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The General Settings section contains the Clinical Monitoring options for nursing in Order Entry.

 

 

Select Web Client > Tables > Clinical > Nursing category > Clinical Monitoring > General Settings

 

General Settings - Nursing Clinical Monitoring Options

 

 

•Use Clinical Monitoring: Activates Clinical Monitoring for nursing medication order entry. This field is grayed out but always checked "yes," since some Clinical Monitoring checks are required for Promoting Interoperability.

 

•Allergy Checking: Allows the system to automatically perform allergy checks at the time of order entry. Whenever a medication is entered for a patient, the system compares the new medication to any drug allergy entered on the patient through the TruBridge EHR. If there are any drug allergies documented that correspond to the medication selected, a menu will display showing the drug selected, the allergy, the drug class and any possible symptoms. This field is grayed out but always checked "yes," since this Clinical Monitoring check is required for Promoting Interoperability.

 

•Drug Interaction Checking: Allows the system to automatically perform drug interaction checks at the time of order entry. Whenever a medication is entered for a patient, the system compares the new medication to all medications the patient is currently taking or has taken within the last 24 hours. Any possible interactions will display. The drug interactions are ranked as contraindicated, major, moderate, or minor. This field is grayed out but always checked "yes," since this Clinical Monitoring check is required for Promoting Interoperability.

 

•Duplicate Therapy Checking: Select the check box to allow the system to automatically perform duplicate therapy checks at the time of order entry.  As soon as the medication is selected, the patient's current orders are reviewed for duplicate therapy. Duplicate Therapy Checking is based on the NDC number, which is entered on the Pharmacy Information screen for each medication.

 

•Food Interaction Checking: Select the check box to allow the system to automatically perform food interaction checks at the time of order entry. If a medication that has an interaction to food is selected, the Clinical Monitoring screen displays. A monograph may then be printed or displayed. To auto-print food interactions select Autoprint. If the patient is in a room, the report will print to the default nursing station printer. Enter a printer number in the field labeled Autoprint Printer for Patients Not In A Room if this report will be utilized for patients not registered in a room.

 

•Disease Interaction Checking: Select the check box to allow the system to automatically perform disease interaction checking at the time of order entry. Whenever a medication is entered for a patient, the system compares the new medication to the diagnosis for the patient to ensure the drug does not interfere with the diagnosis. It will also provide a drug/drug screening for current medications, checking for disease monitoring.

 

•General Precaution Checking: Activates or deactivates General Precaution Checking, which screens a medication's active and inactive ingredients against the patient's age and gender to help determine whether the order should be continued. This checking more specifically provides individual and daily dosing information for pediatric, adult and geriatric age ranges.

 

•IV Compatibility Checking: Select the check box to allow the system to automatically perform IV compatibility checks at the time of order entry. If a medication that is not compatible with an existing medication in the patient's pharmacy profile, the clinical monitoring screen will display. A monograph may then be printed or displayed.

 

•Pregnancy Checking: Select the check box to allow the system to automatically perform pregnancy checking for females (based upon age range) at the time of order entry. If a medication that is a risk for pregnant women is ordered, the clinical monitoring screen will display the drug name involved in the pregnancy warning and the level of severity.

 

•Lactation Checking: Select the check box to allow the system to automatically perform lactation checking for females (based upon age range) at the time of order entry. If a medication that is a risk for lactating women is ordered, the clinical monitoring screen will display the drug name involved in the lactation warning and the level of severity.

 

•Ethanol Checking: Select the check box to allow the system to automatically perform ethanol checking at the time of order entry. If a medication that has an interaction with ethanol is ordered, the clinical monitoring screen will display the drug name involved in the ethanol warning and the level of severity.

 

•Tobacco Checking: Select the check box to allow the system to automatically perform tobacco checking at the time of order entry. If a medication that is not compatible with tobacco usage is ordered, the clinical monitoring screen will display the drug name involved in the tobacco warning and the level of severity.

 

•Patient Specific Dosing: Select the check box to allow the system to automatically perform patient specific dosing. Patient specific dosing will run once all order entry fields have been reviewed prior to updating the order. Only Overdose and Sub therapeutic information will be displayed; the PSD window will not display if neither is triggered. A diagnosis, listed at the top of the PSD window, may be added during order entry. Once added, the PSD window may be reloaded.

 

•Reference Range Checks: The system automatically applies reference range checking to medication orders with associated lab tests if these tests have associated reference ranges; this field is by default inaccessible but activated.

 

•Boxed Warning Checks: Select the check box to allow the system to automatically perform checking for boxed warnings at the time of order entry. If a medication with a boxed warning is ordered, the clinical monitoring screen will display the drug name with the boxed warning and the message "A Boxed Warning was identified for this medication." NOTE: Drug Monographs are not available on medications with boxed warnings.

   

•Use Overrides: Select the check box to allow the user to enter override reasons at the time of order entry for any medication that meets the checks described above.

 

•Override Required: Select the check box adjacent to each type of Clinical Monitoring Check that requires a reason be documented before proceeding with order entry.

 

•Override Required for Non-Formulary Meds: Select the check box to require an override reason when non-formulary medications are ordered.

 

•Use Allergy Table: This field is not used by Nursing Clinical Monitoring.

 

•Use Drug Information: This field is not used by Nursing Clinical Monitoring.

 

•Allow Unknown NDC#: This field is not used by Nursing Clinical Monitoring.

 

•Autoprint Printer For Patients Not In A Room: When Food Interaction Checking is activated by a check-mark, this field allows a specific printer number to be entered for food interactions to print for any patients not assigned to beds.

 

Select Save to save any changes.

 

NOTE:  View Audit has been moved to Report Dashboard and is no longer an option within this application.