Prescribing before admission

When a patient is admitted on TrakCare, this automatically generates an admission on
HEPMA with the patient assigned the same ward and consultant as on TrakCare.

Prescriptions can only be created when a patient has been admitted on HEPMA, so to
prescribe before admission the patient will have to be admitted manually on HEPMA.

This must only be done within 24 hours of the planned admission to avoid problems
arising.

Admitting a Patient

• Log in to HEPMA and from the Home screen, click on the green Admit Discharge
  Transfer tile.
• Enter the CHI to find and select the patient.
• For patients in ARI, only select ARI DOSA as the ward, even if they will be
  admitted to another ward.
• Choose the consultant, or choose Unknown, Consultant if unsure. You can also
  type the first part of the surname instead of scrolling through the list.
• When the patient is admitted on TrakCare, the ward location and consultant will be
  updated in HEPMA.
• If the patient has already been admitted in HEPMA, the Admission tab will already
  have a ward and consultant in displayed. Do not transfer them to DoSA. It may be
  better to avoid prescribing in advance of surgery to avoid causing confusion.

Prescribing

• Prescribe drugs as normal, but to avoid any regular medicines getting given
  unintentionally at 0800, 1200, and 1400, change the Start on date and time to a
  time when the patient should be in theatre, but before you want the first regular
  doses to be given.
  • On the other hand, if you do want some drugs given at the regular times,
    choose a time before the administration time.
• STAT doses of pre-operative medication type drugs such as Paracetamol and
  Omeprazole can also be prescribed in advance. For example, Omeprazole could
  be prescribed for 0730 if the patient is to be admitted at 0700 to ensure maximum
  efficacy.
• Any STAT or regular doses that are to be given pre-operatively should be
  communicated to DoSA or ward staff by other means to ensure they are noticed,
  e.g., by a phone call to DoSA or the ward.

Patients may attend but subsequently have their procedure cancelled. When they leave hospital, they will be discharged on TrakCare, which will also discharge them on HEPMA and remove any prescriptions done in advance.

Some patients may not attend and thus not be admitted on TrakCare. In this situation, it is the responsibility of the prescriber to manually discharge them on HEPMA to remove them from the Administration Round board for DoSA.

Discharging a Patient who doesn’t Attend

• Log in to HEPMA and from the Home screen, click on the green Admit Discharge
  Transfer tile.
• Enter the CHI to find and select the patient.
• Click on the Discharge tab on the left.
• Click on the green Discharge Patient button at the bottom right.
• A message will appear under the patient banner to say you have been successful.

DoSA staff will contact the prescriber to tell them about any undischarged patients hanging around in the Administration Round board in HEPMA.

Admission or operating list plans may change, and the patient doesn’t get formally admitted on TrakCare.

• Manually discharge the patient on HEPMA to cancel any prescriptions. If this isn’t done, the prescriptions will become active the next time the patient is admitted.
• They will also remain in the DoSA ward area until the next admission if not manually discharged.

Admitted patients will appear in the DoSA ward administration area on HEPMA.

• Patients not physically present in DoSA should be kept to a minimum.

Patients could be admitted as an emergency after pre-admission prescribing has been done.

• All prescriptions would become active at this point which may not be appropriate, although they shouldn’t be administered if the Start On date and time have been modified as described above.

Admit patient manually to DoSA on HEPMA.

Prescribe drugs and modify the Start On date and time to after the last dose to be admitted.

Communicate directly with DoSA or the ward about any drugs to be given pre-operatively.

Discharge any patients that don’t attend hospital.