Pharmacy Inpatient Setup

Inpatient Pharmacy took a good while to set-up. Here are my notes on how I have done that. I have only done Unit Dose though. Questions: Post on the hardhats Google Group. http://groups.google.com/group/hardhats.

Prerequisites for Set-up

 * MAS Wards and Rooms have to be completely configured before you start configuring Inpatient Pharmacy, as Inpatient Pharmacy Parameters references them.
 * Menu: PSJU MGR
 * Key: PSJU MGR for access to the Supervisor Menu
 * Menu: PSS MGR (No keys necessary except for entering drugs)

Printers Configuration
You can be of course a high tech place with Automatic Drawers (Pyxii or OmniCells), ATCs and BCMA. This section is for the rest of us who may need printed MARs, Pick Lists to fill the Carts, and Labels to send new medications to the Wards.

For general help setting up printers on Unix, go here: Setting up a Linux Printer. The authors (including me) don't cover how to add a printer to Unix using cups; you should find how to do that yourself. We cover how to add a Unix Printer to VISTA.

The following to help you configure the various printer types that Inpatient Pharmacy uses.

Pick Lists
Pick lists print on normal paper. Configure a printer with the following SubType:  NAME: P-HPLJ4SI-P12                    SELECTABLE AT SIGN-ON: NO  RIGHT MARGIN: 96                      FORM FEED: # PAGE LENGTH: 57                      BACK SPACE: $C(8) OPEN EXECUTE: W $C(27,69),$C(27),"&l0O",$C(27),"(0N",$C(27),"(s0p12h0s0b4099T" ,$C(27),"&k2G" S $X=0                  DESCRIPTION: HP JL4Si 12 pitch Courier

Labels
VISTA UD Package expects 15/16" high 3.5 wide labels 2 across in a dot-matrix label printer. It's hardcoded in the Mumps routines. So hardcoded that you can only change labels with difficulty. If you have Zebras, Medsphere has written code to do Zebras in OpenVista. As to what Printer SubType to use, that depends on the printer. I have an Epson FX-890 and it took me a couple of weeks of trial and error to get this SubType I made:  NAME: P-EPSON-DM-P15-5L                 RIGHT MARGIN: 132  FORM FEED: ""                         PAGE LENGTH: 5  BACK SPACE: $C(8)  OPEN EXECUTE: W *27,"@",*27,"g",*27,"2",*27,"C",*5,*27,"0",*27,"N",*1,*27,"k",  DESCRIPTION: Epson Dot-Matrix 15 cpi/5 lpi OPEN EXECUTE DESCRIPTION:     *27,"@",         Reset   *27,"g",         15 cpi   *27,"2",         1/6 in line spacing *27,"C",*5,     Page Length = 5 * 1/6 in = 5/6 in   *27,"0",         1/8 in line spacing *27,"N",*1,     Bottom Margin = 1 * 1/8  = 1/8 in   *27,"k",*1,      Font = Sans Serif *27,"2"         1/6 in line spacing To my disappointment, if you put anything in the close execute, it will be executed even if you do nothing in the Unit Dose package but browse a patient. This caused the labels to "jiggle". I had to remove close executes after all. The other funny thing I discovered is that the UD package does not send any form feeds to move to the next label: just an line feed. It's very unorthodox, making it difficult to write correct sequences, until I figured out that it 'guesses' the next label by doing a line feed and (after a lot of testing the disbelief from me) it works okay.
 * 1,*27,"2"

MARs
If you are not using BCMA for eMARs, you will need paper MARs. VISTA can print MARs for Paper Documentation, with Active Medications Pre-Printed. I tried printing them as Portrait; and for a while, I couldn't get to print them as Landscape until I wrote the exact correct PCL for me. My nurses prefer the Landscape version. Here are the subtypes you need for MARs:

Portrait:  NAME: P-HPLJ2-P16                      SELECTABLE AT SIGN-ON: NO  RIGHT MARGIN: 132                     FORM FEED: # PAGE LENGTH: 80 OPEN EXECUTE: W *27,"E",*27,"(8U",*27,"(s0P",*27,"(s16H",*27,"(s9V",*27,"(s0S" ,*27,"(s-3B",*27,"(s0T",*27,"&l88P",*27,"&a255M",*27,"&k2S",*27,"&l8D",*27,"&s1C ",*27,"&k2G"                           CLOSE EXECUTE: W *27,"E"

Landscape:  NAME: P-HPLJ2-P16-LS                   SELECTABLE AT SIGN-ON: NO  RIGHT MARGIN: 132                     FORM FEED: # PAGE LENGTH: 80 OPEN EXECUTE: W *27,"E",*27,"&l1O",*27,"(8U",*27,"(s0P",*27,"(s16H",*27,"(s9V" ,*27,"(s0S",*27,"(s-3B",*27,"(s0T",*27,"&l88P",*27,"&l0E",*27,"&l0L",*27,"&a18L" ,*27,"&k2S",*27,"&l8D",*27,"&s1C",*27,"&k2G" CLOSE EXECUTE: W *27,"E"

Pre-Exchange Report
I found most printer types work fine here. I just use the Pick List definition.

Schedule Set-up
Find the Hospital's policy for their Administration Times, prohibited abbreviations, and whether some wards get specific administration times. In my case, the Children's Ward had different administration times. You may delete Schedules are not used.

Menu: PSS MGR > Standard Schedule Edit

My end result: 

Drug File Set-up
Before you do anything, you need to enter all the drugs that your pharmacy uses from your pharmacy formulary. That will take 1-3 months. Here's how: Enter a Drug. Before I started, I deleted all traces of the old drug file using this routine I wrote: http://bazaar.launchpad.net/~sam-habiel/astronaut-vista-server/enhancements/view/head:/JJIHDCLR.m

Also, I learned it may be better to configure the Schedules first before doing the drugs, as you use Schedules when you make orderable items. So I would recommend that. I didn't do that when I set-up the drug file, so I had to go back and fix some stuff after I was done.

There's a section on advanced drug file set-up below. You don't need to that now, so I put it at the bottom.

IV Room Set-up
The next step is to set-up the IV Room. While technically not needed if you are only doing Unit Dose, it's required for some options in the UD menu to work.

 Select Unit Dose Medications Option: IOE Inpatient Order Entry

Whoops ... You don't have an IV ROOM defined ... You MUST define at least one IV ROOM before you can continue.

Select IV ROOM: NULL Are you adding 'NULL' as a new IV ROOM (the 1ST)? No//  (No) ??

Select IV ROOM: NULL ROOM Are you adding 'NULL ROOM' as a new IV ROOM (the 1ST)? No// Y (Yes) NAME: NULL ROOM// LENGTH OF LABEL: 5?? Type a whole number between 12 and 66. LENGTH OF LABEL: 12 WIDTH OF LABEL: ?? Enter the maximum allowable width of your label in number of character s. If you do not enter data into this field, the system will use '30' as       the default. If a line of print cannot fit within the width you define here, it will continue on the next line of the label. WIDTH OF LABEL: 35 LINE FEEDS BETWEEN LABELS: N?? Type a whole number between 0 and 6. LINE FEEDS BETWEEN LABELS: 1 END OF LABEL TEXT: **ICH SOUTH** HEADER LABEL: SHOW BED LOCATION ON LABEL: USE SUSPENSE FUNCTIONS: DOSE DUE LINE: LVP'S GOOD FOR HOW MANY DAYS: 1 HYPERAL GOOD FOR HOW MANY DAYS: 1 PB'S GOOD FOR HOW MANY DAYS: 1 SYRN'S GOOD FOR HOW MANY DAYS: 1 CHEMO'S GOOD FOR HOW MANY DAYS: 1 STOP TIME FOR ORDER: EXPIRE ALL ORDERS ON SAME DAY: ACTIVITY RULER: TOTAL VOL. ON HYPERAL LABELS: Select START OF COVERAGE: ?? Select START OF COVERAGE: 0830 Are you adding '0830' as a new START OF COVERAGE (the 1ST for this IV ROOM)? No// Y (Yes) END OF COVERAGE: 1700 TYPE: A ADMIXTURES AND PRIMARIES MANUFACTURING TIME: 1200 DESCRIPTION: 0830 to 1700// Select START OF COVERAGE: "0830" Are you adding '0830' as a new START OF COVERAGE (the 2ND for this IV ROOM)? No// Y (Yes) END OF COVERAGE: 1700 TYPE: P PIGGYBACKS MANUFACTURING TIME: 1200 DESCRIPTION: 0830 to 1700// Select START OF COVERAGE: "0830" Are you adding '0830' as a new START OF COVERAGE (the 3RD for this IV ROOM)? No// Y (Yes) END OF COVERAGE: 1700 TYPE: H HYPERALS MANUFACTURING TIME: 1200 DESCRIPTION: 0830 to 1700// Select START OF COVERAGE: "0830 ?? Select START OF COVERAGE: "0830" Are you adding '0830' as a new START OF COVERAGE (the 4TH for this IV ROOM)? No// Y  (Yes)  END OF COVERAGE: 1700  TYPE: S  SYRINGE  MANUFACTURING TIME: 1200  DESCRIPTION: 0830 to 1700// Select START OF COVERAGE: "0830"  Are you adding '0830' as a new START OF COVERAGE (the 5TH for this IV ROOM)? No// Y  (Yes)  END OF COVERAGE: 1700  TYPE: C  CHEMOTHERAPY  MANUFACTURING TIME: 1200  DESCRIPTION: 0830 to 1700// Select START OF COVERAGE: ?    Answer with START OF COVERAGE   Choose from:   1            0830     A covering from 0830 to 1700   2            0830     P covering from 0830 to 1700   3            0830     H covering from 0830 to 1700   4            0830     S covering from 0830 to 1700   5            0830     C covering from 0830 to 1700        You may enter a new START OF COVERAGE, if you wish        Answer must be in military time (i.e., 4 NUMBERS)! Select START OF COVERAGE: Select DELIVERY TIME: 1500 Are you adding '1500' as a new DELIVERY TIME (the 1ST for this IV ROOM)? No// Y (Yes) Select DELIVERY TIME: LABEL DEVICE: HOME//  TELNET

REPORT DEVICE: HOME//  TELNET

INACTIVATION DATE: DAYS TO RETAIN IV STATS:

You are signed on under the NULL ROOM IV ROOM

Current IV LABEL device is: TELNET

Current IV REPORT device is: TELNET

System Parameters
Go to Supervisor Menu > PARameters Edit Menu > Systems Parameters Edit

 Select PARameters Edit Menu Option: systems Parameters Edit

NON-FORMULARY MESSAGE: THERE ARE NO LINES! Edit? NO// y YES

[ WRAP ]==[INSERT ]=========< NON-FORMULARY MESSAGE [Press H for help]==== This drug is non-formulary. Please contact the Inpatient Pharmacy before ordering.

PRINT 6 BLOCKS FOR THE PRN MAR: 1 YES Recommended PRINT DIET ABBR LABEL ON MAR:  Don't turn on unless you use Dietetics MAR SORT: ? Choose from: 0       Sort by order's Schedule Type and then Medication Names. 1       Sort by order's Medication Names. MAR SORT: 0 Sort by order's Schedule Type and then Medication Names. ATC SORT PARAMETER: CALC UNITS NEEDED PRN ORDERS: ? Enter a 1 if you would like to have the UNITS NEEDED calculated for PRN orders on the Pick List. Choose from: 1       YES CALC UNITS NEEDED PRN ORDERS: DAYS UNTIL STOP FOR ONE-TIME: 1 ROUND ATC PICK LIST UNITS: EXPIRED IV TIME LIMIT: ? Type the Number of Hours between 0 and 24 that continuous IV orders may be    renewed after expiring EXPIRED IV TIME LIMIT: PRIORITIES FOR PENDING NOTIFY: ? Choose from: S       STAT SA      STAT/ASAP SAN     STAT/ASAP/NOW A       ASAP AN      ASAP/NOW N       NOW SN      STAT/NOW PRIORITIES FOR PENDING NOTIFY: PRIORITIES FOR ACTIVE NOTIFY:

Ward Parameters Set-up
To reach this menu, you need to go to Supervisor Menu > PARameters Edit Menu. What you do here is configure the parameters for how Inpatient Pharmacy will behave for the Ward (or as Americans like to call it nowadays: Unit). You need to collect the following information:
 * When do Orders have to get renewed? That will you Days until stop.
 * When should Orders stop when they expire? That's called the "Order Wall".
 * When should the Start Date be? As soon as the med is ordered, or at the next admin time?
 * Are you going to print labels when you process the orders? When?

Here's an example for one ward I configured. All my other wards look the same 

Select Supervisor's Menu Option: PARameters Edit Menu

AUto-Discontinue Set-Up IUP   Inpatient User Parameters Edit IWP   Inpatient Ward Parameters Edit Clinic Definition Systems Parameters Edit

Select PARameters Edit Menu Option: IWP Inpatient Ward Parameters Edit

Select WARD: ? You may enter a new INPATIENT WARD PARAMETERS, if you wish Enter a ward for which you want to tailor the Inpatient Medication package. Answer with WARD LOCATION NAME Do you want the entire 15-Entry WARD LOCATION List? Y (Yes)Choose from: 1St Floor                              *** INACTIVE *** Adolescent 2L 201-213 South to exit: Child 2R 214-225 South Dapa 3R 314-326 General/adult 3L 300-313 South         *** INACTIVE *** Hinniker 1R 118-129 South              *** INACTIVE *** Ichs Admissions                        *** INACTIVE *** Ichs Adolescent                        *** INACTIVE *** Ichs Adult                             *** INACTIVE *** Ichs Beds                              *** INACTIVE *** Ichs Child                             *** INACTIVE *** Ichs Dapa                              *** INACTIVE *** Ichs Hiniker                           *** INACTIVE *** Intracare Hospital System              *** INACTIVE *** Restore 1L 101-111 South Select WARD: RESTORE 1L 101-111 SOUTH Are you adding 'Restore 1L 101-111 South' as    a new INPATIENT WARD PARAMETERS (the 1ST)? No// Y (Yes)

DAYS UNTIL STOP DATE/TIME: 30 DAYS UNTIL STOP FOR ONE-TIME: 1 SAME STOP DATE ON ALL ORDERS: Y YES TIME OF DAY THAT ORDERS STOP: 2359 DEFAULT START DATE CALCULATION: ? Enter "0" to use the closest admin time, "1" to use the next admin time, or "2" to use "now" as the default start time for orders. Choose from: 0       USE CLOSEST ADMIN TIME AS DEFAULT 1       USE NEXT ADMIN TIME AS DEFAULT 2       USE NOW AS DEFAULT DEFAULT START DATE CALCULATION: 1 USE NEXT ADMIN TIME AS DEFAULT START TIME FOR 24 HOUR MAR: 1500 LABEL FOR WARD STAFF: ? Choose from: 0       NO LABELS 1       FIRST LABEL ON ORDER ENTRY/EDIT 2       LABEL ON ENTRY/EDIT AND VERIFICATION 3       FIRST LABEL ON NURSE VERIFICATION LABEL FOR WARD STAFF: 0 NO LABELS WARD LABEL PRINTER POINTER: LABEL FOR PHARMACY: ? Choose from: 0       NO LABELS 1       FIRST LABEL ON ORDER ENTRY/EDIT 2       LABEL ON ENTRY/EDIT AND VERIFICATION 3       FIRST LABEL ON PHARMACIST VERIFICATION LABEL FOR PHARMACY: 3 FIRST LABEL ON PHARMACIST VERIFICATION PHARMACY LABEL PRINTER POINTER: PHAR 1  PHAR-IP-DM      Inpatient Pharmacy Dot-Matrix     PHAR-IP-DM 2  PHAR-IP-LS      IP Pharmacy Landscape CHOOSE 1-2: 1 PHAR-IP-DM    Inpatient Pharmacy Dot-Matrix     PHAR-IP-DM LABEL ON AUTO-DISCONTINUE: ? Answer 'YES' to have labels created when this ward's patients' orders are auto-discontinued. Choose from: 1       YES 0       NO LABEL ON AUTO-DISCONTINUE: 0  NO MAR HEADER LABELS: ? Enter "YES" if MAR header labels should be generated for this ward. Choose from: 1       YES MAR HEADER LABELS: 1  YES DAYS NEW LABELS LAST: ? Enter a whole number between 0 and 35.

ANY NEW LABELS OLDER THAN THE NUMBER OF DAYS SPECIFIED HERE WILL AUTOMATICALLY BE PURGED. DAYS NEW LABELS LAST: ? Enter a whole number between 0 and 35.

ANY NEW LABELS OLDER THAN THE NUMBER OF DAYS SPECIFIED HERE WILL AUTOMATICALLY BE PURGED. DAYS NEW LABELS LAST: 1 MAR ORDER SELECTION DEFAULT: ? Answer must be 1-10 characters in length.

Enter the number corresponding to the type of orders to be included on MARs printed for this ward. Multiple types (except 1) may be selected using "-" or "," as delimiters.

Choose from: 1 - All Medications 2 - Non-IV Medications only 3 - IV Piggybacks 4 - LVPs 5 - TPNs 6 - Chemotherapy Medications (IV) MAR ORDER SELECTION DEFAULT: 2 2 - Non-IV Medications only PRINT PENDING ORDERS ON MAR: ? Enter YES to include acknowledged pending orders on the MARs Choose from: 1       YES PRINT PENDING ORDERS ON MAR: ?? Enter YES to include the pending orders that were acknowledged by a nurs e on the MARs and the Medication Due Worksheet. Choose from: 1       YES PRINT PENDING ORDERS ON MAR: 'SELF MED' IN ORDER ENTRY: PRE-EXCHANGE REPORT DEVICE: ? Enter a device on which the Pre-Exchange Report may be printed. Answer with DEVICE NAME, or LOCAL SYNONYM, or $I, or VOLUME SET(CPU), or    SIGN-ON/SYSTEM DEVICE, or FORM CURRENTLY MOUNTED Do you want the entire DEVICE List? N (No) PRE-EXCHANGE REPORT DEVICE: PHAR-IP-LS     IP Pharmacy Landscape STAT NOW MAIL GROUP: ? Answer with MAIL GROUP NAME Do you want the entire 236-Entry MAIL GROUP List? N (No) STAT NOW MAIL GROUP: PSJ 1  PSJ STAT NOW ACTIVE ORDER 2  PSJ STAT NOW PENDING ORDER 3  PSJ-ORDERS REINSTATED CHOOSE 1-3: 2 PSJ STAT NOW PENDING ORDER PRIORITIES FOR NOTIFICATION: ? Choose from: S       STAT SA      STAT/ASAP SAN     STAT/ASAP/NOW A       ASAP AN      ASAP/NOW N       NOW SN      STAT/NOW PRIORITIES FOR NOTIFICATION: SAN STAT/ASAP/NOW

Medication Distribution Set-up
Here we set-up the Administeration Teams (VISTA's fancy term for Medication Carts) and configure how Pick Lists will behave.

Set-up Administering Teams
Administering Teams are bascially Medication Carts. For each MAS Ward, you configure each Cart Location and put the beds in that Cart Location. You can have multiple Carts for each Ward. In my case, I didn't, so you will only see only one Cart Location in my example.  Select Core Applications Option: UD Unit Dose Medications

(Inpatient Medications - Version 5.0 04/16/99)

HI, HABIEL,SAM! (PHARMACIST & PROVIDER)

Align Labels (Unit Dose) Discontinue All of a Patient's Orders EUP   Edit Inpatient User Parameters Hold All of a Patient's Orders IOE   Inpatient Order Entry IPF   Inpatient Profile INQuiries Menu ... Label Print/Reprint Non-Verified/Pending Orders Order Entry PAtient Profile (Unit Dose) Reports Menu ...         Supervisor's Menu ...

Select Unit Dose Medications Option: SUPERvisor's Menu

Administering Teams Clinic Groups MANagement Reports Menu ... Non-Standard Schedule Report Non-Standard Schedule Search Order Set Enter/Edit PARameters Edit Menu ... PATient Order Purge **> Out of order: TEMPORARILY UNAVAILABLE PIck List Menu ... Ward Groups

Select Supervisor's Menu Option: ADMINistering Teams

Select WARD: CHILD 2R 214-225 SOUTH Are you adding 'Child 2R 214-225 South' as    a new MEDICATION ADMINISTERING TEAM (the 1ST)? No// Y (Yes) Select TEAM: CHILDREN Are you adding 'CHILDREN' as a new TEAM? No// Y (Yes) Select ROOM-BED: 214-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '214-A-ICHS' as a new ROOM-BED (the 1ST for this TEAM)? No// Y

(Yes) Select ROOM-BED: 214-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '214-B-ICHS' as a new ROOM-BED (the 2ND for this TEAM)? No// Y

(Yes) Select ROOM-BED: 215-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '215-A-ICHS' as a new ROOM-BED (the 3RD for this TEAM)? No// Y

(Yes) Select ROOM-BED: 215-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '215-B-ICHS' as a new ROOM-BED (the 4TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 216-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '216-A-ICHS' as a new ROOM-BED (the 5TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 216-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '216-B-ICHS' as a new ROOM-BED (the 6TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 217-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '217-A-ICHS' as a new ROOM-BED (the 7TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 217-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '217-B-ICHS' as a new ROOM-BED (the 8TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 218-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '218-A-ICHS' as a new ROOM-BED (the 9TH for this TEAM)? No// Y

(Yes) Select ROOM-BED: 218-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '218-B-ICHS' as a new ROOM-BED (the 10TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 219-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '219-A-ICHS' as a new ROOM-BED (the 11TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 219-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '219-B-ICHS' as a new ROOM-BED (the 12TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 220-1 ?? Select ROOM-BED: 220-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '220-A-ICHS' as a new ROOM-BED (the 13TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 220-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '220-B-ICHS' as a new ROOM-BED (the 14TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 221-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '221-A-ICHS' as a new ROOM-BED (the 15TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 221-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '221-B-ICHS' as a new ROOM-BED (the 16TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 222-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '222-A-ICHS' as a new ROOM-BED (the 17TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 222-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '222-B-ICHS' as a new ROOM-BED (the 18TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 223-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '223-A-ICHS' as a new ROOM-BED (the 19TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 223-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '223-B-ICHS' as a new ROOM-BED (the 20TH for this TEAM)? No// Y (Yes) Select ROOM-BED: 224-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '224-A-ICHS' as a new ROOM-BED (the 21ST for this TEAM)? No// Y (Yes) Select ROOM-BED: 224-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '224-B-ICHS' as a new ROOM-BED (the 22ND for this TEAM)? No// Y (Yes) Select ROOM-BED: 225-A-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '225-A-ICHS' as a new ROOM-BED (the 23RD for this TEAM)? No// Y (Yes) Select ROOM-BED: 225-B-ICHS WARD(S):    ICHS Beds Child 2R 214-225 South Are you adding '225-B-ICHS' as a new ROOM-BED (the 24TH for this TEAM)? No// Y (Yes) Select ROOM-BED: ? Answer with ROOM-BED Do you want the entire 24-Entry ROOM-BED List? Y (Yes) Choose from: 214-A-ICHS 214-B-ICHS 215-A-ICHS 215-B-ICHS 216-A-ICHS 216-B-ICHS 217-A-ICHS 217-B-ICHS 218-A-ICHS 218-B-ICHS 219-A-ICHS 219-B-ICHS 220-A-ICHS 220-B-ICHS 221-A-ICHS 221-B-ICHS 222-A-ICHS 222-B-ICHS 223-A-ICHS 223-B-ICHS to exit: 224-A-ICHS 224-B-ICHS 225-A-ICHS 225-B-ICHS You may enter a new ROOM-BED, if you wish

THE ROOM-BED CHOSEN MUST ALREADY BE DEFINED IN THE ROOM-BED FILE. Answer with ROOM-BED NAME, or WARD(S) WHICH CAN ASSIGN Do you want the entire ROOM-BED List? N (No) Select ROOM-BED: Select TEAM: ? Answer with TEAM: CHILDREN You may enter a new TEAM, if you wish Answer must be 3-15 characters in length.

ENTER THE NAME OF A TEAM THAT ADMINISTERS MEDICATION ON THIS WARD. Select TEAM:

Set-up Ward Groups
In a real world Inpatient Pharmacy that does Medication Cart Exchanges, the medication carts are filled at specific intervals (typically daily), with different sets of wards filled at different times to distribute workload. For example, if you have Ward A, B, C, D; you may fill A & B at 4pm and C & D at 2am. A ward group is a grouping of A & B or C & D together: to print the Pick List so that the medication drawers can filled and then the carts exchanged.

In the section immediately above, you configured which carts are in each Ward and which beds are in each Cart. A Ward Group will contain a collection of Wards that are filled together in a Medication Cart Exchange run.

When you print a pick list, you will be asked for which Ward Group you want to run your pick list.  Select Supervisor's Menu Option: ward Groups

Select WARD GROUP NAME: 1ST FLOOR Are you adding '1ST FLOOR' as a new WARD GROUP (the 1ST)? No// Y (Yes) WARD GROUP TYPE: ? Choose from: M       MAS P       PHARMACY WARD GROUP TYPE: ?? Differentiates between MAS ward groups and PHARMACY ward groups. Only PHARMACY ward groups are selectable in the PICK LIST options and no two PHARMACY ward groups may contain the same ward (for dose counting and        tracking purposes). MAS ward groups may be set up as desired, and are selectable (along with PHARMACY ward groups) in all other print options. Choose from: M       MAS P       PHARMACY WARD GROUP TYPE: P PHARMACY WARD GROUP ATC DEVICE POINTER: NAME: 1ST FLOOR// Select WARD: RESTORE 1L 101-111 SOUTH Are you adding 'Restore 1L 101-111 South' as a new WARD? No// Y (Yes) Select WARD: LENGTH OF PICK LIST (in hours): 48 PICK LIST - OMIT WARD SORT: ? Answer 'YES' (or '1') to have the pick list NOT sort by ward. Choose from: 0       NO (SORT BY WARD) 1       YES (DO NOT SORT BY WARD) PICK LIST - OMIT WARD SORT: ?? The Pick List normally sorts orders by TEAM, WARD, ROOM-BED... To       have the Pick List omit the WARD sort, answer 'YES' here, and the Pick List will sort by TEAM, ROOM-BED (and NOT by WARD). Any change here will NOT affect any Pick Lists that have already been run. Choose from: 0       NO (SORT BY WARD) 1       YES (DO NOT SORT BY WARD) PICK LIST - OMIT WARD SORT: NO NO (SORT BY WARD) PICK LIST - OMIT ROOM-BED SORT: NO NO (SORT BY ROOM-BED) PICK LIST - ROOM/BED SORT: ROO ROOM-BED PICK LIST - FORM FEED/PATIENT: NO NO PICK LIST - FORM FEED/WARD: YES  YES PICK LIST - LINES ON FORM FEED: ?? This is a flag that tells the pick list to print the "FILLED BY" and t he       "CHECKED BY" lines after each ward or patient. This is used only if eit her of the "PICK LIST FORM FEED/PATIENT" or "PICK LIST FORM FEED/WARD" site parameters is turned on. Choose from: 1       YES 0       NO PICK LIST - LINES ON FORM FEED: 1  YES PRINT NON-ACTIVE ORDERS FIRST: ? Answer 'YES' to have expired and dc'd orders print before active orders for each patient on the pick list. Choose from: 1       YES 0       NO PRINT NON-ACTIVE ORDERS FIRST: NO  NO BAXTER ATC DEVICE: USE OLD ATC INTERFACE:

Select WARD GROUP NAME: ? Answer with WARD GROUP NAME: 1ST FLOOR PHARMACY You may enter a new WARD GROUP, if you wish Answer must be 1-20 characters in length. Select WARD GROUP NAME: 2ND FLOOR Are you adding '2ND FLOOR' as a new WARD GROUP (the 2ND)? No// Y (Yes) WARD GROUP TYPE: P PHARMACY WARD GROUP ATC DEVICE POINTER: NAME: 2ND FLOOR// Select WARD: ADOLESCENT 2L 201-213 SOUTH Are you adding 'Adolescent 2L 201-213 South' as a new WARD? No// Y (Yes) Select WARD: CHILD 2R 214-225 SOUTH Are you adding 'Child 2R 214-225 South' as a new WARD? No// Y (Yes) Select WARD: LENGTH OF PICK LIST (in hours): 48 PICK LIST - OMIT WARD SORT: NO NO (SORT BY WARD) PICK LIST - OMIT ROOM-BED SORT: NO NO (SORT BY ROOM-BED) PICK LIST - ROOM/BED SORT: ?? Enter how you want the pick list to sort the room-bed.

Enter a '1' to have the pick lists sort orders by BED-ROOM. Choose from: 0       ROOM-BED 1       BED-ROOM PICK LIST - ROOM/BED SORT: 0 ROOM-BED PICK LIST - FORM FEED/PATIENT: N NO PICK LIST - FORM FEED/WARD: Y  YES PICK LIST - LINES ON FORM FEED: Y YES PRINT NON-ACTIVE ORDERS FIRST: N NO BAXTER ATC DEVICE: USE OLD ATC INTERFACE:

Select WARD GROUP NAME: 3RD FLOOR Are you adding '3RD FLOOR' as a new WARD GROUP (the 3RD)? No// Y (Yes) WARD GROUP TYPE: P PHARMACY WARD GROUP ATC DEVICE POINTER: NAME: 3RD FLOOR// Select WARD: GENERAL/ADULT 3L 300-313 SOUTH      *** INACTIVE *** Are you adding 'General/Adult 3L 300-313 South' as    a new WARD (the 1ST for this WARD GROUP)? No// Y (Yes) Select WARD: DAPA 3R 314-326 Are you adding 'DAPA 3R 314-326' as a new WARD (the 2ND for this WARD GROUP)? No// Y (Yes) Select WARD: LENGTH OF PICK LIST (in hours): 48 PICK LIST - OMIT WARD SORT: ^LENGTH OF PICK LIST (in hours) LENGTH OF PICK LIST (in hours): 48// ?? If an entry is found here when a pick list is run for this ward group, the Unit Dose package will add the number of hours found to the start da te       to produce a DEFAULT stop date. LENGTH OF PICK LIST (in hours): 48// PICK LIST - OMIT WARD SORT: NO NO (SORT BY WARD) PICK LIST - OMIT ROOM-BED SORT: NO NO (SORT BY ROOM-BED) PICK LIST - ROOM/BED SORT: ROO ROOM-BED PICK LIST - FORM FEED/PATIENT: NO NO PICK LIST - FORM FEED/WARD: YES  YES PICK LIST - LINES ON FORM FEED: YES YES PRINT NON-ACTIVE ORDERS FIRST: NO NO BAXTER ATC DEVICE: USE OLD ATC INTERFACE:

Select WARD GROUP NAME: ? Answer with WARD GROUP NAME Choose from: 1ST FLOOR PHARMACY 2ND FLOOR PHARMACY 3RD FLOOR PHARMACY You may enter a new WARD GROUP, if you wish Answer must be 1-20 characters in length. Select WARD GROUP NAME:

Entering DEA Numbers
The DEA is a fact of life in the US and is baked into the pharmacy software. Even if you use VISTA outside of the US, you need to set-up DEA#'s/VA#'s in order to be able to order controlled substances. There are two steps: entering an institutional DEA number; then entering each Provider's DEA or VA #.

DEA Logic in VISTA
For any drug that has the DEA Special Handling field that is between 2 to 5, VISTA will want either one of these two conditions for the provider to be able to order it:

EITHER: An Institutional DEA # and a Provider VA #

OR: Provider DEA #

That means that if all your providers have DEA #'s, you don't need an institutional DEA #.

Each of these set-ups follows how the DEA dictates that Hospitals allows its providers to prescribe.

Enter Institutional DEA #'s
Entering a DEA number for each institution is done through the Kernel Management Menu, as below.  Core Applications ...         Device Management ...          Menu Management ...          Programmer Options ...          Operations Management ...          Spool Management ...          Information Security Officer Menu ...          Taskman Management ...          User Management ...   FM     VA FileMan ...          Application Utilities ...          Capacity Planning ...          HL7 Main Menu ...          Manage Mailman ... MAS Parameter Entry/Edit

Select Systems Manager Menu Option: OPERations Management

System Status Introductory text edit CPU/Service/User/Device Stats RJD   Kill off a users' job Alert Management ...         Alpha/Beta Test Option Usage Menu ... Clean old Job Nodes in XUTL Delete Old (>14 d) Alerts Foundations Management Kernel Management Menu ... Post sign-in Text Edit RPC Broker Management Menu ...         User Management Menu ...

Select Operations Management Option: KERNel Management Menu

Ask if Production Account Edit Site IP lockout Enter/Edit Kernel Site Parameters Institution DEA# edit Institution Edit Kernel New Features Help Kernel PKI Parameter Edit Load Institution NPI values NPF cleanup main menu ... Release IP lock

Select Kernel Management Menu Option: INST 1   Institution DEA# edit 2   Institution Edit CHOOSE 1-2: 1 Institution DEA# edit

Select INSTITUTION NAME: INTRACARE HOSPITAL SYSTEM   TX  MC(M)  840203 FACILITY DEA NUMBER:

Enter Providers' DEA #'s or VA #'s
To edit DEA or VA #'s for providers, you can either directly edit the entry in File 200, or use the option PSO PROVIDER EDIT. Normally, this option lives in Supervisor menu in the Outpatient Pharmacy Manager Menu, but you can copy it over to the person who is supposed to maintain credentialing.

 'Edit Provider'    Option name: PSO PROVIDER EDIT This option is used to edit provider information. New providers cannot be    entered using this option.

Provider: HABIEL,SAM

AUTHORIZED TO WRITE MED ORDERS: YES

NON-VA PRESCRIBER: TAX ID: EXCLUSIONARY CHECK PERFORMED: DATE EXCLUSIONARY LIST CHECKED: ON EXCLUSIONARY LIST: AUTHORIZED TO WRITE MED ORDERS: YES// DEA#: VA#:

Entering and Configuring Pharmacy Users
To create Pharmacy Users, you need to do the following:
 * Create a user with access to the menu option PSJU MGR
 * Pharmacists get PSJ RPHARM key to be able to verify orders.
 * Anybody who runs Pick Lists should get PSJU PL key.
 * Supervisors get PSJU MGR key.

Pharmacists should be added to two mail groups:
 * GMRA REQUEST NEW REACTANT - Allergies that cannot be added through CPRS need to go to pharamcists or others for further investigation.
 * PSJ STAT NOW PENDING ORDER - Mailgroup for Pharmacists to receive STAT orders notices.

For TIU, add to ASU Class Pharmacist.

Last, you need to set pharmacists to auto-verify when they finish an order in Inpatient Pharmacy. This needs to be done user by user:  Select Supervisor's Menu Option: PARameters Edit Menu

AUto-Discontinue Set-Up IUP   Inpatient User Parameters Edit IWP   Inpatient Ward Parameters Edit Clinic Definition Systems Parameters Edit

Select PARameters Edit Menu Option: IUP Inpatient User Parameters Edit

Select INPATIENT USER: XXXXX         PHARMACIST ...OK? Yes//  (Yes)

This user is a PHARMACIST.

ALLOW AUTO-VERIFY FOR USER: YES//

Patient Medication Information Sheets Set-up
If the complete PSN is installed, VISTA includes Patient Medication Information Sheets. They can come in handy. The option is called 'PSNPMIS PRINT'. The option uses defaults which you can set throught the Pharmacy System Parameters Edit off the Pharmacy Data Management menu.  'Print a PMI Sheet'    Option name: PSNPMIS PRINT This option will print a Patient Medication Information Sheet for a drug selected from the local drug file. Drugs in the local drug file must be linked to entries in the National Drug File at the site and entries in the National Drug File must have been linked to a GCNSEQNO thus a PMIS by the National Drug File Manager. A PMIS can be printed in either English or Spanish.

Select Pharmacy Data Management Option: Pharmacy System Parameters Edit PMIS PRINTER: PHAR-IP-POR-P12// PMIS LANGUAGE: English// WARNING LABEL SOURCE: NEW// CMOP WARNING LABEL SOURCE: OPAI WARNING LABEL SOURCE:

Order Set Creation
You can create order sets in Inpatient Pharmacy. These are purely optional. And they have nothing to do with order sets in CPRS. Once you have order sets in CPRS that are entered by the providers, there is no need for them in the pharmacy. As such, they are there for a pharmacy that only uses VISTA without online order entry.  Select Supervisor's Menu Option: order Set Enter/Edit

Select ORDER SET: DETOX ORDERS Are you adding 'DETOX ORDERS' as    a new UNIT DOSE ORDER SET (the 1ST)? No// Y (Yes) NAME: DETOX ORDERS// Select ORDERABLE ITEM: CLONIDINE 1  CLONIDINE       TAB 2  CLONIDINE       PATCH 3  CLONIDINE ER       TAB CHOOSE 1-3: 1 CLONIDINE     TAB Are you adding 'CLONIDINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: ? Answer must be 1-60 characters in length. DOSAGE ORDERED: ?? This is the total amount of the medication that is to be administered as one dose, such as '500MG' or '100CC'. This cannot be a number only. The type of unit (MG, CC, etc.) must be included. DOSAGE ORDERED: 0.1MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: O  ONE TIME SCHEDULE: NOW SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: CLONIDINE 1  CLONIDINE 0.1MG TAB           CV490 2  CLONIDINE 0.2MG TAB           CV490 3  CLONIDINE 0.3MG TAB           CV490 CHOOSE 1-3: 1 CLONIDINE 0.1MG TAB         CV490 Are you adding 'CLONIDINE 0.1MG TAB' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: CLONIDINE PATCH ?? Select ORDERABLE ITEM: CLONIDINE CLONIDINE     TAB ...OK? Yes// N (No) CLONIDI 1  CLONIDINE       PATCH 2  CLONIDINE ER       TAB CHOOSE 1-2: 1 CLONIDINE     PATCH Are you adding 'CLONIDINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: ? Answer must be 1-60 characters in length. DOSAGE ORDERED: 0.2MG/WEEK DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: po ORAL      PO  SCHEDULE TYPE: C  CONTINUOUS SCHEDULE: QWEEKLY      09 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: CLONIDI 1  CLONIDINE 0.1MG/DAY TRANSDERMAL SYS           CV490 2  CLONIDINE 0.2MG/DAY TRANSDERMAL SYS           CV490 3  CLONIDINE 0.3MG/DAY TRANSDERMAL SYS           CV490 CHOOSE 1-3: 2 CLONIDINE 0.2MG/DAY TRANSDERMAL SYS         CV490 Are you adding 'CLONIDINE 0.2MG/DAY TRANSDERMAL SYS' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: PEPCID FAMOTIDINE     TAB Are you adding 'FAMOTIDINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 20MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: C  CONTINUOUS SCHEDULE: BID      09-21 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: FAMOTIDINE 20MG TAB          GA301 Are you adding 'FAMOTIDINE 20MG TAB' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: FELDENE PIROXICAM     CAP,ORAL Are you adding 'PIROXICAM' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 20MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: C  CONTINUOUS SCHEDULE: QDAY      09 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: FELDENE PIROXICAM 20MG CAP         MS102 Are you adding 'PIROXICAM 20MG CAP' as a new DISPENSE DRUG? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: CLONIDINE 1  CLONIDINE       TAB 2  CLONIDINE       PATCH CHOOSE 1-2: 1 CLONIDINE     TAB ORDERABLE ITEM: CLONIDINE// DOSAGE ORDERED: 0.1MG// DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: ORAL// SCHEDULE TYPE: ONE TIME// SCHEDULE: NOW// SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: CLONIDINE 0.1MG TAB// DISPENSE DRUG: CLONIDINE 0.1MG TAB// UNITS PER DOSE: 1// Select DISPENSE DRUG: Select ORDERABLE ITEM: "CLONIDINE" 1  CLONIDINE       TAB 2  CLONIDINE       PATCH 3  CLONIDINE ER       TAB CHOOSE 1-3: 1 CLONIDINE     TAB Are you adding 'CLONIDINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 0.1MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: Q8H      01-09-17 SPECIAL INSTRUCTIONS: FOR SBP > 150 Select DISPENSE DRUG: CLONIDINE 1  CLONIDINE 0.1MG TAB           CV490 2  CLONIDINE 0.2MG TAB           CV490 3  CLONIDINE 0.3MG TAB           CV490 CHOOSE 1-3: 1 CLONIDINE 0.1MG TAB         CV490 Are you adding 'CLONIDINE 0.1MG TAB' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: LOPERAMIDE 1  LOPERAMIDE       CAP,ORAL 2  LOPERAMIDE       LIQUID,ORAL CHOOSE 1-2: 1 LOPERAMIDE     CAP,ORAL Are you adding 'LOPERAMIDE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 4MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: Q2H PRN?? Enter the schedule for this orderable item. SCHEDULE: Q2H      01-03-05-07-09-11-13-15-17-19-21-23 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: ^SPECIAL INSTRUCTIONS SPECIAL INSTRUCTIONS: MAX 10MG DAILY Select DISPENSE DRUG: loperamide 2MG CAP          GA208 Are you adding 'LOPERAMIDE 2MG CAP' as a new DISPENSE DRUG? No// y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM:   LOPERAMIDE ORDERABLE ITEM: LOPERAMIDE// DOSAGE ORDERED: 4MG// 2mg DAY (nD) OR DOSE (nL) LIMIT: ^DOSAGE ORDERED DOSAGE ORDERED: 2mg// 2MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: ORAL// ^DOSE?? MED ROUTE: ORAL// ^DAY (nD) OR DOSE (nL) LIMIT DAY (nD) OR DOSE (nL) LIMIT: 10L START DAY AND TIME: MED ROUTE: ORAL// SCHEDULE TYPE: PRN// SCHEDULE: Q2H// SPECIAL INSTRUCTIONS: MAX 10MG DAILY// Select DISPENSE DRUG: LOPERAMIDE 2MG CAP// DISPENSE DRUG: LOPERAMIDE 2MG CAP// UNITS PER DOSE: 1// Select DISPENSE DRUG: Select ORDERABLE ITEM: "LOPERAMIDE" 1  LOPERAMIDE       CAP,ORAL 2  LOPERAMIDE       LIQUID,ORAL CHOOSE 1-2: 1 LOPERAMIDE     CAP,ORAL Are you adding 'LOPERAMIDE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 4MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: ^DAY (nD) OR DOSE (nL) LIMIT DAY (nD) OR DOSE (nL) LIMIT: 10L START DAY AND TIME: MED ROUTE: ^START DAY AND TIME START DAY AND TIME: NOW?? Examples of Valid Dates: JAN 20 1957 or 20 JAN 57 or 1/20/57 or 012057 (omitting punctuation) T  (for TODAY),  T+1 (for TOMORROW),  T+2,  T+7, etc. T-1 (for YESTERDAY), T-3W (for 3 WEEKS AGO), etc. If the year is omitted, the computer uses CURRENT YEAR. A 2-digit year means no more than 20 years in the future, or 80 years in the past. If the date is omitted, the current date is assumed. Follow the date with a time, such as JAN 20@10, T@10AM, 10:30, etc. You may enter NOON, MIDNIGHT, or NOW to indicate the time. Time is REQUIRED to be entered. Enter the day and time after the order is selected that this order should start. START DAY AND TIME: NOW?? Examples of Valid Dates: JAN 20 1957 or 20 JAN 57 or 1/20/57 or 012057 (omitting punctuation) T  (for TODAY),  T+1 (for TOMORROW),  T+2,  T+7, etc. T-1 (for YESTERDAY), T-3W (for 3 WEEKS AGO), etc. If the year is omitted, the computer uses CURRENT YEAR. A 2-digit year means no more than 20 years in the future, or 80 years in the past. If the date is omitted, the current date is assumed. Follow the date with a time, such as JAN 20@10, T@10AM, 10:30, etc. You may enter NOON, MIDNIGHT, or NOW to indicate the time. Time is REQUIRED to be entered. Enter the day and time after the order is selected that this order should start. START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: O  ONE TIME SCHEDULE: NOW SPECIAL INSTRUCTIONS: MAX 10MG/DAY (5 CAPS) Select DISPENSE DRUG: ? You may enter a new DISPENSE DRUG, if you wish Only dispense drugs that are marked for Unit Dose use and that are tied to this order's ORDERABLE ITEM are selectable.

Answer with DRUG NUMBER, or GENERIC NAME, or VA PRODUCT NAME, or    NATIONAL DRUG CLASS, or NDC, or Application PACKAGES' USE, or     ATC MNEMONIC, or DRUG TEXT ENTRY, or SYNONYM Do you want the entire DRUG List? N (No) Select DISPENSE DRUG: LOPERAMIDE 2MG CAP          GA208 Are you adding 'LOPERAMIDE 2MG CAP' as a new DISPENSE DRUG? No// Y (Yes) UNITS PER DOSE: 2 Select DISPENSE DRUG: Select ORDERABLE ITEM: ? Answer with ORDERABLE ITEM Choose from: CLONIDINE CLONIDINE PIROXICAM LOPERAMIDE LOPERAMIDE FAMOTIDINE CLONIDINE You may enter a new ORDERABLE ITEM, if you wish Enter the orderable item to identify this medication. Each orderable item chosen is an individual order within the order set. Answer with PHARMACY ORDERABLE ITEM NAME, or SYNONYM, or    OI-DRUG TEXT ENTRY Do you want the entire 408-Entry PHARMACY ORDERABLE ITEM List? N (No) Select ORDERABLE ITEM: PHENRGAN ?? Select ORDERABLE ITEM: PROMETH 1  PROMETHAZINE       TAB 2  PROMETHAZINE       INJ,SOLN 3  PROMETHAZINE       SUPP,RTL CHOOSE 1-3: 1 PROMETHAZINE     TAB Are you adding 'PROMETHAZINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 25MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: Q8H      01-09-17 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: ^SPECIAL INSTRUCTIONS SPECIAL INSTRUCTIONS: FOR N/V Select DISPENSE DRUG: PROMETHAZINE 25MG TAB          AH100 Are you adding 'PROMETHAZINE 25MG TAB' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: PROMETHAZINE PROMETHAZINE     TAB ...OK? Yes//  (Yes)

ORDERABLE ITEM: PROMETHAZINE// DOSAGE ORDERED: 25MG// ^ Select ORDERABLE ITEM: PROME THAZINE  PROMETHAZINE     TAB ...OK? Yes// N (No) PROME 1  PROMETHAZINE       INJ,SOLN 2  PROMETHAZINE       SUPP,RTL CHOOSE 1-2: 1 PROMETHAZINE     INJ,SOLN Are you adding 'PROMETHAZINE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 25MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: IM INTRAMUSCULAR      IM  SCHEDULE TYPE: P  PRN SCHEDULE: Q8H      01-09-17 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: PHENERGAN PROMETHAZINE 25MG/ML 1ML INJ         AH100 Are you adding 'PROMETHAZINE 25MG/ML 1ML INJ' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: LIBRIUM CHLORDIAZEPOXIDE     CAP,ORAL Are you adding 'CHLORDIAZEPOXIDE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 25MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: Q4H      01-05-09-13-17-21 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: LIBRIUM,25LIBRIUM CHLORDIAZEPOXIDE 25MG CAP         CN3 02            Are you adding 'CHLORDIAZEPOXIDE 25MG CAP' as     a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM: "LIBRIUM" CHLORDIAZEPOXIDE     CAP,ORAL Are you adding 'CHLORDIAZEPOXIDE' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 50MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: Q4H      01-05-09-13-17-21 SPECIAL INSTRUCTIONS: Select DISPENSE DRUG: CHLORA,50 ?? Select DISPENSE DRUG: LIBR,50 ?? Select DISPENSE DRUG: LIBRIUM 1  LIBRIUM  CHLORDIAZEPOXIDE 5MG CAP         CN302 2  LIBRIUM  CHLORDIAZEPOXIDE 10MG CAP         CN302 3  LIBRIUM  CHLORDIAZEPOXIDE 25MG CAP         CN302 CHOOSE 1-3: 3 CHLORDIAZEPOXIDE 25MG CAP         CN302 Are you adding 'CHLORDIAZEPOXIDE 25MG CAP' as    a new DISPENSE DRUG (the 1ST for this ORDERABLE ITEM)? No// Y (Yes) UNITS PER DOSE: 2 Select DISPENSE DRUG: Select ORDERABLE ITEM: AMBIEN ZOLPIDEM     TAB Are you adding 'ZOLPIDEM' as a new ORDERABLE ITEM? No// Y (Yes) DOSAGE ORDERED: 10MG DAY (nD) OR DOSE (nL) LIMIT: START DAY AND TIME: MED ROUTE: PO ORAL      PO  SCHEDULE TYPE: P  PRN SCHEDULE: QHS      21 SPECIAL INSTRUCTIONS: FOR INSOMNIA Select DISPENSE DRUG: AMBIEN ZOLPIDEM 10MG TAB         CN309 Are you adding 'ZOLPIDEM 10MG TAB' as a new DISPENSE DRUG? No// Y (Yes) UNITS PER DOSE: 1 Select DISPENSE DRUG: Select ORDERABLE ITEM:

Auto Stop Dates for specific drugs
<pre style="padding:1em;border:1px dashed #2f6fab;color:black;background-color:#f9f9f9;line-height:1.1em"> Orderable Item -> WARFARIN Dosage Form   ->  TAB

Dispense Drugs: --- WARFARIN 1MG TAB  N/F WARFARIN 2.5MG TAB  N/F WARFARIN 5MG TAB  N/F

Are you sure you want to edit this Orderable Item? NO// YES

Now editing Orderable Item: WARFARIN  TAB Orderable Item Name: WARFARIN//

This Orderable Item is Non-Formulary.

This Orderable Item is marked as a Non-VA Med.

Select OI-DRUG TEXT ENTRY: INACTIVE DATE: DAY (nD) or DOSE (nL) LIMIT: 4D MED ROUTE: ORAL// SCHEDULE TYPE: FILL ON REQUEST// SCHEDULE: QDAY// PATIENT INSTRUCTIONS:

Select SYNONYM:

Dose limits for specific drugs
<pre style="padding:1em;border:1px dashed #2f6fab;color:black;background-color:#f9f9f9;line-height:1.1em"> PHARMACY ORDERABLE ITEM List                         AUG 15,2011@10:03   PAGE 1 NAME                                     DAY (nD) or DOSE (nL) LIMIT

ACETAMINOPHEN/CODEINE                    4D ACETAMINOPHEN/HYDROCODONE                4D ACYCLOVIR                                10D ACYCLOVIR                                10D ALPRAZOLAM                               4D AMOXICILLIN                              10D AMOXICILLIN                              10D AMOXICILLIN/CLAVULANATE                  10D ATROPINE/DIPHENOXYLATE                   4D AZITHROMYCIN                             10D AZITHROMYCIN                             10D BUPRENORPHINE                            4D BUSPIRONE                                60L CEFPROZIL                                10D CEFTRIAXONE                              10D CEPHALEXIN                               10D CEPHALEXIN                               10D CHLORDIAZEPOXIDE                         4D CIPROFLOXACIN                            10D CIPROFLOXACIN                            10D CLARITHROMYCIN                           10D CLINDAMYCIN                              10D CLONAZEPAM                               4D CLONAZEPAM                               4D DEXAMETHASONE/NEOMYCIN/POLYMYXIN B       10D DIAZEPAM                                 4D DIAZEPAM                                 4D DOXYCYCLINE                              10D DRONABINOL                               4D ERYTHROMYCIN                             10D ERYTHROMYCIN                             10D FLUCONAZOLE                              10D GENTAMICIN                               10D GENTAMICIN                               10D HYDROCORTISONE/NEOMYCIN/POLYMYXIN B      10D HYDROCORTISONE/NEOMYCIN/POLYMYXIN B      10D KETOROLAC                                5D LEVOFLOXACIN                             10D LOPERAMIDE                               16L LORAZEPAM                                4D LORAZEPAM                                4D METRONIDAZOLE                            10D MODAFINIL                                4D NITROFURANTOIN                           10D NYSTATIN                                 10D NYSTATIN                                 10D NYSTATIN                                 10D OSELTAMIVIR                              5D PENICILLIN                               10D PENICILLIN G BENZATHINE                  10D PENICILLIN G PROCAINE                    10D PENICILLIN VK                            10D PHENOBARBITAL                            4D SULFACETAMIDE                            10D SULFAMETHOXAZOLE/TRIMETHOPRIM            10D SULFAMETHOXAZOLE/TRIMETHOPRIM            10D SUMATRIPTAN                              12L TEMAZEPAM                                4D WARFARIN                                 4D ZANAMIVIR                                10D ZIPRASIDONE                              40L ZOLMITRIPTAN                             10L ZOLMITRIPTAN                             10L ZOLPIDEM                                 4D