This form can be completed by an MD, PA, NP, RN, or medical student. If completed by an RN or medical student, it must be cosigned. For additional information, see the Overview of Discharge Orders, Instructions, and the Patient Care Referral Form.
Changes made to discharge medication orders trigger an alert for clinicians if the Patient Discharge Medications List (PDML) has already been saved and printed. See Handling the Notifications When Medications Have Changed After PDML Print. The Order Status for patients whose PDML may require reprinting is Discharge (in red).
Face Sheet Discharge Orders and Instructions are not available in the newborn nurseries. You cannot access the forms, even if you select a patient from the associated maternity unit lists or from patient lookup.
If you haven't already:
Select the patient and click Face Sheet Discharge (ALT+F) or Discharge (ALT+G).
If needed, click the Medications folder to access the form.
When available for the selected patient's care unit, the Patient Discharge Medication List (PDML) is generated automatically. If prompted, click one of the buttons at the bottom of the message to continue:
Remind Me Later (ALT+R)—The message will be closed, and presented whenever you open the Medications folder in Discharge.
Close and Don't Remind Me (ALT+C)—The message will be closed and never presented again.
To print prescriptions for all medications with the Rx column checked
Click Print Rx.
If you added, edited, or deleted any medication prescriptions, type your signing key when prompted, then click OK (ALT+O).
Medication prescriptions that have not been printed on the care unit printer are checked by default and listed above those that have already been printed. Click to uncheck or check items under Print to Unit until the prescriptions you want to print are checked.
If the patient wants to fill discharge medication prescriptions through the MGH Outpatient Pharmacy, you can have the prescription print in the pharmacy so it will be ready as soon as possible. Click to uncheck or check items under Print to MGH Outpatient Pharmacy until the medication prescriptions you want to print are checked.
Click Outpatient Pharmacy Hours (ALT+P) to display this information. Click OK (ALT+O) to close the message.
You can print if the pharmacy is closed; the prescription is filled when the pharmacy next opens.
To pick up the medication, the patient must present a medication prescription printed on the care unit and signed by the ordering provider. You cannot print to the pharmacy without printing the official care unit copy. Give the signed prescription that is printed in the care unit to the patient.
To display details of a medication prescription, click its line in the list, then click Zoom (ALT+Z). Click Close (ALT+C) to return to the list.
The primary thermal printer on the care unit is selected by default. If needed, select the backup thermal printer or the default standard paper printer.
Click Print (ALT+P).
If there are prescriptions for medications selected to print to the outpatient pharmacy, and the pharmacy is not currently open, you are notified of the pharmacy hours. The prescriptions will be filled when the pharmacy opens. Click OK (ALT+O) to close the message.
The name of the provider who printed is displayed to in parentheses after the summary description of the order in the list of prescriptions to be printed. When an MD, NP, PA, or CNM prints prescriptions, the system checks the name of the provider to be printed on each scrip against the name of the provider currently logged in to the system. If the two are not the same, you are prompted to change the prescriptions selected for printing to your name. Change the name on the printout if you plan to sign the prescriptions yourself.
Thermal paper printouts comply with requirements for tamper-proofing from the Centers for Medicare & Medicaid Services (CMS). Also for compliance, refill and dispense amounts are surrounded by double asterisks.
Prescriptions print one per page on all printers. On thermal printers, when you print more than one prescription at a time, the pages are perforated for easy separation, then fully cut at the end of the last page.
The number and type of printout (thermal or standard paper) is tracked for all prescriptions. Reprinting should be avoided.
Each prescription printout includes a unique Rx reference number. This number displays to the right of the MGH heading, and at the bottom of the form. Prescriptions from MGH Provider Order Entry are prefixed with the letter "P".
The prescription ID is also displayed in the detail (zoom) view of the order.
If you are called to verify a prescription, you can generate a report based on either the patient's medical record number (MRN) or the prescription reference number. See Generating a Prescription Verification Report.
See also:
Reconciling pre-admission (PAML), inpatient, and discharge medication orders—Side-by-side Comparison
Providing anticoagulation therapy data (warfarin, fondaparinux, or enoxaparin)
Viewing, saving, and printing the patient discharge medication list (PDML)
Writing Prescriptions for Services, Equipment, and Supplies for Discharge.