# Entering Allergies from the Orders Tab

Although allergies and adverse reactions are not orders and CPRS does not display them on the Orders tab, you can enter allergies and adverse reactions from the Orders tab. You can also enter allergies from the Cover Sheet tab. (See Entering Allergies from the Cover Sheet .)

To enter allergies or adverse reactions from the Orders tab, take the following steps:

1. Select the Orders tab.

2. Select Allergies from the Write Orders pane.

The Allergy Reactant Lookup dialog appears.

Note: Your site may have defined and configured other order menus to include allergy-entry dialogs. Regardless of the allergy-entry menu you select, if you haven’t entered encounter information, the Location for Current Activities dialog appears before the Allergy Reactant Lookup dialog appears. You must complete the Location for Current Activities dialog before proceeding.

3. Type the causative agent in the search field. (You must enter the first three letters (minimum) of the agent's name.)

4. Select Search.

Matching agents appear in the Select from one of the following items pane. If the causative agent you typed does not match any of the agents currently available for your site, CPRS displays the Causative Agent Not On File dialog, from which you can select one of the following options:

Note: The patient's chart will not be updated unless you choose a causative agent that is on file.

5. If you click on any drug ingredient listed in the Drug Ingredients File drop-down, you will get a notification that Drug Class cross checking will not occur. However, if you check the checkbox next to the notification, you will be able to enter the drug ingredient, as shown below (the notification is highlighted in red for emphasis):

a) Yes : Use this option to request that the causative agent be added for your site. When you click Yes, CPRS displays the Enter Optional Comments dialog, which enables you to type additional comments (optional), such as the signs or symptoms that occurred as a result of contact with this causative agent, or whether you observed these symptoms firsthand. After you type your comments, click Continue. CPRS then sends to members of your site's GMRA Request New Reactant mail group a message that includes the following items:

· The causative agent you attempted to enter

· The name of the patient for whom you attempted to make this entry

· Your name, title, and contact information

· Your comments

Note: When the bulletin is sent, a message such as the following will display. This message also informs the user that the allergy was NOT entered into the patient"s record.

"Members of your site's GMRA Request New Reactant mail group will review this message and, if appropriate, add the causative agent to your site's ALLERGIES file."

Note: If your site's IRM staff has not yet added members to your site's GMRA Request New Reactant mail group, CPRS displays the following message: Mail group GMRA Request New Reactant has no members - Contact IRM.

b) No : Use this option if you want to try an alternate spelling or trade name for your causative agent, or if you want to type another causative agent.

c) Cancel : Use this option if you want to cancel your allergy order.

6. If the causative agent you typed matches an agent that is currently available for your site, select the agent. (Click + to expand a heading.)

Note: With CPRS GUI 24 or later, you may not add free-text causative agents. If you select an item under the "Add new free-text allergy" heading, CPRS displays the Causative Agent Not On File dialog.

7. Select OK .

The Enter Allergy or Adverse Reaction dialog appears.

Note : You can view a patient's current allergies or adverse reactions by clicking the Active Allergies button. Also, CPRS no longer allows the user to change the allergy Originator.

8. Use the Observed or Historical option button to indicate whether the entry is for an observed or historical allergy, respectively. (When you point your mouse at either of these buttons, CPRS displays a hover hint explaining the observed and historical options.)

Note: Observed or Historical used to have a default, but the user must now select the appropriate choice. CPRS does not allow you to select future dates for observed allergy/adverse reaction entries.

Note: When you select Observed for a drug reaction, CPRS generates a Progress Note. Once this note is signed by the user entering the allergy or by an administrative update user, the note will be viewable by all users.

9. Select the Nature of Reaction (Allergy, Pharmacological, or Unknown).

The Nature of Reaction (also known as mechanism) can be Allergy, Pharmacologic, or Unknown. An allergic reaction occurs because the patient is sensitive to a causative agent, regardless of the amount the patient is exposed to. A pharmacologic (non-allergic) reaction occurs when the patient is sensitive to an agent under certain conditions, such as exposure to a large amount. Unknown is provided if you are not sure what mechanism to enter.

Note: Allergies are a subset of the world of adverse reactions. All allergies are adverse reactions, but not all adverse reactions are allergies.

10. If you are entering an observed allergy, use the Reaction Date/Time and Severity boxes to select a reaction date, time, and severity. (The Severity box is not visible for historical allergies. When the Severity box is visible, CPRS displays a ? button next to it. If you click this button, CPRS displays text that provides information about available severity selections.)

Note: CPRS does not allow you to enter future dates for observed reactions.

11. Using the Signs/Symptoms box, select one or more signs or symptoms. The signs and symptoms you select appear in the Selected Symptoms pane.

12. To associate a date and time with a symptom (optional), click to select the symptom in the Selected Symptoms pane.

13. Select the Date/Time button located below the Selected Symptoms pane.

CPRS displays the Select Date/Time dialog, from which you can select the date and time that the symptom first appeared.

Note: If you mistakenly enter a sign or symptom but have not yet accepted it by selecting OK, select the symptom in the Selected Symptoms pane and click the Remove button located beneath the pane.

14. Type comments for the allergy in the Comments box.

15. If you have marked the allergy or adverse reaction on the patient's identification (ID) band (or if you know someone else has), select the ID Band Marked check box.

Note: CPRS activates the ID Band Marked check box only for inpatients and then only if your site's IRM staff has set a parameter indicating that your site wants to track this information. Depending on whether your IRM staff has set related parameters, if you do not select activated ID Band Marked check box, the system may send a bulletin notifying a mail group that the patient's allergy or adverse reaction is not marked on his or her ID band.

16. Select OK.

Note: When you click OK, CPRS generates an email bulletin to the GMRA MARK CHART mail group. The bulletin provides a reminder that the patient chart must be updated with the allergy/adverse reaction information displayed in the bulletin message.

17. If the newly entered allergy is related to existing pending and active orders, then the Existing Medication Allergy dialog is displayed for each order discovered.

18. An Existing Medication Allergy will result in the NEW ALLERGY ENTERED/ACTIVE MED notification being sent to the default providers defined in the ORB PROVIDER RECIPIENTS parameter. Those providers who are able to receive the notification are displayed. Note, if a default provider recipient is unable to receive the notification they will not be listed.

19. The person entering the new allergy will also be able to select Optional Recipients to receive the NEW ALLERGY ENTERED/ACTIVE MED notification.

Note: Although CPRS does not display allergy-related assessments on the Orders tab, you can also enter an assessment of no known allergies (NKA) from the Orders tab.

Related topics

Entering Allergies from the Cover Sheet Tab

Causative Agent Not on File

Marking Allergies as Entered in Error

Viewing Allergies/Adverse Reactions