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04/07/17 MD -- Adult Electrolyte Protocol Updates NOW LIVE - Clarification
From: Michele Durda
To: All Nurses
Cc: Pharmacists , Health Care Assistant ( former allhuc)
Sent: Friday, April 7, 2017 11:57:51 AM
Subject: Adult Electrolyte Protocol Updates NOW LIVE - Clarification
Adult Electrolyte protocol scenarios
The updates to the Adult Electrolyte Protocol went live yesterday. There appears to be some confusion about some of the workflow changes.
Please note the following:
- The IMPLEMENT protocol sheet should only be used ONCE (when prescriber indicates that the protocol is in effect)
- Use the TREATMENT Regimen pages when a patient has a lab value that requires treatment
- If a patient's serum calcium value is below 8 on the floor , an ionized calcium does not need to be drawn; however, if an ionized calcium value is available and low, it may be treated according to the protocol
- If a patient's serum calcium value is below 8 in the ICU , an ionized calcium should be drawn and treated, if low
I am attaching a list of "scenarios" you may encounter with the Electrolyte Protocol and the steps that should be followed. Please review this document - I think it will answer a lot of your questions.
Please note that it is particularly important that night shift understand the appropriate workflow, since the majority of lab values result early AM.
Lastly, don't forget that during this transition period, we have a number of patients with electrolyte protocol implementation orders that were written BEFORE the roll out of the updated protocol. These patients will not have the IMPLEMENT order set and associated orders on their chart or in their EMR. This is okay; we will just allow these patients to "wash out". You do not need to go back and place the IMPLEMENT order set on their chart; However, please use the TREATMENT Regimen sheets if these patients have a lab value that needs to be treated. By next week, the majority of patients will be on the updated protocol from the beginning of their stay.
As always, please feel free to contact me or Jerry Robinson with questions.
Thanks,
Michele
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Michele Durda, Pharm.D.
Medication Safety/Drug Utilization Pharmacist Huntsville Hospital