Ordering Continuous Clinic Infusions

Continuous infusion orders run at a specified rate. As the user selects a solution and/or additive, the items from that list are displayed to the right under Solution/Additive. For continuous infusion orders the only optional fields are the Comments and the Duration or Total Volume fields. The schedule field is not available.

The Additive Frequency field enables users to select which IV bag the additive should be placed:

1 Bag/Day: The additive should be put in one bag for 24 hours, normally the first bag.
All Bags: The additive should be placed in all bags given to the patient.
See Comments: The provider wants something other than the above options and will put appropriate instructions in the Comments box.

Note: If the user selects “See Comments” for the Additive Frequency but does not enter appropriate instructions in the Comments box, Pharmacy may interpret that as All Bags.

To order continuous Clinic Infusions, use these steps:

Select the Orders tab.
From the Write Orders pane, select Clinic Infusions.

Note: Depending on how menus are set up at your particular site, you may need to select a different option from the Write Orders pane. Many sites have customized the items in the Write Orders pane. Check with your CAC (or the person who manages information resources at your site) if you have trouble locating the Clinic Infusions item.

Note: The following prompts will be slightly different based on the patient’s location. You will be asked to verify that you want to write Clinic Infusions and to ensure that the encounter location is a clinic location.

If prompted, enter the appropriate clinic for the encounter information. This will generally happen with an outpatient that does not yet have an encounter defined.

You can use an existing appointment if one exists or create a new one. To use Clinic Infusions, you must enter a location that was previously defined clinic. If you chose a clinic location, you will see this dialog.

This show the dialog asking the
user to confirm that they want to order clinic infusions.

This dialog is to ensure that the user knows they are about to enter Clinic Infusions.

To continue ordering Clinic Medications, select Yes and continue to the next step. To stop the Clinic Medications process, choose No.
(Conditional) If the patient’s current location is not a clinic, change the patient’s location to the appropriate clinic.

The Clinic Infusion Order dialog displays.

The Infusion Order dialog for continuous infusion orders does not use a schedule, but it does have an infusion rate. For continuous infusion orders, the new Additive Frequency field enables providers to indicate into which IV bag the additive should be placed.

Select the needed solutions from the Solutions tab.
7.Select an additive from the list (if necessary) and edit the strength if needed. Repeat for additional additives if necessary. How users can edit the strength field will depend on the values for strength defined in the pharmacy files as follows:

If a single strength is defined, users cannot edit the field.
If multiple values for strength are defined in the pharmacy files, the field will have a drop-down list from which users can choose a strength.
If no values have been defined, users can type in a strength. If a strength includes a decimal point, the value must begin with a number: so, .5 is not valid, but 0.5 is.

The solution and additives you select will appear in the Solution/Additive grid.

Note: To remove an additive or a solution, select the solution or additive and select Remove.

Enter a volume and strength in the Solution/Additive grid (if necessary).
Select the Additive Frequency from the list:

1 Bag/Day: The additive should be put in one bag for 24 hours, normally the first bag.
All Bags: The additive should be placed in all bags given to the patient.
See Comments: The provider wants something other than the above options. Enter the appropriate instructions in the Comments box.

Select a Route (such as intravenous, epidural, IV piggyback, etc.) If the desired route is not available, select the Other option in the list of routes to bring the expanded med route form that lists all possible IV routes.
In the Type field, select Continuous.

Note: If you change the IV Type from Continuous to Intermittent, the Schedule field becomes available and the Infusion Rate field becomes the Infusion over Time field.

Note: For a definition of Continuous and Intermittent orders, select the IV Type Help link and a message box will display with a short definition of what the terms mean.

The
Informational Help Text message box shown here contains the definintions
for and examples of Continuous and Intermenittent IV types.

To help providers enter the correct type of infusion order, this dialog provides a definition of Continuous and Intermittent infusion orders.

Enter an infusion rate in ml/hr.
Select a Priority.
(Optional) Enter a number for the duration or total volume of fluids for this order.
Select the appropriate unit (liters-L, milliliters-ml, days, or hours).

Note: If you change the units, the value in the Duration or the Total Volume field will be removed and you will need to enter it again. This is a safety feature to ensure the patient does not receive a dangerous amount of fluid.

Enter any comments (if necessary).
Review the order text at the bottom of the dialog to ensure that it is correct. Make any necessary corrections.
Select Accept Order.
Review order check items and respond appropriately. If the order should not be entered because of a possible interaction, select Cancel. If the order is okay to accept, select Accept Order.
To enter additional Clinic Infusion orders, repeat steps 6-19 as needed. To finish, select Quit. For an outpatient, when you select quit, the encounter location will remain with the current clinic. For an inpatient, when you select Quit, the encounter location will go back to the location where the patient was before you began entering Clinic Infusion orders.

Note: The order must be signed before it is sent. You can either sign the order now or wait until later.