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Inpatient Orders Setup Overview

Inpatient Orders Setup Overview. February 2008. Managing Quick Orders. ACT Create/Modify Actions DIS Enable/Disable Order Dialogs GEN Create/Modify Generic Orders LST List Primary Order Menus MNU Create/Modify Order Menus

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Inpatient Orders Setup Overview

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  1. Inpatient Orders Setup Overview February 2008

  2. Managing Quick Orders • 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

  3. Menus Choose multiple items (hold control key and select desired orders) Users can see what items are available Useful when not all items are always chosen Sets Choose only 1 item Only see items when ordering Saves steps Useful when every item must be used Useful for multiple route (IV/IM) medication orders Useful for combination scheduled and as needed medication orders (i.e. Albuterol SVN Q6H and Q2H PRN) Menus vs Sets

  4. Order Menus

  5. Creating a Menu • Select ORDER MENU: ORZM ADMISSION ORDER MENU// ORZM ADMISSION ORDER MENU Are you adding 'ORZM ADMISSION ORDER MENU' as a new ORDER DIALOG? No// Y (Yes) • Do you wish to copy an existing menu? YES// NO • DISPLAY TEXT: New Menu • DESCRIPTION: • No existing text • Edit? NO// y YES • Test Menu • COLUMN WIDTH: 40 • MNEMONIC WIDTH: 2 • PATH SWITCH: • ENTRY ACTION: • EXIT ACTION:

  6. Creating a Menu

  7. Adding an Item • Using the Add option, any quick order created can be placed on the menu. • Users need to enter the row and column for placing it. Add: menu Menu Items ITEM: PSIVZ D5W WITH 20KCL ROW: 5 COLUMN: 1 DISPLAY TEXT: MNEMONIC

  8. Quick Order Namespaces

  9. Laboratory Quick Orders • Create quick orders • Lab Collect (LC) – AM lab draws (i.e. 0700) • Immediate Collect (IC) – Now/Timed lab draws • Ward Collect (WC) – Ward collected specimen • Send Patient (SP) – Outpatient labs

  10. Lab package nomenclature

  11. Lab Collect - Laboratory Quick Orders • Select QUICK ORDER NAME: LRZ LC LIPID PROFILE • NAME: LRZ LC LIPID PROFILE Replace • DISPLAY TEXT: Lipid Profile// • VERIFY ORDER: • DESCRIPTION: • No existing text • Edit? NO// • ENTRY ACTION: • Lab Test: LIPID PROFILE (ANMC)// • Collected By: Lab blood team// • Collection Sample: BLOOD // • Collection Date/Time: Next Lab collection// • How often: ONCE//

  12. Review Order ------------------------------------------------------------------------------ Lab Test: LIPID PROFILE (ANMC) Collected By: Lab blood team Collection Sample: BLOOD Specimen: SERUM Collection Date/Time: NEXT Lab collection How often: ONCE ------------------------------------------------------------------------------- • (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  13. Lab Orders for Daily Labs • Select QUICK ORDER NAME: LRZ LC PT • NAME: LRZ LC PT/ • DISPLAY TEXT: Protime// • VERIFY ORDER: • DESCRIPTION: • No existing text • Edit? NO// • ENTRY ACTION: • Lab Test: PROTIME// • Collected By: Lab blood team// • Collection Sample: BLOOD // • MIX WELL. 4.5ML REQUIRED FOR THE 5ML TUBE. • Collection Date/Time: NEXT Lab collection// • How often: DAILY// • Maximum number of days for continuous orders is 5; enter a duration • as either a number of days (3) or Xnumber of times (X3). • How long: 5//

  14. Review and place -------------------------------------------------------------------------- Lab Test: PROTIME Collected By: Lab blood team Collection Sample: BLOOD Specimen: PLASMA Collection Date/Time: NEXT Lab collection How often: DAILY How long: 5 -------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  15. Immediate Collect - Lab Quick Orders • Select QUICK ORDER NAME: LRZ IC LIPID PROFILE • NAME: LRZ IC LIPID PROFILE Replace • DISPLAY TEXT: Lipid Profile// • VERIFY ORDER: • DESCRIPTION: • No existing text • Edit? NO// • ENTRY ACTION: • Lab Test: LIPID PROFILE (ANMC)// • Collected By: Immediate collect by blood team • Collection Sample: BLOOD // • Collection Date/Time: NOW// • How often: ONCE//

  16. Review Order ------------------------------------------------------------------------------ Lab Test: LIPID PROFILE (ANMC) Collected By: Immediate collect by blood team Collection Sample: BLOOD Specimen: SERUM Collection Date/Time: NOW How often: ONCE ------------------------------------------------------------------------------- • (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  17. Ward Collect - Lab Quick Orders • Select QUICK ORDER NAME: LRZ WC LIPID PROFILE • NAME: LRZ WC LIPID PROFILE Replace • DISPLAY TEXT: Lipid Profile// • VERIFY ORDER: • DESCRIPTION: • No existing text • Edit? NO// • ENTRY ACTION: • Lab Test: LIPID PROFILE (ANMC)// • Collected By: Ward/Clinic Collect • Collection Sample: BLOOD // • Collection Date/Time: TODAY// • How often: ONCE//

  18. Review Order ------------------------------------------------------------------------------ Lab Test: LIPID PROFILE (ANMC) Collected By: Ward/Clinic Collect Sample: BLOOD Specimen: SERUM Collection Date/Time: TODAY How often: ONCE ------------------------------------------------------------------------------- • (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  19. Quick Orders - Radiology • Select QUICK ORDER NAME: RAZ ELBOW XRAY Are you adding 'RAZ ELBOW XRAY' as a new ORDER DIALOG? No// Y (Yes) • TYPE OF QUICK ORDER: IMAGING • NAME: RAZ ELBOW XRAY// • DISPLAY TEXT: Elbow Xray • VERIFY ORDER: y YES • DESCRIPTION: No existing text Edit? NO//Y Elbow xray for outpatients • Select one of the following imaging types: ANGIO/NEURO/INTERVENTIONAL GENERAL RADIOLOGY ULTRASOUND • Select IMAGING TYPE: general RADIOLOGY

  20. Quick Orders - Radiology • Radiology Procedure: ELBOW 2 VIEWS • Procedure Modifier: • History and Reason for Exam: No existing text Edit? No// • Category: INPATIENT • Is this patient scheduled for pre-op? NO// • Date Desired: TODAY// • Mode of Transport: AMBULATORY • Is patient on isolation procedures? • Urgency: ROUTINE//

  21. Review Order ------------------------------------------------------------------------------- Radiology Procedure: ELBOW 2 VIEWS Category: INPATIENT Date Desired: TODAY Mode of Transport: AMBULATORY Urgency: ROUTINE Submit request to: X-RAY ------------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE// Auto-accept this order? NO//

  22. Inpatient Medications • Unit dose medication quick orders (PSJZ) • oral, ophthalmic, otic, nasal, inhalation, rectal, topical, subcutaneous, intramuscular, and intravenous push medication routes • IV Piggyback quick orders (PSJIVZ) • IV Fluid / IV Infusion quick orders (PSIVZ)

  23. Quick Order – Inpatient Unit Dose Meds • Select QUICK ORDER NAME: PSJZ METFORMIN XR 1000MG DAILY Are you adding 'PSJZ METFORMIN XR 1000MG DAILY' as a new ORDER DIALOG? No// Y (Yes) • TYPE OF QUICK ORDER: INPATIENT MEDICATIONS • NAME: PSJZ METFORMIN XR 1000MG DAILY Replace • DISPLAY TEXT: Metformin XR 1000mg DAILY • VERIFY ORDER: Y YES • DESCRIPTION: No existing text Edit? NO// • ENTRY ACTION:

  24. Quick Order – Inpatient Meds • Medication: METFORMIN • 1 METFORMIN TAB,ORAL • 2 METFORMIN TAB,SA • CHOOSE 1-2: 2 METFORMIN TAB,SA • Complex dose? NO// • Choose from (or enter another): 1 500MG $0.286 2 1000MG $0.572 • Dose: 2 1000MG $0.572 • Route: ORAL// • Schedule: QDAY// • Give First Dose NOW? NO// • Priority: ROUTINE// • Comments: Take 30 minutes before breakfast Edit? No// (No)

  25. Review Order ------------------------------------------------------------------------------- Medication: METFORMIN TAB,SA Instructions: 1000MG ORAL QDAY Priority: ROUTINE ------------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  26. Quick Orders – IV Piggyback Meds • Select QUICK ORDER NAME: 'PSJIVZ CEFTRIAXONE 1GM IVPB Q24H‘ Are you adding 'PSJIVZ CEFTRIAXONE 1GM IVPB Q24H' as a new ORDER DIALOG? No// Y (Yes) • TYPE OF QUICK ORDER: INPATIENT MEDICATIONS • NAME: PSJIVZ CEFTRIAXONE 1GM IVPB Q24H Replace • DISPLAY TEXT: PSJIVZ CEFTRIAXONE 1GM IVPB Q24H Replace • VERIFY ORDER: YES// • DESCRIPTION: No existing text Edit? NO// • ENTRY ACTION:

  27. Quick Order – IV Piggyback Meds • Medication: CEFTRIAXONE INJ,SOLN • Complex dose? NO// • Choose from (or enter another): 1 1GM/1VIAL $0.569 2 1GM/1VIAL 3 2GM/2VIAL $1.138 4 2GM/2VIAL • Dose or Rate: 1 1GM/1VIAL $0.569 ...OK? YES// • Route: IVPB// IV PIGGYBACK IVPB • Schedule: Q24H • Give First Dose NOW? NO// • Priority: ROUTINE// • Comments: No existing text Edit? No// (No)

  28. Review Order ----------------------------------------------------------------------------- Medication: CEFTRIAXONE INJ Instructions: 1GM/1VIAL IV PIGGYBACK Q24H Priority: ROUTINE ------------------------------------------------------------------------------ (P)lace, (E)dit, or (C)ancel this quick order? PLACE// Auto-accept this order? NO//

  29. Quick Orders – IV Fluid Meds • Select QUICK ORDER NAME: 'PSIVZ D5W WITH 30KCL‘ Are you adding 'PSIVZ D5W WITH 30KCL' as a new ORDER DIALOG? No// Y (Yes) • TYPE OF QUICK ORDER: IV MEDICATIONS • NAME: PSIVZ D5W WITH 30KCL Replace • DISPLAY TEXT: D5W 1000CC with 30KCL Replace • VERIFY ORDER: YES// • DESCRIPTION: No existing text Edit? NO// • ENTRY ACTION:

  30. Quick Orders – IV Fluid Meds • Solution: DEXTROSE INJ,SOLN // • Additives: 1: POTASSIUM CHLORIDE INJ,SOLN 30 MEQ 2: <enter more> Can add multiples Select (1-2) or <return> to continue: • Infusion Rate: <Enter> • Schedule: <Enter> • Priority: ROUTINE// • Provider Comments: No existing text Edit? No//

  31. Review Order ------------------------------------------------------------------------------ Solutions: DEXTROSE INJ,SOLN 1000 ml Additives: POTASSIUM CHLORIDE INJ,SOLN 30 MEQ Priority: ROUTINE ------------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE// Auto-accept this order? NO//

  32. Quick Orders - Nursing • TYPE OF QUICK ORDER: NURSING • NAME: ORZ FOLEY CATHETER// • DISPLAY TEXT: Foley Catheter to Drainage • VERIFY ORDER: • DESCRIPTION: No existing text Edit? NO// • ENTRY ACTION: • Patient Care: FOLEY CATHETER • Instructions: Empty drainage bag q shift • Start Date/Time: NOW// • Stop Date/Time: t+2 (FEB 24, 2004)

  33. Review Order ------------------------------------------------------------------------------- Patient Care: FOLEY CATHETER Instructions: Empty drainage bag q shift Start Date/Time: NOW Stop Date/Time: 7 DAYS FROM TODAY ----------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  34. Generic Orders • (OR GXMOVE orders are installed with EHR) • NAME: OR GXMOVE ADMIT PATIENT Replace • DISPLAY TEXT: Admit Patient// • SIGNATURE REQUIRED: ORES// • VERIFY ORDER: • ASK FOR ANOTHER ORDER: • DESCRIPTION: This allows admission of a patient as a generic order (does no interaction with MAS). Edit? NO// • ENTRY ACTION: • EXIT ACTION: K OREVNT// • VALIDATION: • ADDITIONAL TEXT: • DISPLAY GROUP: M.A.S.//

  35. Generic Orders • Answer with ITEMS, or SEQUENCE Choose from: 1 OR GTX EVENT 2 OR GTX TREATING SPECIALTY 3 OR GTX PROVIDER 4 OR GTX PROVIDER 1 5 OR GTX FREE TEXT 1 • Auto-accept this order? NO//

  36. Quick Orders - Consults • Select Order Menu Management Option: QO Enter/edit quick orders • Select QUICK ORDER NAME: GMRCZ PHYSICAL THERAPY • NAME: GMRCZ PHYSICAL THERAPY • DISPLAY TEXT: Physical Therapy Consult • VERIFY ORDER: YES// • DESCRIPTION: Quick order for physical therapy consult • Edit? NO// • ENTRY ACTION: • Consult to Service/Specialty: PHYSICAL THERAPY// • Consult Type: • Reason for Request: • No existing text • Edit? No// (No) • Category: OUTPATIENT// • Urgency: ROUTINE// • Place of Consultation: Consultant's Choice// • Attention: • Provisional Diagnosis:

  37. Review Order ------------------------------------------------------------------------------- Consult to Service/Specialty: PHYSICAL THERAPY Category: OUTPATIENT Urgency: ROUTINE Place of Consultation: Consultant's Choice ------------------------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

  38. Order Sets • Select ORDER SET NAME: LRZSET DIABETIC TESTS • NAME: LRZSET DIABETIC TESTS Replace • DISPLAY TEXT: Diabetic Yearly tests Replace • DESCRIPTION: No existing text Edit? NO// • ENTRY ACTION: • EXIT ACTION: • ORDER SET COMPONENTS: 1 LRZ HGBA1C OUTPT 2 LRZ LIPID PANEL 3 LRZ TSH OUTPT Select COMPONENT SEQUENCE#:

  39. Questions and Discussion

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