Writing and changing chemotherapy orders is restricted to authorized providers. Restrictions apply to changes for chemotherapy medication orders.
You can completely discontinue treatment based on a protocol, and treat the patient using a standard regimen. See Overview of Changing Protocol Treatments.
If you haven't already:
Click Write (ALT+W).
Click Chemo (ALT+H).
From the orders list:
To access the LMR Oncology Infusion Flowsheet, click Infusion Flowsheet (ALT+F). Click Orders in the CAS to return to the session list.
Click the line for the order to edit.
Click either Dose field as appropriate to the dosing you want to change.
Depending on the regimen or protocol, change the dose as follows:
If defined for the selected medication, dose changes and reasons are presented in a list box. Click a line in the Choose Dose Modification list to select it, then click OK. Dose modifications defined as percentages or changes by a specified amount are calculated automatically. For percentages, the modification description includes what dose the percentage is based on—either the amount of the original standard dose for the regimen or protocol, or the previous dose order. Changes by a specified amount are based on the previous dose.
If Dose Modifications are not defined for a protocol order, changes to the dosing are not allowed. If necessary, you can omit an order when writing a new set by unchecking it on the chemo meds list, delete it from orders awaiting activation, or discontinue it if it has been activated.
For regimens only, the Dose Modification options may include "Something other than what is listed above." Pediatric orders with conditional dosing (determined by the age and/or weight range the patient falls into) do not offer this "something other" option. Select this option to enter your own dose. Click OK to close the list. Type a specific value for either the base dose (standard) upon which the total is calculated, or the Total Dose. You cannot change the units for the amount. Restrictions apply to changes for chemotherapy medication orders.
For pediatric treatments only, some modifications calculate a total dose that is not automatically recalculated against the patient's BSA on activation. The reason for Do Not Recalculate is provided automatically when you select a dose modification with the notation "This will result in a fixed dose that will not recalculate at the time of activation." Recalculated dosing that would increase the total dose is ignored because the dose is capped. If recalculating the dose on activation would decrease the dose by more than 5%, the orders with the higher fixed dose must be approved before they can be activated. See Defining Approval and Authorization for more information on recalculating weight-based dosing at activation.
For regimens only, if dose modifications are not defined, enter your own dose. Type a specific value for either the base dose ("standard") upon which the total is calculated, or the Total Dose. You cannot change the units for the amount. Restrictions apply to changes for chemotherapy medication orders.
If prompted, type the reason for changing the order, then click OK. This is required if you did not choose a defined modification.
Click Close (ALT+C) to display the list of orders for this session.
Edit additional orders as needed, then sign the session.
Click Back to UCM (ALT+B) after the new orders are saved.
See also: Chemo Order Procedures