This is what we do (magic 5.5): #1 create a new order type that is not included in the MAR access dictionary. Pharmacy enters multiple orders from a set for these dose ranges. The first order in the set is the only one that has an order type that displays on e-MAR, the others are filed without patient specific dosing information just so they get to the dispensing machine. The nurse can then profile dispense any item size entered. Next, activate the 'other dosage forms' on page 8. This allows the nurse to scan any size and still link back to one e-MAR order so all the documentation is in one place. Audit works nice too. The only problem we've had with this is that there is a 'multiple dose form' screen that presents for the nurse and there are not any instructions for the user to know how to maneuver past the screen when finished (can't hit <enter>, must be <F12> or <shift><rt arrow>). Our nurses tend to get stuck on this screen and think that they have lost network connection. We're thinking about asking for a custom to either allow <enter> or at least put some instructions on how to exit the screen. #2 we enter a separate order for every drug product that might be needed for standard PRNs. However, for more conditional type orders (e.g. thiamine 100 mg po daily, give po when able) we do try to determine the appropriate route for the patient and only enter that order. In an example like this, we would enter the 'po when able' into Admin Criteria on the IV order and it would be a reminder. At some point the nurse will Hold Acknowledge and let the pharmacist know the patient was ready for oral and then pharmacy would enter the other order instead. Jeff Lee Assistant Director of Pharmacy, Support Services DCH Regional Medical Center 809 University Blvd E. Tuscaloosa, AL 35401 (205) 750-5323 [EMAIL PROTECTED]
The information contained in this e-mail message is confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent responsible to deliver it to the intended recipient, the reader is hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. ________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Jo Boyce Sent: Tuesday, April 03, 2007 10:22 AM To: [email protected] Subject: [MEDITECH-L] eMAR: Med range orders and Same med with differentroutes ordered Hi All, I need your assistance with a couple questions if you are using eMAR. We are Magic 5.5 1. Medication range orders - How are your orders for medications with a range placed in Pharmacy? I'll give an example. The order is for Morphine 1-5mg IV. We have 2mg, 4mg, and 10mg Tubex's in Pyxis. Currently the nurse picks the Tubex that is closest to the amount given. If 1mg given they would pick the 2mg Tubex, if 5mg given they pick the 10mg Tubex. Now the problem with this is that Pharmacy will have to Profile all 3 drug amounts on the patient's eMAR in order for the nurse to be able to pick whichever dose is closest. 2. Same medication but different routes - Sometimes the MD writes an order that a medication can be given by one route (PO) or another (IV). Examples: Zofran 4mg PO or IV (if pt unable to take PO). Tylenol PO or PR. Also these orders may be entered on different dates (Pt takes PO initially then can't take PO so MD orders IV or PR). Do you have both orders profiled on the eMAR? If so I'm concerned with the nurse seeing both routes if they were entered on different dates (different RX#s). Any suggestions would be greatly appreciated. Thanks Jo -- Jo Boyce, RNC Clinical Analyst Speare Memorial Hospital 16 Hospital Rd Plymouth, NH 03264 [EMAIL PROTECTED] Phone: (603)238-6458 Fax: (603)536-5336 Confidentiality Notice: The information contained in this e-mail and any attachments is privileged and confidential and may contain information that is protected by law. It is intended only for the use of the addressee(s) indicated above. Use or disclosure of information e-mailed in error is respectfully prohibited. If you have received this e-mail in error, please contact the sender and immediately delete the original message. This e-mail and any attachments may contain confidential and privileged information. If you are not the intended recipient, please notify the sender immediately by return e-mail, delete this e-mail and destroy any copies. Any dissemination or use of this information by a person other than the intended recipient is unauthorized and may be illegal. ** Confidential Information ** The Information contained in this email message is confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent responsible to deliver it to the intended recipient, the reader is hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited.
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