MAY 2025
EDITION 38
Cerner eMR BTFv5 Enhancement: Comfort Observation and Symptom Assessment (COSA) Chart
From 27 May 2025 , NSLHD will transition from the paper-based Care of the Dying to the Cerner eMR Between The Flags (BTF) Comfort Observation and Symptom Assessment (COSA) Chart . This state-endorsed chart is designed to support consistent, high-quality documentation and symptom monitoring for ADULT patients receiving end-of-life care. The eMR build is part of the Clinical Excellence Commission’s (CEC) Initiating Last Days of Life Management Plan and aligns with NSQHS Standard 5 – Comprehensive Care and and Standard 6 – Communicating for Safety . Its implementation positions NSLHD in line with other local health districts and supports the transition to the Single Digital Patient Record. When to use the COSA chart he Use the COSA chart when the treating medical team has formally documented a change in the patient’s care goals—from active treatment to supportive end-of-life care—and SAGO Adult observations are no longer required. Either medical officers or nursing staff can switch the patient’s BTF chart from SAGO Adult to COSA. COSA defaults to 4-hourly observations. Nursing staff will document comfort observations and symptom assessments directly in the eMR COSA Chart. Once COSA is activated, comfort observations will no longer be documented in iView. During downtime The downtime form will be the CEC paper COSA Chart, which can be ordered as instructed below. The COSA Quick Reference Guide and COSA Demonstration Video can be access via he eMR User Guides And Support Documentation > Powerchart General
For further information contact : kellie.cooper@health.nsw.gov.au (Advance Care Planning Facilitator)
Comprehensive Care Standard
Communicating for Safety Standard
Clonazepam Oral Liquid: Avoiding Dosing Confusion
The April 2025 edition of Australian Prescriber features an important article titled: “Medicinal mishap: Clonazepam oral liquid—confusion between drops, milligrams and millilitres.” Authored by Joey Chan (Senior Pharmacist) and Dr Abigail E Franklin (Palliative Medicine Physician) of the Adolescent and Young Adult Hospice, the article highlights serious medication errors linked to the prescribing and administration of clonazepam oral liquid. Unlike most oral liquid medicines, clonazepam oral liquid must be prescribed and measured in drops—not millilitres. This distinction is critical, as confusion between drops, milligrams, and millilitres has led to significant dosing errors, with the potential for harmful adverse effects. In response, SA Health and the Victorian Therapeutics Advisory Group (VicTAG) have issued safety alerts urging health professionals to: Prescribe doses in number of drops, with the corresponding milligram (mg) amount in brackets. Measure and administer doses in drops, not millilitres. The NSW Clinical Excellence Commission is also developing an advisory to support safe use of clonazepam oral liquid across the state.
Healthcare professionals are strongly encouraged to remain vigilant and ensure clear, consistent communication when prescribing or administering clonazepam oral liquid to avoid preventable harm.
🔗 Read the full article here
Medication Safety Standard
Made with FlippingBook - professional solution for displaying marketing and sales documents online