Clinic Infusions (Overview)

Clinic Infusions enable a CPRS user to place several different kinds of infusion orders, including intravenous (IV), epidural, IV piggyback, and so on, that are dispensed by inpatient pharmacy and administered to an outpatient in a clinic setting. Clinic Infusions enable VistA order checks to function for such medication orders.

Clinic Infusions orders must be placed from a clinic location. When providers select the Clinic Infusions item under the Write Order pane, CPRS will ask the providers to confirm that they are placing a Clinic Infusions order. Either before or after the confirmation dialog appears, providers must assign the encounter location to an appropriate clinic. For outpatients, providers will be prompted if no encounter location has been defined yet and then asked to confirm that they want to order Clinic Medications. For inpatients, providers will be asked to confirm that they want to order Clinic Medications first and then prompted for an appropriate clinic location.

Other than being ordered from a clinic, the infusion ordering process is almost identical to ordering infusions from any other location. However, to be comprehensive, the steps for Clinic Infusions should be complete in this section of the manual. As they are almost identical, the information in this section is the same as much of the information under the infusions ordering section.

Continuous versus Intermittent Infusion Orders

In the Infusion Order dialog, the order type—Continuous or Intermittent— affects whether some fields are available or visible. The two types of IVs are defined as follows:

Continuous IV: an IV that runs at a specified rate (ml/hr, mcg/kg/min, etc.).
Intermittent IV: an IV administered at scheduled intervals (Q4H, QDAY) or One-Time only, “over a specified period of time” (e.g., “Infuse over 30 min.”).

For Intermittent orders, the Infusion Rate field changes to be Infuse over Time, the Schedule field becomes available (not greyed out), and checkboxes display for the PRN and Give additional Dose Now options. On both dialogs, required fields are identified by an asterisk following the field label (such as Route*, for example). Intermittent orders no longer require a solution to finish the order. Continuous orders still require a solution before the order can be finished. For CPRS to accept the order, the user must enter values in the required fields, including the units.

For the Route field, CPRS uses the following rules to define whether it displays a default route for the selected medication:

If all of the orderable items on the order have the same default medication route defined, CPRS designates the default medication route in the selection list.
If one or more orderable items on the order have different default medication routes, no medication route in the selection list will be denoted as the default.