Changing prescriptions

You can change prescriptions by:

  • Adding notes

  • Modifying the prescription

  • Setting a daily dose

  • Changing the enteral route

You might modify a prescription if you want to change the prescription's frequency, dose quantity, course duration, indication, or instructions. Modifying a prescription is quicker than stopping a prescription, and starting a new prescription. Modifying a prescription allows you to change more than one dose.

Read more about modifying prescriptions

You don't need to be the prescriber to modify a prescription. If you are not the original prescriber and you modify the prescription, the prescriber name is updated to your name. You can change the instructions of a prescription without updating the prescriber name to your name.

Read about adding instructions without updating the prescriber name

If you are a prescriber, you can adjust or omit a current or future dose. You might adjust a dose if you only want to change one dose, or small number of doses. You might omit a dose if you don't want to give that dose.

Read more about adjusting and omitting doses

If you modify a prescription, Nervecentre stops the current prescription and replaces it with the modified prescription. You can view the events log for the medication to see any modifications made to the prescription.

Read more about the events log

If you only change the indication or instructions when you modify a prescription, Nervecentre stops and replaces the prescription if:

  • The dose sentence includes a 'THEN' clause in 'every x hours'

  • It's a STAT or PRN dose sentence

Nervecentre doesn't stop and replace the prescription if:

  • The dose sentence includes a 'THEN' clause in 'every x days'

  • It's a dose sentence that is not a STAT, PRN, infusion, or fluid

  • You prescribed the prescription without a dose sentence

Sometimes you might want to adjust a few doses rather than modify the prescription.

For example, today is the 1st March. Your patient has a prescription where they take 7.5 mg once a day at night. In two days, you want to increase the patient's dose to 15 mg.

You have the following options:

  1. Modify the prescription so the dose is 15 mg, and the start time is in two days

    Nervecentre stops the current prescription, which means your patient is no longer receiving 7.5 mg tonight or tomorrow. Nervecentre starts the prescription of 15 mg in two days time.

  2. Adjust the dose in two days time to 15 mg

    This avoids a gap in the patient's medication, but Nervecentre only changes the dose on that day. Nervecentre doesn't change the doses for the days after that. You might choose to do this if the patient only needed a different dose for a few days.

  3. Modify the prescription so the dose is 15 mg starting tonight, then adjust the doses for tonight and tomorrow to 7.5 mg

    This also avoids a gap in the patient's medication. You might choose to do this if the patient needed a different dose from a specific day and onwards.

Changing prescriptions on a mobile

  1. From your patient list, select a patient.

  2. From Chart > Current, select a prescription.

  3. To add a note:

    1. Select .

    2. Select Add note.

    3. Enter a note.

    4. Select OK.

  1. From your patient list, select a patient.

  2. From Chart > Current, select a prescription.

  3. Select > Modify prescription.

  4. Select a field to change.

    In this example, Frequency is changed.

  5. To add a reason for modifying the prescription:

    1. Select Reason for change.

    2. Enter the reason.

    3. Select Back > Submit.

Changing prescriptions on a desktop

From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds. To view current medications select > Current.

Current medications appear below Draft.

Select one or more medications.

Supply

Double-click a medication in to select the supply location.

The list of supply options available depends on your organisation.

Read more about recording a supply source

Notes

Double-click to add a free text comment.

Ph

If you have pharmacy permissions, you can mark medications as checked or not checked. Double-click a medication in the Ph column, and select Approved or Unapproved.

Mouseover to see details about who approved the prescription, and when.

Read more about pharmacy checks

Alt

Shows the highest level of alert shown at the point of prescribing.

Double-click to view information about the alert.

Select one or more medications to view the actions available. The options you see depend on your permissions.

Stop prescription

Select to stop the prescription. You must give a reason.

Read about stopping a prescription

Pause prescription

Select to pause the prescription. You can provide notes.

Read about pausing a prescription

Modify prescription

Select to modify the prescription. You can modify any parameters allowed by the dose sentence, or choose a different dose sentence for the same medication.

Read about modifying a prescription

Pharmacy reviewed drug chart

For pharmacists. Select to record that you reviewed the MAR. You can add notes.

Read about pharmacy review

Create TTO from selected

Select to add one or medications as a TTO.

Read about creating TTOs

Change enteral route

Select to choose a route from the list of routes associated with the dose sentence.

Read about changing the enteral route

Pharmacy review

If the MAR Medicines Administration Record. Also known as drug chart. A list of all medication prescribed and administered (given)., has been reviewed by pharmacy, pharmacy details appear below Current.

Select View history for more details.

  1. From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds.

  2. Select the medication’s name to view the events log.

  3. Select Add note.

  4. Enter your note.

  5. Select Save.

  1. From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds.

  2. View current prescriptions or the MAR.

    • To view current prescriptions, select > Current.

    • To view the MAR, select .

  3. Select the name of a prescription.

  4. Select Modify prescription.

  5. Select an option.

    • To modify the prescription, select Modify prescription.

    • To modify a non-dose sentence, or to make more significant changes than the dose sentence allows, search for the medication and complete the dose sentence questions.

  6. Modify the prescription. Complete mandatory fields, including Reason for change.

  7. Select Modify.

    If a user who is not the original prescriber modifies the prescription, the prescriber name is updated.

Some medications, for example, warfarin, can require a prescriber to set the dose quantity every day, depending on test results. You can’t administer the medication until the dose quantity is set.

The first day’s dose is entered during the prescribing process.

Read about prescribing

  1. From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds.

    On the MAR, the first dose is set and can be administered as expected.

  2. For subsequent doses, select the dose from the MAR and then select Set dose.

  3. Enter a new dose quantity.

  4. Mouseover the dosed cell to see prescriber details.

To add instructions without updating the prescriber name:

  1. From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds.

  2. Select .

  3. Select the name of the medication.

  4. Select Instructions.

  5. Enter instructions.

  6. Select Save.

  1. From  Inpatients > Patient List > double-click on a patient's name > Patient Detail, select Meds.

  2. Select > Current, and select medications.

  3. Select Change enteral route.

  4. Select route options.

    This shows any enteral routes you added in the EPMA banner on a desktop, or prescribe form on a mobile.

    Read about adding enteral routes

    Selected routes are green.

  5. Select Save.