Note: Depending on how menus are set up at your particular site, you may need to select a different option from the Write Orders pane. Many sites have customized the items in the Write Orders pane. Check with your CAC (or the person who manages information resources at your site) if you have trouble locating the Clinic Medications item.
Note: The following prompts will be slightly different based on the patient’s location. You will be asked to verify that you want to write Clinic Medications and to ensure that the encounter location is a clinic location.
You can use an existing appointment if one exists or create a new one. To use Clinic Medications, you must enter a location that was previously defined clinic. If you chose a clinic location, you will see this dialog.
This dialog is to ensure that the user knows they are about to enter Clinic Medications.
Note: CPRS now only auto-selects (highlights in blue and places that entry in the field) a medication, dosage, route, or schedule if the user types enough characters to uniquely identify an item in the list. If the user does not enter enough characters to uniquely identify an item, CPRS waits until the user manually selects an item using the mouse or the keyboard.
Once the name is selected, CPRS displays a second dialog to select the items for the rest of the order. In the top field of the second dialog, the generic medication name and the synonym (usually a brand name) are displayed.
Note: If the selected medication is a controlled substance that requires the signature of a provider with a DEA or VA number, the DEA# Required dialog appears. CPRS allows orders for controlled substances only when selected providers are able to sign the orders. You may need to exit the Medication Order dialog, change the provider selection, and then reenter the dialog.
You must have a DEA# or VA# to order certain medications
Note: After you begin a complex dose medication order, you must remain on the Complex tab until you finish the order. If you switch to the Dosage tab, CPRS clears all complex dosages and you will be forced to start again.
The dosage may not begin with a decimal, for example .5; it must begin with a numerical value, 0.5 for example. Also, the character “^” may not be entered in the Dosage field. (The associated cost is displayed to the right of the dosage.)
Note: CPRS now only auto-selects (highlights in blue and places that entry in the field) a medication, dosage, route, or schedule if the user types enough characters to uniquely identify an item in the list. If the user does not enter enough characters to uniquely identify an item, CPRS waits until the user manually selects an item using the mouse or the keyboard.
Enter a Route by either selecting one from the list or typing in a valid route.
When the user selects a regular schedule that does not have PRN, the administration times may display in the Schedule column. The administration times will display if they have been defined for the ward or if there is a default.
- Select one or more checkboxes by the appropriate days of the week.
- If the schedule requires specific administration times skip to steps c and d. To select a schedule from the list, highlight the schedule and select Add.
Note: Users can assign either a schedule from the list or specific administration times, but not both. If launched from the Complex tab, the Day-of-Week Schedule builder does not display one-time schedules in the schedule list. Also, because the user is specifying days of the week and a schedule, the list will contain only schedules less than 24 hours (for example, Q36H will not be in the list).
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To use a specific administration time, select the hour and minutes (if the user only selects the hour, the minutes will default to zero) and select Add.
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Repeat step c until you have entered all required administration times
Warning: The administration times in the Schedule field apply to each day of the week that is listed, such as TU-TH-SA@0800-2000, for example. To create a schedule such as TU@0800 TH@2000, users would have to enter two separate orders using the complex medication order dialog. Also, users may not enter a schedule that only has administration times and PRN but no days.
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If you make a mistake while selecting an administration time or schedule, do one of the following to remove it:
- For a single administration time, highlight the hour and minutes in the Set Administration Time fields and select Remove (so to remove 08:00, you would have to select that time in the Set Administration Time fields not in the Schedule text box.)
- To remove the schedule, highlight the schedule and select Remove.
- To remove the entire schedule and begin again with step a, select Reset.
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Review the Schedule field.
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When you have the correct schedule, select OK.
The Order with Schedule ‘OTHER’ dialog allows you to enter a customized day-of-week and/or administration-time schedule. The user can enter specific administration times or select a schedule from the available list.
Select PRN if necessary.
PRN will display in the schedule field if the PRN checkbox is checked or if the schedule is defined in the Pharmacy files as a PRN schedule.
(Optional) Enter a Comment if desire by moving the cursor to the field and typing the comment.
The date and time that the patient is scheduled to receive the first dose of the medication appears under the Comments field. (For example, CPRS cannot show an expected first dose for “on call” or schedules with PRN. On the complex tab, it will not try to determine an expected first dose after a THEN because the first item must be completed.) If you want the patient to receive an additional dose now, check the Give additional dose now check box. CPRS displays a warning box such as the one shown below
This graphic shows the warning that ordering providers receive if they select the Give additional dose now check box. The warning makes it clear that CPRS is creating two orders with different schedules.
Note: Make sure that you are careful about using give-additional-dose-now functionality. When you click the check box, CPRS creates two new orders and sends it to Inpatient Medications. Make sure the “Give additional dose now” and the regular order with the original schedule you entered do not overmedicate the patient. “Give additional dose now” is not available for ONCE, ONE-TIME, or NOW orders. It is also not available for delayed orders.
Check the warning message to ensure that the orders you created are what you expected. If the orders are acceptable, select OK. If not, select Cancel to clear the Give additional dose now check box.
Select Accept Order.
Note: If you do not complete the mandatory items or if the information is incorrect, CPRS sends a message telling you that the information is incorrect and showing you the correct type of response
(Conditional) If the medication ordered may be contraindicated because of allergies, drug interactions, or duplicate orders, CPRS will display the Order Check window. Carefully review all order checks and decide if the medication should be ordered. Do one of the following:
- To proceed, select Accept Order.
- To stop the ordering process and return to the dialog, Cancel Order.
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Enter another medication or
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select Quit.
When you select Quit, if the patient is in inpatient, CPRS changes the patient’s location back to where the patient was before changing to the clinic.