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Topics: Restrictions to Editing Chemo Orders Changing Chemo Orders in an Oncology Protocol Editing Chemo Orders Before Activation Defining Approval and Authorization 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 |
Non-chemo vs. chemo pre-admission orders—If you write pre-admission orders that are not drawn from a chemotherapy regimen or protocol (that is, not ordered via the chemo player), you must sign the session before you can write chemo orders. This separates the ancillary pre-admission orders from chemotherapy-related orders. When you write both ancillary and chemotherapy pre-admission orders for a single admission date, the final result is one session of ancillary pre-admit orders, one pair of chemo-related sessions (Session#1, and Chemotherapy Session #2), and any subsequent pairs of new inpatient chemo order (NICO) sessions for each week of scheduled treatment. Ancillary pre-admission orders are not replicated with the chemo-related orders. The ancillary and chemo-related orders can be activated in any sequence, and activating one session does not affect the other. 4 day resign—Pre-admission orders for chemo that are older than four (4) days must be resigned by an oncologist before they can be activated. See Resigning Chemo Pre-Admission Orders. A report of chemo pre-admission orders requiring resign is available. See Viewing or Printing the Resign Report. Pre-admission chemo expiration—At midnight on the date of expected admission date for chemo, 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 midnight of the third day after the expected treatment date, the all of the remaining inactive orders for the treatment are purged from the patient record automatically. Expired chemo pre-admission orders must be rewritten—they cannot be renewed. The expected admission date for chemo pre-admission orders can be changed before the orders are activated or expired. The Day 1 start of treatment date can also be edited before activation. See Changing Dates for Chemo Pre-Admission Orders. Order expiration—If you change an admission date, remember to update the date of day 1/day 0 if appropriate; see Changing the Day 1/ Day 0 Date. If the admission 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. Authorization or Approval Pending—Only the chemo orders of a pre-admit/NICO session (Chemotherapy Session #2) are restricted by rules for authorization and approval. Orders with either the Approval Pending or the Authorization Pending status do not split into seven-day sessions for activation. They cannot be activated until signed off. Orders pending Authorization cannot be edited. Fellows can edit their own chemo orders before they're approved—see Editing Unapproved Chemo Orders. |