Ordering Investigations

NOTE

Always order from the scrachpad (Home Screen) using favourites

• Once you’ve set up a favourite, the order will be made in the same way and needs only your signature to complete
• Setting up favoruites:
  1. Get tests: search for the tests you want to favourite in scratchpad
  2. Order when found click the sign button (top right corner; envelope with a number indicating the number of tests ordered)
  3. Input data; fill in data how you want it daily
     • If they’re the same class of test (e.g. blood also highlight or click and drag them all and input once for their common fields e.g. clinician collect y/n or date/time or hold+control and select the same classes)
     • Leave blank the sections which need adjusting each time e.g. patient weight for MRIs
  4. Add to favourites
     • Highlight the tests in the list of orders that you want to put into one folder → right click → select add to favourites
  5. Generate folders
     • Click create folders and create various useful categories and place those selected tests in the appropriate folders:
       • Bloods
         • Common bloods
           • FBC
           • EUC
           • CMP
           • LFT
           • CRP
           • APTT
           • INR
           • Troponin
           • BSL
           • Blood culture
           • beta-HCG
           • Amylase/Lipase
           • VBG
           • ABG
         • Geris bloods
           • TFTs
           • Vitamin B12
           • Folate
           • Iron studies
           • Vitamin D
           • Syphilis antibodies
         • Specialty specific scerens
           • Haemolysis: blood film review, LDH, reticulocytes, unconjugated bilirubin, haptoglobin, direct antiglobulin test, G6PD, ANA ± other autoimmune, CD55/CD59/PNH testing
           • Thrombophilia: Anti-cardiolipin Ab antibody, EPG, IEPG, protein C, protein S, homocysteine, anti-thrombin III, prothrombin genotype, factor V leiden genotyping, lupus anticoagulant, activated protein C resistance
           • Rheum/autoimmune: ANA, ENA, dsDNA, rheumatoid factor, cryoglobulin, ESR, C3, C4, IgG subclasses, ACPA, uric acid +/– viral.
           • Gastro/liver: Faecal calprotectin, ceruloplasmin, serum copper, iron studies, viral, autoimmune, e.g. ANA/IgG subclasses, anti-smooth muscle Ab, antimicrosomal Ab, anti-mitochondrial Ab, alpha-1-antitrypsin, serum paracetamol, urine drug screen, toxicology screen, anti-liver kidney microsomal Ab, cancer screen (e.g. AFP, CA19-9)
       • Nursing Orders
         • Urine/faeces/swabs folder
           • Faeces: VRE screen (nasal and rectal), faecal bacterial screen, C. diff, faecal ova and cysts and parasites, faeces viral screen
           • Urine: Urine microscopy, culture, sensitivities
           • Sputum: Respiratory rapid nucleic acid detection (aka rapid viral/fu swab), respiratory virus RNA detection (longer version of previous), sputum culture, culture swab nasal/pharynx/tonsil, acid-fast bacilli
           • Surgical: Wound swabs, body fuid crystal examination, body fuid culture. (Leave ‘Body site’ and ‘Specimen type’ blank so it’ll be all-purpose. And it’s indeed very versatile
           • Miscellaneous: MRSA screen
       • Allied health
         • Consider also inputting the reason for referral as its usually common and you can always put the tailored version in the clinical history as required
       • Imaging
         • Chest X-ray
         • Abdo X-ray (supine and erect)
         • Pelvis X-ray
         • CTB (CT brain)
         • MRI brain
         • CT AP (CT abdomen pelvis)
         • CTPA ≠ VQ
         • Abdomen ultrasound
         • CT BCAP (brain chest abdomen pelvis) often used for cancer staging
         • Echocardiography
  6. Repeat for the other tests
  7. Sign and order away

Custom Order

• For times when the favourite might not work and you need to order something slightly different
• Same way as usual order except click modify instead of sign after you click the scratchpad sign button
  • Takes you to the standard orders page and you can modify whatever needs modifying
• To change the whole standard (e.g. changing terms, pager changes or in ED when everything becomes clinician collect)
  • Go to order tab → click add → under the star button → click down arrow → click modify favourites → now you can add or delete as needed
  • Unfortunately, you can’t directly modify the ‘Favourite’ you’ve already saved, so you’ll need to delete the old ‘Favourite’ and recreate it via the whole process