Ignacio Valdes Implementation Log/Episode13
Ordering configuration
The Intracare Implementation Log Episode12 (Back to Log Homepage) Episode14
Contents
- 1 The Problem
- 2 First Answer, be sure to read the manual
- 3 This is the manual
- 4 DSM IV Axis I psychiatric diagnoses are in fact available
- 5 Try it out
- 6 Christen a new Domain
- 7 The bad news
- 8 Restore default ordering menus
- 9 Remove an ordering menu with the @ sign
- 10 Once again, RTFM
- 11 Nurses get ORES key
The Problem
Ignacio Valdes Date: Tue, 16 Sep 2008 16:38:42 -0500
Let the ordering configuration begin! This looks like it will be by far the most complicated part of all this.
I have uploaded to the files section a copy of our admission order form:
for RTF and
as .doc just in case.
What is the best way to proceed in getting this into ordering so that one does not have to go to multiple sub-headings to do a set of orders. I am aware of 'Order Sets' but not if they can be sub-selectable like for instance one does not normally enter urine pregnancy test on males.
The first part, Admitting diagnosis will be a DSM IV Axis I diagnosis. Inpatient, partial and outpatient are covered elsewhere so they are not an issue. I do not know what to do about 'Programs:' as that is a local bed control issue to be done.
So that leaves Precautions which should definitely be executable orders in effect for a certain period and possibly canceled after a period of time, for instance Suicide precautions. How/where should I add the different Precautions into ordering? Same with Restrictions.
When one enters a generic consult, how do consultantee's know that they are being consulted?
How does one 'bundle' Vital signs Pulse, Respriation, BP?
Probably many more questions to come...
-- IV
ivaldes Date: Wed, 17 Sep 2008 11:51:05 -0700 (PDT)
Seems like I am getting into little trodden territory. Is there a CAC manual for defining order sets? If so, can anyone furnish a link to the right manual? -- IV
First Answer, be sure to read the manual
Sam Habiel Date: Wed, 17 Sep 2008 19:41:46 -0700
Both the VA and IHS have good manuals on how to do this sort of thing, but you will fumble a little at the beginning.
Go to
- http://www.va.gov/vdl, look for CPRS, and look for the CPRS set-up
manual. Or
Here are the steps:
1.Admitting Diagnosis: (ICD in Encounter; DSM not available in CPRS)
2. Allergies: (Allergies Component)
Height: Weight: (vitals)
3. Admit to: ÿ Inpatient ÿ Partial Hospital Program ÿ
Intensive Outpatient Program
(Generic Order; part of an order set possibly)
4. Programs: ÿ PICU (Adult) ÿ Adolescent Program □ D.A.P.A.
ÿ Adult General Program ÿ Children's Program □ Other
______________________
(Generic Order etc.)
5. Precautions: ÿ Seizure ÿ Assault ÿ Fall ÿ Homicidal
ÿ Detox ÿ Elopement ÿ Suicide ÿ Other ____________________
ÿ Sexual Acting Out ÿ May go off unit to smoke with staff escort &
at staff discretion.
ÿ Unit restriction first 24 hours ÿ May go off unit for
recreation therapy
(Generic Order)
6. Restrictions: ÿ No Restriction of Telephone and/or Visitors.
ÿ Restriction of Telephone, Requires Clinical Justification:
ÿ Restriction of Visitors, Requires Clinical Justification:
ÿ Complete Personal/Body Search, Requires Clinical Justification
ÿ Search personal belongings and pat search, Requires Clinical
Justification
(Generic Order)
7. Vital Signs: ÿ Routine : Q 4 hours while awake X 24 hours
ÿ Other: ________________________________________________________________________________________
(Generic Order)
8. Diet: ÿ Regular ÿ Other:
_______________________________________________________________________
(Dietetics Order if you use the package; otherwise, Generic Order)
9. Lab: ÿ Routine Admit Panel (CMP, CBC, RPR,TSH, T4 FREE)
ÿ Urine Pregnancy Test ÿ UDS ÿ U/A
ÿ Other:
(Lab order)
10. Tuberculosis Screen: ÿ PPD (0.1cc intradermal) ÿ Chest X-Ray,
Clinical Justification:
(Text order or Radiology order)
11. Contract Physician or other: ______________________________ for:
________________
(notes; part of history)
ÿ History & Physical ÿ Other:
(notes; part of history)
12. Medications: Children Adults and Adolescents
ÿ Maalox 15cc p.o. q 4 h. prn indigestion ÿ Maalox 30cc p.o. q 4 h.
prn indigestion
ÿ Tylenol mg. p.o. q 4 h. prn headache/pain/temp ÿ Tylenol
650mg. p.o. q 4 h. prn headache/pain/temp
(pharmacy orders)
AGE
4-5 years
6-8 years
9-10 years
11 years
Weight
36-47 LB
48-59 LB
60-71 LB
72-95 LB
Tylenol
240 mg.
320 mg.
400 mg.
480 mg.
13. ÿ Psychosocial History
14. ÿ Individual Therapy ÿ Unit Staff ÿ Affiliate Staff (Name of
Affiliate Staff)
15. ÿ Family Therapy ÿ Unit Staff ÿ Affiliate Staff (Name of
Affiliate Staff)
16. ÿ Chemical Dependency Assessment
17. ÿ Recreation Therapy
(14-17: notes)
ÿ A.M. ÿ P.M.
DATE ORDERED TIME ORDERED
The way I would do it is as follows, assuming you have lab, pharmacy, and radiology running (if not, you will have to use generic orders).
Create individual generic orders for all your items. There's a steep learning curve, but you eventually get the hang of it. Create quick orders for labs, pharmacy, radiology
Create an order set, possibly several of them depending on the circumastances (e.g. males don't get hcg because... well... because...)
After ordering and signing, create a note template that will include the rest of the information, and that pulls in all orders automatically into the note text.
Your workflow may look like this:
- Initial evaluation note, saved, not signed.
- Vitals, Allergies, etc.
- Order Set.
- Complete note.
- Encounter information
Sam
This is the manual
ivaldes Date: Thu, 18 Sep 2008 10:23:59 -0700 (PDT)
Is this the right manual?
Sam Habiel Date: Thu, 18 Sep 2008 18:03:57 -0700
Yes.
DSM IV Axis I psychiatric diagnoses are in fact available
I, Valdes Date: Fri, 19 Sep 2008 09:30:43 -0700 (PDT)
FYI everyone, the Diagnosis dialog DOES have access to apparently all DSM IV Diagnostic and Statistic Manual of Mental Disorders Axis I, however, you have to go to the Other Diagnosis dialog and search for them. It looks good enough for what we do. The mental leap is that the default Psychiatric Diagnosis set has only very basic diagnosis but it seems that all or most with qualifiers ARE available through the Other Diagnosis search.
-- IV
I, Valdes Date: Thu, 25 Sep 2008 11:14:39 -0700 (PDT)
Try it out
Okay, I tried to put in some text orders into CPRS but when I try to save them as quick orders, it says that the text orders dialog box does not support quick orders. I looked at the CPRS manual setup it looks daunting. -- IV
I, Valdes Date: Thu, 25 Sep 2008 13:35:41 -0700 (PDT)
Is anyone willing to talk me through creating order sets by phone? If so, please contact me offline. -- IV
I, Valdes Date: Fri, 26 Sep 2008 11:45:14 -0700 (PDT)
I spoke to Sam today and we got through much of defining an order set. The full terminal session for this is below. However, the new order set menu did not show up because the system is not 'christened'? Per Sam, the menu below shows the problem which is that system is pointing at BETA.VISTA-OFFICE.ORG and not INTRACARE HOSPITAL INSTITUTION? He said to please post this to Hardhats on how to christen the system.
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpatient)
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [BETA.VISTA-OFFICE.ORG]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Full terminal session for creating an order set menu that consists of CBC, TSH and RPR:
Script started on Fri 26 Sep 2008 12:54:09 PM CDT
[vista@vista ~]$ gtm
GTM>S DUZ=60 D ^XUP
Setting up programmer environment
This is a TEST account.
Terminal Type set to: C-VT100
Select OPTION NAME: OR PARAM
1 OR PARAM ADD MENU Assign Primary Order Menu
2 OR PARAM CHART COPY Chart Copy Parameters
3 OR PARAM COORDINATOR MENU CPRS Configuration (Clin
Coord)
4 OR PARAM IRM MENU CPRS Configuration (IRM)
5 OR PARAM ORDER MISC Miscellaneous Parameters
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 3 OR PARAM COORDINATOR MENU CPRS Configuration (Clin
Coord)
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select CPRS Configuration (Clin Coord) Option: ?
AL Allocate OE/RR Security Keys
KK Check for Multiple Keys
DC Edit DC Reasons
GP GUI Parameters ...
GA GUI Access - Tabs, RPL
MI Miscellaneous Parameters
NO Notification Mgmt Menu ...
OC Order Checking Mgmt Menu ...
MM Order Menu Management ...
LI Patient List Mgmt Menu ...
FP Print Formats
PR Print/Report Parameters ...
RE Release/Cancel Delayed Orders
US Unsigned orders search
EX Set Unsigned Orders View on Exit
NA Search orders by Nature or Status
CM Care Management Menu ...
DO Event Delayed Orders Menu ...
PM Performance Monitor Report
Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select CPRS Configuration (Clin Coord) Option: MM Order Menu
Management
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option: ?
OI Manage orderable items ...
PM Enter/edit prompts
GO Enter/edit generic orders
QO Enter/edit quick orders
QU Edit personal quick orders by user
ST Enter/edit order sets
AC Enter/edit actions
MN Enter/edit order menus
AO Assign Primary Order Menu
CP Convert protocols
SR Search/replace components
LM List Primary Order Menus
DS Disable/Enable order dialogs
CS Review Quick Orders for Inactive ICD9 Codes
Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option: QO Enter/edit quick orders
Select QUICK ORDER NAME: LRZ CBC NOW
Are you adding 'LRZ CBC NOW' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: ?
Answer with DISPLAY GROUP NAME
Do you want the entire DISPLAY GROUP List? ?
TYPE OF QUICK ORDER: LAB LABORATORY
NAME: LRZ CBC NOW//
DISPLAY TEXT: CBC
VERIFY ORDER: N NO
DESCRIPTION:
No existing text
Edit? NO//
ENTRY ACTION:
Lab Test: CBC
1 CBC
2 CBC & MORPHOLOGY (NO DIFF)
3 CBC & MORPHOLOGY (WITH DIFF)
4 CBC PROFILE
CHOOSE 1-4: 1 CBC
This is just a test...
SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward. This method is limited to laboratory defined collection times.
SP Send patient to lab
WC Ward collect & deliver
LC Lab blood team
Collected By: LC Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD //
Collection Date/Time: N (SEP 26, 2008@13:00)
Urgency: Routine
How often: once 1600
-------------------------------------------------------------------------------
Lab Test: CBC
Collection Sample: BLOOD
Specimen: BLOOD
Collection Date/Time: NOW
Urgency: ROUTINE
How often: ONCE
-------------------------------------------------------------------------------
(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//
Select QUICK ORDER NAME: RPR
Are you adding 'RPR' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: lab LABORATORY
NAME: RPR//
DISPLAY TEXT: RPR
VERIFY ORDER: N NO
DESCRIPTION:
No existing text
Edit? NO//
ENTRY ACTION:
Lab Test: RPR
SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward. This method is limited to laboratory defined collection times.
SP Send patient to lab
WC Ward collect & deliver
LC Lab blood team
Collected By: LC Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD //
Collection Date/Time: N (SEP 26, 2008@13:02)
Urgency: Routine
How often: once 1600
-------------------------------------------------------------------------------
Lab Test: RPR
Collection Sample: BLOOD
Specimen: SERUM
Collection Date/Time: NOW
Urgency: ROUTINE
How often: ONCE
-------------------------------------------------------------------------------
(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//
Select QUICK ORDER NAME: TSH
Are you adding 'TSH' as a new ORDER DIALOG? No// Y (Yes)
TYPE OF QUICK ORDER: lab LABORATORY
NAME: TSH//
DISPLAY TEXT: TSH
VERIFY ORDER: N NO
DESCRIPTION:
No existing text
Edit? NO//
ENTRY ACTION:
Lab Test: TSH
The input value contains control characters.
Enter a lab test to be ordered for this patient.
Lab Test: rsh ??
Enter a lab test to be ordered for this patient.
Lab Test: tsh TSH
SEND TO LAB - Means the patient is ambulatory and will be sent to the
Laboratory draw room to have blood drawn.
WARD COLLECT - Means that either the physician or a nurse will be
collecting
the sample on the ward.
LAB BLOOD TEAM - Means the phlebotomist from Lab will draw the blood
on the
ward. This method is limited to laboratory defined collection times.
SP Send patient to lab
WC Ward collect & deliver
LC Lab blood team
Collected By: LC Lab blood team
There are no lab collection times defined!
Collected By:
Collection Sample: BLOOD //
Collection Date/Time: Now (SEP 26, 2008@13:03)
Urgency: Routine
How often:
-------------------------------------------------------------------------------
Lab Test: TSH
Collection Sample: BLOOD
Specimen: SERUM
Collection Date/Time: NOW
Urgency: ROUTINE
-------------------------------------------------------------------------------
(P)lace, (E)dit, or (C)ancel this quick order? PLACE//
Auto-accept this order? NO//
Select QUICK ORDER NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option: ST Enter/edit order sets
Select ORDER SET NAME: ORZ Routine Admit Panel
Are you adding 'ORZ Routine Admit Panel' as
a new ORDER DIALOG? No// Y (Yes)
Do you wish to copy an existing order set? YES// NO
NAME: ORZ Routine Admit Panel Replace
DISPLAY TEXT: Routine Admit Panel
DESCRIPTION:
No existing text
Edit? NO//
ENTRY ACTION:
EXIT ACTION:
Select COMPONENT SEQUENCE#: 10
SEQUENCE: 10//
ITEM: LRZ CBC NOW
Select COMPONENT SEQUENCE#: 20
SEQUENCE: 20//
ITEM: LRZ TSH??
Enter an order dialog; a dialog that is an ancestor may not also
be a
sub-item.
ITEM: TSH
Select COMPONENT SEQUENCE#: 30
SEQUENCE: 30//
ITEM: RPR
Select COMPONENT SEQUENCE#:
Select ORDER SET NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option: MN Enter/edit order menus
Select ORDER MENU: ?
Answer with ORDER DIALOG NAME
Do you want the entire ORDER DIALOG List? ??
You may enter a new ORDER DIALOG, if you wish
This is the name of the dialog; entries that were converted
from the
Protocol file will retain the same name. Namespacing is not
required,
but still encouraged.
Select ORDER MENU: ??
Choose from:
FHWMENU
GMRVORMENU
OR ADD MENU CLINICIAN
OR GMENU ACTIVITY ORDERS
OR GMENU ORDER SETS
OR GMENU OTHER ORDERS
OR GMENU PATIENT CARE ORDERS
OR GXMOVE PATIENT MOVEMENT
You may enter a new ORDER DIALOG, if you wish
This is the name of the dialog; entries that were converted
from the
Protocol file will retain the same name. Namespacing is not
required,
but still encouraged.
Select ORDER MENU: OR ADD MENU CLINICIAN
Menu Editor Sep 26, 2008@13:09:44 Page:
1 of 3
Menu: OR ADD MENU CLINICIAN Column
Width: 26
Sep 26, 2008@13:09:44
|0 ORDER SETS... 30 PATIENT CARE... 70 LABORATORY...
|1 Patient Movement 31 Condom Catheter 71 Chem 7
|2 Diagnosis 32 Guaiac Stools 72 T&S
|3 Condition 33 Incentive Spirometer 73 Glucose
+4 Allergies 34 Dressing Change 74 CBC w/Diff
| 75 PT
|10 PARAMETERS... 40 DIETETICS... 76 PTT
|11 TPR B/P 41 Regular Diet 77 CPK
|12 Weight 42 Tubefeeding 78 CPK
113 I & O 43 NPO at Midnight 79 LDH
|14 Call HO on 80 Urinalysis
| 50 IV FLUIDS... 81 Culture &
Suscept
|20 ACTIVITY... 51 OUTPATIENT MEDS...
|21 Ad Lib 55 INPATIENT MEDS... 90 OTHER
ORDERS...
+23 Bed Rest / BRP 91 EKG: Portable
|24 Ambulate TID 60 IMAGING ...
|25 Up in Chair TID 61 Chest 2 views PA&LAT 99 Text Only
Order
+ + Next Screen - Prev Screen ?? More
Actions >>>
EXIT is not a valid selection.
Select Action: Next Screen// q Q
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select CPRS Configuration (Clin Coord) Option:
Do you really want to halt? YES//
Logged out at Sep 26, 2008 1:12 pm
GTM>
GTM>S DUZ=60 D ^XUP
Setting up programmer environment
This is a TEST account.
Terminal Type set to: C-VT100
Select OPTION NAME: XPAR MENU TOOLS General Parameter Tools
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: LV List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpatient)
Values for ORWOR WRITE ORDERS LIST
Parameter Instance Value
----------------------------------------------------------------------------
PKG: ORDER ENTRY/RESULTS REPOR 20 GMRAOR ALLERGY
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55 PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60 LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70 RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80 GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85 GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90 GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99 OR GXTEXT WORD
PROCESSING OR
Enter RETURN to continue or '^' to exit: EP
Enter either RETURN or '^'.
Enter RETURN to continue or '^' to exit:
Enter either RETURN or '^'.
Enter RETURN to continue or '^' to exit: ^
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: EP Edit Parameter Values
--- Edit Parameter Values ---
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpatient)
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [BETA.VISTA-OFFICE.ORG]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection: 2.7 Division INTRACARE HOSPITAL INSTITUTION
Setting ORWOR WRITE ORDERS LIST for Division: INTRACARE HOSPITAL
INSTITUTION
Select Sequence: 10
Are you adding 10 as a new Sequence? Yes// YES
Sequence: 10// 10
Order Dialog: ?
Answer with ORDER DIALOG NAME, or DISPLAY TEXT
Do you want the entire ORDER DIALOG List? Y (Yes)
Choose from:
1300
FHW OP MEAL
FHW SPECIAL MEAL
FHW1
FHW2
FHW3
FHW4
FHW7
FHW8
FHWMENU
FHWN1
FHWN2
GMRCOR CONSULT
GMRCOR REQUEST
GMRCR NEUROLOGY INPATIENT
GMRVOR
GMRVORADMIT V/M
GMRVORB/P
GMRVORHT
GMRVORMENU
'^' TO STOP:
GMRVORPULSE
GMRVORRESP
GMRVORTEMP
GMRVORTPR
GMRVORTPR B/P
GMRVORWT
IRON
LR OTHER LAB TESTS
LRTZ GLUCOSE SERUM SP TODAY
LRZ CBC NOW
LRZ HEMOGLOBIN AIC
LRZ HGB TODAY
LRZ LIPID PROFILE
LRZ MICROALBUMIN
LRZ OCCULT BLOOD
LRZ PLATELET TODAY
LRZ PT/PTT TODAY
LRZ WBC TODAY
NUTRITION
Neurology Inpatient
OR ADD MENU CLINICIAN
OR GMENU ACTIVITY ORDERS
'^' TO STOP:
OR GMENU ORDER SETS
OR GMENU OTHER ORDERS
OR GMENU PATIENT CARE ORDERS
OR GWCOND CONDITION
OR GWDIAG DIAGNOSIS
OR GWINST DNR
OR GXACTV AD LIB
OR GXACTV AMBULATE
OR GXACTV AMBULATE TID
OR GXACTV BATHROOM PRIVILEGES
OR GXACTV BED REST
OR GXACTV BED REST / BRP
OR GXACTV HOB UP
OR GXACTV MAY LEAVE WARD
OR GXACTV OTHER ACTIVITY ORDER
OR GXACTV OUT OF BED
OR GXACTV PROVIDE TRAPEZE
OR GXACTV ROM EXERCISE
OR GXACTV TURN PATIENT
OR GXACTV UP IN CHAIR
OR GXACTV UP IN CHAIR TID
OR GXHEMO ARTERIAL LINE
'^' TO STOP:
OR GXHEMO ARTERIAL SHEATH
OR GXHEMO CARDIAC OUTPUT
OR GXHEMO HEMODYNAMICS ITEM
OR GXHEMO SWAN GANZ CATHETER
OR GXHEMO VENOUS SHEATH
OR GXMISC GENERAL
OR GXMOVE ADMIT PATIENT
OR GXMOVE DISCHARGE
OR GXMOVE EVENT
OR GXMOVE PATIENT MOVEMENT
OR GXMOVE TRANSFER
OR GXMOVE TREATING SPECIALTY
OR GXNURS CHEST TUBE
OR GXNURS GLASCOW COMA
OR GXNURS GUAIAC ASPIRATE
OR GXNURS GUAIAC EMESIS
OR GXNURS GUAIAC STOOLS
OR GXNURS NEURO CHECK
OR GXNURS NURSING ITEM
OR GXNURS PUSH FLUIDS
OR GXNURS URINE PH
OR GXNURS URINE SPEC GRAV
'^' TO STOP:
OR GXOXGN MASK 35 PER CENT
OR GXOXGN MASK 40 PER CENT
OR GXOXGN MASK 50 PER CENT
OR GXOXGN O2 3 LT NASAL CANNUL
OR GXOXGN O2 4 LT NASAL CANNUL
OR GXOXGN OXYGEN THERAPY ITEM
OR GXOXGN VENTILATOR
OR GXPARM CALL HO ON
OR GXPARM I AND O
OR GXRESP CHEST PT
OR GXRESP INCENTIVE SPIROMETER
OR GXRESP RESPIRATORY ITEM
OR GXRESP SUCTION
OR GXRESP TCDB
OR GXRESP TRACH CARE
OR GXSKIN AIR MATTRESS
OR GXSKIN COLD PACKS
OR GXSKIN DRESSING CHANGE
OR GXSKIN SHEEPSKIN
OR GXSKIN SKIN AND WOUND ITEM
OR GXSKIN WARM PACKS
OR GXSKIN WARM SOAKS
'^' TO STOP: ^
Select Sequence:
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [BETA.VISTA-OFFICE.ORG]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection:
-------------------------------------------------------------------------------
Select PARAMETER DEFINITION NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option:
Do you really want to halt? YES//
Logged out at Sep 26, 2008 1:17 pm
GTM>
GTM>S DUZ=60 D ^XUP
Setting up programmer environment
This is a TEST account.
Terminal Type set to: C-VT100
Select OPTION NAME: OR PARAM
1 OR PARAM ADD MENU Assign Primary Order Menu
2 OR PARAM CHART COPY Chart Copy Parameters
3 OR PARAM COORDINATOR MENU CPRS Configuration (Clin
Coord)
4 OR PARAM IRM MENU CPRS Configuration (IRM)
5 OR PARAM ORDER MISC Miscellaneous Parameters
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 3 OR PARAM COORDINATOR MENU CPRS Configuration (Clin
Coord)
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select CPRS Configuration (Clin Coord) Option: MM Order Menu
Management
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option: MN Enter/edit order menus
Select ORDER MENU: OR ADD MENU CLINICIAN
Menu Editor Sep 26, 2008@13:18:27 Page:
1 of 3
Menu: OR ADD MENU CLINICIAN Column
Width: 26
Sep 26, 2008@13:18:59
2
|0 ORDER SETS... 30 PATIENT CARE... 70 LABORATORY...
+1 Patient Movement 31 Condom Catheter 71 Chem 7
|
|
+
|
|
|
|
3
|
|
|
|
+ + Next Screen - Prev Screen ?? More
Actions >>>
Menu Items Text or Header Row
Add: Menu Menu Items
ITEM: ORZ Routine Admit Panel
ROW: 20
COLUMN: 1
DISPLAY TEXT:
MNEMONIC:
ITEM:
Rebuilding menu display ...
Menu Editor Sep 26, 2008@13:20:11 Page:
2 of 3
Menu: OR ADD MENU CLINICIAN Column
Width: 26
Sep 26, 2008@13:23:07
3
|
|
4
|
|
|
|
+
|
|
|
|
5
|
+ Next Screen - Prev Screen ?? More
Actions >>>
Select Action: Quit// QUIT
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select Order Menu Management Option:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select CPRS Configuration (Clin Coord) Option:
Do you really want to halt? YES//
Logged out at Sep 26, 2008 1:23 pm
GTM>h
[vista@vista ~]$ exit
exit
Script done on Fri 26 Sep 2008 01:23:20 PM CDT
[vista@vista ~]$
Christen a new Domain
Sam Habiel Date: Fri, 26 Sep 2008 19:26:50 -0700
I.e. A domain was not created and/or was not pointing to the right institution.
Sam
I, Valdes Date: Tue, 30 Sep 2008 09:46:56 -0700 (PDT)
Can anyone please guide me as how to rectify this problem? -- IV
Nancy Anthracite Date: Tue, 30 Sep 2008 14:00:29 -0400
See http://www.hardhats.org/projects/VistA_Install/Vista_Install.html Step 41 or the wiki
I, Valdes Date: Tue, 30 Sep 2008 14:22:25 -0700 (PDT)
I did steps 41-48 and it worked somehow. However, I had to go back and re-constitute the Routine Admit Panel menu as it did not recognize it immediately then I restarted CPRS and it appeared. An un-wanted side effect is that all of the default Order menu items like labs and such disappeared. Sam says I will have to re-constitute all of that myself unless there is another way to get them back along with the menu I just created?
-- IV
The bad news
Sam Habiel Date: Thu, 2 Oct 2008 17:01:40 -0700
"Sam says I will have to re-constitute all of that myself unless there is another way to get them back along with the menu I just created?"
Sorry to break the bad news to you: the fact is sites take at least 6 months to get ready for EHR, and a lot of that time (at least 2 months FTE) gets spent on configuring the pharmacy package, the lab package, the radiology package, creating all the quick orders, the menus, hanging the quick orders on the menus, hanging the menus on CRPS, configuring note titles, configuring allergy tracking, configuring consults and list goes on... To speak nothing of creating TIU Templates, which takes forever depending on how many templates you want to create.
Sam
I, Valdes Date: Fri, 3 Oct 2008 06:43:02 -0700 (PDT)
That's about what I expected, however, I'm still trying to understand why creating a single order set made all the useful default WorldVistA ordering menus disappear? -- IV
Sam Habiel Date: Fri, 3 Oct 2008 11:52:57 -0700
It's done so that you can customize the ordering by division, service, user class etc. Once you set a list at a lower level, it overrides what is set at a higher level. Initially, this didn't work because you didn't have your system set up correctly.
To reconstitute the list, look at orwor write orders list for system, and copy the menus that you see. It should less than take 5 minutes.
Sam
I, Valdes Date: Fri, 10 Oct 2008 09:44:51 -0700 (PDT)
So here is the terminal session done with Sam Habiel for how one brings back the default WorldVistA ordering menus after adding a custom order set. I miskeyed a few things such as XBAR instead of XPAR so just note and probably ignore the mistakes I made. This also shows how to change the order such as adding an inpatient medication item. You do the following, then restart CPRS and the menus are all back. I will show in the next note how to remove the inpatient medication list that I have as sequence 5 using the apparently commonly used @
[vista@vista ~]$ gtm
GTM>S DUZ=60 D ^XUP
Setting up programmer environment
This is a TEST account.
Terminal Type set to: C-VT100
Select OPTION NAME: XBAR MENU TOOLS ??
Select OPTION NAME: XBAR MENU TOOLS ??
Select OPTION NAME: XBAR ??
Select OPTION NAME: XPAR MENU TOOLS General Parameter Tools
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ORWOR WRITE ORDERS LIST ??
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: LV List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpa
tient)
Values for ORWOR WRITE ORDERS LIST
Parameter Instance Value
----------------------------------------------------------------------------
SYS: VISTA.ICH.LOCAL 10 ORZ Routine Admit
Panel
PKG: ORDER ENTRY/RESULTS REPOR 20 GMRAOR ALLERGY
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55 PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60 LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70 RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80 GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85 GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90 GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99 OR GXTEXT WORD
PROCESSING OR
Enter RETURN to continue or '^' to exit:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: EDIT
1 Edit Parameter Definition Keyword
2 Edit Parameter Values
3 Edit Parameter Values with Template
CHOOSE 1-3: 2 Edit Parameter Values
--- Edit Parameter Values ---
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpatient)
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection: 3 System VISTA.ICH.LOCAL
-------- Setting ORWOR WRITE ORDERS LIST for System: VISTA.ICH.LOCAL
--------
Select Sequence: ?
Sequence Value
-------- -----
10 ORZ Routine Admit Panel
Select Sequence: 20
Are you adding 20 as a new Sequence? Yes// YES
Sequence: 20// 20
Order Dialog: PSO OERR
Select Sequence: 30
Are you adding 30 as a new Sequence? Yes// YES
Sequence: 30// 30
Order Dialog: LR OTHER LAB TESTS
Select Sequence: 40
Are you adding 40 as a new Sequence? Yes// YES
Sequence: 40// 40
Order Dialog: GMRAOR ALLERGY ENTER/EDIT ??
Order Dialog: GMRAOR ALLERGY
The input value contains control characters.
Order Dialog: GMRAOR ALLERGY ??
Order Dialog: GMRAOR ??
Order Dialog: GMRAOR ??
Order Dialog: RA OERR EXAM
Select Sequence: 50
Are you adding 50 as a new Sequence? Yes// YES
Sequence: 50// 50
Order Dialog: GMRCOR CONSULT
Select Sequence: 60
Are you adding 60 as a new Sequence? Yes// YES
Sequence: 60// 60
Order Dialog: GMRCOR REQUEST
Select Sequence: 70
Are you adding 70 as a new Sequence? Yes// YES
Sequence: 70// 70
Order Dialog: GMRVOR
1 GMRVOR
2 GMRVORADMIT V/M
3 GMRVORB/P
4 GMRVORHT
5 GMRVORMENU
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 1 GMRVOR
Select Sequence: 80
Are you adding 80 as a new Sequence? Yes// YES
Sequence: 80// 80
Order Dialog: OR GTEXT WORD PROCESSING ??
Order Dialog: OR GXTEXT
1 OR GXTEXT TEXT ONLY ORDER
2 OR GXTEXT WORD PROCESSING ORDER
CHOOSE 1-2: 2 OR GXTEXT WORD PROCESSING ORDER
Select Sequence:
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection:
-------------------------------------------------------------------------------
Select PARAMETER DEFINITION NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ORWOR WRITE ORDERS ??
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ORWOR ??
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: LV List Values for a Selected
Parameter
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpa
tient)
Values for ORWOR WRITE ORDERS LIST
Parameter Instance Value
----------------------------------------------------------------------------
SYS: VISTA.ICH.LOCAL 10 ORZ Routine Admit
Panel
SYS: VISTA.ICH.LOCAL 20 PSO OERR
SYS: VISTA.ICH.LOCAL 30 LR OTHER LAB TESTS
SYS: VISTA.ICH.LOCAL 40 RA OERR EXAM
SYS: VISTA.ICH.LOCAL 50 GMRCOR CONSULT
SYS: VISTA.ICH.LOCAL 60 GMRCOR REQUEST
SYS: VISTA.ICH.LOCAL 70 GMRVOR
SYS: VISTA.ICH.LOCAL 80 OR GXTEXT WORD
PROCESSING OR
PKG: ORDER ENTRY/RESULTS REPOR 20 GMRAOR ALLERGY
ENTER/EDIT
PKG: ORDER ENTRY/RESULTS REPOR 55 PSO OERR
PKG: ORDER ENTRY/RESULTS REPOR 60 LR OTHER LAB TESTS
PKG: ORDER ENTRY/RESULTS REPOR 70 RA OERR EXAM
PKG: ORDER ENTRY/RESULTS REPOR 80 GMRCOR CONSULT
PKG: ORDER ENTRY/RESULTS REPOR 85 GMRCOR REQUEST
PKG: ORDER ENTRY/RESULTS REPOR 90 GMRVOR
PKG: ORDER ENTRY/RESULTS REPOR 99 OR GXTEXT WORD
PROCESSING OR
Enter RETURN to continue or '^' to exit:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ?
LV List Values for a Selected Parameter
LE List Values for a Selected Entity
LP List Values for a Selected Package
LT List Values for a Selected Template
EP Edit Parameter Values
ET Edit Parameter Values with Template
EK Edit Parameter Definition Keyword
Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: EP Edit Parameter Values
--- Edit Parameter Values ---
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST The input
valu
e contains control characters.
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpa
tient)
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection: 3 System VISTA.ICH.LOCAL
-------- Setting ORWOR WRITE ORDERS LIST for System: VISTA.ICH.LOCAL
--------
Select Sequence: 5
Are you adding 5 as a new Sequence? Yes// YES
Sequence: 5// 5
Order Dialog: PSJ
1 PSJ OR PAT OE
2 PSJI OR PAT FLUID OE
3 PSJQ1 EPINEPHRINE
4 PSJZ AMINOPN 1GM
CHOOSE 1-4: 1 PSJ OR PAT OE
Select Sequence:
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection:
-------------------------------------------------------------------------------
Select PARAMETER DEFINITION NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option:
Do you really want to halt? YES//
Logged out at Oct 10, 2008 11:30 am
GTM>h
I, Valdes Date: Fri, 10 Oct 2008 09:46:40 -0700 (PDT)
Here is how you remove a ordering menu item with use of the @ sign. Pretty simple. Please ignore the few times I went off into the weeds. -- IV
[vista@vista ~]$ gtm
GTM>S DUZ=60 D ^XUP
Setting up programmer environment
This is a TEST account.
Terminal Type set to: C-VT100
Select OPTION NAME: XPAR
1 XPAR EDIT BY TEMPLATE Edit Parameter Values with
Template
2 XPAR EDIT KEYWORD Edit Parameter Definition Keyword
3 XPAR EDIT PARAMETER Edit Parameter Values
4 XPAR LIST BY ENTITY List Values for a Selected Entity
5 XPAR LIST BY PACKAGE List Values for a Selected Package
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: ^
Select OPTION NAME: XPAR MENU TOOLS General Parameter Tools
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ?
LV List Values for a Selected Parameter
LE List Values for a Selected Entity
LP List Values for a Selected Package
LT List Values for a Selected Template
EP Edit Parameter Values
ET Edit Parameter Values with TemplateSelect PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Writ
EK Edit Parameter Definition Keyword
Enter ?? for more options, ??? for brief descriptions, ?OPTION for
help text.
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option: ED
1 Edit Parameter Definition Keyword
2 Edit Parameter Values
3 Edit Parameter Values with Template
CHOOSE 1-3: 2 Edit Parameter Values
--- Edit Parameter Values ---
Select PARAMETER DEFINITION NAME: ??
Choose from:
ANRV GUI VERSION Active ANRV Executable
BPS USRSCR Display claims for ONE or ALL users
DENTV CPT QUICK LIST
DENTV CVISION CVision Setup Parameters
DENTV DATE RANGE Dental Date Range Parameter
DENTV DRM ADMINISTRATOR
DENTV DRM BOILERPLATE PROMPT
DENTV DRM DAS TURNOFF Turn off sending data to DAS (file 221)
DENTV DRM DEF ENC TAB
DENTV DRM DEF STARTUP TAB Default DRM Startup Tab
DENTV DRM DEF TEMP FOLDER Temporary Folder Location for PC
DENTV DRM DEF TX TAB Default treatment tab display
DENTV DRM DIVISION
DENTV DRM EXCEL EXTRACT
DENTV DRM EXTRACT FOLDER Default history extract folder
DENTV DRM EXTRACT IP
DENTV DRM EXTRACT PORT
DENTV DRM EXTRACT SERVER Excel Extract Server Name
DENTV DRM NOTE WIDTH Progress note wordwrap width
DENTV DRM USER CHAR ACCESS
DENTV ICD9 QUICK LIST
DENTV PAGE SETUP Printing Page Setup Param
DENTV TP CODE BOILERPLATE CODE BOILERPLATE (COMPREHENSIVE
EXAM)
DENTV TP DX PROMPT USER OPTION TO ADD DX TO PLANNED ITEMS
DENTV TP NOTE OBJECTS DRM TREATMENT SYSTEM NOTE DATA OBJECTS
DENTV TP NOTE SEQUENCE NOTE SEQUENCE
DENTV TP TREEVIEW DEFAULT DEFAULT TREEVIEW DISPLAY
DENTV TX CODELINKS Treatment Planning Personal Code Links
DENTV TX HNPRESETS Common Head & Neck Findings
DENTV TX SPEEDCODES Tretment Planning Personal Speed Codes
DG PT DIRECTORY CALL CENTER Enable Patient Directory Call
Center
DGMT MAPR 0 DEPENDENTS Max. Ann. Rate - 0 Dependents
DGMT MAPR 1 DEPENDENTS Max. Ann. Rate - 1 Dependents
DGMT MAPR GLOBAL RATE Allowable Medical Expense Rates
DGMT MAPR N DEPENDENTS Max. Ann. Rate - 1+n Dependents
DGPF QUERY TRY LIMIT Patient Record Flags Query Try Limit
DGQE VIC REQUEST EXPIRATION VIC Request Expiration
DGQE VIC REQUEST PURGE VIC Request Purge
DGRR PL GENDER Gender
DGRR PL MAX NUM PATIENTS RET Maximum Number of Patients
Returned
DGRR PL NUM PATIENTS PER PAGE Number of Patients per Page
^
Select PARAMETER DEFINITION NAME: EP ??
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDER LISTS ??
Select PARAMETER DEFINITION NAME: ORWOR WRITE ORDERS LIST Write
Orders (Inpa
tient)
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection: 3 System VISTA.ICH.LOCAL
-------- Setting ORWOR WRITE ORDERS LIST for System: VISTA.ICH.LOCAL
--------
Select Sequence: 5
Sequence: 5// @ ...deleted
ORWOR WRITE ORDERS LIST may be set for the following:
1 User USR [choose from NEW PERSON]
2 Location LOC [choose from HOSPITAL LOCATION]
2.3 Service SRV [choose from SERVICE/SECTION]
2.7 Division DIV [INTRACARE HOSPITAL INSTITUTION]
3 System SYS [VISTA.ICH.LOCAL]
4 Package PKG [ORDER ENTRY/RESULTS REPORTING]
Enter selection:
-------------------------------------------------------------------------------
Select PARAMETER DEFINITION NAME:
You have PENDING ALERTS
Enter "VA to jump to VIEW ALERTS option
Select General Parameter Tools Option:
Do you really want to halt? YES//
Logged out at Oct 10, 2008 11:36 am
GTM>h
Woodhouse Gregory Date: Fri, 10 Oct 2008 10:26:12 -0700
On Oct 10, 2008, at 9:44 AM, I, Valdes wrote:
> Select OPTION NAME: XBAR MENU TOOLS ??
So, you're a traditional Chomskian at heart? (Look up "X bar theory" in linguistics.)
I, Valdes Date: Fri, 10 Oct 2008 11:13:30 -0700 (PDT)
I'd say I am an accidential Chomskian but it is a good read on wikipedia. It answers the eternal question as to why o why I had to do all of that sentence diagramming in grade and high school. -- IV
Once again, RTFM
I, Valdes Date: Mon, 1 Dec 2008 13:01:11 -0800 (PST)
Sam is there any particular vdl or other document for setting up order sets and pharmacy? -- IV
Sam Habiel Date: Mon, 1 Dec 2008 14:20:53 -0800
http://www.va.gov/vdl/documents/Clinical/Comp_Patient_Recrd_Sys_(CPRS)/cprssetup.pdf
You need to read this manual from the first page to the end. It's the bible.
Sam
Nurses get ORES key
I, Valdes Date: Wed, 3 Dec 2008 13:37:14 -0800 (PST)
The default Nurse ID's in WVEHR have security key ORES vs ORELSE. The nurses in admissions frequently take orders by phone (especially late night) from the physicians and sign them on behalf of the physician which the physician then signs later. Is ORES what they should have in this situation?
Per CPRSsetup guide:
ORES • Assigned to users authorized to write and sign orders. • Typically assigned to licensed physician. • Allows holders to electronically sign orders. ORELSE • Assigned to users authorized to release physician’s orders. • Typically assigned to RN’s. OREMAS • Assigned to users authorized to release patient orders as signed on chart. • Typically assigned to Ward Clerks.
-- IV
David Whitten Date: Wed, 3 Dec 2008 18:03:50 -0600
I suspect it depends on the practice at the site. If you expect the nurses in admissions to write and sign orders, then you need to give them ORES. I did a search through the code and found that there are two PROTOCOLs which specify actions for the separate keys:
They look mostly alike, the ORELSE protocol has ORC VERIFY MENU and ORC ALERT RESULTS whereas the ORES one doesn't.
I expect that CPRS can be used to enforce whatever policy your site has.
Best Regards, David
Select OPTION: INQUIRE TO FILE ENTRIES
OUTPUT FROM WHAT FILE: 101 PROTOCOL
Select PROTOCOL NAME: ORC ORES ORDER ACTIONS Order action menu for
ORES key holders
ANOTHER ONE: ORC ORELSE ORDER ACTIONS Order action menu for ORELSE key
holders
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// BOTH Computed Fields and Record
Number (IEN)
NAME: ORC ORES ORDER ACTIONS
ITEM TEXT: Order action menu for ORES key holders
TYPE: menu
COLUMN WIDTH: 20 MNEMONIC WIDTH: 2
ITEM: ORC CHANGE ORDERS SEQUENCE: 11
ITEM: ORC RENEW ORDERS SEQUENCE: 12
ITEM: ORC SIGN ORDERS SEQUENCE: 21
ITEM: ORC WARD COMMENTS SEQUENCE: 34
ITEM: ORC DETAILED DISPLAY SEQUENCE: 41
ITEM: ORC DISCONTINUE ORDERS SEQUENCE: 14
ITEM: ORC HOLD ORDERS SEQUENCE: 23
ITEM: ORC FLAG ORDERS SEQUENCE: 32
ITEM: ORC PRINT ORDERS SEQUENCE: 44
ITEM: ORC UNHOLD ORDERS SEQUENCE: 24
ITEM: ORC UNFLAG ORDERS SEQUENCE: 33
ITEM: ORC ALERT RESULTS SEQUENCE: 43
ITEM: ORC COMPLETE ORDERS SEQUENCE: 22
ITEM: ORC DELAY EVENT SEQUENCE: 31
ITEM: ORC REWRITE ORDERS SEQUENCE: 13
ITEM: ORC RESULTS DISPLAY SEQUENCE: 42
EXIT ACTION: D DESELECT^ORCHART(ORNMBR):'$G(OREBUILD)
ENTRY ACTION: S XQORM(0)="1AD\",(XQORM("?"),XQORM("??"))="D
ITEMHELP^ORCHART",
VALMBCK="",ORNMBR=$P(XQORNOD(0),"=",2) D SELECT^ORCHART(ORNMBR)
HEADER: W "" MENU PROMPT: Select Action:
NAME: ORC ORELSE ORDER ACTIONS
ITEM TEXT: Order action menu for ORELSE key holders
TYPE: menu
COLUMN WIDTH: 20 MNEMONIC WIDTH: 2
ITEM: ORC CHANGE ORDERS SEQUENCE: 11
ITEM: ORC RENEW ORDERS SEQUENCE: 12
ITEM: ORC SIGN ORDERS SEQUENCE: 21
DISPLAY NAME: Sign/On Chart
ITEM: ORC WARD COMMENTS SEQUENCE: 34
ITEM: ORC DETAILED DISPLAY SEQUENCE: 42
ITEM: ORC DISCONTINUE ORDERS SEQUENCE: 14
ITEM: ORC VERIFY MENU SEQUENCE: 31
ITEM: ORC HOLD ORDERS SEQUENCE: 23
ITEM: ORC FLAG ORDERS SEQUENCE: 32
ITEM: ORC PRINT ORDERS SEQUENCE: 44
ITEM: ORC UNHOLD ORDERS SEQUENCE: 24
ITEM: ORC UNFLAG ORDERS SEQUENCE: 33
ITEM: ORC COMPLETE ORDERS SEQUENCE: 22
ITEM: ORC DELAY EVENT SEQUENCE: 41
ITEM: ORC REWRITE ORDERS SEQUENCE: 13
ITEM: ORC RESULTS DISPLAY SEQUENCE: 43
EXIT ACTION: D DESELECT^ORCHART(ORNMBR):'$G(OREBUILD)
ENTRY ACTION: S XQORM(0)="1AD\",(XQORM("?"),XQORM("??"))="D
ITEMHELP^ORCHART",
VALMBCK="",ORNMBR=$P(XQORNOD(0),"=",2) D SELECT^ORCHART(ORNMBR)
HEADER: W "" MENU PROMPT: Select Action:
Nancy Anthracite Date: Wed, 03 Dec 2008 20:32:33 -0500
In the VA, as I understand it, the nurses can write nursing orders and they can take verbal orders that later need to be signed. They do not get the ORES key.
Nancy Anthracite Date: Wed, 03 Dec 2008 20:34:13 -0500
Except Nurse Practitioners do get ORES. -- Nancy Anthracite Episode12 Log Homepage Episode14
