Drug-Breastfeeding Contraindication Alert

The ambulatory departments are joining the Baby-Friendly initiative with the documentation for breastfeeding mothers.

The process will include the addition of the Breastfeeding field in the ambulatory nursing intakes. If a clinician is ordering a medication and the documentation states the patient is breastfeeding (not just lactating) that alert will present itself as you are adding the medication to the scratchpad. You will be able to cancel the order at that time, or override it and continue.

The alert will present to anyone who is placing the order.

New Alert for C. diff by PCR Orders

In the next few weeks, there will be a new alert added that will aid in the prevention of ordering unnecessary C. diff by PCR testing.

As approved by the Use & Standards governance committee, the alert will impact inpatient ordering only.

There will be an alert that will prevent ordering C. diff by PCR if a previous C. diff has been ordered within 7 days.  

According to Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA), it is recommending to not repeat Clostridium difficile testing (within 7 days) during the same episode of diarrhea.  As a result, all Stool C difficile toxin by PCR orders placed within 7 days of the previous order will be rejected.

IDSA Clinical Practice Guidelines

Drug-Food Alerts: Review and Suppress for Encounter

Coming in January-- Drug-Food Alerts:  Review and Suppress for Encounter.

Functionality: Will allow providers to filter a Drug-Food alert for themselves only for a specific patient for the duration of the patient’s encounter. Providers and IT personnel will have the ability to remove filtering.

How to Suppress the Drug-Food alert:

1)      Select ‘Review & Suppress for Encounter’ as an Override Reason on the alert

2)      Select ‘Continue’

How to remove suppression:

1)      Select ‘Check Interactions’ at the top of the patient’s Order Profile

2)      A red sphere appears to the left of all orders with interactions. Find the medication in question and click to view all interactions for the order. See allergy example below.

3)      Under Provider Filtered Alerts, check the box under ‘Unfilter’

4)      Select Continue.

5)      This will cause the alert to fire again upon order entry of that medication.

Duplicate Checking: Hemoglobin A1c

Hemoglobin A1C now has restricted duplicate checking of 7 days (it was a warning for less than 1 day). If the test needs to be performed within a 7-day period, the lab would need to override the restriction.

This restricted duplicate checking will not prevent future orders if the requested collection day(s) are separated by more than 7 days.