PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG"

Transcription

1 MED Hospitalist Stroke-TIA Vital Signs Vital Signs Q4H (DEF)* Q2H Q1H Vital Signs Orthostatic Activity Activity Bedrest, for 12 hours then Up ad lib (DEF)* Bedrest, for 24 hours then Up ad lib Up Ad Lib Diet NPO No exceptions Comments: Notify Provider once Bedside Swallow Screen is passed for diet orders Nursing Orders Quality Measures STK Patient Education Stroke/TIA, document education daily in I-View NIH Stroke Scale (NIHSS) On Admit and on Discharge Modified Rankin Scale (mrs) On Admit and on Discharge Elevate Head of Bed 30 Degrees Flat in Bed Flat in Bed as tolerated for 24 hours, then HOB as desired. HOB degrees IF at risk for airway obstruction, aspiration or increased ICP Bedside Swallow Screen Raise HOB to 90 degrees briefly to perform bedside swallow screen. If patient fails screen, keep NPO including po medications until cleared by SLP; for alternate medication routes. Blood Glucose Monitor POC Q6H, while NPO then QID AC and HS. If patient is non-diabetic, may discontinue in 24 hours IF no insulin given Cardiac Monitor Neuro Checks Q4H (DEF)* Q2H Q1H Temperature Greater Than 38 degrees C (100 F) Page 1 of 6

2 Other (See Special Instructions) Blood Glucose LESS Than 60 mg/dl OR GREATER Than 400 mg/dl Other (See Special Instructions) Any occurrence of Atrial Fibrillation and obtain 12 lead ECG stat Other (See Special Instructions) Deterioration of neurologic status Systolic Blood Pressure Greater Than 220 mmhg (DEF)* Systolic Blood Pressure Greater Than 180 mmhg Systolic Blood Pressure Greater Than Diastolic Blood Pressure Greater Than 120 mmhg (DEF)* Diastolic Blood Pressure Greater Than 105 mmhg Diastolic Blood Pressure Greater Than SCD Medications ***(NOTE)*** Order the appropriate medications OR select a reason from the dropdown box for medication not being given Reason for Oral Factor Xa Inhibitor Reason Stroke VTE Mechanical Prophylaxis Not Ordered Reason Stroke VTE Pharmacological Prophylaxis Not Ordered Reason Stroke VTE Prophylaxis Not Ordered Reason IV Thrombolytic Therapy Not Initiated aspirin 325 mg tab EC PO DAILY, Clinical Instructions: Do NOT give if intracranial hemorrhage. May give PO IF bedside swallowing screen passed (DEF)* 300 mg supp PR ONCE, Clinical Instructions: Do NOT give if intracranial hemorrhage 324 mg tab chew NG TUBE DAILY Comments: Use 4 81mg tabs. Reason Aspirin Not Given on Arrival Reason Aspirin Not Prescribed at Discharge aspirin-dipyridamole (Aggrenox) 1 cap PO cap ER BID Reason Antithrombotics Not Given by End Day 2 Reason Antithrombotic Therapy Not Prescribed Discharge acetaminophen (Tylenol) 325 mg tab PO BID Reason Statin Not Prescribed at Discharge Reason LDL-c Not Done atorvastatin (Lipitor) 40 mg tab PO DAILY (DEF)* 20 mg tab PO DAILY Page 2 of 6

3 rosuvastatin (Crestor) 20 mg tab PO BEDTIME Hold Medication Hold Next Dose Detail: Other (specify in Special Instructions), Special Instructions: No sedatives or sleeping pills for 24 hours (DEF)* Hold Next Dose Detail: Other (specify in Special Instructions), Special Instructions: No sedatives or sleeping pills for 48 hours acetaminophen (Tylenol) 650 mg tab PO Q6H, PRN Other (see comment) (DEF)* Comments: PRN Pain Mild or Temperature GREATER than 100 degfgive if GREATER Than 4 hours since last dose acetaminophen given. 650 mg supp PR Q6H, PRN Other (see comment) Comments: PRN Pain Mild or Temperature GREATER than 100 degfgive if GREATER Than 4 hours since last dose acetaminophen given. 650 mg tab chew NG TUBE Q6H, PRN Other (see comment) Comments: PRN Pain Mild or Temperature GREATER than 100 degfgive if GREATER Than 4 hours since last dose acetaminophen given. Humalog (Available at BMCB and BMCN ONLY) unit inj SUBCUT Q6H Comments: For Non- Diabetic patients: May discontinue in 24 H if no insulin given. Blood Glucose Administer: unit, units units units units Blood Glucose > 430: 6 units and notify physician Reason Alcohol/Substance Abuse Medication Not Prescribed Reason Tobacco Cessation Med Not Given IV Solutions Sodium Chloride 0.9% (Normal Saline Bolus) 10 ml/kg IVPB bag ONCE, Duration: 1 dose, Rate: 250 ml/hour Comments: Administer 1 dose and discontinue. Max Dose 1000 ml. Sodium Chloride 0.9% (Normal Saline) IV bag 100 ml/hour (DEF)* IV bag 75 ml/hour IV bag 50 ml/hour Laboratory ESR Homocysteine Level ANA Screen Page 3 of 6

4 Serum B12 level Vitamin D Hemoglobin A1C TSH Serum CRP Lipid Profile Early AM, ONCE Comments: Patient needs to be fasting Liver Profile Comments: If not already done CBC. Early AM, DAILY BMP Early AM, DAILY Urinalysis Routine, ONCE Urine Culture Routine, ONCE Toxicology Screen 12 - Urine Routine, ONCE Troponin Radiology ***(NOTE)*** IF Kidney function is within normal limits, no contrast allergy and able to have MRI. CT Angio Head/Neck w/wo Contrast MR Brain w/o Contrast ***(NOTE)*** If kidney function within normal limits, CONTRAST ALLERGY PRESENT and able to have MRI: MR Brain w/o Contrast MR Angio Head w/o Contrast MR Angio Neck w/ Contrast Page 4 of 6

5 ***(NOTE)*** If kidney function within normal limits, no contrast allergy and UNABLE to have MRI: CT Angio Head/Neck w/wo Contrast +24 Hours CT Head w/o Contrast ***(NOTE)*** If ABNORMAL kidney function and able to have MRI: MR Brain w/o Contrast MR Angio Head w/o Contrast US Carotid Doppler Scan ***(NOTE)*** If ABNORMAL kidney function and UNABLE to have MRI: US Carotid Doppler Scan US Transcranial Doppler Scan Stroke, Pending Discharge - No, ONCE +24 Hours CT Head w/o Contrast Respiratory Oxygen Therapy. Nasal Cannula, 2, if O2 Sat Less than 94% Pulse Oximetry (Continuous) Special Instructions: Reposition pulse oximetry probe Q8H and assess skin that has been in contact with probe Cardiology ECG Standard Routine, If not done in ED. ECG Standard Stat, 12 Lead ECG for any occurrence of atrial fibrillation Echo 2-D and M-Mode with Bubble Study Consults Neurology, Stroke Patient Neuropsychology, Stroke, Contact Dr. Rossilli ( ) Comments: Consult should not delay discharge Rehab Medicine, Stroke, Contact Adria Johnson ( ) Endovascular Neurosurgery, Stroke Page 5 of 6

6 Cardiology, Stroke Social Work Consult Routine, Discharge Planning, Physician, Stroke patient for Rehab disposition. (DEF)* Other - See Special Instructions, Assess for discharge needs Consult Physical Therapy Stroke Patient Consult Occupational Therapy Stroke Patient Consult Speech Therapy Stroke Patient Dietitian Consult Other - See Special Instructions, For Diet and Education Consult Diabetes-Adult Consult Palliative Care, Adult Consult Hospice Consult Wound Care Consult Pharmacy Page 6 of 6

PHYSICIAN ORDERS TRANSIENT ISCHEMIC ATTACK (TIA) OBSERVATION

PHYSICIAN ORDERS TRANSIENT ISCHEMIC ATTACK (TIA) OBSERVATION SCREENING- ABCD-2 Score The ABCD2 score is a risk assessment tool designed to improve the prediction of short-term stroke risk after a transient ischemic attack (TIA). Higher ABCD2 scores are associated

More information

Ischemic Stroke Clinical Pathway

Ischemic Stroke Clinical Pathway Ischemic Stroke Clinical Pathway Legal Treatments Advance Directives Refer to the ED Stroke Algorithm Patient exam: review history, Check VS/Neuro every 2 hour or per M.D. order Strict I & O s Cardiac

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT Condition/Status This powerplan is only intended for use in those patients having symptoms related to alcohol withdrawal. See DSM-IV-TR criteria listed in the Alcohol Withdrawal ICU

More information

Infectious Disease Service if Norepinephrine reaches 10 mcg/min or GREATER. Not available at Baptist Nassau. Notify Physician (BMCD)

Infectious Disease Service if Norepinephrine reaches 10 mcg/min or GREATER. Not available at Baptist Nassau. Notify Physician (BMCD) DRUG AND TREATMENT Nursing Orders Communication Order If CVP unavailable, administer fluid boluses every 30 minutes except monitor O2 requirements Comments: Every 30 minutes evaluate FiO2 and for appearance

More information

Acute Ischemic Stroke with tpa

Acute Ischemic Stroke with tpa Admission/Condition/Diagnosis Admission: Admitting Physician Attending Physician Assign to Inpatient Status Transfer to Level of Care: Physician MUST document in notes the risk, severity, and skilled nursing

More information

SLIDING SCALE INSULIN ASPART PROTOCOL PLAN

SLIDING SCALE INSULIN ASPART PROTOCOL PLAN Weight Allergies Patient Care Accucheck Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h Sliding Scale Insulin Protocol Follow SSI Reference Text Medications

More information

General PROVIDER INITIALS: PHYSICIAN ORDERS

General PROVIDER INITIALS: PHYSICIAN ORDERS Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 General Vital Signs

More information

SLIDING SCALE INSULIN REGULAR PLAN

SLIDING SCALE INSULIN REGULAR PLAN PHYSICIAN S Weight Allergies DETAILS Patient Care POC Blood Sugar Check Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h Sliding Scale Insulin Regular Guidelines

More information

General PROVIDER INITIAL: PHYSICIAN ORDERS. Vital Signs

General PROVIDER INITIAL: PHYSICIAN ORDERS. Vital Signs Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 Discontinue all lorazepam

More information

Announcements ADMIT order REQUIRED to be entered to complete admission process for all appropriate ordersets.

Announcements ADMIT order REQUIRED to be entered to complete admission process for all appropriate ordersets. Page 1 of 9 HOSP: STROKE POST ALTEPLASE (tpa) INFUSION ORDERSET [1020] 6/9/10 PT OT ST start time restriction removed 5/4//10 Revised VTE Prophylaxis 4/13/10 mult new changes 12/22/09 stroke coordinator

More information

REMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as "Stroke Service" in Cerner.

REMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as Stroke Service in Cerner. ACUTE STROKE CLINICAL PATHWAY QEH/HH PCH KCMH Souris Western Stewart Memorial O'Leary PATIENT ID INCLUSION CRITERIA* All patients admitted to hosptial with a suspected diagnosis of acute ischemic stroke

More information

[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats.

[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats. Glycemic Control - Insulin Infusion NOTE: For treatment of Diabetic Ketoacidosis or Hyperglycemic Hyperosmolar Syndrome please go to order set named Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar

More information

INR: RUPTURED ANEURYSM: POST EMBOLIZATION Patient Identification Page 1 of 5. Allergies: Weight: kg Diagnosis:

INR: RUPTURED ANEURYSM: POST EMBOLIZATION Patient Identification Page 1 of 5. Allergies: Weight: kg Diagnosis: Page 1 of 5 Allergies: Weight: kg Diagnosis: Service: Admission Admit to Inpatient Admit to Daypatient Place on Outpatient Observation Status Hospital Attending: Attending Physician Attending Provider:

More information

Appendix L: HQO Year 1 Implementation Priorities

Appendix L: HQO Year 1 Implementation Priorities Appendix L: HQO Year 1 Implementation Priorities Chronic Obstructive Pulmonary Disease (Source: COPD Chairs) Non-Invasive Positive Pressure Ventilation Early Ambulation If possible, seek patient preferences

More information

[ ] Cardiac monitoring Routine, Until discontinued, Starting today, PACU (only)

[ ] Cardiac monitoring Routine, Until discontinued, Starting today, PACU (only) If appropriate for patient condition, please consider the following order sets: Hydration Order for Reducing Risk of Radiocontrast Induced Nephrotoxicity #683 Over the Counter Patient Care Products #767

More information

Chronic Obstructive Pulmonary Disease (COPD) Admission Order Set

Chronic Obstructive Pulmonary Disease (COPD) Admission Order Set Patient Name: PHN: Page 1/1 Admit to Dr: Notified Consult: Dr: Family Dr: Precautions: Contact Droplet Enhanced Droplet Airborne - Reason: _ Code Status: Full Resuscitation or Consults: Reason: Dietician

More information

The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards

The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards Wendi J. Roberts RN, BA, MS, TNS, CLNC Field Director, Surveyor Management and Development Division of Accreditation and Certification

More information

Electronic Medication Administration Record (emar) (For Cerner Sites Only)

Electronic Medication Administration Record (emar) (For Cerner Sites Only) POLICY NO. 1009 Approved: 12/05 Effective: 12/05 Reviewed: 9/10; 5/12 1. Purpose: Electronic Medication Administration Record (emar) (For Cerner Sites Only) To provide direction for the transcription and

More information

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT

More information

Stroke/TIA Interdisciplinary Plan of Care

Stroke/TIA Interdisciplinary Plan of Care Stroke/TIA Interdisciplinary Plan of Care Patient/family involved in development of plan of care Patient/family agrees with plan of care Patient unable to be involved in plan of care ER and 1st 24 Hours

More information

(30251) Insulin SQ Prandial Carbohydrate

(30251) Insulin SQ Prandial Carbohydrate Diagnosis Patient MUST BE educated using carbohydrate counting for prial insulin coverage before hospitalization to be eligible for this order set Nursing Metered Glucose (Single Select Section) Metered

More information

DATE / TIME PROVIDER INITIALS PHYSICIAN ORDERS

DATE / TIME PROVIDER INITIALS PHYSICIAN ORDERS If appropriate for this patient, please consider the following order sets: Heart Failure Addendum #609; Acute COPD #789, Glycemic Control - Insulin Infusion #824, Glycemic Control - Subcutaneous Addendum

More information

Allergies: Weight: kg Diagnosis:

Allergies: Weight: kg Diagnosis: Page 1 of 4 Allergies: Weight: kg Diagnosis: Service: Attending: Patients with Type 1 diabetes must never be on supplementary insulin alone. Most patients with Type 2 diabetes should have daily regimen

More information

Heart Center Packages

Heart Center Packages Heart Center Packages For more information and appointments, Please contact The Heart Center of Excellence at the American Hospital Dubai Tel: +971-4-377-6571 Email: heartcenter@ahdubai.com www.ahdubai.com

More information

Community health care services Alternatives to acute admission & Facilitated discharge options. Directory

Community health care services Alternatives to acute admission & Facilitated discharge options. Directory Community health care services Alternatives to acute admission & Facilitated discharge options Directory Introduction The purpose of this directory is to provide primary and secondary health and social

More information

STATEMENT OF STANDARD

STATEMENT OF STANDARD OHSU HEALTH CARE SYSTEM PRACTICE STANDARD Acute Stroke Practice Standard for the Emergency Department (includes ischemic stroke, TIAs, intracerebral hemorrhage, and non-subarachnoid hemorrhage), PS 01.11

More information

Quiz 4 Arrhythmias summary statistics and question answers

Quiz 4 Arrhythmias summary statistics and question answers 1 Quiz 4 Arrhythmias summary statistics and question answers The correct answers to questions are indicated by *. All students were awarded 2 points for question #2 due to no appropriate responses for

More information

Ischemic Stroke Diagnosis and Medical Management. Richard M. Zweifler, MD System Chair of Neurology Ochsner Health System

Ischemic Stroke Diagnosis and Medical Management. Richard M. Zweifler, MD System Chair of Neurology Ochsner Health System Ischemic Stroke Diagnosis and Medical Management Richard M. Zweifler, MD System Chair of Neurology Ochsner Health System Stroke Epidemiology Nearly 800,000 Americans suffer stroke annually Fourth leading

More information

DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES

DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES One Children s Plaza Dayton, OH 45404-1815 www.childrensdayton.org DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES DISCLAIMER: This Clinical Practice Guideline (CPG) generally describes a recommended

More information

Survey of Canadian Physicians Use of anti-thrombotic therapy for Atrial Fibrillation

Survey of Canadian Physicians Use of anti-thrombotic therapy for Atrial Fibrillation Survey of Canadian Physicians Use of anti-thrombotic therapy for Atrial Fibrillation On the following pages are a number of questions asking about the conditions under which you would prescribe anticoagulation

More information

Medical Management of Ischemic Stroke: An Update. Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center

Medical Management of Ischemic Stroke: An Update. Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center Medical Management of Ischemic Stroke: An Update Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center Objectives Diagnostic evaluation and management of acute ischemic stroke. Inpatient management

More information

ACUTE STROKE REGISTRY (NJASR) VERSION 2.0) (Continued)

ACUTE STROKE REGISTRY (NJASR) VERSION 2.0) (Continued) New Jersey Department of Health ACUTE STROKE REGISTRY (NJASR) VERSION 2.0 A. DEMOGRAPHIC DATA *Hospital Type (1): 1=Primary 2=Comprehensive 3=Other *Hospital Code (2): *Hospital Transferred From Code (3):

More information

Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes

Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes Nursing home patients with diabetes treated with insulin and certain oral diabetes medications (i.e. sulfonylureas and glitinides) are

More information

Acute Myocardial Infarction (the formulary thrombolytic for AMI at AAMC is TNK, please see the TNK monograph in this manual for information)

Acute Myocardial Infarction (the formulary thrombolytic for AMI at AAMC is TNK, please see the TNK monograph in this manual for information) ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Alteplase (Tissue Plasminogen Activator (t-pa)), Activase in the Treatment

More information

convey the clinical quality measure's title, number, owner/developer and contact

convey the clinical quality measure's title, number, owner/developer and contact CMS-0033-P 153 convey the clinical quality measure's title, number, owner/developer and contact information, and a link to existing electronic specifications where applicable. TABLE 20: Proposed Clinical

More information

Diabetic Ketoacidosis: When Sugar Isn t Sweet!!!

Diabetic Ketoacidosis: When Sugar Isn t Sweet!!! Diabetic Ketoacidosis: When Sugar Isn t Sweet!!! W Ricks Hanna Jr MD Assistant Professor of Pediatrics University of Tennessee Health Science Center LeBonheur Children s Hospital Introduction Diabetes

More information

Anticoagulation Dosing at UCDMC Indication Agent Standard Dose Comments and Dose Adjustments VTE Prophylaxis All Services UFH 5,000 units SC q 8 h

Anticoagulation Dosing at UCDMC Indication Agent Standard Dose Comments and Dose Adjustments VTE Prophylaxis All Services UFH 5,000 units SC q 8 h Indication Agent Standard Dose Comments and Dose Adjustments VTE Prophylaxis All Services UFH 5,000 units SC q 8 h See EMR adult VTE prophylaxis CI order set Enoxaparin See service specific dosing Assess

More information

Inpatient and Outpatient Manual Changes for 2015

Inpatient and Outpatient Manual Changes for 2015 Inpatient and Outpatient Manual Changes for 2015 Jill Daniel Project Manager Quality Measures Abstraction 15-036-AB GoToWebinar The Questions Chat Box Set your audio option Introduction to Data Dictionary

More information

Rx Updates New Guidelines, New Medications What You Need to Know

Rx Updates New Guidelines, New Medications What You Need to Know Rx Updates New Guidelines, New Medications What You Need to Know Maria Pruchnicki, PharmD, BCPS, BCACP, CLS Associate Professor of Clinical Pharmacy OSU College of Pharmacy Background scope and impact

More information

Primary & Comprehensive Stroke Centers Use of Telemedicine for Stroke Care

Primary & Comprehensive Stroke Centers Use of Telemedicine for Stroke Care Primary & Comprehensive Stroke Centers Use of Telemedicine for Stroke Care 2 nd Annual Stroke Seminar March 29, 2011 Karen Ellmers, RN, MS, CCNS ellmersk@ohsu.edu Lecture Objectives and Outline 1. Discuss

More information

PHYSICIAN ORDERS / PROGRESS NOTES

PHYSICIAN ORDERS / PROGRESS NOTES PHYSICIAN / PROGRESS NOTES Drs Joseph Thibodeau and Louis Violi Created: 4/10 - Next Review: 4/10 Page 1 of 5 Initiation Phase: Emergency Department Notify Interventional Cardiology and Cath Lab immediately

More information

ACLS PRE-TEST ANNOTATED ANSWER KEY

ACLS PRE-TEST ANNOTATED ANSWER KEY ACLS PRE-TEST ANNOTATED ANSWER KEY June, 2011 Question 1: Question 2: There is no pulse with this rhythm. Question 3: Question 4: Question 5: Question 6: Question 7: Question 8: Question 9: Question 10:

More information

REFERENCE. Admit to: Program/Service: Diagnosis: Droplet/ Contact Airborne/ Contact

REFERENCE. Admit to: Program/Service: Diagnosis: Droplet/ Contact Airborne/ Contact Weight (kg) REFER TO THE ALLERGY SCREEN IN MEDITECH FOR ALLERGY INFORMATION To complete the order form, fill in the required blanks and/or check the appropriate boxes. To delete orders, draw one line through

More information

Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA

Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA Disclosures Jeanie Luciano Genentech speakers bureau Claranne Mathiesen - none 1 Objective

More information

D( desired ) Q( quantity) X ( amount ) H( have)

D( desired ) Q( quantity) X ( amount ) H( have) Name: 3 (Pickar) Drug Dosage Calculations Chapter 10: Oral Dosage of Drugs Example 1 The physician orders Lasix 40 mg p.o. daily. You have Lasix in 20 mg, 40 mg, and 80 mg tablets. If you use the 20 mg

More information

Level III Stroke Center Data Collection Requirements

Level III Stroke Center Data Collection Requirements Who? Level III Stroke Center Data Collection Requirements All LERN Level III Stroke Centers. LERN Level I and II Stroke Centers have reporting requirements to The Joint Commission or other Board approved

More information

Clinical Pathway Total Hip and Knee Replacement

Clinical Pathway Total Hip and Knee Replacement Procedure: THR TKR SIDE: RIGHT LEFT DISCHARGE DESTINATION: HOME INPATIENT REHAB PREADMISSION TARGET DISCHARGE DATE 1. Assessment Preadmission assessment completed Consult: anesthesia or internal medicine

More information

SHINE Study Ordering Instructions for Investigators SUNY Downstate

SHINE Study Ordering Instructions for Investigators SUNY Downstate General Directions SHINE Study Ordering Instructions for Investigators SUNY Downstate 1) Call Spiro Demetis to get patient admitted to ICU ASAP. Cell: 646-261-5730; Pager: 917-760-1653. Let him know that

More information

Interventional Radiology Post Procedure Orders

Interventional Radiology Post Procedure Orders Interventional Radiology Post Procedure Orders ALLERGIES & SENSITIVITIES: NKA Unapproved Abbreviations: QD, Q.D., qd, q.d., QOD, Q.O.D., qod, q.o.d., MgSO₄, MSO₄, MS, IU, U or u, ug, Trailing Zero (X.0mg),

More information

Stroke Care First week

Stroke Care First week Stroke Care First week Florence Nightingale (1820 1910) Stroke Unit Dedicated personnel trained in stroke management Stepwise guidelines supported by explicit checklists Continuous monitoring available

More information

Intermedix Inc. EMR 2006 Data Element Name. Compliant. Data Number. Elements

Intermedix Inc. EMR 2006 Data Element Name. Compliant. Data Number. Elements D01_01 EMS Agency X D01_02 EMS Agency D01_03 EMS Agency State X D01_04 EMS Agency County X D01_05 Primary Type of Service D01_06 Other Types of Service D01_07 Level of Service X D01_08 Organizational Type

More information

Meaningful Use (MU) Education

Meaningful Use (MU) Education Meaningful Use (MU) Education The 2014 MU training program has been developed to ensure high quality patient outcomes in conjunction with meeting CMS regulatory requirements. The new charting and ordering

More information

PHYSICIAN ORDERS. Alcohol Withdrawal [3040000935] Alcohol Withdrawal [3040000935] Height Weight Allergies

PHYSICIAN ORDERS. Alcohol Withdrawal [3040000935] Alcohol Withdrawal [3040000935] Height Weight Allergies Height Weight Allergies Please consider these other order sets: -Medical-Surgical Electrolyte Replacement -Critical Care Electrolyte Replacement General Discontinue all previously ordered benzodiazepines

More information

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor.

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor. This is a SAMPLE of the pretest you can access with your AHA PALS Course Manual at Heart.org/Eccstudent using your personal code that comes with your PALS Course Manual The American Heart Association strongly

More information

Stroke/VTE Quality Measure Build for Meaningful Use Stage 1

Stroke/VTE Quality Measure Build for Meaningful Use Stage 1 Stroke/VTE Quality Measure Build for Meaningful Use Stage 1 Presented by Susan Haviland, BSN RN Senior Consult, Santa Rosa Consulting Meaningful Use Quality Measures Centers for Medicare and Medicaid Services

More information

Instructor Guide: CPOE (Order Entry) for the Nurse. Trainer Notes. Objective Learn about PowerPlans. Benefits of CPOE. Learn about Nurse Review

Instructor Guide: CPOE (Order Entry) for the Nurse. Trainer Notes. Objective Learn about PowerPlans. Benefits of CPOE. Learn about Nurse Review Instructor Guide: CPOE (Order Entry) for the Nurse Trainer Notes Section Name Duration Order Entry 45 minutes Objective Learn about PowerPlans Benefits of CPOE Learn about Nurse Review You ll Need Parking

More information

AHA/ASA Ischemic Stroke Performance Measures

AHA/ASA Ischemic Stroke Performance Measures AHA/ASA Ischemic Stroke Performance Measures 1. Venous thromboembolism prophylaxis Percentage of patients with ischemic stroke who receive venous thromboembolism prophylaxis Numerator Hospital day 0 or

More information

EMS Management of Stroke. Deaver Shattuck, M.D. Brian Wiseman, M.D. Keith Woodward, M.D.

EMS Management of Stroke. Deaver Shattuck, M.D. Brian Wiseman, M.D. Keith Woodward, M.D. EMS Management of Stroke Deaver Shattuck, M.D. Brian Wiseman, M.D. Keith Woodward, M.D. Financial Disclosure: No relevant financial relationship exists Working Together to End Stroke Formed in 2013 Identified

More information

DVT/PE Management with Rivaroxaban (Xarelto)

DVT/PE Management with Rivaroxaban (Xarelto) DVT/PE Management with Rivaroxaban (Xarelto) Rivaroxaban is FDA approved for the acute treatment of DVT and PE and reduction in risk of recurrence of DVT and PE. FDA approved indications: Non valvular

More information

REGIONAL SUSPECTED STROKE PROTOCOL

REGIONAL SUSPECTED STROKE PROTOCOL 1. Stroke refers to any spontaneous damage to the brain caused by an abnormality of the blood supply by means of a clot or bleed. Strokes should be treated emergently. During a stroke, up to 2 million

More information

Secondary Stroke Prevention Luke Bradbury, MD 10/4/14 Fall WAPA Conferfence

Secondary Stroke Prevention Luke Bradbury, MD 10/4/14 Fall WAPA Conferfence Guidelines Secondary Stroke Prevention Luke Bradbury, MD 10/4/14 Fall WAPA Conferfence Stroke/TIA Nearly 700,000 ischemic strokes and 240,000 TIAs every year in the United States Currently, the risk for

More information

ALBERTA PROVINCIAL STROKE STRATEGY (APSS)

ALBERTA PROVINCIAL STROKE STRATEGY (APSS) ALBERTA PROVINCIAL STROKE STRATEGY (APSS) Stroke Systems of Care Key Components APSS Pillar Recommendations March 28, 2007 1 The following is a summary of the key components and APSS Pillar recommendations

More information

ACUTE STROKE UNIT ORIENTATION

ACUTE STROKE UNIT ORIENTATION ACUTE STROKE UNIT ORIENTATION 2014 TEACHING YOUR STROKE PATIENTS ABOUT THEIR MEDICATION Please refer to Module 8: Secondary Stroke Prevention for additional information Blood Pressure Medication Angiotensin

More information

Z Take this folder with you to your

Z Take this folder with you to your my health care notebook Why? Being an active part of your health care team helps you feel better and helps you get even better care. Starting on Day 1, you can keep track of important information and questions.

More information

Stroke: Major Public Health Burden. Stroke: Major Public Health Burden. Stroke: Major Public Health Burden 5/21/2012

Stroke: Major Public Health Burden. Stroke: Major Public Health Burden. Stroke: Major Public Health Burden 5/21/2012 Faculty Prevention Sharon Ewer, RN, BSN, CNRN Stroke Program Coordinator Baptist Health Montgomery, Alabama Satellite Conference and Live Webcast Monday, May 21, 2012 2:00 4:00 p.m. Central Time Produced

More information

CH CONSCIOUS SEDATION

CH CONSCIOUS SEDATION Summary: CH CONSCIOUS SEDATION It is the policy of Carondelet Health that moderate conscious sedation of patients will be undertaken with appropriate evaluation and monitoring. Effective Date: 9/4/04 Revision

More information

A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration

A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration of nurse A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration 1. Check times for point of care meter blood glucose testing. Pre-Breakfast

More information

Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients

Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients Developed by the Mid Atlantic Renal Coalition and the Kidney End of Life Coalition September 2009 This project was supported,

More information

PHSW Procedural Sedation Post-Test Answer Key. For the following questions, circle the letter of the correct answer(s) or the word true or false.

PHSW Procedural Sedation Post-Test Answer Key. For the following questions, circle the letter of the correct answer(s) or the word true or false. PHSW Procedural Sedation Post-Test Answer Key 1 1. Define Procedural (Conscious) Sedation: A medically controlled state of depressed consciousness where the patient retains the ability to continuously

More information

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND Monitor patient on the ward to detect trends in vital signs and to manage accordingly To recognise deteriorating trends and request relevant medical/out

More information

Dabigatran (Pradaxa) Guidelines

Dabigatran (Pradaxa) Guidelines Dabigatran (Pradaxa) Guidelines Dabigatran is a new anticoagulant for reducing the risk of stroke in patients with atrial fibrillation. Dabigatran is a direct thrombin inhibitor, similar to warfarin, without

More information

IN-HOME QUALITY IMPROVEMENT BEST PRACTICE: PHYSICIAN RELATIONSHIPS NURSE TRACK

IN-HOME QUALITY IMPROVEMENT BEST PRACTICE: PHYSICIAN RELATIONSHIPS NURSE TRACK IN-HOME QUALITY IMPROVEMENT BEST PRACTICE: PHYSICIAN RELATIONSHIPS NURSE TRACK Best Practice Intervention Packages were designed for use by any In-Home Provider Agency to support reducing avoidable hospitalizations

More information

Developing VA GDx: An Informatics Platform to Capture and Integrate Genetic Diagnostic Testing Data into the VA Electronic Medical Record

Developing VA GDx: An Informatics Platform to Capture and Integrate Genetic Diagnostic Testing Data into the VA Electronic Medical Record Developing VA GDx: An Informatics Platform to Capture and Integrate Genetic Diagnostic Testing Data into the VA Electronic Medical Record Scott L. DuVall Jun 27, 2014 1 Julie Lynch Vickie Venne Dawn Provenzale

More information

4/24/2015. Urgent, STAT, Super STAT, ASAP! Achieving timely lab testing for the Emergency Department. Learning Objectives.

4/24/2015. Urgent, STAT, Super STAT, ASAP! Achieving timely lab testing for the Emergency Department. Learning Objectives. Urgent, STAT, Super STAT, ASAP! Achieving timely lab testing for the Emergency Department Nichole Korpi-Steiner, PhD, DABCC, FACB University of North Carolina Chapel Hill, NC Learning Objectives Describe

More information

Clinical Audit in Hospital Authority. Dr Betty Young Convenor for Clinical Audit, Hospital Authority

Clinical Audit in Hospital Authority. Dr Betty Young Convenor for Clinical Audit, Hospital Authority Clinical Audit in Hospital Authority Dr Betty Young Convenor for Clinical Audit, Hospital Authority Background 1990 1992 1996 1998 2005 Establishment of the Hospital Authority Quality Assurance Subcommittee

More information

EMSPIC State NEMSIS Datasets

EMSPIC State NEMSIS Datasets E01_01 Patient Care Report Number X X E01_02 Software Creator X X E01_03 Software Name X X E01_04 Sofware Version X X E02_01 EMS Agency Number X X E02_02 Incident Number X E02_03 EMS Unit (Vehicle) Response

More information

Code Stroke: Early Recognition and Emergency Management of the Acute Stroke Patient

Code Stroke: Early Recognition and Emergency Management of the Acute Stroke Patient Code Stroke: Early Recognition and Emergency Management of the Acute Stroke Patient Ali Grubbs, RN BSN Clinical Staff Leader VUMC Adult Emergency Department Vanderbilt Adult Emergency Department Patient

More information

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Family physician with Rivergrove Medical Clinic Practice in the north end since 1985 Medical Director of the Wellness

More information

SMR On Call Notes. Created by P. Raut, PGY-2 IM Ottawa. Draft 1 Updated April 2012

SMR On Call Notes. Created by P. Raut, PGY-2 IM Ottawa. Draft 1 Updated April 2012 SMR n Call Notes Created by P. Raut, PGY-2 IM ttawa. Draft 1 Updated April 2012 SMR n Call Notes An Admission Note Template Admission Note Template Identification Allergies Physicians What medications

More information

Using the Pupillometer in Clinical Practice

Using the Pupillometer in Clinical Practice Using the Pupillometer in Clinical Practice Claude Hemphill MD M.A.S. chmephill@sfgh.ucsf.edu Kathy Johnson RN, MSN KJOHNSON@queens.org Mary Kay Bader RN, MSN, CCNS Badermk@aol.com Pupillometry: How It

More information

Approved: Acute Stroke Ready Hospital Advanced Certification Program

Approved: Acute Stroke Ready Hospital Advanced Certification Program Approved: Acute Stroke Ready Hospital Advanced Certification Program The Joint Commission recently developed a new Disease- Specific Care Advanced Certification program for Acute Stroke Ready Hospitals

More information

The patient s response to therapy within the first hour in the Emergency Room is one of the most reliable ways to predict need for hospitalization.

The patient s response to therapy within the first hour in the Emergency Room is one of the most reliable ways to predict need for hospitalization. Emergency Room Asthma Management Algorithm The Emergency Room Asthma Management Algorithm is to be used for any patient seen in the Emergency Room with the diagnosis of asthma. (The initial history should

More information

I-PASS FRONT-LINE PROVIDER WORKSHOP PATIENT SUMMARY & WRTITEN HANDOFF EXERCISE Pediatric Providers

I-PASS FRONT-LINE PROVIDER WORKSHOP PATIENT SUMMARY & WRTITEN HANDOFF EXERCISE Pediatric Providers PATIENT SUMMARY & WRTITEN HANDOFF EXERCISE Pediatric Providers INSTRUCTIONS: This activity should be completed BEFORE attending the in-person I-PASS Front-line Provider Workshop. Please bring a copy of

More information

Lothian Diabetes Handbook MANAGEMENT OF DIABETIC KETOACIDOSIS

Lothian Diabetes Handbook MANAGEMENT OF DIABETIC KETOACIDOSIS MANAGEMENT OF DIABETIC KETOACIDOSIS 90 MANAGEMENT OF DIABETIC KETOACIDOSIS Diagnosis elevated plasma and/or urinary ketones metabolic acidosis (raised H + /low serum bicarbonate) Remember that hyperglycaemia,

More information

2.5mg SC daily. INR target 2-3 30 mg SC q 12 hr or 40mg daily. 10 mg PO q day (CrCl 30 ml/min). Avoid if < 30 ml/min. 2.

2.5mg SC daily. INR target 2-3 30 mg SC q 12 hr or 40mg daily. 10 mg PO q day (CrCl 30 ml/min). Avoid if < 30 ml/min. 2. Anticoagulation dosing at UCDMC (SC=subcutaneously; CI=continuous infusion) Indication Agent Dose Comments Prophylaxis Any or No bleeding risk factors see adult heparin (VTE prophylaxis) IV infusion order

More information

GUIDELINES FOR MANAGEMENT OF PEDIATRIC DKA IMMEDIATE ASSESSMENT

GUIDELINES FOR MANAGEMENT OF PEDIATRIC DKA IMMEDIATE ASSESSMENT GUIDELINES FOR MANAGEMENT OF PEDIATRIC DKA IMMEDIATE ASSESSMENT PLEASE NOTE: the DKA protocol and supplementary material are designed as a guideline/algorithm for treating the majority of cases of DKA

More information

Healthcare Math: Calculating Dosage

Healthcare Math: Calculating Dosage Healthcare Math: Calculating Dosage Industry: Healthcare Content Area: Mathematics Core Topics: Applying medical abbreviations to math problems, using formulas, solving algebraic equations Objective: Students

More information

Thrombolysis from a nursing perspective. Gill Cluckie Stroke specialist nurse Guy s and St. Thomas NHS Foundation Trust

Thrombolysis from a nursing perspective. Gill Cluckie Stroke specialist nurse Guy s and St. Thomas NHS Foundation Trust Thrombolysis from a nursing perspective Gill Cluckie Stroke specialist nurse Guy s and St. Thomas NHS Foundation Trust First hour managing the infusion First 24 hours: Observations Complication identification

More information

INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco

INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco CLINICAL RECOGNITION Background: Appropriate inpatient glycemic

More information

Nursing Care and Considerations for Patients with Atrial Fibrillation. Kris Kinghorn RN, MSN, ANP-BC

Nursing Care and Considerations for Patients with Atrial Fibrillation. Kris Kinghorn RN, MSN, ANP-BC Nursing Care and Considerations for Patients with Atrial Fibrillation Kris Kinghorn RN, MSN, ANP-BC Case Study 66 y/o female (Mrs. Olus A. Blader) Admitted with c/o palpitations and lightheadedness PMH:

More information

Stroke Reperfusion Therapy: IV t-pa Treatment Phase

Stroke Reperfusion Therapy: IV t-pa Treatment Phase Stroke Reperfusion Therapy: IV t-pa Treatment Phase IV tpa Administration for Adult Patients Arriving Within 3 Hours. Page Contents Consent Form Indications for IV tpa Contraindications Warnings t-pa Dosing

More information

ONCE ONLY GLUCAGON and Fast Acting Glucose gel (PGD) For nurse administration under Patient Group Direction (Trust wide PGD in place)

ONCE ONLY GLUCAGON and Fast Acting Glucose gel (PGD) For nurse administration under Patient Group Direction (Trust wide PGD in place) ADULT INSULIN PRERIPTION AND BLOOD GLUCOSE MONITORING CHART Ward CONSULTANT DATE OF ADMISSION Please affix Patient s label here Ward Ward.../...year PATIENT NAME....... DATE OF BIRTH... NHS NUMBER.......

More information

Building an Emergency Response to Acute Stroke

Building an Emergency Response to Acute Stroke Great Lakes Stroke Network August 2006 Building an Emergency Response to Acute Stroke Wende N. Fedder RN, BSN, MBA Director, Stroke & Neurovascular Services Alexian Brothers Hospital Network Elk Grove

More information

New Treatments for Stroke Prevention in Atrial Fibrillation. John C. Andrefsky, MD, FAHA NEOMED Internal Medicine Review course May 5 th, 2013

New Treatments for Stroke Prevention in Atrial Fibrillation. John C. Andrefsky, MD, FAHA NEOMED Internal Medicine Review course May 5 th, 2013 New Treatments for Stroke Prevention in Atrial Fibrillation John C. Andrefsky, MD, FAHA NEOMED Internal Medicine Review course May 5 th, 2013 Classification Paroxysmal atrial fibrillation (AF) Last < 7

More information

Heart Failure Clinical Pathway

Heart Failure Clinical Pathway Patient & Family Guide 2016 Heart Failure Clinical Pathway www.nshealth.ca Heart Failure Clinical Pathway Your hospital stay will follow a written care plan called a Clinical Pathway. The pathway is a

More information

Rehabilitation Integrated Transition Tracking System (RITTS)

Rehabilitation Integrated Transition Tracking System (RITTS) Rehab Criteria The patient must have a physical impairment requiring rehabilitation OR have a known cognitive impairment requiring ongoing rehabilitation support or services. The patient is medically stable:

More information

Diabetes: When To Treat With Insulin and Treatment Goals

Diabetes: When To Treat With Insulin and Treatment Goals Diabetes: When To Treat With Insulin and Treatment Goals Lanita. S. White, Pharm.D. Director, UAMS 12 th Street Health and Wellness Center Assistant Professor of Pharmacy Practice, UAMS College of Pharmacy

More information

Scoring: NM (0) FM (3) PM (2) MM (1) Standard. A qualified Anesthetist administers all

Scoring: NM (0) FM (3) PM (2) MM (1) Standard. A qualified Anesthetist administers all Chapter VI Scoring: Standard AN.1. A qualified Anesthetist administers all anesthesia. AN.2. One Anesthetist is physically present inside the operating room throughout the operation. AN.3. The Anesthetist

More information

Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria.

Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. Kidney Complications Diabetic Nephropathy Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. The peak incidence of nephropathy is usually 15-25 years

More information

Women, Children s and Sexual Health Division, Maternity Services. Guideline: Hyperemesis Gravidarum

Women, Children s and Sexual Health Division, Maternity Services. Guideline: Hyperemesis Gravidarum 1 Introduction: Women, Children s and Sexual Health Division, Maternity Services Guideline: affects 1-2% of pregnant women, who can lose up to 30% of their body weight if severely affected. Ambulatory

More information