Inpatient Orders Setup Inpatient Orders Setup OverviewOverview

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• 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

Menus vs Sets

• 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)

Order Menus

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:

Creating a Menu

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

Quick Order NamespacesNamespace Department

RA Radiology

LR Laboratory

PSO Outpatient Medications

PSJ Inpatient (Unit Dose) Meds

PSJIV IV Piggybacks

PSIV IV Fluids / IV Infusions

GMRC Consults

OR CPRS

FH Dietary

* Use namespace+Z = local quick order

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

Lab package nomenclature

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//

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//

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//

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//

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//

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//

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//

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//

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

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//

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//

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)

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:

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)

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

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:

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)

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//

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:

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//

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//

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)

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//

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.//

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//

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:

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//

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 OUTPTSelect COMPONENT SEQUENCE#:

Questions and Discussion