Write Orders for Desensitization

Select the patient.
Click Desensitize Medication (ALT+Z).
If the patient does not have an allergy record for the medication ordered for desensitization:

Click OK (ALT+O) to acknowledge the message.
Update the patient's allergy record to include the medication ordered for desensitization. See Recording Allergies, Restrictions, and Adverse Reactions.
After recording the allergy, you will be prompted to provide a reason for overriding the intervention. See Responding to Drug - Allergy Interventions.

If there is more than one, click to select a session. Sessions contain one or more orders for chemo agents that require desensitization orders.
Click Desensitization Orders (ALT+O).

Associated orders (medications, nursing, etc.) must be ordered before you generate the worksheet.

From the list of chemo orders for the session, click Associated Orders (ALT+O).
Click to select the Write Associated Orders option.
Click to check orders to be included. Nursing instructions are checked by default. Click OK.
When prompted:

Click Yes to write other associated orders, or edit the selected orders . See Writing Orders and Editing Orders.
Click No to sign the associated orders without additions or changes.

Associated orders (medications, nursing, etc.) must be ordered before you generate the worksheet.

From the list of chemo sessions, click Associated Orders (ALT+O).
When prompted, click to select the View/Copy Previous Associated Orders option and copy associated orders from previous desensitization treatments.
Click the Zoom link to display the associated orders from a particular visit.
Click the Zoom link for an order to display details. Click Close to return to the orders list.
Click Copy to use the previous associated orders for the current treatment.
Click OK when prompted to copy orders.
When prompted to add/edit orders:

If you want to edit any of the copied orders or write additional orders, click Yes (ALT+Y) to display the orders list. See Editing Orders or Writing Orders.
To take the orders as written, click No (ALT+N). When prompted, type your signing key, then click OK (ALT+O).

Associated orders (medications, nursing, etc.) must be ordered before you generate the worksheet. If this is the first desensitization for this patient with the selected chemo treatment, see Writing Associated Orders For Desensitization; if previous orders are available, see Copying Previous Associated Orders.
You can copy and edit desensitization worksheets from previous treatments if available. See step 3 below.

If needed, click to select an order. (See Accessing the chemo order(s) to be desensitized.)
Click Desensitization Worksheet (ALT+W).

The medication for desensitization and the dose targeted by the oncologist are automatically included on the spreadsheet.

Click Previous (active only if worksheet is available).
Click the Zoom link for the order you want to display.
Click Copy to use the previous worksheet for the current treatment. If you do not want the previous worksheet, click Close.

You can edit or even clear and recalculate the copied worksheet before submitting it—see next. Go to step 9 to submit the copy without changes.

Type values for standard volume per bag and the final rate of infusion, and additional volume if needed.
Select a level of severity. If needed, you can edit the number of bags and steps per bag.

Changing the level of severity clears all calculated results.

To insert a new step before an existing step, enter the number of the existing step in the Add a step before field. Click to calculate the parameters for the new step and add them to the spreadsheet. When prompted to confirm, click OK to accept the new step, or Cancel to return to the worksheet without making the change. Repeat for as many steps as you need to add.
To remove an added step (numbered with red text), type its number in the Delete added step field, then click . When prompted to confirm, click OK to accept the deletion, or Cancel to return to the worksheet without making the change.
To add more steps for every bag, type over the number of steps per bag, then click Calculate.
To add more bags, type over the number of bags, then click Calculate.

To edit the volume for a bag, click the Edit link to its left. Type a volume (milliliters), then click Update to recalculate its parameters.
To edit either the flow rate and/or infusion time for a step, click its Edit link. Type to change one or both numbers. Click Update to recalculate the cumulative time, volume, dose, cumulative dose, and fold increase, as applicable, for the step.

To write new instructions, click for the step. Type your instructions, then click OK to return to the worksheet.
To edit or erase existing instructions, click for the step. Type over to edit the text, click Remove to clear, click Restore to bring back instructions you just removed. Click OK to return to the worksheet.

Click Submit to finalize the calculated dosing and attach the desensitization orders to the chemotherapy orders for approval and activation.

To start again, click Clear.
To generate a paper copy of the spreadsheet, click Print.
To generate a copy of the spreadsheet in a Word document, click Export to Word. When prompted, click to Open the document in Word, or Save the document as a file. You can save the document from Word as well.
To return to the UCM patient list without writing orders, click Close.