HealthCare Software/Application Tools

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Our Electronic Medical Records Systems and Hand Charting is the fastest most effective use of “Evidence Based Practice Information” and “Patient Information”.

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This is the screen that will allow you to enter in medication orders.

First the Shift time type is imported by selecting one of them as the default on the shift times screen were during initial setup you can define your facilities shift times. Second The medications work the autocomplete box gives you options for medications as you type in the name. This is important because the name of the medication ties into a part of the database that holds all of the information about that medication for instance the medications classification. That way when generate the MAR (Medication Administration Record) or run comparisons for drug interactions the database has data to do that thinking.

Dynamic Patient Selection

Next by entering the patient name the Medication Order is to be administered to, that field in the database will dynamically search the list of patients you have already put into the system. You can also click the down arrow to select a patient from a list. This searchable Auto-Complete Box is set up to show a Patients picture beside the Name, Gender and, Location data for more precise records creation.

Dynamic Medication Selection

Options for Drug route are a separate variable already required by the five rights of administration but help to in this case as well act as a limiter to whittle down the administration information that may be relevant.

Routes Given

This picture shows the screen is used to store your ordering doctor's information. Like the patient information it is entered once and from then on is just pulled up by things like the medication order sheet.

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The order can be taken down by a nurse over the phone as a written order the doctor either sends as a script or simply enters himself. Verbal orders should only be noted as such temporarily during emergency situations when working side by side with the doctor.

How Taken

Finally the order information is finished off by entering in the Diagnosis or procedure the medication is being prescribed to treat. This set of choices comes from a full IDC 9 data base that is updateable and editable depending on an employee’s user permissions. Not Applicable is preselected as a default to make the order, "Quick to enter!” Simply make sure there is a “NOT APPLICABLE” with a code of Zero "0" is an option in each of the diagnosis and procedure editable grid tables. This is meant to be a time saver and it is best practice to specify the reason for the medication but if not specified per facility policy that is an option as well. Click “Save” and you are done. The Medication administration times are all entered at one time from the Times and M.A.R.s task.

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