Complete the Nursing Discharge Medications Form

This form can be completed by an RN or NP. For additional information, see the Overview of Discharge Orders, Instructions, and the Patient Care Referral Form.
To help clinicians recall what will be seen by the patient, each field with information entered that prints on the Post-Hospital Patient Care Plan (PHPCP) is flagged with the icon. Please keep in mind that information on the PHPCP should be patient-friendly, phrased to be easily understood by people who don't have medical training.
Changes made to discharge medication instructions or last/date time given 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.

Select the patient and click Face Sheet Discharge (ALT+F) or Discharge (ALT+G).
Click the Medications folder in the Instructions section to access the page. The default display has 3 sections.

Pre-admission medications (PAML)—displayed automatically if the list is in progress, ready for review, or reviewed.

To hide,click the vertical -PAML- button on the right side of the Discharge Medications list
To show, click +PAML+.

These are the meds ordered for discharge by the MD/NP/PA
Prescription printing (medications)—The status is indicated in the RX Print column: N = Not printed; U = Printed to the unit printer, do not send to MGH pharmacy; UO = Printed to unit and MGH outpatient pharmacy (hold the mouse pointer over the heading to display the abbreviation key). See Printing Prescriptions For Discharge Medications.
Nursing instructions for patient—Flagged with <NI> in the Inst column. These print on the Face Sheet, Patient Care Referral, Nursing Discharge Note, and Patient Discharge Meds List (PDML). To add instructions, click to select a medication, then click Nursing Discharge Med Instructions. See Writing Instructions for Medications. Click the <NI> flag to edit. Hold the mouse pointer over the <NI> flag to display the instructions temporarily (includes MD/NP/PA instructions if available).

Last Given: The date and time of the last administration for each medication is drawn from the eMAR (electronic medication administration record). If the patient is on warfarin, the last three (3) administrations are listed. You can record missing administrations and amend administration records in the eMAR to update the discharge orders as needed. To edit manually, click the row to select a medication, then type the date and time.

To write nursing instructions that will print on the PDML, click to select the med in the Discharge Medications list, then click Nursing Discharge Med Instructions. See Writing Instructions for Medications.
To display the patient's reconciled medication list for discharge, click View/Print Pt D/charge Med List.
To generate a paper copy for the patient, click Save and Print. (Printing is only available after the discharge medication orders have been reconciled by the discharging provider.
To return to the nursing discharge medications form, click Exit.

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Complete other Instructions forms if applicable. See also: Instructions for Discharge Orders and Instructions .
Save the changes, and finalize the orders if the patient is ready for discharge:

Click Save.
Type your signing key in the field provided.
Click Yes or No to indicate whether the patient is ready to be discharged. If Yes, click one or more checkboxes to sign off on the discharge.
Click OK (ALT+O).