To display cumulative dose information, click Cumulative Dose (ALT+U). This is not available for NSMC inpatient. See Evaluating Cumulative Dose Information.
To display chemo orders from all sites that have been activated in the past 6 months, click Chemo View (Historical). See Viewing Historical Chemo Information.
For the initial treatment, select a diagnosis.
If you plan to add exception orders, or order from a regimen for an alternate diagnosis, click to check Exception Orders (ALT+E) .
Only MDs can write exception orders. See Overview of Exception orders for more information.
See also: Writing Exception Orders for Chemotherapy Medications.
To order from a regimen for an alternate diagnosis:
If you haven't already, click to check Exception Orders (ALT+E) .
Click Alternate Diagnosis (ALT+T) .
Select an alternate diagnosis.
Select a treatment from the Regimen drop-down list.
If you select the Exception regimen, you must write every order from scratch. The custom regimen will be saved for the patient.
The options available are based on the primary diagnosis, or the alternate diagnosis if that option is selected.
Pediatric regimens are offered only to clinicians with pediatrics authorization.
If the option is available, select from the Indications drop-down list.
Indication is required if present.
The information must be updated when ordering subsequent treatments after 60 days.
Type the identifying number in the Cycle /Week field, if empty. Press TAB or click the next field to continue.
Phase (pediatric) and Weekly (adult) treatments are not numbered—no entry is needed.
For adult patients on cycle-defined treatments, the cycle number increments automatically for subsequent cycles after the first is written.
For pediatric treatments defined by week or cycle, you must enter the number every time. The numbers need not be sequential.ࠀ
Type the date of Day 1 or Day 0 of the treatment. Press TAB or click the next field to continue.
If you are writing the orders after the patient has started treatment, enter the past date that the treatment started. You will be prompted to confirm that Day 1/ Day0 is in the past.
The relation of the current date to the initial date of treatment is displayed to the right of the Day 1/ Day 0 field. "Today is day..." will be a negative number if the start of treatment is set for the future; and positive if the treatment starts today or has already started.
Enter the height and weight:
If no data is available from the LMR, type the patient’s height and weight, using customary US or metric units. At the request of the Chemotherapy Safety Committee, only one type of unit is allowed, dependent on the care setting. The alternative units and BSA are calculated automatically. Press TAB or click the next field to continue.
If there is data available from the patient’s ambulatory Longitudinal Medical Record (LMR), the difference between the LMR weight and the most recent Chemo Order Entry (COE) weight is displayed. For comparison and calculation, as with manual entry described above, the care setting determines which unit—US customary or metric—is used. If there is no previous COE weight (including the case that the last COE weight is expired), the difference is 100%.
To display the LMR data, click View LMR Weight & Height. The values, entry date, and percent difference are displayed. As with manual entry described above, the care setting determines which unit—US customary or metric—is used. Click Update COE with LMR Information (ALT+U) to use this data for ordering chemo; click Cancel (ALT+C) to close the display without using the LMR weight. The alternative units and BSA are calculated automatically.
Weight and height for chemo calculations is stored separately from any other order entry values—for example, the values used for weight-based dosing of medications ordered outside of a regimen or protocol. Weight must be re-entered every 30 days for oncology patients, every 90 days for patients receiving chemotherapy for other conditions.
Click OK (ALT+ O ).
See also: