CPOE Computerized Physician Order Entry

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Hello, am new here.....in reference to CPOE does your system ( electronic health record system ie: Cerner, allscripts, epic, ect...) require the nurse to acknowledge a medication order, then have to execute the order and sign off....or the provider enters the order, it shows up on a tracking screen with an icon or column, or color indicating that an order is pending and the nurse opens it , executes that order and signs off?

Seems like some systems have an extra acknowledge step that is a carry over from inpatient nursing verifying orders....

Thanks!!!!!

Navy ER Nurse

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Specializes in Emergency & Trauma/Adult ICU.

Our ER system contains the acknowledge step in a "flag new orders" box that is optional. It's not necessary to do anything to acknowledge the order.

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Specializes in ER, ICU.

Signing off is so 20th century. It pops into your MAR and you give it and document.

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Ours has an acknowledgement step, but it isn't required to click on it to see the order or carry it out.

I find it very useful in helping to avoid medication errors. I work in the ED, and if the acknowledge step is used, it alerts other nurses that may be trying to help you that you are working on that order so they don't duplicate it.

The only challenge is that sometimes you will acknowledge an order, but then get distracted with something else that takes priority, and the acknowledged order might not get done as quickly as it could have. I've never had it seriously affect patient care though.

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Signing off is so 20th century. It pops into your MAR and you give it and document.

For our system, clicking on a "completed" button IS signing off AND constitutes documentation that the order was done.

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Specializes in Med Surg/Tele/ER.

With our system all orders are supposed to be red until completed. Then turn green when you click on the order, and either document admin or non admin.....now that does not always happen. Many times new orders show up green, and completed orders stay red....its a nightmare! You are constantly clicking on all orders to be sure nothing new has popped up....aggghhh! I hate Meditech!:down:

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Thank you everyone for your responses, I appreciate your taking the time to answer. Your answers confirm my experience as well. Our ER is developing it's own ED CPOE module and I am advocating for the best streamlined process that does not have any additional steps.

What are the names of your programs you use in your ED's? anyone use Epic??

Thanks again!!!

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Specializes in ER.

We use EPIC, have used it at 3 different hospitals, and depending on how much money your facility spends for all the bells and whistles, it can be great, or an onerous task in the first 6 months. The first place I used it was a Kaiser facility, in 1996, and it was great.

Next place was a teaching University hospital, and they did well.

Current place is a not for profit, with less money, and they had to make a lot of changes in the first 6 months. It is configured differently for each system that buys it.

Kind of like buying a car, some facilities add all the extras, some buy basic, and some add custom finishes.

In my opinion and experience, EPIC is at the top of the game as far as any EMR system out there I have used.

I use Allscripts as well, for UR, and it doesn't even compare. Have used CERNER, T-system, QNXT, etc.

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Specializes in Emergency Dept. Trauma. Pediatrics.
Thank you everyone for your responses, I appreciate your taking the time to answer. Your answers confirm my experience as well. Our ER is developing it's own ED CPOE module and I am advocating for the best streamlined process that does not have any additional steps.

What are the names of your programs you use in your ED's? anyone use Epic??

Thanks again!!!

We just went to CPOE in our Facility and use Cerner they changed the ED program to First Net to flow with this. I can't remember the name of it before the change a few days ago.

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Specializes in Emergency, Critical Care (CEN, CCRN).

We use Epic oneChart as well, system-wide, though ours comes in two flavors: the standard "floor" view, and the "trackboard" view that you only get if you're signed into the Emergency Center. Epic for EC is a breeze. You sign into your team and assign yourself to your patients, and everything shows up on one easy screen. The system pops up different icons depending on what's going on with each patient - Waiting for RN, Waiting for MD, New Orders, Meds Due, Disposition Pending, Discharge, Admit, and so on. Orders of any kind can be acknowledged from the main screen, and the "New Orders" icon goes away once you acknowledge, but the icon for meds won't go away until the med is actually charted off in the eMAR. You have the option to chart off non-medication physician-to-nurse orders as "Complete," but you really don't have to; acknowledging the order is considered a statement that you've done that task.

We also have Epic tied into the Pyxis system, so if you override pull a med or fluids for a patient, it'll show up a different color in the eMAR until you link it to an active physician order or document it as an emergency administration. (For example, you pulled sublingual nitro tabs and baby aspirin per protocol for new onset chest pain; or your patient started seizing, the MD verbally ordered a dose of IV Ativan on the spot, and then he/she went back and put the order in after the situation was controlled.) Override meds are otherwise charted the same as any other med.

Hope this helps!

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We use Horizon Cinicals.

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