Skilled Nursing Facilities

Complex Order Updates

When updating orders, depending on what element you are updating in the order, you are completing a 'simple' or a 'complex' order update. Complex order updates are updates to orders when the intent of the order is changing (ex: dose, frequency of the order). When updating orders that are considered a complex update, you are prompted with an Alert telling you the updates you making require the original order to be discontinued, and a new order to be created.

  1. Click Actions then click Update next to the applicable order.

  3. Click outside of the field updated. View the Alert!

  4. Enter the new Start Date and time for all schedules included in the order.

  6. Acknowledge any warnings, if applicable.

  7. Review the updated order, click Acknowledge.

  8. Enter Authentication and click Authenticate.

  9. In the Complex Update window, enter Communication Method.

  10. Enter Ordered By.

  11. Enter Discontinue Original Order as of Date and Time.

  12. Enter a Reason, if applicable.

  13. Verify New Order Date and Time.

  14. Verify New Start Date and Time.

  15. If the order you are updating has supply status of "On Hand" (contains active supplies), select Yes to continue to use the supply/inventory on hand. Select No to inform the pharmacy they need to send a new supply when they receive the update.

  16. View Update Summary showing the Original Order vs. Updated Order information, including Order Summary and Routine information to ensure accuracy.

  17. Click Discontinue & New.

  18. Enter Authentication, if required, and click Authenticate. The original order has a status of Discontinued, and a new order is placed in the Order List.

  • When you are prompted to enter new start date, the Original Start Date/time appears below.

  • Inventory on hand example: the change is doubling the dose and the supply/inventory on hand is 10mg strength tablets; this supply could be used by administering 2 tablets. Answering Yes informs the pharmacy they do not need to send a new supply when they receive the update, they can wait until they get a reorder request before dispensing 20mg tablets. Answering No, the pharmacy is notified to send a new supply of 20mg tablets when they receive the update.

  • Any change or correction made to the residents name in PointClickCare must be followed by a phone call to the pharmacy to inform them of the change. This prevents medications being shipped with the wrong resident name on the label.

  • If you are see the Alert! prompting for a discontinue and new, then you changed a field that requires practitioner signature or communication of update to pharmacy.

  • If you are updating a legacy order for the first time, it is a complex update regardless of field(s) updated.

  • The earliest start date entered is the effective start date of the new order for the update(s) to take place.

  • Ensure discontinue date/time is before new start date/time to avoid duplicates on eMAR.

  • All changes are saved and recorded in the Audit Details report.

  • You must have security permission to update orders.

    • Clinical module > Enhanced Orders Management (parent header) > Update Order = Yes.