Scenario 11

Prescribe PBS scripts, chart medication orders, administer and supply using medications management, medication requests, consolidated orders, verbal orders, scope of practice.

Clinicians employed at our health service are authorised, within their defined national registration category, to write prescriptions (for example, PBS, rural and remote prescriptions (S100 Scheme, HCP)) which are printed on individual PBS script paper or printed on a single batch prescription which is sent by the health service to the pharmacy for dispensing.

Our health service stocks and supplies patients' prescription medications, that are packed by an external pharmacist.

Health Practitioners employed at our health service are authorised, within their defined national registration category to chart a medication order.

Health practitioners who are not prescribers are authorised to chart medication orders within a defined scope of practice (for example, CARPA, SASA, nurse initiated medications). These medications may be defined by drug or by schedule. Medications outside the scope of practice require a verbal order.

Health practitioners who are not prescribers are required to seek verbal orders for specific scheduled medication (for example, S8).

The quantity and the date last administered and last supplied or both, of medicines are displayed in the patient’s medication summary.

After review, bulk orders for patient inventory of prescription medications are sent to the supplier. When the patient's order is received, the inventory for the patient's medication is receipted against the order.

System Parameter - Configuration

Configure the following settings in File > System Parameters.

Table 1. System Parameters - Configuration
System Parameters
System - Modules Medication View On
Medications Management On
Prescribing On
System Parameters - Clinical Brand Off
Generic Prescribing On
Generic Prescribing Mandatory Off
Enforce choice of once off/short course or regular medication Optional
Print prescription by default Optional
Use Health Centre Prescription defaults Optional
Show generics in Drug Browser Optional
Use default prescription repeats Optional
Show Prescriber’s Comments On
Use RTPM Service VIC only optional
Require password on adverse reaction prescribing Optional
Enable label printing On
Print Labels by default Off
Default label count Set as required
System Parameters - Prescription Forms Custom prescriptions Optional
Interactions - Include non-specific category interactions Optional
Interactions - Exclude minor non-specific pregnancy Optional
Consolidated orders On
Consolidated order templates Set as required
Medication Requests
  • Name
  • Plural Name
  • Information Text
  • Selection Information Text
 On
Medication Request template On
Create medication request by default On
Show out of stock inventory Optional
Print S8 prescriptions on a separate page On
System Parameters - Web Services Clinical Decision Support (CDS) Optional - but encouraged as a clinical safety initiative
Tip:

If the Medications Management module is enabled, Print labels by default doesn't work.

Use Health Centre Prescription defaults - if used with Enforce choice of once off/short course or regular medication, regular medication duration does not default to the health centre prescription default duration.

Show Prescriber’s Comments - if enabled prints the prescriber's comments on the medication request.

Medication Request - if enabled optional to set Name, Plural Name, Information Text, Selection Information Text.

Medication Request template - can be reprinted only by users with a recorded prescriber number.

Show out of stock inventory - if off, the default view is inventory stock only.

Reference Tables - Configuration

Configure the following settings in File > Reference Tables.

Table 2. Reference Tables - Configuration
Reference Tables
Editing Encounter Places Medication Pick up Location On
Formularies Formulary On - Create as required
Scope of Practice Scope of Practice On - Create as required
Tip: Set up formularies to restrict what medications a nurse can view in MIMS or create medication orders for.

Medications listed in a Scope of Practice will not require a verbal order for user groups assigned with the scope of practice.

User Group - Configuration

Configure the following settings in File > User Groups.

Table 3. User Group - Configuration
User Groups
Provider Type System Right Viewing Right Program Right Formulary Right Scope of Practice
PBS Prescriber Consolidated Orders - Manage On Common N/A On - select appropriate On - select appropriate
Medication View On
Medication Administer On
Medication Dispense Off
Medication Supply On
Medication History On
Prescribing Full On
Prescribing Once Off/Short course On
Imprest Management Off
Health Practitioner (who is not a prescriber) Consolidated Orders - Manage On Common N/A On - select appropriate On - select appropriate
Medication View On
Medication Administer On
Medication Dispense Off
Medication Supply On
Medication History On
Prescribing Full Off
Prescribing Once Off/Short course On
Imprest Management Off
Health Practitioner, prescriber with restrictions, such as a Nurse Practitioner Consolidated Orders - Manage On Common N/A On - select appropriate On - select appropriate
Medication View On
Medication Administer On
Medication Dispense Off
Medication Supply On
Medication History On
Prescribing Full On
Prescribing Once Off/Short course On
Imprest Management Off
Tip:

On the Formulary Rights tab, set All Products formulary. Optionally create other locally defined formularies.

Formulary - create a formulary to restrict the MIMS medication view and available list of medications for charting medication orders. Assign the formulary to the user group.

Scope of Practice - assign the same formulary as scope of practice.

Providers - Configuration

Configure the following settings in File > Providers.

Table 4. Providers - Configuration
Providers
Provider Type Prescriber Number Verbal Order Schedule Drug Selection Encounter Place Use Scope of Practice
PBS Prescriber To be recorded N/A N/A N/A Off
Health practitioner (who are not a prescriber N/A On Set one or more options Set as required On
Health Practitioner, prescriber with restrictions, such as a Nurse Practitioner To be recorded On Set one or more options Set as required On
Tip: Verbal Order:S1, S2, S3, S4, S5, S6, S7, S8, S9, Un-Scheduled- set one or more options to require that any medication order created for medications included in the selected Schedule requires a Verbal Order. For example, if a nurse needs to be able to prescribe S1, S2 and S3 medications without a verbal order, deselect S1, S2 and S3 and set S4-S9.
Tip: To require a verbal order only for particular encounter places, select the required Encounter Place.

If you deselect an encounter place, the provider does not require a verbal order at that encounter place.

If you want a provider to always require a verbal order at all encounter places,for Encounter Places, set Select All.

Tip: Medication listed in a Scope of Practice that is assigned to a user group that the provider belongs to overrides Verbal Order > Schedule Drug Selection selected for the provider.

Printer Assignment - Configuration

Configure the following settings in File > Printer Assignments.

Table 5. Printer Assignments - Configuration
Printer Assignments
Printer Assignments Prescriptions Set tray default
Medication Labels - Label Template Select dispense label template

Clinical Record - Configuration

When prescribing medications, use the following settings.

Table 6. Clinical Record - Configuration
Clinical Record - Medication Summary
Medication Requests Pickup Location Set as per patient's instruction
DAA Type Set as per patient's instruction