6 - ENTER ALLERGY INFORMATION – INCLUDING ‘NO ALLERGIES’

Picture 25Allergy information should be verified with the Patient at each visit.

From the Patients’ Chart select the ‘Allergies’ tab from the toolbar or the ‘Allergies’ button within the Medications History.

NO ALLERGIES

If the Patient has no allergies, select the most appropriate option from this list.

  • NKA – No Known Allergies
  • NKDA – No Known Drug Allergies
  • NKDI – No Known Drug Intolerances
  • NKI – No Known Intolerances

Select ‘Add’

Select ‘Reviewed with Patient\Exit’

This will add an entry in the Allergy ‘Reviewed with Patient’ log.

ENTER ALLERGY

  • Enter all or part of the ‘Allergen Name’ then select from the dropdown.
  • Enter all or part of the ‘Reaction(s)’ then select from the dropdown. This will enable the ‘Add’ button.
  • Enter the ‘Severity’- This is required for the allergy alert
  • Enter Source – Internal is from the Patient directly. External is from an outside source like medical records.
  • Enter ‘Memo’ if necessary
  • Select ‘Add’
  • Select Reviewed with Patient\Exit when complete

REMOVE ALLERGY - Allergies should only be removed if there is an entry error.

  • Double click on the Allergy
  • It will appear in the ‘Allergy Record Information’
  • Add an Internal Note, as needed
  • Select the appropriate ‘Reason for Removal’ from the dropdown.
    • Select the + button to add multiple
    • Select the X button to delete
  • Select ‘Delete All Entries for Allergen’
  • Select ‘Reviewed with Patient\Exit’

    INACTIVATE ALLERGY – Double click on the Allergy

  • It will appear in the ‘Allergy Record Information’
  • Select the ‘Inactive’ check box
  • Add an Internal Note, as needed
  • Select ‘Add’

ALLERGIES CANNOT BE DELETED