> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Clinical Order Sets & Standing Orders (User Guide)

> Audience: Prescribers, nurses, clinical staff Status: Draft (WS5 pending — content subject to refinement) Last Updated: 2026-05-08

**Audience:** Prescribers, nurses, clinical staff
**Status:** Draft (WS5 pending — content subject to refinement)
**Last Updated:** 2026-05-08

***

## Overview

Order sets are reusable bundles of orders (labs, medications, assessments, monitoring) that can be activated against a patient chart in one step. Standing order protocols let nurses execute pre-approved orders within defined parameters without an additional prescriber order.

## Activate an Order Set From a Patient Chart

1. Open the patient chart (`/cl/charts/:id`).
2. Tap the floating **+** action button (bottom-right) and select **Start Order Set**.
   * The action requires the `cl.order_sets.activate` permission and a linked `pm_patients` record.
3. Choose a template, review the items grouped by category (Labs, Medications, Assessments, Monitoring), uncheck any items that should not be activated, add an optional reason, and submit.
4. The activation is recorded in `cl_order_set_activations`. Individual orders are then created through CL-05 / CL-09 hooks (Phase 2).

## Browse and Manage Order Set Templates

* Navigate to **CL → Resources → Order Sets** (`/cl/order-sets`).
* Search by name or category. Drafts, approved, and retired templates are listed (filter as needed).
* Use **New Order Set** to create a template (requires `cl.order_sets.manage`). Add items per category, mark required defaults, and save.
* Order sets are hidden when an admin disables `order_sets_enabled` in CL module settings.

## Execute a Standing Order (Nurses)

1. Navigate to **CL → Resources → Standing Order Protocols** (`/cl/standing-orders`).
2. Select an active protocol (within its effective/expiration window).
3. Open **Execute** and complete the parameter form. Frequency limits are enforced before submission (e.g., "max 2 per 24h").
4. Submitted executions are append-only — they cannot be edited or deleted. Review and corrections happen via the supervisor review workflow.

## Permissions

| Permission                   | Purpose                                      |
| ---------------------------- | -------------------------------------------- |
| `cl.order_sets.view`         | View templates and activation history        |
| `cl.order_sets.manage`       | Create/edit/retire templates                 |
| `cl.order_sets.activate`     | Activate templates against patient charts    |
| `cl.standing_orders.view`    | View standing order protocols and executions |
| `cl.standing_orders.manage`  | Create/edit standing order protocols         |
| `cl.standing_orders.execute` | Record standing order executions             |
| `cl.standing_orders.review`  | Review nurse executions                      |

## Related

* Spec: `specs/cl/specs/CL-44-clinical-order-sets-standing-orders.md`
* Admin guide: [`order-sets-admin-guide.md`](./order-sets-admin-guide.md)