Procedure orders include requests for patient movement (admission, transfer, discharge, leave of absence, etc.), investigations (laboratory tests, interventions, assessments, etc.), consultations, patient alerts (e.g., Mental Health Act forms) and precautions (e.g., isolation for communicable disease risks).
Some procedure orders have unique properties, highlighted here.
Isolation and Discontinuation of Isolation
Patients can be placed on contact and/or droplet and/or airborne precautions by means of an "Initiate Isolation" order. A different order is required to remove isolation precautions already in place.
“Discontinue Isolation” orders have some unique properties, illustrating how just-in-time instruction, guidance and documentation can be supported with an integrated workflow. Orders, progress notes, external information and internal health data can be combined when ordering and documentation processes are explicitly linked:
Point of Care Testing (POCT)
The Connect Care initiative promotes standardization of procedure orders provincially, where this is both possible and helpful. However, some procedures are particularly sensitive to locally available equipment, expertise and other resources. This is particularly true for POCT orderables. Some settings have the relevant equipment near the bedside and others need to delegate the workflow. This can lead to confusion when prescribers seek the right intervention from among a list of available POCT orders. Prescribers should familiarize themselves with local practice, preferentially use the "facility list" tab in order search results, and save the most appropriate order as a favourite... and so reduce dependence on the precise wording in an order listing.
Patients may need to be placed on spinal precautions for a period of time or until specific conditions are satisfied. This is accomplished by using the Spinal Precautions Order Panel.
Initiate Spine Precautions
Open a patient's chart to the appropriate (usually emergency or inpatient) encounter, then open the Orders Activity and search for "spinal".
Select the "Spinal Precautions Panel" appearing in the Order Sets and Panels section.
Use the order composer and its checkboxes to select, then specify, all parameters for the needed spinal precautions. All related orders are organized and can be selected within this panel.
Save (for attending sign) or sign the orders.
Clear Spine Precautions
To clear spinal precautions, the original order needs to be discontinued and appropriate documentation needs to be completed.
In the "Orders" activity, under "Active Orders">>"Precautions & Restraints">>"Spinal Precautions", select "Discontinue".
In the "Notes" activity, create a new note and select the "Type" as "Spinal Clearance" (search for "spinal") to bring up the Spinal Clearance Documentation template. Use the provided checkboxes and text spaces to document satisfaction or requirements for spine precautions clearance.
Review Past Spinal Precautions
Previously cleared precautions can be seen in the "Summary" activity >>"Overview" tab.