MEDICATION ORDER PowerPlan Warfarin Initiation€¦ · This time does NOT reflect the first dose...
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Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 1 MNCLHD Quick Reference Guide MEDICATION ORDER – PowerPlan Warfarin Initiation Smarter Safer Better Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan Introduction PowerPlans assist you to place medication, pathology and radiology orders at once. With the Warfarin Initiation PowerPlan you can order multiple Warfarin doses, Warfarin reminder tasks, related pathology tests (INR / Prothrombin Time) and order a Pharmacy consult, in the one order. Before ordering any new medications you should check the Medication List and MAR Summary to ensure the medication has NOT already been ordered. 1) Click the blue + (Add) button beside New Order Entry in the Patient Summary screen 2) In the Search field type PowerPlan. 3) Choose the appropriate PowerPlan from the list. In this case choose Coumadin Initiation PowerPlan (7 days). 4) The Add Plan Window opens. a) Leave the Confirm Day 1 Start Date/Time as it auto-populates unless you need to start the plan in the future. This time does NOT reflect the first dose time, but it is THE START TIME for the plan. b) The Confirm Phase Action panel allows you to select how many phases (days) you wish to set up. It auto-populates to initiate only Day 1. If you wish to set up future days at the start, click the down arrow on the row you wish to also initiate today and change to Order now. c) Click OK 5) Click Done to close the Order/Medication search window. 6) In the View menu, you will see the Warfarin-Initiation PowerPlan (7 days). a) Under this you will see Days 1 through to 7. b) The days that you selected to Order now are bold and have a small lightbulb icon in front of them. c) Click on Day 1 (Initiated Pending) and the relevant orders and information will be visible in the Plan profile (see picture on right of page). 7) In the Orders tab, the Pink and Blue sections contain decision support which may help guide your ordering. 1 2 3 4a 4b
Transcript of MEDICATION ORDER PowerPlan Warfarin Initiation€¦ · This time does NOT reflect the first dose...
Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 1
MNCLHD Quick Reference Guide
MEDICATION ORDER – PowerPlan Warfarin
Initiation
Smarter Safer Better
Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan
Introduction
PowerPlans assist you to place medication, pathology and radiology orders at once. With the Warfarin Initiation PowerPlan you can order multiple Warfarin doses, Warfarin reminder tasks, related pathology tests (INR / Prothrombin Time) and order a Pharmacy consult, in the one order. Before ordering any new medications you should check the Medication List and MAR Summary to ensure the medication has NOT already been ordered.
1) Click the blue + (Add) button beside New Order Entry in the Patient Summary screen
2) In the Search field type PowerPlan. 3) Choose the appropriate PowerPlan from the list. In this case choose Coumadin Initiation PowerPlan (7 days).
4) The Add Plan Window opens. a) Leave the Confirm Day 1 Start Date/Time as it auto-populates unless you need to start the plan in the
future. This time does NOT reflect the first dose time, but it is THE START TIME for the plan. b) The Confirm Phase Action panel allows you to select how many phases (days) you wish to set up. It
auto-populates to initiate only Day 1. If you wish to set up future days at the start, click the down arrow on the row you wish to also initiate today and change to Order now.
c) Click OK 5) Click Done to close the Order/Medication search window. 6) In the View menu, you will see the Warfarin-Initiation PowerPlan (7 days).
a) Under this you will see Days 1 through to 7. b) The days that you selected to Order now are bold and have a small lightbulb icon in front of them. c) Click on Day 1 (Initiated Pending) and the relevant orders and information will be visible in the Plan profile
(see picture on right of page). 7) In the Orders tab, the Pink and Blue sections contain decision support which may help guide your ordering.
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Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 2
MNCLHD Quick Reference Guide
MEDICATION ORDER – PowerPlan Warfarin
Initiation
Smarter Safer Better
Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan
8) Starting at the top of the page, choose the appropriate Pathology Test e.g. INR, Coagulation Profile or Liver Function test by ticking the appropriate check box.
9) In the Medications section, after considering the decision support information, choose the appropriate medication and select an order sentence from the drop down menu.
10) Check the box beside the warfarin reminder is ticked. This will set a reminder task at midday each day that will appear on the MAR. This will prompt clinicians to check there is a warfarin dose charted for the day.
11) In the Consults section a Pharmacy consult is ordered by default.
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Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 3
MNCLHD Quick Reference Guide
MEDICATION ORDER – PowerPlan Warfarin
Initiation
Smarter Safer Better
Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan
12) When the warfarin order sentence is chosen the scratchpad will open below the order. 13) Check all details and include the Indication. Click Orders For Signature. 14) A Clinical History alert will appear (if pathology is ordered). Enter the current Clinical History and click
OK. 15) A Pregnancy alert will appear (if this information has not already been documented in the patient’s chart)
for females aged 10 – 59 years.
16) The Orders screen will reopen. Orders with the icon require details to be checked and entered in the scratchpad. Click on each order and the scratchpad will open below.
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Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 4
MNCLHD Quick Reference Guide
MEDICATION ORDER – PowerPlan Warfarin
Initiation
Smarter Safer Better
Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan
17) For the warfarin reminder choose the Indication and Target INR from the drop down menus and check all other details are correct.
18) For the Consult Pharmacy enter your Phone/Page Number, choose the appropriate responses for High Risk Patient? And Reason for Consult. Add any further details regarding…
19) Once complete click Sign and enter password 20) Click on the MAR or MAR Summary in the Menu. Click Refresh and check that the medication is
displaying as intended.
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Acknowledgement: Western NSW LHD Date issued: November 2018 Page | 5
MNCLHD Quick Reference Guide
MEDICATION ORDER – PowerPlan Warfarin
Initiation
Smarter Safer Better
Aboriginal artwork produced by Gumbaynggirr Artist Brentyn Lugnan
IF THE INR IS TOO HIGH – PLEASE CHART A WITHHOLD WARFARIN ORDER:
21) Click on the Orders tab on the left hand side menu of the Patient Summary page 22) In the View menu, select the Warfarin Initiation Plan (7days). 23) Open the relevant Day required and you will find an Order sentence in the drop-down box for a
WITHHOLD order. Please order this instead of the Dose order to ensure the nursing staff are aware that a clinical decision has been made relating to today’s warfarin order.
24) Complete the scratchpad details, initiate and sign. 25) Go to the MAR click Refresh to ensure that the WITHHOLD order is saved as intended. Inform nursing
staff of the new medication order that has been added to the patient’s chart.
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