Patient Chart: Orders

The following topics are discussed on this page. Use the links to jump to the desired subject:

Introduction to Orders Tracking

To view inactive orders

To filter orders

To view order details

To place orders on hold

To resume orders that are on hold

To edit an order

To discontinue orders

To administer orders

To unadminister orders

Introduction to Orders

The Orders Tracking page is used to view the patient's existing orders and status. Orders are listed in either the PRN, Scheduled, or Future section and display the Description, Start Date/Time, Scheduled Times, Frequency, Dosage (if applicable), and Last Completed date/time (if applicable). These sections can be collapsed/expanded using the expand arrow button in the section header. Each order displays a color coded symbol to the left of the order to indicate it's current status or priority:

For each order, you have the ability to view additional details, edit, and/or verify the order form this page. Use the following buttons to access these features:

Note: For non-formulary medications to appear on the Orders Tracking and eMAR pages, the user must have permissions granted for Home Medications. This setting in defined in the User Administration module. (Go to UA and select the appropriate user. Then, from the OM User Department Permissions tab, check the Home Medications department and select the appropriate permissions.)

  To view inactive orders

The Orders Tracking tab defaults to a display of active orders for the current visit. To view inactive (historical) orders, click the double arrow button to display the lower filter bar. Then, check the show inactive orders check box located on the right side of the page. For inactive orders on the Orders Tracking page, the Administer button will remain enabled for non - medication orders to allow those orders to be completed. For inactive orders on the eMAR page, the Administer button will remain enabled for Medication orders. When administering inactive orders, a message is displayed alerting the user that the order has been discharged and confirming that the user wants to continue. The discharged patient orders will be displayed with a black icon (inactive) in all the change screens.

HINT: When viewing inactive orders, you may also want to filter the list by the desired department, date, and/or sort order so viewing the desired orders is easier.

To filter orders

The Orders list can be filtered to display specific orders by using several different options. To access some of these filter fields, you must click the black double arrow expand button located at the right of the filter bar:

• Department: To filter the list by department, use the drop-down list in the Department field and select the desired department(s). To return to the default list of all results, check Select All.

• Date: You also have the option to filter the list by date and due time. To filter the list by date, use the drop-down list in the Date field to select Current Due, Overdue, or Due to Expire.  To return to the default list, select Active.

• Sort: After filtering the orders, you may also choose the desired sort order for the list. You can sort the list by Order Name, Order Type, Order Status, and Creation Time. Select the desired option in the Sort field.

• View, Start Date and End Date: Click the black expand button (double arrow) located to the right of the Filter bar to display additional filter options: View, Start Date, and End Date. Since the default view is for the current visit, use the View field to select other options: Recent Visits, Date Range, or All Visits. If you select Date Range, use the Start Date and End Date fields to specify the time period to view. If you select Selected Visit or Date Range, use the Start Date and End Date fields to specify the time period to view. If you select Recent Visits, enter the number of visits in the adjacent field. Then, select the types of visits to display in the third field.

Note: Previous visit data is not editable.

• Show Inactive Orders: To display inactive orders on the page, click the double-arrow expand button to display the field, Then, check the show inactive orders box.

TIP: To save your filter settings, go to Actions > Save Filter Settings. This saves the current user's settings as a default for future visits to the page. Note: This feature is controlled in User Administration by the Hospital - Patient Chart - Save Filter Settings security item.

To view order details

The View Order Details button, ,  opens the details area for the order. Details regarding the order are displayed on the screen. To hide the Order Details area, click the button again. The information for each order is displayed in several sections: Order Details, Diagnosis, and History. Also, from the Order Details area, you can hold, resume (for held orders), or edit the order using the appropriate button.

Special Instructions that appear in this field can come from 3 locations:
 - The Formulary Item Master (or Order Item Master in CD) in the Medication Special Instructions grid
 - The Formulary Item Master (or Order Item Master in CD) in the Special Instructions field
 - Or, instructions entered in the Special Instructions field during Order Entry.

To place orders on hold

1. From the Order Details area (the Show Details button has been clicked), click Hold. The Hold Order box is displayed.

2. In the Hold Date/Time fields, enter the appropriate date and time to start the hold.

3. In the Hold Physician field, select the physician ordering this order to be held. Type the first few letters of the physician name to display matching results.

4. In the Reason field, select the appropriate reason for holding the order.

5. In the Notes field, enter additional comments regarding the hold of this order.

6. Click Save. You are returned to the Patient Chart: Orders Tracking page.

To resume orders that are on hold

1. From the Order Details area (the Show Details button has been clicked), click Resume. The Resume Order box is displayed.

2. In the Resume Date/Time fields, enter the appropriate date and time to resume the order.

3. In the Resume Physician field, select the physician who ordered this to be resumed. Type the first few letters of the physician name to display matching results.

4. In the Reason field, select the appropriate reason for resuming the order.

5. In the Notes field, enter additional comments regarding this order.

6. (For Medication Orders) The Mark Medication as Not Administered While On Hold check box defaults to checked. This indicates that the administration times that occurred during the hold period will be marked as Not Administered. To leave the administration times as un-documented, uncheck this box.

7. Click Save. You are returned to the Patient Chart: Orders Tracking page.

To edit an order

1. From the Order Details area (the Show Details button has been clicked), click Edit. The Edit Order box is displayed.

2. In the Ordering Physician field, select the physician ordering the changes to this order. Type the first few letters of the physician name to display matching results.

3. In the Special Instructions field, enter special instructions regarding this order.

4. In the Comment field, enter additional comments regarding the edit of this order.

5. In the Reason field, select the appropriate reason for changing the order.

6. (RX and IV orders only) For RX and IV orders, you are able to modify key components of the order without discontinuing the order and creating a new order. For those orders, making changes to the following fields, affects the application in this way:

1. • Duration: If the user extends the duration (changes the duration to be greater than the original value), new schedules of this order are created for the extended time period. If the user decreases the duration (changed the duration to be less than the original value), order schedules that are past the new duration are removed.

   • Home Medication and Use Home Supply: User can toggle on/off these check boxes. If the Home Med designation is not checked and the user checks it, the medication is added on the Home Medications list. If the Home Med designation was previously checked and the user unchecks it, the Home Medication list in unaffected.

   • Times: Any individual/scheduled orders that have a date/time prior to the current date/time are not changed. Any individual/schedule orders that have a date/time greater than the current date/time are updated to reflect the new time(s).

   • Priority and Source: Priority affects the display/sort order in the eMAR. Changes to Priority will also be reflected in the eMAR.

7. Click Save. You are returned to the Patient Chart: Orders Tracking page.

To discontinue orders

Orders may be discontinued from the Orders Tracking page.

1. To discontinue orders, check the box for the desired orders. Then, click Discontinue Selected. The Discontinue Order box is displayed.

2. The Discontinued Date and Time fields default to the current date and time. Modify these fields, if necessary, by using the calendar and clock icons.

3. The Discontinued By field default to the current user. Modify this field, if necessary, by using the drop-down list.

4. In the Reason field, select the appropriate reason using the drop-down list. (Note: For providers that have a staff type that is set to auto-sign, the reason field defaults to "per provider order".)

5. If desired, enter additional notes regarding the discontinuation in the Notes field.

6. Click Save.

To administer orders

Currently, only nursing task orders can be administered from the Orders Tracking page. For all other order types, go to the appropriate module, e.g. Pharmacy, Laboratory, Radiology, to administer orders.  

To "administer" a nursing task order, check the desired box(es) to the left of the order(s) and click the Administer Selected button.

To unadminister orders

For certain types of orders, you may need to unadminister the order to undocument it or to generate a credit for the service/order. To unadminister an order, the order must have first been administered.

1. Click the Show Details button to display the administration details of the order.
2. From the Administration Details section, click the Edit button. The Edit Administration box is displayed.
3. Check the Not Administered, Clear Entry box.
4. In the Reason field, select the reason that the administration did not occur.
5. Click Save. The administration is displayed with a red circle strike through icon to indicate it was not administered.

To verify orders

Orders can be verified from the Orders Tracking page. You can verify all orders or individual orders one at a time. To verify all orders, click Verify All.  You will be presented with each order to review. For each displayed order, click one of the following buttons:

• Click Review and Next to move to mark this item as verified and move to the next item for review.

• Click Skip and Next if you would like to leave the currently displayed order as unverified and move to the next order.

Finished on this page?

Once you are finished on the Orders Tracking page, you can navigate to other areas using the carousel options at the bottom of the page in the green bar. To go to the Main page, click the underlined Main link. Or, to go to CPOE or EMAR, click the links located in the left or right corner, respectively.

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