Two charts open
We’ve heard feedback from many clinicians about our change to allow two charts open. Many have been happy about this change, noting that it allows work to continue on one patient while addressing issues on another patient. We’ve also heard concerns that this may be a safety risk.
When this change was made, it was made taking into consideration the experience of other children’s hospitals, as well as the available published evidence. More than 80% of surveyed hospitals allow two or more charts open, and the study published below showed no increase in wrong chart orders when moving from two to four available charts. We will continue to monitor the incidence of wrong patient orders.
Order interface change
We recently transitioned the look of inpatient orders to look like prescriptions. This change allows better use of the keyboard and tab keys, and brings us in line with standard Cerner recommendations used at most pediatric Cerner hospitals. We are adjusting the build of some orders to assure that information is visible.
PRN prescription dispense amounts
Based on previously reported safety issues with inappropriately large amounts of prescribed medications, Cerner instituted a change in the code that now requires users to decide how much of a medication to dispense when prescribing a PRN medication. This change has both positive and potentially negative effects. Not all PRN prescriptions assume that the patient should receive all doses as if they were scheduled, and could result in excess prescription amounts. For example, a medication given as every hour as needed would calculate to 24 doses per day. That will no longer occur. On the other hand, the new change does require clinicians to manually calculate volumes of some liquid medications, with can slow work down and potentially introduce error. We are actively working to find an acceptable improvement to this issue and will communicate once we’re ready to roll it out.