Pre-Admission Order

Covered in this topic:

Scenario 1: Pre-admission orders for Same-Day transfer from Clinic (CP) to Inpatient (IP) visit

Scenario 2: Pre-admission orders for patients scheduled for future dated admissions

Entering Orders that are to schedule out after the date of admission

A pre-admission (pre-admit) order is placed prior to a patient’s visit/stay at a UHN facility. The pre-admission orders are all placed with a start-if condition.

The pre-admission process will vary depending on when and where the patient is coming from.

Scenario 1: Pre-admission orders for Same-Day Transfer from Clinic (CP) to Inpatient (IP) visit

Prescriber must place the orders under a "preadmitted" visit (created by the unit clerk or delegate upon request for an IP bed). Order entry follows the usual steps - see Order Entry Overview topic for more information.

Scenario 2: Pre-admission orders for patients scheduled for future dated admissions

Prescriber must place the orders on a preadmitted visit with an order block condition:

1. Select preadmitted patient visit.

2. Click on Order Entry under Patient Shortcuts in the top right corner of the Order Entry screen, click on Direct order entry by [physician name].

3. Select Edit.

4. The Order Block Condition window opens. Select Preadmission Orders then click OK.

5. Click OK on the bottom of the Order Entry - Order Information screen.

6. On the Order Entry - Adding Order screen, enter orders according to the usual steps. To enter orders that are to schedule out after the date of admission, see the last section in this topic (bottom of document), Entering Orders that are to schedule out after the date of admission.

7. Important: Every order that you place under the Order Block settings for Pre-admission will have a start-if condition automatically filled into the When field. It will appear in the top section of the MAR and therefore not schedule out for dispensing/administration until the condition is met. When the clerk activates the visit indicating that the patient has arrived, these conditional orders will automatically activate and schedule out on the MAR.

8. On the MAR:

Entering Orders that are to schedule out after the date of admission

For orders that are to schedule out after the date of admission, use the EPR shortcuts for the date whereby t = day of admission. Do not use the ddmmyy format.

Shortcuts

Example: You want a specific medication to start 3 days after admission. On the Order Profile tab, in the When field select the dosing interval and the start at ___ option on the Frequency Options list. When prompted to enter the start at date/time, enter t+3. The medication will then schedule out 3 days after admission. All orders placed this way will have a start if condition if associated with them.

Note:

• The "t+___" shortcut should NOT be used for multiple-linked medication or lab orders, as the order does NOT schedule out properly on the MAR. In this context, "t" does not necessarily refer to "today" but refers to the last scheduled dose. See Date & Time Formats topic for more information.

• Please order steroid tapers using pre-built option(s) on the Frequency Options screen (example: for medication SOLU-MEDROL, the pre-built option is daily at for ___ days, followed by ___).

For more information on tapering doses, see the Tapering Dose Medications topic.

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