Home Forums Discussions Problems Made an change and cannot reverse it.

One of my nurses was trying to codify a medication when she clicked on apraclonidine instead of clonidine and then she clicked change everywhere. How can I change it back.
Can it be globally reversed or do we need to do it one by one .

Lois

If she did it for all patients in the practice, I think you are out of luck. That's why there are 2 warnings. It will be one by one. You can do a search for apracloidine to idenify those patients if you otherwise do not use it.

If it is an individual, you can deleate the apraclonidine and re-prescribe clonidine.

Go to reports -> Medications -> Medication Name (Active) = apraclonidine
Add criteria to Query.

Go to reports -> Medications -> Date Last Refills = (in Value put date this occurred)
Add criteria to Query.

Run report. Every patient who had clonidine change to apraclonidine will show up in Query Results.

Change back to clonidine one at a time.

If you have 100 patients now showing apraclonidine. You can change them back to clonidine by doing it in reverse. If you have 100 patients showing apraclonidine and 7 of those are really on it, the change those to a drug like Zebra capsules 10 mg. Do the change, then change those back.

Or alternatively, write the patients' names down, and go back and change those from clonidine to apraclonidine.

If you think each step through one at a time, you will do fine. I agree with Wendell's approach, I would just add putting in the criteria for that date. That way everyone who comes up will be the one's affected (unless of course, they were prescribed clonidine that day) in which case you could run a clonidine prescription report for everyone who was prescribed clonidine for that day.

I know you have many patients, but given the fact that apraclonidine is used for postsurgical intraocular pressure prevention or treatment, you can't have that many on it. It is also not generally used for pediatrics.

Given the fact the program has the ability to change all medications instantly that match what was selected, it would seem like it would have the ability to immediately change them back if necessary.

It would be really cool if it were patient specific, e.g. Please find all patients whose meds were changed after certain medication was changed to apraclonidine on patient ID# 1234.

Bert, I have tried to change them all back and can't find a way

To my knowledge this cannot be changed globally. You will have to use query as described above and go in and manually remove scrip and write new. I did this once and globally changed a med, but it was when there was an error in the program and I actually hit cancel and it changed it anyway.....I now have to change that at the pt. level - makes me leery of global changes unless I am 100% sure.....

Didn't think of that. You can't really codify an already codified drug. Have to think some more.

So how much information have you added since the error?

?? what do you mean?

I think for all new scripts we have it right. But if we codified it to apraclonidine, does that mean everytime I write for clonidine after codifying it will change it? Stupid question I guess but I am now wondering. I'll look and see what happened to the last script for clonidine. Don't use it all that much so I could go back and remove it from everyone's list and re enter it ...... Could I?

Thanks Wendell

1. Any new medication you write will not be affected by the codification (sp?). That would lead to a lot of problems.

2. As far as changes, and now it is even worse, but if you caught the error right away you could grab one of the saved copies from the VSS and maybe change it back.

3. Personally, I would simply do a search for apraclonidine using the Reports function, print out the list and then go back and change them all one at a time.

Thanks, I'll have someone do that tomorrow. I don't think it will be very many unless it went all the way back six years.

OMG I hope not!

LOL

what is the VSS?

One, I don't think think there is a time limit.

Two, I can't believe you don't use much clonidine. If this happened to me, I would be digging out of it for over a year.

Microsoft uses Volumn Shadow Service to take snapshot of their server, mainly to make point in time copies of databases so they can be backed up properly. Since, you set VSS on whole drives, they affect all of the shared folders. This means that your OS (if Vista or above and any server 2003 and above) will automatically have shadow copies (if turned on) of your data. If you have a lot of hard drive space (and you can direct the shadow copies to very large drives), you could even set up one hours copies for two or three days. While these don't replace backups, they are very nice for situations like these.

Here, you could have stopped the presses, and restored a version from 45 minutes ago once you decided you didn't mind losing x amount of notes and messages, all of which could be re-entered. Where this is especially helpful is if you corrupt your whole database. You could be back up and running in under 10 minutes rather than going to last night's backup.

http://technet.microsoft.com/en-us/library/ee923636(WS.10).aspx