Manage Orders

A resident's Manage Orders page is where you can view and edit the details of your resident's medications. You can also schedule vitals checks on Manage Orders.

Navigate to Manage Orders

There are a few ways to access a resident's Manage Orders page:

• Option 1: In the Medications dropdown menu at the top of your page, click Manage Orders. This brings you to a landing page where you can select a resident or applicant name in the space provided. Click Manage Orders to navigate to that person's page. 

This landing page is also the area in which you can download MARs and Physician Orders in bulk! Read these How do I print MARs for all or multiple residents? and How do I view and print Physician’s Orders for all residents? for more details. 

• Option 2: On a Resident or Applicant profile, click the Manage Orders button beneath their photo.  

• Option 3: If you are on any medications pages (Pass Meds, Administer PRNs, Pharmacies, Medication-related Reports), you can click on the linked resident's name to go directly to their Manage Orders page.

MARs and Physician Orders

The Manage Orders landing page as shown in the first section of this article gives you options to efficiently generate MARs and POs for multiple residents at a time. Read on to learn details about these documents.

MARs

MARs contain a lot of information about each order, and will display all vitals checks recorded on the Pass Meds page.

• On a resident's Manage Orders page, you can quickly review and print their current month's MAR by clicking the blue Current MAR button below their photo.
  • You can also generate this document at the top of your resident's profiles below their photo.
• To look at previous month's MARs, use the Past MARs button to select the month or months you need to see.
• The Blank MAR (also called Unfilled MAR) will generate a MAR document with all of the resident's current orders, but displays no administration records (no staff initials) in the boxes. This document is designed for printing as a paper MAR if you need staff to document on paper.

The key toward the middle of each page of a MAR shows you the full names of staff initials that display on the MAR, and the symbols that indicate the following:

• Not Recorded means the order was scheduled but never recorded (sometimes called a "hole on the MAR"). This displays as a dash symbol.
• Not Scheduled means the order was not scheduled for a particular date or time. This displays as an X on a gray background.
• An Exception could be a refusal or other reason the resident did not take the medication as scheduled. Any time an order has exceptions during the month, the reason and notes will display below the order on the MAR. This displays as an exclamation mark on a red background.
• Self Administered orders will display as a small person icon on a blue background. These orders do not display for documentation on the Pass Meds page.
• On Leave Meds Packaged refers to orders that were scheduled while a resident was documented as being On Leave, and the order was marked as having some doses packed. When the resident is returned from leave, more information about this will show at the end of the MAR document. This status displays as a black filled circle on a yellow background.
  • Read this article for more information about resident On Leave status: How to Set a Resident "On Leave".
• On Leave Meds Not Packaged refers to orders that were scheduled while a resident was documented as being On Leave, but the order was marked as not having any doses packed. When the resident is returned from leave, more information about this will show at the end of the MAR document. This status displays as an unfilled circle.
• On Hold means the order was scheduled for temporary hold for a particular date or time. This status displays as an uppercase "H" on a gray background. Read this article for more information about scheduling holds: Medication Holds. 

Physician Orders

• Click the Physician Orders button to select either Print Current Physician Orders or Print All Physician Orders.
  • Print Current Physician Orders generates for view the list of resident orders that are active on the Manage Orders page. You can Print All or you can click Select Meds to Print if you want to select specific orders to display on the document. If you choose to select meds, the meds will be grouped by Prescriber.
  • Print All Physician Orders will require a date range and generate a document that contains all orders that were active during your date range. This can include discontinued orders, and will display the date of discontinuation.

• Physician Orders always display a column for Diagnoses for the orders. To fulfill this column, you can edit your orders and type the diagnosis for the order in the Diagnosis field. Read this article for more information about editing orders: How to Edit Medications, PRNs, and Treatments.
• The final page of Physician Orders documents contains a New Orders section for prescribers to write new orders if needed.
• The signature lines at the ends of each page can be customized, and you can add a custom disclaimer to display at the end of each page. Read this article for more information: How can I add a disclaimer and signatures to resident Physician Orders?

Edit MAR

• The Edit MAR feature allows nurses and admins to update the information displaying on MAR documents. It is typically only available to specific staff members.
• If staff need to update an administration record that they recently created, this can be done using Med Pass History. Read this article to learn more: Med Pass History.

This powerful page allows us to click the squares that represent individual order administrations to change any information.

Use the arrows to either side of the month and year (below the resident photo) to view different months, and you can filter by Order Name or Time of Day.

1. To edit a record, find the order you want to change and click the square representing the administration time.
2. A pane from the right side of your screen gives you options to update the administration outcome (Passed, Refused, Adverse Reaction, or Other), and you can make updates to the date, time, and dose administered.
3. Users with administrator permissions can also change the staff member who administered the order (Administered By) and delete administrations.
4. Click the Submit button to save any changes.

For more details about the MAR Editor, read this article: How to Edit a Resident's MAR.

Order Types

Routines and PRNs

Routines and PRNs include all of the medication orders for your residents.

For complete details about how to add these orders and all of the details of the Add/Edit orders pages, read this article: How to Manually Add a New Medication.

Treatments

Treatments are scheduled non-drug orders that show on Pass Meds for staff to document. Some examples of treatments are vitals checks, oxygen orders, and wound care.

The main difference between routine medications and treatment orders is that treatments do not have Routes or Doses.

For more information about Treatments, read this article: How to Add a Treatment.

Informationals

Informationals are orders that display on resident Physician Orders documents, but do not require any administration records on the eMAR. These may pertain to specific statements required by your state license or a doctor's recommendation.

We can organize informational orders into different types, and if all or many of your residents need the same details on their Physician Orders documents, we can manage these in settings and easily apply them to all or selected residents.

Common informational orders may include:

• Dietary recommendations: Low salt diet, No concentrated sweets, Regular
• Code Status
• Immunizations: Pneumonia, Influenza
• Lab Orders
• "Ancillary Orders"

For complete details about Informationals, read this article: Informational Orders.

Options Dropdown Menu

The Options button to the right of each order gives a list of actions that may be slightly different depending on your company's medication settings and features. Also, your security role will determine which options you can access. 

See below for details about each Options item:

Edit MAR This takes us to the Edit MAR page for this particular order. On the Edit MAR page, you can edit administration records by clicking on a box that represents a specific administration time.

• Near the top of the Manage Orders page below the photo, you can click the Edit MAR button to access this page for all of the resident's orders.
• For more information about the Edit MAR page, read this article: How to Edit a Resident's MAR.

eFax Refill Click here to submit a refill request to your pharmacy or prescribers! Read this article for more information about eFax Refills: eFax Refills.

Request Resupply Instead of eFax Refills, you may have a different refill request setting that submits your requests directly to your pharmacy's software without using fax. Read more information about this type of refill request here: How to Request Refills through your Pharmacy Integration.

Schedule Hold This is a useful feature that allows you to schedule med holds. Orders on hold will not display on Pass Meds until the hold is over, and the schedule can be edited as needed. Read this article for more information about med holds: Medication Holds. 

Discontinue Click Discontinue to confirm and enter a reason for the discontinuation of the medication. You will find all discontinued orders in the DC/Changed tab on Manage Orders. Discontinued orders can be cloned to create new ones if needed. You can learn more about discontinued orders here: Discontinuing Medications.

Disable Routine/PRN/Treatment This option removes the medication from showing in Pass Meds. It is similar to Schedule Hold, except there is no scheduling component. It is an ideal practice to use Schedule Hold instead.

Replicate Across Residents  This allows you to copy the order onto other resident's MARs. Click the checkbox next to the resident names to copy the order. This is most often utilized for Treatment orders for vitals checks. Read more about this feature here: How to Replicate Orders and Vitals Across Residents.

Clone allows you to duplicate a medication for the resident, and you can change the order type between routine, PRN, and treatment.  A common use is cloning an order from a routine medication to create a PRN. You can also clone orders that have been discontinued in the DC/Changed tab to create new orders. Read more about this feature here: Clone a Medication, Treatment, or PRN.

Enable Drug Counting If you have Drug Count turned on for your community, this option is how you will add this order to be counted. This opens a pane where you should choose to 'Create New Account' and add the current quantity on hand. For more information, read this article: Enabling Medications for the Drug Count.

Disable Drug Counting For orders that have been added to the drug count, you can click this option to remove them from the drug count.

Edit Drug Count Link For orders that have been added to the drug count, you will see this option to edit whether the order quantity is linked to another order quantity. It is uncommon to link the quantities, but may be done if the same package of a drug is used for routine and PRN administration. 

Link to Drug Database If you have Drug Database turned on for your community, you typically link the order to the database when you are adding it when you search for a name and NDC #. This option allows you to search for the order within our drug database if you have not already linked it. Read this article for more information about the Drug Database feature: ALIS Drug Database Reference Guide.

Edit Drug Database Link If the order is already linked to the drug database, this option allows you to link it to another. Use this if you have made a mistake with the name and NDC of the order.

Delete Drug Database Link This is very unlikely to be used. You can remove the order's link to the drug database with this option.

Delete will remove the order from the MAR and med pass. You will not be able to delete an order if administrations times have already elapsed in on Pass Meds, but you can discontinue the order instead.

Audit History

Of the tabs in a row across the middle of the page, the last one is called Audit. Here is where you can review all events that have taken place to add, edit, and discontinue your resident's orders. 

A useful way to search for details about an order is to begin typing the name of the order in the Notes filter. If you add just the first few letters of the name of the order and click the magnifying glass, you can see a detailed history of all updates made to your order. 

This audit also shows all vitals records.

Scheduled Vitals

The Wellness Vitals tab provides a way to schedule vitals for your team to record on a separate Record Vitals page. Most communities prefer to add scheduled vitals checks as Treatments so that they display in Pass Meds, which removes the need for staff to visit two different pages to document their items.

Read this article for more details and best practices for vitals: Recording Vitals.

Miscellaneous

• You can update the resident's med cart on the right side of the page below the pharmacy contact button. For more information about med carts, read this article: Med Carts.
• You can navigate to other residents' Manage Orders pages using the menu at the top right of the page below the search.
• The order types showing as a column of tabs on the left side of the page when you are looking at Orders will help you navigate quickly to the different sections. Click one of the order types to jump to that section.

Related Articles:

How to Manually Add a New Medication

How to Edit a Resident's MAR