eMM – How to avoid Free Text Dose Errors

PowerChart only recognises specific numerals and units of measure to document doses of medication. If you do not use these system-recognised options you will see a warning that you are trying to use a free-text value. Free-text doses are more difficult for pharmacy to process and need to be transcribed at every administration, which has been known to result in errors.

Free text doses should be avoided except for the following situations:

• Variable doses or ranges where the nurse needs to specify the dose actually given (e.g. warfarin, PRN analgesics, insulin pumps)
• Chemotherapy medications with multiple ingredients (e.g. double/triple ingredient intrathecal preparations)
• Placeholder orders which have a paper order form but also require an order in eMM (e.g. PCAs, TPN)

When ordering a medication that has a free text value as a dose, a pop up will appear (see below):


 

The prescriber has typed ‘1/2’ instead of 0.5 (see below):

If the order is signed, the MAR administration screen will not display the free text dose or unit, the person documenting the administration will have to fill these mandatory fields in every time (see below):


 

Common errors that cause the free-text value include use of fractions, numbers or units spelled out in full, or non-approved abbreviations:

• drop instead of drops(s) 
• cap/capsules instead of cap(s)
• tab/tablet instead of tab(s)
• sachet instead of sachet(s)
• puff instead of puff(s)
• iu instead of Units or International_Units
• one instead of 1
• 1/2 or 1/4 instead of 0.5 or 0.25
• mgs instead of mg
• mcg/micrograms instead of microg
• ng/nanograms instead of nanog
• mls instead of mL

To avoid this problem, use order sentences to prescribe. These have been created with the correct, system-recognised unit of measure for appropriate prescribing.

System-recognised units of measure:

System-recognised dose form units:

Note the “s” must be included for the unit to be recognised, but the parentheses can be omitted.