Overview of Chemo Order Entry

Topics:

Writing Chemo Orders

Chemo Treatment Plans

Restrictions to Editing Chemo Orders

Changing Chemo Orders in an Oncology Protocol

Editing Chemo Orders Before Activation

Editing Active Chemo Orders

Exception Orders

Reusing Previous Orders

Defining Approval and Authorization

Approving Chemo

Desensitization

Activating Chemo Orders

Activation Dates and Expiration of Inpatient Chemo Orders

Ordering, Activation, and Expiration of Chemo Pre-Admission Orders

Activation Dates and Expiration of Ambulatory Chemo Orders

Expiration of Active Chemo Orders

Handling Orders Across Treatment Locations

Sending Chemo Sessions Between MGH Inpatient & Ambulatory

Standing Orders for Ambulatory Chemo

Expiration Rules for NICO Sessions Awaiting Activation—At midnight on the date of expected treatment start for the week, the session status is set to Expired. For two (2) additional days, the treatment date can be changed to reset the status to awaiting activation. At 12:01 a.m. on the fourth (4th) day after the expected treatment date, all of the remaining inactive orders for the treatment, expired or otherwise, are purged from the patient record automatically.

Postpone Day1/ Day 0 or Start of Week Treatment Date, Orders Awaiting Activation—If the patient will not receive treatment as scheduled, you can reset the treatment date to prevent the orders that are awaiting activation from expiring. See Changing the Treatment Date.

Order expiration—If you change a treatment activation date, remember to update the date of day 1/day 0 if appropriate—see Changing the Day 1/ Day 0 Date. If the activation date is changed and the start of treatment date is not, orders for treatment days that have passed by the admission date will expire based on the treatment day. For example, orders for day one that were activated at admission on day two would expire as soon as they were activated.

Postpone Treatment Date, Orders Active—If you activate orders and the treatment must be delayed, you can reset the treatment date of any day in the session to prevent the orders from expiring. For example, you can move the date of day 9 forward one or more days; the following days in the treatment will also move forward. See Changing the Treatment Day. A new order is created for each chemo medication that is affected by a change of treatment date. The change date orders must be activated as with any new chemo order.