Concept explainer
Medication safety
Describes the checks Pensieve applies to medication orders, including dose range, allergy and interaction review, and how a prescriber sees them.
A medication order in Pensieve passes a set of safety checks before it acts, and again before a dose reaches a patient. This page describes the checks Forge applies at ordering, including dose range, allergy and interaction review, and how a prescriber sees each one.
Checks at ordering
When a clinician places a medication order, Forge reviews it against the patient's record and the catalogue entry for the drug. The review runs before the order is recorded, so the prescriber weighs each finding at the point of decision.
| Check | What it reviews | What it does |
|---|---|---|
| Dose range | The ordered dose against the safe range for the drug and the patient | Holds placement when the dose sits above the ceiling |
| Allergy | The order against the patient's recorded allergies | Holds placement on a severe allergy match |
| Interaction | The order against the patient's other active medication | Warns on an interaction for the prescriber to weigh |
| Pregnancy | The order against a recorded pregnancy | Holds placement on a contraindicated drug |
A hard stop holds the order
Dose above the ceiling, a severe allergy match and a contraindicated drug in pregnancy each hold the order. Placement proceeds once the prescriber records a reason that answers the specific finding, and that reason is kept against the order for review.
How a prescriber sees a check
You see each check in the order preview, before you place the order. A warning shows what Forge found and lets you continue with your eyes open. A hard stop shows the same and asks for a reason before the order proceeds.
If a finding sits behind the order, you see it here rather than after the fact. The preview carries the drug, the dose and the route you chose, and the finding sits alongside them so the decision stays in one place.
An override carries a reason
An override answers a named finding. Forge records who placed the override, the finding it answers, and the reason the prescriber gave. The override is kept against the order, so a reviewer sees the finding, the decision and the person together.
An override answers the finding it names, so a reason recorded against a dose range hold clears that hold alone. The section on alerting and override sets out how overrides are retained across the platform.
Checks at administration
A dose passes further checks at the bedside, after the drug is dispensed and received in the ward. These gates sit on the administering member of staff rather than the prescriber.
| Gate | What it requires |
|---|---|
| Ward receipt | The drug is dispensed and received in the ward before a dose is given |
| The five rights | The administering nurse verifies the five rights at the bedside |
| Controlled drug | A named witness confirms a controlled drug dose |
| High-alert drug | A second member of staff confirms a high-alert dose |
A controlled drug carries a witness
A controlled drug dose records a witness drawn from the staff on shift, together with the batch and any waste returned. A high-alert drug records a second check by a named member of staff before the dose is given.
Prepare, decide, record
The shape of every medication check is the same. The platform prepares the finding from the record and the catalogue, the clinician decides how to act on it, and the record captures who decided and why. The finding informs the decision; the person holds it.
Common questions
Can a prescriber place an order that a check holds?
A prescriber records a reason that answers the finding, and the order then proceeds. The reason stays against the order, so the decision reads clearly in review.
When is a medication charged?
A medication is charged per dispense, for each strip or vial the pharmacy issues, rather than per dose. A course dispensed twice raises a charge for each dispense.
Where does dose scheduling happen?
Each ordered dose becomes a scheduled task in Quest with a due time, and carries the outcome recorded against it as the course runs. Read more on medication schedules.
Read how an order is checked before it acts in order verification.