?Change the existing in Verify Orders
No notification of change is sent to anyone
On the MAR: only displays the changed order
No obious indication of
... [Show More] what the order originally looked like on the MAR
?Discontinue and place a new order in order activity
Nurse recieves notification of change
Change on MAR
Psysician might need to cosign
?If you make changes in Verification, does anyone get notified of the changes?
Nope! Only change things do not alter the intent of the order
?When should you change an order in verify order?
If there is an error you can correct without changing the intent of the order
?When should yoh discontinue an order and place a new order
Modification which change the intent of the order or that other clinicians should be aware of
?What field allows you to control whether a physician receives a cosign message?
Order mode
?How can you document time spent intervening on an order
Create a new I-vent
?What's the advantage of leaving an i-veng open?
If the issue is unresolved, an icon appears on the verify queue as a reminder
?Who can see i-vents
Only pharmacy users. They are not part of the legal medical record and do not appeR to nurses or physicians
?How can a nurse send a message to the pharmacy? Where does the message appear?
On the MAR; rx icon next to relevent order. It will appear in the medicatikn messages folder of the in basket
?What are 2 ways a pharmacist can send a message to a nurse
Adding comment to a message, the nurse send him
Or click Rx message in verify orders or medication activity
?How can the pharmacist change the way a verified order is being dispensed without entering a new order
Reverify order, go to medication, order Hx, reverify orders
?3 things you can modify about an order without creating multiple rows an the MAR
End date/time, administration instructions, rate
?Difference between Let Expire and Discontinue
Let expiring: clears expiring flag but keeps it active untill its end time.
Discontinue: cancels the order immediately
?What do you have to do to change an order from IV to PO
Discontinue IV order, enter new order PO form
?Nurse send message to pharmacy from Mar, home supply is run out , pharmacist starts dispense order
Pharmacist from Inbasket- clicking Order HX and reverify _ edit dispense information, clear patient supplied for checkbox
Back in basker: done! Or done with comment
?True or false: the only way to adjust the ongoing schedule for an order is to discontinue it and enter a new order
False ; a pharmacist can reschedule an active order from the medications activity or crom medication message in the in basket, using the adjust time button, just edding excist orders it doesnt create a new order
?True or false: epic will automatically pick a dispense location for each order
True!
?What 3 main things does Epic use to determine the dispense location for order?
Patient unit
Dispense location
Products available in each dispense location
?True or false: the med.list(EFY) record attached to a dispense location reflects the number of packages currently stocked in that dispense location
False. Med list do nog track the number of packages. They only track when products and packages should be available in that location
?When is an order added to a patient's profile?
When the order is verified( door apotheker)
?A physician orders a morphine 5 mg/ml syringe for his patient. Epic picks a dispense location of ADS LOAD PHARMACY. Why?
It's a narcotic
?Do you need to do anything to geg a batch to run?
No, batches run automatically
?CF means, wat does the time on a label next to CF indicate?
CartFill: time indicates;time label was printed
?When are first dose labels printed ( or sent to the dispense queue) for an order that will be included in a batch?
After the order is verified
?True or false, an order might have any number of first doses (including none)
True
?True or false: dispense queue is an optional feature
True
?Suppose your hospital is using the dispense queue in its central pharmacy. You open the queue and find that you aren't seeing any dispenses to print, what might be wrong?
There might be not any outstanding first doses or redispenses in the queue.
Alternately, if you are looking at cart fills all of the dispenses may have been printed allready
?Dispense preperation
Technicians use this to document preparing a dose of an IV or custom syringe. They scan the dose being prepared and the products used to prepare it.
?Dispense check activity
Pharmacists document that they have checked a dispense after it's been prepared, and ready to go to the floor
?Dispense tracking activity
Pharmacy staff (personeel) to record that they have send doses to the floor, and by nurses or unit clerks on the floor to record that dose have been received
?What does it mean for an order to be sign and held
An order in the system with a signature, but that is not yet released. It will be released ( usually by a nurse) when the patient arrives at the appropriate place of care
?Examples of orders that require advanced preparation
Pre-op orders for patients with surgeries scheduled today or tomorrow. (Scheduled infusions: bv chemo)
?True or false, when you click verify, the system prints labels for every order included in the current set of results
False!!it only prints labels for the orders you currently have selected in the results
?What is the different between saving the results of a report and making the report favorite
Saved results: reflect a specific moment in time
A favorite report is just easier to find and run.
?True or false: you can configure carts to be started manually or automatically
True
?You've already done an a initial cart fill, including an order for acetaminophen tablets with a dose of 650mg (2*325mg) q8h. The fill says to add 6 tab. Someone modifies the dose of this order, reducing it to 325mg (1tab 325mg tab) q8h. How will this change be reflected on the update fill list?
It will tell you to remove all 6 tablets of the original order, and then to add 3 of the same tablets for the new order
?How can you tell the difference between an uldate fill list and a total fill list?
In the header on the first page, in the upper-right corner, an update fill list says "update report" a total fill list says " full report"
?Where can you find how an order is charged.
Charging on dispens/ charging on administration
From the Order History activity
?What triggers a charge for an order that is charged for on administration
Documenting it as given on the electronic MAR
?True or false: if an order is charged for on administration, you do not need to return an unused dose to generate a credit
True, because it wasn't used, it was not documented on the MAR as given and a charge was not triggered
?What is the purpose of the Bulk charge activity
The bulk charge activity is used to drop charges when an order is not documented as dispensed in Epic or not documented as administratered in Epic
?Where can you see if a medication has been verified and whether any doses have been dispensed?
Order history activity
?How can you see dispenses that were sent to dispense queue?
In order history: put a check in the box for show in-process dispenses
?How can you manually dispense another dose of a nedication to replace a damaged or missing dose
Redispense by clicking dispense in order history
?What is the advantage of using the reprint labels activity, rather than reprinting from label history?
Reprint labels allows you to select multiple labels over time, while label history reprints only one order or dose at a time
?If you want to view a label before you reprinted it for a single order, how could you do that?
Go to med. Activity click label Hx >> reprint /preview labels click Preview to preview the label. Click print to reprinft it.
?If you wanted to find all the orders for a certain drug in your hospital, how would you do it?
The Rx search medication Orders Report
?you need to place an order for a dose of vancomycin, to be given intravenously. What could you type in the place new order field?
Vanco iv
?why comes only one choice of vancomycine on the preferende list? Even though it can be dispensed in many different ways. What is causing this to happen?
Intelligent medication selection for iv's causes only one choice to be found on the preference list.
?when a pharmacist places orders, what appears on the preference list tab? On the database lookup tab?
The pharmacist pref list tab contains everything that is availlable, or in stock, in their pharmacy. The database lookup tab contains every single record from the third party data, including medication and non-medication records
?which order modes will caus the ordering provider to receive a cosign request?
Verbal with readback and telephone with readback will cause a cosign request for the ordering provider. Per protocol and transcribed from paper will not.
? What is summary sentence
The gray order details below the order name
?true/false. a nurse must acknowledge dicontinued orders
True. All new, modified or discontinued medications must be acknowledged by a nurs
?You are supposed to hang a IVPB for your patient, but is hasn't arrived on the floor yet. Sometimes IVPBs come from Central Pharmacy and sometimes they come from th Satellite Pharmacy on 2nd floor. HOw can you figure out where it is coming from
On the MAR, click the summary sentence for the order and look at the dispense location.
?The nurse next to you is frustrated. The doctor asked her to order some D5N5 with potassium phosphate for a patient, and she can't find an order for that. What should she do?
She should search for " custom " and use the custom IV infusion builder order.
?Who can enter the height and weight for a patient?
any clinician with access to Flowsheets can enter the height and weight. Typically this will be the nurse, but pharmacists can also enther them
?You see that the pharmacist has not verified an order for Percocet for your patient, but it is on the override list for the ADS cabinet. THe physiscian tells you to administer the med right away. What steps will you have to take after the order is verified
You will need to find the new order on the MAR, click LINK to RELATED order, and indicate the OVerride Pull is associated with this order.
?true/false: nursus begin barcode-enabled medication administration by scanning the medicatien
false. Nurses should scan the patient to begin medication administration
?what are two ways to begin documenting an administration
scan the medication barcode or click a due time on the MAR
?how does barcode scanning help the nurse to check the 5 rights of medication administration?
using barcoding helps ensure accuracy for most of the five rights. When the nurse scans the patient and the medication, all details can be checked against the active order in the system. While the nurse should still personally check the five rights, Epic will warn the nurse if the patient, themedication, the dose, or the time ar not correct.
?What are 2 reasons why a nurse might have to pull a medication from an ADS Cabinet on override for a patien?
because the order has not yet been entered into Epic, or it has been entered but not yet verified. In that case, the nurse will not find the order on the patient's profile; if the patient needs the medication immediately. the nurses only option is to pull it on override
?How does an override pull look on the MAR
an override pull is marked with the color fucsia and ADS cabinet icon
?when and why should the nurse link an override pull on the MAR
after the medication order is verified, the nurse should link the override pull to the active order. THis shows that the doctor indeed placed the order for this med and the nurse didn't just give the patient a medication with no associated order
?wich barcode should be scanned for different types of medications
NDC barcode closest to the medication
?in wich section of the medication reconciliation navigator do you decide whether a home med should be ordered for this admission?
in the reconcile Home medications section you determine whether the medication should be ordered, not ordered, replaced or discontinued
?When reviewing the patient's home medications, what does the person icon indicate?
the house icon indicates that the medication was entered in Epic as an outpatient prescription
?When revieweing the patient's home medications, what does the person icon indicat?
the erson icon indicates that the patient reported taking that medication
?What additional information do pharmacists see in the order composer?
dispense information
?what is the difference between pharmacist an physician preference list?
the preference list for physicians is smaller and specific to their specially; it also includes non-medication orders.
?what is the difference between pharmacst an physician facility list
there is no difference
?what does it mean to Sign&Hold an order?
It means that the order has been authorized, but it is not released or active untill the patient arrives to another location or stage of care
?Where can you see a patient's diagnoses for this admission?
in the summary activity, on the overview report, in the problem list section. Or in the patient Header
?list three places you can review a patient's lab result. How is each different?
Summary activity: overview report; shows only specific common lab results, and only those from the last 48 hours
Summary activity; Labs - entire admission report: shows all the lab results from the current admission
Results review activity; shows all results in patient's chart, regardless of which encounter they were on
Chart Search; finds all lab orders and results that match your search, regardless of which encounter they came from; also finds diagnoses, medication, and procedure orders
?How can you determine whether a patient has an active, unresulted lab order?
look in the orders activity. On the active tab, check the Lab section for active unresulted orders. If ther is no Lab section, there are no active orders for labs.
?which patients appear in the verify queue?
any patients with orders needing verification in units your filters allow you to see
?After selecting a filter, do you have to select it again if you log in to a different computer? or will it stick with you from one computer to the next?
after you select a filter, it will continue to apply to you and only you no matter what computer you log in to
?How can you identify a recordered home medication when verifying orders?
Ter is a Recordered from link to the home medication
?what is the duration of an order?
duration is the infusion time for an IVPB
?How can you identify that an order was edited and what was edited?
a warning about the edit appears at the top of the screen and the edit is highlighted in blue
?what types of changes to an order causs an Edit to appear for pharmacists to verify?
Changes in rate-based dose, end date or admin instructions are the only types of edits. All other changes cause a discontinue and reorder. [Show Less]