LSS 5.6.4: Insulin Sliding Scale, Prednisone Tapers, Alternating Dose, Topical Medications

Overview: Ordering sliding scales for insulin, prednisone tapers or other tapers, alternating doses for medications such as coumadin, and topical medications

Location: Change Details popup window under Medications in the Orders function.

Buttons:

To enter in an insulin sliding scale, select the type of insulin as usual by entering the name of the insulin in the Medication Name Search textbox under Medications in AOM (ambulatory order management), or select from your previously entered favorites list. 

When the medication has been found, look at the Dose field.  If text appears in the Dose field, then the dose has previously been set to zero.  If no text appears, then the dose is not set to zero and you need to enter zero for the dose.  Click on the field, and enter 0 in the popup window that appears.

Enter UD in the Frequency or Directions field.  (UD = as directed).  The frequency of the administration will be entered in the text field as instructions when you enter in the sliding scale.

Enter the quantity to be dispensed or the days to be dispensed as desired.

Click on the Details field to open up the Change Details popup window.  Now click on the Instructions field to open up the Enter Instructions popup window.  Type in the instructions you desire and save.

This can be saved into your favorites list, so all you have to do when entering a new prescription for a sliding scale is to select this entry from the favorites list and then change the instructions field under Details popup window.  The amount to dispense or the days to dispense can also be changed in the Details popup window. 

You can have multiple entries of the same medication in your favorites window, allowing you to preenter several formats of sliding scales.  If the only difference is in the instructions field, it won't be immediately apparent which text is associated with each entry for the same medication until you click on the Details field which brings up the Change Details popup window.

This same process can be used for a prednisone tapering schedule, or an alternating dose schedule for coumadin.  Just select the appropriate medication in the Medication Name Search textbox or from your list of favorites.  As above, enter 0 for the dose if it text is not already present in the Dose field, and UD for the Frequency/Direction field.  Enter in the appropriate instructions in the Enter Instructions popup window by clicking on the Details field, and then the Instructions field.  The frequency of administration will entered as text in the Instructions field when you fill this in.

For topical medications,  enter 0 for the dose, and UD for the frequency and Topical for the route, and then edit the instructions appropriately.