Ordering from an Access and Flush set (MGH and DFCI ambulatory chemotherapy units only)
A set may have more orders than can be displayed in the available viewing area. To display additional orders, use the scrollbar on the right.
To display details of an order, click to select its line, then click Zoom (ALT+Z).
To order
Click the associated checkbox to select an order: . You can also click its line or press the up or down arrow keys to highlight an order, then click Order (ALT+O).
To unselect and order, click the checkbox. You can also click its line or press the up or down arrow keys to highlight an order, then click Delete (ALT+D).
When an order is highlighted, its parameters are displayed in the tab sections at the bottom. Click a tab to view its contents.
To close the sets and templates, click OK (ALT+O).
Ordering from a set (ambulatory chemotherapy units only)
To open a set
Click the service, unit, or pathway folder to find the set you need.
Click its folder to display the orders in a set. Orders appear in the list to the right.
A set may have more orders than can be displayed in the available viewing area. To display additional orders, use the scrollbar on the right.
To display details of an order, click to select its line, then click Zoom(ALT+Z).
To order
Click the associated checkbox to select an order: . You can also click its line or press the up or down arrow keys to highlight an order, then click Order (ALT+O).
To unselect and order, click the checkbox. You can also click its line or press the up or down arrow keys to highlight an order, then click Delete (ALT+D).
When an order is highlighted, its parameters are displayed in the tab sections at the bottom. Click a tab to view its contents.
To edit a medication order
Med tab dose—Click to select a dose from the drop-down list. For Other, when prompted, type the amount, then select the units, or click Other Unit and type a description.
Med tab frequency—Click to select a frequency from the drop-down list. For Other, when prompted, type a description.
Med tab as needed administration—Click to check PRN, or to change existing reason(s), click . When prompted, check one or more reasons. For reasons needing additional parameters, indicated by (__), click the Less than or Greater than checkbox, then type the threshold number and units. Click OK (ALT+O) to close the reasons list.
Start/duration tab Start time—Click to select an option. For Other, see Defining non-standard start times.
Start/duration tab duration—Type the total number of doses, days, or hours to give the medication.
Start/duration tab duration unit—Click to select doses, days, or hours.
Instructions tab—Type as needed.
To edit an IV fluid order
IV1 tab Amount —Type the rate.
IV1 tab Start—Click to select an option. For Other, see Defining Non-Standard Start Times.
Scheduled days can be changed by clicking Other, then clicking the By Day option in the Start day section. When prompted, type the day number(s) as described, then click OK (ALT+ O ).
IV1 tab Site—Click to select from the drop-down list.
IV1 tab Heplock When—Type a description of the condition(s) to meet for adding a saline lock to the IV.
IV Fluids with the saline lock option selected automatically generate two (2) consequent medication orders on completion. See Overview of Consequent Orders .
Instructions tab—Type as needed.
Press TAB to update the order display in the list.
To edit a general care order
The summary cannot be changed. If available, type instructions as needed.
Press TAB to update the order display in the list.
To close the sets and templates, click OK (ALT+O).
Ordering from a template (inpatient and ED only)
To open a template
Click the service, unit, or pathway folder to find the template you need.
Double-click its folder to open a template. (You can also click to select the folder, then click Order.)
To access information provided by the department or service that owns the template:
Click More Info (when available).
Click the CAS icon in the taskbar at the bottom of your screen to return to the template.
Click in the upper right of the information page to close it.
Select orders from a template:
To select an order, click its checkbox to mark it. The fields associated with an order become active when you click the checkbox for the order.
To undo an order, click its checkbox to remove the mark.
Due to a limit in the number of characters a single line can hold, some orders may require several lines, each with a separate checkbox. Keep in mind that you need to check off every line that you want the nurse to see.
Type to fill in open text fields, such as the location in 'Admit To.'
Click the to the right of any drop-down list to view the options, then click any line to select it.
Some orders can be edited. To access the original order form for an order, select it in the scratch pad, then click Edit (ALT+E). See Editing Orders.
Click Order to access the blank form for the order indicated by the section heading. See Writing Orders.
Medications that require approval are automatically approved for use when checked off on a template. Approval is designated as applicable by ID (Infectious Disease), the Heart Failure Group, EP (Electrophysiology), Restricted Mediations For Neonates, Pain and Palliative Care, or GI (Gastroenterology).
Review all pages (current page number and the total number of pages is displayed in the blue title heading.
Click Next Page (ALT+N) to move forward, and click Prev Page (ALT+P) to go back.
If required information has not been completed, you cannot change the page.
Close the template by clicking OK (ALT+O).
The OK button is active only on the last page, when all required fields are completed.
Orders selected on the template are checked against existing orders for conflicts and potential adverse reactions. See Responding to Interventions.
Ordering a change to the patient's admission status (inpatient only)
Click the Admission Orders folder.
Click the green Admit Status folder. The order appears in the list to the right.
Click the associated checkbox to select the changing status order: . You can also click its line or press the up or down arrow keys to highlight an order, then click Order (ALT+O).
To close the sets and templates, click OK (ALT+O).
Update the admit status when signing. See Documenting Patient Admission Status.
Write additional orders as needed, then sign the session.
See also