See the Overview of Exception Orders for more information.
For detailed instructions, see Ordering Chemotherapy.
Write orders as part of a standard regimen. This is optimal if there is only one group of orders reused for every episode of treatment in the regimen. If additional order groups are defined for subsequent treatments, the exception order must be rewritten and authorized for the new group of orders.
In order to add chemo medications to the chemo set as exceptions:
When selecting a regimen, click the Exception Orders checkbox.
From the chemo folder, click Add Chemo to write the order. Repeat for each exception needed.
Provide a reason for the exception orders when prompted.
Build an Exception Order custom regimen. The Exception Order option is available with each of the diagnoses defined in Order Entry, and is used in conjunction with a standard regimen. This means going through the ordering process twice for every treatment, first using the standard regimen, then selecting the Exception Order option. For the first treatment for an individual patient, you write orders to this empty folder—including non-chemo order types such as hydration, general medications, lab tests, general nursing care, or antiemetics, as well as chemo exception orders. The exception orders must be authorized before the orders can be carried out. For subsequent treatments, these orders can be reused as needed, and exception orders do not have to be authorized again.
In order to build a custom regimen:
When selecting from the Regimen drop-down list, click Exception.
Click the Exception Orders checkbox.
From the non-chemo folders, click Edit to write orders for medications, IV fluids, and general care.
From the chemo folder, click Add Chemo to write the order. Repeat for each exception needed.
Provide a reason for the exception orders when prompted.
Select orders from an alternate regimen, one not usually associated with the patient's selected diagnosis. As with the Exception Order option, alternate regimens are usually used in conjunction with a standard. Also like the Exception Order, once authorized for a particular patient, Exception Orders selected from an alternate regimen need only be authorized for the first treatment.
In order to write from an alternate regimen:
After selecting the primary diagnosis, click the Exception Orders checkbox.
Click to check the Alternate Diagnosis checkbox.
Select a treatment from the Regimen drop-down list.
Provide a reason for the exception orders when prompted.