A patient’s Tx Sheet can be accessed by utilizing the 3-dot menu next to the patient’s name or by clicking on the patient’s name in the status board.
The Tx Sheet consists of three main areas: the header, the treatment section, and the footer.
Header Section
This section consists of the ordering bar and is where the patient’s doctor, exam type, ward, and hospitalization can be selected/edited. These selections will automatically add exam, ward fees, and hospitalization fees to the invoice, under the selected doctor’s initials.
💡 ProTip: You must select a doctor first before being allowed to choose a hospitalization!
Treatment Section
Along the top of the Treatment Section, the current date will display and will indicate what day of hospitalization the patient is in. For patients that are hospitalized for greater than a day, you will have the option to select a past date within the patient’s visit to view completed treatments. Noticed that the Day of hospitalization will update. A time bar is also displayed along the top portion and a red arrow and line indicates the current hour period.
The main part of the Treatment Section consists of treatment orders for the patient broken out into different Categories:
Basic Observations
Monitoring
Medications
Patient Care
Procedures
Administrative Tasks
Continuous Infusions
Vaccines
Diagnostics
Misc
Uncategorized
Where an order appears in these categories is based on which category was selected when creating the product in the Admin Section.
When an ordered is discontinued, it will move to the Discontinued section, unless it is in the Medication category. For safety reasons, these items go to the bottom of the Medication category and are greyed out, so you can see all medications given during the visit.
In addition, there’s a “Hide Stopped Meds” filter toggle to the Tx Sheet footer which is helpful if you’d like to only see active medication treatments on your treatment sheet. A product label tooltip is also displayed by hovering over the medication name to easily show the date and time this product was stopped.
📓 Please note:
The “Hide Stopped Meds” filter is applicable across all visit pages and will automatically turn “off” if you navigate to the Status Board, Admin, or log out of Instinct.
If you click the Discontinued/Completed section to view other discontinued or completed items, the “Hide Stopped Meds” toggle will automatically turn off so your medical team won’t ever have a chance of missing the medications that were discontinued.
Each treatment order will display the last value recorded next to the label, as well as the quantity and frequency for the treatment. For medications, dosage and when it was last given will also be displayed.
💡ProTip: What are the differences between Optional q1h frequency, q1h, PRN, and Until Completed?
Optional q1h frequency means this treatment is available to complete every hour, but will never turn overdue if not addressed (just like Progress Notes). Choosing this would be appropriate for orders such as “collect stool” where it would only be necessary to mark completed once collected. You can also use this to display diazepam instructions if a patient were to have a seizure (with an order note over-communicating this!). We only recommend using it when the treatment is truly optional.
Every 1h is a treatment that must be addressed every hour (it will turn overdue if it is not marked as Completed or Not Completed).
PRN and Until Completed icons are simply communication tools and do not impact the frequency or start time of the treatment.
The time a treatment order is due is indicated on the sheet by colored blocks.
Red Block indicates an overdue (O) treatment
Green Block indicates a scheduled (S) treatment
Yellow Block indicates the treatment is due (D) now
Grey Block indicates a completed treatment
Footer Section
The Footer Section contains 4 main functions. The ability to Bulk Edit treatments, Save the Tx Sheet as a PDF, Copy Txs, and Copy Vitals.
Bulk Edit
Bulk Edit allows you to change or discontinue multiple treatments at the same time.
To Bulk Edit, simply click the pencil icon in the lower left corner of the Treatment Sheet to open the Bulk Edit tool. Alternatively, you may press CTRL+E (we love our keyboard shortcuts!).
Check boxes will appear to the left of each order so you can easily select treatments to bulk edit. You can also click to check a whole category (or entire sheet) of treatments using the corresponding box:
Once selected, you can either click “Edit” at the bottom of the page to begin editing start/end times, frequency, and the assigned doctor, or click the “Discontinue” box to quickly discontinue all selected treatments. As a safeguard, a confirmation pop-up will appear if you select “Discontinue”.
A few things to keep in mind:
Progress Notes and already discontinued items are not available to bulk edit.
Bulk editing when ordering a Product Group is still available.
If you’re bulk editing an order that has multiple schedules, bulk edit mode will split these into separate orders so you can edit each one individually:
Students (or those who create “draft orders”) are only allowed to bulk edit non-restricted orders and restricted orders that are still in draft mode. In draft mode, restricted orders will not have a checkbox next to the order:
Students may still edit current draft mode orders and they will remain as draft orders.
Save
The Save button allows you to download a PDF of the treatment sheet for any patient (checked in or out) at any time.
You have 3 options:
Summary PDF: This includes only pertinent nurse notes and is built for sharing with referring hospitals.
Detailed PDF: This displays all ordered treatments and is the best document to share for legal proceedings.
Future PDF: This displays a clean day of scheduled treatments and is useful for referring vets if they want to continue your plan for a patient (use as a day-to-day template).
Copy Txs
Copy Txs allows you to copy treatments from the sheet into a separate document or another program. You can Copy Treatments in three formats:
All Medications (only copies items under the ‘Medications’ category)
All Tx (completed & discontinued treatment order details)
All Tx w/Nurse Notes (includes all of those free typed notes as well)
💡 ProTip: Ctrl+V is a keyboard shortcut for pasting on windows computers.
Copy Vitals
Clicking on the Copy Vitals button allows you to copy Vitals either in a list or table format into a separate document or another program. You can Copy Vitals in four formats:
Intake: First weight/TPR
SOAP: Most recent 5 weights/TPRs/Ins/Outs
Latest: The most recent vitals recorded
All: All vitals for the entire visit
