Good morning pharmacists,

 

As mentioned yesterday in huddle, here is the information regarding neuro drains and the prophylactic antibiotics that are used with them. This will mainly affect those who staff as the neuro ICU clin spec, the UB3, and the UB8. These changes will go live in PROD on Tuesday, March 16th. This should not impact pharmacy very much, except for more clear communication about when to discontinue the antibiotic. Please note the new indication of Prophylaxis, Neuro Drain that is defaulted for the antibiotics in the PowerPlan. I have attached a tip sheet and included additional information below:

 

 

• The orders for up to 4 bulb suction drains (JP), up to 1 external ventricular drain, and up to 2 hemovac drains are at the top
• Next are medication orders for Ancef, clindamycin, or vancomycin (including a linked order for Pharmacy to Dose according to the standard pharmacokinetic services)
• Each has a new indication for Prophylaxis, Neuro Drain which was developed recently for this particular purpose
• At the bottom is a bulb suction drain care (JP) order and a hemovac drain care order that has the special comment "Please remove drain and discontinue NEURO Drain and Antibiotic Orders"
• These orders are for providers intending to discontinue both the drain(s) and antibiotics
• The provider will click into the active NEURO Drain and Antibiotics Orders and initiate the relevant discontinue order
• The nurse would then discontinue the NEURO Drain and Antibiotics Orders
• This would discontinue both the order for the drain and the associated antibiotic

We are also making minor changes to certain related PowerPlans detailed below:

• JP and hemovac orders will be replaced with NEURO Drain and Antibiotic Orders PowerPlan inside NEUROSURG PostOp Craniotomy Orders and NEUROSURG Spine MAJOR / MINOR PostOp
• The orders are essentially being moved inside the NEURO Drain and Antibiotic Orders subphase, where the antibiotic orders are also located.
• Bulb Suction Drain(s) Care and Hemovac Drain Care orders will be removed from NEUROSURG Major PeriOp Phased
• The orders are being discontinued along with the NEUROSURG Major PeriOp Phased. This is potentially leading to the patient having the drain without an order for the drain in Cerner. The neurosurgery physicians and PAs have agreed for its removal, as it is creating workflow issues and was not intended to be included when the plan was developed.