Hospice medications: one list, the hospice's directions, and the nurse one tap away

One list, one log. A medication the hospice orders is an ordinary medication on Prescriptions, and every dose of it goes into the same dose log as every other medication, so the history is continuous, a dose given by one person shows for everyone, and the care team sees one list. The app never says what to give or how much: it shows the hospice's own directions and puts Call the hospice nurse one tap away. Medications saved before hospice care read exactly as they did.

Review the medications. After the care chapter is switched to hospice care, the care chapter page offers Review the medications, its own page. Every current medication is listed with Keep or Stopped by hospice. Stopped by hospice stops it the app's usual way: the status becomes Stopped from that day with the reason Stopped by hospice, a Stopped entry goes into its dose history, its reminders end, and it stays in the history under Stopped. Nothing is deleted, and Undo takes it back during the same visit. Add the hospice medications and Add the comfort kit open Prescriptions with a new medication already marked as ordered by the hospice (the comfort kit ones also carry the Comfort kit tag).

Hospice details. While the circle is in hospice care, and on any medication ordered by the hospice, each medication on Prescriptions has a section called Hospice details. Ordered by (Choose one: The hospice, or Another doctor or clinic) puts the Hospice medication badge on the card. Also there: the hospice pharmacy's name, Part of the comfort kit the hospice left, How it is given (Choose one, including Under the tongue, In the cheek, On the skin, Under the skin, Rectal and Injection, or Other in your own words), the hospice's directions exactly as written, the hours between doses from the directions for an as-needed medication, a patch changed on its own schedule, and A controlled medication: keep a count. The directions are the same field as Directions on the label, so there is one set of directions.

Giving an as-needed dose. On a hospice medication's card (on Prescriptions, on the care team's Medications tab and on Comfort care) the hospice's directions show in large type, with Call the hospice nurse when the number is on the care chapter page. Under them: Last given 2:10 PM by the person who gave it, and, when hours between doses are typed, next allowed at the time they make. Give a dose asks Why is it being given? (Choose one: pain, hard breathing, restlessness or agitation, anxiety, gurgling or secretions, nausea, fever, or Other in your own words), the time and a note. Before the next allowed time it asks once, for example It's been 1 hr 20 min. Give anyway?, with the hospice nurse's number and Follow the hospice's directions. If you are not sure, call the hospice nurse. It never blocks a dose: Give anyway saves it like any other.

How is the patient now? From 45 minutes after an as-needed dose of a hospice medication, and for up to 12 hours, the dose asks How is Jane now? (with the patient's first name): Better, The same or Worse. The answer is saved on that dose, with who answered, and shows beside it from then on.

A patch. Turn on A patch changed on its own schedule (72 hours to start, any number of hours can be typed). The patch then has no daily dose and is never counted as missed on a day. Its card says when it was last changed, where, and when the next change is due, and lists the last three sites so the next one goes somewhere else. Log a patch change asks where the new patch is (Choose one: upper arm, chest, upper back or thigh, left or right, or Other) and Old patch removed; if that is not ticked it asks once whether the old patch was taken off, then saves either way. The change goes into the dose log like any dose. When a change comes due, the people who get medication reminders get the same phone notification a dose reminder sends, once per change.

A controlled medication. The count on hand under On hand already goes down with each dose given. A controlled medication also has Count check: type how many there are now and a note. The check keeps who counted, the number and when, beside the count the dose log expected, and says plainly when they differ, for example Counted 18 by John. The count on hand said 20: 2 fewer than expected. Tell the hospice nurse. The count on hand itself changes only with I counted under On hand.

Who sees it: everyone who sees the medications today, the family's managers, the caregiver role and the care team's logins on the patient. A Home Team professional logs doses, patch changes and counts once Getting started is finished. The patient's own sign-in never sees the review page.