Setting Order Entry Options
Each order entry option and its function is detailed below. If you would like to skip to a specific option, select the option from the following list.
For new users, the "Use formulary dosage fields" checkbox should be checked.
Note: Dosage fields include the "Dose", "Per" and "Qty/dose" fields found in each formulary drug record and in each order. The "Dose" is typically a drug strength (e.g., 50MG). The "Per" is typically an IV solution, injection or oral liquid volume (e.g., 500ML). The "Qty/dose" (i.e., quantity per dose) is the number of units (e.g. tablets, vials, etc) per dose. The default "Qty/dose" value is "1".
If this option is checked, the program will prompt you upon initialization of every order for the exact date/time you would like the order to start.
Prompt/charge starter doses on unit dose orders
Most users want the program to ask them for initial starter doses (i.e., to last until the next fill (pick) list is generated.
Always prompt for item quantity
Check this if you always want the program to ask you what quantity per dose to dispense/charge for every ingredient you select. Since most ingredients use the default value of "1" per dose, very few facilities want to use this option. Rather, most facilities choose one of the following:
Check this option if the program should automatically charge for one time orders (e.g., stats).
Charge demand-fill as miscellaneous
Most users want the program to charge for demand-fill items such as bulk items and PRN meds as a miscellaneous charge (non-scheduled) rather than trying to match the charge to a pre-scheduled time.
Order items must come from the formulary
Check this box if you want to be sure users always select an item from the formulary table. HOS recommends this box be checked.
Warning: If left unchecked, users may accidentally enter "free text" and lose charges because the item was not actually in the formulary with a charge-code. Never-the-less, if this box is checked, users may still need some means of entering new orders for new drugs before someone has an opportunity (or the authority) to enter these new items into the formulary with a valid charge-code/price. To allow for this situation, create new formulary records for a variety of miscellaneous items and assign charge-codes to them. For example, "Miscellaneous cost $1-10"; "Miscellaneous cost $10-20";"Miscellaneous cost $20-30"; etc. During order entry, users can select the appropriate miscellaneous item from the formulary list based on that item's cost, edit the description to a real drug name and continue with order entry. When possible, someone else could create a real formulary record for the new drug to be used for subsequent new orders.
Most users should not check this box. If this box is checked, an IRx user-defined field is displayed in the Order Entry screen. You may use this field to track external prescription numbers generated by another vendor (e.g., a CPOE system).
Most users should not check this box. If this box is checked, an Rx# will be generated for all inpatient orders in addition to outpatient orders. The number is displayed in the upper left corner of the order entry screen. You enter the number to start with in the Next Outpatient Rx Number field (Options/Order Entry). This utility can be used by facilities that opt to process inpatient orders as opposed to outpatient orders for billing/reporting capabilities, yet still need a prescription number generated for each order.
Schedule Floor stock IV orders
Check this box if you want the program to automatically generate administration schedules (doses) for Floor Stock IV orders. This would allow FS IV orders to include administration times on the MAR, and would provide the system with pre-scheduled charge transaction records for you to charge against. (Otherwise, floor stock charges are entered as miscellaneous charges).
Discontinued orders must be verified
Sometimes orders are discontinued by staff members who are not authorized to enter active orders. If this box is checked, these orders will be included with the "to be verified" orders.
Charge all scheduled doses in advance
Check this box if you want to have the program automatically charge all scheduled doses in advance (i.e., at the time the order is scheduled). This auto charge feature will typically be used in conjunction with the Auto Credit feature (see below).
Credit all charged doses after DC'd date/time
Check this box if you want to have the program automatically credit all scheduled doses that are after the patient discharge date/time or an order's DC'd date/time.
During order entry, the effective start time is usually the same as the date/time the order is entered. However, you can select to have your order start times "rounded off" to values that are more practical for drug administration by selecting one of the options in the upper left part of the screen.
Select the default for how you would like the ingredient description to read on the order.
Note
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Select Full if you would like the dosage information associated with an item to be displayed in the order screen. This is the HOS preferred view, and is the only view that supports the use of dosage fields. *This default does not change the way an item appears on a label/Fill List/MAR.
The Standard view (dosage info not shown) may be used by some users if the formulary dosage fields have not been completed and the dosage information is imbedded into the drug description. This is NOT the preferred HOS view.
Set DC time for one-time orders to equal ___ hours
Most users will leave this field blank. It is intended for interfaces with other vendors (such as autodispensing systems) if they require a stop date that is scheduled several hours after the start date even if a one-time order is DC'd immediately upon entry.
Enter the number of days that new orders can be effective for (unless otherwise specified at order entry time).
Typical values for this (JCAHO required) field are 30 or 15 days. After this number of days, the order should be stopped unless renewed by the doctor.
The standard number of hours used to determine when a compounded drug expires, typically used for calculating the expiration date for IV admixtures. This value is usually set at 24, 48 or 72 hours by hospital/pharmacy policy.
Tip
Default rate for IV Piggybacks (mls/hr)
The standard IV rate for piggybacks (e.g., typically 100 or 200 ml/hr).
Tip
Select the number of days the program should wait (after the Stop Date/Time has expired) before automatically discontinuing an order. (i.e. 1 = DC the day after the stop date; 2 = DC two days after the stop date).
Typically this is set for 1-2 days.
Select Soft Stop if you don't want the program to DC orders automatically.
This option determines if the program should charge as you dispense, or wait for you to enter the charge at a later time (e.g., charge from the MAR, charge after seeing what was taken from the cassette, etc.). The preferred method is to charge upon dispensing for "All orders" (and, if desired, reconcile the pharmacy charges with the MAR (e.g., by exception) rather than having to enter every charge from the MAR).
Tip
Patient number and Charge code number check methods
In some cases, a "check digit" may be used at the end of the patient account number and/or the drug charge code (CDM) number to help ensure these numbers are keyed in correctly. Ask your data processing or information systems manager which (if any) "check digit calculation" method(s) is/are used. Options for each default are "MOD-10", "MOD-11", or "None".
If you are going to be entering outpatient prescriptions, enter the prescription number you want the program to start with.