Updated calculations for Calculated Creatinine Clearance in Carboplatin orders Copied

We updated the calculated creatinine clearance for Carboplatin orders to ensure the system uses and displays the correct value recommended by the NCCN Guidelines for patients with low serum creatinine. These changes will be seen in any location where the dose information is shown (e.g., order editor, adjust dose box, Admix, MAR, etc.).

Serum Creatinine was updated as follows:

• If the order is saved to use the NCCN Guidelines recommendation to use 0.7 mg/dL in the equation in the order, the order details will display with S. Creatinine: 0.7 mg/dL instead of the patient’s actual serum creatinine.
• For Carboplatin orders using the 0.7 mg/dL adjustment in the order, users will see the S. Creatinine notification when editing the order or approving regimen treatment if the patient’s latest serum creatinine value differs from what is saved in the order.

The calculated Creatinine clearance for the order will behave as follows:

• When the patient’s serum Creatinine is <0.7 mg/dL, the Creatinine clearance is calculated using 0.7 mg/dL.
• If the Creatinine clearance is less than 125 mL/min, then the system will use the actual calculated Creatinine clearance value for the dose.
• If the calculated Creatinine clearance is greater than 125 mL/min, then the system will display the patient’s calculated clearance on the screen but will use 125 mL/min for the dose.
  • The system will alert you to this adjustment by displaying a simpler, clearer message of Capped at 125 mL/min on the screen following the patient’s actual calculated Creatinine clearance.

NOTE: These updates will not be applied to existing Carboplatin orders or regimens including Carboplatin. To confirm or adjust doses, open the order editor for these updates to take effect.