Dream Factory by TruBridge Ideas Portal
Currently when a provider is ordering a medication that may require Non-Standard times, they need to go through a series of steps to accomplish the task.
Step 1: Select the drop down for Non-Standard,
Step 2: Enter the times/frequencies.
Step 3: Update to show "New" times on IV Medication Order Edit screen.
Step 4: Enter the time for the first dose in the First Dose Date/Time field to avoid the possibility of an extra dose populating on the MAR with an incorrect time.
My proposal is change the process so the provider only has 2 things to edit. First they select "Non Standard" from the drop down field. Second, enter a time in the First Dose Date/Time field.
In the background, program the system to automatically update the frequency times.
I've attached screenshots of the current process.
UPDATE:
It's been quite a while since I've looked at this idea and when reviewing it today, I read through the comments and then followed what Michelle suggested. In the process, I found the only way to get times to populate the MAR correctly is accomplished when the pharmacist changes the option from "Standard Times" to "Hours Between Doses" using the option on the Pharmacy screen.
But in my original submission for this idea, I was describing the order process from a nurse or Provider viewpoint. There isn't a field for a user in CPOE to select "hours between doses". They can select the Magnifying glass for the Frequency Table, but if they change the frequency to every 8 hours from the table, they get 0000, 0800, 1600 as that frequency is set up with the setting of "Standard Frequency".
Users in CPOE need to change the frequency to Non-Standard and enters new times.
However, now that I've been "playing" with this, I think my idea can be amended making the process even simpler for nurses or providers by adding an option in the frequency drop down menu for "Hours Between Doses" and a field that allows a numeric value to be entered. Giving clinicians (nurses and providers) on nursing units the ability to enter hours between doses reduces the risk for med errors and increases the accuracy of medication administration.
I'm adding an additional screenshot (IV medication order edit) for clarity...
We had a situation where a patient was to get an antibiotic every 8 hours but they had to do nonstandard times so they did not have to wait for the next standard time to get it... They got the IV med 4 hours apart because of human error on how the nonstandard times were entered. The solution proposed here would have solved this issue. If it is every 8 hours it should be form the first dose date and time, not go into non-standard times and do the calculation yourself which allows for human error.
The hours between doses field is often used for IV medications. Once the Start Time is entered, the subsequent doses are calculated based on that time to allow a "floating" time rather than preset. The initial time should be changed to the next hour to allow time to obtain the medication and all orders are timed accordingly.
I'm curious why non-standard Standard Times would be preferred over this workflow.