Integrated Assessments: CIWA-Ar, CIWA-B, COWS

Record CIWA-AR, CIWA-B, and COWS under the Doctor's Orders tab, Med Log tab, and/or any evaluation form with the patient.ciwa_ar, patient.ciwa_b and/or patient.cows fields.

• CIWA-AR: Log a patient's CIWA-AR score (from 0 to 67), containing 10 questions to assess the patient's alcohol withdrawal symptoms.
• CIWA-B: Log a patient's CIWA-B score (from 0 to 80), containing 20 questions to assess the patient's benzodiazaphine withdrawal symptoms.
• COWS: Log a patient's COWS score (from 0 to 48), containing 11 questions to assess the patient's opioid withdrawal symptoms.

Not seeing these assessments on the patient chart? Check out this article on configuring integrated assessments. 

Required Roles: Integrated Assessments can only be logged by Super Admins, Record Admins, Doctors, Nurses, and Techs.

Doctor's Orders

The Doctor's Orders tab on the Patient Chart allows you natively record CIWA-AR, CIWA-B, and COWS. The name of this tab can be customized per organization, so this is the tab setup as Orders in the Patient Processes settings.

Let's review how to log CIWA-AR, CIWA-B, and COWS:

1. From the patient chart, open the Doctor's Orders tab.
2. The top of the page allows a quick snapshot of the patient's integrated assessments.
3. Click the + icon next to CIWA-Ar, CIWA-B, or COWs.
4. CIWA-AR: Select the Date/Time administered and use the drop-downs to complete each of the fields. The score will automatically calculate. Click Submit.
5. CIWA-B: Select the Date/Time administered and use the drop-downs to complete each of the fields. The score will automatically calculate. Click Submit.
6. COWS: Select the Date/Time administered and use the drop-downs to complete each of the fields. The score will automatically calculate. Click Submit.
7. The section updates to display the recently logged information.
8. Click on the History (clock) icon to view a full list of the patient's past assessment results.
9. From this pop-up, you can view the responses for each question and overall score including who logged the result and when.
10. Super Admin can delete logs made by mistake. The logs will be hidden but still available under Show Deleted button.

Med Log

The Med Log tab (often called MARs or MORs) on the Patient Chart allows you natively record CIWA-AR, CIWA-B, and COWS entries, just like the Doctor's Orders tab. The name of this tab can be customized per organization, so this is the tab setup as MARs in the Patient Processes settings.

Please review the steps above to add a CIWA-Ar, CIWA-B, or COWS entry.

Evaluation

Assessments can also be documented in any Evaluation form where the patient.ciwa_ar, patient.ciwa_b and/or patient.cows fields are included. You will also be able to view the patient's documented assessment history. Click here for more information on editing Evaluation Templates.  

CIWA-AR

From the Evaluation, document the patient's CIWA-AR using the available fields.  

You can click the CIWA-Ar Hx button to view the patient's past history. Alternatively—if the patient.ciwa_ar_current field is added to the evaluation—the patient's most recent CIWA-AR results will automatically display. 

CIWA-B

From the Evaluation, document the patient's CIWA-AR using the available fields. 

You can click the CIWA-B Hx button to view the patient's past history. Alternatively—if the patient.ciwa_b_current field is added to the evaluation—the patient's most recent CIWA-B results will automatically display. 

COWS

From the Evaluation, document the patient's COWS using the available fields.

You can click the COWS Hx button to view the patient's past history. Alternatively—if the patient.cows_current field is added to the evaluation—the patient's most recent COWs results will automatically display. 

Report on Integrated Assessments

The History Report allows users to get historical patient results for the CIWA-Ar, CIWA-B, and COWs integrated assessments across the board.