Approved Hospital Formulary
Add Formweb to your mobile device
Approved Hospital Formulary
4/21/23 js HOSP Acute Alcohol Withdrawal PowerPlan Updates and the MINDS Assessment
April 28, 2023
From: "Jackson Spradlin" <jackson.spradlin@hhsys.org>
To: "Pharmacists" <allpharm@hhsys.org>
Sent: Friday, April 21, 2023 2:26:55 PM
Subject: HOSP Acute Alcohol Withdrawal PowerPlan Updates and the MINDS Assessment
To: "Pharmacists" <allpharm@hhsys.org>
Sent: Friday, April 21, 2023 2:26:55 PM
Subject: HOSP Acute Alcohol Withdrawal PowerPlan Updates and the MINDS Assessment
Good afternoon!
I have been working diligently over the past several months with a group of pharmacists, nurses, and providers to update Huntsville Hospital's HOSP Acute Alcohol Withdrawal PowerPlan. This PowerPlan is a great tool to aid in the management of patients experiencing, or at risk for, alcohol withdrawal syndrome. The PowerPlan has been reorganized for improved ease of use, and new ICU protocols have been developed. Finally, the Minnesota Detoxification Scale (MINDS) is an assessment tool that will be implemented for the assessment and monitoring of these patients housewide. This will be replacing our current use of RASS. The Cerner go-live date for the updated PowerPlan and MINDS assessment is this coming Monday, April 24. Orders won't drastically change compared to what you're used to seeing from this PowerPlan, but I wanted to include a few key points regarding the updates below:
- The PowerPlan is organized into subphases to assist providers in appropriately ordering medications based on risk of severe alcohol withdrawal development.
- Low risk (PRN Medications ONLY)
- Standard risk (Scheduled and PRN Benzodiazepines)
- High risk (HIGH DOSE, Scheduled and PRN Benzodiazepines)
- Severe Symptoms Requiring ICU Admission (Benzodiazepine/PHENobarbital Dose Escalation)
- Not all patients admitted to the ICU who are found to have alcohol withdrawal symptoms will require the ICU Subphase. This subphase is intended for patients whose alcohol withdrawal symptoms are severe enough to warrant ICU admission. We expect infrequent use of this subphase, but try to evaluate if a patient's symptoms are noted to be severe if you see these orders. This subphase of orders should only be verified for patients admitted to the ICU.
- PRN orders will now have the indication "MINDS > 4" unless otherwise ordered by provider. Max doses are now listed on PRN orders at which the nurse should contact the provider.
- As with any PowerPlan that involves a taper, please pay attention to the start times of the orders when verifying the scheduled medications. Depending on the time of day the PowerPlan is ordered, there is the potential for doses to be delayed/too early. This has always been the case with this PowerPlan as well as others, so this just serves as a reminder.
- The MINDS assessment charting will located in a couple of places. You'll be able to find it within Interactive View and I&O -> Adult and ICU Quick Views/Adult and ICU Systems Assessment. Additionally, pharmacy IT will have it added to the things that can be found under Results Review -> Recent Results -> Pharmacist View.
Please let me know if you have any questions, comments, or concerns as this rolls out. Thanks!