# Ordering a Diet

You can place several different types of diet orders from the Orders tab, including regular diet orders, tubefeeding orders, early/late tray orders, isolations/precautions orders, and additional orders.

### Prevent Previous Active Diet Replacing NPO Order Upon Expire, Discontinue, or Cancel

The dietetics ordering functionality has been modified in order to prevent previous active diet orders replacing Nothing Permitted Orally (NPO) orders upon expiration, DC, or cancellation. The following changes have been made:

and the NPO diet remains intact.

1. The NPO orderable item will be added to the Auto-DC Rules with the CPRS v31b installation. With this change, the auto-DC rules will prevent the discontinuation of the NPO diet orders for the following event types:

   - Specialty transfer (S)

   - OR (O)

   - Transfer (T)

2. When NPO diet orders are attempted to be manually discontinued,CPRS prevents that action from being taken and displays the dialog box to the user with text “NPO Diet cannot be discontinued”.

3. CPRS disallows all diet orders to have an Expiration Date/Time when ordered and prevent automatic reinstatement of a previous diet. If a new diet order is desired, a new diet must be ordered to replace the active diet order.

4. When ordering NPO, if a patient is currently on tube-feeding, the provider is displayed the dialog box “The patient currently has an active tubefeeding order <display the current tube-feeding order here>“.

5. The Cancel Future Order Prompt from the tubefeeding order dialog has been removed. A conversion routine has been created to remove the prompt from any Quick Order. Additionally, Quick Orders will no longer allow the features of Auto Accept or Verify.

6. Accepting a tubefeeding order will prompt one of two different messages depending on the current diet status of the patient. If there is no existing order, the user will be prompted to enter a new diet order. If an existing diet order is present, the user will be prompted to keep the current diet or enter a new diet order.

### How Discharge Affects Diet Orders

The Nutrition and Food Service (N&FS) VistA package manages all diet-related order processing. The auto-discontinue process cannot discontinue active diet orders.

If the diet is to be replaced, then a new diet should be ordered.

Also, the rules for auto-discontinuing (auto-dc) orders can be affected by how different VistA packages handle discontinuing and how the package communicates with CPRS. Depending on the set up and parameters, the results may be different that a user might expect.

Note: If discharging/readmitting patients the Nutrition & Food Service package will auto-dc diet orders upon discharge. Plan to print diet lists pre-discharge so that patient’s current diet and standing orders can be manually re-entered/re-ordered upon admission.

Related Topics

Regular Diet Orders

Tubefeeding Diet Order

Early / Late Tray Orders

Isolations / Precautions Order

Additional Diet Order

Writing Orders (o verview)