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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


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


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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