<< Back to News

7/25/19 jh Cerner Tipsheet document
July 29, 2019

From: "Joseph Ho" <joseph.ho@hhsys.org>
To: "Pharmacists" <allpharm@hhsys.org>
Sent: Thursday, July 25, 2019 3:54:50 PM
Subject: Cerner Tipsheet document

Hey all,

Moving forward, all Cerner tipsheets are being uploaded to a searchable PDF on Formweb (/hhsys/) under the link for Pharmacy Information Technology called Cerner Tip Sheet and Reference Guide.  All information that was in the Cerner Netlearning competency has been added. We will also continue sending e-mails to update you on changes and discoveries. For example, some Cerner TPN tips are included below and have been added to page 19 of the tipsheet document.

Please look for more information to come about verifying orders for drips as well as the “Ordered As” field during verification and how it impacts the MAR.

Cerner TPN Tips

1)    Removing ingredients:

1. When entering TPN ingredients in the TPN PowerForm, the most recent ingredient amounts are automatically pulled forward. When an ingredient that was previously in the TPN is removed, make sure to update the ingredient amount to 0. When we backspace/delete or leave the ingredient we are removing blank, it will continue to pull the most recent # value forward (skipping the blank one). This means that the summary information (within Documentation) that you are copying/pasting into the TPN order comments field (in MedManager) will also contain the ingredient that's been removed with a value of zero.
2. After you paste the summary information into the order comments field, go ahead and delete the line item in order comments for any ingredients you have removed/zeroed out. This helps prevent the ingredient from being accidentally added during compounding.
3. Once you have changed the removed ingredient to 0 on the TPN PowerForm, the next day it will populate with 0 again so you can at that stage just delete the 0 from the PowerForm so the ingredient does not populate in the summary or get pasted into order comments. This saves you the step of having to remember to delete the line item from the order comments. Each day the removed ingredient will repopulate as 0 again in the PowerForm, but you can just delete the 0 again.

2)    Osmolarity calculated in the powernote is based on goal and not necessarily accurate. If you are unsure of the osmolarity of your TPN, Abacus and Global RPh can be helpful. For a PPN, the QRG can give guidance on recommended TPN macronutrients based on a given rate.

3)    Cyclic TPNs: Please type **cyclic** in the top line of the order comments during order verification. Remember that the first line in the comments cannot be blank... be cautious when copying and pasting.

4)    If you modify a TPN order, it will not print a label. Either enter a new one, or add "1" to the initial dose field.  The initial dose field is a default of zero so that in the event a physician changes the rate on a TPN, it will not auto print a label to PSP.

Do not alter the route to read "peripheral or central". Choose the route that best reflects what is happening at the time of entry (or what will be happening when the TPN hangs). Abacus does math to determine the appropriateness of TPN contents based on the route. If you need to make a comment to the explain that the bag may hang either peripherally or centrally, that is fine, but Abacus (and the TPN technician) needs to know which way the bag needs to be prepared.

Thanks so much!

Joseph Ho, Pharm.D.
Clinical Pharmacist - Transitions of Care
Lead Pharmacist - Cerner Pharmacy Education
Huntsville Hospital
joseph.ho@hhsys.org

Cell: 504-214-7705