How to Complete a Medication Reconciliation w/ KeyPhrases
To use KeyPhrases to document your medication reconciliation, follow the steps below: Begin by writing your note as normal. Click to place your curser in the Information and Education box […]
How to Create a New Medication Order
To place a new medication order, follow the steps below: Click on the Search icon with the client open. Type Client Orders in the search bar. Select Client Orders (Client) from the […]
How to Place a Legal Status Order in Client Orders
This will go over placing a legal status order in client orders. This order Identifies the client’s legal status when the legal status order is placed. You can add multiple […]
How to Document Multiple Admins Within the Hour
For Medication Orders, the setting âMultiple Admins Allowed Within Hourâ can be set in the Order Setup (Administration) Screen by a System Administrator to enable staff to administer medication more […]
How to View Whiteboard Observations
For all Order Types except âActivityâ and âSafety Check,â you may be able to see info about a completed order on the Whiteboard under the âObservationsâ column. For this to […]
How to Document an Order as Self-Administered
For Medication order types there may be an option to check an order as âMay Self Administerâ. To be able to set an order as May Self Administer the setting […]
How to Duel Sign a Client Order
This will go over how to dual sign a client’s order. Dual singing needs to be done if the medication the client is having ordered is a controlled substance. Click […]
How to Add or Edit a Diagnosis to an Order
For Order Types âLabs, Additional, Safety Check, Adaptive Equipmentâ, you may need to enter in a Diagnosis. For this to be enabled, the âDiagnosis Requiredâ option must be set for […]
How to View and Edit Client Order Comments
For all order types you may have a comments box to add additional notes about an order. For the comments box to appear âOrder Commentsâ must be enabled for that […]
How to Modify the Order Rationale
For all Order Types except âActivityâ it may be required that you select a reason as to why the order is being placed (typically a diagnosis or problem). To be […]