Pediatric medication orders w/co-signature | Forum

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Jul 27 '17
2017-07-27 18:55:23
A question from our pharmacist.
Hello everyone,
We are trying to come up with a process to capture pediatric medication order co-signatures on drug dictionary entries that are also used for adult dosing. Currently we have an eMAR assessment attached at our Pediatric Order type's level that prompts a soft stop co-signature. This works well if the default order type in the drug dictionary is a pediatric one.
Meditech is stating a rule is not capable of invoking the co-signature function. We would be interested in knowing if any other facilities have a work around for this issue.

Colleen Beres RN, MSN
Sr. Clinical Analyst
Fauquier Health | 500 Hospital Drive Warrenton, VA 20186
o: (540) 316-5524 | f: (540) 316-5501 |<>

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Jul 27 '17
2017-07-27 19:45:07
Colleen, you can add an addition co-sign via a cds query that is attribute conditional on age,etc. The macro in the cds query attribute calls which will give you co-sign box that you can use to capture the co-sign user's inits in the cds, for the documentation.
Michael Carpenter | Sr.Systems Analyst | ENGAGE |<> | 509.232.8340 |<>;
Jul 28 '17
2017-07-28 13:39:52
Hi Colleen,
We had asked Meditech for this about 2 years ago, and were told the same thing. Our pediatric population is small, so we did something similar to what you did, but it's an intervention that the nurses document on after giving the med.
If you get any personal replies, would you share them?
Jul 28 '17
2017-07-28 14:18:17
I had recently inquired with Meditech about the ability to requiring a co-signature for a specific medication but limiting it to a patient's location and received this response:
Unfortunately the only limiting factors at this time are by MED and IV order
types and by control schedule in the NUR eMAR Access group. There is proposal
14233/ IDEA-3827 currently that has been submitted that would add co-signatures
by location/age/weight.
I had our task set to a status of "Idea/Proposal" so we may be notified if this ever makes it to development. Maybe if others inquire about this proposal it may move it along?? I can always hope.
Lorna Schledorn, CPhT
Systems Analyst, Clinical
Information Systems
UR Medicine/Noyes Health
111 Clara Barton St
Dansville, NY 14437
Jul 28 '17
2017-07-28 15:09:45
Are you Magic, Client server or 6.1? In 5.67 C/S In the drug dictionary under the PCS/POM tab, PCS co-sign, there is a location box. I can make individual units a co-sign by selecting the unit and placing a Y in the eMAR co-sign field.

Stacy Stanford, Pharm.D., BCPS
Clinical Informatics Pharmacist
Salina Regional Health Center

Jul 28 '17
2017-07-28 16:35:45
I failed to mention we are Magic 5.67sr20, the only option we have is on page 4 of the PHA drug dictionary, Co-Signature for Doc MED? and Co-Signature for Doc IV? Y or N.
Jul 28 '17
2017-07-28 15:41:24
Ask about a custom using a custom keyword allowing rules to pull in the cosignature functionality on eMAR. (Magic)
Jeff Lee, MS, RPh
Pharmacy Manager Informatics
DCH Health System
809 University Blvd E
Tuscaloosa AL 35401
Jul 31 '17
2017-07-31 12:11:19
If I remember correctly, Kevin McConnell discussed this during his MUSE presentation this year! I believe he has a rule built to require cosignatures that can be formatted to require based on age or other criteria.>;
Katie J. Sams
Clinical Informatics Analyst
Mercy Medical Center
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