Complete the Pharmacy Form

• This form can be completed by pharmacy staff. 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.

• If you haven't already:

1. Select the patient and click Face Sheet Discharge (ALT+F) or Discharge (ALT+G).

2. Click the Pharmacy folder to access the form. The default display has 3 sections:

• Discharge medications

• These are the meds ordered for discharge by the MD/NP/PA; the last administration information is drawn from the eMAR

• 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.

• Pharmacy instructions for patient—Flagged with <PI> 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 Pharmacy Discharge Med Instructions.  See Writing Instructions for Medications. Click the <PI> flag to edit. Hold the mouse pointer over the <PI> flag to display the instructions temporarily (includes MD/NP/PA and/or RN instructions if available).

• 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+.

• Inpatient medications not selected for discharge—scroll down to view the entire list

• Pharmacist comments: Click to check None if applicable; otherwise, type to include general pharmacy information on the Post-Hospital Patient Care Plan (PHPCP). To work in a larger text area, click the field, then click Zoom. To return to the order, click OK.

• To access and print patient and family education materials, click the Patient/Family Education link on the Pharmacy page, or the folder to the left.. This opens the MGH Patient and Family Education and Resources page.

• Patient Discharge Medication List (PDML):

• To write pharmacy instructions that will print on the PDML, click to select the med in the Discharge Medications list, then click Pharmacy Discharge Med Instructions.  See Writing Instructions for Medications. (Existing pharmacy instructions for patient are flagged with <PI> in the Inst column of the Discharge Medications list above.)

• 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 pharmacy form, click Exit.

• See also: Overview of the Patient Discharge Medication List (PDML)

• To access Knowledge Link:

• Click .

• Click Exit (ALT+E) to close KnowledgeLink.

• Click Pop Out (ALT+P) to open KnowledgeLink in a separate window from the CAS.

• Toggle between Order Entry and KnowledgeLink by clicking the icons in the taskbar.

• Click to close the KnowledgeLink window.

• Save the changes, and finalize the orders if the patient is ready for discharge:

1. Click Save.

2. Type your signing key in the field provided.

3. 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.

4. Click OK (ALT+O).