Medication Cleanup

 

This was the Medical Staff Bulletin sent on September 26, 2019 by Jane Murgatroyd, on behalf of the EPR Medication Cleanup Project.

 

Updates to the EPR eManual are currently in progress. Updates will be ongoing as medication procedures are updated to standards based on ordering best practices, safety and efficiency.

 

 

MEDICAL STAFF BULLETIN

 

VOL 45 NO 91

 

Attention - EPR Medication Order Screens Being Updated to New Standards

 

September 26, 2019

 

Situation

  
EPR medication order entry screens are being revised incrementally until all medication procedures adhere to updated standards based on ordering best practices, safety and efficiency.
 

Background

  
While EPR system functionality, nomenclature standards and clinical best practices for medication procedures evolved over time, UHN has not had the opportunity to re-examine prior medication builds. Long lists and outdated order options (typical orders, routes, and frequencies, dangerous truncations of routes, inconsistent layout standards, dose range formats, etc.) create confusion, frustration and can lead to prescribing errors.
 

Assessment

  
The EPR Optimization program launched one of many projects to improve ("clean-up") EPR. One of the work packages is focused on cleaning-up and standardizing the medication order entry screens.
 

What to Expect

  
Prescribers may notice the following changes:
  • Frequency options are customized per medication
  • Routes will be displayed according to a standard sequence on screens
  • Routes and frequencies will be fully spelled out
  • Typical orders for less frequently used routes across UHN will not be built. They can be ordered via the 'Create your own' order on Order Profile
  • Text Displaying the dosage form will be removed unless there are more than one dosage forms available for the medication
  • If applicable, conditional options associated with 'hold if' and 'process if' are customized per class of medication

Below are medications revised on September 27, 2019:

 

  • metformin
  • sitagliptin
  • gliclazide immediate release
  • gliclazide MR (modified release)
  • glyburide
  • repaglinide
  • acarbose
  • predniSONE
  • fludrocortisone
  • dexamethasone
  • hydrocortisone
  • {SOLU-CORTEF} hydrocortisone sodium succinate
  • hydrocortisone rectal
  • hydrocortisone topical *NEW procedure*
  • {SOLU-MEDROL} methylprednisolone sodium succinate
  • {DEPO-MEDROL} methylprednisolone acetate
  • prednisoLONE sodium phosphate
  • {LANTUS} insulin glargine
  • {LEVEMIR} insulin detemir
  • {HUMULIN N} insulin isophane
  • {NOVOLIN GE NPH} insulin isophane
  • {HUMALOG MIX 25} insulin lispro - insulin lispro protamine
  • {NOVOMIX 30} insulin aspart - insulin aspart protamine
  • {NOVOLIN GE 30-70} insulin regular - insulin isophane
  • {HUMULIN 30-70} insulin regular - insulin isophane
  • {NOVORAPID} insulin aspart
  • {HUMALOG} insulin lispro
  • {HUMULIN R} insulin regular
  • {NOVOLIN GE TORONTO} insulin regular
  • levothyroxine
  • methimazole
  • propylthiouracil
  • liothyronine
  • {LUGOL SOLUTION} iodine - potassium iodide
  • cosyntropin
  • desmopressin
  • glucose oral (for 75 g oral glucose tolerance test)
  • glucagon
  • dextrose oral
  • testosterone cypionate
  • testosterone enanthate

 

Details of the changes can be found in the EPR Release Notices.

 

For further questions, please feel free to contact the Project Team at EPRMedicationCleanup@uhn.ca

 

If there are any technical issues with the above medication procedures, please contact the Help Desk at x4357.

 

 

 

Back to Top