UNIVERSITY OF KENTUCKY HOSPITAL POLICY NUMBER: PH-04-04

CHANDLER MEDICAL CENTER FIRST ISSUED: 3/88

Department of Pharmacy Policy CURRENT AS OF 8/09

SUBJECT: Automatic Stop Orders / Order Cancellation

SEE ALSO: Pharmacy policy P-04-17, Vancomycin Continuation Policy.

PURPOSE: To define the medication policies for automatic stop orders or cancellation of current
orders.

INFORMATION:

A. Orders for medications are automatically discontinued when patients are:

1. transferred to or from an Intensive Care Unit
2. transferred to or from another medical service
3. sent to the Operating Room or Delivery Room. An exception may be made if
the physician or dentist so indicated in the pre-operative orders.

B. Physicians are encouraged to write for a specific length of therapy on appropriate drugs
and to limit their orders for drugs which require frequent monitoring of response such as
anticoagulants and cancer chemotherapeutic agents.

C. Orders that are written as “hold” will be interpreted as a discontinue order by the
pharmacy and entered as such into the pharmacy computer. If the time frame or
parameters are designated, the order shall be discontinued and a new order shall be
entered in the pharmacy computer to start at the time the physician has indicated. If the
order has been put “on hold” without any time frame or parameters indicated, the order
shall be discontinued. In this case, the physician will need to write a new order to restart
the medication.

D. All new orders for vancomycin will be dispensed and given a 72 hour stop date. If use of
the vancomycin meets the guidelines, vancomycin will be continued. If vancomycin use
does not meet the criteria, the adult or pediatric Infectious Disease (ID) consult service
should be contacted by the team to discuss the continued use of the antimicrobial with
the attending physician. See PH-04-15 Vancomycin Continuation Policy for details.

E. Drugs may have Automatic Stop Order limits as approved by the Pharmacy and
Therapeutics Committee.

1. Orders for ketorolac will be discontinued automatically after five days.

Approved:__________________________Authorized:_________________________________
Kimberley B. Hite, MS, PharmD John Armitstead, MS
Manager, Inpatient, Pharmacy Services Director, Pharmacy Services