Nursing Technology and Informatics Committee

1. Nursing Technology and Informatics Committee Educational Power Point sent to Nurses related to “Hold Medication x 1 Dose” orders in Power Chart October 2009

2. HOLD Medication for 1 Dose

3. ~Background~ • Hold ‘medication’ with parameters or x 1 dose is acceptable per NMH policy • PowerChart does not have the capability for the prescriber to hold one dose of a medication • Physicians are currently using the MD to RN communication order to hold 1 dose of medication • This can lead to errors as it is not grouped in the Medication section and the MD to RN Communication order stays visible until discontinued

4. ~HOLD x 1 Dose Solution~ • MD selects an order “Hold Medication x 1 Dose” • Free text entry of name of medication to hold • Free text entry of when to hold • Free text entry for reason to hold • Order will go to top of Scheduled medications on the eMAR and Task List • RN will chart ‘Not done’ on the medication task of the dose that is held

5. ~HOLD x 1 Dose Solution~ • Reason “Hold dose per MD order” • Hold Medication x 1 Dose order can then be charted as done and the task and order will go to complete • If the medication dose to be held is not on the eMAR yet, the Hold Medication x 1 Dose order should stay on the eMAR / Task List until the medication is charted as ‘not done’

6. Search for the order:

7. Free Text entry of medication name and when to hold Medication name is shown in parentheses next to Hold Medication order, when to hold and reason is free-text

8. Display on the eMAR at the top of the Scheduled Medications The Hold order will not appear beside the medication to be held. Always located at the TOP of medication list (unable to place next to the order for the medication to be held).

9. Display on the Task List at the top of Scheduled Medications The Hold order will not appear beside the medication to be held. Always located at the TOP of medication list (unable to place next to the order for the medication to be held).

10. Chart “Not Done” Chart 1000 Lovenox dose as “Not Done” Hold per MD order

11. Chart the “Hold medication x 1” order Chart the Hold Medication x 1 Dose order to complete the task

12. Hold Medication x 1 Dose Order will go to complete

13. MAR View View result documentation within MAR View

14. ~Reminders~ • Hold medication x 1 Dose order should remain on the eMAR / Task List until actual dose is charted as “held” • Indefinite holds are not acceptable. Contact MD to discontinue the medication order

15. ~Recommendations~ • Share this presentation with nursing staff via their mailboxes, in-services, and/or a bulletin board.