WHS POSTOPERATIVE POWERPLAN CHANGES

Size: px
Start display at page:

Download "WHS POSTOPERATIVE POWERPLAN CHANGES"

Transcription

1 Medications simplified and standardized to improve safety and effectiveness in the management of pain, itching, nausea/vomiting. Management: o The Anesthesiologist will continue to manage pain in the PACU. o Surgeon manages pain in the post-operative unit for all patients., Nausea/Vomiting, Respiratory Depression: Hypotension: ESO Orders for the management of hypotension now available in the Anesthesia PACU Phase Orders Hypertension: o OB/GYN notification of obstetric-related hypertension now available o Hypertensive management of the non-ob patient identified Phase/Order Management: To accommodate these safety measures, management of phases will now be different. Significant Changes are highlighted below: WHS POSTOPERATIVE ANESTHESIA ORDERS PACU PHASE IV Solutions Lactated Ringers at 125ml/hr for GYN patients Oxytocin 20 units in 1000ml LR at 175ml/hr for OB patients Management Mild Scale 1-3 Contraindications NSAIDs Acetaminophen 1000 mg PO or IVPB once (IV only if not tolerating PO) Ketorolac (Toradol) 30 mg once Moderate Scale 4-6 Oxycodone 5 mg, 1 tab, PO, once HYDROmorphone (Dilaudid) 0.3 mg, IV push, PRN Q10MIN, if not tolerating PO Morphine 2 mg, IV push, PRN Q10MIN Sever Scale 7-10 HYDROmorphone (Dilaudid) 0.5 mg, IV push, PRN Q10MIN Morphine 4 mg, IV push, Q10MIN FentaNYL 50 mcg, IV push, Q10MIN Promethazine (Phenergan) 6.25 mg, IV push, Q 30MIN Ondansetron (Zofran) 4 mg, IV push, once Scopolamine patch 1 patch, TD, once Shivering Meperidine (Demerol) 12.5 mg, syringe, IV push, Q15MIN, PRN shivering, May repeat x 1 Nalbuphine (Nubain) 5 mg, IV push, Q 20 MIN, PRN itching, May repeat x 1 dose DiphenhydrAMINE (Benadryl) 12.5 mg, IV push, Q15MIN, PRN itching, May repeat x 1 dose Naloxone (Narcan) 0.1 mg, IV push, once Respiratory Hypertension (for non-ob patient) Naloxone (Narcan) 0.1 mg, IV push, Q2MIN, PRN reverse narcotic effect Bronchodilator Protocol, once, STAT select if RT to come to bedside STAT Albuterol (Proventil) 0.083% inh soln 2.5 mg, inh soln, NEB, Q5MIN, PRN wheezing Ipratropium (Atrovent) 0.02% inh soln 0.5 mg, inh soln, inhalation, Q5MIN, PRN wheezing Labetalol (Trandate) 5 mg, IV push, Q5MIN, PRN blood pressure maintenance. Non-OB patients only For repeated SBP > 180 or DBP > 105. Hold for HR < 60. Total max 20 mg HydrALAZINE (Apresoline) 5 mg, IV push, Q15MIN, PRN blood pressure maintenance. Non-OB patients only For repeated SBP greater than 180. Hold for HR > 100. Max total dose 20 mg

2 Hypertension OB Patient Hypotension Agitation Labs Notifying the Provider Notify Surgeon for OB patients with either SBP 140 or DBP 90 on 2 occasions at least 4 hours apart, or an isolated SBP 160 or an isolated DBP 100 Lactated Ringers, 250 ml, IV Bolus, PRN Hypotension, For SBP less than 90 and symptomatic. 1ST Line. May Repeat x 1 Ephedrine 5 mg, IVP, once, PRN Hypotension, For SBP less than 90 and symptomatic. 2ND Line. For post spinal and epidural patients only. If ineffective, repeat dose of 10 mg IVP x 1 Ephedrine 10 mg, IVP, once, PRN Hypotension, For SBP less than 90 and symptomatic. For post spinal and epidural patients only if no clinical improvement after 5 mg dose Midazolam (Versed) 0.5 mg, vial, IV push, Q5MIN, max 2mg Blood Sugar Monitoring POC once, in PACU if diabetic CBC with Platelets Blood, Stat collect Basic Metabolic Panel Blood, Stat collect Hemoglobin and Hematocrit Blood, Stat collect Blood Gas Notification STAT Notify Anesthesia: SBP < 90 general anesthesia, <80 spinal anesthesia, SBP > 160 or DBP >100, HR < 50 or >120 or more than 50% baseline, RR < 10 or > 30, SpO2 < 95%, If vital signs discharge criteria not met at 3 hours in PACU, Persistent Nausea and Vomiting Notify Surgeon: SBP > 160 or DBP >100, Temp > 38 o C (100.4 F), Urine output < 30 in 1 hour, If discharge criteria not met at time of discharge but anesthesia has agreed to patient transfer Respiratory Extubate when patient is awake and breathing spontaneously, sustains head lift > 5 secs, maintains O2 sat > 95% and follows commands. Keep patient intubated until otherwise ordered To maintain oxygen saturation goal > 95%, use nasal prongs at 2-5 liter/min or simple mask at 8-10 liter/min. Capnography/End Tidal CO2 continuous while in PACU WHS POSTOPERATIVE ANESTHESIA ORDERS POST DURAMORPH PHASE (For Duramorph patients only, initiated by the post-op RN once patient arrives to Post-Op Unit) Vital Signs Respiratory Orders for monitoring vital signs, pulse Ox, Oxygen supplementation, & Patient Care (including when to call for Rapid Response Team) Promethazine (Phenergan) 6.25 mg, IV push, Q 4 H PRN Ondansetron (Zofran) 4 mg, IV push, Q 4 H, PRN Notify Provider For persistent N/V call Anesthesiologist ***NOTE***Patient may have a Scopolamine (TransDermScop) patch behind the ear, placed in PACU Diphenhydramine (Benadryl) 25 mg PO (or IV if not tolerating PO), Q 6 H PRN Nalbuphine (Nubain) 2.5 mg, IV Push x 1; If ineffective, notify Anesthesiologist Naloxone (Narcan) 0.1 mg, IV push, Q2MIN, PRN reverse narcotic effect, also PRN respiratory rate < 10/min, unable to respond and/or inadequate ventilator effort call Anesthesiologist and Surgeon immediately and Rapid Response Team if Anesthesia unable to come to bedside.

3 WHS POSTPARTUM CESAREAN SECTION: POSTOPERATIVE ORDERS C/S PHASE Management: SURGEON MANAGES PAIN IN THE POST-OPERATIVE UNIT FOR ALL PATIENTS., Nausea/Vomiting, Respiratory Depression: Phase/Order Management: To accommodate these safety measures, management of phases will now be different Significant Changes are highlighted below: Vital Signs Vital Signs Per Unit Guidelines; If T C recheck in 2 hours Notify Provider Vital Signs T > 38 C (100.4 F) on 2 occasions at least 4 hrs. apart or T greater than or equal to 38.5 C; SBP 140 or DBP > 90 on 2 occasions at least 4 hours apart or any isolated SBP > 160 or DBP 110; HR <50 or >120; RR < 10 or > 30, UO < 120 ml in 4 hrs Non-Pharmacologic Management Heat Therapy, PRN Order, Order K-pad prn for abdomen and/or lower back discomfort Mild Scale 1-3, Acetaminophen Option 1: Acetaminophen 1000 mg PO Q 6 H, while awake, begin 6 hours from prior APAP dose if given Option 2: Acetaminophen 1000 mg IV x 1, begin 6 hours from prior APAP dose if given (for patients NOT TOLERATING PO). Once tolerating PO, switch to PO) Acetaminophen 1000 mg PO Q 6 H, while awake, begin 6 hours from prior APAP dose if given Mild Scale 1-3, NSAID Option 1: ketorolac (Toradol) 30 mg, IV push, Q6H, for 3 doses, begin 6 hours from prior ketorolac if given (Once complete or if tolerating PO, switch to PO ibuprofen 600 mg Q6H) ibuprofen 600 mg, PO, Q6H, while awake, to begin after IV ketorolac complete Option 2: ibuprofen 600 mg, PO, Q6H, while awake, to begin after IV ketorolac given Or: Contraindications NSAIDs Moderate Scale 4-6 Oxycodone 5 mg, 1 tab, PO, Q 3 H, PRN, MR x 1 hr, if ineffective, may escalate to severe PO pain order at next PRN frequency HYDROmorphone (Dilaudid) 0.2 mg, IV push, Q2H, PRN, if not tolerating PO Morphine 2 mg, IV push, Q3H, PRN Sever Scale 7-10 Oxycodone 10 mg, 1 tab, PO, Q 3 H, PRN, MR x 1 hr, if ineffective, may escalate to severe PO pain order at next PRN frequency HYDROmorphone (Dilaudid) 0.5 mg, IV push, PRN Q10MIN Morphine 4 mg, IV push, Q3H, PRN ***NOTE*** Patient may request a lower level of pain medication than pain level indicated Opioid Reversal naloxone (Narcan) 0.1 mg, IV push, Q2MIN, PRN reverse narcotic effect, Also PRN respiratory rate less than 10/minute, unable to respond and/or inadequate ventilatory effort, then call Anesthesiologist and Obstetrician immediately and Rapid Response Team if anesthesia unable to come to bedside. supplied as vial. Antibiotics For all antibiotics, use WHS Infectious Disease Orders WHS POSTPARTUM CESAREAN SECTION: SURGEON COMFORT C/S PHASE Activated after Anesthesia Post Duramorph Phase has completed (24 hours) in patients who received spinal Duramorph, or activated immediately upon arrival to post-op unit if patient did not receive spinal Duramorph. Ondansetron SoluTab (Zofran ODT) 4 mg, PO, Q 4 H, PRN Ondansetron (Zofran) 4 mg, IV push, Q 4 H, PRN, if not tolerating PO and has IV in place Promethazine (Phenergan) 6.25 mg IV Q 4 H PRN, if not tolerating PO and has IV in place Nursing Task: Remove Scopolamine Patch 24 hours from placement, if placed Diphenhydramine (Benadryl) 25 mg PO (or IV if not tolerating PO), Q 6 H PRN Zolpidem (Ambien) PRN is no longer available/has been removed from the powerplan

4 WHS POSTOPERATIVE GYN: POSTOPERATIVE ORDERS GYN PHASE Management: o SURGEON MANAGES PAIN IN THE POST-OPERATIVE UNIT FOR ALL PATIENTS., Nausea/Vomiting, Respiratory Depression: Phase/Order Management: To accommodate safety measures, management of phases will now be different. Note: Urine Voiding Urinary Catheter Insertion Intermittent/Straight, PRN. For post void residual > 200 ml. Insert continuous foley catheter if straight catheter needed greater than 2 times Bladder Scan for post void residual, PRN, every 6 hours for urinary retention and/or PRN distension See order changes identified in the WHS Postpartum Cesarean: Postoperative Orders C/S Phase. Management VTE Prophylaxis Intermittent Pneumatic Compression Knee High - On Remove 1 hour every 8 hours. Continue Intermittent Pneumatic Compression Device until ambulating independently. Antibiotics Antibiotics Removed. For all antibiotics, use WHS Infectious Disease Orders WHS POSTOPERATIVE GYN: SURGEON COMFORT ORDERS GYN PHASE See changes outlined in WHS Postpartum C/S: Surgeon Comfort Orders C/S Phase See changes outlined in WHS Postpartum C/S: Surgeon Comfort Orders C/S Phase Zolpidem (Ambien) Removed For additional orders refer to Powerplan: ing Medications Common

5 Women s Oncology Postoperative WHS PHASE Management: SURGEON MANAGES PAIN IN THE POST-OPERATIVE UNIT FOR ALL PATIENTS., Nausea/Vomiting, Respiratory Depression: Phase/Order Management: To accommodate safety measures, management of phases will now be different. Note: Urine Voiding See changes outlined in WHS Postoperative GYN See order changes identified in the WHS Postpartum Cesarean: Postoperative Orders C/S Phase, and the following: Management Mild Scale 1-3, Acetaminophen Option 3: Acetaminophen 1000 mg IV x 3, begin 6 hours from prior APAP dose if given, for patients not tolerating PO meds Acetaminophen 1000 mg PO Q 6 H, while awake, begin 6 hours from prior APAP dose Opioid Reversal VTE Prophylaxis Antibiotics Patient Controlled Analgesia (PCA): Note: PRN IV and PO opioids and concomitant PCA opioids are generally to be avoided. Please choose either (1) PRN IV and PO opioids or (2) PCA opioid. For orders, refer to Powerplan: PCA Hydromorphone Intravenous For orders, refer to Powerplan: PCA Morphine Intravenous See WHS Postoperative GYN above Intermittent Pneumatic Compression Knee High - On - Remove 1 hour every 8 hours. Continue Intermittent Pneumatic Compression Device until ambulating independently. Option 1 (bowel not involved): cefazolin (Ancef) 2 g, IV, Q8H, x 2, Give 1 st dose 8 hours from last dose. To D/C 24 hr from surgery end time Option 2 (when expanded anaerobic coverage needed), select both: cefazolin (Ancef) 2 g, IV, Q8H, x 2, Give 1 st dose 8 hours from last dose. To D/C 24 hr from surgery end time metronidazole (Flagyl) 500 mg IVPB, Give 1 st dose 8 hours from last dose. To D/C 24 hr from surgery end time Type 1 Allergy to Penicillin or severe allergy to Cephalosporins: (assumes patient received 5 mg/kg gentamicin pre-op, if gentamicin < 5 mg/kg administered pre-op, add gentamicin post-op) Option 1: clindamycin 900 mg, IVPB, Q8H, x 2. Give 1 st dose 8 hr from last dose. To D/C 24 hrs from surgery end time. Option 2 (when expanded anaerobic coverage needed), select both: clindamycin 900 mg, IVPB, Q8H, x 2. Give 1 st dose 8 hr from last dose. To D/C 24 hrs from surgery end time. metronidazole (Flagyl) 500 mg IVPB, Give 1 st dose 8 hours from last dose. To D/C 24 hr from surgery end time Postoperative Vancomycin: If estimated CrCl =< 40 ml/min, no vancomycin postoperative dose needed. Vancomycin 15 mg/kg, IVPB, once, Indication: Peri-operative/procedural prophylaxis, Reason: Prophylaxis If estimated CrCl > 40 ml/min, Give 12 hours after the previous dose. Do not give any doses beyond 24 hrs from surgery end time. Women s Oncology Postoperative: SURGEON COMFORT ORDERS GYN Ondansetron SoluTab (Zofran ODT) 4 mg, PO, Q 4 H, PRN Ondansetron (Zofran) 4 mg, IV push, Q 4 H, PRN, if not tolerating PO and has IV in place Promethazine (Phenergan) 6.25 mg IV Q 4 H PRN, if not tolerating PO and has IV in place metoclopramide (Reglan) 10 mg, IV push, Q 6 H, PRN Nursing Task: Remove Scopolamine Patch 24 hours from placement, if placed See changes outlined in WHS Postpartum C/S: Surgeon Comfort Orders C/S Phase Zolpidem (Ambien) Removed For additional orders refer to Powerplan: ing Medications Common

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG Available at: BMC-B BMC-D BMC-N BMC-S Activity Activity Bedrest with BRP, with assistance at nurse's discretion (DEF)* Ambulate with Assistance Diet Communication Order Patient to remain NPO while in PACU

More information

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders - Phase: Pediatric Spine Surgery General Orders PHYSICIAN S Diagnosis Weight Allergies Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert

More information

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:.

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:. - Phase:. PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert IV to INT when tolerating

More information

morphine 30 mg/ 30 ml (1 mg/ml) Opioid of choice

morphine 30 mg/ 30 ml (1 mg/ml) Opioid of choice PATIENT CONTROLLED ANALGESIA (PCA) PLAN Allergies: Medication Selection: morphine 30 mg/ 30 ml (1 mg/ml) Opioid of choice HYDROmorphone (Dilaudid ) 6 mg/ 30 ml (0.2 mg/ml) fentanyl 300 mcg/ 30 ml (10 mcg/ml)

More information

EPIDURAL / INTRATHECAL POST-OP PLAN

EPIDURAL / INTRATHECAL POST-OP PLAN EPIDURAL / INTRATHECAL POST-OP PLAN Diagnosis Weight PHYSICIAN S Allergies Patient Care Vital Signs Per Unit Standards, PLUS check and record RR q1h x 12, then q2h x 6, until 24h following narcotic administration.

More information

Initials * Page 1 of 6. (place patient label here) Patient Name: Diagnosis: Allergies with reaction type:

Initials * Page 1 of 6. (place patient label here) Patient Name: Diagnosis: Allergies with reaction type: Patient Name: Diagnosis: Allergies with reaction type: Orthopedic Upper Ext Post Op Version 3 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical

More information

1. Attending Physician: Dr Syn Pager: Cell: Co-Morbidities:

1. Attending Physician: Dr Syn Pager: Cell: Co-Morbidities: BARIATRIC SURGERY IMMEDIATE POST-OP PLAN (Includes Post Op Day 1) Denotes order requirement Antibiotic administered in the OR at: 1. Attending Physician: Dr Syn Pager: 740-6545 Cell: 438-9415 2. To remain

More information

ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI

ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI Date & Time Post-Op Inpatient General Orthopedic Page 1 of 5 Pharmacy Mnemonic: POIGOP1 1. Admit as inpatient to Dr. 2.Diagnosis: 3.Admit to PACU and then to floor ICU 4.Radiology: AP Pelvis in PACU AP

More information

Physician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan

Physician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Anes (ERAS) Pre-insertion Phase, When to Initiate: Other-See Special Instructions,

More information

GENERAL SURGERY POST-OP PLAN

GENERAL SURGERY POST-OP PLAN GENERAL SURGERY POST-OP PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom

More information

(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder

(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder (Page 1 of 5) Allergies/Sensitivities/Reactions: Height: Inches cm Weight: Kg Pounds = Automatic = Physician s option, Check off to Order Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental

More information

Bariatric Surgery Post Op Plan PACU Phase

Bariatric Surgery Post Op Plan PACU Phase Bariatric Surgery Post Op Plan PACU Phase PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Code Status

More information

ORTHO TOTAL KNEE REPLACEMENT POST-OP PLAN - Phase: PACU Ortho Phase

ORTHO TOTAL KNEE REPLACEMENT POST-OP PLAN - Phase: PACU Ortho Phase - Phase: PACU Ortho Phase PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Patient Condition Acuity Level Floor Status Acuity Level Critical Acuity Level Intermediate

More information

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase Total Knee Replacement Post-Op Plan - PACU Ortho Phase Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights) Patient Condition

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available at: ALL Adult Facilities Non Categorized SUB Protocol(SUB)* SUB Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as a separate form***

More information

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Bedrest STRICT Bedrest Up to

More information

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Discharge Anticipated in 24 Hour (Patient Discharge Anticipated in 24 Hours) Patient

More information

BARIATRIC SURGERY POST-OP PLAN - Phase: PACU Phase

BARIATRIC SURGERY POST-OP PLAN - Phase: PACU Phase - Phase: PACU Phase Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status: Inpatient (Inpatient

More information

(30689) PROT Pain PCA Adult Patient Controlled Analgesia

(30689) PROT Pain PCA Adult Patient Controlled Analgesia Diagnosis Allergies Nursing Assess and Document PCA: 1. Assess and document pain rating, sedation level and respiratory rate every 2 hours; assess and document pain rating, sedation level and respiratory

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available at: ALL Adult Facilities Non Categorized SUB ED Abdominal Pain Protocol(SUB)* ***The above subphase is available at the end of the plan*** SUB ED Abdominal Pain Protocol Lab

More information

Hip Hemiarthroplasty Post Op Version 2 4/20/17

Hip Hemiarthroplasty Post Op Version 2 4/20/17 Patient Name: Diagnosis: Allergies with reaction type: Hip Hemiarthroplasty Post Op Version 2 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro PCU ICU General

More information

OB/GYN CESAREAN SECTION POST-OP PLAN - Phase: General Orders

OB/GYN CESAREAN SECTION POST-OP PLAN - Phase: General Orders - Phase: General Orders DETAILS Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom Privileges Bedrest Up to Bedside Commode

More information

Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017

Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017 Patient Name: Diagnosis: Allergies with reaction type: Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017 Diagnosis Preferred Location/Unit Surgical ICU Code Status: Full Code Activity Ambulate

More information

A UMC Health System Performance Improvement Initiative for use in all units where cardiac/surgical patients are admitted.

A UMC Health System Performance Improvement Initiative for use in all units where cardiac/surgical patients are admitted. A UMC Health System Performance Improvement Initiative for use in all units where cardiac/surgical patients are admitted Denotes guideline requirement Attending Physician: Resident/Fellow: Allergies_ Diagnosis:

More information

Physician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan

Physician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Oral Maxillofacial Postop Phase, When to Initiate: LEB Oral Maxillofacial Post Op Phase Admission/Transfer/Discharge

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG Available at ALL facilities Non Categorized SUB ED Chest Pain: STEMI Protocol(SUB)* SUB ED Chest Pain: STEMI Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as

More information

IV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU

IV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU Post Op Non ICU Admit Plan Begin Immediately/PACU PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Request Patient Bed Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights) Patient Condition

More information

General. Code Status (Single Response) ( ) Full Code Details ( ) Full code - unverified Details ( ) DNRCC Allow additional therapies?

General. Code Status (Single Response) ( ) Full Code Details ( ) Full code - unverified Details ( ) DNRCC Allow additional therapies? Post Operative Above and Below Knee Amputation Admission [3041300028] Consider adding Insulin Adult -- Subcutaneous Insulin and Hypoglycemia Management [3041300000] General Admission (Single Response)

More information

1. Attending Physician: Resident/Fellow: 2. Admit: MEDICAL/SURGICAL ICU Other: Designation: In Patient Out Patient. 5.

1. Attending Physician: Resident/Fellow: 2. Admit: MEDICAL/SURGICAL ICU Other: Designation: In Patient Out Patient. 5. UROLOGY POST OPERATIVE PLAN Patient Label Here A UMC Health System Performance Improvement Initiative for use in all units where surgical patients receive care in support of Surgical Care Improvement Program

More information

INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders

INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders - Phase: Pre-Procedure Orders DETAILS Patient Care Obtain Consent If one is not present on chart today. Vital Signs Per Policy Insert Peripheral Line T;N, Start IV on right side If left radial access is

More information

THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION

THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer ***PROVIDER MUST CHECK MEDICATION LIST PRIOR TO PLACING THESE S*** Patient Care Vital Signs

More information

***SPECIAL CONSIDERATION:

***SPECIAL CONSIDERATION: ADULT ANESTHESIA POST-OP OUTPATIENT SURGERY PLAN Dx PHYSICIAN S Weight Allergies DETAILS Admit/Discharge/Transfer Return Patient to PACU Patient Care ***Patients who are at high risk for obstructive sleep

More information

PICU ADMIT DKA PLAN - Phase: Begin Immediately

PICU ADMIT DKA PLAN - Phase: Begin Immediately - Phase: Begin Immediately Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: PICU, Pt Status: Inpatient (LOS > 2 midnights) Requested Location: PICU, Pt Status: Observation

More information

A UMC Health System Performance Improvement Initiative for use in all units where patients with are admitted for Surgical Care Improvement Project.

A UMC Health System Performance Improvement Initiative for use in all units where patients with are admitted for Surgical Care Improvement Project. ENDOLUMINAL AAA POST-OP PLAN A UMC Health System Performance Improvement Initiative for use in all units where patients with are admitted for Surgical Care Improvement Project. *Denotes guideline requirement

More information

Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders

Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders Diagnosis Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Request for Outpatient Services Location: Outpatient Surgery Communication Misc

More information

Procedure: Laser Transurethral Resection of Prostate or Transurethral Resection of Prostate

Procedure: Laser Transurethral Resection of Prostate or Transurethral Resection of Prostate Laser Transurethral Resection Of Prostate Or Transurethral Resection Of Prostate Post-Operative Plan Patient Label Here A UMC Health System Performance Improvement Initiative for use in all units where

More information

To be ordered if results are not on the chart or have not already been ordered.

To be ordered if results are not on the chart or have not already been ordered. r*po1004*r PO1004 Page 1 of 3 DATE HOUR PRE OP STANDING ORDERS To be ordered if results are not on the chart or have not already been ordered. Do not duplicate orders from other sources. 1. No narcotics

More information

Total Hip Replacement Post Op Version 4 4/20/17

Total Hip Replacement Post Op Version 4 4/20/17 Patient Name: Diagnosis: Allergies with reaction type: Total Hip Replacement Post Op Version 4 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical

More information

GENERAL SURGERY PLAN - Phase:.

GENERAL SURGERY PLAN - Phase:. - Phase:. PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom Privileges

More information

1. Attending Physician: Resident/Fellow: 2. Consult

1. Attending Physician: Resident/Fellow: 2. Consult COLON POST OP PLAN A UMC Health System Performance Improvement Initiative for use in all units where surgical patients receive care in support of Surgical Care Improvement Program (SCIP). * Denotes guideline

More information

Emergency Department Chest Pain, Suspected Cardiac Adult Order Set

Emergency Department Chest Pain, Suspected Cardiac Adult Order Set Form Title Form Number Chest Pain, Suspected Cardiac Adult Order Set 20746 2018, Alberta Health Services, CKCM This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0

More information

Orthopedic Admission Hip Fracture Version 2 1/25/2017

Orthopedic Admission Hip Fracture Version 2 1/25/2017 Patient Name: Initial each page and Sign/Date/Time last page Diagnosis: Allergies with reaction type: Orthopedic Admission Hip Fracture Version 2 1/25/2017 Patient Placement Patient Status If the physician

More information

r*po1004*r PHYSICIAN S ORDERS Page 1 of 7 HOUR THORACOTOMY POSTOPERATIVE ORDERS General x Admit to Inpatient Status x Admitting Physician: Admit to:

r*po1004*r PHYSICIAN S ORDERS Page 1 of 7 HOUR THORACOTOMY POSTOPERATIVE ORDERS General x Admit to Inpatient Status x Admitting Physician: Admit to: PHYSICIAN S ORDERS Page 1 of 7 General x Admit to Inpatient Status x Admitting Physician: Admit to: SICU Telemetry Med/Surg room x Resuscitation status: see Resuscitation Status Order Activity x Bed rest

More information

LYSIS OF ADHESIONS POST-OP PLAN - Phase: PACU Phase

LYSIS OF ADHESIONS POST-OP PLAN - Phase: PACU Phase - Phase: PACU Phase PHYSICIAN S Diagnosis Weight Allergies Communication Place Device at Bedside Confirm there are 3 x Aliquots of 0.2% Ropivacaine. 2 x Medfusion Infusion pumps. Confirm 3 x PF Aliquots

More information

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU - Phase: Begin Immediately/PACU Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status:

More information

Physician Orders ADULT: Head and Neck Postoperative Plan

Physician Orders ADULT: Head and Neck Postoperative Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Head and Neck Postoperative Phase, When to Initiate: Head and Neck Post Operative Phase, Monitor and Record T,P,R,BP,

More information

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Kidney-Panc/Panc Transp Post Op Phase, When to Initiate: Kidney-Panc/Panc Transp Post Op Phase Vital Signs Vital

More information

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient

More information

UMC Health System Patient Label Here PHYSICIAN ORDERS

UMC Health System Patient Label Here PHYSICIAN ORDERS Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient

More information

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU - Phase: Begin Immediately/PACU PHYSICIAN S Diagnosis Weight Allergies Laboratory Calcium Level STAT Outpatient/PACU, T;N PTH Intact STAT Outpatient/PACU, T;N 1 of 7 - Phase: When Patient Arrives to Room

More information

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis COPD PLAN UMC Health System PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest

More information

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post Op Plan PACU Ortho Phase

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post Op Plan PACU Ortho Phase Total Knee Replacement Post Op Plan PACU Ortho Phase PHYSICIAN S Weight Allergies DETAILS Admit/Discharge/Transfer Request Patient Bed Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights),

More information

Physician Orders ADULT: Vascular Surgery AAA Endovascular Post Op Plan

Physician Orders ADULT: Vascular Surgery AAA Endovascular Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Endovascular PACU Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,

More information

Sample. Fractured Hip Post-Operative Orders. Legend < Mandatory fields o Optional fields. Height Allergies: List or o Up to date in electronic system

Sample. Fractured Hip Post-Operative Orders. Legend < Mandatory fields o Optional fields. Height Allergies: List or o Up to date in electronic system Legend Mandatory fields o Optional fields Height Allergies: List or o Up to date in electronic system cm Weight Diagnosis kg Date (yyyy-mon-dd) Time (hh:mm) Anticipated Date Of Discharge (ADOD) o Greater

More information

(31189) Hypothermia Initiation Phase One

(31189) Hypothermia Initiation Phase One Hypothermia Initiation Phase One Diagnosis Allergies For hypothermia tracking purposes only. Please do not uncheck.- Required Cardiac Emergency Tracking For hypothermia tracking purposes only. Consults

More information

OB/GYN ANTEPARTUM PLAN

OB/GYN ANTEPARTUM PLAN OB/GYN ANTEPARTUM PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Bedrest STRICT Bedrest Up to Bedside Commode Only

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG Available ONLY at: BMC-B BMC-D BMC-N BMC-S Intubation Phase Notify Therapy for STAT intubation SUB Rapid Sequence Induction(SUB)* ***The above subphase is available at the end of the powerplan under the

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT PACE Vital Signs Vital Signs PRE-OP, On arrival Nursing Orders Initiate ANES Anesthesia PACE PowerPlan Weigh Patient PRE-OP Pre op. Provide patient with incentive spirometry teaching

More information

Physician Orders ADULT: Ortho Total Joint Plan

Physician Orders ADULT: Ortho Total Joint Plan Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Ortho Total Joint Preop Phase, When to Initiate: Other-See Special Instructions, initiate

More information

Assessment. Consults & Referrals

Assessment. Consults & Referrals University of Virginia Health System Clinical Pathway: Whipple Enhanced Recovery After () LOS: 4-5 days Date of Origin/Revision: June 29, 2016/September 6, 2017/January 31, 2018 : SAS : : : D1 D2 D 3/

More information

OPEN AAA/MAJOR ABDOMINAL POST-OP PLAN - Phase:.

OPEN AAA/MAJOR ABDOMINAL POST-OP PLAN - Phase:. - Phase:. PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Maintain Gastric Tube Maintain Nasogastric - NG, Low Intermittent Suction Maintain Nasogastric - NG, Low Constant

More information

Physician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan

Physician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Repair Open Postop Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,

More information

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP PLAN - Phase:.

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP PLAN - Phase:. - Phase:. PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards, q15min x 4, q30min x 2, then q1h x 4 until sheath discontinued. Per Unit Standards Perform Neurovascular

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG Available at: BMC-A BMC-B BMC-C BMC-D BMC-N BMC-S BMC-T BMC-W PACE Nursing Orders Patient Education Instruct patient to bring corresponding films to surgery (e.g. back films for back surgery, brain films

More information

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP ADMIT PLAN - Phase: Begin Immediately/PACU Phase

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP ADMIT PLAN - Phase: Begin Immediately/PACU Phase - Phase: Begin Immediately/PACU Phase PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Requested Location: CICU Patient Condition Acuity Level Critical Acuity Level

More information

Physician Orders ADULT: Sickle Cell Inpatient Plan

Physician Orders ADULT: Sickle Cell Inpatient Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Sickle Cell Inpatient Phase, When to Initiate: When patient arrives to unit Sickle Cell Inpatient Phase Admission/Transfer/Discharge

More information

ADMIT DIABETIC KETOACIDOSIS (DKA) PLAN - Phase: Begin Immediately/Emergency Center

ADMIT DIABETIC KETOACIDOSIS (DKA) PLAN - Phase: Begin Immediately/Emergency Center - Phase: Begin Immediately/Emergency Center Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Requested Location: MICU, Pt Status: Inpatient (LOS > 2 midnights) Requested Location: 5E

More information

ADMIT STROKE NEUROINTERVENTION PLAN - Phase: Begin Immediately

ADMIT STROKE NEUROINTERVENTION PLAN - Phase: Begin Immediately - Phase: Begin Immediately PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt

More information

ADMIT GENERAL MEDICINE PLAN - Phase: Begin Immediately

ADMIT GENERAL MEDICINE PLAN - Phase: Begin Immediately - Phase: Begin Immediately Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Patient Condition Acuity Level Floor Status Acuity Level Critical Acuity Level Intermediate Continuous Telemetry

More information

Physician Orders PEDIATRIC: : LEB ED Trauma (Major) Plan

Physician Orders PEDIATRIC: : LEB ED Trauma (Major) Plan LEB ED Standing Orders Trauma (Major) Ph Non Categorized Criteria: Patients between 0-18 years of age that present with a Major Trauma that meet LeBonheur Trauma stat or Trauma Alert Guidelines.(NOTE)*

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S PACE Vital Signs Vital Signs PRE-OP, On arrival Nursing Orders Initiate ANES Anesthesia PACE PowerPlan Weigh Patient PRE-OP Pre op. Provide patient

More information

Patient Label Here. ORTHOPEDIC POST-OPERATIVE ADMIT PLAN (Includes Post Op Days 1-2) Antibiotic administered in the OR at:

Patient Label Here. ORTHOPEDIC POST-OPERATIVE ADMIT PLAN (Includes Post Op Days 1-2) Antibiotic administered in the OR at: ORTHOPEDIC POST-OPERATIVE ADMIT PLAN (Includes Post Op Days 1-2) A UMC Health System Performance Improvement Initiative for use in all units where surgical patients receive care in support of Surgical

More information

Purpose: The goal of epidural anesthesia is to reduce or eliminate pain in the laboring patient.

Purpose: The goal of epidural anesthesia is to reduce or eliminate pain in the laboring patient. Alaska Native Medical Center: Mother Baby Unit Subject: Epidural Anesthesia/PCEA in Laboring Patients Guideline: Epidural Anesthesia in Laboring Patients REVISION DATE: March 2013 REPLACES: L&D Epidural

More information

LIFEGIFT BRAIN DEATH PLAN

LIFEGIFT BRAIN DEATH PLAN Diagnosis Weight Allergies Admit/Discharge/Transfer ***THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING*** Patient Status Pt Status: Inpatient (Inpatient only procedure)

More information

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS DRUG AND TREATMENT Intubation Phase Notify Therapy for STAT intubation Medications SUB Rapid Sequence Induction (SUB)* ***Reminder: Order SUB Rapid Sequence Induction (SUB) on a separate form*** lidocaine

More information

GENERAL SURGERY POST OP ORDERS. Admit to floor to Dr. l Inpatient l Observation l Telemetry

GENERAL SURGERY POST OP ORDERS. Admit to floor to Dr. l Inpatient l Observation l Telemetry Check appropriate boxes: ** Admit to floor to Dr. l Inpatient l Observation l Telemetry Diagnosis: Consult Dr. Reason: l I have called Dr., add to his/her list. Diet: l NPO l Regular NURSING ERS: Activity:

More information

GENERAL MEDICINE PLAN

GENERAL MEDICINE PLAN GENERAL MEDICINE PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom

More information

RITUXIMAB RHEUMATOLOGY VASCULITIS

RITUXIMAB RHEUMATOLOGY VASCULITIS . PHYSICIAN (Patient Sticker) ORDER SET : CDH 208-237 Approved - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility Name:

More information

Attach patient label here. Physician Orders ADULT: Palliative Care Plan

Attach patient label here. Physician Orders ADULT: Palliative Care Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Palliative Care Phase, When to Initiate: Palliative Care Phase Admission/Transfer/Discharge Patient Status Initial

More information

DRUG ALLERGIES WT: KG

DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Pre-Op Nursing Orders Communication Order Confirm patient has brought corresponding films for surgery (e.g. back films for back surgery, brain

More information

PEDIATRIC LIFEGIFT BRAIN DEATH PLAN

PEDIATRIC LIFEGIFT BRAIN DEATH PLAN PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING. Patient Status Pt Status: Inpatient (Inpatient only

More information

IF YOU RECEIVED THIS FACSIMILE IN ERROR, PLEASE CALL IMMEDIATELY. ADMISSION INSTRUCTIONS: Admitted to Dr.

IF YOU RECEIVED THIS FACSIMILE IN ERROR, PLEASE CALL IMMEDIATELY. ADMISSION INSTRUCTIONS: Admitted to Dr. ADMISSION INSTRUCTIONS: Admitted to Dr. Procedure: Right Hip Left Hip CODE STATUS: Full DNR level of intervention DIET: Dysphagia screen consult SLP High protein, high energy Regular Nutrient dense Boost

More information

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis GI BLEED PLAN UMC Health System Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Notify Provider of VS Parameters Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist

More information

Patient Label Here CAROTID POST OP PLAN. Antibiotic administered in the OR at: Physician Signature Date/Time

Patient Label Here CAROTID POST OP PLAN. Antibiotic administered in the OR at: Physician Signature Date/Time CAROTID POST OP PLAN A UMC Health System Performance Improvement Initiative for use in all units where patients with carotid surgery are admitted in support of the Surgical Care Improvement Program (SCIP).

More information

OSF NORTHERN REGION EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS ILS, ALS. SMO: Adult Pain Management

OSF NORTHERN REGION EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS ILS, ALS. SMO: Adult Pain Management OSF NORTHERN REGION EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS ILS, ALS SMO: Adult Pain Management Overview: Objective: Provide a reasonable relief of severe pain to make packaging and transport

More information

POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT

POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT PHYSICIAN S SHEET Automatically Activate, if not in agreement, cross out and initial Activated by Checking Box ALLERGIES: None known YES Patient s Height: Patient s Weight: ALL MEDICATION and INTRAVENOUS

More information

IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015

IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015 Purpose: To provide guidance to practitioners caring for pediatric patients who need inpatient hospital care during a disaster. Disclaimer: This guideline is not meant to be all inclusive, replace an existing

More information

STROKE NEUROINTERVENTION PLAN - Phase:.

STROKE NEUROINTERVENTION PLAN - Phase:. - Phase:. PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Notify Nurse (DO NOT USE FOR MEDS) Right Lower Extremity-Check peripheral pulse distal to the cath site. If

More information

I.D. Number: To provide effective safe pain management using epidural/intrathecal route.

I.D. Number: To provide effective safe pain management using epidural/intrathecal route. Policies and Procedures Title: EPIDUAL/INTATHECAL ANALGESIA CAE OF PATIENTS ECEIVING I.D. Number: 1047 Authorization: [X] SH Nursing Practice Committee Source: Nursing Date evised: Sept 2012 Date Effective:

More information

INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE WEEKS 0, 2, 6)

INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE WEEKS 0, 2, 6) . INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE CDH 208-211 Approved 2/18 - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility

More information

TRAUMA AND SURGICAL ICU PLAN

TRAUMA AND SURGICAL ICU PLAN TRAUMA AND SURGICAL ICU PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards Daily Weight Insert Peripheral Line Patient Activity Bedrest, Bed Position: HOB Greater

More information

GENERAL SURGICAL ADULT POST-OPERATIVE ORDERS 1 of 4

GENERAL SURGICAL ADULT POST-OPERATIVE ORDERS 1 of 4 down ADULT POST-OPERATIVE 1 of 4 9 Actual 9 Estimated Patient ID Area Weight kg 9 Actual 9 Estimated Height cm ALLERGIES: REFER TO ALLERGY PROFILE/ POWERCHART Admit to: Post Anesthesia Care Unit (PACU),

More information

VAN WERT COUNTY HOSPITAL. Policy/Procedure: Departmental No.: N 11-36A. Issue Date: 7-97 By: Nursing No. of Pages: 6

VAN WERT COUNTY HOSPITAL. Policy/Procedure: Departmental No.: N 11-36A. Issue Date: 7-97 By: Nursing No. of Pages: 6 VAN WERT COUNTY HOSPITAL Policy/Procedure: Departmental No.: N 11-36A Issue Date: 7-97 By: Nursing No. of Pages: 6 Reviewed: 9-14, 8-11, 8-10 Revised: 9-14 Distribution List: All Nursing Departments Concurrence:

More information

Baptist Health Lexington. ERAS Protocols

Baptist Health Lexington. ERAS Protocols Baptist Health Lexington ERAS Protocols Enhanced Recovery After Surgery BHLex Colorectal ERAS Protocol Preoperative Patient/Family Education: PAT and office, ERAS brochure & educational flyer/checklist

More information

Physician Orders Pediatric: LEB ED Asthma Plan

Physician Orders Pediatric: LEB ED Asthma Plan LEB ED Triage Standing SOB/Wheeze Asthma Non Categorized Criteria: Patients greater than 2 years of age with a history of asthma or airway active disease or two or more previous illnesses treated with

More information

PHYSICIAN ORDER SET : Patient: DOB: Gender: Patient Phone #: Height: Weight:

PHYSICIAN ORDER SET : Patient: DOB: Gender: Patient Phone #: Height: Weight: . (Patient Sticker) CDH 208-203 Approved 2/18 - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility Name: Ordering Provider:

More information

disease or in clients who consume alcohol on a regular basis. bilirubin

disease or in clients who consume alcohol on a regular basis. bilirubin NON-OPIOID Acetaminophen(Tylenol) Therapeutic class: Analgesic, antipyretic Aspirin (ASA, Acetylsalicylic Acid) Analgesic, NSAID, antipyretic Non-Opioid Analgesics COMMON USES WHAT I NEED TO KNOW AS A

More information

PHYSICIAN ORDERS Diagnosis

PHYSICIAN ORDERS Diagnosis GENERAL UROLOGY PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Strict Intake and Output Per Unit Standards q4h q12h Patient Activity Assist as Needed Up in Chair,

More information

UMC Health System Patient Label Here PHYSICIAN ORDERS

UMC Health System Patient Label Here PHYSICIAN ORDERS Weight Allergies Patient Care Vital Signs Per Unit Standards, Q5 min during critical event. Insert Peripheral Line Use 20 gauge or larger. Notify Nurse (DO NOT USE FOR MEDS) Place crash cart with cardiac

More information