Order Chemotherapy—Edit Chemo Med Instructions

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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

• Edit a chemo order

• Click the line for an order to highlight it and display its parameters in the section beneath the order list.

• Dose modifications

• AUC dose modifications

• Change the preset weight

• Adjust dosing of oral medications

• If needed, make limited changes to the scheduled day(s)

• If needed, prevent recalculation of dosing of chemotherapeutics at activation—based on adjustments made to the patient's weight, height, or creatinine

• Order desensitization

• Update administration instructions

• Write or Edit a prescription for an oral investigational chemo med

1. Open the prescription form:

• To write a new prescription, click line for the chemo med needing a prescription, then click Add Prescription.

• To view or edit an existing prescription, click line for the prescription ("Take Home Prescription"), then click View/Edit Prescription.

2. If you want to manually enter patient directions, click to check As Directed Prescription (Enter Directions Below). The text for the Sig line will read "See Directions", rather than being constructed automatically from the dose, form, frequency, and duration.

3. Select a Strength from the drop-down list. If Other, type a description, then click OK (ALT+O).

4. If you have not checked As Directed Prescription, select the appropriate Dose, Form, and Frequency.

5. If needed, type the number of days for the administration duration—for ___ day(s).

6. Type a Dispense amount, then select the appropriate form. Day(s) and Month(s) supply are at the end of the list.

7. Type the number of Refills allowed, if any.

8. If needed, type a description in the Directions field.

• The scheduled days are automatically added to the directions.

• Directions are required if you checked As Directed Prescription, which automatically defines the Sig as "See Directions".

• If you did not check As Directed Prescription, directions should not conflict with the Sig that is automatically constructed from the dose, form, frequency, and duration.

• Directions print on the prescription.

To avoid prescription errors:

• Include a brief notation of purpose (e.g., "for cough"), unless inappropriate.

• Do not use vague instructions such as "Take as directed" as the sole direction for use.

• Avoid use of abbreviations and Latin directions for use.

9. No Substitutions is selected by default. Click to uncheck if appropriate.

10. Click Sign/Print.

11. When prompted:

• Type your clinical signing key.

• Click to select printing options. You can opt to print to the pharmacy or to the local printer, or to both, or not to print at all.

• Click OK.

• You can write more than one prescription for the same chemo medication order. Prescriptions are not replicated when chemo order sessions split for activation by week. See Overview of Chemo Activation.

• The prescription is active immediately on signing the chemo order session, or if needed, after the session is authorized or approved.

• If you opt to print, nothing will print until the chemo orders are signed, and authorized or approved if needed. See Overview of Chemotherapy Approval or Authorization.

• You can print or reprint  the prescription from the active orders list to the local printer—see Printing Active Orders: Prescription for Oral Investigational Chemo Medication.

• Once active, the prescription cannot be edited.

• 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 .