New to hospital. Any tips on order verification with Epic?

[GravityBeetle]

Yet another pharmacists who escaped retail to hospital here. A bit overwhelming to be honest. I felt like a pro in retail, but now I'm completely lost and looking for any help I can get. What are the things you look out for when verifying orders on Epic? So far I only know to look for appropriate renal or weight dosing, therapeutic interchange if we don't have the med based on our P&T list, and appropriate dispensing pyxis (eg to make sure ED doesn't have to run too far to get what they need).

On what occasions do you look beyond the verify order screen? It seems most things are already on there (CrCl, weight, relevant labs like Na, K, etc.). Which duplication therapies do you worry about? I see a lot duplicate opioids, laxatives, N/V meds, etc that are part of order sets that I just override. Infusion rates is another thing I still have to look up, but it seems Epic usually auto-populates those fields appropriately. What about appropriateness of therapy? When do you call on that or would you leave that to the clinical pharmacist?

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[njac]

For allergies, ex: cephalosporin entered on pcn-allergic pt:
1. Open the allergy tab and see if anyone commented on previously tolerated cephalosporins or a BS allergy like n/v
2. Go to medications tab. Select “filters” look for and select any cephalosporins. Once these are selected click on the “history” tab to the right (if you do this prior to filtering just for cephalosporins it will bring up every Med ever ordered. Don’t do that) this will select just for previous orders for cephalosporins- make sure they’ve received one before (not just entered and immediately d/c’d)


Ditto for other cross-reactive meds and allergies - this is how to see if they’ve ever tolerated the Med in question before at your institution.



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[jjcayce123]

You are very lucky! I started at a hospital with Epic but ended upmoving and am on a hospital with Cerner. Cerner is horrible. I miss Epic

 

[PharmDBro2017]

It’s super user friendly, you’ll be an expert in 6-12 months on it so don’t worry.

There’s a IV infusion tab on the home screen, it lets you know if the patient has peripheral access, PICC, etc. and when it was placed. Good to check when verifying IV KCl orders, TPN strengths, and ped antibiotics (IV vs. IM).


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[njac]

It’s super user friendly, you’ll be an expert in 6-12 months on it so don’t worry.

There’s a IV infusion tab on the home screen, it lets you know if the patient has peripheral access, PICC, etc. and when it was placed. Good to check when verifying IV KCl orders, TPN strengths, and ped antibiotics (IV vs. IM).


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In ours this is called “LDA” I thinks it’s “lines, drains, access”? I had to wrench it in - also shows og vs dobhoff tubes etc


Edit: I lied - it’s “waldo”


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[gwarm01]

Keep a clinical resource like Lexi or UpToDate open in the background to reference for your peds doses. It'll take a while to remember the appropriate weight-based doses of everything, and you can't count on Epic to catch everything (especially since your system appears to have some funny quirks).