MEDICATION CUSTOM ORDERS

The Clinical Management for Behavioral Health Services (CMBHS) system provides the user the ability to document a wide-array of medication related services. Whether your program administers medications directly to clients, prescribes medications, or does neither and your primary need is to document the client’s medications prescribed by other providers, CMBHS seeks to facilitate the documentation process.

This section of the CMBHS Help provides instructions for the creation of medication custom orders that allow the documentation of frequently used medication orders to be created as medication custom orders that can be entered into a client record with just one CLICK. MED061

Before You Start

• Before you use the CMBHS custom medication order function, it is important for users to be aware of all applicable laws, rules and contract provisions related to documentation of client medications. CMBHS cannot ensure that providers know and follow the rules or prevent users from making medication errors. If you are not sure that you know the applicable laws, rules and contract provisions related to documentation of medications, do not document medications in CMBHS. Contact your supervisor.
• The CMBHS user organization must be one that provides direct services to clients in order to access the medication custom order function and the user must be assigned a role that allows the use of this function.

Business Rules

• The user must have a role that permits Write access to the Custom Order page. The roles that have this access are Medication Specialist-Licensed, Nurse, Local CMBHS Security Administrator, AND DSHS System Administrator.
• The user must create the Custom Orders at the CMBHS Location where the Custom Orders will be used.
  • CAUTION: Custom Orders were originally designed to be user specific (created and used by a single clinician). A change in the near future to allow custom orders to be Location specific (created and used by multiple users at a Location), is planned. .
  • Check the CMBHS Release Notes in Help for information about the change to this function.

How to Access the Medication Custom Order Page

• To access the Medication Custom Order move your pointer to the Administrative Toolbar at the top of every page of CMBHS. Hover over the Provider Tools tab, and when the sub-menu items display, Hover over Medication. As you do so, Medication Custom Order will display. CLICK on it.
• The Medication Custom Order, page MED061, will open.

How to Create a Custom Medication Order

• First, check the Existing Custom Orders List to see if the order you need to create has already been created. This quick check will ensure that you are not creating a duplicate custom order. If no duplicate custom order exists, you may now create the custom order.
• Enter a name for your custom order. You may use any name for your custom order however, it is recommended that appropriate staff within your organization agree upon a naming convention for custom orders. This will help reduce medication errors and allow others to distinguish between custom orders.
• Complete all the required data fields with the order information.
• Check the order narrative to ensure that it is correct and then CLICK on the Save button.

Existing Custom Orders List

• At the top of the Medication Custom Order page you will see the Existing Custom Orders List. To the left of the List is a box with a + or – sign inside.
• CLICK in the box to Open and Close the list.
• If there are already existing custom orders for your location, the following information will display about each order on the Existing Custom Orders List.

Order Information

• Order Name – the name of the custom order
• Medication Narrative - the narrative for the order created by CMBHS.
• Provision Type – the provision type of the order (Prescribed, Administered, Dispensed)

Medication Custom Order Data Fields

Order Name

• Enter a name for your custom order. You may use any name for your custom order however, it is recommended that you use a naming convention agreed-upon within your organization for CMBHS custom orders.
• TYPE the name into the text box.

Medication

• To use this medication documentation function, start TYPING the first 3 to 5 letters of the name of the medication you are searching for. Medications beginning with the letters you type will begin to display. The medication you want may display at any time, even after typing only one or 2 letters.
• When you see the medication you want, CLICK on it. The name of the medication will fill in the appropriate data fields.
• If you do not see the medication you are looking for, an alternative is to CLICK on the word more when you see it. The list will then display all the medications in the list with the medication you have entered as an ingredient.
• If no No

Medication Not on List

• If the medication you are looking for is not in the List, CLICK on the Medication Not on List box and Type the name of the medication directly into the Custom Order.
• You can then continue to complete the order data fields.

Custom Medication Order Data Fields

Provision Type (Required)

• Provision Type refers to the type of medication service provided to the client.
• You may select only one Provision Type.
• Provision Type answer choices:

Provision Type (Required)	Custom Medication Order Data Fields
Prescribed	The client will get a filled prescription for the medication at an outside pharmacy. This may mean that the client leaves with a paper prescription, or that a prescription is transmitted to an outside pharmacy via fax or other electronic means from your facility
Administered	The client is given a dose of the medication at your facility to be taken immediately, on site.
Dispensed	The client will leave with a supply of the medication provided by your facility.
Other	Select Other if none of these Provision Types apply.

Form

• Form refers to the shape and structure of the medication. All possible medication Forms are numerous, but the drop down list will populate only with those appropriate to that medication.
• If the appropriate dosage Form is not already displayed, select it from the list.

Strength

• Select the medication Strength from the drop down list. Remember, you can specify amounts greater or less than one unit later, in the Dosage Unit section.

Dosage

• Enter a numeric dosage in the Dosage box, indicating the number of units to be given. This is not the same as the dosage strength.
  • Example 1: An order stating “50mg Promethazine” could be entered as “Promethazine Hcl tablet, 25mg, 2, whole” to equal 50mg.
  • Example 2: Similarly, an order for 12.5mg Promethazine could be entered “Promethazine Hcl tablet, 25mg, 1, half” which is equal to the 12.5mg Promethazine ordered.

Dosage Unit

• In the Dosage Unit field, TYPE in the unit to be used.
• The Unit will vary based on what Forms the medication is available in.
  • Example 1: An order stating “50mg Promethazine” could be entered as “Promethazine Hcl tablet, 25mg Tablets and capsules will generally be indicated in whole, half, or another fraction of a unit, while other medications will list units such as weights, volumes or other dosage units.

Route

• Document the Route by which the medication will be given. This field will generally populate itself, based on the medication.

Frequency

• Select the Frequency the medication is to be taken from the drop-down list.

PRN

If the order is for a medication to be given PRN, also document the following:

for agitation

for agitation and/or anxiety

for alcohol withdrawal

for allergic rhinitis

for allergies

for allergy symptoms

for anxiety

for chest pain

for constipation

for control of blood sugar levels

for control of detoxification symptoms

for control of seizures

for cough

for diarrhea

for excessive urinary urgency

for eye dryness

for eye redness

for fever

for headache

for headache and/or fever

for heartburn

for high blood pressure

for indigestion

for indigestion and/or heartburn

for inflammation

for insomnia

for itching

for loose stool

for low blood pressure

for lower digestive gas

for migraine

for muscle pain

for muscle pain and/or spasms

for muscle spasms

for nasal congestion

for nasal dryness

for nausea

for nausea and/or vomiting

for nicotine withdrawal

for opioid-induced constipation

for oral dryness

for pain

for pain and/or fever

for pain and/or headache

for rash

for shortness of breath

for shortness of breath and/or wheezing

for sleep

for soreness of throat

for swelling

for swelling and/or inflammation

for upper digestive gas

for upper respiratory symptoms

for urinary retention

for vaginal dryness

for vomiting

for wheezing

until cleared

until healed

Other

• In the Dosage Unit field, TYPE in the unit to be used.
• The Unit will vary based on what Forms the medication is available in.

Additional Instructions

• You may type any additional instructions in the Medication Order in this text box.
• These instructions will appear in the Order Narrative.

Priority

• Select a Priority from the drop-down box.
  • Routine
  • Done
  • STAT

Day Supply

• This field will only display if you have selected Prescribed or Dispensed as the Provision Type. It will not display if you have selected Administered.
• Indicate how many days supply should be or has been given to the client.

Quantity

• This field will only display if you have selected Prescribed or Dispensed as the Provision Type. It will not display if you have selected Administered.
• Quantity refers to the total number to be given to or taken by the client.

Refills

• This field will only display if you have selected Prescribed or Dispensed as the Provision Type. It will not display if you have selected Administered.
• Indicate the number of refills using a whole number.

Order Narrative

• CMBHS translates the data you have entered into a narrative order. Review the narrative to ensure that the order reads correctly.
• If the order does not read correctly, review the information you entered in the data fields that appear to be in error.

What Next?

• After completing the required data fields, CLICK on the Save or Cancel buttons.
• Save will add your new Custom Medication Order to the Custom Order List and it will be available to you for documenting medication orders for clients at your location.
• If you CLICK on Cancel the Custom Medication Order will be deleted and can not be retrieved.
  • NOTE: Check the CMBHS Release Notes for information about an important change to this function. When originally deployed this was a user specific function. A change will be made to this function to allow custom orders to be Location specific). This means that multiple authorized users at a Location can view and use Custom Orders Created for the Location.
  • Access the CMBHS Release Notes from the CMBHS Help tab at the top of every page of CMBHS. When the Help Page opens, the Release Notes are the last item in the Table of Contents.

   

   

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