In our current state, if we want to change any detail on an intermittent medication in CIS, we need to cancel/reorder. This causes several issues, including:
- The timing is altered, and does not reflect the last administration of the medication, potentially causing a dosing error
- It creates multiple lines in the MAR, making historical review onerous
In addition, if we want to hold a medication, we have a less-than-ideal work around, with a home-grown order called “hold med.” This order does not actually tag the medication in question, so there is no guarantee that the medication will not be given.
In Early May, we will be implementing two standard Cerner tools for intermittent medications. These include modify, and suspend/resume.
Modify – we will turn on modify for all order details, including dose, route, frequency, duration, PRN reason, etc. This will assure that dose timing is preserved, especially when changing a frequency.
Suspend/resume – now, with a single click, a medication can be held. It will stay on the orders tab (labeled as suspended) and on the MAR (grayed out). When it is time to restart the medication, simply right-click and resume the medication.
Attention providers: As with all order activity, modifying/suspending/resuming MUST be accompanied by verbal communication to make sure that the patient’s nurse knows the action that took place.
More information about this will be sent in the few days leading up to the change.