Order Chemotherapy—Change the Scheduled Days

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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)

• Orders written for ambulatory care do not transfer to inpatient records, and vice versa. When entering orders for your patient to continue with treatment mid cycle, be aware that the correct day 1 date should be entered upon ordering. This will ensure that the treatment which the patient has received at another facility will not be duplicated upon administration. For example: Your patient began treatment on 1/1/10 and received days 1 and 2 as an outpatient. Your patient is now being admitted to inpatient on day 3 (1/3/10). When writing inpatient orders, be sure to enter the day 1 date as 1/1/10. If the day 1 date is entered as today, you will need to delete days 1 and 2 from the scheduled days for all applicable orders. See Overview of Handling Chemo Orders Across Treatment Locations.

• Chemo meds must have scheduled days to be included in the order session. A chemo med with no numbers after "Day(s)" in the description is not part of the orders even if it is checked off.

• If an active chemo order from a previous treatment was discontinued, the scheduled days for the order were deleted automatically. You must restore the scheduled days to include the order in the current session.

• For some protocols, scheduled days cannot be changed. If allowed, the Scheduled Days button is active.

1. Click the Schedule tab, then click Sched days/doses.

2. For protocols, click OK (ALT+ O ) to acknowledge that you have read the instructions regarding required permission from the Sponsor, Principal Investigator, and IRB to change days of treatment.

3. Click the Days (ALT+Y) option.

4. In the Days field, type numbers separated by commas (,) to designate days of the treatment. There are limits to the changes allowed. Use negative numbers for days prior to a defining event—for example, a bone marrow transplant. To indicate a number of consecutive days, type the first and last day of the range, separated by a colon (:).

5. If you decrease the number of scheduled days, type the reason when prompted.

6. Click OK (ALT+ O ).

• 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

• 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 .