About Option Settings

Ascend-I.P. options make it possible for you to configure the software to fit your particular needs. The following is a list of the tabbed option sections available under the Utilities-->Options menus.

You can mouse click on each tab to review and modify the options for that section.

Order Entry	Enter defaults that control the order entry process.
Order Types/History	Enter Order Types, default label prompts and automatic rewrite exceptions. Turn on/off order changes tracking.
Formulary	Edit the lists that are available to you when entering drug formulary items.
Administration Times	Specify frequency codes and their corresponding administration times/intervals.
Facility	Enter information about your facility/hospital.
Clinical Reviews	Edit the lists that are available to you when entering clinical review and intervention data.
Labels/IVs	Select printers you want to use for various label types. Select IV label defaults.
Report/Label Defaults	Set the effective time period for various reports and batch label functions.
Interfaces	Specify your active interfaces to other software vendors.
Admission	Select defaults that control the admission process.
Inventory Areas	Specify defaults that control the processing of floor stock areas.
MAR	Enter defaults to customize your MAR.
Stop Orders	Customize your Stop Order notices.
Routes	Add to or delete from the current list of routes available to you when entering formulary items and/or entering an order.

This list is available to you from within the drug formulary maintenance utility. It is used to assign narcotic schedule numbers to drug records. Note: you may not have to do this if you enter NDC numbers in the formulary records. If NDC numbers are in place, the next (monthly) program/database update process will insert the narcotic schedule number into the records for you.

User defined definitions can enable you to perform sophisticated searches and reports centered around the drugs you have targeted. The user-defined definitions are available to you when entering formulary drug records. Formulary records may be "tagged" with one or more (no limit) of these labels. Once a drug record is tagged, you can generate reports that locate the orders containing any drugs that have been tagged. For example, you could print a monthly report containing drug usage information for all orders with a "DUE TARGET DRUG" user-defined tag, including any related patient or doctor data. You could print a report showing all doctors who have ordered "HIGH COST" drugs. You could find out which doctors are ordering non-formulary drugs, how often, and for what purposes......(and so on). The number and types of reports you can generate using user-defined fields is practically unlimited.

The "administration times" tab lets you customize the dosing interval or administration times associated with "Sig codes".

Typical "Sig codes" recognized by Ascend-IP are already listed (e.g., QD, BID, TID, QID, Q4H, Q8H, etc.) but you can add your own codes, or modify the ones that are on the list (e.g., change Q6H to Q6HRS, or add Q6HRS to the list). "Sig codes" must be assigned an interval (in hours) or be assigned specific administration times. If they cannot be assigned an interval or specific times, they probably don't belong on this table (see warning below). For example, "Q6H" can be assigned an interval of every "6" hours. Subsequent Q6H orders would be scheduled for every 6 hours starting with the "start date and time" for the order. Alternatively, Q6H could be assigned 4 specific dosage times (e.g., "00:00", "06:00", "12:00", "18:00") under the columns (Dose1, Dose2, Dose3, Dose4). Sig codes cannot simultaneously be assigned an interval AND specific times (the program won't allow it!!). Therefore, if you need to be able schedule by interval or by specific times, assign specific times to one code and assign an interval to a slight variation of that code (e.g., use specific times for "Q8H" and an interval for "Q8HRS").

WARNING: Do not enter other codes here unless they are strictly intended for "scheduling" administration times for orders. Every code on this list MUST be associated with an interval or with administration times. Therefore, route codes (e.g. PO), dosage form codes (e.g. TAB), site codes (e.g., OU) and other such codes MUST NOT BE ENTERED here or orders will be scheduled incorrectly.

Each Sig code can be assigned a "full description" for medication safety purposes. The full description should be entered under the column next each Sig code. Example: Sig code: "Q6H" ---> Full description: "Every 6 Hours". At order entry time, the Sig code will be automatically replaced by the full description. For example, in this case "25MG Q6H BY MOUTH" will become "25MG Every 6 Hours BY MOUTH". Hint: Enter "full description" fields using a mixture of upper and/or lower case that is consistent with how you normally enter Sigs.

You should assign a Par level value for each Sig code if possible. The Par level is the number of doses per 24 hours associated with this Sig code. Par level doses are typically used to set default dispensing amounts for demand-fill/PRN types of orders. For example, Q6H should be assigned a par level of "4" and BID should be assigned "2". If the number of doses per day varies (e.g. Q18H), leave the par level blank.

Note: you DO NOT need to make entries in the table for "PRN", "AS NEEDED", "STAT", "NOW", "ONE TIME", "X 1" or "ONCE" as these are recognized by the program automatically. The system also automatically recognizes Sigs containing the phrase "GIVE AT" followed by one or more times of the day, separated by commas (HHMM or HH:MM format). For example, "GIVE AT 1700" and "GIVE AT 12:30, 7:30, 22:00" would cause the order to be scheduled at those times every day.

The default list; Creating additional administration times lists if needed: Most hospitals only need one list of "administration times" (i.e., the "default" list) for the entire facility. However, some hospitals need a different list for certain units or nursing service areas. For example, ICU may require different "BID" times than the times used by the rest of the hospital. If this is the case, add a separate list by using the "Add list" button. Click on the unnamed list on the left and enter a name (e.g., ICU). Then, with the "ICU" list selected, use the "Add time" button on the right side to add a new (blank) administration time record to the ICU list. Click in the blank record (under "Definition") and enter the schedule code (e.g., "QID"). Next click on the "interval" area, or on the "administration times" (Dose 1) area. Enter the respective dosing interval or administration time as desired. If a second administration time per day is required, enter the time under "Dose 2". Add additional dosage times per day under "Dose 3", "Dose 4", etc. as shown. Repeat these steps for all of the schedule codes that will be needed by ICU. Add other unique lists as needed (e.g., MATERNITY, PSYCH, etc.). Please use the Room list utility to pre-assign any unique administration lists you have created to their respective beds ("Utilities"-->"Room list"--->modify the "Schedule list" field for the target beds).

The "Facility" tab allows you to specify the name, address and other facility data. Some of this data is used to configure reports and labels with facility information. The "Server path" field specifies the location of Ascend-IP data, which may be located on another computer. The "Workstation Id" should be a name that is unique to this computer. The Workstation Id enables Ascend-IP to track order entry by workstation, among other purposes.

If the computer is a newly added client workstation, or if the data has been relocated, select the "Browse" button to locate and select the "Ascend-IP" folder on the server. Note: DO NOT select the data folder which is located one directory deeper than the server's "Ascend-IP" folder/directory. On single station (one computer) systems, the target "server" folder will be on the local hard disk (typically "C:\Program files\Ascend-IP "). After selecting the proper Ascend-IP folder, a message regarding "Connecting" various data files will appear, indicating that the local client is establishing proper links to the database tables.

For each licensed computer (client), specify a unique Workstation Id and specify the path to the (server) Ascend-IP database.

This tab provides access to the lists that appear whenever you edit a "clinical review" record (e.g., an allergy, drug interaction, duplicate drug, food-drug warning, an intervention record created by the pharmacist, etc.). You can add to, delete from or edit the contents of these lists as needed.

Four clinical list types can be edited by selecting the desired list type from the drop-down near the top of the screen. To edit an existing item on the list that appears, click on the item, select the <Edit> button, and then edit it using typical word processing methods. To delete an item, click on it then select the <Delete> button. To add an item to the selected list type, click on the <Add> button and enter the description you want to use. It will appear in the list in alphabetic order.

These drop down lists allow you to select appropriate levels for drug-drug and drug-food interaction checks and warnings. A disclaimer notice will appear...please read it carefully. The user assumes all risks by changes interaction significance and/or severity levels.

Each type of check/warning can be independently controlled by checking the appropriate boxes. These include allergy, duplicate, pediatric, geriatric, lactation and pregnancy warnings.

Some of your staff (e.g., pharmacy technicians) may be authorized to enter orders, but they are held as "inactive" until checked ("verified") by a pharmacist. Check this if you want these staff to receive allergy, duplicate, interaction, etc. warnings at order entry time. If it is unchecked, only pharmacists will receive the warning when they "verify" the order.

In some cases, multiple warnings are issued at one time. For example, one order might generate a duplicate warning, a drug interaction and a geriatric warning. If this check box is checked, the user will be forced to "view" each warning before they can proceed with order entry.

Check these if you want the program to screen for these potential problems. Uncheck them if you'd rather do it yourself.

The next tab allows you to assign an available Windows printer object to your various label formats. The program will also ask you which printer to use when you attempt to print a label and no default printer has been assigned to that label type. In some cases, you may want to direct two or more label formats to the same printer, if they use the same label stock (e.g., to save money, free up counter space, etc.). In other cases, it may be convenient to direct a particular format to different printers for different computers (e.g., to reduce walking distance to retrieve labels, provide redundancy in case of equipment failure, etc.).

Click on the drop down arrow to display a list (of Windows printer objects) available to this computer for a particular label format. Local and network printers accessible by this computer should be listed. If the printer you want is not listed, add it to your computer's desktop (e.g., Start-->Settings-->Printers-->Add a printer) or contact your IT department for assistance. You or your IT department should also set the printer's properties to match the height and width of the label stock loaded in that printer.

This option changes the default sort order for printed batch IV labels from a "room order" sort to a "order description" sort, allowing labels for the same medications or solutions to be grouped together as they print.

If checked, an additional label will be printed containing information about the prescription. This might be used for insurance purposes, as a reference copy, etc.

If this option is checked, when an "IV type" order is DC'd, a reminder prints on the IV label printer. (This may help prevent the mixing of unwanted IVs, especially if the IV room/hood is located some distance from the order entry area.)

If this option is checked, when a "unit dose" type order is DC'd, a reminder prints on the IV label printer.

Specify how how many days after a patient or order is DC'd that they should continue to appear on the IV Summary reports.

This section lets you set the effective period for various reports and batch label printing sessions. For example, you can tell the program that you usually want to have the "Fill list" (aka, pick list) print for an effective period of 15:00 today through 14:59 tomorrow, as shown below. The default period can be altered at printing time if desired. For each line, set the start date (e.g., 0 = today, 1 = tomorrow, 2= 2 days from now, -1 = yesterday, -2 = 2 days ago, etc.). You can also limit the report/labels to a specified range of rooms/beds. Select the starting and ending room/bed from the drop down list.. In the example below, the "Stop order report" will print for rooms 106 through 501.

Most users will want to set the effective times for the "Charges" option to include several days in the past. For example, you could set the period to be from "5 days ago at 00:00" to "yesterday at 23:59". This ensures that backdated charge transactions will be included in the charge processing/printing routine.

The Fill list "Page break with patient" box may be checked if you want the program to start a new page with each patient. This report may be clearer to follow but typically uses much more paper.

This table tells Ascend-IP to save information for other computer systems. This only applies to our interfaces that send data, not to those that receive data from other systems. It is NOT necessary to have charge/billing interfaces listed here.

Having interfaces listed unnecessarily will add many unwanted records to your database, and may reduce performance. Therefore , upon first installing Ascend-IP, check the table to see if it contains any unused interface entries. Please contact Hann's On Software to determine if it is OK to delete these entries. Later on, once you set up "real" interfaces, then Hann's On Software will advise you which values should be entered into this table. DO NOT ADD TO, OR DELETE FROM, THIS TABLE WITHOUT SPECIFIC ADVICE FROM HANN'S ON SOFTWARE.

The Admission tab allows you to set required fields for manual patient admissions and/or for order entry. If a "Required for admission" item is checked, you will not be able to create a new patient record without this admission data. If a "Required for order entry" item is checked, you will be unable to enter orders for that patient until the missing admission data is entered. In some facilities, data such as allergies, height and weight may not be available upon admission and should not, therefore, be "required" for admission, but might reasonably be required before orders are entered.

The "User defined definitions" are "tags" that may be assigned to a patient record on the admission screen. The tags are useful in producing concurrent and retrospective reports that identify, include or exclude these patients. You can assign as many tags to a particular patient as you want (i.e., as may be required for multiple reports). To add a new definition, select the "Add..." button, then click on the blank record (immediately below the last record). Enter the definition using typical word processing methods.

Floor stock (FS) inventory areas normally contain drugs that are not dispensed directly from pharmacy, but are stored near/in patient-care units. These may include automated dispensing system cabinets (Pyxis, Suremed, Omnicell, etc.) or inventory that is otherwise controlled "manually" in some manner (e.g., via FS charge slips, FS stickers, etc.).

Ascend-IP can be configured to distinguish between orders that are to be treated as "floor stock" versus those that are not. FS lists can be pre-built for each area and an appropriate FS list can be pre-assigned to each bed if desired. This enables the program to automatically know when a drug should be set up as a "floor stock" order or not. Since the program does not prompt for "starter doses" or labels for FS orders, this allows order entry to proceed logically and smoothly.

Prior to doing extensive work manually building floor stock inventory areas, please contact HOS for advice. For example, inventory areas controlled by automated dispensing systems can often have their corresponding Ascend-IP floor stock inventory lists/tables built automatically as part of an initial setup plan. HOS can also send the entire Ascend-IP formulary to these vendors to aid them in building their initial drug tables.

The table on the right of the screen displays the names assigned to your floor stock (FS) inventory areas (lists). For "manually-maintained" floor stock areas (i.e., those not controlled by an automated dispensing cabinet), you can <Add> or <Delete> these names/lists as needed. For automated dispensing systems, the area/list name should normally match the name assigned to the dispensing cabinet. This name is often created and added to the list automatically when the vendor sends us their initial setup files. The check boxes to the right of each FS area list/name are explained below:

This checkbox should only be used for areas/lists that are controlled by automated dispensing cabinets. If this boxed is checked, the program will display an alert at order entry time IF the drug you have selected is NOT listed on the FS inventory list, OR IF the inventory level of the drug in the cabinet has reached "0". The alert gives you the opportunity to make the order a regular "unit dose" order rather than a "floor stock unit dose" (FS-UD) order, as might normally be the case. Therefore, you can choose to dispense this order from the pharmacy, rather than from the FS cabinet. Alternatively, you can choose to continue the order as a FS-UD order and restock the FS cabinet with the missing drug.

If this box is checked for a FS inventory area, then at order entry time, IF the drug you have selected is found on the FS inventory list that has been pre-assigned to that bed, the program will automatically make the order a "floor stock unit dose" (FS-UD) order, even if the drug is listed as 'unit dose" in the formulary. This has a number of uses and advantages. It allows a drug to be ordered as "non-floor stock", or "floor stock" depending upon where the patient is located in your facility. For example, lets assume we have assigned ATROPINE 0.4MG INJ in the drug formulary to a "unit dose" order type. Lets assume this drug IS listed on the "Surgical unit" floor stock inventory list, but IS NOT listed on the "Maternity unit" list. If an order for ATROPINE 0.4MG INJ is entered on a patient who is in the Maternity unit, that order will be a "unit dose" order and pharmacy will be expected to dispense it. However, if ATROPINE 0.4MG INJ is ordered for a patient in the Surgical unit, the order will automatically be converted to a "floor stock" order and pharmacy will not be expected to dispense it. Furthermore, in the later case, the pharmacy will not be prompted for starter labels/charges for this FS-UD order as desired.

In conclusion, you DO NOT have to necessarily pre-assign a "FS" type to a drug in the formulary, and you DO NOT have to list the drug in the formulary twice, once for each type, if you utilize floor stock lists in this manner. This makes sense if the drug is not always a floor stock item.

On the other hand, if a drug will ALWAYS be dispensed as floor stock, regardless of patient location, then assigning the "Floor stock unit dose" or "Floor stock IV" category to an item in the drug formulary makes sense. Schedule II narcotics would probably be handled in this manner.

The check boxes on the left of the screen control program functions that can automatically occur if you choose to " process" inventory (floor stock) areas manually. This could be used if your floor stock inventory is NOT controlled via automated dispensing systems. We do not recommend checking these boxes if automated dispensing systems are used in the facility. The available options include to "print labels" (e.g., restock labels), "print reports" (e.g., restock/inventory control reports), and "clear daily usage" automatically. Inventory areas can be processed manually by selecting either:

This table allows you to add, modify or delete route codes and route definitions. To modify a route, click on it in the list and then edit the code/description (in the same manner as if you are using a word processor).