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 or edited. These selections will automatically add exam, ward fees, and hospitalization fees to the invoice, under the selected doctor’s initials.
The header also displays a Copy and Print option to easily transfer records when needed.
Copy treatments, medications and vitals
Clicking the Copy button allows you to copy information from the Tx sheet into a separate document or another program.
All Medications copies items in the Medications category.
All Tx copies all treatment order details (Ordered, Completed and Discontinued treatments).
All Tx w/Nurse Notes includes all notes typed in the Treatment Notes field upon treatment completion.
Tip: Ctrl+V is a keyboard shortcut for pasting on Windows computers and Command+V is a keyboard shortcut for pasting on Mac computers.
Print Tx sheets
Clicking the Print button from a Tx sheet allows you to print treatment records.
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.
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/Completed section, unless it is in the Medication category. For safety reasons, Medications go to the bottom of the Medication category (instead of the Discounted/Completed section) and are greyed out, so you can see all medications given during the visit.
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.
Pro Tip: 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 the ability to Bulk Edit treatments and Hide Stopped Meds.
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 (Windows) or Command+E (Mac).
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.
The Hide Stopped Meds filter toggle on the Tx Sheet footer 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 the product was stopped.
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 or 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.