Download CPOE Medication Order Entry

CPOE Medication Order Entry
Ordering Specific Medications
Any medication can be ordered individually. These can
be searched by either the brand or generic name.
NOTE: The search field setting of either starts with or
contains can alter search results.
Ordering Specific Medications (con’t)
All order sentences following the word Reference:***
***Pediatric Dosing Below*** as displayed in the
following image, are Pediatric specific.
***Neonatal Dosing Below*** as displayed in the
following image, are Neonatal specific.
 Ordering medications in Ordersets are disease or
indication specific.
 Complicated medication orders (requiring labs,
monitoring, etc.) should be ordered through the
Orderset:
Any fields with an asterisk (*) are required.
Required fields that are not complete will be highlighted
in yellow. Once all yellow fields are completed, the
order can be signed and processed.
Best Practice: To place a completed medication order,
six items are needed:
 Drug
 Dose
 Dose Unit
 Route
 Frequency
 Indication
Best Practice: When placing orders, choose the
appropriate order sentence—the order sentences will
generally have 5 out of 6 fields completed. If the
specific order sentence isn’t available, the closest
sentence can be picked and the specific details
modified.
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Medication Order Entry Dose Calculation
 Dose calculation may be required for specific
medications and for weight based dosing. The
dose calculator will only open when the medication
has been configured as requiring a weight-based
dose.
 Further detail available on Weight Based Dosing
QRC.
 Multiple orders can be placed at one time, then
click the Sign button.
CPOE Medication Order Entry
Making Changes on Medication Orders Existing on the Profile
Active medication orders can be modified by right-clicking on the order and selecting Modify from the drop-down
menu.
Fields on a medication that should NOT be modified:
 Dose Unit
 Drug Form
 Route of administration
If changes need to be made to any of the above, the order should be discontinued and a new order placed.
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CPOE Medication Order Entry
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IV Fluid Ordering — Continuous Medications
When ordering IV fluids, select the most
appropriate order sentence.
Note that there are two tabs:
 Details specific to the order (Start,
Stop, Route, etc.).
 Details specific to the infusion contents and the rate.
Update details accordingly on supplemental tabs. Additional details can be added to the infusion instructions.
Continuous Infusions
A starting rate and indication will be required to start a continuous infusion. This may default from the order sentence
or be a required field.
DO NOT change either the volume or additive
dose (these fields may be locked).
 If a change needs to be made to the
concentration, the order should be
discontinued and a new order placed.
When changing an IV Infusion Rate, right-click
and select Modify. Modify the rate to display
correctly in Intake and Output.
J:\..Training & Education\EMR\QRCs\CPOE Medication Order Entry
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CPOE Medication Order Entry
Taper Dosing Orders (con’t)
Special Scenarios
 TPN— (Orderset to be added for labs and
placeholder order) actual ordering of
components to remain on paper.
 PCA’s—Ordering driven through Ordersets.
 Chemotherapy— Remains a paper order process.
 Investigational Drugs—Remain a paper order
process.
Insulin Orderset
Some medication orders are associated with a sliding
scale dosage. An example is insulin. To view or modify
the sliding scale dosage associated with a medication
order, complete the following steps:
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2.
The Dosing Calculator will open allowing the user to
enter taper details and calculate steps.
There are four main sections:
 Start
 Taper Details
 Planned Regimen
 Order Details.
3.
Click the Calculate Steps button and the Planned
Regimen section is filled in along with the details.
NOTE: The final dose cannot be zero.
1. Click the +Add icon on the Orders tab from the
menu.
2. Type Insulin in the Find field and click the
Search button (binoculars).
3. Select Insulin Therapy Subcutaneous Adult
found in the Search results window.
4. Click Done.
5. Click the box to select Appropriate Order.
 Insulin Type
 Fingersticks
6.
7.
8.
9.
Complete the order details by entering the dose.
Click Orders for Signature.
Click Sign.
Click Refresh.
 Change to Insulin Frequency, Change BGT
Frequency
Taper Details
Within the Taper Details section, you have an option to
choose whether you need to create a set of orders that
have reducing or increasing doses.
 Change to BGT Frequency, Change Insulin
 The default unit for each increasing or reducing
Frequency
dose comes from the unit of measure selected in
the Start section.
Aerosol Treatment
1.
 The default within the taper dialog box is Reduce.
Order Aerosol Treatment AND Order the
Medication.
 You may also increase or reduce by a defined
 If Aerosol Treatment frequency is Modified,
percentage.
Modify Medication Frequency.
 If reducing or increasing by a percent, make sure
 If Medication for Aerosol Treatment frequency is
you select whether you want to reduce or
increase by a percent of the previous dose or by a
percent of the starting dose.
Modified, Modify Aerosol Treatment frequency.
Taper Dosing Orders
A physician may order a medication with a tapering
dose.
1.
Once all the required fields are filled out in the
Taper Details section, the Calculate Steps button is
enabled.
2.
Click Calculate Steps.
After placing an order for Prednisone, for example:
1.
Click on the Taper Dosing icon.
J:\..Training & Education\EMR\QRCs\CPOE Medication Order Entry
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CPOE Medication Order Entry
Planned Regimen and Order Details
3.
Carefully review the schedule of the calculated
taper steps.
 May need to change frequency.
 If customization is needed, you can add or
remove taper steps by selecting the plus or minus
signs to the right of the last row in the Planned
Regimen.
2. Once details of the taper regimen are finalized, click
OK.
 The taper regimen is added to the orders
scratchpad.
3. Click the Sign button.
 To view the contents of the entire taper, you must
select the plus sign to the left of the taper name.
Planned Regimen and Order Details
Modifying Tapers
1. Each order within the taper regimen is eligible to be
modified.
2. Right-click on a taper regimen and select Modify.

The Details window displays allowing you to
make any necessary modifications.
3. Click the Orders for Signature button when all
changes are made.
Medication Clinical Decision Support (mCDS)
Alert Window
The Medication Clinical Decision Support (mCDS) Alert
window provides you with alerts and warnings
concerning medication you are ordering for the patient.
When a Decision Support alert window opens, you must
take action before you can proceed.
Such actions include removing the new order, removing
the order already on the patient’s chart, or entering an
override reason.
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Medication Clinical Decision Support (mCDS)
Alert Window (con’t)
1.
The Medical Clinical Decision Support (mCDS) has
3 separate sections in the alert pop-up window.
A. Allergy
B. Drug/Drug
C. Duplicate Therapy
Note: Additional information can be found on the
Medication Clinical Decision Support (mCDS) Alert
Window QRC.