Order Chemotherapy—Previous Orders

Click link for steps, for additional details

See Chemo Overview: Reusing Exception Orders for information on the requirements for reusing previous orders.

This patient has previously signed chemo orders. The orders as defined by the standard regimen or protocol are displayed by default. Up to three (3) previous order sessions from the last six (6) months are displayed on the tabs beneath. Each previous tab is labeled with the date the orders were signed.

Hold the mouse pointer over a dated tab to display the name of the regimen or protocol.
Click a dated tab to display the orders in that previous session.
Orders from a previous session that differ from the standard for the regimen or protocol are highlighted with bold text.
On the initial implementation of this enhancement, only the standard regimen or protocol and the last signed previous session is available. Additional sessions will be included as they are signed.

To access the LMR Oncology Infusion Flowsheet, click Infusion Flowsheet (ALT+F).
To display details of an order, click its line to select it, then click Zoom (ALT+Z).
To generate a paper copy of the orders, click to select a session (standard or dated previous), then click Print (ALT+P).
To continue:

To use the standard regimen or protocol, click the Standard Regimen or Standard Protocol tab, then click Select (ALT+S).
To start with what was ordered on a previous treatment, click the dated tab for the previous session, then click Select (ALT+S).

If prompted that orders were discontinued after the session was signed, click OK (ALT+O) to acknowledge the message.
If you start from a previous session, and a pre-selected order from the previous chemo orders was omitted automatically by its dosing rules, you will be prompted to review the need for this chemo medication. To respond:

Click Recalculate to enter the patient's current GFR (glomerular filtration rate). If a dose is calculated, the medication is added to the selected orders. If the rule set determines that the medication should be omitted, the medication will remain unselected. This process will continue for subsequent chemo order sessions when you order from previous.
Click OMIT to manually remove this order from the session. When prompted, type the reason for omitting this required medication. The manual omission will apply to subsequent cycles.
Click Cancel to return to the chemotherapy ordering session. If you click to select the medication at issue, you will be prompted to enter the GFR.

The effect of discontinuing a chemo order that has been signed—whether it has been activated or not—is to delete the scheduled days, not to omit or uncheck it on the order set. You must enter the days to administer that drug if you want to include it in the orders.