Adding a script request to a medical record for a patient
For a patient who has an open episode
From the medical record patient for the patient, mouse over the episode's top bar.
This displays the hidden icons to control the episode.
Click on the button that says "Rx". On mouseover, the text should display "Add Rx".
This brings up the prescription entry screen.
Selecting the Drug to Prescribe
Enter the drug you wish to prescribe to the patient.
You may start with the line and seq number if you know them, or begin by typing the first few letters of the drug name in the description box to bring up matches.
If your drug is not listed in the products box, you can check "Drug Not Listed."
This allows you to manually enter the drug name as you want it displayed on the prescription.
If you are aware that your pharmacy does not carry the product, or the customer has indicated that they will fill it at a facility besides your pharmacy, check "External Fill."
This indicates to the Pharmacy that the prescription will be handled elsewhere.
Instructions for the Prescription
There are multiple ways to write the instructions. You can manually type in recommendations, or select the draft instructions and then press "Draft" to apply them.
(If there are no common draft instructions set up for the drug you are trying to prescribe, these fields will be blank. Contact your pharmacy administrator if you wish to have common draft instructions set up for a frequently prescribed product.)
In addition, draft instructions can be set to a profile. (Contact your administrator to set up specific profiles for your most commonly prescribed drugs.)
In the example below, we have selected the drug profile of "Standard Intern." This automatically fills in the instructions that were pre-defined for the prescription. These instructions can still be edited.
Dose Calculator / Adjusting the Patient's Weight
For prescriptions that require an exact weight for the patient (e.g. chemotherapy), you can update the weight directly from the prescription without having to return to the patient record.
This tool also provides a place to calculate a precise dosage for liquid amounts. (Future planned enhancement will also provide the M2 calculation based on species.)
Other Options on the Script
- Total Qty: Adjust the quantity of the items for the prescription. 1 box, 30 pills, etc. The unit for the product should automatically appear next to the quantity.
- Refills: Select the refills for the prescription. For controlled substances, confirm with the pharmacy before setting refill amounts. Many scheduled substances must be set as NR per state law. (The script will be blocked at the fill point if it goes against the controlled substance settings designated by your pharmacy.)
- Animal usage: For food animals, provide any contra-indication against dairy, egg, or meat consumption after taking the prescription.
- Prescribing DVM: The clinician who must ultimately approve the prescription. This can be different from the person entering the prescription request.
- Pharmacy: For hospitals with multiple pharmacy locations, select the pharmacy that will need to fill the prescription.
- Patient Status: Indicate whether the patient is inpatient, outpatient, going home, or an ASAP/STAT emergency. Your pharmacy can customize these statuses for different or additional options as well.
- Comments: Any additional information for the pharmacist, or which the pharmacist will need to share with the client.
After entering all the details for the prescription, clickin on the "Add Script" button.
The script will appear in the top right corner of the Prescription Request page. This will allow the clinician to request multiple scripts on the same page, without having to exit back to the patient record.
Scripts that have been entered but not submitted can be removed or edited by clicking on the pencil icon (to edit) or the red X button (to remove.)
Clinician Approval
"Send Pending Approval Notice" can be used when a script has been requested by a student, but needs additional clinician approval before going to the pharmacy.
When this button is clicked, then a notice is sent out in two places:
The "My Pending Prescriptions (Prescribing DVM)" widget on the Home page. The prescription can be approved by double clicking the prescription an entering the username and password of the Prescribing DVM.
Internal Vet View mail:
In the Internal Mail system, clicking on the patient name will load the patient record and the script, at which point the clinician can approve the script.
Once the prescriptions have all been confirmed and verified, the clinician can click on Approve Scripts and send the prescription on to the Pharmacy for a fill.
For a patient with no episode (Bill-only episode)
For patients who need a refill of a prescription that requires veterinarian approval (such as for a controlled substance) but for which it is not necessary for the patient to be present, you can create a "Purchase Only" or "Bill Only Episode."
The Admissions personnel will search for the patient and client, and save the appointment type to that which is designated as your Bill Only. (See your administrator for assistance in determining which episode type is Bill Only.)
At this point, the clinician can open the patient's record ad submit a prescription request as outlined above. The prescription will appear on the patient's medical record for future reference, and can be invoiced to the client as normal.
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My hospital issues orders to be filled overnight at the Pharmacy. How do I request this medicine?Daily Fill Request Start by selecting "In Hospital Use (Administration Record)" to generate a MAR record for tracking of the prescription. Choose the correct pharmacy from the drop down menu. Select the Daily Fill radio button from the options at the top of the prescription.
Start and End Dates The start date will always default to tomorrow, which is when the automatic re-approval and refill process will begin. You can choose an end-date if the patient will be getting medication that has a specific recommended maximum prescription length, or leave it blank if the patient will be taking the medication for an unknown length of time.
My patient needs this medicine immediately. How do I request the first dose right away?Request First Dose Now "Request First Dose Now" will send an approved prescription to the standard pharmacy queue before starting the Daily Fill approvals. Use this if the patient will need this medication right away, instead of waiting until the morning.
If the patient received today's medication through other means, such as client prepared medicines that same day or from a separate CDM draw, leave this checkbox empty. Note that Daily Fills cannot be initiated from a CDM. Drug Selection Enter in the line and sequence number of the drug if you know it. Or use the smart search box to look up the correct drug. (Use "Drug Not Listed" only for compounds, or as instructed by the DVM.)
Daily Quantity A simplified drug selection form appears. Since Daily Fills are refills on a daily basis for a set length of time, input a single daily quantity instead of a total fill quantity. Include any other pertinent information for the pharmacy, such as a patient's temporary location or comments regarding the preparation.
Approval process The approval process for a Daily Fill prescription is the same as any other prescription. A student or technician may request it, then the supervising clinician approves it.
How can I see the history of Daily Fills?Viewing Daily Fill History Daily Fills have their own section on the new Prescriptions tab. This tab will display any current Daily Fills for inpatients, as well as any historical daily fills for patients who have been discharged.
How do I cancel Daily Fills?Cancelling Daily Fills If a patient is being discharged, the Daily Fill will automatically cancel the Approved prescription for the next day overnight. No further action is necessary. If a patient is being sent home but the episode is not ready for Discharged, you can cancel the Daily Fill from the patient record manually. Click on the Ban sign next to the prescription on the episode or on the Daily Fills tab to cancel. You will get a prompt asking you to confirm. Cancelled Daily Fills will disappear from the Daily Fills tab, and move to the Complete History instead.
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