I agree those "combo" meds can be a problem. One thing you can do to minimize it is to routinely include Order Comments "linking" the two orders as well. "Give with 250 mg metformin to equal Glucovance 1.25/250" and "Give with glyburide 1.25 mg to equal Glucovance 1.25/250". That gives the prescriber a better chance to correctly identify the medication involved when writing the order change. That also provides the nurse and pharmacist with the reason the two orders were linked to begin with. I'm not sure if the rule Kevin suggested can be attached only to specific problem drugs or not. If it must be applied globally, then you will most likely get so many unneeded warnings that the important ones are likely to to get missed anyway. Bill Whitten Pharmacist Lake City Medical Center Lake City, FL (386)719-9343
________________________________ From: Sherlene Christen [mailto:[EMAIL PROTECTED] Sent: Thursday, June 28, 2007 8:33 AM To: Whitten Bill Subject: RE: [MEDITECH-L] Question for PHA Example: Patient comes in with a home med of Glucovance 1.25/250. We don't stock that compound therefore we enter 2 separate orders for Metformin & Glyburide (the two components that make up Glucovance) and link them. The physician making rounds looks at the MAR and reviews the patient's orders, chooses to discontinue one of these components (being that they are listed as separtate orders on the MAR), but choosing to leave the other active. This is where the discontinue process goes wrong, as it is too easy when discontinuing a linked order, to bypass the small message that tells you that you are discontinuing 2 orders. If we don't link the orders, then we have the reverse problem. Thanks, Sherlene Christen Sr Analyst_IT Duke Health Raleigh Hospital Pharmacy Department 3400 Wake Forest Rd. Raleigh, NC 27609 Phone: 919-954-3573 Fax: 919-954-3124 "Whitten Bill" <[EMAIL PROTECTED]> 06/28/2007 07:51 AM To <[EMAIL PROTECTED]>, "Sherlene Christen" <[EMAIL PROTECTED]> cc <[EMAIL PROTECTED]>, <[email protected]> Subject RE: [MEDITECH-L] Question for PHA If this is really a problem, perhaps you should look at why the orders are being linked in the first place. Generally you link orders that are supposed to be administered together, such as Demerol + Phenergan. When the prescriber orders one to be discontinued, it implies the other is to be discontinued as well. Hence the default response. Bill Whitten Pharmacist Lake City Medical Center Lake City, FL (386)719-9343 ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Wednesday, June 27, 2007 5:15 PM To: Sherlene Christen Cc: [EMAIL PROTECTED]; [email protected] Subject: Re: [MEDITECH-L] Question for PHA Even in Quick Batch, the confirmation message is "2 eligible Rx's selected. Discontinue?". Of course, the default response is Yes, so they can <Enter> through it without noticing that there are multiple linked Rxs. But to answer your question... No, we've never used a Rule for this situation. Steven Dailey, RPh Pharmacist/Informatics Union Hospital Elkton, MD 21921 Note: This message and any attachments are intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the sender. Sherlene Christen <[EMAIL PROTECTED]> Sent by: [EMAIL PROTECTED] 06/27/2007 11:53 AM To <[email protected]> cc Subject [MEDITECH-L] Question for PHA We are Magic, 5.4SR sr2. Does anyone have a PHA rule that will flag during a Rx DC, when an Rx is "Linked" to warn the user that they are discontinuing a linked order? I know that you get somewhat of a pop-up when you are in mode individual. However, our pharmacists process orders function defaults to mode quick batch, and they like it that way. Thanks, Sherlene Christen Sr Analyst_IT Duke Health Raleigh Hospital Pharmacy Department 3400 Wake Forest Rd. Raleigh, NC 27609 Phone: 919-954-3573 Fax: 919-954-3124=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*= To subscribe or unsubscribe to the meditech-l, visit http://mtusers.com/mailman/listinfo/meditech-l_mtusers.com To check the status of the meditech-l, visit MTUsers.NET For help, email [EMAIL PROTECTED] Please visit and add information to the MTUsers WikiPedia at MTUsers.NET/mwiki ______________________________________ meditech-l mailing list [email protected] http://mtusers.com/mailman/listinfo/meditech-l_mtusers.com
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