Procedure documentationCreating Orders for Standard Drugs

 

You use this medication order to order standard drugs such as, for example, tablets, suppositories, etc. The order contains no special screen areas for flow rates or ingredients.

Note Note

You can also create an order without an end date. The system creates an order without an end date if you do not enter an order duration or an end date for the order.

You should note that the system cannot calculate the overall quantity of an order without an end date.

When generating events the system uses the event generation horizon which is entered in the master data of the corresponding drug (Inpatient tab page). If the event generation horizon is not determined in the drug master, the system uses the value of system parameter N1MEEVTH or, if the system parameter is not maintained, a standard duration of 5 days.

See System Parameters for Medication

End of the note.

The Activate Suspended function is provided in the medication order dialog for the entry of initially suspended medication orders. This function activates a new order, as yet unsaved, while automatically setting the suspension start date to the order start and adjusting the change history accordingly.

Prerequisites

You select a standard drug in the drug search or in the order.

Note Note

In Customizing, you can determine user-specific presettings for order management, to control and preset the data in the order. The system takes into account the presettings assigned to the user when creating an order.

See Maintaining User-Specific Presettings

See Order Management Tab Page

End of the note.

Procedure

  1. Select a patient in a view in the clinical work station or in the patient organizer and choose Create Order (Create Order).

    Alternatively you can create an order using a corresponding task in the documentation work station.

    You can also create a new order in the order dialog. To do this, choose Create Order (Create Order).

    Note Note

    As the order type results from the order process, the system does not support the transfer of the order type from the order template.

    End of the note.

    Depending on the user parameter N1ME_NO_DRUG_SEL you will access the drug search or the Create Order screen.

    In the drug search you can also search for order templates which you can use as a basis for the order you wish to create.

    See Finding Drugs Using Order Templates

  2. Select the standard drug(s) to be ordered in the drug search or in the input help of the Mnemonic field in the Create Order screen.

  3. Enter the required data in the order.

    In the compressed view the system displays each order in a separate row. Depending on the user parameter N1ME_ORDGRI_OPENROW the system highlights the opened (selected) order (row) in the Compressed View.

    The system presets the following order data:

    • Depending on the user parameter N1ME_DEFOTYP the system presets the order type.

    • The system presets the standard dose, the administration route, etc. from the drug master data.

  4. You should take note of the following fields for entering/changing data in the compressed view:

    • Choose the icons with the quick info text Dose or Alternative Dose in the compressed view to toggle between the dose display (e.g. 1 tablet) and the strength display (e.g. 500 mg) of the drug in the Dose field.

      You can also use the hotspot on the Unit Dose field to toggle between the active agents of the drug.

    • Choose Dose Calculation (Dose Calculation) in the compressed view to calculate the dose for the order. See Calculate Dose for Standard Drugs

    • If you determine the individual dose for each administration time in an order, and have entered a quantity in cycle definition, the system will combine this information. The quantity entered in the cycle is used as a multiplier. In this way you can define administrations which are irregular as far as the quantity is concerned.

      The system will check the value which results from the quantity and unit against the maximum individual dose and will display a warning where necessary. The system will also display this warning if you manually create a new event which exceeds the maximum individual dose.

      Example Example

      You have defined a cycle 1-2-1. The individual dose of 2 tablets results in an administration of 2 tablets in the morning, 4 tablets at lunchtime and 2 tablets in the evening.

      End of the example.

      Note that, in case of orders for drugs which cannot be dosed precisely, the quantity in the cycle is not relevant.

      Furthermore the system will also check the combination of individual dose and cycle against the daily dose. Note that, for this, the system will use the 24 hours before the administration time which results from the cycle as the day. The system displays a warning if necessary. The system will also display this warning if the daily dose is exceeded in the following ways:

      • by manually created new events in the order

      • by changing the dose of the events with the "Administration" purpose

      • by changing the administration time

      The system will take into account the components of an administered drug and any other valid orders which may simultaneously exist for the patient and which contain the same drug. The system will not take into account drugs with the same agents when checking the maximum daily dose.

    • If you use "Dose" as the unit for the duration of the order, the system will use the individual dose entered in the order as the basis for event generation.

      Example Example

      You create an order with the cycle 1-2-1, individual dose 1 tablet and duration 3 doses. This results in the administration of 1 tablet in the morning and 2 tablets at lunchtime. The order then ends.

      If the order does not begin until the afternoon, the system would generate 3 events with 1 tablet each, although, according to the cycle, the last administration (at lunchtime) is defined with 2 tablets.

      End of the example.

    • Choose Height/Weight not Entered (Height/Weight not Entered) or Height/Weight of Patient (Height/Weight of Patient) in the Further Patient Information column, to enter or change the height and weight of the patient.

    • If you set the PRN Medication indicator for an order, the drug is ordered on request. The system creates a PRN main event with the entire daily dose for each day. The system will not create the individual administration events until the administration of the PRN medication main event is documented.

      If you set the indicator, you must also enter a check condition, which determines the conditions under which the patient should actually receive the drug, e.g. when in pain.

    • Set the Immediate Dose indicator if you wish to ensure that an additional event is created outside of the cycle times at the start of the order.

      If the order start time is the same as the first event, the following system behavior results:

      • If the purpose of the order was determined as “administration” and the order start time is exactly the same as that which results from the cycle definition for the first event, the system will not generate an additional event when the Immediate Dose indicator is selected. In connection with the order duration of exactly one dose, the system sets the event time of the single generated event to the start of the order.

      • If the purpose of the order is "dispensing" or "prescription printing", the system will generate an additional event with the "administration" purpose, even if the time of the order is exactly the same as the first determined cycle time.

  5. Choose Detail (Detail) in the row of the order in the compressed view, to open this order in the Expanded View.

  6. Choose Change Drug Drug (Change Drug) to have the system propose alternative drugs (generics) for the selected order.

    See Changing Drugs/Changing Drugs to Default

    Note Note

    Note that if you change the order description by selecting another drug in the Propose Alternatives and Propose Issue Quantity functions the system will overwrite using the drug description of the alternative.

    In such cases you should therefore use the Comment field in the order which is not overwritten by the system when alternative drugs are selected.

    End of the note.

  7. Enter the data necessary for ordering standard drugs on the following tab pages of the expanded view:

    • Order Tab Page

      When you create an anamnestic order, the system sets the "Anamnesis" value in the Pat. Own Medic. field for the patient's own medication. The system cannot generate events for this anamnestic order. However, this medication may be relevant for clinical interaction checks, which are only possible if an order exists.

      The system presets the organizational units on this tab page using the case. You can enter a comment for the order.

      You can also assign indicators or automatically transfer these from the drug search.

      Furthermore you can also create a check condition for the order and indicate that the prerequisite entered there must be checked before a drug can be administered.

      The Check Condition is set under the following circumstances and is no longer ready for input:

      • the Check Condition Indicator is set in the drug master

      • the PRN Medication indicator is set in the compressed view

      In case of orders with the Print Prescription purpose the system will not set the Check Condition indicator and it is also not ready for input. You can still enter a text for a check condition, e.g. in order to print this on the prescription.

      In case of orders with the Dispensing purpose you can set the Check Condition indicator and confirm this during administration.

    • Sliding Dose tab page

      See Sliding Dose

    • Event tab page

      You can define a different fill source for the first event, e.g. the drug stockroom of the care unit or outpatient clinic.

      Note Note

      Choose Replace Drug for Event (Replace Drug for Event) to call the manual substitution for medication events.

      End of the note.

  8. To add several orders, choose Add Orders Add Order (Add Orders).

    You access the drug search where you can use the corresponding functions (e.g. multiple selection) to create several orders.

  9. To activate one or more orders, select the order(s) and then choose Activate Orders (Activate Orders). See Activating an Order.

  10. To generate the events for one or more orders, select the order(s) and then choose Generate Events (Generate Events).

  11. In additional to the events which the system generates for an order, you can also manually create orders. Choose New Row (New Row) on the Event tab page, to create a new event.

    In case of manually created events, you can determine the purpose of the event in the Administration, Dispensing andPrescription Printingcolumns, regardless of the purpose of the order.

    This means that, for outpatient orders (dispensing or prescription printing) you can also document an administration of the same drug, in addition to a dispensing or prescription printout, within an order. You do not need to enter two orders with differing purposes (administration and dispensing or prescription printout).

    Note Note

    When a patient is discharged, you can also use the existing orders for the administration for a prescription printout or to dispense the drug. You must only create a subsequent order if you wish to use another drug.

    End of the note.

    The system flags (manual) events where the purpose can be changed, in the Changeable Purpose column.

  12. To activate several orders in one work step and simultaneously generate the corresponding events, select the orders in the compressed view and then choose Schedule Orders Schedule (Schedule Orders).

    See Scheduling Orders

  13. To document a single administration, dispensing or prescription printout for an order quickly and directly from the order, select it and then choose Execute Order (Execute Order).

    See Executing an Order

  14. You can print the order. Choose Print Order (Print Order).

    The Print Preview screen appears.

  15. Save the order.