Each continuous infusion is ordered separately, which makes them easy to monitor on the vitals screen.
Table of Contents
Ordering Fluids
- At the top of the Tx Sheet, type “IV Fluids” in the field that says “+Add Order” to search for the specific fluid type.
- Enter the order details such as quantity (rate), route, frequency that it needs to be documented (most hospitals set this to q2h), start time, end time, and order notes, if desired. Then click “Order”.
Ordering Additives
Ordering an additive follows the same steps as ordering a fluid.
- Type “Additive” in the “+Add Order” field.
- Enter order details such as quantity (associated with the units), route, frequency that it needs to be documented (we recommend aligning this with your IV Fluid order frequency), start time, end time, and order notes, if desired. Then click “Order”.
Ordering a CRI
Ordering a CRI follows the same steps as ordering fluids and additives.
- Type “CRI” in the “+Add Order” field.
- Enter order details such as quantity (associated with the units), route, frequency (this can vary depending on the type of CRI), start time, end time, and order notes, if desired. Then click “Order”.
💡 ProTip: Your practice sets the units for each CRI. If there is no custom unit of measure next to the quantity, you should enter the units and the dosage details in the order notes.
When viewing the Vitals tab:
- The values will trend from left to right for the entire visit.
- You can click and drag each trend line to move it forwards and backwards in time.
- The high and low for the visit is displayed to the left of the trend line.
Changing the Rate of any Continuous Infusion
Doctor Steps:
- Order the change (Change IV Fluid, Change CRI, Change IVF Additive).
- Schedule Frequency to “Once”.
- Communicate your instructions in the Order Notes section.
Nurse Steps:
- If the Continuous Infusion is due to be recorded at the same time, the current rate should be recorded so the TVI is accurate.
- Change the patient’s fluid pump to the new rate.
Complete the Change Order in Instinct.
- Lastly, open the Continuous Infusion order and change the rate.
The Change Orders will help to document and track exactly when the change occurred and what doctor directed the change.
Charge Capture for Fluids, Additives, and CRI’s
Please keep in mind charging varies based on your hospital workflow.
Timed fluid charges can automatically bill in the background q2, q12, q24, etc. using Automatic Charges. Products with an Automatic Charge are displayed with a dollar sign on the treatment sheet (hover over for more information):
If a treatment is ordered with an Automatic Charge linked to it, the Automatic Charge fee will be included on the Invoice at the scheduled start time. For example, if the current time is 12pm and the order starts at 2pm, the fee will start at 2pm. The frequency of any Automatic Charges can also be set up in the Instinct Admin, which are then automatically added to the Instinct Invoice at your desired frequency (one time, q2, q12, q24, etc.).
Please keep in mind Automatic Charges land on the Invoice at the scheduled start time, regardless if it’s been Completed or not. If an Automatic Charge is added to the Instinct Invoice in error, it can be manually voided.
For more information on Automatic Charges and how to create them, click here.
Charging for Fluid Bags and Medication for Additives and CRI’s
Please keep in mind charging varies based on your hospital workflow.
The One-off button is an easy way to charge for a new fluid bag and capture initial medication charges or refills for additives or CRI’s.
If you charge per IVF bag, you can search for the name/ID of the fluid bag and order as a One-off.
If you charge for the initial additive/CRI medication (or need to refill a bag/pump), simply search for the name/ID of the medication and order as a One-off.
💡 ProTip: Please do not use the One-Off feature to record any items with an automatic charge, as this may impact your billing cycle.