Intermittent infusion orders have many of the same required fields as continuous orders, but there are some important differences. Intermittent refers to an infusion order administered at scheduled intervals (Q4H, QDAY) or One-Time only, "over a specified period of time" (e.g., "Infuse over 30 min."). For intermittent infusion orders, as the user selects a solution and/or additive, the items from that list are displayed to the right under Solution/Additive. For Intermittent infusion orders the only optional fields are the Comments, Infuse Over, and the Duration or Total Volume fields.
However, for intermittent orders, the Infusion Rate field changes to the Infuse Over Time field where the user enters either a number of minutes or hours. the schedule field is not available.
To order intermittent infusion orders, follow these steps:
1. Select the Orders tab.
2. Select the active orders view from the View Orders pane
-or-
select View | Active Orders (includes pending, recent activity).
3. Select Infusion (or your site's equivalent) in the Write Orders list box.
Note: The IV fluids item may be labeled differently or may not be available from your Write Orders list box.
The Infusion Order dialog displays as shown below.
The Infusion Order dialog for intermittent infusion orders
Note: If encounter information has not been entered, the encounter information dialog will appear before the Infusion Order dialog. You must complete the encounter information dialog before proceeding.
4. Select a solution from the Solutions tab.
After you select a solution, CPRS automatically moves to the Additives tab.
5. Select an additive from the list (if necessary). Repeat for additional additives if necessary.
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.
6. Enter a volume and strength in the Solution/Additive grid (if necessary). If the desired route is not available select the Other option in the list of route to bring the expanded med route form that list all possible IV routes.
7. Select the Route (for example, intravenous, epidural, IV piggyback, etc) from the drop-down list.
8. In the Type drop-down box, select Intermittent.
Note: If you change the IV Type from Intermittent to Continuous, the Schedule field becomes unavailable (greyed out) and the Infusion over Time field becomes the Infusion Rate 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.
9. Select a schedule from the list or create one using the Day-of-Week schedule builder.
Note: When a user writes an intermittent infusion order with a schedule of ONCE, the following will happen in CPRS:
§ The DURATION field will be disabled.
§ The Give Additional Dose Now option will be disabled
§ Expected First Dose and Administration Times will not be displayed
Note: When a user writes an intermittent infusion order with a schedule of On Call or a PRN, the following will happen in CPRS:
§ Expected First Dose and Administration Times will not be displayed
10. If you selected an existing schedule, skip to step 13. If you selected OTHER, CPRS displays the Order with Schedule "OTHER" dialog. Take the following steps:
a) Select one or more check boxes by the appropriate days of the week.
b) If the schedule requires specific administration times skip to steps c and d. To select a schedule from the list, highlight the schedule and select Add.
Note: Users can assign either a schedule from the list or specific administration times, but not both.
c) To use a specific administration time, select the hour and minutes (if the user only selects the hour, the minutes will default to zero) and select Add.
d) Repeat step c until you have entered all required administration times.
Warning: The administration times in the Schedule field apply to each day of the week that is listed, such as TU-TH-SA@0800-2000, for example. To create a schedule such as TU@0800 TH@2000, users would have to enter two separate orders using the complex medication order dialog. Also, users may not enter a schedule that only has administration times and PRN but no days.
e) If you make a mistake while selecting an administration time or schedule, do one of the following to remove it:
§ For a single administration time, highlight the hour and minutes in the Set Administration Time fields and select Remove (so to remove 08:00, you would have to select that time in the Set Administration Time fields not in the Schedule text box.)
§ To remove the schedule, highlight the schedule and select Remove.
§ To remove the entire schedule and begin again with step a, select Reset.
f) Review the Schedule field.
g) When you have the correct schedule, select OK.
11. If necessary, select the PRN check box.
12. Enter the number for the duration over which to infuse the medication.
13. Move to the next field and select the unit of time (the units can be only Minutes or Hours) over which the infusion should be given.
For example, you might enter 30 for the number, move to the next field, and then select minutes to define infuse over 30 minutes.
14. Select the Priority.
15. Enter a number for the duration or total volume.
16. Move to the next field and select the appropriate unit (liters-L, milliliters-ml, days, hours, or doses).
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 insure the patient does not receive a dangerous amount of fluid.
17. If necessary, select the Give additional dose now check box.
Note: Make sure that you are careful about using give-additional-dose-now functionality. When you click the check box, CPRS creates two new orders and sends it to Inpatient Medications. Make sure the "Give additional dose now" and the regular order with the original schedule you entered do not overmedicate the patient. "Give additional dose now" is not available for ONCE, ONE-TIME, or NOW orders. It is also not available for delayed orders.
18. Enter any comments (if necessary).
19. Review the order text at the bottom of the dialog to ensure that it is correct.
20. If the order text is correct, select Accept Order.
21. Enter another order
-or-
select Quit.
Note: The order must be signed before it is sent. You can either sign the order now or wait until later.
Related topics
Ordering Inpatient Medications (Simple Dose)
Ordering Inpatient Medications (Complex Dose)
Ordering Outpatient Medications (Simple Dose)
Ordering Outpatient Medications (Complex Dose)
Other Medication Actions (popup menu)