Order Chemotherapy—Set Up AUC Dosing

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• Select the patient

• Start the chemo order session

• Set up the treatment—Regimen/protocol, diagnosis, numbering, day 1/day 0, patient height and weight

• Confirm treatment setup

• Reusing previous order parameters

• Open the chemo player

• Check information on the actual treatment administered previously —access the LMR Oncology Infusion Flowsheet

• Non-chemo orders—select, edit, add

• Chemo orders—select

• Click Next (ALT+N) to open the Chemotherapy folder and display the orders in the grid to the right.

• Results for relevant laboratory tests are displayed in a grid above the order list. If no results are displayed, check the Results viewer by clicking Results in the CAS toolbar on the left—see Checking Last Known Values for Lab Results.

• Set up AUC dosing if prompted

1. Type the patient's serum creatinine concentration, then press TAB. The creatinine clearance result is calculated automatically based on the CrCl equation required by the treatment.

2. For exception orders, type the target AUC. To modify a target AUC preset by the regimen or protocol:

1. Click AUC Modifications (ALT+ M ).

2. Click to select a modification option.

3. Click OK (ALT+ O ).

The AUC Dose is calculated automatically when you move to the next entry.

3. If allowed by the treatment, click one of the two recalculation options.

• Recalculated dosing is based on the creatinine value entered when these orders are activated. If the resulting dose differs by more than five percent (5%) from the original the orders must be approved by an attending oncologist or pediatric oncology NP or PA . Dosing changes triggered by NP/PA activation must be approved by an attending.

• If you choose not to allow recalculation, type a reason for doing so.

4. Click OK (ALT+ O ). The calculated Total Dose is entered automatically.

• Set up pediatric AUC rule-driven dosing if prompted

• Set up weight for dosing if prompted

• If any of the orders is PO, a message reminding you to use dose options appears. Click OK (ALT+O).

• Missing scheduled days: If an order for chemo was discontinued, a message displays that an order does not have scheduled days. Click OK (ALT+O). You must restore the scheduled days to include the order in this session. See Editing scheduled days.

• Select orders from the chemo set

• Undo order selections in the chemo set

• Edit a chemo order

• Add a chemo exception order (MD only)

• Complete the session

• Add a memo as needed (which is saved as a General Care order)

• As needed, view order details, view or print a list of chemo and medication orders only, or make changes before signing.

• Sign the session

• Check the orders awaiting activation

• See also Overview of Chemo Order Entry .