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For inpatient orders, if the order does not have to be filled by pharmacy because the patient will be using medications from home, click to check Pt. to use home supply.
If this medication is available on formulary at the MGH pharmacy, you must provide a reason for using a supply from outside the hospital. Allowing patients to take medications brought from outside of MGH bypasses all bar code based safety checking, which is used by the MGH electronic Medication Administration Record (eMAR). You may be contacted by a pharmacist to re-order the medication if it is available from MGH formulary.
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if prompted, type your reason for allowing the patient to take a medication from outside the hospital.
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Click OK (ALT+O).
Orders with Pt. To use home supply are flagged <POM>.
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To indicate as needed medication (not available for taper or sliding scale administrations):
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Click to check PRN (ALT+P). To edit , click
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When prompted, click the associated checkbox to select one or more reasons. Reasons are listed alphabetically.
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For reasons needing delimiting values (such as temperature), type to describe the clinical requirements. Less than (<) and greater than (>) symbols are allowed.
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For Other, type a description. Use pre-defined reasons rather than the Other option whenever appropriate.
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Select a Start Time (Routine, Today, Stat, In AM, Specific Date/Time, On Call to OR/CATH, On Discharge—for new discharge meds only—or Other).
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The time of first dose for the Routine start time is based on the time the order is written, the frequency, and the MGH pharmacy 50% rule for Standard Medication Administration Time (SMAT). For inpatient orders only, the start time based on the current time is displayed to the right of the field. Because the start time for special orders (pre-admission, post-op, transfer, new inpatient chemo) is based on the time of activation, this information is not available when writing this type of order. The start time is also not available when writing medication orders for discharge.
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Specific date and time is offered for inpatient non-chemo medications only.
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For specific date and time, you can only select a future date, within the next 7 days.
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To change the specific date or time from the default, type over the entry or select from the calendar.
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To note reasons for holding the medications, type in the Hold if field.
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Type the number of days or total doses in the Duration field, then click an option to select the units.
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Duration is not definable for x1 medications.
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Duration for defined Repetitive Order medications is set automatically, and cannot be edited. The options of Weeks/Months is available only for these medications.
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Total doses are calculated automatically from the selected frequency and number of days when provided.
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Type instructions as needed.
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Enter the name of the approving MD if the use of the medication is restricted (the Approval by field appears only when required). See as appropriate:
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Click OK (ALT+O).