ PROMETHAZINE 25MG SUPP
  • 4 PSJZ PROMETHAZINE 25MG IM
  • Select COMPONENT SEQUENCE#:
mix of orders
Mix of orders
  • Can be a mix of orders: medication, lab, generic, nursing, ect…
menus
Menus
  • Consider organizational structure
  • Same as outpatient vs something new?
  • Additional categories for inpatient
  • “All other meds…” options
building menus
Building Menus

Order Menu Management

ACT Create/Modify Actions

DIS Enable/Disable Order Dialogs

GEN Create/Modify Generic Orders

LST List Primary Order Menus

MNU Create/Modify Order Menus

OIC Create/Modify Orderable Items

PAR Menu Parameters ...

PMT Create/Modify Prompts

PRI Assign Primary Order Menu

PRT Convert Protocols

QOC Create/Modify Quick Orders

QOR Create/Modify QO Restrictions

SET Create/Modify Order Sets

SRC Search/Replace Components

SRO Search/Replace Orderables

menus1
Menus
  • Naming convention
    • Add an “M” to denote menu
    • Consider “…” in display text to denote link to menu
  • Column width
    • for 2 columns = 40
    • For 3 columns = 27
  • Path switch – probably “yes”
all other meds
All other meds…
  • For Outpatient Meds
    • PSO OERR
  • For Inpatient Unit Dose/non IVs
    • PSJ OR PAT OE
  • For IVs (Additives and Solutions)
    • PSJI OR PAT FLUID OE
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