core 1 (paediatric) participant guide · 5 mins 1. navigate to advance growth chart 2. click on...

Medical Officer

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Participant Details

Name:

Date:

This Participant Handbook contains a range of information, which we have deemed to be particularly

relevant to your ieMR training. It has been designed as a take home document, to provide the necessary

information to support you after this session. A notes column has been provided for you to utilise throughout

the session.

Version History

Version Date Modified by Role Description

1.0 17/08/2018 Michelle Ogden System Trainer Initial Draft

1.1 28/09/2018 Michelle Ogden System Trainer Content Update

1.1 23/04/2019 Cass Bailey System Trainer Content Update to match FG update

1.2 23/05/2019 Christine Holland System Trainer Content Update

Scope

▪ To inform Medical Officers of new functionality within ieMR and familiarise themselves with reviewing,

administering and managing medications and fluids in ieMR.

▪ To allow participants to practice using new ieMR functionality including medication administration and

management.

▪ To assess confidence at the end of the lesson to identify if participant requires further training or

support.

Roles

▪ Participant: Attend mandatory ILT training to learn ieMR Advanced Release basic functionality and

reinforce that knowledge by completing a practice activity. Demonstrate readiness by successfully

completing the confidence check.

Pre-requisites

▪ R3 ieMR training

Topics Covered

1. Adding a Weight

2. Adding an Allergy

3. Inpatient Medication Orders and Favourites

4. Overview of MAR Summary and MAR

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5. Medication Administration via the MAW

6. Rescheduling and withholding medication doses within the MAR

7. Amending Medication Order

8. Ordering IV Fluids and Continuous Infusions

9. Ordering Prescriptions

Session Login Information

▪ Computer - Use generic password

▪ Login: Student-tth

▪ Password: student

▪ ieMR - Red icon

▪ Log into relevant Train Domain

▪ Use login and patient details on card provided

Session Content

1. Adding a Weight Notes:

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1. Navigate to Advance Growth Chart

2. Click on Enter New

3. Select Measurement from the drop-down menu

4. Enter Weight measured of 34.5 kg in the Paediatric Growth

Chart

5. Click on the to sign the form and confirm changes

6. Refresh the page

2. Adding an Allergy Notes:

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1. Select the Allergies section of the patient chart

2. Click Add+

3. Search for Amoxycillin

4. Double click the Amoxycillin allergy, ensuring it has the

MULTUM vocabulary

Note: Selecting the Allergy substance from the catalog will ensure that it

is included in the MULTUM vocabulary, so that the drug-allergy

interaction check occurs within the system. This alerts the clinician that

the patient has an allergy to the drug they are ordering.

5. Complete the allergy details as clinically appropriate:

a. Category: Drug

b. Reaction symptoms: Hives

c. Severity: Mild

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d. Info Source: Parent

e. Onset: About – Week of – Select today a week prior

6. Click OK

7. Click the Reverse Allergy Check button. Explain if an allergy has

been documented in a patient’s chart after medications have

been ordered, it is possible to perform a Reverse Allergy Check.

This will perform a drug allergy check against all charted

medications across all encounters.

8. Click the button. It signifies that you

have checked the patient’s allergies. Clicking this will update the

last Reviewed date against your electronic signature.

3. Inpatient Medication Orders and Favourites Notes:

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Orders Page Customisation

1. Navigate to the Orders screen

2. Click on Customize View (top right-hand side of Orders pane)

3. The Customize View pop up will appear;

4. From this window Trainer to add the following customisations using the Add -> and <- Remove key to move them across:

a) Ordering Physician

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b) Type

c) Order Name/Details d) Status

e) Notifications

f) Details

5. Click Ok and Refresh

To save these preferences, use the Exit icon on the Toolbar. Then, the

preferences with be applied to any patient’s chart.

Inpatient Medication Ordering


2. Click Add+

3. Search for the following order sentences (DON’T click Done until ALL

medications below are ordered):

4. Par 500 FOUR and select Paracetamol 500 mg oral tablet (15

mg/kg, Tablet, Oral, FOUR times a day)

▪ Order Sentences and what they mean, multiple for each drug

based on dose form (liquid, tablet, strengths etc.).

▪ Important to select the correct Order Sentence for the patient.

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▪ While many are based on AMH Children’s, the system does not

replace the need of the doctor to look up and select the

appropriate dose for the patient.

▪ If none of the order sentences are appropriate, choose the closest

and you will be able to modify later

▪ Terminologies such as OD, BD and TDS, STAT are not in ieMR

Dose Calculator Information

The dose calculator will launch for medication order sentences that

require a calculation i.e. mg/kg or mg/m2. If the patient has a weight,

height or creatinine clearance documented, this will auto-populate

within the dose calculator.

The dose calculator will only pull in data within its validity period:

• Weight is valid for 7 days

• Height is valid for 90 days

• Creatinine clearance is valid for 7 days

Dose Calculator can also calculate dosing based on Body Surface Area

using the Mosteller algorithm

5. Select the drop-down arrow next to the Rounding Rule field

6. Adjust Rounding Rule to Down nearest one hundred and twenty-

five

Note: This will adjust the Final Dose field to the new rounded dose

which will be 500mg (As this is a tablet form dose, the dose should be

the size of the tablet or half/quarter if the tablet is scored).

7. Input Adjust Reason as Dose Rounded

8. Click Apply Dose

9. The order will populate in the scratchpad and you will be able to

add further medication orders.

1. Search for the following:

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b) Ibu 100 PRN and select Ibuprofen 100mg/5ml oral

suspension (10mg/kg, Suspension, Oral, THREE times a day,

PRN for pain/fever, Indication:-)

10. Click Apply Standard Dose

11. From the Orders screen, Search for Cet 10 Once and Select

Cetirizine (10mg, Oral, ONCE only)

12. Continue Adding Orders

a. Search for Benpen 60 and select Benzylpenicillin sodium

(60mg/kg, Injection, IV, 6 hourly, infuse over 30 minute(s))

13. This will launch the Dose Calculator

14. Select Apply Standard Dose.

This will fire the Allergy Interaction Checking Rule. This window

displays clinically appropriate information about the allergy and the

medication that have potential to interact. This is a decision support

window only and relies on prescribers to use their clinical judgement to

override the alert or remove the identified order. This also fires for

duplicate orders

15. Tick to Remove Identified Order and click OK

16. Search for the search for the final medication:

a. Cefotax 50 and select cefOTAXIME (50 mg/kg, Injection, IV,

6 hourly)

17. This will launch the Dose Calculator

18. As can be seen, the Final dose calculated for the Cefotaxime dose is

1,725 mg calculated by multiplying 50 mg (target dose) by 34.5kg

(patients weight).

19. Select Apply Standard Dose

Again, this will fire the Allergy Interaction Checking Rule.

20. Select “Clinical judgement applied” in the Current Override Reason

drop down menu, click OK.

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21. Click Done

Important Note: At TTH prescribers are required to choose only

one route of administration for PRN medications. If more than one route

of administration is required, a second order should be written with the

recognition this may carry a risk of over-dosing.

Complete the order details for each medication:

1. Paracetamol 500 mg oral tablet (15 mg/kg, Tablet, Oral, FOUR

times a day)

a. Indication: Pain

b. Select the Frequency drop down and click the ellipsis icon

to modify the schedule times

c. Change administration times to: 0800, 1200, 1800, 2200

(Do not sign medications yet)

2. Ibuprofen 100 mg/5 mL oral suspension (10 mg/kg,

Suspension, Oral, THREE times a day, PRN for pain/fever,

Indication: -)

a. Select PRN reason: pain/fever

b. In Max PRN dose/24hr enter: 1020mg (this is 3 doses of

340mg)

Max PRN dose will not automatically calculate based on the

dose applied. It is still the responsibility of the prescriber to determine

what they would like the Max dose to be and complete this section.

Prescribers should be aware that entering a Max dose will NOT provide

an alert to staff if they attempt to prescribe above the designated max

dose.

It is a paediatric specific that dose ranges SHOULD NOT be used for

paediatric patients to help minimize the risk of overdosing to patients. It

is the responsibility of the prescriber to choose the dose that is clinically

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relevant for their patient and review regularly to determine if a different

dose/frequency for the PRN medication is required.

3. Cetirizine (10mg, Oral, ONCE only)

a. Highlight that the Frequency is ONCE only

b. It is good protocol to then check the First Dose Priority: For

ONCE ONLY order sentences this should pre-populate to

NOW, however, if this is not the case this should be changed

by using the drop-down arrows

c. Indication: Itch

4. cefOTAXIME (50 mg/kg, Injection, IV, 6 hourly)

a. Enter Indication: Infection

b. First Dose Priority pre-populated to: NOW

Important Note: If the first dose priority is set to NOW and the

frequency is set to scheduled, there may be a risk of repeat dosing within

a small-time period depending on the default scheduled times.

5. Adjust Frequency to THREE times a day

6. Select !Review Schedule to review the first dose date/time and

ensure the next administration time is correct

7. For training today; Keep the Frequency as THREE times a day

and change the First Dose Priority to ROUTINE

Important note: At TTH prescribers are required to obtain ID

approval codes, some antibiotics are restricted for appropriate use and

need approval from infectious diseases.

Do not sign yet

Add a medication to Favourites folder 1. Right click on a medication (still within the orders for signature

screen), select Add to Favourites

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2. Select New Folder, enter a name for the folder and click ok. The

medication will save into your favourites folder.

3. Click OK to sign the medications just ordered

Note: When ordering IV Antibiotics, the first dose priority will

automatically be set to NOW. This will place a STAT order for the

antibiotic in the medication chart and then the next dose at either a

Scheduled or Interval frequency. If the frequency is set to Schedule (e.g.

TWO/THREE/FOUR times a day), there is a risk that the next dose may

be within a small-time period causing overdosing. To prevent this there

are multiple options depending on the clinical scenario.

a. Using the Skip Administration of the next dose function;

▪ Patient will receive a STAT dose now, the next scheduled

dose will be withheld, then administration will continue

as per the schedule

b. Change the First Dose Priority from NOW to ROUTINE;

▪ The first dose will occur at the next scheduled time rather

than STAT

c. Modify the Frequency to an hourly interval (e.g. change to 8

hourly instead of THREE times daily)

4. Overview of MAR Summary and MAR Notes:

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Overview of the MAR Summary (Medication Administration Record)

The MAR Summary; will display current encounter and all previous

encounters.

1. Select MAR Summary from the Menu

2. The default view is 8 hours per column. To alter the date range or

column intervals left click the button at the top left of the

screen

3. Select Change Interval, set to Q24 Hours

4. Layout of MAR Summary:

a) Time View: all medications are displayed in reverse

chronological order

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b) Show Views: allows medications to be displayed in a

different view

c) Yellow column: orientates to current date/time or interval

d) Blue tile: Current scheduled meds/pending fluids and

infusions

e) Green tile: PRN meds

f) Grey tile: Future, Given or Discontinued

g) Red tile with white writing: Overdue meds

h) Red tile with black writing: NOW/Stat doses

5. Change the filter to All Medications (System) by selecting it from

the dropdown menu so you can view discontinued and ONCE only

(STAT) orders previously administered

6. Click elsewhere otherwise when you scroll the page by mistake the

filter will get changed

Overview of the MAR (Medication Administration Record)

This replaces the National Inpatient Medication Chart (NIMC).

Medication can be administered from the MAR in addition to

withholding a single dose, rescheduling administration times and

recording a dose not able to be given.

1. Navigate to the MAR

2. Change the filter to All Medications (System) for visibility of

discontinued and ONCE only (STAT) orders previously

administered

3. The grey banner bar shows the time frame displayed in the MAR

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4. There are 5 View options for the MAR.

5. These allow the user to view the MAR in various formats

Each view gives the user options which they can click on to quickly

navigate the MAR, you can also de-select certain sections if required.

6. The left-hand side of the MAR lists the medication orders associated with the selected patient

7. It is divided up into various sections outlined by their colours (which you can quickly navigate to using the Time View options)

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8. The time bar running along the top of the page indicates the date and time, the current time is highlighted in yellow

9. Each Activity task populates when the medication has been ordered and they will appear in the following colours:

▪ Yellow column: orientates to current date/time or

interval

▪ Blue tile: Current scheduled meds/pending fluids and

infusions

▪ Green tile: PRN meds

NOTE: The ‘Last given’ dose and date/time

displayed is the dose that was last administered, this may

be from a different order for the same medication from

any encounter and include both regular and PRN

medication

▪ Grey tile: Future, Given or Discontinued

▪ Red tile with white writing: Overdue meds

▪ Red tile with black writing: NOW/Stat doses

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10. When a medication has been actioned or signed off, an action

task cell will appear in the smaller section below indicating the

time in which that medication was signed off

11. Hover the mouse over the Medication Order to view the order

sentence in detail (full)

12. Right click a medication, select Order Info, review tabs

13. Right click a medication, select Reference Manual

Important Note:The Reference Manual information is not to be

distributed as the TTH has not yet certified where this is sourced from.

Please follow your current policy and procedures to obtain medication

reference material.

5. Medication Administration via the MAW Notes:

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2. Identify Cetirizine and Ibuprofen orders

3. Hover over the order and read the order details including any

special instructions and comments – this is where you would find

the pharmacists “purple pen” notes

4. Review the information on the administration task regarding date

and time of last dose – It is most important that this is performed

for every medication administration

5. Once you have reviewed the order and prepared the medications

in the med room, proceed to the patient’s bedside

6. At the patient’s bedside open PowerChart, perform a verbal PPID

and an allergy check against the banner bar:

7. Click on the allergies hyperlink in the banner bar which will open

the allergies window

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8. Review the patient’s allergies and click Reverse allergy check

9. Navigate to the MAW

10. Scan patients ID wrist band

11. If unable to scan wrist band select Next and enter an Override

reason

12. Click Yes

13. Place a tick in the box next to Cetirizine and Ibuprofen

14. Left click the Result column to review the order information

Note:

▪ Order details: Light blue banner bar that contains all the core

order details of the medication being administered; you can

right click on this to see further order info e.g. order comments

▪ Performed date/time: defaults to the current date and time,

however this can be changed if required

▪ Performed by: defaults to the user logged in

▪ Witnessed by: nurse witness. This has search capabilities.

When you click the tick to sign they will be asked to enter their

name and password. Leave blank if medication is a single-check

medication.

▪ Diluent: use this field to document the fluid in which a

medication is diluted e.g. normal saline flushes (pre- or post) or

the volume of the fluid in the burette plus flushes

▪ Not Given and Reason: to document if you haven’t given a

medication and the reason why. This will remove the task and

prevent it from going overdue

▪ Comment: Allows you to write comments regarding that

administration activity e.g. if a patient has self-administered a

medication the nurse will need to document that as a comment

as they will still need to sign off on the administration task

15. Enter the name of the witness/co-sign: Yolo, Mary, click OK

16. The witness/co-sign will be prompted to enter their password. (For

training today: enter password: train)

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17. Click OK and Sign

18. Refresh the MAR and review the action cell

Note: the dose tile displays the last given date/time of a medication

dose (within the last 5 days)

19. Navigate to the MAR Summary and refresh the screen to view the

given dose. This is an alternative way of viewing administered doses

of medication to the MAR

6. Rescheduling and withholding medication doses within the MAR Notes:

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Rescheduling Medication

Rescheduling the administration times of a medication is completed

within the MAR, not in the ordering page.


2. Right click the Medication Order Details cell for Paracetamol. Select

Reschedule admin times

3. Review the current times and for training today; update to 0600,

1200, 1800, 2200 hrs

4. Select a reschedule option for the next administration and click Save

5. Refresh the MAR to view the updated administration times

Note: You will see a single reschedule option if the medication is ordered

with an hourly interval frequency

Rescheduling a single dose of a medication – Trainer to demonstrate

1. Right click on a future dose of a medication and select

Reschedule this Dose

2. Alter time and select OK

3. Enter reschedule reason: No access- Patient off ward

4. Review your changes on the MAR

Withholding a single dose of Medication

1. Right click the next paracetamol dose and select Chart Not Done

2. From the Reason Not Done drop down menu select Withhold per

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3. If the next dose is outside the 120minute limit, you will receive a

warning message stating invalid date/ time. Click OK and modify

the date/time: T for today, N for Now

4. Sign by clicking on the green tick

5. Click Refresh to view the withheld dose in the Action Display cell

*Not Done: Withhold per Medical Officer. The Administration Task

cell is no longer available on the MAR for that dose.

7. Amending Medication Order Notes:

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Modify Medication Frequency

In the situation where a medication frequency needs to be changed, this

is performed through the orders screen. Using the modify function to

alter the frequency, indication, priority and stop date, but NOT the

Dose. To change a medication dose the order must be cancelled and

reordered.

1. Navigate to the Orders Screen and Right click the Paracetamol

order

2. Select Modify

3. Select the drop-down arrow next to Frequency

4. Change to THREE times a day

Note: you can click the ellipsis again to modify the administration times

5. Select Orders for Signature, Sign the changes

6. Navigate to the MAR to refresh and review changes

Cancel/Discontinue Medications

1. Navigate to the Orders page.

2. Right click on the Ibuprofen order and select Cancel/Discontinue.

3. Enter the Discontinue Reason as No longer required.

4. Click Orders for Signature and Sign

5. Navigate to the MAR to review changes

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Important Note: cancel/discontinue orders applies to future

administration doses only. If an overdue order exists for a discontinued

order it will still need to be actioned accordingly on the MAR (i.e. chart

not done, not given) as overdue tasks do not automatically remove.

Ensure you always check the MAR after cancelling/discontinuing.

Cancel/Reorder Medications

This function is used for dose and route changes of a medication.

1. Right click paracetamol and select Cancel/Reorder.

2. Change the dose to 250 mg

Note: if the Dose calculator is required again use this icon

3. Select the discontinued order and enter Discontinue Reason as

Different dose/route

4. Click Orders for Signature and then Sign

5. Refresh the page


7. Press refresh

Suspend & Resume Medications

1. From the Orders page

2. Select the Paracetamol order and right click Suspend

3. In the Details tab, select the Suspend Reason as Nil by Mouth. Here,

you can add additional Comments: Pt for US Abdo

Note: You can adjust the date/time you want the medication to suspend

from, for today don’t do this

4. Click Orders for Signature and Sign

5. The status of the order displays as Processing

6. Refresh the page to see the order status as Suspended. Review in

MAR.

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Resume Medication Order

1. To resume the order, right click and select Resume. Enter the

Resume date and time to 24hours in the future

2. Select a Resume reason > Oral intake resumed

3. Click Orders for Signature and then Sign

4. Refresh the page

The order will remain in a Suspended status until the time of Resume

(the medication will appear greyed out in the MAR and no

Administration Task cell will appear until the order has passed the

Resume time)

8. Ordering IV Fluids and Continuous Infusions Notes:

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Ordering Fluid Bolus


2. Click Add+

3. In the search field type Bolus and select the following order

sentence:

a. Sodium Chloride 0.9% intravenous infusion (20 mL/kg, IV,

order duration: 1 dose(s), Indication: Hypovolaemia, Bolus

dose. Assess response promptly. Dose may be repeated.)

4. This will launch the Dosage Calculator

5. Enter weight and review the Final Dose (i.e.. 690 mL)

6. Click Apply Dose, click Done

7. There are missing Order Entry Details , click on Rate and enter

999

8. The infuse over field will auto populate

9. Enter Weight if not auto populated

10. Click Sign, enter password: train, Click OK

11. Refresh the page

Important Note: If you would like the bolus to be pushed

through immediately, click into the Rate field and enter 999 mL/hr. This

will indicate to the nursing staff to push the fluid rapidly but must also

be accompanied by verbal communication to the nurse.

TRAINER DEMO: Beginning and Ending a Bolus Fluid

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Ordering Maintenance Fluids


2. Click Add+

3. In the search field type gluc 5 sod 0.9 and select the following

order sentence:

a. Glucose 5% with 0.9% Sodium Chloride intravenous

infusion (mL/hr, 1,000mL, IV continuous infusion, order

duration: 1 dose(s), Indication: Maintenance fluid)

4. This will launch a ‘Rate Recommendation’ window

5. Review details and note the recommended Rate of 74.5 mL/hr for

our patient

6. Click OK then Done

7. Input the Rate as per the recommendations but adjust it to the

nearest mL (i.e. 75 mL/hr) (The ‘Infuse Over’´ field will

automatically populate to 13.3 hour(s))

8. Add the patient’s weight if it has not auto populated

9. Click Sign, enter password: train, Click OK

10. Refresh the page


Beginning Maintenance Fluids


2. Hover over the order and read the order details including any

special instructions and comments – this is where you would find

the pharmacists “purple pen” notes

3. Review the information on the administration task regarding date

and time of last dose – It is most important that this is performed

for every medication administration

4. Once you have reviewed the order and prepared the medications

in the med room, proceed to the patient’s bedside

5. At the patient’s bedside open PowerChart, perform a verbal PPID

and an allergy check against the banner bar:

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▪ Click on the allergies hyperlink in the banner bar which will

open the allergies window

▪ Review the patient’s allergies and click Reverse allergy check

6. Navigate to the MAW

7. Scan patients ID wrist band (for today we don’t have a scanner)

a) If unable to scan wrist band select Next and enter an Override

reason

b) Click Yes

c) Place a tick in the box next to Glucose 5% and Sodium Chloride

0.9%

d) Left click the Result column to review the order information

1. Set the site to Peripheral Intravenous Cannula.

2. Enter witness: Yolo, Mary

3. Click Apply

4. Witness will be prompted to enter their password: train

5. Click ok, sign.

Modifying the rate of fluid order

The rate can be modified after a fluid has been commenced.

1. Navigate to the orders page; find the Sodium Chloride

maintenance fluid order.

2. Right click, select Modify

In the Details tab the *Duration unit and *Duration from now to

end point fields are now mandatory fields, select bag(s) and enter 1

successively

Important Note: A system requirement is that for any

modification to a Continuous IV infusion the duration unit and duration

from now to end-point must be completed as all IV orders must be 1 bag

at a time.

3. Click on Continuous Details tab, in the Rate field delete 75 and

enter 50

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Note: This is 2/3 maintenance fluid which must be calculated by the

prescriber

4. Click Orders for Signature, click Sign, enter password: train, click

OK.

5. Refresh the Orders page.

6. Navigate to the MAR, Refresh and review the order details

7. Navigate to the Fluid Balance Band of Interactive View

Note: This will also display fluids infused in the Operating Theatre

Important Note: It is best practice to utilise medication orders

with prebuilt order sentences (i.e. additives already added to base

solutions). However, you can also add an additive to a base solution if an

order sentence does not exist/or match your requirements. Below is an

example of manually adding an additive to a base solution

Order fluids with an Additive

It is best practice to utilise medication orders with prebuilt order

sentences (i.e. additives already added to base solutions). However,

you can also add an additive to a base solution if an order sentence

does not exist/or match your requirements. Below is an example of

manually adding an additive to a base solution

We are now going to order a fluid with a Sodium Bicarbonate Additive:

1. From the Orders page, Click Add+ 2. Search for 0.9 gluc and select Glucose 5% with 0.9% Sodium

Chloride intravenous infusion (mL/hr, 1,000 mL, IV continuous infusion, order duration: 1 dose(s))

3. Click Done

4. In the continuous details tab click the Additive button 5. Search and select Sodium Bicarbonate additive 6. Click Done 7. In the Additive dose field type 60mmol 8. Click Rate field and enter 127 mL/hr (this is a hyper-hydration rate

that has been calculated using BSA) 9. The Infuse Over field will auto populate when you click out of Rate

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10. Click into the Details Tab

Note: Viewing the Details Tab is the only way to determine if an infusion is truly continuous, or if the order has a duration.

If a second or third bag is required, you will need to create a fluid

sequence.

11. Sign order

Creating a Sequence of Fluid Orders

Creating a fluid sequence order is the easiest way to chart a series of

fluid orders to run successively. For example, a patient requires fluid

rehydration – 3 bags to run one after another. To preview this, we will

order the NAC Infusion Sequence

1. Navigate to the Orders page of the patient chart.

2. Click Add+

3. In the Enter name to create sequence field, enter NAC Infusion

Sequence and then press Enter.

4. The lower half of the screen has updated with the name of your

pending sequence.

5. Within the search field type acetylc 5 and add the following orders:

a) Acetylcysteine IV three phase protocol: Infusion 1 (60 min

bag) (continuous) Paediatric 20-50kg

b) Acetylcysteine IV three phase protocol: Infusion 2 (4 hr bag)

(continuous) Paediatric 20-50kg

c) Acetylcysteine IV three phase protocol: Infusion 3 (16 hr

bag) (continuous) Paediatric 20-50kg

6. The orders are now displayed below the sequence name. The

order in which these will be administered can be changed by

clicking the up/down arrows. Orders can be removed by using the

icon. More fluids can be added if required.

7. Click Create Sequence

8. This will launch the dose calculator for each individual bag

9. Select Apply Dose for each of the 3 bags

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10. Click Done

Important Note: It is important to remember that there is no

duration specified in the Details tab, and that the duration is NOT a

mandatory field, this is because the infusion is a true continuous infusion

11. Click Sign, enter password: train, click OK and Refresh.

12. The completed IV continuous infusion orders are displayed,

including the Fluid sequence. To view the fluid orders in the

Manage Infusions screen, click the Manage Infusions tab on the

Orders screen. Hover over Legend to view type.

10. Ordering Prescriptions Notes:

10

mins

Note: The following activity is to show the functionality of completing

the prescription generation fields for those of you the may work in

Outpatient Clinics. PLEASE NOTE: The correct workflow for creating

discharge prescriptions for inpatients will be done using the Discharge

Reconciliation functionality – this will be demonstrated in Core Two.

1. Navigate to Orders page, click Add+

2. Change the Type to Discharge prescription

3. Search trim sulf susp and select trimethoprim-sulfamethoxazole

40mg-200mg/5mL oral suspension 4mg/kg, Oral, TWICE a day

4. In the Dosage Calculator note the final dose is 138mg, the Standard

dose is 136mg

5. Click Apply Standard Dose, click Done

6. Check the Order Details as below:

a. Frequency: TWICE a day

b. Dispense: 1 bottle(s)

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c. Refill: 0 Note: repeats will always autofill to 0 for

discharge prescriptions but outpatient prescriptions will

default to the PBS quantity

d. Indication: UTI

e. PBS Status: PBS

f. Special instructions: Please give 17mls twice daily

g. Select: Select: Acute and select a stop date for 5 days in the

future

7. *Select Send To and choose More “Do Not Send” Reasons then Do

not send: other (There are no printers currently set up in the

training domain)

8. DO NOT sign at this time as we will continue to add further

discharge medications for the script

Prescribing Streamlined Authority PBS Medications

9. From the Orders page, click Add+

10. Search for Monte 5 night and select

Montelukast 5mg oral chewable tablet (1 tab(s), Oral, night,

tab(s))

11. In the OEF, click on PBS tab.

Important Note: If the medication that was being ordered

required a phone authority approval number, this padlock would be

closed. This indicates that the prescriber must obtain the approval

number and manually type it in to the mandatory field named “PBS

approval number”

12. Select the first streamlined PBS Listing

a. Asthma Treatment Phase: First-line prevention Clinical

criteria: *The condition must be frequent intermittent; OR

*The condition must be mild persistent, AND *The

treatment must be the single preventer agent, AND *The

treatment must be an alternative to sodium cromoglicate;

OR *The treatment must be an alternative to nedocromil

sodium. Population criteria: *Patient must be aged 6 to 14

years inclusive

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13. Click the Details tab, notice the Dispense field has prepopulated

with the PBS dispense amount

14. Enter the Indication to complete the order details. Click the

Indication field and enter: Asthma

15. *Select Send To and choose Do Not Send More reasons than Do


training domain)

Prescribing Phone Authority PBS Medications

1. Select Add+ to add the final discharge medication

2. Search for Rita 10 TWICE and select

Ritalin 10 mg oral IMMEDIATE release tablet 1 tab(s), Oral,

TWICE a day (morning and midday), tab(s) [Greater Than or

Equal To 6 year(s)]

3. In the OEF, click on PBS tab. Notice that the Listings now have a

closed padlock next to them, indicating that they are restricted and

require a Phone authority approval number. This PBS code will

need to be manually entered in the new mandatory section in the

Details tab

4. Select the first PBS Listing:

a. Attention deficit hyperactivity disorder Treatment must be in

accordance with the law of the relevant State or Territory

5. Click the Details tab, notice the Dispense field has prepopulated

with the PBS dispense amount

6. Complete the Order details as below:

a. Repeats field 1

b. Indication as ADHD

c. Is this a specified condition? Tick Yes

d. Repeat Interval as 40 days

e. PBS Status as PBS

f. PBS approval number: Z1234AA (Note this the phone

authority obtained by the prescriber, for training it is made up)

7. *Select Send To and choose More “Do Not Send” Reasons then Do


training domain)

8. Click Sign, enter password: train, click OK. Refresh the page to

update the information

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9. Navigate to Medication History to show documented prescription

Note: On any occasion that a reprint of a prescription is required, the

prescriber must destroy the original copy.

Practice Activity and Readiness Check

60

mins ▪ Complete Core 1 Confidence Check handout

core 1 (paediatric) participant guide · 5 mins 1. navigate to advance growth chart 2. click on...

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