From what I understand, this durationUnits list provided in the config is applied as a filter on the masterConfig duration units list returned by the treatmentConfig service.
Which only contains the 3 following duration units (and their factor):
It works when I add the Hour(s) and Minute(s) to this list:
TID and BID (3x/day and 2x/day) are frequencies, so that’s a little different than this question about durations. A drug order may have both (give Paracetamol 500mg 3x/day for 7 days).
On an acute inpatient service, it would be possible to have durations that are only a few hours long, but those mainly apply to giving IV fluids (give Normal Saline 200 ml/hr for 6 hours); it’s not very common for medications. I cannot think of a situation that would call for a med order with duration measured in minutes — but willing to hear of a good example.
Well, perhaps one — rapid treatment of clot-busting drugs for a heart attack, where you give a drug in a very rapid infusion for a half hour, then a slower infusion for an hour. But that’s about the only one that comes to mind — it’s very rare, and I don’t know if I would make Minutes a regular member of the Duration field.
Those are really frequencies (how often you need to give and re-give the med) as opposed to duration (the entire period of time that it takes to give all doses of the drug). If I need to give labetalol multiple times rapidly, the order would say “Labetalol 20mg IV every 10 minutes” – “every 10 minutes” is a frequency. This order either would not have a duration because there’s no specified limit (many med orders have no duration), or it might have a dose limit rather than a time duration: “… up to 160mg max”. Dose limits sometimes replace time durations, but that’s out of scope for this question.
does the admistration of i.v Artesunate qualify then because ideally it’s given at 0,12 and 24hours then followed by artemesin-containing orals unless ofcourse in a few cases when the duration may not be predefined when u may need to go beyond 3 doses if the patient hasnt improved yet enough to be able to take orals…
If I know that the order is only for those three doses, I’ll enter
Artesunate XXX mg IV every 12 hours x 3 doses
Frequency is every 12 hours;
Duration is 3 doses (in this case, it’s confusing to enter “x 1 day” or “x 24 hours” because that normally would be just two doses. This is an unusual order because you’re basically ordering it for a day and a half).
If I didn’t know in advance when the patient will be ready to change to oral therapy, I’d just write the order with no duration, and when the patient was ready to switch I’d change the order.
Bahmni ordering is not so advanced. It would be best to break the order - into 3 different ones. In a way, I see logic as well, as the Medication instructions are different and time-period specific (dates). May not make sense for billing/pharmacy - they would probably just want to dispense a single unit.