We have created all of these types of meds as compounds so that they are one
order for Pharmacy, eMAR, and for POM. We use the label comments to assist the
nurse with the actual ordered med name ex. Glucovance 1.25/250 equals glyburide
1.25 mg plus metformin 250 mg (1.2 of 50 mg tab).
Melissa Wyant, R.Ph.
Pharmacy Application Analyst, IS
Holyoke Medical Center
Phone: 413-534-2842
>>> "Whitten Bill" <[EMAIL PROTECTED]> 6/28/2007 5:32 PM >>>
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
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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
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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
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