IMH Order Sets and CarePlans
Top
ANES CARD CRIT CARE ED ENDO ENT GI GU GYN HB/SNF LAB LTC MED NEPH NEURO NURS OB OPHTH ORTHO PACU PED PULM RAD SURG TRANSFUSE
A B C D E F G H I K L M N O P R S T U V W

IHS Order Sets and CarePlans, current as of 03/13/23.
 A
ABO Type and Rh IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Blood Typing (ABO/Rh)
      • Blood, Lab Collect
Activity Intolerance Plan of Care IRDL
  • Consults
    • ❑ Consult to Social Services
      • Activity Intolerance Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Activity Intolerance Plan of Care
Amikacin IV - Pharmacy to Dose - IMH
  • Medications
    • ❑ Amikacin IV - Pharmacy to Dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Amikacin IV - Pharmacy to dose.
ANES - Continuous Epidural Order Set - IMH
  • Activity
    • ❑ Up to Chair
      • PRN, With Assistance. Assistance required until patient is steady on legs.
    • ❑ Ambulate with Assistance
      • PRN, Assistance required until patient is steady on legs.
    • ❑ Bedrest
      • While epidural catheter in place and 6 hours post discontinuation (unless otherwise ordered by surgeon)
  • IV Solutions
    • ❑ LR
      • 1,000 mL, IV, 20 mL/hr
  • Medications
    • Analgesics
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q1hr, PRN for Breakthrough Pain
        • ❑ 4 mg, Syringe, IV Push, q1hr, PRN for Breakthrough Pain
        • ❑ 6 mg, Syringe, IV Push, q1hr, PRN for Breakthrough Pain
      • ❑ HYDROmorphone
        • ❑ 0.5 mg, Syringe, IV Push, q2hr, PRN for Breakthrough Pain
        • ❑ 1 mg, Syringe, IV Push, q2hr, PRN for Breakthrough Pain
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q8hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q8hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
    • Anxiolytics
      • ❑ LORazepam
        • ❑ 1 mg, Syringe, IV Push, q2hr, PRN for Anxiety
        • ❑ 0.5 mg, Syringe, IV Push, q2hr, PRN for Anxiety
    • Other Meds
      • ❑ naloxone
        • 0.2 mg, Vial, IV Push, As Directed, PRN for Respiratory Depression
      • ❑ nalbuphine
        • 5 mg, Vial, IV Push, q4hr, PRN for Itching
      • ❑ diphenhydrAMINE
        • 12.5 mg, Vial, IV Push, q2hr, PRN for Itching
  • Patient Care
    • ❑ Nursing Communication
      • Maintain IV access for 6 hours and until patient is able to ambulate.
    • ❑ Nursing Communication
      • While epidural in place only administer narcotics ordered or approved by anesthesiologist.
    • ❑ Pharmacy Communication Order.
      • While epidural in place, all orders for narcotics to be held unless ordered or approved by anesthesiologist.
    • ❑ Pharmacy Communication Order.
      • Daily, While epidural in place, hold all anticoagulants and antiplatelet agents with the following exceptions: Prophylactic SQ heparin, warfarin as long as INR <1.25 and Aspirin (all strengths).
    • ❑ Straight Cath
      • PRN, PRN urinary retention- if necessary to cath more than twice insert indwelling foley catheter.
    • ❑ Notify Provider
      • Notify ANES if pain relief is inadequate or if INR is greater than 1.25 while epidural is in place.
    • ❑ Neurovascular Assessment Lower Extremity
      • 6x/Day, Lower extremity Neuro checks to assess sensory and motor function. Notify ANES if significant motor blockade or sensory change.
    • ❑ Notify Provider
      • T+1;0700, When epidural discontinued, continue breakthrough IV pain meds until attending provider makes rounds. Ask provider on next rounds to review or change pain medications, or resume previously held narcotics / sedatives.
    • ❑ Hold Med
      • PRN, See Order Comments
    • ❑ Nursing Communication
      • See Order Comments
  • Respiratory
    • ❑ Oxygen Therapy
      • 2 L, Nasal Cannula, < 90%
    • ❑ Pulse Oximetry Continuous
      • Call for SPO2 less than 90%
  • Special
    • ❑ fentanyl 2 mcg/mL-bupivacaine 0.1% Epidural 250 mL
      • 250 mL, Soln-IV, Epidural, EPIDURAL
      • 500 mcg
    • ❑ fentanyl 5mcg/mL-ropivacaine 0.1%-Epidural NS 500 mL
      • 100 mL
      • 350 mL, Epidural, Epidural
      • 2,500 mcg
  • Vital Signs
    • ❑ Vital Signs POC
      • UD, Respiratory Rate & O2 Sat q 1 hour - may discontinue 4 hours after epidural discontinued. Notify ANES of hypotension.
    • ❑ NS Bolus
      • 500 mL, IV, Once, PRN for Other (see comment)
    • ❑ Notify Provider Vital Signs
      • SBP < 100, O2 sat < 90
ANES - Continuous Peripheral Nerve Block & PCRA Order Set - IMH
  • Activity
    • ❑ Knee Immobilizer
      • Lower extremity block (i.e.femoral, sciatic, lumbar plexus, popliteal) patient must have knee immobilizer in place for entire duration and 24 hours after infusion is stopped. May stand or walk with assistance only.
    • ❑ Arm Sling
      • to operative upper extremity if continuous peripheral nerve block catheter in shoulder - refer to "Information for Outpatient Continuous Peripheral Nerve Block Infusions". Upper extremity block activity per surgeon orders.
  • Communication
    • ❑ Discharge Instructions
      • See Order Comment
    • ❑ Discontinue
      • ❑ T+3;0700, Peripheral Nerve Block Catheter - in the am.
      • ❑ T+3;1700, Peripheral Nerve Block Catheter - in the pm.
  • Medications
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, q6hr, PRN for Pain - Moderate, 5 dose(s)/time(s)
      • ❑ 15 mg, Vial, IV Push, q6hr, PRN for Pain - Moderate, 5 dose(s)/time(s)
    • ❑ celecoxib
      • 200 mg, Cap, Oral, Daily, 3 day(s)
    • ❑ LORazepam
      • ❑ 0.5 mg, Injection, IV Push, q6hr, PRN for Anxiety, 3 day(s)
      • ❑ 1 mg, Injection, IV Push, q6hr, PRN for Anxiety, 3 day(s)
    • ❑ LORazepam
      • ❑ 1 mg, Tab, Oral, q6hr, PRN for Anxiety, 3 day(s)
      • ❑ 0.5 mg, Tab, Oral, q6hr, PRN for Anxiety, 3 day(s)
  • Patient Care
    • ❑ Catheter
      • ❑ Intrascalene
      • ❑ Supraclavicular
      • ❑ Femoral
      • ❑ Popliteal
      • ❑ Sciatic
      • ❑ TAP
      • ❑ Infraclavicular
      • ❑ Saphenous
      • ❑ Other
    • ❑ Nursing Communication Order
      • Protect affected extremities (area of body) until sensation returns to normal status. Maintain IV access while nerve block catheter in place during hospitalization.
    • ❑ Dressing Reinforce
      • qShift - 8 hour, PRN, Peripheral nerve block dressing as needed. Check dressing and catheter insertion site every 8 hours. Reinforce dressing as needed. Do not attempt to remove occlusive dressing
    • ❑ Notify Provider
      • Call Anesthesiologist for severe breakthrough pain. Call Anesthesiologist for signs of local anesthetic toxicity such as over sedation, confusion, tinnitus, tremors, mouth / lip numbness / tingling, excitability.
  • Special
    • ❑ Local Anesthetic Device
      • ❑ Disposable Bolus
      • ❑ Electronic PCRA
      • ❑ Electronic
      • ❑ Disposable
    • ❑ Marcaine 0.125% / 550 mL PM Disp Bolus
      • 550 mL, Nerve Block, Routine, 6 mL/hr
      • 687.5 mg
    • ❑ ropivacaine 0.2% / 550 mL Premix
      • 1,100 mg
      • 550 mL, Nerve Block, Routine, 6 mL/hr
    • ❑ Marcaine 0.125% / 550 mL
      • 412.5 mL, Nerve Block, Routine, 6 mL/hr
      • 137.5 mL
    • ❑ ropivacaine 0.2% / 550 mL Pump
      • 220 mL
      • 330 mL, Nerve Block, Routine, 6 mL/hr
    • ❑ Marcaine 0.125% / 550 mL
      • 412.5 mL, Nerve Block, Routine, 8 mL/hr
      • 137.5 mL
    • ❑ ropivacaine 0.2% / 550 mL Pump
      • 330 mL, Nerve Block, Routine, 8 mL/hr
      • 220 mL
    • ❑ Marcaine 0.125% / 550 mL
      • 412.5 mL, Nerve Block, Routine, 8 mL/hr
      • 137.5 mL
    • ❑ ropivacaine 0.2% / 550 mL Premix
      • 550 mL, Nerve Block, Routine, 8 mL/hr
      • 1,100 mg
ANES - Obstetric Laboring Epidural Analgesia (PCEA) Order Set - IMH
  • Activity
    • ❑ Patient Activity Misc
      • No ambulation during epidural infusion.
  • Communication
    • ❑ Patient Education
      • Provide education to patient regarding epidural and use of PCEA button. Document education.
  • IV Solutions
    • ❑ fentaNYL
      • 100 mcg, Vial, IV Push, Once, PRN for Breakthrough Pain
    • ❑ fentanyl 2 mcg/mL-bupivacaine 0.125% Epidural 250 mL
      • 250 mL, IV, PCA, Pt Adm Bolus (mL): 5, Lockout Interval (min): 10, 1-hour Limit (mL) 25, Cont Basal Rate (mL/hr): 10
      • 250 mL
    • ❑ fentanyl 2 mcg/mL-bupivacaine 0.1% Epidural 250 mL
      • 250 mL, IV, Pt Adm Bolus (mL): 5, Lockout Interval (min): 10, 1-hour Limit (mL) 25, Cont Basal Rate (mL/hr): 10
    • ❑ naloxone
      • 40 mcg, Injection, IV Push, q2hr, PRN for Respiratory Depression
  • Medications
    • Antiemetics
      • ❑ ondansetron
        • 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • Anti-pyretics
      • ❑ nalbuphine
        • 2 mg, Vial, IV Push, q1hr, PRN for Itching, 2 dose(s)/time(s)
      • ❑ diphenhydrAMINE
        • 12.5 mg, Vial, IV Push, q6hr, PRN for Itching, 2 dose(s)/time(s)
    • ❑ LR
      • 500 mL, IV, PRN, Other (see comment), See Comment
    • ❑ ePHEDrine
      • 5 mg, Injection, IV Push, q5min, PRN for Other (see comment), 2 dose(s)/time(s)
    • ❑ Phenylephrine
      • 100 mcg, Injection, IV Push, q5min, PRN Other (see comment), 2 dose(s)/time(s)
  • Patient Care
    • ❑ Nursing Communication
      • While epidural infusing, only administer narcotics ordered by anesthesiologist.
    • ❑ Pharmacy Communication Order.
      • While epidural infusing, all orders for narcotics to be held unless ordered or approved by anesthesiologist.
    • ❑ Nursing Communication
      • For epidural induced hypotension, position patient in side-laying position, elevate legs and administer fluid bolus. See Medication section for further instructions.
    • ❑ Notify Provider
      • Notify ANES if naloxone (Narcan), ephedrine, or phenylephrine administered, respiratory rate < 12 breaths/min, or inadequate analgesia
    • ❑ Notify Provider
      • Notify ANES for Sedation Level - frequently drowsy, somnolent, minimal or no response to pain; Excessive motor block (inability to bend knees or numbness above T4 level); for catheter removal instructions when urgent anticoagulation is required.
    • ❑ Notify Provider
      • Notify Anesthesiologist if hypotension is unresolved or recurs after administration of ephedrine or phenylephrine.
    • ❑ Hold Med
      • See Order Comments
    • ❑ Nursing Communication Order
      • See Order Comments
ANES - OPS Post-Operative Order Set - IMH
  • IV Solutions
    • ❑ LR
      • 1,000 mL, IV, 125 mL/hr
    • ❑ NS
      • 500 mL, IV, 10 mL/hr
    • ❑ Discontinue IV
      • When tolerating po fluids.
  • Medications
    • Analgesics
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, PRN for Pain
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, PRN for Pain
      • ❑ acetaminophen
        • 650 mg, Tab, Oral, Once, PRN for Headache
      • ❑ oxyCODONE
        • ❑ 5 mg, Tab, Oral, Once
        • ❑ 10 mg, Tab, Oral, Once
    • Antiemetics
      • ❑ ondansetron
        • 4 mg, Vial, IV Push, Once, PRN for Nausea/Vomiting
      • ❑ LR
        • 500 mL, IV, 10 mL/hr
      • ❑ LR
        • 500 mL, IV, 75 mL/hr
      • ❑ Notify Provider
        • Notify Anesthesiologist for Pain or Nausea/Vomiting.
    • ❑ phenazopyridine
      • 200 mg, Tab, Oral, Once, PRN for Urinary discomfort
  • Patient Care
    • ❑ Discharge When Patient Meets Criteria
      • Per Surgeon discharge instructions and / or when outpatient d / c criteria met.
ANES - OPS Pre-Procedure Order Set - IMH
  • Medications
    • Antiemetics
      • ❑ dexamethasone
        • 8 mg, IV Push, Once
      • ❑ famotidine
        • 20 mg, Vial, IV Push, Once
      • ❑ pantoprazole
        • 40 mg, Vial, IV Push, Once
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, Once
        • ❑ 4 mg, Vial, IV Push, Once
      • ❑ scopolamine
        • 1.5 mg, Patch-72, Transdermal, Once
      • ❑ gabapentin
        • 300 mg, Cap, Oral, Once
      • ❑ pregabalin
        • 75 mg, Cap, Oral, Once
      • ❑ celecoxib
        • 200 mg, Cap, Oral, Once
      • ❑ acetaminophen
        • 1,000 mg, Tab, Oral, Once
      • ❑ meperidine
        • 50 mg, Syringe, IV Push, On Call
      • ❑ LORazepam
        • 1 mg, Injection, IV Push, On Call
      • ❑ prochlorperazine
        • ❑ 5 mg, Vial, IV Push, On Call
        • ❑ 10 mg, Vial, IV Push, On Call
      • ❑ midazolam
        • 0.5 mg/kg, Syringe, Oral, On Call
ANES - PACU Adult Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Communication Order
      • Discharge from PACU when discharge criteria is met. Transfer patient to floor/outpatient/home per surgeon's orders.
  • Diet
    • ❑ Diet Order
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ NPO
      • ❑ NPO, Ice Chips - if not ordered NPO per surgeon
  • IV Solutions
    • ❑ LR
      • 1,000 mL, IV, 125 mL/hr
    • ❑ NS
      • 500 mL, IV, 10 mL/hr
  • Medications
    • Analgesics
      • ❑ fentaNYL
        • 25 mcg, Injection, IV Push, q3min, PRN for Pain - Severe, 4 dose(s)/time(s)
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, Once, PRN for Pain - Moderate
      • ❑ oxyCODONE
        • 5 mg, Tab, Oral, Once, PRN for Pain - Mild
      • ❑ oxyCODONE
        • 10 mg, Tab, Oral, Once, PRN for Pain - Moderate
    • Antiemetics
      • ❑ ondansetron
        • 4 mg, Vial, IV Push, Once, PRN for Nausea/Vomiting
      • ❑ Nursing Communication Order
        • If patient admitted, PACU RN may administer Dilaudid (hydromorphone) (if available) or Morphine (if Dilaudid not available) or Compazine (prochlorperazine) below
      • ❑ HYDROmorphone
        • 0.5 mg, Syringe, IV Push, q5min, PRN for Breakthrough Pain, 4 dose(s)/time(s)
      • ❑ morphine
        • 2 mg, Syringe, IV Push, q5min, PRN for Breakthrough Pain, 5 dose(s)/time(s)
      • ❑ prochlorperazine
        • 2.5 mg, Vial, IV Push, q15min, PRN for Nausea/Vomiting, 2 dose(s)/time(s)
    • ❑ ePHEDrine
      • 5 mg, Injection, IV Push, q5min, PRN for Other (see comment), 2 dose(s)/time(s)
    • ❑ Phenylephrine
      • 100 mcg, Injection, IV Push, q5min, PRN for Other (see comment), 2 dose(s)/time(s)
    • ❑ phenazopyridine
      • 200 mg, Tab, Oral, Once, PRN for Urinary discomfort
    • ❑ meperidine
      • 25 mg, Syringe, IV Push, q10min, PRN for shivering, 2 dose(s)/time(s)
    • ❑ diphenhydrAMINE
      • 12.5 mg, Vial, IV Push, Once, PRN for Itching
  • Patient Care
    • ❑ Blood Glucose POC
      • On arrival for all Insulin Dependent Diabetics & PRN
    • ❑ Notify Provider
      • See Comment
  • Respiratory
    • ❑ Oxygen Therapy
      • 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • Keep O2 sat equal to or greater than 92%. Wean as tolerated to room air.
    • ❑ Continuous Positive Airway Pressure
      • per Respiratory Therapy.
    • ❑ Bi-level Positive Airway Pressure
      • per Respiratory Therapy.
    • ❑ Pulse Oximetry Continuous
      • Call for SPO2 < 92 or less than patient's baseline.
ANES - PACU Pediatric Order Set - IMH
  • IV Solutions
    • ❑ LR
      • 500 mL, IV, 10 mL/hr
    • ❑ LR
      • 500 mL, IV, 75 mL/hr
  • Medications
    • Analgesics
      • ❑ fentaNYL
        • 0.5 mcg/kg, Injection, IV Push, q5min, PRN for Pain, 2 dose(s)/time(s)
    • Antiemetics
      • ❑ ondansetron
        • ❑ 0.1 mg/kg, Vial, IV Push, Once, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, Once, PRN for Nausea/Vomiting
  • Patient Care
    • ❑ Notify Provider
      • Call Anesthesiologist for unrelieved pain, SP02 < 95% or less than baseline.
  • Respiratory
    • ❑ Titrate Oxygen
      • 95%, or at baseline
    • ❑ Oxygen Therapy
      • Humidified blow by.
ANES - Post-Operative Respiratory Order Set - IMH
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
      • ❑ FIO2: 40%, Face Shield
      • ❑ FIO2: 50%, Face Shield
      • ❑ FIO2: 75%, Face Shield
      • ❑ FIO2: 100%, Face Shield
    • ❑ Discontinue
      • Discontinue oxygen
    • ❑ Titrate Oxygen
      • ❑ 0.92
      • ❑ 0.91
      • ❑ 0.9
      • ❑ 0.89
      • ❑ 0.88
      • ❑ 0.87
      • ❑ baseline
    • ❑ Notify Provider Vital Signs
      • ❑ O2 sat < 90
      • ❑ O2 sat < 92
      • ❑ O2 sat < 91
      • ❑ O2 sat < 89
      • ❑ O2 sat < 88
      • ❑ O2 sat < 87
    • ❑ Pulse Oximetry Continuous
      • for 24 hr
    • ❑ CPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: CPAP, HS
      • ❑ Mode: CPAP, PRN
      • ❑ per home CPAP
    • ❑ BIPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: BiPAP, HS
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
    • ❑ Ventilator Care
      • per Respiratory Therapy / MD order
    • ❑ Ventilator Settings
      • Per Respiratory Therapy
    • ❑ Incentive Spirometry RT
      • q2hr-WA
ANES - Pre-Operative Order Set - IMH
  • Diagnostic Tests
    • ❑ EKG
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of HTN
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of CAD
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Use of Medications
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Heart Failure
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Valvular Disease
      • ❑ Stat, Other: __________
    • ❑ EKG - OP Surgery Area
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of HTN
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of CAD
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Use of Medications
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Heart Failure
      • ❑ Stat, Reason: Patient greater than 50 years of age and history of Valvular Disease
      • ❑ Stat, Other: __________
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 NPO, after midnight, except selected medications.
      • ❑ NPO, Room Service Eligible: No, except selected medications
    • ❑ Diet Order
      • T+1;0600 Clear Liquid
    • ❑ Diet Order
      • T+1;1000 NPO, Room Service Eligible: No, except selected medications
  • IV Solutions
    • ❑ LR
      • 1,000 mL, IV, 10 mL/hr
    • ❑ 1/2 NS
      • 500 mL, IV, 10 mL/hr
    • ❑ LR
      • 500 mL, IV, 10 mL/hr
    • ❑ D5LR
      • 500 mL, IV, 10 mL/hr
    • ❑ NS
      • 500 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ SARS-CoV-2 (COVID-19) Antigen
      • Nasopharyngeal Swab, Routine collect, T;N, Nurse collect, Reason: Pre-Op Covid 19 Testing
    • ❑ CBC
      • ❑ Blood, Routine collect, T;N, Reason: High blood loss procedure.
      • ❑ Blood, Routine collect, T;N, Reason: other: ___________
    • ❑ Potassium Level
      • ❑ Blood, Routine collect, T;N, Reason: Use of Medications
      • ❑ Blood, Routine collect, T;N, Reason: other: ___________
    • ❑ PT/INR
      • ❑ Blood, Routine collect, T;N, Reason: Anti Coagulants
      • ❑ Blood, Routine collect, T;N, Reason: other: ___________
    • ❑ Comprehensive Metabolic Panel
      • ❑ Blood, Routine collect, T;N, Reason: Hepatic Dysfunction
      • ❑ Blood, Routine collect, T;N, Reason: other: ___________
    • ❑ Basic Metabolic Panel
      • ❑ Blood, Routine collect, T;N, Reason: Diabetes
      • ❑ Blood, Routine collect, T;N, Reason: Renal Failure
      • ❑ Blood, Routine collect, T;N, Reason: Use of Medication
      • ❑ Blood, Routine collect, T;N, Reason: other: ___________
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N
  • Medications
    • ❑ metoprolol
      • 25 mg, Tab, Oral, On Call
    • ❑ lidocaine 1% injectable solution
      • 0.1 mL, Vial, Intradermal, On Call
    • ❑ lidocaine-prilocaine 2.5%-2.5% topical cream
      • 1 app, Cream, TOP, On Call
    • ❑ lidocaine-prilocaine 2.5%-2.5% topical cream
      • 1 app, Cream, TOP, On Call
  • Patient Care
    • ❑ Blood Glucose POC
      • On ALL diabetic patients upon arrival to OPSD.
    • ❑ Nursing Communication
      • See Comment
    • ❑ Nursing Communication
      • See Comment
ANES - Single Dose Epidural / Spinal Narcotic Order Set - IMH
  • Communication
    • ❑ Pharmacy Communication Order.
      • Once, Discontinue SDE orders 24 hours after initiation of order set.
    • ❑ Nursing Communication Order
      • Discontinue SDE orders 24 hours after initiation of order set.
  • Medications
    • ❑ naloxone
      • 0.2 mg, Vial, IV Push, As Directed, PRN for Respiratory Depression
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q8hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q8hr, PRN for Nausea/Vomiting
    • ❑ prochlorperazine
      • 5 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
    • ❑ nalbuphine
      • 5 mg, Vial, IV Push, q4hr, PRN for Itching
    • ❑ diphenhydrAMINE
      • 12.5 mg, Vial, IV Push, q2hr, PRN for Itching
  • Patient Care
    • ❑ Nursing Communication
      • Keep an ampule of naloxone 0.4mg in patient's medication drawer.
    • ❑ Nursing Communication
      • May have narcotics for pain as ordered by surgeon.
    • ❑ Nursing Communication
      • Exclude Continuous Pulse Oximetry for post-op C-Section patient when awake.
    • ❑ Notify Provider
      • Notify ANES. when naloxone given.
    • ❑ Catheterize as needed
      • Per Policy / Algorithm
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • 0.9
    • ❑ Pulse Oximetry Continuous
      • If O2 started, continuous pulse oximetry for 15 min after O2 discontinued
  • Vital Signs
    • ❑ Vital Signs POC
      • Respiratory Rate q 1 hour until order discontinued. Other vital signs per physician orders or routine post-op vital signs.
Antibody Screen IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Collected, T;N, Once, Lab Collect
    • ❑ .Antibody Screen
      • Blood, T;N, Once, Lab Collect
Anxiety Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Anxiety Plan of Care
Autologous Units IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Autologous Unit
      • Blood
 B
Basic Cancer Plan of Care
  • Consults
    • ❑ Consult to Dietitian
      • as needed
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Basic Cancer Plan of Care
Basic Surgery Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Basic Surgery Plan of Care
Bleeding Risk Plan of Care
  • Communication
    • ❑ Patient Education
      • Coumadin handout for home use
    • ❑ Patient Education
      • List medications (w/ over-the-counter) to avoid. Check w/ pharmacist/physician.
    • ❑ Patient Education
      • Video: "Coumadin Therapy and You".
  • Patient Care
    • ❑ Misc Nursing Task
      • Report symptoms to the physician.
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Bleeding Risk Plan of Care
Blood Culture X 2 IRDL
  • Laboratory
    • ❑ Culture - Blood
      • Blood, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, T;N, Lab Collect
Bowel Dysfunction Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Bowel Dysfunction Plan of Care
Bowel Incontinence Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Bowel Incontinence Plan of Care
BUN Venous/Arterial (Dialysis) IRDL
  • Laboratory
    • ❑ BUN Venous
      • Blood, Nurse collect
    • ❑ BUN-Arterial
      • Blood, Nurse collect
    • ❑ BUN-Peripheral
      • Blood, Nurse collect
 C
CARD - Acute Coronary Syndrome (ACS/Chest Pain/Angina) Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
  • Consults
    • ❑ Consult to Cardiology
      • Repage Cardiologist if no call back within 10 minutes. Document return call time in Medical Record.
    • ❑ Consult to Diabetic Nurse Specialist
      • Diabetic Education
  • Diagnostic Tests
    • ❑ Hold Med
      • Hold Beta Blockers for 24 hours prior to Exercise Stress Echo
    • ❑ Hold Med
      • Hold Beta Blockers for 24 hours prior to Stress Cardiolite
    • ❑ XR Chest 1 View Portable
      • Routine, 0
    • ❑ CT Angio Pulmonary
      • Stat
    • ❑ EKG
      • Stat, STAT ECG should be done within 5 minutes of arrival - immediately notify the MD of results., 0
    • ❑ EKG
      • Stat, PRN, Per episode of Chest Pain & Initial ECG is not diagnostic, patient remains symptomatic and suspicious for ACS, repeat ECG at 15-30 minute intervals during the first hour of symptoms and new onset symptoms. Call provider with results.
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ Angiomax 250 mg/50 mL
      • 250 mg
      • 50 mL, IV, Routine, See Comments
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ nitroglycerin drip
      • 250 mL, IV, Routine, See Comments, Total volume (mL): 250
      • 50 mg
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Lipid Panel
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ACE Inhibitor
      • ❑ enalapril
        • 2.5 mg, Tab, Oral, Daily
      • ❑ lisinopril
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, BID
    • Beta Blockers
      • ❑ metoprolol
        • ❑ 25 mg, Tab, Oral, 4x/Day, 48 hr
        • ❑ 50 mg, Tab, Oral, 4x/Day, 48 hr
      • ❑ carvedilol
        • ❑ 3.125 mg, Tab, Oral, BID, 48 hr
        • ❑ 6.25 mg, Tab, Oral, BID, 48 hr
    • Lipid Regulating Meds
      • ❑ atorvastatin
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 20 mg, Tab, Oral, Daily
        • ❑ 40 mg, Tab, Oral, Daily
        • ❑ 80 mg, Tab, Oral, Daily
      • ❑ rosuvastatin
        • ❑ 20 mg, Tab, Oral, Daily
        • ❑ 40 mg, Tab, Oral, BID
    • Platelet Aggregation Inhibitors
      • ❑ clopidogrel
        • 75 mg, Tab, Oral, Daily
      • ❑ prasugrel
        • 60 mg, Tab, Oral, Once
      • ❑ prasugrel
        • 10 mg, Tab, Oral, Daily
      • ❑ ticagrelor
        • 180 mg, Tab, Oral, Once
      • ❑ ticagrelor
        • 90 mg, Tab, Oral, BID
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain
    • ❑ nitroglycerin 2% topical ointment
      • ❑ 0.5 in, Ointment, TOP, BID
      • ❑ 1 in, Ointment, TOP, BID
      • ❑ 2 in, Ointment, TOP, BID
    • ❑ Patch/Paste Removal
      • T;1900, Q24hr, Remove Nitroglycerin Ointment at 7 pm
    • ❑ atropine
      • ❑ 0.5 mg, Syringe, IV Push, As Directed, PRN bradycardia
      • ❑ 1 mg, Syringe, IV Push, As Directed, PRN bradycardia
    • ❑ morphine
      • 2 mg, Syringe, IV Push, q2hr, PRN Pain
    • ❑ enoxaparin
      • ❑ 1 mg/kg, Syringe, Subcutaneous, q12hr
      • ❑ 1 mg/kg, Syringe, Subcutaneous, Once
      • ❑ 1 mg/kg, Syringe, Subcutaneous, Daily
    • ❑ heparin
      • 5000 unit(s), Injection, Subcutaneous, 3x/Day
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once
    • ❑ Reason Aspirin Not Given on Arrival
      • ❑ Allergy
      • ❑ Antiplatelet therapy contraindicated
      • ❑ Coumadin/Warfarin as pre-arrival med
      • ❑ Other: ________
    • ❑ aspirin
      • ❑ 81 mg, Tab-Chew, Oral, Daily
      • ❑ 162 mg, Tab-Chew, Oral, Daily
      • ❑ 325 mg, Tab, Oral, Daily
  • Patient Care
    • AMI Quality Measures
      • ❑ Reason Aspirin Not Given on Arrival
        • ❑ Allergy
        • ❑ Antiplatelet therapy contraindicated
        • ❑ Coumadin/Warfarin as pre-arrival med
      • ❑ Reason for Fibrinolytic Therapy Delay
        • ❑ Balloon pump within 30 min of arrival
        • ❑ CP arrest within 30 min of arrival
        • ❑ Intubation within 30 min of arrival
        • ❑ Patient/Family refusal of therapy
      • ❑ Reason for PCI Delay
        • ❑ Balloon pump within 90 min of arrival
        • ❑ CP arrest within 90 min of arrival
        • ❑ Intubation within 90 min of arrival
        • ❑ Patient/Family refusal of therapy
    • ❑ Patient Education
      • qShift - 8 hour, ACS Discharge Instructions, Cardiac Discharge Medication handout & Smoking Cessation (if patient has smoked within the past year)
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
    • ❑ Notify Provider
      • For symptomatic Non-Sustained V-tach ( 3 or more in a row)
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • keep O2 Sat greater than or equal to 90%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
CARD - Alteplase (Activase) Infusion for Pulmonary Embolus - IMH
  • Activity
    • ❑ Bedrest
      • Strict bedrest during Alteplase (Activase) infusion.
  • Communication
    • ❑ Nursing Communication Order
      • Prior to administering Heparin, check to be sure patient has not received an anticoagulant within the last 24 hours.
    • ❑ Notify Provider
      • if patient has received an anticoagulant within the last 24 hours.
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Stat
    • ❑ XR Chest 1 View Frontal
      • Stat
    • ❑ EKG
      • Stat
  • IV Solutions
    • ❑ Nursing Communication Order
      • Do not add, push or piggyback medications into alteplase infusion.
    • ❑ Nursing Communication Order
      • Infuse 100mg of alteplase over 2 hours (NOTE: Alteplase (Activase) for pulmonary embolus is NOT weight adjusted) -- 2nd RN must verify dosage and pump programming prior to administration, document in Medical Record.
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ alteplase.
      • Per Protocol for PE, Kit, IV, Once
    • ❑ Sodium Chloride 0.9% Intermittent
      • 50 mL, IV, 25 mL/hr
    • ❑ alteplase.
      • 50 mg, Kit, IV Push, Once
    • ❑ alteplase.
      • 50 mg, Kit, IV Push, Once
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Routine, Per DVT/PE Protocol
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Precautions
      • Bleeding Precautions
  • Vital Signs
    • ❑ Vital Signs POC
      • q 1 hour
CARD - Amiodarone (Cordarone) Infusion Order Set - IMH
  • IV Solutions
    • ❑ Nursing Communication
      • Amiodarone Infusion: Begin maintenance infusion at 1mg/min or 33 cc/hr x 6 hours then reduce maintenance infusion to 0.5mg/min or 17 cc/hr.
    • ❑ amiodarone 450 mg/250 mL
      • 450 mg
      • 250 mL, IV, Routine, 6 hr, 33 mL/hr
    • ❑ amiodarone 450 mg/250 mL
      • 450 mg
      • 250 mL, IV, Routine, 17 mL/hr
  • Medications
    • ❑ amiodarone
      • 150 mg, IV Piggyback, Once, Infuse over 10 minute(s)
  • Vital Signs
    • ❑ Vital Signs POC
      • 5 minutes after infusion started, then every 15 minutes x 2, then every 30 minutes x 2, then if stable every 4 hours until amiodarone discontinued.
CARD - Atrial Fibrillation Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
  • Consults
    • ❑ Consult to Diabetic Nurse Specialist
      • diabetic education
  • Diagnostic Tests
    • ❑ ECG
      • A-Fib
    • ❑ Echocardiogram for Heart Station
      • A-Fib
    • ❑ CT Angio Pulmonary
      • Stat
    • ❑ ECG
      • Stat, PRN, Per episode of Chest Pain
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1200 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ CMP
      • Blood, Stat collect, T;N
    • ❑ BMP
      • Blood, Stat collect, T;N
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Digoxin Lvl
      • Blood, Stat collect, T;N
    • ❑ Lipid Panel
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ TSH
      • Blood, Stat collect, T;N
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Blood Culture
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Blood Culture
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Urine Culture
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ BMP
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Antiarrhythmics
      • ❑ amiodarone
        • ❑ 200 mg, Tab, Oral, Daily
        • ❑ 200 mg, Tab, Oral, BID
        • ❑ 400 mg, Tab, Oral, Daily
        • ❑ 400 mg, Tab, Oral, BID
      • ❑ sotalol
        • ❑ 80 mg, Tab, Oral, BID
        • ❑ 120 mg, Tab, Oral, BID
        • ❑ 160 mg, Tab, Oral, BID
    • Anticoagulants
      • ❑ Pradaxa
        • ❑ 150 mg, Cap, Oral, BID
        • ❑ 75 mg, Cap, Oral, BID
      • ❑ Xarelto
        • ❑ 20 mg, Tab, Oral, qPM-WM
        • ❑ 15 mg, Tab, Oral, qPM-WM
    • Beta Blockers
      • ❑ Lopressor
        • ❑ 50 mg, Tab, Oral, BID
        • ❑ 100 mg, Tab, Oral, BID
        • ❑ 25 mg, Tab, Oral, BID
        • ❑ 12.5 mg, Tab, Oral, BID
      • ❑ Toprol-XL
        • ❑ 25 mg, Tab-24, Oral, Daily
        • ❑ 50 mg, Tab-24, Oral, Daily
        • ❑ 100 mg, Tab-24, Oral, Daily
      • ❑ metoprolol
        • ❑ 5 mg, IV Push, q4hr, PRN heart rate
        • ❑ 5 mg, IV Push, q2hr, PRN heart rate
      • ❑ esmolol 2500 mg/ 250 mL IV PM
        • 2,500 mg
        • 250 mL, IV, Routine, See Comments
    • Calcium Channel Blockers
      • ❑ Cardizem
        • ❑ 60 mg, Tab, Oral, 4x/Day
        • ❑ 30 mg, Tab, Oral, 4x/Day
      • ❑ Cardizem CD
        • ❑ 120 mg, Cap-24, Oral, Daily
        • ❑ 180 mg, Cap-24, Oral, Daily
        • ❑ 240 mg, Cap-24, Oral, Daily
        • ❑ 360 mg, Cap-24, Oral, Daily
      • ❑ Cardizem
        • ❑ 10 mg, IV Push, q1hr, PRN heart rate
        • ❑ 15 mg, IV Push, q1hr, PRN heart rate
        • ❑ 20 mg, IV Push, q1hr, PRN heart rate
    • Cardiac Glycosides
      • ❑ digoxin
        • ❑ 125 mcg, Tab, Oral, Daily
        • ❑ 250 mcg, Tab, Oral, Daily
        • ❑ 250 mcg, Vial, IV Push, Daily
    • Platelet Inhibitor
      • ❑ aspirin
        • ❑ 81 mg, Tab-Chew, Chewed, Daily
        • ❑ 325 mg, Tab, Oral, Daily
      • ❑ Plavix
        • 75 mg, Tab, Oral, Daily
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain
    • ❑ atropine
      • ❑ 0.5 mg, Syringe, IV Push, UD, PRN bradycardia
      • ❑ 1 mg, Syringe, IV Push, UD, PRN bradycardia
  • Patient Care
    • ❑ SCDs
      • ❑ Knee High
      • ❑ Thigh High
    • ❑ Notify Provider Vital Signs
      • T > 38.5, HR > 120, HR < 50, SBP > 190, SBP < 90, DBP > 100, RR > 24, RR < 12, O2 sat < 92, UO < 50ml/hr for 2hr
    • ❑ Notify Provider
      • For symptomatic Non-Sustained V-tach (3 or more in a row)
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
    • ❑ Patient Education
      • Basic Atrial Fibrillation Education
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Routine
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Titrate Oxygen
      • ❑ Keep sats greater than or equal to > 92 %
      • ❑ Keep sats greater than or equal to > 91%
      • ❑ Keep sats greater than or equal to > 90%
      • ❑ Keep sats greater than or equal to > 88%
      • ❑ Keep sats greater than or equal to patient's baseline
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
CARD - Cardiac Catheterization Post-Procedure Order Set-IMH
  • Activity
    • ❑ Supine Bedrest
      • ❑ for 6 hours
      • ❑ for 2 hours
      • ❑ for 3 hours
    • ❑ Up ad Lib
      • if asymptomatic and stable after bedrest with assistance.
    • ❑ Nursing Communication
      • Keep affected extremity straight. May elevate HOB less than 30 degrees. After 1 hour of supine bedrest, may log roll patient for comfort.
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
    • ❑ Mucomyst
      • 600 mg, Soln-Oral, Oral, Once
    • ❑ Discharge Patient
      • For Outpatient procedure may discharge patient if patient has no bleeding or expanding hematoma at cath site.
    • ❑ Discharge Instructions
      • Discharge patient home with Cardiac Cath Lab discharge instruction sheet.
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes, Encourage PO fluids
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Encourage PO fluids
      • ❑ Cardiac, Room Service Eligible: No, Encourage PO fluids
      • ❑ Renal | Caloric, Room Service Eligible: Yes, Diabetic, 1800 kcal, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal, Encourage PO fluids
  • IV Solutions
    • ❑ Sodium Chloride 0.45%
      • ❑ 1,000 mL, IV, hr, 50 mL/hr
      • ❑ 1,000 mL, IV, hr, 75 mL/hr
      • ❑ 1,000 mL, IV, hr, 100 mL/hr
      • ❑ 1,000 mL, IV, hr, 125 mL/hr
      • ❑ 1,000 mL, IV, hr, 10 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, hr, 50 mL/hr
      • ❑ 1,000 mL, IV, hr, 75 mL/hr
      • ❑ 1,000 mL, IV, hr, 100 mL/hr
      • ❑ 1,000 mL, IV, hr, 125 mL/hr
      • ❑ 1,000 mL, IV, hr, 10 mL/hr
    • ❑ Sodium Bicarbonate 150 mEq/D5W 1000 mL
      • 150 mEq
      • 1,000 mL, IV, Routine, hr, 1 mL/kg/hr
  • Medications
    • ❑ Pharmacy Communication Order.
      • Patient received iodinated contrast and is with active metformin order. Evaluate need to hold metformin per policy.
    • ❑ morphine
      • 2 mg, Syringe, IV Push, q2hr, PRN for Pain - Severe
    • ❑ HYDROmorphone
      • 1 mg, Syringe, IV Push, q2hr, PRN for Pain - Severe
    • ❑ prochlorperazine
      • ❑ 10 mg, Vial, IM, q4hr, PRN for Nausea/Vomiting
      • ❑ 5 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q6hr, PRN for Pain - Mild
  • Patient Care
    • ❑ Dressing Removal
      • PRN, If bleeding noted from access site: Remove dressing and apply manual compression at puncture site for 15 minutes or until bleeding stops. Replace access site dressing. Notify Cardiologist if bleeding not controlled or if bleeding recurs.
    • ❑ Dressing Removal
      • T+1;1000, Morning following procedure.
    • ❑ Insert Foley Catheter
      • Indwelling
    • ❑ Straight Cath
      • PRN
    • ❑ Notify Provider Vital Signs
      • Notify Cardiologist / Cath Lab if: SBP greater than 170 or less than 100 (unless previously documented as normal for patient). Decrease in SPO2 to less than 92% on room air (if SPO2 previously normal)., HR > 100, HR < 50, SBP > 170, SBP < 100, O2 sat < 9
    • ❑ Notify Provider
      • See Comment
    • ❑ Notify Provider
      • See Comment
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q 15 mins. x 4, q 30 mins. x 4, then every 1 hour X 4, then resume routine VS.
      • ❑ q 15 mins. x 4, q 30 mins. x 4, then every 4 hours until 8am
    • ❑ Cardiac Cath site check
      • ❑ q 15 mins. x 4, q 30 mins. x 4, then every 1 hour X 4, then with vital signs. Include site pulses and pulses distal to site with these checks.
      • ❑ q 15 mins. x 4, q 30 mins. x 4, then every 4 hours until 8 am. Include site pulses and pulses distal to site with these checks.
CARD - Cardiac Catheterization Pre-Procedure / Peripheral Angiogram Order Set - IMH
  • Activity
    • ❑ Up ad Lib
      • Up ad lib in room prior to procedure.
  • Communication
    • ❑ Patient Education
      • Coronary Angiography
  • Condition
    • ❑ Procedure / Consent
      • Invasive Cardiovascular Procedure
  • Diagnostic Tests
    • ❑ ECG
      • ECG within 30 days of the procedure in medical record.
    • ❑ XR Chest 2 Views
      • T;N, 0
  • Diet
    • ❑ Diet Order
      • T+1;0001 NPO, Room Service Eligible: No, after midnight except for water
    • ❑ Diet Order
      • T+1;0600 Clear Liquid, Room Service Eligible: Yes, If catheterization is scheduled for noon or later- may have clear liquid breakfast or mid - morning clear liquid snack. Then NPO except for water and meds.
    • ❑ Diet Order
      • T+1;1000 NPO, Room Service Eligible: No
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
    • ❑ D5W with 0.9% NaCl
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Chem 12
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
  • Medications
    • ❑ Pharmacy Communication Order.
      • Patient received iodinated contrast and is with active metformin order. Evaluate need to hold metformin per policy.
    • ❑ Hold Med
      • If the patient is receiving insulin, give 1/2 the usual dose of insulin the night before and the morning of the procedure.
    • ❑ Hold Med
      • D/C Heparin infusion @ ______ & hang NS.
    • ❑ Hold Med
      • D/C Lovenox and other anticoagulants after pm dose on day prior to procedure.
    • ❑ Nursing Communication
      • Instruct the patient to take, or give the patient, their prescribed medications at the usual times.
    • ❑ Mucomyst
      • 600 mg, Soln-Oral, Oral, BID, 2 dose(s)/time(s)
    • ❑ clopidogrel
      • ❑ 75 mg, Tab, Oral, Once
      • ❑ 300 mg, Tab, Oral, Once
    • ❑ prasugrel
      • ❑ 10 mg, Tab, Oral, Daily
      • ❑ 5 mg, Tab, Oral, Daily
    • ❑ aspirin
      • ❑ 81 mg, Tab-Chew, Chewed, Daily
      • ❑ 162 mg, Tab-Chew, Chewed, Daily
      • ❑ 325 mg, Tab, Oral, Daily
    • ❑ methylPREDNISolone sodium succinate
      • ❑ 125 mg, Vial, IV Push, On Call
      • ❑ 40 mg, Vial, IV Push, On Call
    • ❑ diphenhydrAMINE
      • ❑ 25 mg, Oral, On Call
      • ❑ 50 mg, Oral, On Call
    • ❑ diphenhydrAMINE
      • ❑ 25 mg, Vial, IV Push, On Call
      • ❑ 50 mg, Vial, IV Push, On Call
    • ❑ predniSONE
      • 50 mg, Tab, Oral, q6hr, 3 dose(s)/time(s)
  • Patient Care
    • ❑ Nursing Communication
      • Have patient void prior to departure to CCL.
  • Vital Signs
    • ❑ Vital Signs POC
      • Per Routine
CARD - Cardizem Infusion Order Set - IMH
  • IV Solutions
    • ❑ Cardizem
      • ❑ 10 mg, Vial, IV Push, q15min, PRN heart rate, 2 dose(s)/time(s)
      • ❑ 20 mg, Vial, IV Push, q15min, PRN heart rate, 2 dose(s)/time(s)
      • ❑ 25 mg, Vial, IV Push, q15min, PRN heart rate, 2 dose(s)/time(s)
    • ❑ Cardizem
      • ❑ 10 mg, Vial, IV Push, Once, PRN heart rate
      • ❑ 20 mg, Vial, IV Push, Once, PRN heart rate
    • ❑ Cardizem
      • ❑ 10 mg, Vial, IV Push, Once, PRN heart rate
      • ❑ 20 mg, Vial, IV Push, Once, PRN heart rate
      • ❑ 25 mg, Vial, IV Push, Once, PRN heart rate
    • ❑ Nursing Communication Order
      • Begin Cardizem Infusion if target heart rate is not below __110___ or sinus rhythm not achieved after bolus dose.
    • ❑ Nursing Communication Order
      • Cardizem Infusion: Once target HR achieved, decrease infusion by 5mg/hr every 1 hour to maintain target HR.
    • ❑ Nursing Communication Order
      • Cardizem Infusion: If HR sustained < 100 may discontinue infusion.
    • ❑ Nursing Communication Order
      • Stop Cardizem if patient converts to Sinus Rhythm.
    • ❑ diltiazem 125mg/100 mL
      • 125 mg
      • 100 mL, IV, Routine, See Comments
    • ❑ Nursing Communication Order
      • Cardizem Infusion: Maintain drip at ordered rate - DO NOT TITRATE.
    • ❑ diltiazem 125mg/100 mL
      • 100 mL, IV, Routine, mL/hr
  • Patient Care
    • ❑ Notify Provider
      • If target HR is not obtained with maximum dose of Cardizem or if difficulty titrating.
    • ❑ Notify Provider
      • Systolic BP <90
  • Vital Signs
    • ❑ Vital Signs POC
      • 5 minutes after infusion started, then every 15 minutes x 2, then every 30 minutes x 2, then if stable every 4 hours until Cardizem discontinued.
CARD - Corvert (Ibutilide) Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Nursing - Refer to Reference Text / Nurse Prep for additional instructions for Corvert.
    • ❑ Nursing Communication
      • Adequate anticoagulation required for patients with Atrial Fibrillation of more than 2 to 3 days.
    • ❑ Notify Provider
      • Notify physician of abnormal potassium or magnesium labs.
  • IV Solutions
    • ❑ NS
      • 250 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ Potassium Level
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ Nursing Communication
      • For patients weighing 60 kg or more, give 1 mg Corvert. For patients weighing less than 60 kg, give 0.01 mg/kg of Corvert.
    • ❑ Corvert
      • ❑ 1 mg, Injection, IV Piggyback, Once, Infuse over 10 minute(s)
      • ❑ 0.01 mg/kg, Injection, IV Piggyback, Once, Infuse over 10 minute(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • T;N, Order potassium and magnesium levels if not resulted in previous 24 hours.
  • Vital Signs
    • ❑ Height & Weight POC
    • ❑ Vital Signs POC
      • Prior to infusion, every 2-3 minutes during infusion and upon completion. Then every 15 minutes x 2, every 30 minutes x 2, at completion of infusion.
CARD - General Cardiology Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Surgical, Anticipated LOS 2 midnights or more
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Surgical, Anticipated LOS 1 midnight or less
  • Consults
    • ❑ Consult to Diabetic Nurse Specialist
      • Diabetes Education
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • Routine
    • ❑ XR Chest 2 Views
      • Routine, Transport Mode: Stretcher
    • ❑ EKG
      • Routine, qAM, for 3 day(s), Portable
    • ❑ EKG
      • Stat, PRN, Per episode of Chest Pain & Initial ECG is not diagnostic, patient remains symptomatic and suspicious for ACS, repeat ECG at 15-30 minute intervals during the first hour of symptoms and new onset symptoms. Call provider with results.
    • ❑ Echocardiogram for Heart Station
      • ❑ Routine
      • ❑ Stat
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75, mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 10 mL/hr
    • ❑ D5W with 0.9% NaCl
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
  • Laboratory
    • AM Labs
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ Comprehensive Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ Digoxin Lvl
        • Blood, AM Draw collect, T+1;0500
      • ❑ Magnesium Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ NT-proBNP
        • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Fasting Lipid Profile
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Digoxin Lvl
      • Blood, Routine collect, T;N
    • ❑ Thyroid Stimulating Hormone
      • Blood, Routine collect, T;N
    • ❑ NT-proBNP
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ Stool for Blood
      • ❑ Stool, Routine collect, T;N, q1hr, for 3 dose(s)/time(s), Nurse collect
      • ❑ Stool, Routine collect, T;N, Once, Nurse collect
  • Medications
    • ACE Inhibitor
      • ❑ lisinopril
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, BID
        • ❑ 20 mg, Tab, Oral, Daily
        • ❑ 20 mg, Tab, Oral, BID
        • ❑ 40 mg, Tab, Oral, Daily
        • ❑ 40 mg, Tab, Oral, BID
      • ❑ enalapril
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 2.5 mg, Tab, Oral, BID
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, BID
        • ❑ 10 mg, Tab, Oral, BID
        • ❑ 20 mg, Tab, Oral, BID
    • Anticoagulants
      • ❑ warfarin
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, Daily
      • ❑ enoxaparin
        • 1 mg/kg, Syringe, Subcutaneous, q12hr
      • ❑ dabigatran
        • ❑ 150 mg, Cap, Oral, BID
        • ❑ 75 mg, Cap, Oral, BID
      • ❑ rivaroxaban
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 20 mg, Tab, Oral, qPM-WM
      • ❑ apixaban
        • ❑ 5 mg, Tab, Oral, BID
        • ❑ 2.5 mg, Tab, Oral, BID
    • Anti-Thrombotic
      • ❑ clopidogrel
        • 75 mg, Tab, Oral, Daily
      • ❑ clopidogrel
        • 300 mg, Tab, Oral, Once
    • ARB
      • ❑ valsartan
        • ❑ 40 mg, Tab, Oral, Daily
        • ❑ 40 mg, Tab, Oral, BID
        • ❑ 80 mg, Tab, Oral, Daily
        • ❑ 80 mg, Tab, Oral, BID
        • ❑ 160 mg, Tab, Oral, Daily
        • ❑ 160 mg, Tab, Oral, BID
        • ❑ 320 mg, Tab, Oral, Daily
      • ❑ losartan
        • ❑ 25 mg, Tab, Oral, Daily
        • ❑ 50 mg, Tab, Oral, Daily
        • ❑ 50 mg, Tab, Oral, BID
        • ❑ 100 mg, Tab, Oral, Daily
    • Beta Blockers
      • ❑ metoprolol
        • ❑ 12.5 mg, Tab, Oral, BID
        • ❑ 25 mg, Tab, Oral, BID
        • ❑ 50 mg, Tab, Oral, BID
        • ❑ 100 mg, Tab, Oral, BID
      • ❑ atenolol
        • ❑ 25 mg, Tab, Oral, Daily
        • ❑ 25 mg, Tab, Oral, BID
        • ❑ 50 mg, Tab, Oral, Daily
        • ❑ 50 mg, Tab, Oral, BID
        • ❑ 100 mg, Tab, Oral, Daily
        • ❑ 100 mg, Tab, Oral, BID
      • ❑ metoprolol extended release
        • ❑ 25 mg, Tab-24, Oral, Daily
        • ❑ 50 mg, Tab-24, Oral, Daily
        • ❑ 100 mg, Tab-24, Oral, Daily
        • ❑ 200 mg, Tab-24, Oral, Daily
      • ❑ carvedilol
        • ❑ 3.125 mg, Tab, Oral, Daily
        • ❑ 6.25 mg, Tab, Oral, Daily
        • ❑ 12.5 mg, Tab, Oral, Daily
        • ❑ 25 mg, Tab, Oral, Daily
    • Diuretics
      • ❑ furosemide
        • ❑ 20 mg, Tab, Oral, qAM
        • ❑ 20 mg, Tab, Oral, BID
        • ❑ 20 mg, Vial, IV Push, Daily
        • ❑ 20 mg, Vial, IV Push, BID
        • ❑ 40 mg, Tab, Oral, qAM
        • ❑ 40 mg, Tab, Oral, BID
        • ❑ 40 mg, Vial, IV Push, Daily
        • ❑ 40 mg, Vial, IV Push, BID
        • ❑ 80 mg, IV Piggyback, Daily
        • ❑ 40 mg, Vial, IV Push, Once
      • ❑ Lasix Drip
        • 90 mL, IV, Routine
        • 100 mg
    • Platelet Inhibitor
      • ❑ prasugrel
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, Daily
      • ❑ ticagrelor
        • 90 mg, Tab, Oral, BID
    • Statin
      • ❑ atorvastatin
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 20 mg, Tab, Oral, Daily
        • ❑ 40 mg, Tab, Oral, Daily
        • ❑ 80 mg, Tab, Oral, Daily
    • Vasodilators
      • ❑ isosorbide mononitrate
        • ❑ 60 mg, Tab-ER, Oral, Daily
        • ❑ 30 mg, Tab-ER, Oral, Daily
        • ❑ 90 mg, Tab-ER, Oral, Daily
        • ❑ 120 mg, Tab-ER, Oral, Daily
      • ❑ nitroglycerin
        • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain
      • ❑ atropine
        • 0.5 mg, Syringe, IV Push, UD, PRN bradycardia
      • ❑ nitroglycerin 50 mg/250 mL-D5W IV Sol
        • 250 mL, IV, Routine, See Comments
        • 50 mg
    • ❑ aspirin
      • ❑ 325 mg, Tab, Oral, Daily
      • ❑ 81 mg, Tab-Chew, Chewed, Daily
    • ❑ Reason Aspirin Not Given on Arrival
      • ❑ Allergy
      • ❑ Antiplatelet therapy contraindicated
      • ❑ Coumadin/Warfarin as pre-arrival med
      • ❑ Other: _____
  • Non Categorized
    • ❑ Reason for Fibrinolytic Therapy Delay
      • ❑ Balloon pump within 30 min of arrival
      • ❑ CP arrest within 30 min of arrival
      • ❑ Intubation within 30 min of arrival
      • ❑ Patient/Family refusal of therapy
      • ❑ Other: ______
    • ❑ Reason for PCI Delay
      • ❑ Balloon pump within 90 min of arrival
      • ❑ CP arrest within 90 min of arrival
      • ❑ Intubation within 90 min of arrival
      • ❑ Patient/Family refusal of therapy
      • ❑ Other: ______
  • Patient Care
    • ❑ Head of Bed
      • elevation 45 degrees
    • ❑ Notify Provider
      • For symptomatic Non-Sustained V-tach (3 or more in a row)
    • ❑ Notify Provider Vital Signs
      • T > 39, HR > 120, HR < 50, SBP > 180, SBP < 90, DBP > 100, RR > 24, RR < 12, O2 sat < 92
    • ❑ Notify Provider Vital Signs
      • ❑ For 2 consecutive hours, UO < 25
      • ❑ For 2 consecutive hours, UO < 50
    • ❑ Notify Provider Laboratory Results
      • Call MD for 1st elevated Troponin or if subsequent troponin exceeds twice the prior value.
    • ❑ Notify Provider Laboratory Results
      • If Hct < 30 and / or < 20% of baseline repeat STAT and call MD.
    • ❑ Notify Provider Laboratory Results
      • If platelet count decreases to < 100,000 or < 50% of baseline, then discontinue anticoagulant and IIb / IIIa Inhibitor, repeat platelet count STAT and call MD.
    • ❑ Pharmacy Communication Order.
      • Once, PRN, See Comment
    • ❑ Saline Lock Insertion
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat, Blood
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals), Weigh daily
CARD - Interventional Cardiology Diagnostic Post-Catheterization Order Set - IMH
  • Activity
    • ❑ Bedrest Supine
      • Patient to lie flat on back for _______ hours post-sheath removal.
    • ❑ Ambulate with Assistance
      • After strict bedrest completed.
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
    • ❑ Place in Extended Recovery
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Notify Provider
      • ❑ Dr. Allan upon arrival to unit.
      • ❑ Dr. Bouhussein upon arrival to unit.
      • ❑ Dr. Bradford upon arrival to unit.
      • ❑ Dr. DeWeese upon arrival to unit.
      • ❑ Dr. Georgeson upon arrival to unit.
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes, Encourage PO fluids
      • ❑ Low Cholesterol | Low Fat, Room Service Eligible: Yes, Encourage PO fluids
      • ❑ Low Sodium, Room Service Eligible: Yes, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal, Encourage PO fluids
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2200 kcal, Encourage PO fluids
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, hr, 50 mL/hr
      • ❑ 1,000 mL, IV, hr, 75 mL/hr
      • ❑ 1,000 mL, IV, hr, 100 mL/hr
      • ❑ 1,000 mL, IV, hr, 125 mL/hr
      • ❑ 1,000 mL, IV, hr, 10 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, hr, 50 mL/hr
      • ❑ 1,000 mL, IV, hr, 75 mL/hr
      • ❑ 1,000 mL, IV, hr, 100 mL/hr
      • ❑ 1,000 mL, IV, hr, 125 mL/hr
      • ❑ 1,000 mL, IV, hr, 10 mL/hr
  • Medications
    • ❑ Hold Med
      • Hold the following medications __________________________.
    • ❑ Pharmacy Communication Order.
      • Patient received iodinated contrast and is with active metformin order. Evaluate need to hold metformin per policy.
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN for Pain
  • Patient Care
    • ❑ Notify Provider
      • See Comment
    • ❑ Dressing Removal
      • PRN, If bleeding noted from access site: Remove dressing and apply manual compression at puncture site for 15 minutes or until bleeding stops. Replace access site dressing. Notify Cardiologist if bleeding not controlled or if bleeding recurs.
    • ❑ Dressing Removal
      • T+1;1000, Morning following procedure. Notify Cardiologist if: Bleeding, Hematoma, Pain, Pulse loss or "cold" exremity, and Sensory loss/abnormality.
  • Vital Signs
    • ❑ Vital Signs POC
      • q15min x4, then q30min x4, then q4hr until 0800.
    • ❑ Cardiac Cath site check
      • q15min x4, then q30min x4, then q4hr until 0800.
CARD - Pacemaker / ICD Implant Post-Procedure Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Communication Order
      • Return to room.
    • ❑ Place in Extended Recovery
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • T+1;0900, Routine, Once, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Portable
      • Stat, Reason: R/O Pneumothorax, Page MD if abnormal, Transport Mode: Portable
    • ❑ Notify Provider
      • If chest X-ray abnormal
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ ceFAZolin
      • ❑ 1 gm, IV Piggyback, q8hr, Antibiotic Indication Prophylaxis- surgical, 2 dose(s)/time(s)
      • ❑ 2 gm, IV Piggyback, q8hr, Antibiotic Indication Prophylaxis- surgical, 2 dose(s)/time(s)
    • ❑ vancomycin
      • 1 gm, IV Piggyback, Once, Antibiotic Indication Prophylaxis- surgical
    • ❑ traMADol
      • 50 mg, Tab, Oral, q6hr, PRN for Pain - Mild
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Severe
  • Patient Care
    • ❑ Sling Apply
      • ❑ Left Arm
      • ❑ Right Arm
    • ❑ Supine Bedrest
      • ❑ Supine Bedrest x_____ hours
      • ❑ Until AM
    • ❑ Wound Care
      • q1hr, for 3 hr, Nurse to check incision site every hour X 3, then routine.
    • ❑ Discontinue Foley Cath
      • When patient able to stand and pivot
    • ❑ Head of Bed
      • NO higher than 30 degrees.
    • ❑ Patient Education
      • Educate patient regarding sling and use of.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • every hour x3 when routine
CARD - Pacemaker / ICD Implant Pre-Procedure Order Set - IMH
  • Activity
    • ❑ Ambulate
      • as tolerated
  • Communication
    • ❑ Notify Provider
      • Notify Dr. _____________ of admission.
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Stat, If not obtained within the last month.
    • ❑ EKG
      • Stat, Do not obtain if patient has had one within last 30 days and place report in medical record.
  • Diet
    • ❑ Diet Order
      • T+1;0001 NPO, after midnight for permanent pacemaker in the a.m.
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ D5W with 0.9% NaCl
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
  • Laboratory
    • ❑ Notify Provider Laboratory Results
      • Call Pacemaker labs if abnormal.
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ Hold Med
      • Hold all anticoagulants
    • ❑ Hold Med
      • ❑ If insulin dependent diabetic; hold oral hypoglycemic agents and regular insulin morning of procedure.
      • ❑ If insulin dependent diabetic; give half dose long acting insulin morning of the procedure.
    • ❑ Nursing Communication
      • Give morning medications with a sip of water.
    • ❑ ceFAZolin
      • 1 gm, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • ❑ I&O POC
      • ❑ 6x/Day, (q 4 hours)
      • ❑ 3x/Day, (q 8 hours)
    • ❑ Insert Foley Catheter
      • Indwelling, may insert if patient unable to stand / pivot or use bedpan.
    • ❑ Discontinue Foley Cath
      • when patient able to stand / pivot or use bedpan.
    • ❑ Saline Lock Insertion
      • Same side as implant.
    • ❑ Nursing Communication
      • Have patient void prior to sending patient to the Cath Lab.
    • ❑ Nursing Communication
      • No metal snap gowns on patients going to the CCL.
  • Respiratory
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
CARD - STEMI Order Set - IMH
  • Communication
    • ❑ Nursing Communication Order
      • Call Switchboard operator to initiate Medical Alert Code STEMI blast page.
  • Diagnostic Tests
    • ❑ EKG
      • Stat, Reason: Chest Pain Call provider with results.
    • ❑ XR Chest 1 View Frontal
      • Stat, Transport Mode: Portable
  • IV Solutions
    • ❑ NS
      • 1,000 mL, IV, 10 mL/hr
    • ❑ Angiomax 250 mg/50 mL
      • 50 mL, IV, Per Protocol
      • 250 mg
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once, STAT
    • ❑ Reason Aspirin Not Given on Arrival
      • ❑ Allergy
      • ❑ Coumadin/Warfarin as pre-arrival med
      • ❑ Other:___________________
    • ❑ methylPREDNISolone sodium succinate
      • 125 mg, Vial, IV Push, Once
    • ❑ diphenhydrAMINE
      • 25 mg, Vial, IV Push, Once
  • Patient Care
    • AMI Quality Measures
      • ❑ Reason for Fibrinolytic Therapy Delay
        • ❑ Balloon pump within 30 min of arrival
        • ❑ CP arrest within 30 min of arrival
        • ❑ Intubation within 30 min of arrival
        • ❑ Patient/Family refusal of therapy
        • ❑ Other: ____________
      • ❑ Reason for PCI Delay
        • ❑ Balloon pump within 90 min of arrival
        • ❑ CP arrest within 90 min of arrival
        • ❑ Intubation within 90 min of arrival
        • ❑ Patient/Family refusal of therapy
        • ❑ Other: ___________
    • ❑ Nursing Communication Order
      • Place / position defibrillator pads on patient.
  • Respiratory
    • ❑ Oxygen Titrate
      • 0.9
CARD - Telemetry Monitoring Order Set - IMH
  • Patient Care
    • Monitoring
      • ❑ Telemetry Monitoring
        • T+1;0500, q24hr
      • ❑ Telemetry Monitoring
        • T;N
      • ❑ Cardiac Rhythm Strip.
        • T;N, 2x/Day, Printed strips must be validated and signed off by a Nurse each 12 hours shift
      • ❑ Nursing Communication
        • Patient may go to test / procedures off cardiac monitoring.
      • ❑ Nursing Communication
        • May shower off monitor (Telemetry Unit Only)
CARD - Tenecteplase (TNKase) for STEMI Order Set - IMH
  • Communication
    • ❑ Nursing Communication Order
      • NOTE: Refer to Reference Text for (TNKase for MI) additional information.
  • Diagnostic Tests
    • ❑ Nursing Communication Order
      • Nurse to order ECG: 1 hour after initiation.
    • ❑ XR Chest 1 View Frontal
      • T;N, Stat, Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • T;N | NPO
  • IV Solutions
    • ❑ NS
      • 500 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Chem 12
      • Blood, Stat collect, T;N
    • ❑ Urine Pregnancy Test (Qual)
      • Urine, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once, STAT
    • ❑ aspirin
      • 325 mg, Tab, Oral, Daily
    • ❑ TNKase Per Protocol
      • Per Protocol, Vial, IV Push, Once
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 250 mL, IV, Routine, Per Protocol
      • 25,000 unit(s)
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Every other day
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N
    • ❑ Nursing Communication Order
      • Nursing to Order Heparin Anti-Xa - 4 hours after initiation - after TNKase bolus dose (if Heparin administered)
    • ❑ enoxaparin
      • 30 mg, Syringe, IV Push, Once, NOW
    • ❑ enoxaparin
      • 1 mg/kg, Syringe, Subcutaneous, Once, STAT
    • ❑ enoxaparin
      • 0.75 mg/kg, Syringe, Subcutaneous, Once, STAT
    • ❑ Enoxaparin (Lovenox) - Pharmacy to Dose.
      • TNKase for STEMI patient, Subcutaneous, Daily
    • ❑ clopidogrel
      • 300 mg, Tab, Oral, Once
    • ❑ clopidogrel
      • 75 mg, Tab, Oral, Daily
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once
      • ❑ 4 mg, Syringe, IV Push, Once
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ nitroglycerin 2% topical ointment
      • ❑ 1 in, Ointment, TOP, Once, STAT, Start date: T;N
      • ❑ 0.5 in, Ointment, TOP, Once, STAT, Start date: T;N
    • ❑ nitroglycerin 50 mg/250 mL-D5W IV Sol
      • 50 mg
      • 250 mL, IV, STAT, Start date: T;N, See Comments
  • Patient Care
    • ❑ Notify Provider
      • If patient has received an anticoagulant within the last 24 hours.
  • Vital Signs
    • ❑ Vital Signs POC
      • q 1 hour x 2 hours, then per unit protocol
    • ❑ Height & Weight POC
      • Stat
    • ❑ Pulse Oximetry Continuous
      • T;N
    • ❑ Cardiac Monitoring.
      • T;N, Constant order
CARD - Tikosyn (Dofetilide) Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Baseline QTc ______ as determined by MD
    • ❑ Nursing Communication
      • Please obtain Tikosyn Flowsheet and document QTc at 3 hours after the second and subsequent doses of Tikosyn.
  • Consults
    • ❑ Consult Case Management
      • Patient started on Tikosyn.
  • Diagnostic Tests
    • ❑ ECG
      • Stat
    • ❑ Nursing Communication
      • Enter order for ECG 3 hours past 1st dose of Tikosyn.
    • ❑ ECG
      • T+1;0700, Timed, Daily, for 3 day(s)
  • Laboratory
    • ❑ Chem 7
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ dofetilide
      • ❑ 250 mcg, Cap, Oral, BID
      • ❑ 125 mcg, Cap, Oral, BID
      • ❑ 500 mcg, Cap, Oral, BID
    • ❑ Dofetilide (Tikosyn) - Pharmacy to Dose.
      • Pharmacy to dose., Oral, See Instructions
    • ❑ Pharmacy Communication Order.
      • Once, See Comment
    • ❑ Nursing Communication
      • See Comment
  • Patient Care
    • ❑ Notify Provider
      • prior to initiating Tikosyn if Potassuim level is < 4 mEq/L or Magnesium level is < 1.2 mEq/L.
    • ❑ Notify Provider
      • of EKG 3 hours after initial dose of Tikosyn for physician to determine QTc.
    • ❑ Notify Provider
      • Anytime after 2nd dose of Tikosyn if QTc is greater than 500 msec (or greater than 550 msec in patients with ventricular conduction abnormalities), discontinue Tikosyn and notify MD.
  • Vital Signs
    • ❑ Height & Weight POC
CARD - Transesophageal Echocardiography (TEE) / Cardioversion Post-Procedure Order Set - IMH
  • Diagnostic Tests
    • ❑ EKG
      • In CCL
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible
      • ❑ Cardiac | Caloric, Room Service Eligible, Diabetic, 1800 kcal
      • ❑ Cardiac, Room Service Eligible: Yes, Fluid: 1000 ml
      • ❑ Regular, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Patient Care
    • ❑ Notify Provider
      • Patient develops shortness of breath, hemoptysis, or chest pain.
  • Vital Signs
    • ❑ Vital Signs POC
      • 15 minutes x2, every hour x 1, and then prn
CARD - Transesophageal Echocardiography (TEE) / Cardioversion Pre-Procedure Order Set - IMH
  • Condition
    • ❑ Procedure / Consent
      • ❑ Transesophageal Echocardiography
      • ❑ Transesophageal Echocardiography / Cardioversion
      • ❑ Cardioversion
  • Diet
    • ❑ Diet Order
      • T+1;0001 NPO, Room Service Eligible: Yes, After TEE, may resume diet order unless NPO required for another procedure.
    • ❑ Diet Order
      • T+1;0600 Clear Liquid, Room Service Eligible: Yes, NPO after clear liquid breakfast
    • ❑ Diet Order
      • T+1;1000 NPO, Room Service Eligible: Yes, After TEE, may resume diet order unless NPO required for another procedure.
    • ❑ Nursing Communication
      • Patient must be NPO for 6 hours prior to exam.
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 mL, IV, 21 day(s), 50 mL/hr
      • ❑ 1,000 mL, IV, 21 day(s), 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Medications
    • ❑ meperidine
      • mg, Syringe, IV Push, Once
    • ❑ diazePAM
      • mg, Tab, Oral, Once
  • Patient Care
    • ❑ Nursing Communication
      • ❑ Patient may have all medications prior to procedure.
      • ❑ Patient may have cardiac medications only prior to procedure.
    • ❑ Nursing Communication
      • Have patient void prior to procedure.
CARD / ED - Aggrastat - Acute Coronary Syndrome - IMH
  • Communication
    • ❑ Notify Provider
      • If patient has received anticoagulant within last 12 hours. Document physician notified.
    • ❑ Notify Provider Vital Signs
      • SBP > 200, DBP > 110
    • ❑ Notify Provider Laboratory Results
      • If platelet count is < 100,000 or reduced by 50% from baseline
  • IV Solutions
    • ❑ Nursing Communication Order
      • Aggrastat can be administered through the same IV cath with Heparin.
    • ❑ Aggrastat 5mg/100mL IV Sol
      • 5 mg
      • 100 mL, IV, hr, See Comments
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ Creatinine
      • Blood, Stat collect, T;N
    • ❑ Misc Nursing Task
      • Order stat CBC, PT, PTT, Creatinine if not resulted in 24 hours before Aggrastat bolus.
    • ❑ CBC
      • Blood, Timed Study collect
    • ❑ PTT
      • Blood, Timed Study collect
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500, Daily
  • Medications
    • ❑ tirofiban
      • 25 mcg/kg, Soln, IV Push, Once
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once
  • Patient Care
    • ❑ Saline Lock Insertion
      • PRN, Consider placing 2 large bore IV's.
    • ❑ Bleeding Precautions
      • While on Aggrastat
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr
Cardiac Output - Decreased Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Cardiac Output - Decreased Plan of Care
Cellulitis Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Cellulitis Plan of Care
Chest Pain Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Ineffective Tissue Perfusion Plan of Care
Chest Pain/MI/ Cardiovascular Incident Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Chest Pain/MI/Cardiovascular Incident Plan of Care
Constipation Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Constipation Plan of Care
Continuous Mechanical Ventilator Plan of Care
  • Consults
    • ❑ Consult to Respiratory Therapy
      • T;N, Continuous Mechanical Ventilation, 0
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • T;N, Routine, Daily, for 3 day(s), Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • T;N NPO, NPO Until Further Orders
  • Patient Care
    • ❑ Nasogastric/Orogastric Tube Insertion
      • T;N, Other See Special Instructions, Tube Feeding or attach to low suction for nausea/vomiting
CRIT CARE - Adult Diabetic Ketoacidosis (DKA) or Hyperglycemia Hyperosmolar Syndrome Order Set - IMH
  • Activity
    • ❑ Out of bed
      • With assistance
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • Routine, 0
  • Diet
    • ❑ Diet Order
      • ❑ NPO, Room Service Eligible: No
      • ❑ T;N | Clear Liquid, Room Service Eligible: Yes, Diabetic
      • ❑ T;N | Full Liquid, Room Service Eligible: Yes, Diabetic
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Fluid: 1000 ml
      • ❑ Renal | Diabetic, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 | 1,000 mL | mL, IV | IV, 50 | 50 mL/hr | mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ Insulin human 100 units/100 mL Premix
      • 100 mL, IV, Routine, See Infusion Instructions
      • 100 unit(s)
    • ❑ Insulin human 100 units/100 mL Premix
      • 100 mL, IV, Routine, See Infusion Instructions
      • 100 unit(s)
    • ❑ Insulin Drip Premix
      • 100 unit(s)
      • 100 mL, IV, Start date: T;N, See Infusion Instructions
    • ❑ Notify Provider
      • Calculate transition dose of insulin and notify MD.
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ Notify Provider
      • If on insulin drip less than 4 hours notify provider for transition insulin order dose.
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Hgb A1C
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Osmolality
      • Blood, Stat collect, T;N
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ Magnesium Level
      • Blood, Timed Study collect, q12hr
    • ❑ Phosphorus Level
      • Blood, Timed Study collect, q12hr
    • ❑ Basic Metabolic Panel
      • Blood, Timed Study collect, q4hr, for 24 hr
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, Daily
  • Medications
    • ❑ Levemir
      • unit(s), Injection, Subcutaneous, Once
    • ❑ Notify Provider
      • If Blood Glucose > 480 mg/dl after initiation of Levemir
    • ❑ Nursing Communication Order
      • Administer transition dose of Levemir insulin and continue drip for 2 hours.
  • Patient Care
    • ❑ Notify Provider
      • If urine output less than ____ ml / hr.
    • ❑ Blood Glucose POC
      • Once, On Admission
    • ❑ Blood Glucose POC
      • q1hr
    • ❑ Blood Glucose POC
      • ❑ 12x/Day, Q2hrs
      • ❑ 6x/Day, Q4hrs
      • ❑ QIDACHS
    • ❑ Blood Glucose POC
      • 12x/Day, for 4 dose(s)/time(s), q2hr after insulin drip discontinued
    • ❑ Blood Glucose POC
      • QIDACHS, After insulin drip discontinued
    • ❑ Blood Glucose POC
      • QIDACHS
    • ❑ Blood Glucose POC
      • T+1;0200, Q24hr
    • ❑ I&O POC
      • Strict I&O
    • ❑ Notify Provider
      • For drop of blood glucose greater than 100mg/dl in one hour
    • ❑ Notify Provider
      • For K+ < 3.3 mEq/L or > 5.5 mEq/L, notify Provider. If K+ > 5.5 mEq/L, stop all potassium medication orders.
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q1hr
      • ❑ q2hr
CRIT CARE - CCU Sepsis ANI Order Set - IMH
  • Communication
    • ❑ Notify Provider Vital Signs
      • Notify provider after IVF bolus if patient has a decrease in BP by 40 points, SBP less than 90, MAP less than 65 or lactate level is above 4. If fluid bolus ineffective; discuss administration of vasopressor.
    • ❑ Nursing Communication Order
      • Start antibiotics ASAP
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Stat, 0
  • IV Solutions
    • ❑ NS Bolus
      • 30 mL/kg, IV, Once, STAT
    • ❑ LR Bolus
      • 30 mL/kg, IV, Once, STAT
  • Laboratory
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Urine Culture
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Peripheral IV Insertion
      • T;N, Initiate large bore IV
    • ❑ Sepsis Severity Identification Order
      • Neither, Source Unclear, T;N
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
CRIT CARE - Critical Care / Intermediate Care Routine Order Set - IMH
  • Activity
    • ❑ Bedrest
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Stat
    • ❑ XR Chest 1 View Frontal
      • Stat, Transport Mode: Portable
    • ❑ Echocardiogram for Heart Station
      • Stat
    • ❑ EKG
      • T;N, Stat, PRN, Per episode of Chest Pain
    • ❑ Nursing Communication
      • Order ECG PRN - RN's Discretion
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ NPO
      • ❑ Cardiac, Fluid: 1000 ml
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
    • ❑ NS
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N
    • ❑ Digoxin Lvl
      • Blood, Stat collect, T;N
    • ❑ Thyroid Stimulating Hormone
      • Blood, Stat collect, T;N
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Digoxin Lvl
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ NT-proBNP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Fasting Lipid Profile
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN for Chest Pain
    • ❑ atropine
      • ❑ 0.5 mg, Syringe, IV Push, UD, PRN for bradycardia
      • ❑ 1 mg, Syringe, IV Push, UD, PRN for bradycardia
  • Patient Care
    • ❑ I&O POC
      • ❑ q 1 hour-Strict I&O
      • ❑ q 2 hour-Strict I&O
      • ❑ q 4 hour-Strict I&O
    • ❑ Notify Provider
      • For symptomatic Non-Sustained V-tach ( 3 or more in a row)
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
    • ❑ ABG Draw (Resp)
      • T+1;0600, Timed
    • ❑ Oxygen Titrate
      • ❑ Keep O2 Sats > 92%
      • ❑ Keep O2 Sats > 89%
      • ❑ Keep O2 Sats > 90%
      • ❑ Add patient's baseline.
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ CPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: CPAP, HS
      • ❑ Mode: CPAP, PRN
    • ❑ BIPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: BiPAP, HS
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q 1 hour
      • ❑ q 2 hours
CRIT CARE - Glycemic Order Set - IMH
  • Special
    • ❑ Nursing Communication
      • See Reference Text
    • ❑ Blood Glucose POC
      • T;N, q4hr, for 2 dose(s)/time(s), on all patients on admission (may use Chem 12 results if drawn within 1 hour) and in 4 hours.
    • ❑ Nursing Communication
      • See Comments
    • ❑ Blood Glucose POC
      • T;N, q6hr
    • ❑ Pharmacy Communication Order.
      • Glycemic Order: Stop all oral anti-diabetic medications
    • ❑ Hgb A1C
      • Blood, AM Draw collect, T+1;0500
    • ❑ Insulin Regular Sliding Scale
      • Correction Scale, Injection, Subcutaneous, q6hr
    • ❑ insulin regular 100 units/mL human recombinant injectable solution
      • unit(s), Injection, Subcutaneous, q6hr
    • ❑ Insulin Regular Sliding Scale
      • Correction Scale, Injection, Subcutaneous, q6hr
    • ❑ Nursing Communication
      • Recalculate and modify Scheduled insulin dose daily at 0700
CRIT CARE - Therapeutic Hypothermia Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Intensivist
      • Therapeutic Hypothermia
    • ❑ Consult to Anesthesia
      • Nurse to call Anesthesia for Central Line placement
    • ❑ Consult to Neurology
      • For prognostication status post normothermia, and sedation drugs have cleared (72 hours post normothermia)
  • Diet
    • ❑ Diet Order
      • NPO
  • IV Solutions
    • Medications
      • ❑ NS Bolus
        • 30 mL/kg, IV, Once
      • ❑ meperidine
        • 25 mg, Syringe, IV Push, q4hr, PRN for Other (see comment), 4 dose(s)/time(s)
  • Laboratory
    • ❑ Pregnancy Test Qual Serum
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Calcium Level
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Lactic Acid
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Timed Study collect, q4hr
    • ❑ Magnesium Level
      • Blood, Timed Study collect, q4hr
    • ❑ Calcium Level
      • Blood, Timed Study collect, q4hr
  • Patient Care
    • ❑ Neurovascular Checks
      • 6x/Day, (q4hr)
    • ❑ Glasgow Coma Scale
      • 6x/Day
    • ❑ Insert Foley Catheter
      • Indwelling, Use with temperature probe
    • ❑ Misc Nursing Task
      • Bedside Shivering Assessment Scale (BSAS), 6x/Day
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat, Do not temperature correct
    • ❑ ABG Draw (Resp)
      • q8hr, Timed
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • q 15 minutes until cooled at 33°C, then hourly
    • ❑ Temperature
      • q 15 minutes until cooled at 33°C, then hourly
    • ❑ Nursing Communication Order
      • Monitor temperature every 15 minutes until 33°C is reached. Then record start time for 24 hours for total cool time at 33°C.
Crossmatch IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Leuko Reduced Packed Red Cells
      • Blood
Cryoprecipitate IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Cryoprecipitate - 1
      • Blood
 D
Developmental Delay IPOC
  • Consults
    • ❑ Consult to Social Services
      • T;N
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Developmental Delay IPOC
Diabetes Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Diabetes Plan of Care
Dialysis Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Dialysis Plan of Care
Diarrhea Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Diarrhea Plan of Care
DIC Panel IRDL
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, T;N, Once, Lab Collect
    • ❑ PT
      • Blood, T;N, Once, Lab Collect
    • ❑ PTT
      • Blood, T;N, Once, Lab Collect
    • ❑ Fibrinogen.
      • Blood, T;N, Once, Lab Collect
    • ❑ D-Dimer.
      • Blood, T;N, Once, Lab Collect
Direct Coombs IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ Coombs
      • Blood
Directed Units IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Directed Donor Unit
      • Blood
Discharge Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Discharge Plan of Care
 E
ED - Adult Vancomycin IV - Pharmacy to Dose - IMH
  • Medications
    • ❑ ED - Adult Vancomycin IV - Pharmacy to dose
      • ED Pharmacy to Dose, IV Piggyback, Once, Routine, Start date: T;N+60
ED - Common Radiology Tests Order Set - IMH
  • Diagnostic Tests
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • Emergency, 0
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • Emergency, 0
    • ❑ CT Angio Abd Aorta + Iliofemoral
      • Emergency, 0
    • ❑ CT Angio Abdomen/Pelvis
      • Emergency, 0
    • ❑ CT Angio Chest w/ Contrast
      • Emergency, 0
    • ❑ CT Angio Head w/ + w/o Contrast
      • Emergency, 0
    • ❑ CT Angio Lower Extremity Bilat
      • Emergency, 0
    • ❑ CT Angio Neck w/ Contrast
      • Emergency, 0
    • ❑ CT Angio Pulmonary
      • Emergency, 0
    • ❑ CT Angio Renal
      • Emergency, 0
    • ❑ CT Chest w/ Contrast
      • Emergency, 0
    • ❑ CT Chest w/o Contrast
      • Emergency, 0
    • ❑ CT Head or Brain w/o Contrast
      • Emergency, 0
    • ❑ CT Hip w/o Contrast Bilateral
      • Emergency, 0
    • ❑ CT Maxillofacial w/o Contrast
      • Emergency, 0
    • ❑ CT Sinus w/o Contrast
      • Emergency, 0
    • ❑ CT Soft Tissue Neck w/ Contrast
      • Emergency, 0
    • ❑ CT Spine Cervical w/o Contrast
      • Emergency, 0
    • ❑ CT Spine Lumbar w/o Contrast
      • Emergency, 0
    • ❑ CT Spine Thoracic w/o Contrast
      • Emergency, 0
    • ❑ MRA Head w/o Contrast
      • Emergency, 0
    • ❑ MRI Brain w/ + w/o Contrast
      • Emergency, 0
    • ❑ MRI Brain w/o Contrast
      • Emergency, 0
    • ❑ MRI MRCP
      • Emergency, 0
    • ❑ MRI Spine Cervical w/ + w/o Contrast
      • Emergency, 0
    • ❑ MRI Spine Cervical w/o Contrast
      • Emergency, 0
    • ❑ MRI Spine Lumbar w/ + w/o Contrast
      • Emergency, 0
    • ❑ MRI Spine Lumbar w/o Contrast
      • Emergency, 0
    • ❑ MRI Spine Thoracic w/o Contrast
      • Emergency, 0
    • ❑ MRI Spine Thoracic w/ + w/o Contrast
      • Emergency, 0
    • ❑ NM Pulmonary Perfusion Imaging
      • Emergency, 0
    • ❑ NM Pulmonary Ventilation/Perfusion
      • Emergency, 0
    • ❑ NM Stress/Rest MYO ECT
      • Emergency, 0
    • ❑ US Gallbladder
      • Emergency, 0
    • ❑ US LE Venous Duplex Bilateral
      • Emergency, 0
    • ❑ US LE Venous Duplex Left
      • Emergency, 0
    • ❑ US LE Venous Duplex Right
      • Emergency, 0
    • ❑ US OB < 14 weeks
      • Emergency, 0
    • ❑ US Pelvis Non-OB Complete
      • Emergency, 0
    • ❑ US Renal
      • Emergency, 0
    • ❑ US Right Upper Quadrant
      • Emergency, 0
    • ❑ US Testicular
      • Emergency, 0
    • ❑ US Transvaginal Non-OB
      • Emergency, 0
    • ❑ XR Abdomen 2 Views
      • Emergency, 0
    • ❑ XR Abdomen AP
      • Emergency, 0
    • ❑ XR Abdomen KUB
      • Emergency, 0
    • ❑ XR Abdomen Series
      • Emergency, 0
    • ❑ XR Ankle 3 Views Min Lt
      • Emergency, 0
    • ❑ XR Ankle 3 Views Min Rt
      • Emergency, 0
    • ❑ XR BASW Modified
      • Emergency, 0
    • ❑ XR Chest 1 View Frontal
      • Emergency, 0
    • ❑ XR Chest 1 View Portable
      • Emergency, 0
    • ❑ XR Chest 2 Views
      • Emergency, 0
    • ❑ XR Elbow Complete Left
      • Emergency, 0
    • ❑ XR Elbow Complete Right
      • Emergency, 0
    • ❑ XR Foot 3 Views Min Lt
      • Emergency, 0
    • ❑ XR Foot 3 Views Min Rt
      • Emergency, 0
    • ❑ XR Hand 3 Views Min Lt
      • Emergency, 0
    • ❑ XR Hand 3 Views Min Rt
      • Emergency, 0
    • ❑ XR Hip 2-3 Views Lt w/ Pelvis
      • Emergency, 0
    • ❑ XR Hip 2-3 Views Rt w/ Pelvis
      • Emergency, 0
    • ❑ XR Knee 2 Views Left
      • Emergency, 0
    • ❑ XR Knee 2 Views Right
      • Emergency, 0
    • ❑ XR Pelvis AP
      • Emergency, 0
    • ❑ XR Pelvis w/Bilateral Hips
      • Emergency, 0
    • ❑ XR Shoulder 3 Views Left
      • Emergency, 0
    • ❑ XR Shoulder 3 Views Right
      • Emergency, 0
    • ❑ XR Spine Cervical Comp w/ Obliques
      • Emergency, 0
    • ❑ XR Spine Lumbar 5 Views
      • Emergency, 0
    • ❑ XR Spine Thoracic 2 Views
      • Emergency, 0
    • ❑ XR Wrist 3 Views Min Lt
      • Emergency, 0
    • ❑ XR Wrist 3 Views Min Rt
      • Emergency, 0
ED Abdominal Pain ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • If 30 years or older
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Lipase Level
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Heparin Lock Insertion
ED Abdominal Pain Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Once, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Abdomen Series
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Abdomen KUB
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Angio Abdomen/Pelvis
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
    • ❑ CT Angio Chest w/ Contrast
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
    • ❑ US Gallbladder
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
    • ❑ US OB 1st Trimester Each Add'l Gestation
      • T;N, Emergency, Once
    • ❑ US Transvaginal Non-OB
      • T;N, Emergency, Once, Reason: R/O Ovarian Torsion, Transport Mode: Stretcher
    • ❑ US Renal
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
    • ❑ US Testicular
      • T;N, Emergency, Once, Reason: Abdominal Pain, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lactate
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Occult Blood Fecal
      • Stool, Stat collect, T;N, Nurse collect
    • ❑ Wet Mount/KOH
      • Stat collect, T;N, Once, Nurse collect
    • ❑ HIV Rapid Screen
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ RPR
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ famotidine
      • ❑ 20 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 20 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ prochlorperazine
      • ❑ 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 600 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ metoclopramide
      • 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 8 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 15 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 15 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ Dilaudid
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ fentaNYL
      • 50 mcg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ Tylenol
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ Protonix
      • ❑ 40 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 80 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ Fleet Enema
      • 133 mL, Enema, Per rectum, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
    • ❑ ECG 12 lead
      • T;N, Stat
    • ❑ Obtain Old ECG
      • T;N
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Foley Catheter Insertion
      • T;N, Indwelling
    • ❑ Precautions
      • T;N, Stat; Falls Precautions
    • ❑ Pelvic Exam Setup
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ ABG Draw (Resp)
      • T;N, Stat
ED Acetylcysteine (Acetadote) IV Order Set IRDL
  • IV Solutions
    • ❑ acetylcysteine 20% IV 30,000 mg/D5W 850 ml
      • 850 mL, IV, STAT, Start date: T;N, Per Protocol
  • Laboratory
    • ❑ AST
      • Blood, Stat collect, T;N
    • ❑ ALT
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ Acetaminophen Level
      • Blood, Stat collect, T;N
  • Medications
    • ❑ acetylcysteine
      • 70 mg/kg, Oral, q4hr, 17 dose(s)/time(s)
  • Patient Care
    • ❑ Saline Lock Insertion
      • T;N, Stat
    • ❑ Communication Order
      • T;N, Obtain order for Acetylcysteine - 70 mg/kg, Oral, q4h, 17 dose(s)/time(s). Begin after initial IV Acetadote bag infuses if able to tolerate oral therapy. If not, notify physician for orders.
ED Acute Coronary Syndrome (ACS/Chest Pain/Angina) Order Set IRDL
  • Consults
    • ❑ Nursing Communication Order
      • T;N, If Cardiologist called regarding patient - repage if no call back within 10 minutes. Document retrun call time in Medical Record.
  • Diagnostic Tests
    • ❑ CT Angio Abdomen
      • T;N, Emergency, Once
    • ❑ CT Angio Chest w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Angio Pulmonary
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ NM Pulmonary Ventilation/Perfusion
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Chem 12
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ Reason for Fibrinolytic Therapy Delay
      • ❑ Balloon pump within 30 min of arrival
      • ❑ CP arrest within 30 min of arrival
      • ❑ Intubation within 30 min of arrival
      • ❑ Patient/Family refusal of therapy
      • ❑ Other:
    • ❑ aspirin
      • ❑ 324 mg, Tab-Chew, Oral, Once, STAT, Start date: T;N
      • ❑ 300 mg, Supp, Per rectum, Once, STAT, Start date: T;N
    • ❑ Reason Aspirin Not Given on Arrival
      • ❑ Taken Prior to Arrival
      • ❑ Allergy
      • ❑ Antiplatelet therapy contraindicated
      • ❑ Coumadin/Warfarin as pre-arrival med
    • ❑ clopidogrel
      • ❑ 600 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 300 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 75 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ prasugrel
      • 60 mg, Tab, Oral, Once, STAT
    • ❑ ticagrelor
      • 180 mg, Tab, Oral, Once, STAT
    • ❑ heparin
      • 5,000 unit(s), Injection, IV Push, Once, STAT, Start date: T;N
    • ❑ enoxaparin
      • 1 mg/kg, Syringe, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ metoprolol
      • ❑ 5 mg, Vial, IV Push, q5min, STAT, Start date: T;N, 3 dose(s)/time(s)
      • ❑ 50 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 25 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ nitroglycerin 2% topical ointment
      • ❑ 1 in, Ointment, TOP, Once, STAT, Start date: T;N
      • ❑ 0.5 in, Ointment, TOP, Once, STAT, Start date: T;N
    • ❑ nitroglycerin 50 mg/250 mL-D5W IV Sol
      • 50 mg
      • 250 mL, IV, STAT, Start date: T;N, See Comments
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, 50 mL/hr
      • ❑ 1,000 mL, IV, STAT, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT
      • ❑ 500 mL, IV, Once, STAT
      • ❑ 250 mL, IV, Once, STAT
    • ❑ prochlorperazine
      • ❑ 5 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 8 mg, Vial, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once, 0
    • ❑ Foley Catheter Insertion
      • T;N, Once, Stat
    • ❑ Nursing Communication Order
      • Stat ED-ECG 12 Lead should be done within 5 minutes of arrival - immediately notify the MD of results
    • ❑ Nursing Communication Order
      • Initial ED - ECG 12 Lead is not diagnostic, patient remains symptomatic and suspicious for ACS, repeat ECG at 15-30 minute intervals during the first hour of symptoms and new onset symptoms.
    • ❑ Nursing Communication Order
      • Initiate Chest Pain / Acute Myocardial Infarction Quality Measure Dashboard
    • ❑ Obtain Old ECG
      • T;N, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Saline Lock Insertion
      • ❑ T;N, Once, Stat
      • ❑ T;N, Once, Stat
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
    • ❑ BIPAP
      • ❑ Per Respiratory Therapy
      • ❑ Mode: BiPAP, HS
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • keep O2 Sat greater than or equal to 90%
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Acute Severe Hyperkalemia Order Set IMH
  • Communication
    • ❑ Hold Med
      • Hold meds that elevate serum potassium until serum potassium within normal range
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Once, Transport Mode: Portable
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Sodium Bicarbonate 150 mEq/D5W 1000 mL
  • Laboratory
    • ❑ Potassium Level
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500, Once
  • Medications
    • ❑ calcium gluconate
      • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
      • ❑ 1 gm, IV Push, Once, STAT, Start date: T;N
    • ❑ insulin regular 100 units/mL human recombinant injectable solution
      • 10 unit(s), Injection, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 10 minute(s)
    • ❑ dextrose 50% injection
      • ❑ 25 gm, IV Push, Once, STAT, Start date: T;N
      • ❑ 50 gm, IV Push, Once, STAT, Start date: T;N
    • ❑ albuterol 0.5% inhalation solution
      • ❑ 10 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ 20 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
    • ❑ Lasix
      • ❑ 40 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 80 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 40 mg, IV Push, Daily, Start date: T;N
      • ❑ 80 mg, IV Push, Daily, Start date: T;N
      • ❑ 40 mg, IV Push, BID, Start date: T;N
      • ❑ 80 mg, IV Push, BID, Start date: T;N
    • ❑ bumetanide
      • ❑ 2 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, IV Push, Daily, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, Daily, STAT, Start date: T;N
      • ❑ 2 mg, IV Push, BID, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, BID, STAT, Start date: T;N
    • ❑ sodium polystyrene sulfonate
      • ❑ 30 gm, Oral, Once, STAT, Start date: T;N
      • ❑ 15 gm, Oral, Once, STAT, Start date: T;N
      • ❑ 60 gm, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Obtain Old ECG
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Blood Glucose POC
      • T;N, q1hr, for 3 dose(s)/time(s), Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Pharmacy Communication Order.
      • Discontinue oral or parenteral potassium
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N
    • ❑ Pulse Oximetry POC
      • T;N, PRN
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Adult Inpatient Antibiotic Order Set IRDL
  • Medications
    • ❑ cefTRIAXone
      • ❑ 1 gm, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
      • ❑ 2 gm, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ azithromycin
      • ❑ 500 mg, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
      • ❑ 500 mg, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ cefTRIAXone
      • ❑ 1 gm, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
      • ❑ 2 gm, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ vancomycin
      • 125 mg, Oral, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ vancomycin
      • 125 mg, Oral, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ vancomycin
      • 500 mg, Oral, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ cefTRIAXone
      • ❑ 1 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
      • ❑ 2 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ ceFAZolin
      • 2 gm, IV Piggyback, Once, Medication Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ clindamycin
      • 600 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ clindamycin
      • 600 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ ceFAZolin
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ clindamycin
      • 900 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ gentamicin
      • 5 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
      • 0.5 mL, Susp-Inj, IM, Once
    • ❑ cefTRIAXone
      • ❑ 1 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
      • ❑ 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Infuse over 30 minute(s)
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ clindamycin
      • 900 mg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ dexamethasone
      • 0.6 mg/kg, Oral, Once
    • ❑ cefTRIAXone
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ ampicillin
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ moxifloxacin
      • 400 mg, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ Bactrim
      • mL, IV Piggyback, Once, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60
    • ❑ dexamethasone
      • 0.15 mg/kg, IV Piggyback, Once
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60, Infuse over 30 minute(s)
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60
ED Adult Insulin Sliding Scale Order Set IRDL
  • Medications
    • ❑ Insulin Regular Sliding Scale
      • Medium Dose Correction, Injection, Subcutaneous, Once
    • ❑ Insulin Humalog sliding scale
      • Medium Dose Correction, Injection, Subcutaneous, Once
  • Patient Care
    • ❑ Blood Glucose POC
      • Once
ED Adult Outpatient Antibiotic Order Set IRDL
  • Medications
    • ❑ amoxicillin
      • 1 gm, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ azithromycin
      • 500 mg, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ amoxicillin-clavulanate 875 mg-125 mg oral tablet
      • 1 tab(s), Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ cefuroxime
      • 500 mg, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ levoFLOXacin
      • 750 mg, Tab, Oral, Once, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60
    • ❑ amoxicillin-clavulanate 875 mg-125 mg oral tablet
      • 1 tab(s), Oral, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ ciprofloxacin
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Intraabdominal Infection
    • ❑ metroNIDAZOLE
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60
    • ❑ vancomycin
      • 125 mg, Oral, Once, Antibiotic Indication Clostridium difficile infection, Start date: T;N+60
    • ❑ nitrofurantoin
      • 100 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ cephalexin
      • 500 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ cefdinir
      • 300 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ cephalexin
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ cefdinir
      • 300 mg, Tab, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ nitrofurantoin
      • 100 mg, Cap, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ cefTRIAXone
      • ❑ 1 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
      • ❑ 2 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ cefdinir
      • 300 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ amoxicillin-clavulanate 875 mg-125 mg oral tablet
      • 1 tab(s), Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ ciprofloxacin
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60
    • ❑ cefTRIAXone
      • ❑ 500 mg, IM, Once, Antibiotic Indication Other Infection-specify in order comment
      • ❑ 1 gm, IM, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ gentamicin
      • 240 mg, IM, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ azithromycin
      • 2 gm, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ cefTRIAXone
      • ❑ 500 mg, IM, Once, Antibiotic Indication Other Infection-specify in order comment
      • ❑ 1 gm, IM, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ azithromycin
      • 1 gm, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ azithromycin
      • 1 gm, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ metroNIDAZOLE
      • 500 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ metroNIDAZOLE
      • 500 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ metroNIDAZOLE
      • 500 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ clindamycin
      • 300 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ penicillin G benzathine
      • 2,400,000 unit(s), IM, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ cefTRIAXone
      • ❑ 500 mg, IM, Once, Antibiotic Indication Other Infection-specify in order comment
      • ❑ 1 gm, IM, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ cefTRIAXone
      • ❑ 500 mg, IM, Once, Antibiotic Indication Urinary Tract Infection
      • ❑ 1 gm, IM, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ ciprofloxacin
      • 500 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ ciprofloxacin
      • 500 mg, Oral, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ cefepime
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Urinary Tract Infection
    • ❑ amoxicillin-clavulanate 875 mg-125 mg oral tablet
      • 1 tab(s), Tab, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ metroNIDAZOLE
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
      • 0.5 mL, Susp-Inj, IM, Once
    • ❑ cephalexin
      • 500 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ clindamycin
      • 450 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ ceFAZolin
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ vancomycin
      • 20 mg/kg, IV Piggyback, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ doxycycline
      • 100 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ clindamycin
      • 450 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ sulfamethoxazole-trimethoprim 800 mg-160 mg oral tablet
      • 1 tab(s), Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60
    • ❑ cephalexin
      • 500 mg, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ penicillin V potassium
      • 500 mg, Tab, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ clindamycin
      • 450 mg, Oral, Once, Antibiotic Indication Other Infection-specify in order comment
    • ❑ amoxicillin-clavulanate 875 mg-125 mg oral tablet
      • 1 tab(s), Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ clindamycin
      • 450 mg, Cap, Oral, Once, Antibiotic Indication Skin/Soft- Tissue Infection
    • ❑ dexamethasone
      • 0.6 mg/kg, Oral, Once
ED Adult Seizure Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Spine Cervical Comp w/ Obliques
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ MRI Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS Bolus
      • 1,000 mL, IV, Once, STAT, Start date: T;N, 999 mL/hr
    • ❑ Rally Pack
      • 100 mg, IV Piggyback, Once, STAT
      • 10 mL
      • 1,000 mL
    • ❑ LR Bolus
      • 1,000 mL, IV, Once, STAT, Start date: T;N
    • ❑ D10W Bolus
      • 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ Calcium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Dilantin Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Chem 12
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ EtOH Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phenobarbital Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Tegretol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Urine Pregnancy Test (Qual)
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ acetaminophen
      • ❑ 650 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 650 mg, Supp, Per rectum, Once, STAT, Start date: T;N
    • ❑ LORazepam
      • ❑ 2 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 1 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ dextrose 50% injection
      • = 50 mL, Syringe, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Foley Catheter Insertion
      • T;N, Per hospital insertion criteria
    • ❑ Seizure Precautions
      • T;N, STAT
    • ❑ Precautions
      • T;N, Constant Order, Fall precautions
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Obtain consent
      • T;N
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Once, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Once, Stat
ED Allergic Reaction Order Set IRDL
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ hydrOXYzine
      • ❑ 25 mg, Injection, IM, Once, STAT, Start date: T;N
      • ❑ 50 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ diphenhydrAMINE
      • ❑ 50 mg, Vial, IV, Once, STAT, Start date: T;N
      • ❑ 50 mg, Oral, Once, STAT, Start date: T;N
    • ❑ EPINEPHrine 1 mg/mL injectable solution
      • ❑ 0.3 mg, IM, Once, STAT, Start date: T;N
      • ❑ 0.15 mg, IM, Once, STAT, Start date: T;N
    • ❑ dexamethasone
      • ❑ 10 mg, Injection, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Oral, Once, STAT, Start date: T;N
    • ❑ predniSONE
      • 60 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ methylPREDNISolone sodium succinate 125 mg injection
      • 125 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ albuterol 90 mcg/inh inhalation
      • 1 puff(s), Aerosol, INH, Once, STAT, Start date: T;N
    • ❑ albuterol 0.5% inhalation solution
      • ❑ 5 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ 2.5 mg, Soln-Inh, NEB, q1min, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ albuterol 0.083% inhalation solution
      • 2.5 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
    • ❑ racepinephrine 2.25% inhalation solution
      • 0.5 mL, Soln-Inh, NEB, Once, STAT, Start date: T;N
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • 500 mcg, Soln-Inh, NEB, q1min, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ famotidine
      • ❑ 20 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 20 mg, Tab, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Saline Lock Insertion
      • T;N, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry Spot Check - Respiratory
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Alteplase (Activase) Infusion for Pulmonary Embolus IRDL
  • Activity
    • ❑ Bedrest
      • T;N, Stat, Strict bedrest during Alteplase (Activase) infusion.
  • Communication
    • ❑ Nursing Communication Order
      • Prior to administering Heparin, check to be sure patient has not received an anticoagulant within the last 24 hours.
    • ❑ Notify Provider
      • if patient has received an anticoagulant within the last 24 hours
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Stat, Reason: Pulmonary Embolus, Transport Mode: Portable
  • IV Solutions
    • ❑ Nursing Communication Order
      • Do not add, push or piggyback medications into alteplase infusion.
    • ❑ Nursing Communication Order
      • Infuse 100mg of alteplase over 2 hours (NOTE: Alteplase (Activase) for pulmonary embolus is NOT weight adjusted) -- 2nd RN must verify dosage and pump programming prior to administration, document in Medical Record.
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Platelet Count
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Nursing Communication Order
      • T;N, If Pre-treatment PT > 15 seconds or pre-treatment Heparin Anti-Xa elevated, notify physician.
  • Medications
    • ❑ alteplase.
      • Per Protocol for PE, Kit, IV, Once
    • ❑ alteplase.
      • 50 mg, Kit, IV Push, Once
    • ❑ alteplase.
      • 50 mg, Kit, IV Push, Once
    • ❑ Sodium Chloride 0.9% Intermittent
      • 50 mL, IV, 25 mL/hr
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 250 mL, IV, Routine, Per DVT/PE Protocol
      • 25,000 unit(s)
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat
    • ❑ Precautions
      • T;N, Bleeding Precautions
ED Alteplase (Activase) Stroke Order Set IRDL
  • Diagnostic Tests
    • ❑ MRA Head w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
    • ❑ CT Head or Brain w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
    • ❑ MRI Brain w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
  • Medications
    • ❑ Nursing Communication Order
      • Use dosing chart on reference text for Alteplase (Activase) for Acute Ischemic Stroke to determine Alteplase (Activase) bolus & maintenance infusion dosage based upon weight (Maximum total dose cannot exceed 90mg).
    • ❑ Nursing Communication Order
      • NOTE:Pharmacist or Ordering Physician & 2nd RN must verify dosage, including bolus dose & maintenance infusion, prior to administration. Document in EMR.
    • ❑ labetalol
      • 10 mg, IV Push, Once, PRN Other (see comment)
    • ❑ labetalol
      • 20 mg, IV Push, q5min, PRN Other (see comment)
    • ❑ niCARdipine 25 mg/250 mL - IV Sol IVS (Stroke)
      • 250 mL, IV, Routine, See Comments
    • ❑ hydrALAZINE
      • ❑ 10 mg, Vial, IV Push, Once, PRN for Other (see comment)
      • ❑ 20 mg, Vial, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 1.25 mg, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 2.5 mg, IV Push, Once, PRN for Other (see comment)
    • ❑ Nitroprusside 50 mg/250 mL (Stroke)
      • 250 mL, IV, Routine, See Comments
      • 50 mg
    • ❑ alteplase.
      • Per Protocol for Stroke, Kit, IV, Once, STAT
    • ❑ Sodium Chloride 0.9% Intermittent
      • 50 mL, IV, 100 mL/hr
  • Patient Care
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat, 2 large bore Angiocaths, 1 for IV Alteplase (Activase)
    • ❑ Hold Med
      • Do not give aspirin, heparin, or warfarin or other anticoagulants for 24 hours post Alteplase (Activase) infusion.
    • ❑ Precautions
      • Bleeding Precautions
    • ❑ Notify Provider
      • Notify Provider & STOP Alteplase (Activase) if patient complains of severe headache, patient becomes lethargic, or if patient begins to experience hematemesis, hematuria, hemoptysis, or seizures.
    • ❑ Patient Education
      • Alteplase (Activase) patient education completed and handout provided
  • Vital Signs
    • ❑ Vital Signs POC
      • every 15 minutes during treatment, then q 15 minutes x 2 hours, then q 30 minutes x 6 hour, then q 1 x 24 hours after treatment - Document on Alteplase (Activase) flow sheet.
    • ❑ Neurovascular Checks
      • every 15 minutes during treatment, then q 15 minutes x 2 hours, then q 30 minutes x 6 hours, then q 1 hour x 24 hours after treatment- Document on Alteplase (Activase) flow sheet.
ED Altered Mental Status (AMS) ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • Stat, Once, 0
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • T;N NPO
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Urine Culture
      • Urine, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Saline Lock Insert
      • T;N
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ NIH Stroke Scale
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Amiodarone (Cordarone) Infusion Order Set IRDL
  • IV Solutions
    • ❑ Nursing Communication
      • Amiodarone Infusion: Begin maintenance infusion at 1mg/min or 33 cc/hr x 6 hours then reduce maintenance infusion to 0.5mg/min or 17 cc/hr.
    • ❑ amiodarone 450 mg/250 mL
      • 450 mg
      • 250 mL, IV, Routine, 6 hr, 33 mL/hr
    • ❑ amiodarone 450 mg/250 mL
      • 450 mg
      • 250 mL, IV, Routine, 17 mL/hr
  • Medications
    • ❑ amiodarone
      • 150 mg, IV Piggyback, Once, STAT, Infuse over 10 minute(s)
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Once, Stat
ED Blood &/or Blood Products Transfusion Order Set - IRDL
  • Communication
    • ❑ Patient Education
      • Stat, Provide Blood &/or Blood Product handout.
    • ❑ Patient Instruction
      • Instruct patient to call the nurse if he/she has signs/symptoms of reaction.
  • Condition
    • ❑ Obtain consent
      • Stat, for Blood or Blood Product Transfusion
  • IV Solutions
    • ❑ NS
      • 250 mL, IV, STAT, 12 hr, 10 mL/hr
  • Laboratory
    • ❑ Transfuse Blood Product [IMH]
      • ❑ Stat, 1 Unit Packed Red Blood Cells
      • ❑ Stat, 2 Units Packed Red Blood Cells
      • ❑ Stat, 3 Units Packed Red Blood Cells
      • ❑ Stat, 4 Units Packed Red Blood Cells
    • ❑ Transfuse Blood Product [IMH]
      • ❑ Stat, PRN, If hgb < 9, Transfuse 1 Unit PRBC
      • ❑ Stat, PRN, If hgb < 8.5, Transfuse 1 Unit PRBC
      • ❑ Stat, PRN, If hgb < 8, Transfuse 1 Unit PRBC
      • ❑ Stat, PRN, If hgb < 8, Transfuse 2 Units PRBC
    • ❑ Transfuse Blood Product [IMH]
      • hr, Stat, Blood Product: __________________ Total blood product volume: _________mL Saline flush volume: _______mL
    • ❑ Transfuse Blood Product [IMH]
      • ❑ Stat, 1 Unit FFP
      • ❑ Stat, 2 Units FFP
      • ❑ Stat, 3 Units FFP
      • ❑ Stat, 4 Units FFP
    • ❑ Transfuse Blood Product [IMH]
      • Stat, 1 Pack Leukoreduced Plateletpheresis
    • ❑ Fibrinogen.
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Hemoglobin & Hematocrit
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Prothrombin Time
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ BMP
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CMP
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Nursing Communication
      • ❑ Enter order for H&H 1 hour past transfusion.
      • ❑ Enter order for H&H 2 hours past transfusion.
      • ❑ Enter order for H&H immediately after transfusion.
    • ❑ Notify Provider Laboratory Results
      • ❑ Hgb < 6
      • ❑ Hgb < 7
      • ❑ Hgb < 8
      • ❑ Hgb < 9
    • ❑ Nursing Communication
      • ❑ Enter order for CBC 1 hour past transfusion.
      • ❑ Enter order for CBC 2 hours past transfusion.
      • ❑ Enter order for CBC immediately after transfusion.
    • ❑ Notify Provider Laboratory Results
      • ❑ Hgb < 6
      • ❑ Hgb < 7
      • ❑ Hgb < 8
      • ❑ Hgb < 9
  • Patient Care
    • ❑ IV Start
      • Stat, Utilize catheter size at least 18 - 20 gauge for red blood cell administration
    • ❑ Nursing Communication
      • Keep 2 Units PRBC ahead.
    • ❑ Lab Communication Order
      • Other, Stat collect, Keep 2 Units PRBC ahead.
  • Vital Signs
    • ❑ Vital Signs POC
      • Stat, per blood transfusion protocol
ED Blood Culture X 2 - IMH
  • Laboratory
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N
    • ❑ Lactic Acid
      • Blood, Stat collect, T;N
ED Cardizem Infusion Order Set IRDL
  • IV Solutions
    • ❑ NS
      • 250 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ diltiazem 125mg/100 mL
      • 100 mL, IV, STAT, Start date: T;N, See Comments
  • Medications
    • ❑ Cardizem
      • ❑ 10 mg, Vial, IV Push, q15min, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 20 mg, Vial, IV Push, q15min, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 25 mg, Vial, IV Push, q15min, STAT, Start date: T;N, 2 dose(s)/time(s)
  • Patient Care
    • ❑ Nursing Communication
      • Cardizem Infusion: Refer to Reference Text / Nurse Prep for additional instructions.
    • ❑ Nursing Communication
      • TARGET HEART RATE________ WHILE ON CARDIZEM INFUSION.
    • ❑ Nursing Communication
      • Cardizem Infusion: Once target HR achieved, decrease infusion by 5mg/hr every 1 hour to maintain target HR.
    • ❑ Nursing Communication
      • Cardizem Infusion: If HR sustained < 100 may discontinue infusion.
    • ❑ Nursing Communication
      • Cardizem Infusion: Maintain drip at ordered rate - DO NOT TITRATE.
    • ❑ Nursing Communication
      • Stop Cardizem if patient converts to Sinus Rhythm.
    • ❑ Notify Provider
      • If target HR is not obtained with maximum dose of Cardizem or if difficulty titrating.
    • ❑ Notify Provider
      • Systolic BP <90
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Once, Stat
ED Chest Pain / SOB / Presumed Ischemic for Patients >/= 30 years old ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • Stat, Once, Give to ED MD to read, 0
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
    • ❑ XR Chest 2 Views
      • T;N, Emergency
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
  • Medications
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Saline Lock Insert
      • T;N
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Code Stroke ANI Order Set - IMH
  • Communication
    • ❑ Nursing Communication Order
      • Activate Code Stroke protocol
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • NPO
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Saline Lock Insert
      • T;N
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ NIH Stroke Scale
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Code Stroke Panel IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • Stat
    • ❑ CT Head or Brain w/o Contrast
      • Emergency, Reason: Code Stroke
    • ❑ CT Angio Head w/ + w/o Contrast
      • Emergency, Reason: Code Stroke
    • ❑ CT Angio Neck w/ Contrast
      • Emergency, Reason: Code Stroke
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Chem 12
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • Once, Stat
    • ❑ Notify Provider
      • For BS below 70 or above 130
ED Corvert (Ibutilide) Order Set IRDL
  • Communication
    • ❑ Nursing Communication
      • Nursing - Refer to Reference Text / Nurse Prep for additional instructions for Corvert.
    • ❑ Nursing Communication
      • Adequate anticoagulation required for patients with Atrial Fibrillation of more than 2 to 3 days.
    • ❑ Notify Provider
      • Notify physician of abnormal potassium or magnesium labs.
  • IV Solutions
    • ❑ NS
      • 250 mL, IV, STAT, Start date: T;N, 10 mL/hr
  • Laboratory
    • ❑ Potassium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT/INR
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ Nursing Communication
      • For patients weighing 60 kg or more, give 1 mg Corvert. For patients weighing less than 60 kg, give 0.01 mg/kg of Corvert.
    • ❑ Corvert
      • ❑ 1 mg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 10 minute(s)
      • ❑ 0.01 mg/kg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 10 minute(s)
  • Patient Care
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • Once, Stat
ED Cough ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Reason: Cough, Notify ED Provider
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Reason: Cough, Notify ED Provider
  • Diet
    • ❑ Diet Order
      • T;N NPO
  • Patient Care
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
ED CSF Panel IRDL
  • Laboratory
    • ❑ LDH, BODY FLUID
      • Body Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Cell Count Tube 1
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Culture Tube 2 /Gram Stain
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Glucose/Protein Tube 3
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Cell Count Tube 4
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
  • Patient Care
    • ❑ Procedure / Consent
      • Lumbar Puncture
ED Diabetic Patient ANI Order Set - IMH
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
ED DKA or HHS Order Set IRDL
  • Communication
    • ❑ Nursing Communication
      • Diagnostic Criteria for DKA: Serum glucose greater than 250mg/dl, Moderate Ketonuria or Ketonemia, Anion Gap greater than 10mEq/L, Serum Bicarb less than 15mEq/L, Venous or Arterial pH less than 7.3
    • ❑ Nursing Communication
      • Diagnostic Criteria for HHS: Serum glucose greater than 600mg/dl, Minimal Ketonuria or ketonemia, Anion gap greater than 10mEq/L, Serum Bicarb greater than 15mEq/L, Venous or Arterial pH greater than 7.3
    • ❑ Nursing Communication
      • For K+ < 3.3 mEq/L or > 5.5 mEq/L, notify Provider. If K+ > 5.5 mEq/L, stop all potassium medication orders.
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Once, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS Bolus
      • ❑ 2,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ LR Bolus
      • ❑ 2,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 250 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ 1/2 NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 250 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 250 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ KCl 20 mEq/NS 1000 mL
      • 20 mEq
      • 1,000 mL, IV, Routine, mL/hr
    • ❑ KCl 20 mEq in 1/2 NS 1000 mL
      • 1,000 mL, IV, Routine, mL/hr
      • 20 mEq
    • ❑ KCl 20 mEq / LR 1000 mL
      • 1,000 mL, IV, mL/hr
      • 20 mEq
    • ❑ Nursing Communication
      • When Blood Glucose less than 250mg/dl AND anion gap less than 11mEq/L or serum bicarb greater than 18mEq/L - Notify provider for order to change IV Fluids to D5W-1/2NS at current rate.
    • ❑ D5W 1/2 NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
  • Laboratory
    • ❑ SARS-CoV-2 (COVID-19) Antigen
      • Nasopharyngeal Swab, Stat collect, T;N
    • ❑ Hgb A1C
      • Blood, Stat collect, T;N
    • ❑ CPK
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Timed Study collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Amylase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Osmolality
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Venous Blood Gas
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N, Nurse collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ Nursing Communication
      • DO NOT START INSULIN - until Metabolic Profile is resulted and Serum Potassium is above 3.3mEq/L.
    • ❑ Insulin human 100 units/100 mL Premix
      • 100 mL, IV, Routine, See Infusion instructions
      • 100 unit(s)
    • ❑ Insulin Drip Premix
      • 100 unit(s)
      • 100 mL, IV, STAT, Start date: T;N, See Infusion Instructions
    • ❑ Insulin Drip Premix
      • 100 mL, IV, Start date: T;N, See Infusion Instructions
      • 100 unit(s)
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, q1hr, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Insert Foley Catheter
      • T;N, Indwelling
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Bi-level Positive Airway Pressure
      • ❑ Per Respiratory Therapy
      • ❑ Mode: BiPAP, qPM
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Dysuria without Fever ANI Order Set - IMH
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
ED ETOH Detox ANI Order Set - IMH
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ EtOH Level
      • Blood, Stat collect, T;N
    • ❑ ASA Level
      • Blood, Stat collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insert
      • T;N
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Extremity Injury ANI Order Set - IMH
  • Communication
    • ❑ Notify Provider
      • T;N, for pain management
  • Diagnostic Tests
    • ❑ XR Ankle 3 Views Min Lt
      • Emergency
    • ❑ XR Ankle 3 Views Min Rt
      • Emergency
    • ❑ XR Elbow Complete Left
      • Emergency
    • ❑ XR Elbow Complete Right
      • Emergency
    • ❑ XR Foot 3 Views Min Lt
      • Emergency
    • ❑ XR Foot 3 Views Min Rt
      • Emergency
    • ❑ XR Hand 3 Views Min Lt
      • Emergency
    • ❑ XR Hand 3 Views Min Rt
      • Emergency
    • ❑ XR Knee 3 Views Left
      • Emergency
    • ❑ XR Knee 3 Views Right
      • Emergency
    • ❑ XR Shoulder 3 Views Left
      • Emergency
    • ❑ XR Shoulder 3 Views Right
      • Emergency
    • ❑ XR Wrist 3 Views Min Lt
      • Emergency
    • ❑ XR Wrist 3 Views Min Rt
      • Emergency
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
    • ❑ Immobilization
      • T;N, Injured extremity
    • ❑ Elevate Affected Extremity
      • T;N, Injured extremity
    • ❑ Cold Compression
      • T;N, Apply cold compress if injury is less than 48 hours old
ED Eye Complaints ANI Order Set - IMH
  • Medications
    • ❑ tetracaine 0.5% ophthalmic solution
      • ❑ 2 drop(s), Soln, Eye-Both, q30min, PRN Pain, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 2 drop(s), Soln, Eye-Left, q30min, PRN Pain, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 2 drop(s), Soln, Eye-Right, q30min, PRN Pain, STAT, Start date: T;N, 2 dose(s)/time(s)
  • Patient Care
    • ❑ fluorescein 1 mg ophthalmic test
      • 1 EA, Test, OPTH, Once, STAT, Start date: T;N
    • ❑ Eye Equipment Bedside
      • T;N, Once, Stat, Normal Saline Irrigating solution
    • ❑ Wood's Lamp
      • T;N, Once, Stat, At bedside
    • ❑ Visual Acuity Screening
      • T;N, Once, Stat, Document visual acuity
ED Eye Problem Order Set IMH
  • Diagnostic Tests
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Orbit Sella etc. w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Orbit Sella etc. w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Maxillofacial w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Maxillofacial w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • Eye Drops
      • ❑ Cyclogyl 1% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ Tobradex 0.3%-0.1% ophthalmic suspension
        • ❑ 2 drop(s), Susp-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ FML Forte Liquifilm
        • ❑ 2 drop(s), Susp-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ gentamicin 0.3% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ !-Neosporin Ophthalmic
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ hydrocortisone/neomycin/polymyxin B 1%-0.35%-10,000 units/mL ophthalmic suspension
        • ❑ 2 drop(s), Susp-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Susp-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ phenylephrine 2.5% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ phenylephrine 10% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ proparacaine 0.5% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ sulfacetamide sodium 10% ophthalmic solution
        • ❑ 1 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 1 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 1 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ tetracaine 0.5% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ timolol maleate 0.25% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ timolol maleate 0.5% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ tobramycin 0.3% ophthalmic solution
        • ❑ 2 drop(s), Soln-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 2 drop(s), Soln-Opth, Eye-Right, Once, STAT, Start date: T;N
    • Eye Ointments
      • ❑ bacitracin/neomycin/polymyxin B 400 units-3.5 mg-10,000 units/g ophthalmic ointment
        • ❑ 1 app, Oint-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ gentamicin 0.3% ophthalmic ointment
        • ❑ 1 app, Oint-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Right, Once, STAT, Start date: T;N
      • ❑ Tobrex 0.3% ophthalmic ointment
        • ❑ 1 app, Oint-Opth, Eye-Both, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Left, Once, STAT, Start date: T;N
        • ❑ 1 app, Oint-Opth, Eye-Right, Once, STAT, Start date: T;N
    • Pain Control
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, STAT, Start date: T;N
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, Once, STAT, Start date: T;N
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ ondansetron
        • 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ ketorolac
        • ❑ 30 mg, Vial, IM, Once, STAT, Start date: T;N
        • ❑ 15 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 60 mg, Vial, IM, Once, STAT, Start date: T;N
    • Vaccines
      • ❑ Adacel (Tdap)
        • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
      • ❑ tetanus-diphth toxoids (Td) adult/adol
        • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Eye Equipment Bedside
      • T;N, Once, Stat
    • ❑ fluorescein 1 mg ophthalmic test
      • 1 EA, Test, OPTH, Once, STAT, Start date: T;N
    • ❑ Morgan Lens Irrigation
      • T;N, Once, Stat
    • ❑ Slit Lamp
      • T;N, Once, Stat
    • ❑ Wood's Lamp
      • T;N, Once, Stat
    • ❑ Visual Acuity Screening
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Stat
ED Fever greater than 38 degrees ANI Order Set - IMH
  • Medications
    • ❑ Tylenol
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 400 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen
      • 15 mg/kg, Soln-Oral, Oral, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 10 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
ED Flank Pain / UTI / Pyelo Order Set IRDL
  • Diagnostic Tests
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Abdomen
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Abdomen KUB
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Spine Lumbar 5 Views
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US Pelvis Non-OB Complete
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US Renal
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Wet Mount/KOH
      • Micro Specimen, Stat collect, T;N, Nurse collect
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ metoclopramide
      • 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ prochlorperazine
      • ❑ 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ phenazopyridine
      • 100 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • 1 tab(s), Tab, Oral, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • 30 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 1 mg, Syringe, IM, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Insert Foley Catheter
      • T;N, Indwelling
    • ❑ Strain Urine After each Void
      • T;N, PRN, STAT
    • ❑ Pelvic Exam
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Flank Pain ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, 0
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
ED General Order Set IRDL
  • Diagnostic Tests
    • ❑ CT Abdomen w/ + w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Pulmonary
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Cervical w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Abdomen KUB
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Abdomen Series
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Ankle 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Ankle 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Clavicle Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Clavicle Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Elbow Complete Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Elbow Complete Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Femur 2 Views Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Femur 2 Views Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Foot 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Foot 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Forearm Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Forearm Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Hand 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Hand 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Hip 2-3 Views Lt w/ Pelvis
      • T;N, Emergency, Transport Mode: Stretcher, 0
    • ❑ XR Hip 2-3 Views Rt w/ Pelvis
      • T;N, Emergency, Transport Mode: Stretcher, 0
    • ❑ XR Humerus 2 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Humerus 2 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Knee 2 Views Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Knee 2 Views Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Pelvis AP
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Ribs 3 Views Bilateral
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Ribs 3 Views Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Ribs 3 Views Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Shoulder 3 Views Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Shoulder 3 Views Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Spine Cervical 2 Views
      • T;N, Emergency, Transport Mode: Stretcher, 0
    • ❑ XR Spine Cerv 5 Views w/ Flex +/or Ext
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Spine Lumbar 5 Views
      • T;N, Emergency, Transport Mode: Stretcher, 0
    • ❑ XR Spine Thoracic 2 Views
      • T;N, Emergency, Transport Mode: Stretcher, 0
    • ❑ XR Tibia +Fibula 2 Views Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Tibia +Fibula 2 Views Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Wrist 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Wrist 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US Abdomen Complete
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US Gallbladder
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Bilateral
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Right
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Warm IV Fluids
      • T;N, Stat
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Tylenol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Tegretol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Creatine Kinase
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Digoxin Lvl
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ ESR
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Ethanol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Free T4
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hemoglobin & Hematocrit
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lactate
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Dilantin Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Aspirin Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ TSH
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Transfuse Blood Product [IMH]
      • ❑ T;N, Stat, 2 Units PRBC
      • ❑ T;N, Stat, 1 Units PRBC
      • ❑ T;N, Stat, Trauma Blood/ O Negative
    • ❑ Valproic Acid Lvl
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Wet Prep for Trich
      • Vaginal, Stat collect, T;N
  • Medications
    • GI Prophylaxis
      • ❑ famotidine
        • 20 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ metoclopramide
        • 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ ondansetron
        • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
        • ❑ 8 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ pantoprazole
        • 40 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ prochlorperazine
        • ❑ 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 10 mg, Vial, IM, Once, STAT, Start date: T;N
      • ❑ promethazine
        • 25 mg, Tab, Oral, Once, STAT, Start date: T;N
    • Other Meds
      • ❑ dexamethasone
        • ❑ 10 mg, Injection, IV Push, Once, STAT, Start date: T;N
        • ❑ 10 mg, Oral, Once, STAT, Start date: T;N
      • ❑ diphenhydrAMINE
        • ❑ 25 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 25 mg, Oral, Once, STAT, Start date: T;N
        • ❑ 50 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 50 mg, Oral, Once, STAT, Start date: T;N
      • ❑ methylPREDNISolone sodium succinate 125 mg injection
        • 125 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ predniSONE
        • 40 mg, Tab, Oral, Once, STAT, Start date: T;N
    • Pain Control
      • ❑ acetaminophen
        • ❑ 650 mg, Tab, Oral, STAT, Start date: T;N
        • ❑ 650 mg, Supp, Per rectum, Once, STAT, Start date: T;N
        • ❑ 15 mg/kg, Soln-Oral, Once, STAT, Start date: T;N
      • ❑ fentaNYL
        • ❑ 50 mcg, Injection, IV Push, Once, STAT, Start date: T;N
        • ❑ 100 mcg, Injection, IV Push, Once, STAT, Start date: T;N
      • ❑ HYDROmorphone
        • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
        • ❑ 1 mg, Syringe, IM, Once, STAT, Start date: T;N
        • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
        • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
      • ❑ ibuprofen
        • ❑ 10 mg/kg, Soln-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 800 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ ketorolac
        • ❑ 15 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 30 mg, Vial, IM, Once, STAT, Start date: T;N
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
        • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • Respiratory Treatment Orders
      • ❑ albuterol
        • 2.5 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ albuterol 0.5% inhalation solution
        • 2.5 mg, Soln-Inh, NEB, q5min, STAT, Start date: T;N, 3 dose(s)/time(s)
      • ❑ albuterol 0.083% inhalation solution
        • 5 mg, Soln-Inh, NEB, q5min, STAT, Start date: T;N, 3 dose(s)/time(s)
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • 3 mL, Soln, NEB, Once, STAT
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • 3 mL, Soln, NEB, q5min, PRN for Shortness of Breath or wheezing, 3 dose(s)/time(s)
      • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
        • 500 mcg, Soln-Inh, NEB, q5min, STAT, Start date: T;N, 3 dose(s)/time(s)
    • Sedatives
      • ❑ LORazepam
        • ❑ 1 mg, Injection, IV Push, Once, Start date: T;N
        • ❑ 2 mg, Injection, IV Push, Once, Start date: T;N
        • ❑ 1 mg, Tab, Oral, Once, STAT, Start date: T;N
        • ❑ 2 mg, Tab, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Bladder Scan.
      • T;N, Once, Stat
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Once
    • ❑ Fetal Heart Tones
      • T;N, Once, Stat
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, Once, Stat
    • ❑ Nasogastric/Orogastric Tube Insertion
      • T;N, Low Intermittent Suction, Once
    • ❑ Obtain Old ECG
      • T;N
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Temperature
      • T;N, Once, Stat, Rectal
    • ❑ Vital Signs POC
      • T;N, Once, Stat, Orthostatic Vital Signs
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED General Weakness / Syncopal Episode ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • Stat, Once, 0
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • T;N NPO
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
ED GI Bleed ANI Order Set - IMH
  • IV Solutions
    • ❑ NS
      • 1,000 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ CMP
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
ED GI Cocktail Order Set IRDL
  • Medications
    • ❑ aluminum hydroxide/magnesium hydroxide/simethicone 400 mg-400 mg-40 mg/5 mL oral suspension
      • 15 mL, Susp, Oral, Once, Start date: T;N
    • ❑ Lidocaine Viscous
      • 5 mL, Liquid, Oral, Once, Start date: T;N
ED Head Injury ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency
ED Headache Order Set IMH
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ MRI Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ LORazepam
      • 1 mg, Injection, IV Push, Once, STAT, Start date: T;N
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 1 mg, IM, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, IM, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 800 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ SUMAtriptan
      • 6 mg, Injection, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ vancomycin
      • 1 gm, IV Piggyback, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ niMODipine
      • 60 mg, Cap, Oral, Once, STAT, Start date: T;N
    • ❑ nalbuphine
      • ❑ 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ butorphanol
      • 2 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 60 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ traMADol
      • 50 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ phenytoin
      • 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 45 minute(s)
    • ❑ chloramphenicol
      • 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ diazePAM
      • ❑ 5 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ Injection, IM, Once, Start date: T;N
    • ❑ prochlorperazine
      • ❑ 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ metoclopramide
      • ❑ 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ dihydroergotamine
      • 1 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
      • ❑ 1 tab(s), Oral, Once, STAT, Start date: T;N
      • ❑ 2 tab(s), Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • ❑ 1 tab(s), Oral, Once, STAT, Start date: T;N
      • ❑ 2 tab(s), Oral, Once, STAT, Start date: T;N
    • ❑ labetalol
      • ❑ 10 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 20 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN for Chest Pain, STAT, Start date: T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Obtain consent
      • ❑ Lumbar Puncture
      • ❑ Blood Patch
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%
      • ❑ keep O2 Sat greater than or equal to 92%
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline
    • ❑ ABG Draw (Resp)
      • T;N, Once, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Hip Fracture ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ XR Hip 2-3 Views Lt w/ Pelvis
      • Emergency
    • ❑ XR Hip 2-3 Views Rt w/ Pelvis
      • Emergency
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
ED History of Seizure ANI Order Set - IMH
  • Diet
    • ❑ Diet Order
      • T;N NPO
  • Laboratory
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N
    • ❑ Dilantin Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phenobarbital Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Tegretol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
ED Hypoglycemia Order Set IRDL
  • Diet
    • ❑ Diet Order
      • ❑ T;N | Caloric, Room Service Eligible: No, Diabetic, 1800 kcal
      • ❑ T;N | Caloric, Room Service Eligible: No, Diabetic, 1600 kcal
      • ❑ T;N | Caloric, Room Service Eligible: No, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS
      • 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ D10W Bolus
      • 250 mL, IV, Once, STAT
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ NS Bolus
      • 1,000 mL, IV, Once, STAT
    • ❑ Rally Pack
      • 100 mg, IV Piggyback, Once, STAT
      • 1,000 mL
      • 10 mL
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Hgb A1C
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ dextrose 50% injection
      • 12.5 gm, Syringe, IV Push, Once, STAT
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Obtain Old ECG
      • T;N, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Once, Stat
    • ❑ Patient May Take Own Medications
      • Once, Stat
ED Hypoglycemia Treatment (Nursing) Order Set IRDL
  • Medications
    • ❑ glucose
      • 16 gm, Tab, Chewed, q15min, PRN for Low blood sugar, Routine
    • ❑ dextrose 50% injection
      • 12.5 gm, Syringe, IV Push, q15min, PRN for Blood Glucose, Routine
    • ❑ dextrose 50% injection
      • 25 gm, Syringe, IV Push, q15min, PRN for Blood Glucose, Routine
    • ❑ glucagon
      • 1 mg, Vial, Subcutaneous, q15min, PRN for Blood Glucose, Routine
    • ❑ glucagon
      • 1 mg, Vial, IM, q15min, PRN for Blood Glucose, Routine
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Stat, PRN
    • ❑ Notify Provider
      • For finger stick blood sugar less than 40 mg/dl.
ED Incision and Drainage Order Set IRDL
  • IV Solutions
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ LR Bolus
      • 1,000 mL, IV, Once, STAT
  • Laboratory
    • ❑ Culture - Wound
      • Micro Specimen, Stat collect, T;N, Nurse collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 1 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 60 mg, IM, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ I and D Tray Set Up
      • T;N, Once, Stat
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Suture Tray Set Up
      • at bedside
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Procedure / Consent
      • T;N
ED Joint Aspiration Order Set IRDL
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ C-Reactive Protein
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Sedimentation Rate
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Uric Acid
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Body Fluid Cell Count
      • Body Fluid, Stat collect, T;N, Once, Nurse collect
    • ❑ Body Fluid Crystals
      • Fluid, Stat collect, T;N, Once, Nurse collect
    • ❑ GLUCOSE, BODY FLUID
      • Body Fluid, Stat collect, T;N, Once, Nurse collect
    • ❑ PROTEIN, BODY FLUID
      • Body Fluid, Stat collect, T;N, Once, Nurse collect
    • ❑ Culture - Body Fluid
      • Body Fluid, Stat collect, T;N, Once, Nurse collect
  • Medications
    • ❑ Dilaudid
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 1 mg, Syringe, IM, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 15 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 30 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Suture Tray Set Up
      • T;N, Once, Stat, at bedside
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Moderate Sedation Per Protocol
      • T;N, Stat, Per Hospital Policy
    • ❑ Obtain consent
      • T;N
ED Laceration ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ XR Ankle 3 Views Min Lt
      • Emergency
    • ❑ XR Ankle 3 Views Min Rt
      • Emergency
    • ❑ XR Elbow Complete Left
      • Emergency
    • ❑ XR Elbow Complete Right
      • Emergency
    • ❑ XR Foot 3 Views Min Lt
      • Emergency
    • ❑ XR Foot 3 Views Min Rt
      • Emergency
    • ❑ XR Hand 3 Views Min Lt
      • Emergency
    • ❑ XR Hand 3 Views Min Rt
      • Emergency
    • ❑ XR Knee 2 Views Left
      • Emergency
    • ❑ XR Knee 2 Views Right
      • Emergency
    • ❑ XR Shoulder 3 Views Left
      • Emergency
    • ❑ XR Shoulder 3 Views Right
      • Emergency
    • ❑ XR Wrist 3 Views Min Lt
      • Emergency
    • ❑ XR Wrist 3 Views Min Rt
      • Emergency
  • Medications
    • ❑ Adacel (Tdap)
      • 0.5 mL, Susp-Inj, IM, Once, STAT
    • ❑ tetanus-diphth toxoids (Td) adult/adol
      • 0.5 mL, Susp-Inj, IM, Once, STAT
  • Patient Care
    • ❑ Suture Tray Set Up
      • at bedside with Normal Saline for irrigation and Lidocaine 1% plain
    • ❑ Wound Care
      • Cleanse wound with normal saline
    • ❑ lidocaine 1% injectable solution
      • 10 mL, Vial, Intradermal, Once, STAT
ED Lidoderm Patch & Removal Order Set IRDL
  • Medications
    • ❑ Lidoderm Patch
      • ❑ 1 patch(es), Patch, Transdermal, Daily
      • ❑ 2 patch(es), Patch, Transdermal, Daily
    • ❑ Patch/Paste Removal
      • T;2100, HS, Remove lidoderm patch q hs.
    • ❑ Lidoderm Patch
      • ❑ 1 patch(es), Patch, Transdermal, HS
      • ❑ 2 patch(es), Patch, Transdermal, HS
    • ❑ Patch/Paste Removal
      • T+1;0800, qAM, Remove lidoderm patch in the morning.
ED Major Trauma Order Set IMH
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Spine Cervical Comp w/ Obliques
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Pelvis w/Bilateral Hips
      • T;N, Emergency, Transport Mode: Portable
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Head w/ + w/o Contrast
      • T;N, Emergency
    • ❑ CT Angio Neck w/ Contrast
      • T;N, Emergency
    • ❑ CT Spine Cervical w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Maxillofacial w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ Warm IV Fluids
      • T;N, Once, Stat, PRN
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 | 1,000 mL | mL, IV | IV, STAT | STAT, Start date: T;N | T;N, 100 | 100 mL/hr | mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Ethanol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lactic Acid
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CK
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Transfuse Blood Product [IMH]
      • ❑ T;N, Once, Stat, 2 Units PRBC
      • ❑ T;N, Once, Stat, 1 Units PRBC
      • ❑ T;N, Once, Stat, Trauma Blood/ O Negative
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ ceFAZolin
      • ❑ 2 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
      • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ fentaNYL
      • 50 mcg, Injection, IV Push, Once, STAT
    • ❑ ibuprofen
      • 600 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ epinephrine-lidocaine 1:100,000-1% injectable solution
      • 10 mL, Vial, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ lidocaine 1% injectable solution
      • 10 mL, Vial, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ ketamine
      • 2 mg/kg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ etomidate
      • 0.3 mg/kg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ rocuronium
      • 1 mg/kg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ succinylcholine
      • 1.5 mg/kg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ propofol
      • 2 mg/kg, Emulsion, IV Push, Once, STAT, Start date: T;N
    • ❑ tetanus-diphth toxoids (Td) adult/adol
      • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
    • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
      • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 15 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ Let Solution
      • 3 mL, TOP, q20min, STAT, Start date: T;N, 2 dose(s)/time(s)
  • Patient Care
    • ❑ Cervical Collar
      • T;N, Once, Stat
    • ❑ Obtain consent
      • T;N, __________.
    • ❑ Insert Foley Catheter
      • T;N, Indwelling
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Apply Dressing
      • T;N, Stat
    • ❑ Wound Care
      • T;N, Stat
    • ❑ Suture Tray Set Up
      • T;N, Once, Stat
    • ❑ Warming Blanket
      • T;N, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Minor Trauma Order Set IRDL
  • Diagnostic Tests
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Cervical w/o Contrast
      • T;N, Emergency
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Clavicle Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Clavicle Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Elbow Complete Left
      • T;N, Emergency, 0
    • ❑ XR Elbow Complete Right
      • T;N, Emergency, 0
    • ❑ XR Femur 2 Views Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Femur 2 Views Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Foot 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Foot 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Forearm Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Forearm Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Hand 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Hand 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Humerus 2 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Humerus 2 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Knee 2 Views Left
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Knee 2 Views Right
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Pelvis w/Bilateral Hips
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Spine Cervical Cross-Table Lateral
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Spine Cervical Comp w/ Obliques
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Spine Lumbar 2 Views
      • T;N, Emergency
    • ❑ XR Spine Thoracic 2 Views
      • T;N, Emergency
    • ❑ XR Tibia +Fibula 2 Views Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Tibia +Fibula 2 Views Rt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Wrist 3 Views Min Lt
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Wrist 3 Views Min Rt
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
  • Laboratory
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Creatine Kinase
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Ethanol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • Antibiotics
      • ❑ ceFAZolin
        • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N
        • ❑ 2 gm, IV Piggyback, Once, STAT, Start date: T;N
    • GI Prophylaxis
      • ❑ metoclopramide
        • 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
        • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • Immunizations
      • ❑ tetanus-diphth toxoids (Td) adult/adol
        • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
      • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
        • 0.5 mL, Susp-Inj, IM, Once, STAT, Start date: T;N
    • Other Meds
      • ❑ Let Solution
        • 3 mL, TOP, q20min, STAT, Start date: T;N, 2 dose(s)/time(s)
    • Pain Control
      • ❑ HYDROmorphone
        • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
        • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ ketorolac
        • 30 mg, Vial, IV Push, Once, Start date: T;N
      • ❑ morphine
        • 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Apply Dressing
      • T;N, Stat
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Cervical Collar
      • T;N, Once, Stat
    • ❑ Consent Procedure ED
      • T;N, Stat, Incision and Drainage
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Manual Irrigation
      • T;N, Stat, Wound: ____________________
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Remove Ring with Ring Cutter
      • T;N
    • ❑ Steri-Strip Application
      • T;N, Stat, To wound (location) ____________
    • ❑ Suture Tray Set Up
      • T;N, Once, Stat
    • ❑ Wound Care
      • T;N, Stat
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula, Stat
      • ❑ T;N, 3 L, Nasal Cannula, Stat
      • ❑ T;N, 4 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Stat, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED New Onset Seizure ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • T;N, Stat, Once, 0
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, 0
  • Diet
    • ❑ Diet Order
      • T;N NPO
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insert
      • T;N
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Orthopedic / Wounds / Dressings Order Set IRDL
  • Medications
    • ❑ acetaminophen-codeine #3
      • ❑ 1 tab(s), Tab, Oral, Once, Start date: T;N
      • ❑ 2 tab(s), Tab, Oral, Once, STAT, Start date: T;N
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 60 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IM, Once, STAT, Start date: T;N
      • ❑ 4 mg, Syringe, IM, Once, STAT, Start date: T;N
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ LORazepam
      • 1 mg, Injection, IV Push, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 800 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen-hydrocodone 325mg-7.5mg/15ml oral solution
      • ❑ 15 mL, Soln-Oral, Oral, Once, Start date: T;N
      • ❑ 7.5 mL, Soln-Oral, Oral, Once, Start date: T;N
    • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
      • ❑ 1 tab(s), Tab, Oral, STAT, Start date: T;N
      • ❑ 2 tab(s), Tab, Oral, STAT, Start date: T;N
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • ❑ 1 tab(s), Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 2 tab(s), Tab, Oral, Once, STAT, Start date: T;N
    • ❑ silver sulfADIAZINE 1% topical cream
      • 1 app, Cream, TOP, Once, Start date: T;N
    • ❑ Let Solution
      • 3 mL, TOP, q20min, STAT, Start date: T;N, 2 dose(s)/time(s)
    • ❑ tetanus-diphth toxoids (Td) adult/adol
      • 0.5 mL, Susp-Inj, IM, Once, Start date: T;N
    • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
      • 0.5 mL, Susp-Inj, IM, Once, Start date: T;N
  • Patient Care
    • ❑ Moderate Sedation Per Protocol
      • T;N, Once, Stat, Pull packet, complete packet, and monitor patient per policy.
    • ❑ Obtain consent
      • ❑ T;N, Incision and Drainage
      • ❑ T;N, Procedure: _____________
    • ❑ Buddy Tape
      • T;N, Once, Stat, Location: _________________
    • ❑ Clavicle Strap
      • ❑ T;N, Once, Stat, Right
      • ❑ T;N, Once, Stat, Left
    • ❑ Finger Splint Application
      • T;N, Once, Stat, Location: _________________
    • ❑ Knee Immobilizer
      • ❑ T;N, Once, Stat, Right Knee
      • ❑ T;N, Once, Stat, Left Knee
    • ❑ Sling Arm
      • ❑ T;N, Once, Stat, Right Arm
      • ❑ T;N, Once, Stat, Left Arm
    • ❑ Cervical Collar
      • T;N, Once, Stat, Soft Collar
    • ❑ Thumb Spicas
      • ❑ T;N, Once, Stat, Right Thumb
      • ❑ T;N, Once, Stat, Left Thumb
    • ❑ Shoulder Immobilizer Apply
      • ❑ T;N, Once, Stat, Right Arm
      • ❑ T;N, Once, Stat, Left Arm
    • ❑ Cast Shoe
      • ❑ T;N, Once, Stat, Right Foot
      • ❑ T;N, Once, Stat, Left Foot
    • ❑ Walker
      • T;N, Once, Stat
    • ❑ Suture Tray Set Up
      • T;N, Once, Stat
    • ❑ Steri-Strips
      • T;N, Once, Stat
    • ❑ Suture Removal Procedure
      • T;N, Once, Stat
    • ❑ Staple Removal
      • T;N, Once, Stat
    • ❑ Ice Pack
      • T;N, Once, Stat
    • ❑ Ring Removal
      • T;N, Once, Stat
    • ❑ Elevate Affected Extremity
      • T;N, Once, Stat
    • ❑ Apply Dressing
      • T;N, Once, Stat, Location: ________________
    • ❑ Air Cast Care
      • ❑ T;N, Once, Right Ankle
      • ❑ T;N, Once, Left Ankle
    • ❑ Philadelphia Collar
      • T;N, Once, Stat
    • ❑ Wrist Splint
      • ❑ T;N, Once, Stat, Right Wrist
      • ❑ T;N, Once, Stat, Left Wrist
    • ❑ Irrigate Wound
      • T;N, Once, Stat, Manually
    • ❑ Dorsal Splint
      • ❑ T;N, Once, Stat; Right Wrist
      • ❑ T;N, Once, Stat; Left Wrist
    • ❑ Volar Cock Up Splint
      • ❑ T;N, Once, Stat, Right Wrist
      • ❑ T;N, Once, Stat, Left Wrist
    • ❑ Ulnar Gutter Boxer Splint
      • ❑ T;N, Once, Stat, Right Hand
      • ❑ T;N, Once, Stat, Left Hand
    • ❑ Sugar Tong Arm Splint
      • ❑ T;N, Once, Stat, Right Arm
      • ❑ T;N, Once, Stat, Left Arm
    • ❑ Posterior Stirrup Splint
      • ❑ T;N, Once, Stat, Right Leg
      • ❑ T;N, Once, Stat, Left Leg
    • ❑ Sugar Tong Leg Splint
      • ❑ T;N, Once, Stat, Right Leg
      • ❑ T;N, Once, Stat, Left Leg
    • ❑ Jones Dressing
      • T;N, Once, Stat, Location: ________________
    • ❑ Crutches
      • T;N, Once, Stat
    • ❑ Syn Cast
      • ❑ T;N, Once, Stat, Right Arm
      • ❑ T;N, Once, Stat, Left Arm
      • ❑ T;N, Once, Stat, Right Leg
      • ❑ T;N, Once, Stat, Left Leg
    • ❑ LiquiBand at Bedside
      • T;N, Once, Stat
ED Overdose ANI Order Set - IMH
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • Stat, Once
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Acetaminophen Level
      • Blood, Stat collect, T;N
    • ❑ Salicylate Level
      • Blood, Stat collect, T;N
    • ❑ Alcohol Level
      • Blood, Stat collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Saline Lock Insert
      • T;N, Stat
ED Pediatric Illness Order Set IRDL
  • Diagnostic Tests
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Abdomen 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Abdomen Series
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Once, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 500 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 500 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 500 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • 20 mL/kg, IV, Once, STAT, Start date: T;N
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 500 mL, IV, STAT, 100 mL/hr
      • ❑ 500 mL, IV, STAT, 50 mL/hr
      • ❑ 500 mL, IV, STAT, 10 mL/hr
      • ❑ 20 mL/kg, IV, STAT, 2 dose(s)/time(s), BOLUS
    • ❑ Dextrose 5% with 0.2% NaCl
      • 20 mL/kg, IV, STAT, 2 dose(s)/time(s), BOLUS
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N, Nurse collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • Antibiotics
      • ❑ amoxicillin
        • ❑ 30 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 250 mg, Cap, Oral, Once, STAT, Start date: T;N
      • ❑ ampicillin pediatric
        • ❑ 100 mg/kg, IV Push, Once, STAT, Start date: T;N
        • ❑ 50 mg/kg, IV Push, Once, STAT, Start date: T;N
        • ❑ mg, IV Push, Once, STAT, Start date: T;N
      • ❑ azithromycin
        • ❑ 10 mg/kg, Susp-Oral, Oral, STAT, Start date: T;N
        • ❑ 250 mg, Tab, Oral, Once, STAT, Start date: T;N
        • ❑ 500 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ cefprozil
        • ❑ 7.5 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 3.75 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 250 mg, Tab, Oral, Once, STAT, Start date: T;N
        • ❑ 15 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
      • ❑ cefTRIAXone
        • ❑ 50 mg/kg, IV Piggyback, Once, STAT, Start date: T;N
        • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N
      • ❑ clarithromycin
        • ❑ 7.5 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 500 mg, Tab, Oral, Once, STAT, Start date: T;N
        • ❑ 10 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
      • ❑ gentamicin pediatric
        • ❑ 2.5 mg/kg, IV Push, Once, STAT, Start date: T;N
        • ❑ 8 mg, IV Push, Once, STAT, Start date: T;N
        • ❑ 12 mg, IV Push, Once, STAT, Start date: T;N
    • GI Prophylaxis
      • ❑ ondansetron
        • ❑ 2 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
        • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
        • ❑ 8 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
        • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 8 mg, Vial, IV Push, Once, STAT, Start date: T;N
        • ❑ 0.1 mg/kg, Vial, IV Piggyback, Once, STAT, Start date: T;N
      • ❑ metoclopramide
        • 10 mg, IV Push, Once, STAT, Start date: T;N
    • Other Meds
      • ❑ dexamethasone
        • ❑ 0.6 mg/kg, Oral, Once, STAT, Start date: T;N
        • ❑ 0.6 mg/kg, IV Piggyback, Once, STAT, Start date: T;N
        • ❑ 0.15 mg/kg, IV Piggyback, Once, STAT, Start date: T;N
      • ❑ prednisoLONE
        • ❑ 2 mg/kg, Soln-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 1 mg/kg, Soln-Oral, Oral, Once, STAT, Start date: T;N
    • Pain Control
      • ❑ acetaminophen
        • ❑ 15 mg/kg, Soln-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 325 mg, Supp, Per rectum, Once, STAT, Start date: T;N
      • ❑ ibuprofen
        • ❑ 10 mg/kg, Susp-Oral, Oral, Once, STAT, Start date: T;N
        • ❑ 200 mg, Tab, Oral, Once, STAT, Start date: T;N
    • Respiratory Treatment Orders
      • ❑ albuterol 0.5% inhalation solution
        • ❑ 1.25 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
        • ❑ 2.5 mg, Soln-Inh, NEB, q20min, STAT, Start date: T;N
      • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
        • ❑ 0.25 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
        • ❑ 0.5 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ levalbuterol
        • ❑ 0.31 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
        • ❑ 0.63 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, Stat
    • ❑ Seizure Precautions
      • T;N
    • ❑ Precautions
      • T;N, Stat; Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Bi-level Positive Airway Pressure
      • T;N, Stat, Per Respiratory Therapy
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Pediatric Major Trauma Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ XR Spine Cervical Comp w/ Obliques
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Pelvis w/Bilateral Hips
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Maxillofacial w/ + w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Cervical w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Cervical w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Thoracic w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Spine Lumbar w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ Warm IV Fluids
      • T;N, Once, Stat
    • ❑ Nursing Communication
      • T;N, Maintance dose 10mL/kg
    • ❑ NS
      • ❑ 500 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 500 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 500 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • 20 mL/kg, IV, Once, STAT, Start date: T;N
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 500 mL, IV, STAT, 100 mL/hr
      • ❑ 500 mL, IV, STAT, 50 mL/hr
      • ❑ 500 mL, IV, STAT, 10 mL/hr
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lactate
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Amylase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Transfuse Blood Product [IMH]
      • ❑ T;N, Stat, 2 Units PRBC
      • ❑ T;N, Stat, 1 Units PRBC
      • ❑ T;N, Stat, Trauma Blood/ O Negative
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ ceFAZolin
      • 30 mg/kg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ clindamycin
      • ❑ 10 mg/kg, IV Piggyback, Once, Start date: T;N, Infuse over 30 minute(s)
      • ❑ 5 mg/kg, IV Piggyback, Once, Start date: T;N, Infuse over 30 minute(s)
    • ❑ metroNIDAZOLE
      • 10 mg/kg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 60 minute(s)
    • ❑ gentamicin
      • 2.5 mg/kg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ cefTRIAXone
      • ❑ 50 mg/kg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
      • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ LORazepam
      • 0.05 mg/kg, Injection, IV Push, Once, STAT, Start date: T;N
    • ❑ fentaNYL
      • 1 mcg/kg, IV Push, Once, STAT, Start date: T;N
    • ❑ morphine
      • ❑ 0.05 mg/kg, IV Push, Once, STAT, Start date: T;N
      • ❑ 0.1 mg/kg, IV Push, Once, STAT, Start date: T;N
    • ❑ ondansetron
      • ❑ 2 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 8 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 8 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 0.1 mg/kg, Vial, IV Piggyback, Once, STAT, Start date: T;N
    • ❑ metoclopramide
      • ❑ 5 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ prochlorperazine
      • 0.1 mg/kg, IV Push, Once, STAT, Start date: T;N
    • ❑ Nursing Communication
      • Vaccine Consent must be signed before administering Tetanus -diptheria toxoids.
    • ❑ tetanus-diphth toxoids (Td) adult/adol
      • 0.5 mL, Susp-Inj, IM, Once, Start date: T;N
    • ❑ tetanus/diphth/pertussis (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL intramuscular suspension
      • 0.5 mL, Susp-Inj, IM, Once, Start date: T;N
    • ❑ diazePAM
      • 0.1 mg/kg, IV Push, Once, STAT, Start date: T;N
    • ❑ midazolam
      • ❑ 0.1 mg/kg, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Cervical Collar
      • T;N, Once, Stat
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Obtain Old ECG
      • T;N, Stat; Once
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Apply Dressing
      • T;N, Stat, _____________________
    • ❑ Wound Care
      • T;N, Stat, ________________
    • ❑ Suture Tray Set Up
      • T;N, Once, Stat
    • ❑ Warming Blanket
      • T;N, Once, Stat
    • ❑ Skin Stapler Set Up
      • T;N, Once, Stat
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Pharyngitis Order Set IRDL
  • Diagnostic Tests
    • ❑ CT Soft Tissue Neck w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Transport Mode: Portable
    • ❑ XR Neck Soft Tissue
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Group A Strep Rapid Test PCR
      • Throat, Stat collect, T;N, Nurse collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect, see comments
    • ❑ Mononucleosis Screen
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ dexamethasone
      • 10 mg, Oral, Once, STAT, Start date: T;N
    • ❑ ibuprofen
      • 600 mg, Tab, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precaution
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
ED Psych / Substance Abuse Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • Diet
    • ❑ Diet Order
      • Regular, Disposable dishes, Safety Precautions
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Rally Pack
      • 10 mL
      • 100 mg, IV Piggyback, Once, STAT, 999 mL/hr
      • 1,000 mL
  • Laboratory
    • ❑ Tylenol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Ethanol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Aspirin Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Acetone Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Ammonia Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Tegretol Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Creatine Kinase
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lactate
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phenobarbital Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Dilantin Level
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • Sedatives
      • ❑ LORazepam
        • ❑ 2 mg, Injection, IV Push, Once, STAT, Start date: T;N
        • ❑ 2 mg, Tab, Oral, Once, STAT, Start date: T;N
        • ❑ 2 mg, Injection, IM, Once, STAT, Start date: T;N
      • ❑ cloNIDine
        • 0.2 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ ziprasidone
        • ❑ 20 mg, Powder-Inj, IM, q4hr, STAT, Start date: T;N, 2 dose(s)/time(s)
        • ❑ 10 mg, Powder-Inj, IM, q2hr, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ haloperidol
        • ❑ 5 mg, Injection, IV Push, Once, STAT, Start date: T;N
        • ❑ 5 mg, Injection, IM, Once, STAT, Start date: T;N
        • ❑ 10 mg, Injection, IM, Once, STAT, Start date: T;N
      • ❑ diazePAM
        • 10 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ folic acid
      • 1 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ famotidine
      • 20 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ prochlorperazine
      • 5 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ metoclopramide
      • 10 mg, Vial, IV Push, Once, STAT
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ Actidose with Sorbitol
      • 50 gm, Susp-Oral, Oral, Once, STAT, Start date: T;N
    • ❑ charcoal
      • ❑ 1 gm/kg, Oral, Once, STAT, Start date: T;N
      • ❑ 25 mg, Oral, Once, STAT, Start date: T;N
    • ❑ naloxone
      • 0.4 mg, Vial, IV Push, q3min, PRN for Other (see comment), STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Suicide Precautions
      • per policy
    • ❑ Nasogastric/Orogastric Tube Insertion
      • Other See Special Instructions, Lavage till clear
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, Once, Stat, Per hospital insertion criteria
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
    • ❑ Nursing Communication Order
      • ❑ Obtain Involuntary Committment Paperwork
      • ❑ Obtain Voluntary Committment Paperwork
  • Respiratory
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Psychiatric Patients / IVC's ANI Order Set - IMH
  • Laboratory
    • ❑ Tegretol Level
      • Blood, Stat collect, T;N
    • ❑ Lithium Level
      • Blood, Stat collect, T;N
    • ❑ Dilantin Level
      • Blood, Stat collect, T;N
    • ❑ Theophylline Level
      • Blood, Stat collect, T;N
    • ❑ TSH
      • Blood, Stat collect, T;N
    • ❑ Depakote Level
      • Blood, Stat collect, T;N
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ Tylenol Level
      • Blood, Stat collect, T;N
    • ❑ Aspirin Level
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
    • ❑ Ethanol Level
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Nursing Communication Order
      • Clear Room, 1:1 Sitter, Wand Patients (Security to complete), remove clothing, and gather belongings
ED Respiratory Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Once, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ NM Pulmonary Ventilation/Perfusion
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Left
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Right
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ US LE Venous Duplex Bilateral
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Head or Brain w/o Contrast
      • T;N, Emergency, Once, Transport Mode: Stretcher
    • ❑ CT Angio Pulmonary
      • T;N, Emergency, Transport Mode: Stretcher
    • ❑ CT Angio Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 50 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ NT-proBNP
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Beta hCG Quant.
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ albuterol 90 mcg/inh inhalation
      • 2 puff(s), Aerosol, INH, Once, PRN for Wheezing, STAT, Start date: T;N
    • ❑ albuterol 0.5% inhalation solution
      • ❑ 2.5 mg, Soln-Inh, NEB, q1min, PRN for Wheezing, STAT, Start date: T;N, 3 dose(s)/time(s)
      • ❑ 2.5 mg, Soln-Inh, NEB, q1min, PRN for Wheezing, STAT, Start date: T;N, 2 dose(s)/time(s)
    • ❑ albuterol 0.083% inhalation solution
      • 2.5 mg, Soln-Inh, NEB, q1min, PRN for Wheezing, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • 3 mL, Soln, NEB, q1min, PRN for Wheezing, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ Atrovent HFA
      • 2 puff(s), Aerosol, INH, Once, STAT, Start date: T;N
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • 500 mcg, Soln-Inh, NEB, q1hr, PRN for Shortness of Breath or wheezing, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ ibuprofen
      • 800 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ furosemide
      • ❑ 80 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 60 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 40 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ enoxaparin
      • 1 mg/kg, Syringe, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ nitroglycerin 50 mg/250 mL-D5W IV Sol
      • 250 mL, IV, STAT, Start date: T;N, See Comments
      • 50 mg
    • ❑ nitroglycerin 2% topical ointment
      • 1 in, Ointment, TOP, Once, Start date: T;N
    • ❑ methylPREDNISolone sodium succinate 125 mg injection
      • 125 mg, IV Push, Once, STAT, Start date: T;N
    • ❑ levalbuterol
      • ❑ 0.63 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ 1.25 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
    • ❑ dexamethasone
      • ❑ 10 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 10 mg, Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ predniSONE
      • ❑ 40 mg, Tab, Oral, Once, STAT, Start date: T;N
      • ❑ 60 mg, Tab, Oral, Once, STAT, Start date: T;N
    • ❑ guaiFENesin
      • 200 mg, Syrup, Oral, Once, STAT, Start date: T;N
    • ❑ acetaminophen-hydrocodone 325mg-7.5mg/15ml oral solution
      • 15 mL, Soln-Oral, Oral, Once, STAT, Start date: T;N
    • ❑ magnesium sulfate
      • 2 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ morphine
      • 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Obtain Old ECG
      • T;N, Stat; Once
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, per hospital insertion criteria
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Pulse Oximetry POC
      • T;N, Stat, PRN
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ Bi-level Positive Airway Pressure
      • ❑ per Respiratory therapy
      • ❑ Mode: BiPAP, HS
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Patient May Go To Procedure Off Cardiac Monitor
      • T;N, Stat
ED Rhogam Full Dose Order Set
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Rhogam Injection Full Dose
      • Blood
  • Medications
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once
ED Rhogam Mini Dose Order Set
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Rhogam Mini Dose (fee for injection)
      • Blood
  • Medications
    • ❑ RHo (D) immune globulin 50 mcg intramuscular solution
      • 50 mcg, Soln, IM, Once
ED Sepsis ANI Order Set - IMH
  • Communication
    • ❑ Notify Provider Vital Signs
      • Notify provider after IVF bolus if patient has a decrease in BP by 40 points, SBP less than 90, MAP less than 65 or lactate level is above 4. If fluid bolus ineffective; discuss administration of vasopressor.
    • ❑ Nursing Communication Order
      • Start antibiotics ASAP
    • ❑ Nursing Communication
      • T;N, Use Sepsis Checklist
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
  • IV Solutions
    • ❑ NS Bolus
      • ❑ 30 mL/kg, IV, Once, STAT
      • ❑ 1,000 mL, IV, Once, STAT
    • ❑ LR Bolus
      • ❑ 30 mL/kg, IV, Once, STAT
      • ❑ 1,000 mL, IV, Once, STAT
  • Laboratory
    • ❑ Procalcitonin
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Urine Culture
      • Urine, Stat collect, T;N
  • Patient Care
    • ❑ Peripheral IV Insertion
      • T;N, Initiate large bore IV
    • ❑ Sepsis Severity Identification Order
      • Neither, Source Unclear, T;N
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Sepsis Order Set IMH
  • Consults
    • ❑ Core Measure Specialist Communication
      • T;N, Sepsis
  • Diagnostic Tests
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ ED US TTE Limited
      • T;N, Emergency, Once
    • ❑ CT Abdomen/Pelvis w/ Contrast
      • T;N, Emergency, Once
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • T;N, Emergency, Once
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable, 0
    • ❑ XR Chest 2 Views
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ NS Bolus
      • ❑ 30 mL/kg, IV, Once, STAT
      • ❑ 1,000 mL, IV, Once, STAT
    • ❑ LR Bolus
      • ❑ 30 mL/kg, IV, Once, STAT
      • ❑ 1,000 mL, IV, Once, STAT
  • Laboratory
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Procalcitonin
      • Blood, Stat collect, T;N
    • ❑ SARS-CoV-2 (COVID-19) Antigen
      • Nasopharyngeal Swab, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N
    • ❑ Culture - Wound
      • Micro Specimen, Stat collect, T;N
  • Medications
    • Other Meds
      • ❑ Tylenol
        • ❑ 650 mg, Tab, Oral, Once, STAT
        • ❑ 325 mg, Tab, Oral, Once, STAT
        • ❑ 650 mg, Supp, Per rectum, Once, STAT
        • ❑ 325 mg, Supp, Per rectum, Once, STAT
    • Vasopressor Therapy
      • ❑ norepinephrine 4 mg/250 mL
        • 4 mg
        • 250 mL, IV, Routine, See Comments
      • ❑ Vasopressin 20 units/NS 100 mL Premix
        • 100 mL, IV, Routine, 9 mL/hr
        • 20 unit(s)
  • Patient Care
    • ❑ Blood Glucose POC
      • T;N, Once, Stat
    • ❑ Insert Foley Catheter
      • T;N, Indwelling
    • ❑ I&O POC
      • T;N, q1hr
    • ❑ Peripheral IV Insertion
      • T;N, Initiate large bore IV
    • ❑ Notify Provider Vital Signs
      • T;N, Notify provider after IVF bolus if patient has a decrease in BP by 40 points, SBP less than 90, MAP less than 65 or lactate level is above 4. If fluid bolus ineffective; discuss administration of vasopressor.
    • ❑ Nursing Communication
      • T;N, Use Sepsis Checklist
    • ❑ Sepsis Severity Identification Order
      • Neither, Source Unclear, T;N
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula, Stat
      • ❑ T;N, 3 L, Nasal Cannula, Stat
      • ❑ T;N, 4 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Stat, Humidified
    • ❑ Oxygen Titrate
      • ❑ T;N, Stat, 94
      • ❑ T;N, Stat, 93
      • ❑ T;N, Stat, 92
      • ❑ T;N, Stat, 91
      • ❑ T;N, Stat, 90
      • ❑ T;N, Stat, 89
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Cardiac Monitoring.
      • T;N, Stat
    • ❑ Vital Signs POC
      • T;N, Stat, Q30min
ED Sickle Cell ANI Order Set - IMH
  • Consults
    • ❑ Consult to Pain Management
      • T;N, Pain Management
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Reticulocyte Count
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
  • Respiratory
    • ❑ Oxygen Therapy
      • T;N, 2 L, Nasal Cannula, Stat
ED Sickle Cell Crisis Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
    • ❑ CT Chest w/ Contrast
      • T;N, Emergency, Transport Mode: Stretcher
  • IV Solutions
    • ❑ KCl 20 mEq in D5-1/4 NS 1000 mL Premix
      • 1,000 mL, IV, STAT, mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Lipase Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Reticulocyte Count
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
  • Medications
    • ❑ aztreonam
      • 2 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ Benadryl
      • 50 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ morphine
      • 2 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ ketorolac
      • ❑ 30 mg, Vial, IV Push, Once, STAT, Start date: T;N
      • ❑ 60 mg, Vial, IM, Once, STAT, Start date: T;N
    • ❑ Unasyn
      • 3 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ vancomycin
      • 1 gm, IV Piggyback, Once, STAT, Start date: T;N
    • ❑ Zithromax
      • 500 mg, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 60 minute(s)
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, Once, STAT, Start date: T;N
      • ❑ 4 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ Zosyn
      • 4.5 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
    • ❑ prochlorperazine
      • 10 mg, Vial, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat, Once
    • ❑ Obtain Old ECG
      • T;N, Once, Stat
    • ❑ Saline Lock Insertion
      • T;N, Stat
    • ❑ Access Port-a-Cath
      • T;N, Stat
    • ❑ Blood Glucose POC
      • T;N, Stat
    • ❑ Precautions
      • T;N, Constant Order, Fall precautions
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula, Stat
      • ❑ T;N, 3 L, Nasal Cannula, Stat
      • ❑ T;N, 4 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Stat, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Stat, Humidified
    • ❑ Oxygen Titrate
      • ❑ T;N, Stat, keep O2 Sat greater than or equal to 94%.
      • ❑ T;N, Stat, keep O2 Sat greater than or equal to 92%.
      • ❑ T;N, Stat, keep O2 Sat greater than or equal to 91%
      • ❑ T;N, Stat, keep O2 Sat greater than or equal to 90%
      • ❑ T;N, Stat, keep O2 Sat greater than or equal to 89%
      • ❑ T;N, Stat, keep O2 Sat greater than or equal patients baseline.
ED STEMI Order Set IRDL
  • Communication
    • ❑ Nursing Communication Order
      • Call Switchboard operator to initiate Medical Alert Code STEMI blast page
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
  • IV Solutions
    • ❑ NS
      • 1,000 mL, IV, STAT, 10 mL/hr
    • ❑ Angiomax 250 mg/50 mL
      • 50 mL, IV, STAT, Start date: T;N, Per Protocol
      • 250 mg
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ aspirin
      • 324 mg, Tab-Chew, Oral, Once, STAT, Start date: T;N
    • ❑ Benadryl
      • 25 mg, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ SoluMEDROL
      • 125 mg, Vial, IV Push, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ ECG 12 lead
      • T;N, Stat
    • ❑ Saline Lock Insertion
      • T;N, Once, Stat
    • ❑ Nursing Communication Order
      • Place / position defibrillator pads on patient.
  • Respiratory
    • ❑ Oxygen Titrate
      • 0.9
  • Vital Signs
    • ❑ Cardiac Monitoring.
ED Tenecteplase (TNKase) for STEMI Order Set IRDL
  • Diagnostic Tests
    • ❑ XR Chest 1 View Frontal
      • T;N, Stat, Transport Mode: Portable, 0
  • IV Solutions
    • ❑ NS
      • 500 mL, IV, STAT, Start date: T;N, 10 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Chem 12
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Urine Pregnancy Test (Qual)
      • Urine, Stat collect, T;N
  • Medications
    • ❑ aspirin
      • 324 mg, Tab-Chew, Chewed, Once, STAT, Start date: T;N
    • ❑ TNKase Per Protocol
      • Per Protocol, Vial, IV Push, Once, STAT, Start date: T;N
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Per Protocol
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N
    • ❑ Communication Order
      • T;N, Nursing to Order Heparin Anti-Xa 4 hours after TNKase bolus dose (if heparin administered).
    • ❑ Lovenox
      • 30 mg, Syringe, IV Push, Once, STAT, Start date: T;N
    • ❑ Lovenox
      • 1 mg/kg, Syringe, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ Lovenox
      • 0.75 mg/kg, Syringe, Subcutaneous, Once, STAT, Start date: T;N
    • ❑ clopidogrel
      • 300 mg, Tab, Oral, Once
    • ❑ clopidogrel
      • 75 mg, Tab, Oral, Daily
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once
      • ❑ 4 mg, Syringe, IV Push, Once
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain, STAT, Start date: T;N, 3 dose(s)/time(s)
    • ❑ nitroglycerin 2% topical ointment
      • ❑ 1 in, Ointment, TOP, Once, STAT, Start date: T;N
      • ❑ 0.5 in, Ointment, TOP, Once, STAT, Start date: T;N
    • ❑ nitroglycerin 50 mg/250 mL-D5W IV Sol
      • 250 mL, IV, STAT, Start date: T;N, See Comments
      • 50 mg
  • Patient Care
    • ❑ Notify Provider
      • If patient has received an anticoagulant within the last 24 hours.
    • ❑ ECG 12 lead
      • T;N, Stat
  • Vital Signs
    • ❑ Vital Signs POC
      • q 1 hour x 2 hours, then per unit protocol
    • ❑ Height & Weight POC
      • Stat
    • ❑ Pulse Oximetry Continuous
      • T;N
    • ❑ Cardiac Monitoring.
      • T;N, Constant order
ED To Go Packs Order Set IRDL
  • Medications
    • Gastrointestinal Agents
      • ❑ ED To Go Pack Ondansetron ODT 4 mg #4 (Zofran ODT)
        • T;N, Once, Stat, Give as To Go Pack
      • ❑ ED To Go Pack Promethazine HCL 25 mg tablet #4 (Phenergan)
        • T;N, Once, Stat, Give as To Go Pack
    • Pain Control
      • ❑ ED To Go Pack Cyclobenzaprine 5mg tablet #6 (Flexeril)
        • T;N, Once, Stat, Give as To Go Pack
      • ❑ ED To Go Pack Hydrocodone 5 mg / APAP 325mg #4 (Lortab 5)
        • T;N, Once, Stat, Give as To Go Pack
      • ❑ ED To Go Pack Tramadol 50 mg Tabs #4 (Ultram)
        • T;N, Once, Stat, Give as To Go Pack
      • ❑ ED To Go Pack oxycodone/APAP 5/325 #4 (Percocet-5)
        • T;N, Once, Stat, Give as To Go Pack
    • Respiratory Medication
      • ❑ ED To Go Pack albuterol inhaler 8 gm
        • T;N, Once, Stat, Give as To Go Pack
ED Ventilator Order Set IRDL
  • Activity
    • ❑ Head of Bed up
      • T;N, 30-45 degrees unless contraindicated
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Emergency, Transport Mode: Portable
  • IV Solutions
    • ❑ RASS
      • q1hr
    • ❑ Propofol 1000 mg/100 mL drip
      • 100 mL, IV, Routine, See Comments
      • 1,000 mg
    • ❑ Triglycerides
      • Blood, Stat collect
    • ❑ Precedex 400 mcg-NS 100 mL IV PM
    • ❑ Versed
      • 2 mg, IV Push, q15min, PRN Other (see comment)
    • ❑ Versed Drip
      • 100 mL, IV, Routine, See Comments
      • 100 mg
    • ❑ BMP
      • Blood, Stat collect, T;N
    • ❑ Ativan
      • 2 mg, Injection, IV Push, q15min, PRN Agitation
    • ❑ morphine
      • 2 mg, Syringe, IV Push, q15min, PRN Pain
    • ❑ Fentanyl Drip ED
      • 1,000 mcg
      • 100 mL, IV, Routine, See Comments
  • Laboratory
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N, Nurse collect
  • Patient Care
    • ❑ Suction Patient
      • PRN, As condition indicates.
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Ventilator Settings
      • ❑ AC, VC (Volume Control)
      • ❑ AC, PC (Pressure Control)
      • ❑ SIMV/IMV, VC (Volume Control)
      • ❑ SIMV/IMV, PC (Pressure Control)
    • ❑ Consult to Respiratory Therapy
      • Place patient on ventilator settings dictated by patient's condition and / or physician's order.
    • ❑ Nursing Communication Order
      • May order ABG's PRN.
    • ❑ ABG Draw (Resp)
      • T;N, Once, Stat, 30 minutes after being placed on ventilator
ED Vomiting (Severe) ANI Order Set - IMH
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Lipase Level
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
  • Medications
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q30min, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 4 mg, Vial, IV Push, q30min, STAT, Start date: T;N, 2 dose(s)/time(s)
      • ❑ 4 mg, Vial, IM, q30min, STAT, Start date: T;N, 2 dose(s)/time(s)
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
ED Warfarin Patients with Active Bleeding ANI Order Set - IMH
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
  • Patient Care
    • ❑ Saline Lock Insert
      • T;N
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N, Stat
ED Weight Based Heparin Protocol Order Set IRDL
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ heparin
      • 80 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 250 mL, IV, STAT, Start date: T;N, Per DVT/PE Protocol
      • 25,000 unit(s)
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, STAT, Start date: T;N, Per ACS Protocol
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once, STAT, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Per Thrombolytic/GP IIb/IIIa Protocol
  • Patient Care
    • ❑ Notify Provider
      • See Comments
Electrolyte Imbalance Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Electrolyte Imbalance Plan of Care
End of Life Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review End of Life Plan of Care
ENDO - Endoscopy Pre-Procedure Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ ENDO - Upper Endoscopy with Moderate Sedation
      • At bedside with Anesthesia
    • ❑ ENDO - Flexible Sigmoid/Proctoscopy in ENDO
      • At bedside with Anesthesia
    • ❑ ENDO - Flexible Sigmoid/Proctoscopy in ENDO
      • No Sedation
    • ❑ ENDO - Small Enteroscopy with Moderate Sedation
      • At bedside with Anesthesia
  • Condition
    • ❑ Procedure / Consent
      • Indicated endoscopy procedure
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, After Midnight
      • ❑ T+1;0001 NPO, Room Service Eligible: No, NPO after midnight except medications with sip of water
  • Medications
    • ❑ hyoscyamine
      • 0.125 mg, Soln-Oral, Sublingual, On Call, PRN Other (see comment)
    • ❑ Topex
      • 3 spray(s), Spray, Oral, On Call
    • ❑ Lidocaine Viscous
      • 20 mL, Liquid, Oral, On Call
    • ❑ Benadryl
      • 50 mg, Soln-Oral, Oral, On Call, PRN Other (see comment)
    • ❑ Botox
      • 100 unit(s), ENDO, Once
    • ❑ Nursing Communication Order
      • Give any heart, blood pressure, breathing, and / or seizure medications prior to Endoscopy procedure with a sip of water.
    • ❑ Nursing Communication Order
      • ENDO Pre-Procedure: If patient is on insulin, ask MD about insulin adjustment. If patient taking anticoagulants ask MD if it should be held.
    • ❑ Hold Med
      • Hold AM insulin dose prior to procedure.
    • ❑ Hold Med
      • Hold any oral hypoglycemic agents day of procedure.
    • ❑ erythromycin
      • 250 mg, IV Piggyback, On Call
  • Patient Care
    • ❑ Enema Administration
      • Tap Water Enemas Until Clear
  • Special
    • ❑ NS
      • 500 mL, IV, Start date: T+1;0600, 30 mL/hr
ENDO - Peg Tube Replacement Order Set - IMH
  • Patient Care
    • ❑ Low Profile Gastrostomy Tube
      • ❑ Size 12 French
      • ❑ Size 14 French
      • ❑ Size 16 French
      • ❑ Size 18 French
      • ❑ Size 20 French
      • ❑ Size 24 French
      • ❑ Other: ________
    • ❑ Low Profile Gastrostomy Tube
      • ❑ 1.0 cm
      • ❑ 1.5 cm
      • ❑ 2.0 cm
      • ❑ 2.5 cm
      • ❑ 3.0 cm
      • ❑ 3.5 cm
      • ❑ 4.0 cm
      • ❑ Other: _____________
    • ❑ Standard Balloon Gastrostomy Tube
      • ❑ Size 14 French
      • ❑ Size 16 French
      • ❑ Size 18 French
      • ❑ Size 20 French
      • ❑ Size 22 French
      • ❑ Size 24 French
      • ❑ Size 28 French
      • ❑ Size 30 French
      • ❑ Other: ____________
    • ❑ Nursing Communication
      • **ENDO STAFF ONLY** to replace/insert tube into established PEG tract. Initial PEG must be replaced by GI Provider.
ENDO - Post-Procedure Bronchoscopy Order Set - IMH
  • Diet
    • ❑ Diet Order
      • NPO, Room Service Eligible: Yes, for 1 1/2 hours, then resume previous diet.
  • Laboratory
    • ❑ Culture Bronch Wash
      • Bronchial Wash, Routine collect, T;N
    • ❑ AFB Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ Fungus Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ KOH Test
      • Micro Specimen, Routine collect, T;N
    • ❑ Nursing Communication Order
      • Cytology Needed - Complete paper form
    • ❑ AFB Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ Brushings Culture
      • ❑ Micro Specimen, Routine collect, T;N
      • ❑ Micro Specimen, Routine collect, T;N, RUL Sputum
      • ❑ Micro Specimen, Routine collect, T;N, RML Sputum
      • ❑ Micro Specimen, Routine collect, T;N, RLL Sputum
      • ❑ Micro Specimen, Routine collect, T;N, LUL Sputum
      • ❑ Micro Specimen, Routine collect, T;N, LLL Sputum
      • ❑ Micro Specimen, Routine collect, T;N, Bilateral Upper Lobes Sputum
      • ❑ Micro Specimen, Routine collect, T;N, Bilateral Lower Lobes Sputum
      • ❑ Micro Specimen, Routine collect, T;N, Both Lungs Sputum
    • ❑ Fungus Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ KOH Test
      • Micro Specimen, Routine collect, T;N
    • ❑ Nursing Communication
      • Cytology Needed - Complete paper form
    • ❑ Fungus Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ Nursing Communication
      • Pathology Needed - Complete paper form
  • Medications
    • ❑ albuterol 0.042% inhalation solution
      • 1.25 mg, Soln-Inh, NEB, Once
    • ❑ albuterol 0.083% inhalation solution
      • 2.5 mg, Soln-Inh, NEB, Once
    • ❑ ciprofloxacin
      • 400 mg, IV Piggyback, Once, Antibiotic Indication Prophylaxis- surgical
    • ❑ cefTRIAXone
      • 2 gm, IV Piggyback, Once, Antibiotic Indication Prophylaxis- surgical
    • ❑ SoluMEDROL
      • 125 mg, Vial, IV Push, Once
  • Patient Care
    • ❑ Discontinue IV Fluids
      • If Outpatient discontinue IVF prior to discharge
    • ❑ Moderate Sedation Per Protocol
      • Monitor according to Moderate Sedation Policy
ENDO - Pre-Procedure Bronchoscopy Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ ENDO - Bronchoscopy
      • in OR
    • ❑ ENDO - Bronchoscopy
      • with moderate sedation
    • ❑ ENDO - Bronchoscopy
      • With Monitored Anesthesia Care (MAC)
    • ❑ ENDO - Bronchoscopy
      • With Endobronchial Ultrasound
    • ❑ Procedure / Consent
      • Indicated endoscopy procedure
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, Room Service Eligible: No, NPO after midnight
      • ❑ T+1;0001 NPO, Room Service Eligible: No, NPO after midnight except heart, blood pressure, breathing, and seizure medications with sip of water
  • Medications
    • Antibiotics
      • ❑ cefTRIAXone
        • 1 gm, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ciprofloxacin
        • ❑ 500 mg, Tab, Oral, On Call, Antibiotic Indication Prophylaxis- surgical
        • ❑ 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ Versed
      • 2 mg, IV Push, On Call
    • ❑ Afrin 0.05% nasal spray
      • 1 spray(s), Spray-Nasal, Nasal, On Call
    • ❑ codeine
      • 60 mg, Tab, Oral, On Call
    • ❑ Tessalon Perles
      • 200 mg, Cap, Oral, On Call
    • ❑ lidocaine 4% preservative-free injectable solution
      • 5 mL, Vial, NEB, On Call
    • ❑ lidocaine 1% preservative-free injectable solution
      • 10 mL, N/A, On Call
    • ❑ lidocaine 1% preservative-free injectable solution
      • 5 mL, NEB, On Call
    • ❑ Lidocaine Jelly
      • 1 app, Gel, Nasal, On Call
    • ❑ Sodium Chloride 0.9%
      • 500 mL, IV, 30 mL/hr
  • Patient Care
    • ❑ Oxygen
      • Nasal Cannula, **ENDO ONLY** 2-10 L/min to keep sat above 88%
    • ❑ Notify Provider
      • If patient is allergic to pre-procedure bronchoscopy medications, contact MD for further orders.
ENDO - Small Bowel Capsule Post-Procedure Order Set - IMH
  • Diet
    • ❑ Diet Order
      • NPO
    • ❑ Diet Order
      • NPO, Room Service Eligible: No, Drink colorless liquid and have any scheduled medication.
    • ❑ Diet Order
      • Full Liquid, Room Service Eligible: Yes, Full Liquids (no red) and Crackers. May resume patient's pre-procedure diet 8 hours after procedure.
  • Patient Care
    • ❑ Nursing Communication
      • Nursing - Refer to Reference Text / Nurse Prep for small bowel capsule instructions.
ENDO - Small Bowel Capsule Pre-Procedure Endoscopy Order Set - IMH
  • Communication
    • ❑ Procedure / Consent
      • Capsule Endoscopy
    • ❑ Patient Instruction
      • Instruct patient to abstain from smoking 24 hours prior to undergoing Capsule Endoscopy.
  • Diet
    • ❑ Diet Order
      • Clear Liquid, Room Service Eligible, Day before procedure: after lunch
    • ❑ Diet Order
      • T;2200 NPO, Day before procedure: NPO after 10:00pm - may have meds with a sip of water.
  • Medications
    • ❑ magnesium citrate
      • 300 mL, Soln-Oral, Oral, Once
    • ❑ Dulcolax Laxative
      • 10 mg, Tab-EC, Oral, Once
    • ❑ Hold Med
      • Hold AM medication day of procedure.
    • ❑ erythromycin
      • 250 mg, Tab-EC, Oral, Once, Antibiotic Indication Other (specify in order comments), Start date: T+1;0500
    • ❑ Reglan
      • 10 mg, Tab, Oral, Once, Start date: T+1;0500
  • Patient Care
    • ❑ Patient Education
      • Give the patient / family capsule educational material.
ENT - Outpatient Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
  • Condition
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
  • Medications
    • Antibiotic Therapy
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ dexamethasone
      • ❑ 10 mg, IV Piggyback, On Call
      • ❑ 8 mg, IV Piggyback, On Call
      • ❑ 20 mg, IV Piggyback, On Call
    • ❑ glycopyrrolate
      • 0.2 mg, Vial, IV Push, On Call
    • ❑ acetaminophen
      • ❑ 325 mg, Supp, Per rectum, On Call
      • ❑ 650 mg, Supp, Per rectum, On Call
      • ❑ 120 mg, Supp, Per rectum, On Call
    • ❑ oxymetazoline 0.05% nasal spray
      • 3 spray(s), Spray-Nasal, Nasal, q5min, 2 dose(s)/time(s)
ENT - Post-Operative Order Set - IMH
  • Activity
    • ❑ Ambulate
      • TID, Ambulate in hall
    • ❑ Out of bed
      • with assistance
    • ❑ Elevate Head of Bed
      • 20-30 degrees while awake
    • ❑ Patient Activity Misc
      • No Lifting, straining, or sneezing with a closed mouth
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Mechanical soft
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, NPO except ice chips
      • ❑ NPO, Room Service Eligible: No, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, 1800 kcal
      • ❑ Low Residue, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Low Fat, Room Service Eligible: Yes
  • IV Solutions
    • ❑ LR
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
    • ❑ D5LR
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • 1,000 mL, IV, mL/hr
      • 20 mEq
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ Comprehensive Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ PT
        • Blood, AM Draw collect, T+1;0500
      • ❑ PTT
        • Blood, AM Draw collect, T+1;0500
      • ❑ PTH Intact Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ Calcium Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ Calcium Ionized Serum (CDM 2930980)
        • Blood, AM Draw collect, T+1;0500
    • ❑ PTH Intact Level
      • Blood, Routine collect, T;N
    • ❑ Calcium Level
      • Blood, Timed Study collect, q6hr
    • ❑ Calcium Ionized Serum (CDM 2930980)
      • Blood, Timed Study collect, q6hr
    • ❑ Calcium Level
      • Blood, Timed Study collect, q8hr
    • ❑ Calcium Ionized Serum (CDM 2930980)
      • Blood, Timed Study collect, q8hr
  • Medications
    • Analgesics
      • ❑ morphine
        • mg, Syringe, IV Push, q4hr, PRN Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, q4hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg/15 mL oral solution
        • ❑ 5 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Mild
        • ❑ 10 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Mild
        • ❑ 15 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen
        • 500 mg, Tab, Oral, q6hr, PRN for Pain/Fever
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, q8hr, PRN for Pain - Mild
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ promethazine
        • 25 mg, Supp, Per rectum, q6hr, PRN for Nausea/Vomiting
    • ❑ levothyroxine
      • ❑ mcg, Tab, Oral, Daily
      • ❑ mcg, Vial, IV Push, Daily
    • ❑ calcium carbonate
      • ❑ 1,000 mg, Tab-Chew, Chewed, TID
      • ❑ 500 mg, Tab-Chew, Chewed, TID
    • ❑ calcium-vitamin D
      • 2 tab(s), Tab, Oral, BID
    • ❑ oxymetazoline 0.05% nasal spray
      • 1 spray(s), Spray-Nasal, Nasal, q1hr, PRN for Bleeding
    • ❑ sodium chloride 0.65% nasal solution
      • 1 spray(s), Spray, Nasal, q1hr, PRN for Dry nasal passages
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • ❑ 3x/Day, Empty & Record Output q8hrs.
        • ❑ 6x/Day, Empty & Record Output q4hrs.
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
    • Dressing Care
      • ❑ Dressing Change
        • T+1;0900, Daily, Dry dressing change daily, start post-op day #1.
      • ❑ Polysporin
        • 1 app, Ointment, TOP, Daily, Start date: T+1;0900
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • T+1;0600, Post-op Day #1 at 0600
      • ❑ Straight Cath
        • PRN, per urinary retention algorithm
    • ❑ Sequential Compression Device
      • T;N, Daily, Knee High SCDs when in bed
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
Epi, Tonsil, Pharyngitis Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Epi, Tonsils, Pharyngitis Plan of Care
 F
Failure to Thrive (Adult) Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Failure to Thrive (Adult) Plan of Care
Fatigue Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Fatigue Plan of Care
Fever Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Fever Plan of Care
FFP IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ FFP.
      • Blood
Fluid Volume Deficit Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Fluid Volume Deficit Plan of Care
Fluid Volume Excess Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Fluid Volume Excess Plan of Care
 G
Gentamicin IV - Pharmacy to Dose - IMH
  • Medications
    • ❑ Gentamicin IV - Pharmacy to Dose.
      • Pharmacy to Dose., IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Gentamicin IV - Pharmacy to Dose.
Gentamicin IV once daily - Pharmacy to Dose - IMH
  • Medications
    • ❑ Gentamicin IV once daily - Pharmacy to Dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Gentamicin IV once daily - Pharmacy to Dose
GI - GI Bleed Order Set - IMH
  • Activity
    • ❑ Ambulate
      • As Tolerated
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Surgical, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Surgical, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ NPO
      • ❑ NPO, NPO except Ice Chips
      • ❑ NPO, Until seen by GI Consult
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Mechanical soft
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, 1800 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ Hemoglobin & Hematocrit
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Ammonia Level
      • Blood, Routine collect, T;N
    • ❑ Hepatic Function Panel
      • Blood, Routine collect, T;N
    • ❑ Renal Function Panel
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N
    • ❑ Hemoglobin & Hematocrit
      • ❑ Blood, Timed Study collect, q6hr, for 24 hr
      • ❑ Blood, Timed Study collect, q4hr, for 24 hr
      • ❑ Blood, Timed Study collect, q2hr, for 24 hr
      • ❑ Blood, Timed Study collect, q12hr, for 24 hr
    • ❑ Notify Provider Laboratory Results
      • ❑ Hgb < 8
      • ❑ Hgb < 7
      • ❑ Hgb < 6
      • ❑ Hgb < 9
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500
    • ❑ Ammonia Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hepatic Function Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Renal Function Panel
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ Hold Med
      • Hold all anticoagulants unless approved by provider.
    • ❑ phytonadione
      • ❑ 10 mg, Injection, IV Piggyback, Once
      • ❑ 7.5 mg, Injection, IV Piggyback, Once
      • ❑ 5 mg, Injection, IV Piggyback, Once
      • ❑ 2.5 mg, Injection, IV Piggyback, Once
    • ❑ octreotide
      • 50 mcg, Vial, IV Push, Once
    • ❑ Sandostatin 1000 mcg/1000 mL
      • 1,000 mcg
      • 1,000 mL, IV, Routine, 72 hr, 50 mL/hr
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ levoFLOXacin
      • 500 mg, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ promethazine
      • 25 mg, Tab, Oral, q6hr, PRN for Nausea/Vomiting
    • ❑ promethazine
      • 25 mg, Supp, Per rectum, q6hr RT, PRN for Nausea/Vomiting
    • ❑ prochlorperazine
      • 10 mg, Vial, IM, q6hr, PRN for Nausea/Vomiting
    • ❑ metoclopramide
      • 10 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
  • Patient Care
    • Interventions
      • ❑ Nasogastric/Orogastric Tube Care
        • ❑ Low Intermittent Suction, lavage until clear
        • ❑ Low Continuous Suction, lavage until clear
        • ❑ Clamped, lavage until clear
        • ❑ To Gravity, lavage until clear
      • ❑ Nasogastric/Orogastric Tube Flush
        • ❑ PRN, 30ml Sterile Water
        • ❑ PRN, 60ml Sterile Water
      • ❑ Nasogastric/Orogastric Tube Clamping
        • 2 hours on, 2 hours off suction.
      • ❑ Nursing Communication
        • May reposition NG/OG tube if not draining.
    • ❑ I&O POC
      • Strict I&O
    • ❑ Notify Provider Vital Signs
      • HR > 120, HR < 60, SBP > 160, SBP < 80, DBP > 100, RR < 8, O2 sat < 90, UO < 20ml/hr x 2 hr
    • ❑ Insert Foley Catheter
      • Indwelling
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ 0.92
      • ❑ 0.9
      • ❑ 0.89
    • ❑ Pulse Oximetry POC
      • ❑ qShift 8 hr VS
      • ❑ qAM
    • ❑ Incentive Spirometry RT
      • ❑ q2hr-WA, 5-10 repetitions
      • ❑ q1hr-WA, 5-10 repetitions
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ Per Unit Protocol
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Height & Weight POC
      • Once a Day (before meals)
    • ❑ Vital Signs POC
      • ❑ Once, Orthostatic Vital Signs
      • ❑ Once a Day (before meals), Orthostatic Vital Signs
GI - Golytely Prep Order Set - IMH
  • Communication
    • ❑ ENDO - Colonoscopy with Moderate Sedation
      • At Bedside
    • ❑ Procedure / Consent
      • Indicated Endoscopy Procedure
    • ❑ Patient Education
      • Give patient and family colonoscopy pamphlet to read
  • Diet
    • ❑ Dietary Communication
      • Patient may have clear liquids after noon meal on day prior to procedure. (Exclude Jell-O, popsicles or juice that is red or purple)., 0
    • ❑ Diet Order
      • T;1300 Clear Liquid, Clear Liquids after noon meal. Exclude jello, popsicles or juice that is red or purple.
  • Medications
    • ❑ Reglan
      • 10 mg, Vial, IV Push, q2hr, PRN Nausea/Vomiting, 3 dose(s)/time(s)
    • ❑ NS
      • 500 mL, IV, Start date: T+1;0600, 30 mL/hr
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, NPO after midnight
      • ❑ T+1;0001 NPO, Room Service Eligible: No, NPO after midnight except medications with sip of water
    • ❑ GoLYTELY
      • 4,000 mL, Susp-Oral, Oral, Once, Start date: T+1;0600
    • ❑ Diet Order
      • ❑ T+1;0600 | NPO, Afternoon procedure, NPO after 0600
      • ❑ T+1;0600 NPO, Room Service Eligible: No, NPO after 0600 except medications with sip of water
    • ❑ GoLYTELY
      • 4,000 mL, Susp-Oral, Oral, Once, Start date: T+1;0600
    • ❑ Nursing Communication Order
      • If patient's procedure is to be in the afternoon but patient drank prep at night, may have 8 oz black coffee, juice, or water for breakfast.
  • Patient Care
    • ❑ Hold Med
      • Hold all vitamins, iron, pepto-bismol, bulk agents for endoscopy procedure.
    • ❑ Notify Provider
      • If patient taking anticoagulants, ask physician if it should be held prior to Colonoscopy.
    • ❑ Nursing Communication Order
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Pharmacy Communication Order.
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Hold Med
      • Hold A.M. insulin the day of the endoscopy procedure.
    • ❑ Nursing Communication Order
      • Give all heart, blood pressure, seizure and breathing medication with small amount of water prior to endoscopy procedure.
    • ❑ Notify Provider
      • If patient cannot drink at least 3 liters of Golytely.
    • ❑ Nasogastric Tube Insertion
      • PRN, See Comments
    • ❑ Enema Administration
      • T+1;0600, Once, Routine, PRN, If in morning of colonoscopy patient is still passing solid material per rectum, tap water enemas until clear
GI - MoviPrep Order Set - IMH
  • Communication
    • ❑ ENDO - Colonoscopy with Moderate Sedation
      • At Bedside
    • ❑ Procedure / Consent
      • Indicated Endoscopy Procedure
    • ❑ Patient Education
      • Colonoscopy Procedure Education
  • Diet
    • ❑ Diet Order
      • T+1;1100 | Clear Liquid, Room Service Eligible: Yes, On day prior to procedure, Clear liquids only after breakfast (Exclude Jell-O or juice that is red or purple). Patient must be NPO 6 hours prior to procedure.
    • ❑ Diet Order
      • ❑ T+2;0001 | NPO, Room Service Eligible: Yes, Patient must be NPO 6 hours prior to procedure.
      • ❑ T+2;0001 NPO, Room Service Eligible: No, Patient must be NPO 6 hours prior to procedure. May have medications with sip of water
    • ❑ Nursing Communication Order
      • Validate diet order based on the date and time of the endoscopy procedure.
  • Medications
    • ❑ Dulcolax Laxative
      • 10 mg, Tab-EC, HS, 1 dose(s)/time(s)
    • ❑ MoviPrep
      • 1 EA, Packet, Oral, Once, Start date: T+1;1700
    • ❑ MoviPrep
      • 1 EA, Packet, Oral, Once
    • ❑ magnesium citrate
      • 240 mL, Soln-Oral, Oral, Once
    • ❑ NS
      • 500 mL, IV, Start date: T+2;0600, 30 mL/hr
  • Patient Care
    • ❑ Nursing Communication Order
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Pharmacy Communication Order.
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Hold Med
      • Hold A.M. insulin the day of the endoscopy procedure.
    • ❑ Hold Med
      • Hold all vitamins, iron, pepto bismol, bulk agents for endoscopy procedure.
    • ❑ Nursing Communication Order
      • Give all heart, blood pressure, seizure and breathing medication with small amount of water prior to endoscopy procedure.
    • ❑ Notify Provider
      • If patient taking anticoagulants, ask physician if it should be held prior to Colonoscopy.
    • ❑ Enema Administration
      • T+1;0600, Once, Routine, PRN, If in morning of colonoscopy patient is still passing solid material per rectum, tap water enemas until clear
GI - Split Dose Golytely Prep Order Set - IMH
  • Communication
    • ❑ ENDO - Colonoscopy with Moderate Sedation
      • At bedside
    • ❑ Procedure / Consent
      • Indicated Endoscopy Procedure
    • ❑ Patient Education
      • Give patient and family colonoscopy pamphlet to read
  • Diet
    • ❑ Dietary Communication
      • Patient may have a light breakfast on day prior to procedure. (Exclude Jell-O, popsicles or juice that is red or purple)., 0
    • ❑ Diet Order
      • T;1000 | Clear Liquid, Clear Liquids only after breakfast
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, NPO after midnight
      • ❑ T+1;0001 NPO, Room Service Eligible: No, NPO after midnight except medications with sip of water
  • Medications
    • ❑ GoLYTELY
      • 3,000 mL, Susp-Oral, Oral, Once
    • ❑ Dulcolax Laxative
      • 20 mg, Tab-EC, Oral, Once
    • ❑ Reglan
      • 10 mg, Vial, IV Push, q6hr, PRN Nausea/Vomiting
    • ❑ GoLYTELY
      • 1,000 mL, Susp-Oral, Oral, Once
    • ❑ NS
      • 500 mL, IV, 30 mL/hr
  • Patient Care
    • ❑ Hold Med
      • Hold MVI, iron, pepto-bismol, Metamucil and cholestyramine for endoscopy procedure.
    • ❑ Notify Provider
      • If patient taking anticoagulants, ask physician if it should be held prior to Colonoscopy.
    • ❑ Nursing Communication Order
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Pharmacy Communication Order.
      • If patient is on insulin, give half of the scheduled pm insulin dose the night before the endoscopy procedure.
    • ❑ Hold Med
      • Hold A.M. insulin the day of the endoscopy procedure.
    • ❑ Nursing Communication Order
      • Give all heart, blood pressure, seizure and breathing medication with small amount of water prior to endoscopy procedure.
    • ❑ Nasogastric Tube Insertion
      • PRN, See Comments
    • ❑ Enema Administration
      • T+1;0600, Once, Routine, PRN, If in morning of colonoscopy patient is still passing solid material per rectum, tap water enemas until clear.
GI & Vaginal Bleeding Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review GI & Vaginal Bleeding Plan of Care
GU - Extracoporeal Shock Wave Lithotripsy Order Set - IMH
  • Condition
    • ❑ Nursing Communication
      • Make sure current history and physical dated within 30 days of procedure in medical record.
    • ❑ Procedure / Consent
      • ❑ Right Extracorporeal Shock Wave Lithotripsy
      • ❑ Left Extracorporeal Shock Wave Lithotripsy
  • Diagnostic Tests
    • ❑ XR Abdomen KUB
      • Stat
    • ❑ ECG
      • Stat
    • ❑ Nursing Communication
      • Cardiac Clearance must be in the medical record for patients with cardiac pacemakers or internal defibrillators. The patient's cardiologist who completes the clearance will decide if the device should be interrogated post ESWL on the cardiac clearance.
  • Diet
    • ❑ Nursing Communication
      • Patient may have a light diet evening prior to procedure. NPO after midnight. Exception: Patients that are scheduled to be done after 12 noon may have clear liquids until 4 hours before procedure time.
    • ❑ Diet Order
      • Regular, Room Service Eligible, Light diet evening prior to treatment
    • ❑ Diet Order
      • T+1;0001 NPO, Room Service Eligible: No, NPO past Midnight
  • IV Solutions
    • ❑ LR
      • 1000 mL, IV, 100 mL/hr
    • ❑ D5W in LR
      • 1,000 mL, IV, 100 mL/hr
  • Laboratory
    • ❑ PT/INR
      • Blood, Stat collect, T;N
  • Medications
    • Antibiotics
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call
    • ❑ Dulcolax Laxative
      • 15 mg, Tab-EC, Oral, HS, 1 dose(s)/time(s)
    • ❑ Valium
      • 10 mg, Tab, Oral, On Call
    • ❑ Benadryl
      • 25 mg, Oral, On Call
  • Patient Care
    • ❑ Nursing Communication
      • Female patients to sign pregnancy screening form for Extracorporeal Shock Wave Lithotripsy.
    • ❑ hCG Qual Urine
      • Urine, See Comment...
    • ❑ Nursing Communication
      • See Comment
    • ❑ Nursing Communication
      • Patients with Cardiac Pacemaker or Internal Defibrillators must be scheduled for Monitored Anesthesia on the truck.
    • ❑ Nursing Communication
      • For INPATIENTS: Nursing unit to notify OPS if patient has cardiac pacemaker or internal defibrillator.
    • ❑ Nursing Communication
      • Patient to void immediately prior to transport to lithotripsy unit from OPS.
    • ❑ Nursing Communication
      • Patient to take cardiac and hypertension medication morning of treatment with a sip of water.
GU - Prostate Seed Implantation Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
    • ❑ Discharge Patient
      • In AM after Foley discontinued and post-void residual less than 150ml x 2.
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ KCl 10 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
  • Medications
    • Analgesics
      • ❑ morphine
        • 1 mg, Syringe, IV Push, q1hr, PRN Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ ibuprofen
      • 600 mg, Tab, Oral, 4x/Day
    • ❑ tamsulosin
      • 0.4 mg, Cap, Oral, Daily
  • Patient Care
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
    • ❑ Ice Pack
      • To perineum
    • ❑ Discontinue Foley Cath
      • T+1;0700
    • ❑ Bladder Scan.
      • T+1;0700, for 2 dose(s)/time(s), If post-void residual greater than 150ml call MD.
    • ❑ Notify Provider
      • Call if PVR is greater than 150cc x 2.
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr, Routine
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Prostate Surgery Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Medications
    • Analgesics
      • ❑ morphine
        • 1 mg, Syringe, IV Push, q1hr, PRN for Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ ibuprofen
      • 600 mg, Tab, Oral, 4x/Day
    • ❑ tamsulosin
      • 0.4 mg, Cap, Oral, Daily
  • Patient Care
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
    • ❑ Ice Pack
      • To perineum
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Prostatectomy / Transurethral Resection of the Prostate Order Set - IMH
  • Activity
    • ❑ Out of bed
      • ❑ As Tolerated
      • ❑ 3x/Day
    • ❑ Ambulate
      • Progress to ambulation as tolerated
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ CMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ BMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500
    • ❑ Urinalysis Complete
      • Urine, AM Draw collect, T+1;0500, Nurse Collect
    • ❑ Urine Culture
      • Urine, AM Draw collect, T+1;0500, Nurse collect
  • Medications
    • Analgesics
      • ❑ morphine
        • 1 mg, Syringe, IV Push, q1hr, PRN Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
  • Patient Care
    • ❑ Continuous Bladder Irrigation
      • ❑ with Normal Saline, titrate till clear
      • ❑ with Normal Saline, titrate till light pink.
    • ❑ Catheter Irrigation
      • may manually irrigate with 30 - 60 mL of Sterile Normal Saline - YES
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours) Strict I&O
      • ❑ 6x/Day, (q 4 hours) Strict I&O
    • ❑ Notify Provider Vital Signs
      • ❑ For UOP < 100 in 4 hours.
      • ❑ For 2 consecutive hours, UO < 25
      • ❑ For 2 consecutive hours, UO < 50
    • ❑ Nursing Communication
      • Nothing per rectum.
  • Respiratory
    • ❑ ABG Draw (Resp)
      • Routine
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 dose(s)/time(s)
    • ❑ Vital Signs POC
      • q4hrVS
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Radical Prostatectomy Post-Operative Order Set - IMH
  • Activity
    • ❑ Out of bed
      • T+1;0700
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible
      • ❑ Low Cholesterol, Room Service Eligible
      • ❑ Low Sodium, Room Service Eligible
      • ❑ Mechanical Soft, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500
    • ❑ Urinalysis Complete
      • Urine, AM Draw collect, T+1;0500, Nurse Collect
    • ❑ Culture - Urine
      • Urine, AM Draw collect, T+1;0500, Nurse collect
  • Medications
    • Analgesics
      • ❑ morphine
        • 1 mg, Syringe, IV Push, q1hr, PRN for Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ docusate
      • 100 mg, Cap, Oral, BID
    • ❑ ketorolac
      • 30 mg, Vial, IV Push, 4x/Day, 6 dose(s)/time(s)
  • Patient Care
    • Drain Management
      • ❑ Jackson-Pratt Drain to
        • Bulb suction
      • ❑ Record Drain Output
        • ❑ 6x/Day, Empty & Record Output q4hrs.
        • ❑ 3x/Day, Empty & Record Output q8hrs.
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
    • ❑ Notify Provider
      • Call for UOP less than 200 mL in 8 hours.
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O - (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Nursing Communication
      • Nothing per Rectum.
  • Respiratory
    • ❑ ABG Draw (Resp)
      • Routine
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Ureteral Colic General Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ XR KUB
      • Routine
    • ❑ XR KUB
      • T+1;0700, Timed
    • ❑ CT Abdomen/Pelvis w/o Contrast
      • Routine, Stone Chaser
    • ❑ EKG
      • Routine, For patients 40 years of age and greater if not already ordered
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
    • ❑ Diet Order
      • T+1;0001 NPO, after midnight
  • IV Solutions
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
  • Medications
    • Analgesics
      • ❑ morphine
        • ❑ 4 mg, Syringe, IV Push, q30min, PRN Pain - Severe
        • ❑ 2 mg, Syringe, IV, q1hr, PRN Pain - Severe
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • Antiemetics
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN for Pain - Mild
    • ❑ zolpidem
      • 5 mg, Tab, Oral, HS, PRN for Insomnia
  • Patient Care
    • ❑ Notify Provider Vital Signs
      • T;N, Unrelenting pain, Temp > 101'F / 38.3'C, T > 38.3, SBP < 100, DBP < 60
    • ❑ Strain Urine After each Void
      • Strain all Urine for Stones
    • ❑ Sequential Compression Device
      • ❑ Knee High
      • ❑ Thigh High
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Urinary Retention Order Set - IMH
  • Medications
    • ❑ Flomax
      • 0.4 mg, Cap, Oral, Once, NOW
    • ❑ Flomax
      • 0.4 mg, Cap, Oral, Daily, Start date: T+1;1700
    • ❑ Rapaflo
      • ❑ 8 mg, Cap, Oral, qAM-WM
      • ❑ 4 mg, Cap, Oral, qAM-WM
  • Patient Care
    • ❑ Bladder Scan.
      • 3x/Day, (q 8 hours)
    • ❑ Straight Cath
      • ❑ if PVR > 250
      • ❑ if PVR > 150
      • ❑ if PVR > 350
    • ❑ Insert Foley Catheter
      • ❑ Indwelling
      • ❑ Indwelling, Use Coude Catheter
    • ❑ Clamp Catheter (Urine)
      • Clamp Catheter for _____ hours, drain & re-clamp.
GU - Urinary Tract Infection (UTI) General Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ EKG
      • Routine, For patients 40 years of age and greater if not already ordered
    • ❑ XR Chest 2 Views
      • Routine
    • ❑ XR Chest 1 View Frontal
      • Routine
    • ❑ US Renal
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
  • Laboratory
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ morphine
        • 2 mg, Syringe, IV Push, q2hr, PRN Pain - Severe
      • ❑ Tylenol
        • ❑ 650 mg, Tab, Oral, q4hr, PRN Pain/Fever
        • ❑ 650 mg, Tab, Oral, 4x/Day, 4 dose(s)/time(s)
      • ❑ !-Norco 5 mg-325 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN Pain - Moderate
    • Antibiotics
      • ❑ Nursing Communication Order
        • Antibiotics - Administer 1st dose after Blood Cultures drawn (within 4 hours of admission)
      • ❑ Macrobid
        • 100 mg, Cap, Oral, q12hr, Antibiotic Indication Urinary Tract Infection, 5 day(s)
      • ❑ !-Keflex
        • 500 mg, Cap, Oral, q12hr, Antibiotic Indication Urinary Tract Infection, 5 day(s)
      • ❑ cefTRIAXone
        • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Urinary Tract Infection, 7 day(s)
      • ❑ Cipro
        • ❑ 400 mg, IV Piggyback, q12hr, Antibiotic Indication Urinary Tract Infection, 7 day(s)
        • ❑ 200 mg, IV Piggyback, q12hr, Antibiotic Indication Urinary Tract Infection, 7 day(s)
        • ❑ 500 mg, Tab, Oral, q12hr, Antibiotic Indication Urinary Tract Infection, 7 day(s)
    • Antiemetics
      • ❑ prochlorperazine
        • ❑ 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
        • ❑ 10 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ aspirin
      • ❑ 81 mg, Tab-Chew, Chewed, Daily
      • ❑ 325 mg, Tab, Oral, Daily
    • ❑ zolpidem
      • 5 mg, Tab, Oral, HS, PRN for Sleep
    • ❑ temazepam
      • 15 mg, Tab, Oral, HS, PRN for Sleep
    • ❑ Milk of Magnesia
      • 30 mL, Susp-Oral, Oral, q12hr, PRN Constipation
    • ❑ Pepcid
      • ❑ 20 mg, Tab, Oral, Daily
      • ❑ 20 mg, Tab, Oral, BID
      • ❑ 20 mg, Vial, IV Push, Daily
      • ❑ 20 mg, Vial, IV Push, BID
  • Patient Care
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ BIDAC, Routine VS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
GU - Urology General Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ XR Chest 1 View Frontal
      • Transport Mode: Portable
    • ❑ XR KUB
      • Stat
    • ❑ XR KUB
      • ❑ T+1;0700, Routine, Once
      • ❑ T+1;0700, Routine, qAM
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
    • ❑ Diet Order
      • T+1;0001 | NPO, Room Service Eligible: Yes, after midnight
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
  • Laboratory
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Urine Culture
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ BMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ morphine
        • 1 mg, Syringe, IV Push, q1hr, PRN Pain - Severe
      • ❑ !-Norco 5 mg-325 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN Pain - Mild
      • ❑ !-Norco 5 mg-325 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN Pain - Moderate
    • ❑ Pepcid
      • ❑ 20 mg, Tab, Oral, BID
      • ❑ 20 mg, Vial, IV Push, BID
      • ❑ 20 mg, Tab, Oral, Daily
      • ❑ 20 mg, Vial, IV Push, Daily
    • ❑ Protonix
      • ❑ 40 mg, Tab-EC, Oral, Daily
      • ❑ 40 mg, Tab-EC, Oral, BIDAC
  • Patient Care
    • ❑ Foley Catheter Insertion
      • Indwelling
    • ❑ SCDs
      • ❑ Calf
      • ❑ Thigh
    • ❑ Ted Hose
      • ❑ Knee High
      • ❑ Thigh High
    • ❑ Foot Pump
      • Foot SCD's
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
  • Respiratory
    • ❑ Titrate Oxygen
      • ❑ keep sats > 94%
      • ❑ keep sats > 92%.
      • ❑ keep sats > 90%
      • ❑ keep sats at patients baseline.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
GU - Urology Post-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
      • ❑ Medical/Acute, Medical
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • 1,000 mL, IV, mL/hr
      • 20 mEq
  • Laboratory
    • AM Labs
      • ❑ Magnesium Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ Phosphorus Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ BMP
        • Blood, AM Draw collect, T+1;0500
      • ❑ CMP
        • Blood, AM Draw collect, T+1;0500
      • ❑ CBC w/Auto Diff
        • Blood, AM Draw collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ morphine
        • ❑ 1 mg, Syringe, IV Push, q1hr, PRN Pain - Severe
        • ❑ 2 mg, Syringe, IV Push, q1hr, PRN for Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q1hr, PRN for Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
  • Patient Care
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
    • ❑ Notify Provider Vital Signs
      • T > 38.5, HR > 120, HR < 50, SBP > 180, SBP < 90, DBP > 100, RR > 24, RR < 12, O2 sat < 92
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GU - Urology Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telelmetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Condition
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diagnostic Tests
    • ❑ XR Abdomen KUB
      • Stat
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, Room Service Eligible: No, after midnight
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, except medications
  • Laboratory
    • ❑ Urinalysis Complete
      • ❑ Urine, Routine collect, T;N, Nurse Collect
      • ❑ Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
  • Medications
    • Antibiotics
      • ❑ ceFAZolin.
        • Per weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ mitoMYcin
      • 40 mg, Soln, IRRIG, On Call
    • ❑ Fleet Enema
      • 133 mL, Enema, Per rectum, On Call
    • ❑ lidocaine 2% topical gel with applicator
      • 1 app, Gel, TOP, As Directed, PRN for Other (see comment)
  • Patient Care
    • ❑ Sequential Compression Device
      • T;N, Bilateral Knee High SCDs
GYN SURG - Post-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Medical/Acute, Medical
      • ❑ Surgical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Results by 0800
  • Medications
    • Analgesics
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q2hr, PRN Pain - Severe
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q2hr, PRN Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 10 mg, IM, q2hr, PRN Pain - Severe
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ ketorolac
        • 30 mg, Vial, IV Push, q6hr, 48 hr
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, 3x/Day
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q8hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q8hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 10 mg, Vial, IM, q6hr, PRN for Other (see comment)
      • ❑ promethazine
        • 25 mg, Supp, Per rectum, q4hr, PRN for Other (see comment)
    • DVT Prophylaxis
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other: ___________
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other: ___________
  • Patient Care
    • Urinary Catheter Management
      • ❑ Bladder Scan.
        • ❑ Scan patient's bladder if bladder is uncomfortable.
        • ❑ Scan bladder after each attempt at voiding and cath if over 300mL. Stop scans if residuals are under 200mL x 3 consecutive times. (Patient may try to void again before cath)
      • ❑ Discontinue Foley Cath
        • T+1;0600, If Foley present
      • ❑ Straight Cath
        • q4hr, PRN
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
    • ❑ Dressing Removal
      • T+1;1000, Remove abdominal dressing first post-op day and clean with saline
    • ❑ Sequential Compression Device
      • ❑ Knee High - Apply in PACU, discontinue when patient fully ambulatory
      • ❑ unless uncomfortable, or patient up walking
    • ❑ Elevate Foot of Bed
      • Approximately 10 degrees
    • ❑ Discontinue IV
      • When taking fluids and vital signs stable.
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
GYN SURG - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • T+1;0001 | NPO, Room Service Eligible: Yes, NPO after midnight
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ CBC
      • Blood, Stat collect, T;N
  • Medications
    • ❑ Fleet Enema
      • 133 mL, Enema, Per rectum, Once, Start date: T;2100
    • ❑ povidone iodine 0.3% vaginal solution
      • 1 app, Douche, VAG, Once, Start date: T;2100
    • ❑ Notify Provider
      • For severe allergy (anaphylaxis, urticaria, hives, angioedema) to beta-lactams (penicillin, cephalosporins, ertapenem or Invanz, meropenem or Merrem, doripenem or Doribax, imipenem or Primaxin) if ordered
    • ❑ ceFAZolin.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ clindamycin
      • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ gentamicin
      • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ doxycycline
      • ❑ 100 mg, Oral, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ 100 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • ❑ Clip Prep
      • Miniprep and clip pubic hair from urethra down
    • ❑ Procedural Prep
      • Abdominal Prep
    • ❑ Insert Foley Catheter
      • Indwelling, IF ABDOMINAL SURGERY: Place in OR.
 H
HB / SNF - General Admission Order Set - IMH
  • Activity
    • ❑ Weight Bearing
      • ❑ WBAT
      • ❑ NWB
      • ❑ TTWB
    • ❑ Up to Chair
      • with assistance
    • ❑ Out of bed
      • with assistance
  • Admission/Transfer/Discharge
    • ❑ Nursing Communication
      • I have reviewed all orders on this order set, initiate upon arrival to SNF
    • ❑ Admit To:
      • Skilled Nursing Facility, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Activities
      • T+1;0900
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Mechanical soft, Endentulous
      • ❑ Renal, Room Service Eligible: Yes, Fluid: 1000 ml
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ NPO
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2200 kcal
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, AM Draw collect, T+2;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+2;0500
    • ❑ Creatinine
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
  • Patient Care
    • ❑ Skilled Nursing Facility Shower Orders
      • ❑ Yes
      • ❑ No
    • ❑ Dressing Change
      • Daily
    • ❑ Dressing Assessment
      • qShift - 8 hour, Assess and chart dressing condition.
    • ❑ Ted Hose
      • Thigh High Teds - on 23 hours per day.
    • ❑ Discontinue Foley Cath
      • after 24 hours bladder training unless contraindicated.
    • ❑ Bladder Scan.
      • T;N, PRN, For urinary retention
    • ❑ Maintain Foley Catheter
      • qShift - 8 hour, Document necessity, catheter care, patency, and securement. Discuss removal of urinary catheter with Provider when appropriate.
    • ❑ Infectious Disease Screening
      • T+1;0800, Daily
    • ❑ Nursing Communication
      • ❑ Activity Program - Yes
      • ❑ Activity Program - No
    • ❑ I&O POC
      • T;N, 3x/Day, Record PO Intake Only q 8 hours
    • ❑ Order Renewal: SNF
      • T+30;1000, qMonth, May discontinue any unused PRN medications after 30 days
    • ❑ LTC Drug Regimen Review
      • T+21;0900, Once, Within 30 days of admission, every 30 days thereafter, and PRN
    • ❑ FYI Booklet
      • SNF booklets provided to patient or their legal representative (Includes, IMH policiies concerning right to consent or refuse care. IMH policy related to advanced directives. Patients rights and responsiblities, safety info and smoking cessation info.
    • ❑ Patient Education
      • Orient to room, call bell system and fall reduction
    • ❑ Patient Education
      • Gave "Taking Antibiotics in the Hospital" brochure and discussed with patient/family
    • ❑ Provider Notification
      • T;N, Constant order, Document as needed
    • ❑ LTC Resident History and Preferences
      • T+1;0900
    • ❑ LTC Social Services Evaluation
      • T+1;0900, Constant Order
    • ❑ LTC Discharge Planning Assessment
      • T;N
    • ❑ Daily Assessment LTC
      • T+1;0800, Q24hr
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Titrate Oxygen
      • ❑ 92% - keep sats greater than or equal to
      • ❑ 91% - keep sats greater than or equal to
      • ❑ 90% - keep sats greater than or equal to
      • ❑ 89% - keep sats greater than or equal to
      • ❑ 88% - keep sats greater than or equal to
      • ❑ 87% -keep sats greater than or equal to
      • ❑ at patients baseline
    • ❑ CPAP
      • per Respiratory Therapy
    • ❑ BIPAP
      • per Respiratory Therapy
    • ❑ Incentive Spirometry RT
      • q2hr-WA
    • ❑ Flutter Valve
      • ❑ q4hr, and with Nebs
      • ❑ TID, and with Nebs.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • BID, At 0800 and 2000
    • ❑ Vital Signs POC
      • As Directed, PRN
    • ❑ Weight POC
      • ❑ T+1;0900, Daily, for 2 day(s)
      • ❑ T+1;0900, Daily
    • ❑ LTC Weight
      • qWeek
HB / SNF - Nursing Protocol Order Set - IMH
  • Consults
    • ❑ Notify Provider
      • T+1;0700, On rounds if PT/OT/ST needs exist
    • ❑ Consult to Dietitian
      • ❑ T;N, Unable to eat 3 days or greater prior to Admission
      • ❑ T;N, Unintentional weight loss of 10lbs or greater in 1 month (Adult)
      • ❑ T;N, Albumin <3.0/HD patients <4.0
      • ❑ T;N, NPO/clear liquid diet 3 or more days
      • ❑ T;N, New Onset Diabetes
      • ❑ T;N, Unintentional weight loss (Peds)
      • ❑ T;N, Admission diagnosis of failure to thrive (Peds)
      • ❑ T;N, Weight >90th% or <10th% on growth chart (Peds)
    • ❑ Consult to Diabetic Nurse Specialist
      • ❑ T;N, New onset Diabetes
      • ❑ T;N, Uncontrolled Diabetes
      • ❑ T;N, Diabetes in Pregnancy
      • ❑ T;N, Patient on Insulin Pump
      • ❑ T;N, Elevated A1C
      • ❑ T;N, Diabetes Diet Instruction
    • ❑ Consult Wound/Ostomy RN
      • ❑ T;N, Skin Breakdown
      • ❑ T;N, New Ostomy
      • ❑ T;N, Ostomy pouching problems
      • ❑ T;N, Stage 3, 4, unstageable and SDTI wounds
      • ❑ T;N, Wound Vac
      • ❑ T;N
    • ❑ Consult to Discharge Planning Services (CM)
      • ❑ T;N, Admitted from Extended Care Facility and the name of the facility
      • ❑ T;N, Initial Diagnosis of Cancer or Reoccurence
      • ❑ T;N, Alcohol/Drug Abuse
      • ❑ T;N, Fractures over 65 years
      • ❑ T;N, Change in Mental Status/Dementia
      • ❑ T;N, Equipment needed. (Hospital Bed, Bedside Commode, Wheelchair, Walker, etc. at home)
      • ❑ T;N, Financial/Environmental resources inadequate; No Insurance
      • ❑ T;N, Follow by Community Agency (Home Health, Meals on Wheels, Sitters, etc.)
      • ❑ T;N, Victim of Abuse/Neglect
      • ❑ T;N, Readmission to Hospital within 30 days
      • ❑ T;N, Patient traveling when illness/accident occurred
      • ❑ T;N, Hospice Patient
      • ❑ T;N, Unable to return home
      • ❑ T;N, Status Post Code STEMI (this admission)
      • ❑ T;N
    • ❑ Consult to Pastoral Care
      • ❑ T;N, Depression
      • ❑ T;N, First diagnosis/recurrent cancer
      • ❑ T;N, Recent Amputation
      • ❑ T;N, Recent loss in family (within last year)
      • ❑ T;N, Terminal illness
      • ❑ T;N, Request from patient/family for hospital chaplain to visit
      • ❑ T;N, Patient traveling when illness/accident occurred
      • ❑ T;N, Hospice Patient
    • ❑ Nursing Supervisor Communication
      • ❑ T;N, DNR
      • ❑ T;N, Refuse Blood
      • ❑ T;N
    • ❑ Dialysis Communication
      • ❑ T;N, Dialysis patient admitted today
      • ❑ T;N
  • Patient Care
    • ❑ Resuscitation Status
      • T;N, Full Resuscitation
    • ❑ Nursing Communication Order
      • ❑ Assist with meals
      • ❑ Feed patient
      • ❑ Visually impaired
      • ❑ Blind left eye
      • ❑ Blind right eye
      • ❑ Hard of hearing
      • ❑ Does not speak English
      • ❑ Sign Language
    • ❑ Elopement Risk Precautions
    • ❑ Tobacco Cessation Instruction
HB / SNF - Rehab Order Set - IMH
  • PT/OT/ST
    • ❑ Physical Therapy Progress or Discharge LTC
      • T+7;0900, qWeek
    • ❑ Occupational Therapy Progress or Discharge LTC
      • T+7;0900, qWeek
    • ❑ Speech Language Pathology Progress or Discharge LTC
      • T+7;0900, qWeek
HB/SNF - Skin Breakdown Prevention/Treatment Order Set - IMH
  • Communication
    • ❑ Notify Provider
      • Notify provider of presence of any wound(s) due to pressure and document communication details in iView under "Clinician notification".
  • Laboratory
    • ❑ Wound Culture
      • Micro Specimen, Nurse collect
  • Medications
    • ❑ nystatin 100,000 units/g topical powder
      • 1 app, Powder-Top, TOP, TID, Antibiotic Indication Candidiasis
  • Patient Care
    • ❑ Turn Patient POC
      • qShift - 8 hour, Remind and/or assist patient in repositioning using pillows or wedge for support with rounding and as needed.
    • ❑ Offload Heels
      • qShift - 8 hour, Offload pressure to heels using pillows continuously when in bed. Consider heel lift boots if pillows
    • ❑ Dressing Change
      • QWednesday, In addition to floating heels with pillows, apply heel mepilex to boggy, painful, soft and / or blanchable heels for pressure injury prevention.
    • ❑ Rental Bed
      • qAM, Rental Bed Type:______________ Use specialty bed algorithm to determine which specialty surface to order.
    • ❑ Wound Care
      • qShift - 8 hour, For intact skin at risk for breakdown related to incontinence or moisture, apply Aloe Vesta #3 protective ointment until it turns from white to clear after bathing and any cleansing for incontinence.
    • ❑ Incontinence Management
      • qShift - 8 hour, Consider external urinary/fecal pouching; Offer toileting/bedpan/urinal on rounds; Avoid adult briefs whenever possible.
    • ❑ Wound Care
      • qShift - 8 hour, Cleanse gently with bath wipes, pat dry well, apply nickel thick layer of Sensicare barrier cream to entire affected area. Repeat q8 hours and PRN to maintain a visible barrier.
    • ❑ Dressing Change
      • q3day, Cleanse skin tear with Cara-Klenz, replace skin flap (if applicable and possible) to natural position, cover with Mepilex dressing, label dressing with date/time/initials. Repeat q3 days.
    • ❑ Dressing Change
      • Every other day, Cleanse wound with normal saline, apply layer of Intrasite gel to wound bed, cover with Mepilex, label dressing with date/time/initials. Repeat every other day and PRN for soiled or dislodged dressing.
    • ❑ Dressing Change
      • Daily, Cleanse wound with Normal Saline (NS), apply layer of Aquacel AG. If none to minimal exudate, moisten Aquacel lightly with NS. Cover with Mepilex or ABD pad, label dressing with date/time/initials. Repeat daily and PRN for soiled or dislodged dress
    • ❑ Consult Wound/Ostomy RN
      • Skin breakdown - Patient has wound with depth or copious exudate.
    • ❑ Dressing Change
      • q4day, Cleanse area with bath wipes, apply Mepilex, label dressing with date/time/initials. Change q4 days and PRN for soiled or dislodged dressing. Gently peel dressing back for assessment, then replace.
Hypercoagulation Lab Profile - IMH
  • Laboratory
    • ❑ Protein C Functional
      • Blood, Routine collect, T;N
    • ❑ Protein S Functional
      • Blood, Routine collect, T;N
    • ❑ Antithrombin III Ag
      • Blood, Routine collect, T;N
    • ❑ Homocysteine Total
      • Blood, Routine collect, T;N
    • ❑ Lupus Anticoagulant Panel
      • Blood, Routine collect, T;N
    • ❑ Factor V Leiden Mutation
      • Blood, Routine collect, T;N
    • ❑ Anticardiolipin Ab IgG/M Qn
      • Blood, Routine collect, T;N
    • ❑ Prothrombin Nucleotide 20210 by PCR
      • Blood, Routine collect, T;N
 I
IMH Testing
  • IV Solutions
    • ❑ Tirofiban 5mg/100mL IV Sol
      • 5 mg
      • 100 mL, IV, hr, See Comments
    • ❑ TEST bupivacaine 1/16%-Epidural NS 250 mL
      • 31.25 mL
      • 218.75 mL, Epidural, Epidural
    • ❑ TEST Marcaine 1/16%-Epidural NS 250 mL
      • 31.25 mL
      • 218.75 mL, Epidural, Epidural
Impaired Coping Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Adjustment Plan of Care
Impaired Gas Exchange Plan of Care IRDL
  • Consults
    • ❑ Consult to Respiratory Therapy
      • Impaired Gas Exchange Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Gas Exchange Plan of Care
Impaired Memory Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Memory Plan of Care
Impaired Physical Mobility Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Physical Mobility Plan of Care
Impaired Skin Integrity Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Skin Integrity Plan of Care
Impaired Tissue Integrity Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Impaired Tissue Integrity Plan of Care
Ineffective Airway Clearance Plan of Care IRDL
  • Consults
    • ❑ Consult to Respiratory Therapy
      • Ineffective Airway Clearance Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Ineffective Airway Clearance Plan of Care
Ineffective Tissue Perfusion Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Ineffective Tissue Perfusion Plan of Care
Infection/Risk for Infection Plan of Care IRDL
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Risk for Infection Plan of Care
INTER CARD - Post-Intervention Order Set-IMH
  • Activity
    • ❑ Bedrest
      • ________ hours after sheath removal.
  • Admission/Transfer/Discharge
    • ❑ Communication Order
      • Return to room
    • ❑ Place in Extended Recovery
      • ❑ Critical Care
      • ❑ Intermediate Care, Progressive Care
      • ❑ Telemetry, once sheath removed
    • ❑ Place in Observation
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, once sheath removed
    • ❑ Admit to Inpatient
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, once sheath removed
  • Communication
    • ❑ Notify Provider
      • ______________ upon arrival to unit.
  • Diagnostic Tests
    • ❑ ECG
      • Upon arrival to unit
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Cardiac, Room Service Eligible: Yes, Fluid: 1000 ml
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, hr, 50 mL/hr
      • ❑ 1,000 mL, IV, hr, 40 mL/hr
    • ❑ Nursing Communication Order
      • D/C Angiomax 2 hours after PO Plavix given. (Refer to scanned in cath lab medication sheet)
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Chem 7
        • Blood, AM Draw collect, T+1;0500
      • ❑ Fasting Lipid Profile
        • Blood, AM Draw collect, T+1;0500
      • ❑ ACT Monitoring POC
        • ACT @ _____ and Q1hour PRN until level is less than ____, then remove femoral sheath per protocol.
  • Medications
    • ❑ aspirin
      • 325 mg, Tab, Oral, Daily, Start date: T+1;1000
    • ❑ clopidogrel
      • 75 mg, Tab, Oral, Daily, Start date: T+1;1000
    • ❑ prasugrel
      • 10 mg, Tab, Oral, Daily, Start date: T+1;1000
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN for Pain - Mild
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ morphine
      • 2 mg, Syringe, IV Push, q2hr, PRN Pain - Severe
    • ❑ zolpidem
      • 5 mg, Tab, Oral, HS, PRN for Sleep
  • Patient Care
    • ❑ Vascular Sheath Removal
      • Remove sheath per protocol _____________ hours after Angiomax therapy discontinued.
    • ❑ Insert Foley Catheter
      • Indwelling, as needed
    • ❑ Encourage PO Fluids
      • After CCL procedure
    • ❑ Notify Provider
      • See Comment.
    • ❑ Nursing Communication Order
      • See Comments
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q 15 minutes until sheath removed.
    • ❑ Cardiac Cath site check
      • q 15 min. until sheath removed.
    • ❑ Vital Signs POC
      • Post Sheath Removal: q15min x4; then every 30min x4, and then every hour until ambulating; once ambulating q4hr until 0800.
    • ❑ Cardiac Cath site check
      • Post Sheath Removal: Assess site condition, as well as assess site pulse and distal to this q15min x4; then every 30min x4, and then every hour until ambulating; once ambulating q4hr until 0800.
INTER CARD - Pre-Cath / Pre-Intervention / Peripheral Angiogram / Periph Order Set - IMH
  • Diet
    • ❑ Diet Order
      • NPO, Except for po medications.
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ Sodium Bicarbonate 150 mEq/D5W 1000 mL
      • 1,000 mL, IV, Routine, Per Comment
      • 150 mEq
  • Laboratory
    • ❑ Serum Preg Test, Qual
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
  • Medications
    • ❑ Hold Med
      • Hold the following medications morning of procedure: ___________________________ .
    • ❑ Hold Med
      • Hold heparin on call to Cath Lab. Continue GpIIb-3a inhibitors to Cath Lab.
    • ❑ Hold Med
      • Hold Lovenox/Arixtra and other anticoagulants the day of procedure.
    • ❑ Pharmacy Communication Order.
      • Patient received iodinated contrast and is with active metformin order. Evaluate need to hold metformin per policy.
    • ❑ predniSONE
      • 40 mg, Tab, Oral, QID, Start date: T;1600, 4 dose(s)/time(s)
    • ❑ diphenhydrAMINE
      • 50 mg, Oral, On Call
  • Patient Care
    • ❑ Nursing Communication Order
      • History and Physical from most recent office visit on chart.
    • ❑ Nursing Communication Order
      • Most current EKG on chart.
    • ❑ Procedure / Consent
      • Left heart catheterization and possible percutaneous coronary intervention angioplasty and / or stenting
 K
Knowledge Deficit Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Knowledge Deficit Plan of Care
 L
LAB - Cortisol Stimulation Test IRDL
  • Laboratory
    • ❑ Cortrosyn Stimulation Lab Message
      • Blood
    • ❑ Cortrosyn Stimulation Baseline
      • Blood, Timed Study collect, T+1;0700
    • ❑ Cortrosyn Stimulation 30 min
      • Blood, Timed Study collect, T+1;0830
    • ❑ Cortrosyn Stimulation 60 min
      • Blood, Timed Study collect, T+1;0900
    • ❑ Cortrosyn
      • 0.25 mg, IV Push, Once, Start date: T+1;0800
LAB - Covid Testing Order Set - IMH
  • Laboratory
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Routine collect, T;N, Nurse collect
    • ❑ Respiratory Panel (Biofire RT-PCR) with COVID-19 IRDL.
      • Nasopharyngeal, Routine collect, T;N, Nurse collect
    • ❑ SARS-CoV-2 (COVID-19) Antigen
      • Nasopharyngeal Swab, T;N, Nurse collect
LAB - Exposure Exposed Person Order Set - IMH
  • Laboratory
    • ❑ HIV 1,2 Combo AgAb
      • Blood, Stat collect, T;N
    • ❑ Hep B Surface Ag
      • Blood, Stat collect, T;N
    • ❑ Hep C Ab
      • Blood, Stat collect, T;N
    • ❑ ALT
      • Blood, Stat collect, T;N
LAB - Exposure Source Patient Order Set - IMH
  • Laboratory
    • ❑ HIV Ab Screen , Needlestick
      • Blood, Stat collect, T;N
    • ❑ Hep B Surface Ag
      • Blood, Stat collect, T;N
    • ❑ Hep C Ab
      • Blood, Stat collect, T;N
Lab - Rhogam Full Dose Order Set - IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Rhogam Injection Full Dose
      • Blood
  • Medications
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once
LAB - Rhogam Mini Dose Order Set - IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Rhogam Mini Dose (fee for injection)
      • Blood
  • Medications
    • ❑ RHo (D) immune globulin 50 mcg intramuscular solution
      • 50 mcg, Soln, IM, Once
LAB - Rx Drug Labs Order Set - IMH
  • Laboratory
    • ❑ Creatinine
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 7 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Once
    • ❑ Creatinine
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Once
    • ❑ MRSA Nasal PCR
      • Nasal, Routine collect, T;N, Nurse collect
    • ❑ Vancomycin Level Trough
      • Blood, Timed Study collect
    • ❑ Gentamicin Level Trough
      • Blood, Timed Study collect
    • ❑ Gentamicin Level Peak.
      • Blood, Timed Study collect
    • ❑ Gentamicin Level
      • Blood, Timed Study collect
    • ❑ Tobramycin Level Trough
      • Blood, Timed Study collect
    • ❑ Tobramycin Level Peak
      • Blood, Timed Study collect
    • ❑ Tobramycin Level
      • Blood, Timed Study collect
    • ❑ Amikacin Level Trough (Local Lab)
      • Blood, Timed Study collect, Send to neighboring hospital for analysis
    • ❑ Amikacin Level Peak
      • Blood, Timed Study collect
    • ❑ Amikacin Level
      • Blood, Timed Study collect
LAB - Sepsis Panel - IMH
  • Laboratory
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N
    • ❑ Lactate
      • Blood, Stat collect, T;N
    • ❑ Sepsis Lab Notification
      • Blood, Stat collect, T;N, If LA is >2 or >than prior #, repeat LA in 2hrs
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
LAB - Troponin / CPK Reflex Order Set - IMH
  • Laboratory
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N, Troponin Series
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N, Troponin Series
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N, Troponin Series
    • ❑ CK Reflex
      • Blood, Stat collect, T;N
Leuko-Reduced HLA Platelet Pheresis IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ Leuko-Reduced HLA Platelet Pheresis
      • Platelets
LTC ADL Function Rehab IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
LTC Cognitive Loss IPOC
  • ❑ LTC Speech Language Therapy Evaluation and Treatment
    • T;N, Once
LTC Dental Care IPOC
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
LTC Falls IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
LTC Musculoskeletal IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
LTC Neurological IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ LTC Speech Language Therapy Evaluation and Treatment
    • T;N, Once
LTC Nutritional Status IPOC
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ LTC Speech Language Therapy Evaluation and Treatment
    • T;N, Once
LTC Pain IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
LTC Pressure Ulcer IPOC
  • ❑ Physical Therapy Evaluation and Treatment
    • T;N, Once
  • ❑ Occupational Therapy Evaluation and Treatment
    • T;N, Once
 M
MED - Acetylcysteine (Acetadote) IV Order Set - IMH
  • IV Solutions
    • ❑ acetylcysteine 20% IV 30,000 mg/D5W 850 ml
      • 850 mL, IV, Per Protocol
      • 30,000 mg
  • Laboratory
    • ❑ AST
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ ALT
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Acetaminophen Level
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ PT/INR
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Chem 12
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Lactate
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ AST
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ ALT
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ Acetaminophen Level
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ Chem 12
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
    • ❑ Lactate
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
  • Medications
    • ❑ acetylcysteine
      • 70 mg/kg, Oral, q4hr, 17 dose(s)/time(s)
  • Patient Care
    • ❑ Notify Provider
      • Call MD 24 hours after treatment initiation for order to discontinue treatment if patient is asymptomatic at 24 hours with normal AST and ALT levels, INR < 2.0 and documented undetectable acetaminophen levels.
  • Vital Signs
    • ❑ Vital Signs POC
      • Loading Dose- BP every 5 minutes x 3, then every 15 minutes x 3. During infusion - BP every 30 minutes.
    • ❑ Height & Weight POC
MED - Acute Severe Hyperkalemia Order Set - IMH
  • Communication
    • ❑ Hold Med
      • Hold meds that elevate serum potassium until serum potassium within normal range
    • ❑ Pharmacy Communication Order.
      • Discontinue oral or parenteral potassium
    • ❑ Misc Nursing Task
      • Discontinue MED - Acute Severe Hyperkalemia Order Set - IMH when serum potassium within normal limits
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, Routine, Once, Transport Mode: Portable
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 100 mL/hr
      • ❑ 1,000 mL, IV, STAT, Start date: T;N, 10 mL/hr
    • ❑ NS Bolus
      • ❑ 1,000 mL, IV, Once, STAT, Start date: T;N
      • ❑ 500 mL, IV, Once, STAT, Start date: T;N
      • ❑ 250 mL, IV, Once, STAT, Start date: T;N
    • ❑ Sodium Bicarbonate 150 mEq/D5W 1000 mL
      • 1,000 mL, IV, STAT, Start date: T;N, 1 dose(s)/time(s), 250 mL/hr
      • 150 mEq
  • Laboratory
    • ❑ Potassium Level
      • Blood, Timed Study collect
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500, Once
  • Medications
    • ❑ calcium gluconate
      • ❑ 1 gm, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 30 minute(s)
      • ❑ 1 gm, IV Push, Once, STAT, Start date: T;N
    • ❑ insulin regular 100 units/mL human recombinant injectable solution
      • 10 unit(s), Injection, IV Piggyback, Once, STAT, Start date: T;N, Infuse over 10 minute(s)
    • ❑ dextrose 50% injection
      • ❑ 25 gm, IV Push, Once, STAT, Start date: T;N
      • ❑ 50 gm, IV Push, Once, STAT, Start date: T;N
    • ❑ albuterol 0.5% inhalation solution
      • ❑ 10 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
      • ❑ 20 mg, Soln-Inh, NEB, Once, STAT, Start date: T;N
    • ❑ Lasix
      • ❑ 40 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 80 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 40 mg, IV Push, Daily, Start date: T;N
      • ❑ 80 mg, IV Push, Daily, Start date: T;N
      • ❑ 40 mg, IV Push, BID, Start date: T;N
      • ❑ 80 mg, IV Push, BID, Start date: T;N
    • ❑ bumetanide
      • ❑ 2 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 4 mg, IV Push, Once, STAT, Start date: T;N
      • ❑ 2 mg, IV Push, Daily, Start date: T;N
      • ❑ 4 mg, IV Push, Daily, Start date: T;N
      • ❑ 2 mg, IV Push, BID, Start date: T;N
      • ❑ 4 mg, IV Push, BID, Start date: T;N
    • ❑ sodium polystyrene sulfonate
      • ❑ 30 gm, Oral, Once, STAT, Start date: T;N
      • ❑ 15 gm, Oral, Once, STAT, Start date: T;N
      • ❑ 60 gm, Oral, Once, STAT, Start date: T;N
  • Patient Care
    • ❑ EKG
      • T;N, Stat, Once
    • ❑ Blood Glucose POC
      • T;N, q1hr, for 3 dose(s)/time(s), Stat
    • ❑ Blood Glucose POC
      • T;N, q2hr, for 2 dose(s)/time(s), Stat
    • ❑ Precautions
      • T;N, Constant Order, Falls Precautions
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • T;N
    • ❑ Pulse Oximetry POC
      • T;N, PRN
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 94%.
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ ABG Draw (Resp)
      • T;N, Stat
  • Vital Signs
    • ❑ Vital Signs POC
      • q2hr, for 2 dose(s)/time(s)
    • ❑ Vital Signs POC
      • q4hrVS
MED - Adult Hypoglycemia Treatment Order Set - IMH
  • Patient Care
    • ❑ Blood Glucose POC
      • Stat, PRN
    • ❑ Notify Provider
      • For finger stick blood sugar less than 40 mg/dl.
    • ❑ Nursing Communication Order
      • If patient experiences hypoglycemia, perform 0200 fingerstick blood glucose.
    • ❑ glucose
      • 16 gm, Tab-Chew, Chewed, q15min, PRN for Low blood sugar
    • ❑ dextrose 50% injection
      • 12.5 gm, Syringe, IV Push, q15min, PRN for Blood Glucose
    • ❑ dextrose 50% injection
      • 25 gm, Syringe, IV Push, q15min, PRN for Blood Glucose
    • ❑ glucagon
      • 1 mg, Vial, Subcutaneous, q15min, PRN for Blood Glucose
    • ❑ glucagon
      • 1 mg, Vial, IM, q15min, PRN for Blood Glucose
MED - Adult Influenza Immunization Order Set - IMH
  • Patient Care
    • ❑ influenza virus vaccine, inactivated
      • 0.5 mL, Susp-Inj, IM, Once
MED - Adult Insulin Order Set - IMH
  • Diet
    • ❑ Diet Order
      • ❑ Diabetic, Room Service Eligible: Yes, 3CHO Choices/Meal (1200-1500 cal)
      • ❑ Diabetic, Room Service Eligible: Yes, 4CHO Choices/Meal (1600-1900 cal)
      • ❑ Diabetic, Room Service Eligible: Yes, 5CHO Choices/Meal (2000-2200 cal)
  • Laboratory
    • ❑ Hgb A1C
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ Levemir
      • unit(s), Injection, Subcutaneous, qAM-WM
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, qAM-WM
    • ❑ HumuLIN 70/30
      • unit(s), Susp-Inj, Subcutaneous, qAM-WM
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, qPM-WM
    • ❑ HumuLIN 70/30
      • unit(s), Susp-Inj, Subcutaneous, qPM-WM
    • ❑ Levemir
      • unit(s), Injection, Subcutaneous, HS
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, HS
    • ❑ HumuLIN 70/30
      • unit(s), Susp-Inj, Subcutaneous, HS
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qAM-WM
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qNoon-WM
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qPM-WM
    • ❑ insulin regular 100 units/mL human recombinant injectable solution
      • unit(s), Injection, Subcutaneous, 4x/Day
    • ❑ Insulin Humalog sliding scale
      • ❑ Low Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ Low Dose Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Low Dose Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Low Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ Low Dose Correction, Injection, Subcutaneous, 4x/Day
      • ❑ Low Dose Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ Medium Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ Medium Dose Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Medium Dose Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Medium Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ Medium Dose Correction, Injection, Subcutaneous, 4x/Day
      • ❑ Medium Dose Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ High Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ High Dose Correction, Injection, Subcutaneous, 6x/Day
      • ❑ High Dose Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ High Dose Correction, Injection, Subcutaneous, TIDAC
      • ❑ High Dose Correction, Injection, Subcutaneous, 4x/Day
      • ❑ High Dose Correction, Injection, Subcutaneous, BIDAC
  • Patient Care
    • ❑ Blood Glucose POC
      • ❑ TIDAC
      • ❑ QIDACHS
      • ❑ 4x/Day, (q 6 hours) Recommended for patient NPO, on Tube Feedings, or on TPN
      • ❑ AC Breakfast
      • ❑ BIDAC
    • ❑ Blood Glucose POC
      • T;1600, Q24hr, Daily at 1600
    • ❑ Blood Glucose POC
      • T+1;0200, Q24hr, Daily at 0200
MED - Adult Menactra Immunization Order Set - IMH
  • Patient Care
    • ❑ Menactra
      • 0.5 mL, Soln, IM, Once
MED - Adult Pain Medication Order Set - IMH
  • Medications
    • ❑ ibuprofen
      • 400 mg, Tab, Oral, q4hr, PRN for Pain - Mild
    • ❑ naproxen
      • 500 mg, Tab, Oral, q12hr, PRN for Pain - Mild
    • ❑ ketorolac
      • ❑ 10 mg, Tab, Oral, q6hr, PRN for Pain - Mild, 5 day(s)
      • ❑ 15 mg, Vial, IV Push, q6hr, PRN for Pain - Mild, 5 day(s)
      • ❑ 15 mg, Vial, IM, q6hr, PRN for Pain - Mild, 5 day(s)
      • ❑ 30 mg, Vial, IV Push, q6hr, PRN for Pain - Mild, 5 day(s)
      • ❑ 30 mg, Vial, IM, q6hr, PRN for Pain - Mild, 5 day(s)
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q6hr, PRN Pain - Mild
    • ❑ acetaminophen/butalbital/caffeine 325 mg-50 mg-40 mg oral tablet
      • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
    • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
      • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Mild
    • ❑ traMADol
      • 50 mg, Tab, Oral, q6hr, PRN for Pain - Mild
    • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
      • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
    • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
      • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
    • ❑ nalbuphine
      • 10 mg, Vial, IV Push, q4hr, PRN for Pain - Moderate
    • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
      • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
      • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • ❑ oxyCODONE
      • ❑ 5 mg, Tab, Oral, q4hr, PRN Pain - Moderate
      • ❑ 10 mg, Tab, Oral, q4hr, PRN Pain - Moderate
    • ❑ traMADol
      • 100 mg, Tab, Oral, q6hr, PRN for Pain - Moderate
    • ❑ HYDROmorphone
      • ❑ 2 mg, Tab, Oral, q4hr, PRN for Pain - Severe
      • ❑ 4 mg, Tab, Oral, q4hr, PRN for Pain - Severe
      • ❑ 0.5 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
      • ❑ 1 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
      • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
    • ❑ morphine
      • ❑ 15 mg, Tab, Oral, q4hr, PRN Pain - Severe
      • ❑ 30 mg, Tab, Oral, q4hr, PRN Pain - Severe
      • ❑ 1 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
      • ❑ 2 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
      • ❑ 4 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
    • ❑ butorphanol
      • ❑ 1 mg, Vial, IV Push, q4hr, PRN for Pain - Severe
      • ❑ 2 mg, Vial, IV Push, q4hr, PRN for Pain - Severe
MED - Adult Pneumonia Immunization Order Set - IMH
  • Medications
    • ❑ pneumococcal 20-valent conjugate vaccine
      • 0.5 mL, Susp, IM, Once
MED - Anemia Routine Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ XR Chest 1 View Frontal
      • Routine, Transport Mode: Portable
    • ❑ XR Chest 2 Views
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 10 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
  • Laboratory
    • ❑ Hemoglobin & Hematocrit
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Folate, Serum
      • Blood, Routine collect, T;N
    • ❑ Ferritin Serum
      • Blood, Routine collect, T;N
    • ❑ B12 Level
      • Blood, Routine collect, T;N
    • ❑ Iron & IBC
      • Blood, Routine collect, T;N
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ BMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ CMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • ❑ Blood, Timed Study collect, q6hr
      • ❑ Blood, Timed Study collect, q8hr
      • ❑ Blood, Timed Study collect, q12hr
    • ❑ Stool for Blood
      • Stool, Routine collect, T;N, q1hr, for 3 dose(s)/time(s), Nurse collect
  • Patient Care
    • ❑ Notify Provider Vital Signs
      • T > 38.5, HR > 120, HR < 50, SBP > 180, SBP < 90, DBP > 100, RR > 24, RR < 12, O2 sat < 92
    • ❑ SCDs
      • Calf
    • ❑ Ted Hose
      • ❑ Knee High
      • ❑ Thigh High
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Titrate Oxygen
      • ❑ keep sats > 92%.
      • ❑ keep sats > 90%
      • ❑ keep sats at patients baseline.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
MED - Blood &/or Blood Products Transfusion Order Set - IMH
  • Communication
    • ❑ Patient Education
      • Provide Blood &/or Blood Product handout.
    • ❑ Patient Instruction
      • Instruct patient to call the nurse if he/she has signs/symptoms of reaction.
  • Condition
    • ❑ Procedure / Consent
      • for Blood or Blood Product Transfusion
  • IV Solutions
    • ❑ NS
      • ❑ 250 mL, IV, 12 hr, 10 mL/hr
      • ❑ 1,000 mL, IV, 4 hr, 10 mL/hr
  • Laboratory
    • AM Labs
      • ❑ Hemoglobin & Hematocrit
        • Blood, AM Draw collect, T+1;0500, Once, Lab Collect
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500, Once, Lab Collect
      • ❑ CBC w/Auto Diff
        • Blood, AM Draw collect, T+1;0500, Once, Lab Collect
    • ❑ Transfuse Blood Product [IMH]
      • ❑ 1 Unit Packed Red Blood Cells
      • ❑ q2hr, for 2 dose(s)/time(s), 2 Units Packed Red Blood Cells
      • ❑ q2hr, for 3 dose(s)/time(s), 3 Units Packed Red Blood Cells
      • ❑ q2hr, for 4 dose(s)/time(s), 4 Units Packed Red Blood Cells
    • ❑ Transfuse Blood Product [IMH]
      • ❑ PRN, If hgb < 9, Transfuse 1 Unit PRBC
      • ❑ PRN, If hgb < 8.5, Transfuse 1 Unit PRBC
      • ❑ PRN, If hgb < 8, Transfuse 1 Unit PRBC
      • ❑ q2hr, for 2 dose(s)/time(s), PRN, If hgb < 8, Transfuse 2 Units PRBC
    • ❑ Dialysis - Blood Product Transfusion
      • ❑ 1 Unit Packed Red Blood Cells with HEMOdialysis Treatment
      • ❑ q30min, for 2 dose(s)/time(s), 2 Units Packed Red Blood Cells with HEMOdialysis Treatment
    • ❑ Transfuse Blood Product [IMH]
      • hr, Blood Product: ______________ Total blood product volume: _________mL Saline flush volume: _______mL
    • ❑ Transfuse Blood Product [IMH]
      • ❑ 1 Unit Autologous Red Blood Cells
      • ❑ 2 Units Autologous Red Blood Cells
    • ❑ Transfuse Blood Product [IMH]
      • ❑ 1 Unit Donor Specific Red Blood Cells
      • ❑ 2 Units Donor Specific Red Blood Cells
    • ❑ Transfuse Blood Product [IMH]
      • ❑ 1 Unit FFP
      • ❑ q2hr, for 2 dose(s)/time(s), 2 Units FFP
      • ❑ q2hr, for 3 dose(s)/time(s), 3 Units FFP
      • ❑ q2hr, for 4 dose(s)/time(s), 4 Units FFP
    • ❑ Dialysis - Blood Product Transfusion
      • ❑ 1 Unit FFP with HEMOdialysis Treatment
      • ❑ q30min, for 2 dose(s)/time(s), 2 Units FFP with HEMOdialysis Treatment
    • ❑ Transfuse Blood Product [IMH]
      • 1 Pack Leukoreduced Plateletpheresis
    • ❑ Transfuse Blood Product [IMH]
      • 1 Unit Cryoprecipitate (1 unit = 5 pooled units)
    • ❑ Fibrinogen.
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Hemoglobin & Hematocrit
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CBC
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ PTT
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Prothrombin Time
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ BMP
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CMP
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Nursing Communication Order
      • ❑ Enter order for H&H 1 hour past transfusion.
      • ❑ Enter order for H&H 2 hours past transfusion.
      • ❑ Enter order for H&H immediately after transfusion.
    • ❑ Notify Provider Laboratory Results
      • ❑ Hgb < 6
      • ❑ Hgb < 7
      • ❑ Hgb < 8
      • ❑ Hgb < 9
    • ❑ Nursing Communication Order
      • ❑ Enter order for CBC 1 hour past transfusion.
      • ❑ Enter order for CBC 2 hours past transfusion.
      • ❑ Enter order for CBC immediately after transfusion.
    • ❑ Notify Provider Laboratory Results
      • ❑ Hgb < 6
      • ❑ Hgb < 7
      • ❑ Hgb < 8
      • ❑ Hgb < 9
  • Medications
    • Post Transfusion
      • ❑ Lasix
        • ❑ 20 mg, Vial, IV Push, On Call
        • ❑ 40 mg, Vial, IV Push, On Call
      • ❑ Lasix
        • ❑ 20 mg, Vial, IV Push, On Call
        • ❑ 40 mg, Vial, IV Push, On Call
      • ❑ Lasix
        • ❑ 20 mg, Vial, IV Push, On Call
        • ❑ 40 mg, Vial, IV Push, On Call
    • Pre-Transfusion
      • ❑ Benadryl
        • ❑ 25 mg, Vial, IV Push, On Call
        • ❑ 25 mg, Oral, On Call
      • ❑ Tylenol
        • ❑ 650 mg, Tab, Oral, On Call
        • ❑ 650 mg, Supp, Per rectum, On Call
      • ❑ Lasix
        • ❑ 20 mg, Vial, IV Push, On Call
        • ❑ 40 mg, Vial, IV Push, On Call
      • ❑ SoluMEDROL
        • ❑ 80 mg, Vial, IV Push, On Call
        • ❑ 125 mg, Vial, IV Push, On Call
  • Patient Care
    • ❑ IV Start
      • Utilize catheter size at least 18 - 20 gauge for red blood cell administration
    • ❑ Nursing Communication Order
      • Keep 2 Units PRBC ahead.
    • ❑ Lab Communication Order
      • Other, Keep 2 Units PRBC ahead.
  • Vital Signs
    • ❑ Vital Signs POC
      • per blood transfusion protocol
MED - Bone Marrow Aspiration Order Set - IMH
  • Laboratory
    • ❑ Nursing Communication Order
      • Have paper Pathology Form available
  • Patient Care
    • ❑ Procedure / Consent
      • Bone Marrow Aspiration
    • ❑ Nursing Communication Order
      • Supplies at Bedside: 2 pair of appropriately sized sterile gloves, 2% Lidocaine, Bottle of Alcohol, Bottle of Betadine, Scissors, 10cc Syringe, 20G 1 1/2" Needle, and 18G 3 ½" Needle
MED - Central Line Order Set - IMH
  • Communication
    • ❑ Patient Education
      • Daily, Teach patient/family about potential central line infection(s)
    • ❑ Misc Nursing Task
      • T+1;0900, CHG Bath, document in iView < ADL < Hygiene
  • Consults
    • ❑ Consult to PICC Nurse
      • PICC Insertion
    • ❑ Consult to Anesthesia
      • Central Line Insertion
  • Patient Care
    • ❑ Review Need for Central Line
      • T;N, 3x/Day
    • ❑ Central Line Dressing Change
      • T+7;0900, q7day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, 3x/Day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, UD, PRN Other (see comment)
    • ❑ heparin flush 100 units/mL
      • 3 mL, IV Flush, 3x/Day
    • ❑ heparin flush 100 units/mL
      • 3 mL, IV Flush, As Directed, PRN for Other (see comment)
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, 3x/Day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, UD, PRN Other (see comment)
    • ❑ Access Port-a-Cath
    • ❑ Change IV
      • T+7;0900, q7day, Port-a-Cath Needle Change Q7days & PRN
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, Daily
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, UD, PRN Other (see comment)
    • ❑ heparin flush 100 units/mL
      • 5 mL, IV Flush, Daily
    • ❑ heparin flush 100 units/mL
      • 5 mL, IV Flush, As Directed, PRN for Other (see comment)
    • ❑ Arterial / CVP Line Flush
      • 500 mL, IV, Routine, 3 mL/hr
      • 1,000 unit(s)
MED - Clostridium difficile (C diff) Treatment Order Set - IMH
  • Medications
    • ❑ vancomycin
      • 125 mg, Oral, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ vancomycin
      • 125 mg, Oral, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ vancomycin
      • ❑ 500 mg, Oral, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
      • ❑ 500 mg, GTUBE, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ vancomycin
      • 500 mg, Enema, Per rectum, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ vancomycin
      • 125 mg, Oral, q6hr, Antibiotic Indication Clostridium difficile infection, 10 day(s)
    • ❑ vancomycin
      • 125 mg, Oral, q12hr, Antibiotic Indication Clostridium difficile infection, 7 day(s)
    • ❑ vancomycin
      • 125 mg, Oral, Q24hr, Antibiotic Indication Clostridium difficile infection, 7 day(s)
    • ❑ vancomycin
      • 125 mg, Oral, q48hr, Antibiotic Indication Clostridium difficile infection, week(s)
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
MED - Comfort Care Order Set - IMH
  • Activity
    • ❑ Turn Patient POC
      • 12x/Day, q2hr as needed
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Hospice, Anticipated LOS 2 midnights or more
      • ❑ Palliative Care, Anticipated LOS 2 midnights or more, Palliative Care with Hospice
    • ❑ Nursing Communication
      • ❑ Palliative Care - Reason for Admission
      • ❑ Terminal Care - Reason for Admission
  • Consults
    • ❑ Consult to Discharge Planning Services (CM)
      • Hospice
  • Diet
    • ❑ Diet Order
      • Regular, Room Service Eligible: Yes, As Tolerated
    • ❑ Dietary Communication
      • T;N, Comfort Foods for patient
    • ❑ Dietary Communication
      • Regular guest tray once
  • Medications
    • ❑ Nursing Communication
      • Notify Respiratory to discontinue Vapotherm/Bipap 20 minutes after patient has been medicated.
    • ❑ Respiratory Communication
      • Place on Nasal Cannula 2 - 6 L per patient comfort level after Vapotherm/Bipap discontinued. Do not titrate O2 up and do not monitor O2 sats after Vapotherm/Bipap discontinued.
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once, NOW
      • ❑ 4 mg, Syringe, IV Push, Once, NOW
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, Once
      • ❑ 4 mg, Syringe, IV Push, Once
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, q30min, PRN for Other (see comment)
      • ❑ 4 mg, Syringe, IV Push, q30min, PRN for Other (see comment)
    • ❑ LORazepam
      • 0.5 mg, Injection, IV Push, q2hr, PRN for Other (see comment)
    • ❑ LORazepam
      • 0.5 mg, Tab, Per rectum, q2hr, PRN for Other (see comment)
    • ❑ LORazepam
      • 0.5 mg, Tab, Sublingual, q2hr, PRN for Other (see comment)
    • ❑ haloperidol
      • 1 mg, Tab, Sublingual, q6hr, PRN for Other (see comment)
    • ❑ haloperidol
      • 1 mg, Injection, IV Push, q6hr, PRN for Other (see comment)
    • ❑ diazePAM
      • 2.5 mg, Syringe, IV Push, q4hr, PRN for Other (see comment)
    • ❑ diazePAM
      • 5 mg, Tab, Per rectum, q4hr, PRN for Other (see comment)
    • ❑ diazePAM
      • 5 mg, Tab, Sublingual, q4hr, PRN for Other (see comment)
    • ❑ Imodium A-D
      • 2 mg, Cap, Oral, As Directed, for Loose stools
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN for Fever
    • ❑ acetaminophen
      • 650 mg, Supp, Per rectum, q4hr, PRN for Fever
    • ❑ Dulcolax Laxative
      • 10 mg, Supp, Per rectum, Q24hr, PRN Constipation
    • ❑ Check for Fecal Impaction
      • PRN, If no bowel movement for 72 hours. See Comments.
    • ❑ atropine 1% ophthalmic solution
      • 2 drop(s), Sublingual, q1hr, PRN Other (see comment)
    • ❑ dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
      • 10 mL, Oral, q4hr, PRN for Cough and congestion
    • ❑ hyoscyamine
      • 0.125 mg, Tab, Sublingual, q4hr, PRN Other (see comment)
    • ❑ glycopyrrolate
      • 0.4 mg, Vial, IV Push, q6hr, PRN for Other (see comment)
    • ❑ morphine 20 mg/mL oral concentrate
      • ❑ 5 mg, Sublingual, q1hr, PRN Other (see comment)
      • ❑ 5 mg, Sublingual, q4hr, PRN for Other (see comment)
      • ❑ 10 mg, Sublingual, q1hr, PRN Other (see comment)
    • ❑ HYDROmorphone
      • ❑ 0.25 mg, Syringe, IV Push, q30min, PRN for Other (see comment)
      • ❑ 0.5 mg, Syringe, IV Push, q30min, PRN for Other (see comment)
    • ❑ Lidocaine Viscous
      • 5 mL, Liquid, Oral, As Directed, PRN Other (see comment)
    • ❑ ondansetron
      • 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
    • ❑ ondansetron
      • 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ prochlorperazine
      • 10 mg, Tab, Oral, q6hr, PRN for Nausea/Vomiting
    • ❑ prochlorperazine
      • 10 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ promethazine
      • 25 mg, Tab, Oral, q4hr, PRN for Nausea/Vomiting
    • ❑ promethazine
      • 25 mg, Supp, Per rectum, q4hr, PRN for Nausea/Vomiting
    • ❑ haloperidol
      • 1 mg, Tab, Sublingual, q6hr, PRN for Other (see comment)
    • ❑ haloperidol
      • 1 mg, Injection, IV Push, q6hr, PRN for Other (see comment)
    • ❑ aluminum hydroxide/magnesium hydroxide/simethicone 400 mg-400 mg-40 mg/5 mL oral suspension
      • 15 mL, Susp, Oral, QID, PRN for Indigestion
    • ❑ famotidine
      • 20 mg, Vial, IV Push, Daily, PRN for Other (see comment)
    • ❑ famotidine
      • 20 mg, Tab, Oral, Daily, PRN for Other (see comment)
    • ❑ chlorproMAZINE
      • 25 mg, Tab, Oral, QID, PRN for hiccoughs
  • Patient Care
    • ❑ Insert Foley Catheter
      • Indwelling, PRN, If skin breakdown prevention, incontinence, or urinary retention, may insert #16F foley catheter. Follow foley catheter insertion protocol.
    • ❑ Condom Catheter
      • PRN, If skin breakdown prevention or incontinence.
    • ❑ Oral Care
      • TIDWM, and PRN
    • ❑ Nursing Communication Order
      • Continue current treatment of pressure ulcers.
    • ❑ Nursing Communication Order
      • Do not hold scheduled pain or anxiety medications for sedation.
    • ❑ Saline Lock Insertion
      • PRN
    • ❑ Notify Provider
      • If no bowel movement for 72 hours.
    • ❑ Nursing Communication
      • Initiate End of Life Plan of Care
    • ❑ Suction Patient
      • PRN, PRN Yankauer for suctioning - DO NOT DEEP suction. Reposition for excess secretions.
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula, PRN
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula, PRN
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, PRN
      • ❑ 4 L, Nasal Cannula
    • ❑ Bi-level Positive Airway Pressure
      • PRN, Shortness of breath
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Do Not Resuscitate
  • Vital Signs
    • ❑ Vital Signs POC
      • Daily, and PRN
MED - Congestive Heart Failure (CHF) Education Order Set - IMH
  • Consults
    • ❑ Consult to Dietitian
      • T;N, CHF Education
    • ❑ Consult to Pharmacy
      • T;N, CHF Education
    • ❑ Education Heart Failure
      • T;N, Provide red CHF education folder.
    • ❑ Education Heart Failure
      • T+1;0900, Daily, Educate on red CHF education folder content.
    • ❑ Consult to Discharge Planning Services (CM)
      • T;N, CHF
MED - Congestive Heart Failure (CHF) Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Cardiology
      • Congestive Heart Failure
  • Diagnostic Tests
    • AM Diagnostics (tomorrow)
      • ❑ XR Chest 1 View Portable
        • T+1;0700, Timed
    • ❑ XR Chest 2 Views
      • Routine, Transport Mode: Wheelchair
    • ❑ ECG
      • Routine
    • ❑ Echocardiogram for Heart Station
      • Routine
    • ❑ NM Muga Scan
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Low Sodium, Fluid: 2000 ml, Na: 2 gm
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac, Fluid: 1000 ml
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Renal, Fluid: 1000 ml
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Regular, Pureed, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1,000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1,000 mL, IV, 10 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 30 mL/hr
  • Laboratory
    • AM Labs
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Magnesium Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ NT-proBNP
        • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Digoxin Lvl
      • Blood, Routine collect, T;N
    • ❑ Thyroid Stimulating Hormone
      • Blood, Routine collect, T;N
    • ❑ NT-proBNP
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Lipid Panel
      • Blood, Routine collect, T;N
  • Medications
    • ACE Inhibitor
      • ❑ enalapril
        • ❑ 2.5 mg, Tab, Oral, BID
        • ❑ 5 mg, Tab, Oral, BID
        • ❑ 10 mg, Tab, Oral, BID
        • ❑ 20 mg, Tab, Oral, BID
      • ❑ captopril
        • ❑ 6.25 mg, Tab, Oral, TID
        • ❑ 12.5 mg, Tab, Oral, TID
        • ❑ 25 mg, Tab, Oral, TID
        • ❑ 50 mg, Tab, Oral, TID
      • ❑ lisinopril
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 20 mg, Tab, Oral, Daily
      • ❑ ramipril
        • ❑ 2.5 mg, Cap, Oral, Daily
        • ❑ 2.5 mg, Cap, Oral, BID
        • ❑ 5 mg, Cap, Oral, BID
        • ❑ 10 mg, Cap, Oral, Daily
        • ❑ 1.25 mg, Cap, Oral, Daily
    • ARB
      • ❑ Cozaar
        • ❑ 25 mg, Tab, Oral, Daily
        • ❑ 50 mg, Tab, Oral, Daily
        • ❑ 100 mg, Tab, Oral, Daily
      • ❑ Diovan
        • ❑ 40 mg, Tab, Oral, BID
        • ❑ 80 mg, Tab, Oral, BID
        • ❑ 160 mg, Tab, Oral, BID
      • ❑ Atacand
        • ❑ 4 mg, Tab, Oral, Daily
        • ❑ 8 mg, Tab, Oral, Daily
        • ❑ 16 mg, Tab, Oral, Daily
        • ❑ 32 mg, Tab, Oral, Daily
    • Beta Blockers
      • ❑ carvedilol
        • ❑ 3.125 mg, Tab, Oral, BID
        • ❑ 6.25 mg, Tab, Oral, BID
        • ❑ 12.5 mg, Tab, Oral, BID
        • ❑ 25 mg, Tab, Oral, BID
      • ❑ Toprol-XL
        • ❑ 12.5 mg, Tab-24, Oral, Daily
        • ❑ 25 mg, Tab-24, Oral, Daily
        • ❑ 50 mg, Tab-24, Oral, Daily
        • ❑ 100 mg, Tab-24, Oral, Daily
      • ❑ Bystolic
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, Daily
      • ❑ bisoprolol
        • ❑ 1.25 mg, Tab, Oral, Daily
        • ❑ 2.5 mg, Tab, Oral, Daily
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, Daily
    • Diuretics
      • ❑ Lasix
        • ❑ 20 mg, Tab, Oral, qAM
        • ❑ 20 mg, Tab, Oral, BID
        • ❑ 40 mg, Tab, Oral, qAM
        • ❑ 40 mg, Tab, Oral, BID
        • ❑ 20 mg, Vial, IV Push, qAM
        • ❑ 20 mg, Vial, IV Push, BID
        • ❑ 40 mg, Vial, IV Push, qAM
        • ❑ 40 mg, Vial, IV Push, BID
        • ❑ 80 mg, Vial, IV Push, qAM
        • ❑ 80 mg, Vial, IV Push, BID
        • ❑ 80 mg, Vial, IV Push, 3x/Day
      • ❑ Lasix Drip
        • 100 mg
        • 100 mL, IV, 10 mL/hr
      • ❑ metolazone
        • ❑ 5 mg, Tab, Oral, Daily
        • ❑ 10 mg, Tab, Oral, Daily
        • ❑ 2.5 mg, Tab, Oral, Daily
      • ❑ spironolactone
        • ❑ 25 mg, Tab, Oral, Daily
        • ❑ 50 mg, Tab, Oral, Daily
  • Patient Care
    • ❑ Notify Provider
      • ❑ For 2 consecutive hours, Urine Output Less Than 25
      • ❑ For 2 consecutive hours, Urine Output Less Than 50
    • ❑ Heart Failure Education
      • Activity, Diet, Follow-up Appointment, Medications, Symptoms Worsening, & Weight Monitoring
    • ❑ Intake & Output POC
      • 6x/Day
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Routine
    • ❑ Oxygen Titrate
      • Nasal Cannula, 94%
    • ❑ BIPAP
      • Per RT
    • ❑ Oxygen Therapy
      • ❑ Per RT
      • ❑ 2 L
      • ❑ 3 L
      • ❑ 4 L
      • ❑ Vapotherm oxygen therapy per RT
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS, (q 4 hours)
      • ❑ qShift 8 hr VS, (q 8 hours)
    • ❑ Height & Weight POC
      • Once a Day (before meals), Weigh Daily
MED - Coumadin Order Set - IMH
  • Communication
    • ❑ Patient Education
      • Review Coumadin Education with patient / family with first dose of Coumadin.
  • Laboratory
    • ❑ INR
      • Blood, Routine collect, T;N, Once, Lab Collect, If not already ordered or resulted in previous 24
    • ❑ CBC
      • Blood, Routine collect, T;N, Once, Lab Collect, If not already ordered or resulted in previous 24
    • ❑ Notify Provider Laboratory Results
      • See Comments
    • ❑ Pregnancy Test Qual Urine
      • Urine, Routine collect, T;N
    • ❑ INR
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
  • Medications
    • ❑ Pharmacy Communication Order.
      • Daily, Warfarin (Coumadin) - Pharmacy to Dose.
    • ❑ Warfarin (Coumadin) - Pharmacy to Dose.
      • Pharmacy to Dose, Oral, See Instructions, PRN for Other (see comment)
    • ❑ warfarin
      • ❑ mg, Tab, Oral, Daily
      • ❑ 2.5 mg, Tab, Oral, Daily
      • ❑ 5 mg, Tab, Oral, Daily
      • ❑ 10 mg, Tab, Oral, Daily
    • ❑ Warfarin - Freetext
      • Alternating Doses, Oral, See Instructions
    • ❑ Coumadin Sliding Scale
      • Daily
    • ❑ Pharmacy Communication Order.
      • Daily, Coumadin Sliding Scale. Pharmacist to order daily dose of Coumadin per sliding scale order, if not otherwise ordered by provider.
    • ❑ Coumadin Call Daily
      • T;N, Daily, Call Dr. ______________ for daily Coumadin order.
  • Patient Care
    • ❑ Notify Provider Laboratory Results
      • if INR > 3.5 unless otherwise ordered.
    • ❑ Nursing Communication Order
      • Order a one-time Pregnancy Test Qual Urine if patient is female and not currently taking Coumadin, and is less than 55 years of age, and has no history of hysterectomy. Call physician and pharmacy if test is positive.
MED - COVID-19 Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
    • ❑ Consult Dietitian
      • Evaluate for nutritional deficit &/or declining respiratory status
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Routine, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Frontal
      • Routine, Transport Mode: Portable
    • ❑ CT Chest w/ Contrast
      • Routine
    • ❑ CT Chest w/o Contrast
      • Routine
    • ❑ CT Angio Pulmonary
      • Routine
    • ❑ EKG
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Regular
      • ❑ Cardiac
      • ❑ Cardiac | Diabetic, Diabetic, 1800 kcal
      • ❑ Clear Liquid
      • ❑ Full Liquid
      • ❑ Diabetic, Diabetic, 1600 kcal
      • ❑ Diabetic, Diabetic, 1800 kcal
      • ❑ Diabetic, Diabetic, 2000 kcal
      • ❑ Dysphagia, Honey Thick
      • ❑ Dysphagia, Nectar Thick
    • ❑ Dietary Communication
      • Disposable tray and disposable utensils for all meals and snacks
  • IV Solutions
    • ❑ Lactated Ringers
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
    • ❑ LR Bolus
      • 20 mL/kg, IV, Once, STAT, 999 mL, hr
    • ❑ D5NS
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Creatine Kinase
      • Blood, Routine collect, T;N
    • ❑ Ferritin Serum
      • Blood, Routine collect, T;N
    • ❑ Fibrinogen.
      • Blood, Routine collect, T;N
    • ❑ C-Reactive Protein
      • Blood, Routine collect, T;N
    • ❑ Procalcitonin
      • Blood, Routine collect, T;N
    • ❑ D-Dimer.
      • Blood, Routine collect, T;N
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Routine collect, T;N, Nurse collect
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Lactate
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Creatine Kinase
      • Blood, AM Draw collect, T+1;0500
    • ❑ Ferritin Serum
      • Blood, AM Draw collect, T+1;0500
    • ❑ Fibrinogen.
      • Blood, AM Draw collect, T+1;0500
    • ❑ C-Reactive Protein
      • Blood, AM Draw collect, T+1;0500
    • ❑ Procalcitonin
      • Blood, AM Draw collect, T+1;0500
    • ❑ D-Dimer.
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Anticoagulants
      • ❑ Lovenox
        • ❑ 40 mg, Syringe, Subcutaneous, Q24hr
        • ❑ 30 mg, Syringe, Subcutaneous, Q24hr
      • ❑ heparin
        • ❑ 5,000 unit(s), Injection, Subcutaneous, 3x/Day
        • ❑ 5,000 unit(s), Injection, Subcutaneous, q12hr
      • ❑ Arixtra
        • 2.5 mg, Syringe, Subcutaneous, Q24hr
      • ❑ enoxaparin
        • ❑ 1 mg/kg, Syringe, Subcutaneous, q12hr
        • ❑ 1.5 mg/kg, Syringe, Subcutaneous, Q24hr
        • ❑ 1 mg/kg, Syringe, Subcutaneous, Q24hr
    • Anxiolytics
      • ❑ ALPRAZolam
        • ❑ 0.25 mg, Tab, Oral, TID, PRN Anxiety
        • ❑ 0.25 mg, Tab, Oral, QID, PRN Anxiety
    • Other Meds
      • ❑ remdesivir
        • 200 mg, IV Piggyback, Once
      • ❑ remdesivir
        • 100 mg, IV Piggyback, Q24hr, 4 dose(s)/time(s)
      • ❑ remdesivir
        • 200 mg, IV Piggyback, Once
      • ❑ remdesivir
        • 100 mg, IV Piggyback, Q24hr, 4 dose(s)/time(s)
      • ❑ dexamethasone
        • ❑ 6 mg, Tab, Oral, Daily, 10 day(s)
        • ❑ 6 mg, Vial, IV Push, Daily, 10 day(s)
      • ❑ dexamethasone
        • ❑ 6 mg, Vial, IV Push, Daily, 10 day(s)
        • ❑ 6 mg, Tab, Oral, Daily, 10 day(s)
      • ❑ remdesivir
        • 200 mg, IV Piggyback, Once
      • ❑ remdesivir
        • 100 mg, IV Piggyback, Q24hr, 4 dose(s)/time(s)
      • ❑ baricitinib
        • 4 mg, Tab, Oral, Daily, 14 day(s)
      • ❑ dexamethasone
        • ❑ 6 mg, Tab, Oral, Daily, 10 day(s)
        • ❑ 6 mg, Vial, IV Push, Daily, 10 day(s)
      • ❑ remdesivir
        • 200 mg, IV Piggyback, Once
      • ❑ remdesivir
        • 100 mg, IV Piggyback, Q24hr, 4 dose(s)/time(s)
      • ❑ tocilizumab
        • 8 mg/kg, IV Piggyback, Once
    • Respiratory Treatment Orders
      • ❑ albuterol 90 mcg/inh inhalation
        • ❑ 2 puff(s), Aerosol, INH, 4x/Day
        • ❑ 1 puff(s), Aerosol, INH, 4x/Day
        • ❑ 1 puff(s), Aerosol, INH, q4hr, PRN Shortness of Breath or wheezing
        • ❑ 2 puff(s), Aerosol, INH, q6hr, PRN Shortness of Breath or wheezing
      • ❑ albuterol-ipratropium CFC free 100 mcg-20 mcg/inh inhalation aerosol
        • ❑ 1 puff(s), Aerosol, INH, 6x/Day
        • ❑ 1 puff(s), Aerosol, INH, QID
      • ❑ fluticasone-salmeterol 100 mcg-50 mcg inhalation powder
        • 1 puff(s), Inh-Oral Disk, INH, BID
      • ❑ fluticasone-salmeterol 250 mcg-50 mcg inhalation powder
        • 1 puff(s), Inh-Oral Disk, INH, BID
      • ❑ fluticasone-salmeterol 500 mcg-50 mcg inhalation powder
        • 1 puff(s), Inh-Oral Disk, INH, BID
      • ❑ LEVALBUTEROL MDI
        • ❑ 2 puff(s), Aerosol, INH, q4hr
        • ❑ 2 puff(s), Aerosol, INH, q6hr
    • ❑ homatropine-hydrocodone 1.5 mg-5 mg/5 mL oral syrup
      • 5 mL, Syrup, Oral, q4hr, PRN Cough
  • Patient Care
    • ❑ Head of Bed
      • Elevate greater than or equal to 30 when in bed.
    • ❑ Sequential Compression Device
      • T;N, Knee High: Apply bilateral SCDs
    • ❑ Insert Foley Catheter
      • T;N, Indwelling, PRN, May place indwelling Foley catheter, as appropriate per policy, for patients requiring continuous BiPAP or mechanical ventilation.
    • ❑ I&O POC
      • ❑ 3x/Day, Routine, q 8 hours
      • ❑ 6x/Day, Routine, q 4 hours
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Titrate
      • ❑ 88, Keep O2 Sat greater than or equal to 88%. When O2 Sat > 88% on room air, discontinue O2 & repeat O2 Sat on room air in 4 hours. Then order Pulse Ox Ambulatory.
      • ❑ 92, Keep O2 Sat greater than or equal to 92%. When O2 Sat > 92% on room air, discontinue O2 & repeat O2 Sat on room air in 4 hours. Then order Pulse Ox Ambulatory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Metered Dose Inhaler Treatment
      • q6hr, for 2 day(s)
    • ❑ Incentive Spirometry RT
      • BID RT, while awake
    • ❑ Flutter Valve
      • 4x/Day
    • ❑ Oxygen Titrate
      • Hi-flow nasal cannula, PRN, PRN Per RT
    • ❑ Bi-level Positive Airway Pressure
      • PRN, PRN per RT
    • ❑ Respiratory Assessment
      • Daily, RT to assist patient's response to therapy and contact physician as needed for adjustments to treatment.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
MED - Dietary Supplement Order Set - IMH
  • Patient Care
    • ❑ Dietary Supplements
      • ❑ Ensure Enlive, BIDWM
      • ❑ Vital, BIDWM
      • ❑ Med Pass 2.0 (Give to take medications with)
      • ❑ Ensure Clear, TIDWM
      • ❑ Glucema Shake, TIDWM
      • ❑ Nepro Carb Steady, TIDWM
      • ❑ Magic Cup, TIDWM
      • ❑ Ensure Pudding, TIDWM
    • ❑ Dietary Communication
      • ❑ Ensure Enlive, twice a day with breakfast and supper, 0
      • ❑ Vital, twice a day with breakfast and supper
      • ❑ Med Pass 2.0 (Give to take medications with), 0
      • ❑ Ensure Clear three times a day with meals
      • ❑ Glucema Shake three times a day with meals
      • ❑ Nepro Carb Steady three times a day with meals
      • ❑ Magic Cup three times a day with meals
      • ❑ Ensure Pudding three times a day with meals
MED - DuoNeb Order Set - IMH
  • Medications
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, 4x/Day
      • ❑ 3 mL, Soln, NEB, q6hr-WA
      • ❑ 3 mL, Soln, NEB, BID
      • ❑ 3 mL, Soln, NEB, 3x/Day
      • ❑ 3 mL, Soln, NEB, 6x/Day
      • ❑ 3 mL, Soln, NEB, 6x/Day
      • ❑ 3 mL, Soln, NEB, Once, STAT
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q12hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q1min, PRN for Shortness of Breath or wheezing, 3 dose(s)/time(s)
MED - DVT Order Set - IMH
  • Activity
    • ❑ Head of Bed
      • elevation 45 degrees
    • ❑ Out of bed
      • 3x/Day, As tolerated
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible
      • ❑ Regular, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 200 mL/hr
      • ❑ 1000 mL, IV, 250 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
      • 1,000 mL, IV, mL/hr
  • Laboratory
    • ❑ D-Dimer.
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ Chem 12
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
  • Medications
    • ❑ Lovenox
      • 1 mg/kg, Syringe, Subcutaneous, q12hr
    • ❑ Arixtra
      • 5 mg, Syringe, Subcutaneous, q24hr
    • ❑ Arixtra
      • 7.5 mg, Syringe, Subcutaneous, q24hr
    • ❑ Arixtra
      • 10 mg, Syringe, Subcutaneous, q24hr
  • Patient Care
    • ❑ Notify Provider Vital Signs
      • ❑ For 2 consecutive hours, UO < 25
      • ❑ For 2 consecutive hours, UO < 50
    • ❑ Ted Hose
      • ❑ Knee High - Bilateral
      • ❑ Knee High - Right Leg
      • ❑ Knee High - Left Leg
      • ❑ Thigh High - Bilateral
      • ❑ Thigh High - Right Leg
      • ❑ Thigh High - Left Leg
    • ❑ SCDs
      • ❑ Knee High - Bilateral
      • ❑ Knee High - Right Leg
      • ❑ Knee High - Left Leg
      • ❑ Thigh High - Bilateral
      • ❑ Thigh High - Right Leg
      • ❑ Thigh High - Left Leg
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Titrate Oxygen
      • ❑ keep sats greater than or equal to 89%
      • ❑ keep sats greater than or equal to 90%
      • ❑ keep sats greater than or equal to 92%
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
MED - Empiric Antibiotics for Sepsis Order Set - IMH
  • Medications
    • ❑ azithromycin
      • 500 mg, IV Piggyback, Q24hr, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60, 3 dose(s)/time(s)
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60, 7 dose(s)/time(s)
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60, 7 day(s), Infuse over 4 hr
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Upper Respiratory Infection, Start date: T;N+60, 7 dose(s)/time(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Upper Respiratory Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s), Infuse over 4 hr
    • ❑ cefepime
      • 2 gm, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, Start date: T;N+60, 7 day(s)
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60, 7 day(s)
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Urinary Tract Infection, Start date: T;N+60, 7 day(s)
    • ❑ cefTRIAXone
      • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Skin/Soft- Tissue Infection, Start date: T;N+60, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Skin/Soft- Tissue Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ cefTRIAXone
      • 2 gm, IV Piggyback, q12hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Central Nervous System Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, q8hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 day(s)
    • ❑ ampicillin
      • 2 gm, IV Piggyback, q4hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 day(s)
    • ❑ moxifloxacin
      • 400 mg, IV Piggyback, Q24hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 dose(s)/time(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Central Nervous System Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, q8hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 day(s)
    • ❑ Bactrim
      • mL, IV Piggyback, q6hr, Antibiotic Indication Central Nervous System Infection, Start date: T;N+60, 7 day(s)
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60, 7 day(s), Infuse over 4 hr
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ cefepime
      • 2 gm, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Start date: T;N+60, 7 dose(s)/time(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, for Other (see comment), Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
MED - Empiric Treatment of Common Infections Order Set - IMH
  • Medications
    • ❑ ceFAZolin
      • 1 gm, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ levoFLOXacin
      • ❑ 750 mg, Tab, Oral, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
      • ❑ 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, 7 day(s), Infuse over 4 hr
    • ❑ levoFLOXacin
      • ❑ 750 mg, Tab, Oral, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
      • ❑ 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Intraabdominal Infection, 7 day(s)
    • ❑ ceFAZolin
      • 2 gm, IV Piggyback, q8hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
    • ❑ cephalexin
      • 500 mg, Cap, Oral, q6hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Skin/Soft- Tissue Infection, Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
    • ❑ doxycycline
      • 100 mg, Oral, q12hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
    • ❑ clindamycin
      • ❑ 300 mg, Cap, Oral, q8hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
      • ❑ 450 mg, Cap, Oral, q8hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
    • ❑ sulfamethoxazole-trimethoprim 800 mg-160 mg oral tablet
      • ❑ 2 tab(s), Tab, Oral, q12hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
      • ❑ 1 tab(s), Tab, Oral, q12hr, Antibiotic Indication Skin/Soft- Tissue Infection, 7 day(s)
    • ❑ cefTRIAXone
      • 2 gm, IV Piggyback, q12hr, Antibiotic Indication Central Nervous System Infection
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Central Nervous System Infection
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, q8hr, Antibiotic Indication Central Nervous System Infection
    • ❑ ampicillin
      • 2 gm, IV Piggyback, q4hr, Antibiotic Indication Central Nervous System Infection
    • ❑ moxifloxacin
      • 400 mg, IV Piggyback, Q24hr, Antibiotic Indication Central Nervous System Infection
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Central Nervous System Infection
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
    • ❑ acyclovir
      • 10 mg/kg, IV Piggyback, q8hr, Antibiotic Indication Central Nervous System Infection
    • ❑ trimethoprim-sulfamethoxazole injection
      • mL, IV Piggyback, q6hr, Antibiotic Indication Central Nervous System Infection
    • ❑ cefepime
      • 2 gm, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s)
    • ❑ metroNIDAZOLE
      • 500 mg, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, Routine, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
    • ❑ piperacillin-tazobactam
      • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s), Infuse over 4 hr
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
    • ❑ levoFLOXacin
      • 750 mg, IV Piggyback, Q24hr, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s)
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Empiric Therapy-Unclear Source Infection, 7 day(s)
    • ❑ Pharmacy Communication Order.
      • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
MED - End of Life Care Pain medication Order set - IMH
  • Medications
    • ❑ LORazepam
      • ❑ 0.5 mg, Tab, Oral, q4hr, PRN for Other (see comment)
      • ❑ 1 mg, Tab, Oral, q4hr, PRN for Other (see comment)
      • ❑ 2 mg, Tab, Oral, q4hr, PRN for Other (see comment)
      • ❑ 0.5 mg, Tab, Sublingual, q4hr, PRN for Other (see comment)
      • ❑ 1 mg, Tab, Sublingual, q4hr, PRN for Other (see comment)
      • ❑ 2 mg, Tab, Sublingual, q4hr, PRN for Other (see comment)
    • ❑ LORazepam
      • ❑ 0.5 mg, Injection, Subcutaneous, q2hr, PRN for Other (see comment)
      • ❑ 0.5 mg, Injection, Subcutaneous, q4hr, PRN for Other (see comment)
      • ❑ 0.5 mg, Injection, IV Push, q2hr, PRN for Other (see comment)
      • ❑ 0.5 mg, Injection, IV Push, q4hr, PRN for Other (see comment)
      • ❑ 1 mg, Injection, Subcutaneous, q2hr, PRN for Other (see comment)
      • ❑ 1 mg, Injection, Subcutaneous, q4hr, PRN for Other (see comment)
      • ❑ 1 mg, Injection, IV Push, q2hr, PRN for Other (see comment)
      • ❑ 1 mg, Injection, IV Push, q4hr, PRN for Other (see comment)
    • ❑ diazePAM
      • 5 mg, Tab, Oral, q8hr, PRN for Other (see comment)
    • ❑ diazePAM
      • 2.5 mg, Injection, IV Push, q8hr, PRN for Other (see comment)
    • ❑ morphine 5 mg/mL PCA 200 mg/NS qs 40 mL
      • 20 mL, IV, Pt Adm Bolus (mg): 5, Lockout Interval (min): 10, 4-hour Limit (mg): 70, Cont Basal Rate (mg/hr): 10
    • ❑ HYDROmorphone 0.5 mg/mL PCA 20 mg/NS qs 40 mL
      • 10 mL, IV, Pt Adm Bolus (mg): 1, Lockout Interval (min): 20, 4-hour Limit (mg): 12, Cont Basal Rate (mg/hr): 1.5
    • ❑ fentaNYL 50 mcg/mL PCA 2000 mcg/40 mL
      • 40 mL, IV
MED - Fall Prevention Order Set - IMH
  • Patient Care
    • ❑ Obtain consent
      • Fall Prevention Patient Safety Plan
    • ❑ Education Fall Risk
      • T;N, BID
    • ❑ Bedside Commode
      • Stay with patient while toileting
    • ❑ Apply Bed Alarms
      • T;N, Constant order
    • ❑ Apply Chair Alarms
      • T;N, Constant order
    • ❑ Fall Risk Interventions
      • T;N, BID
    • ❑ Misc Nursing Task
      • T;N, Move patient near nursing station as available
    • ❑ Nursing Communication
      • T;N, Purposeful Hourly Rounding
    • ❑ Misc Nursing Task
      • T;N, Fall Matts, as appropriate
MED - General Medicine Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Surgical, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Surgical, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
  • Diagnostic Tests
    • ❑ XR Chest 1 View Frontal
      • Transport Mode: Portable
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Mechanical Soft, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes, Fluid: 1000 ml
      • ❑ NPO, Room Service Eligible: Yes, except ice chips
      • ❑ Dysphagia, Room Service Eligible, Nectar Thick
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1200 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1500 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2200 kcal
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ 1/2 NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • 1,000 mL, IV, mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ BMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ CMP
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Fasting Lipid Profile
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ Pepcid
      • ❑ 20 mg, Tab, Oral, BID
      • ❑ 20 mg, Tab, Oral, Daily
      • ❑ 20 mg, Vial, IV Push, BID
      • ❑ 20 mg, Vial, IV Push, Daily
    • ❑ Protonix
      • ❑ 40 mg, Tab-EC, Oral, Daily
      • ❑ 40 mg, Tab-EC, Oral, BIDAC
      • ❑ 40 mg, Vial, IV Push, Daily
      • ❑ 40 mg, Vial, IV Push, BIDAC
  • Patient Care
    • Interventions
      • ❑ NG/OG Tube Care
        • ❑ Low Intermittent Suction
        • ❑ Low Continuous Suction
        • ❑ Clamped
        • ❑ To Gravity
      • ❑ NG/OG Tube Flush
        • ❑ PRN, 30ml Normal Saline
        • ❑ PRN, 60ml Normal Saline
      • ❑ Nasogastric/Orogastric Tube Clamping
        • 2 hours on, 2 hours off suction.
      • ❑ Nasogastric/Orogastric Tube Do NOT Manipulate
      • ❑ Nursing Communication
        • May reposition NG/OG tube if not draining.
    • ❑ Foley Catheter Insertion
      • Indwelling
    • ❑ Discontinue Foley Cath
      • When patient able to stand / pivot
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Titrate Oxygen
      • ❑ Titrate O2 to keep sats > 92%.
      • ❑ Titrate O2 to keep sats > 90%.
      • ❑ Titrate O2 to keep sats > 89%.
    • ❑ BIPAP
      • ❑ per Repiratory Therapy.
      • ❑ HS
      • ❑ PRN
      • ❑ Mode: Timed, 4 Hours On, 4 Hours Off
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
    • ❑ Height & Weight POC
      • Once a Day (before meals)
    • ❑ Vital Signs POC
      • ❑ Once, Orthostatic Vital Signs
      • ❑ Once a Day (before meals), Orthostatic Vital Signs
MED - GI Cocktail Order Set - IMH
  • Medications
    • ❑ aluminum hydroxide/magnesium hydroxide/simethicone 400 mg-400 mg-40 mg/5 mL oral suspension
      • 15 mL, Susp, Oral, Once, Start date: T;N
    • ❑ Lidocaine Viscous
      • 5 mL, Liquid, Oral, Once, Start date: T;N
MED - Hypertonic Saline 3% Order Set - IMH
  • Communication
    • ❑ Notify Provider Laboratory Results
      • T;N, If increase in serum sodium level exceeds 1.5 mMol/L/hour for any 4 hour period., Na > 120
  • IV Solutions
    • ❑ Sodium Chloride 3%, Intravenous
      • ❑ 500 mL, IV, 30 mL/hr, 16 hr
      • ❑ 500 mL, IV, 40 mL/hr, 12 hr
      • ❑ 500 mL, IV, 50 mL/hr, 10 hr
  • Laboratory
    • ❑ TSH
      • Blood, Routine collect, T;N
    • ❑ Potassium Urine
      • Urine, Routine collect, T;N
    • ❑ Osmolality
      • Blood, Routine collect, T;N
    • ❑ Osmolality Urine
      • Urine, Routine collect, T;N
    • ❑ Sodium Urine
      • Urine, Routine collect, T;N
    • ❑ Sodium Level
      • Blood, Routine collect, T;N, q2hr, for 4 dose(s)/time(s)
    • ❑ Sodium Level
      • Blood, Routine collect, T;N, q6hr, While on sodium chloride infusion
    • ❑ Misc Nursing Task
      • T;N, Order Sodium Level & Potassium Level 2 hours after sodium chloride infusion has been discontinued.
    • ❑ Potassium Level
      • Blood, Routine collect, T;N, q2hr, for 4 dose(s)/time(s)
    • ❑ Potassium Level
      • Blood, Routine collect, T;N, q6hr, While on sodium chloride infusion
  • Patient Care
    • ❑ Neurological Assessment
      • T;N, 12x/Day, Assess mental status at start of Sodium Chloride infusion and Q2hr during infusion.
    • ❑ Respiratory Assessment
      • T;N, 12x/Day, Assess breath sounds at start of Sodium Chloride infusion and Q2hr during infusion.
    • ❑ I&O POC
      • T;N, q1hr
  • Vital Signs
    • ❑ Vital Signs POC
      • 12x/Day, At start of Sodium Chloride infusion and Q2hr during infusion.
MED - Indwelling Catheter Order Set - IMH
  • Patient Care
    • ❑ Review Need for Indwelling Catheter
      • T;N, 3x/Day
    • ❑ Catheter Care POC
      • T;N, Daily, Daily & PRN
    • ❑ Catheter Care POC
      • PRN
    • ❑ Patient Education
      • T;N, Daily, Teach patient/family about CAUTI potential. Document CAUTI education provided in IVIEW < Urinary Catheter section.
MED - Involuntary Commitment Custody Order Set - IMH
  • Patient Care
    • ❑ Involuntary Commitment
      • T;N, Use commitment papers
    • ❑ Involuntary Commitment
      • T+7;0500, q7day, Complete Custody Renewal Order on chart for Involuntary Commitment
MED - Lidoderm Patch & Removal Order Set - IMH
  • Medications
    • ❑ Lidoderm Patch
      • ❑ 1 patch(es), Patch, Transdermal, Daily
      • ❑ 2 patch(es), Patch, Transdermal, Daily
    • ❑ Patch/Paste Removal
      • T;2100, HS, Remove lidoderm patch q hs.
    • ❑ Lidoderm Patch
      • ❑ 1 patch(es), Patch, Transdermal, HS
      • ❑ 2 patch(es), Patch, Transdermal, HS
    • ❑ Patch/Paste Removal
      • T+1;0800, qAM, Remove lidoderm patch in the morning.
MED - Lumbar Puncture Care Order Set - IMH
  • Laboratory
    • ❑ CSF Cell Count Tube 1
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Glucose/Protein Tube 2
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
    • ❑ CSF Culture Tube 3
      • Cerebrospinal Fluid, Stat collect, T;N, Nurse collect
  • Patient Care
    • ❑ Procedure / Consent
      • Lumbar Puncture
    • ❑ Nursing Communication Order
      • Extra needles for lumbar puncture
MED - Mantoux Tuberculin (TB) Skin Test Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • All patients admitted to IMH - HB / SNF unless allergic will receive Mantoux Tuberculin Skin Test.
  • Medications
    • ❑ tuberculin purified protein derivative 5 tuberculin units/0.1 mL intradermal solution
      • 5 TU, Injection, Intradermal, Once
    • ❑ PPD Reading
      • 48 hour test read - Measure & report results in millimeters of induration.
    • ❑ PPD Reading
      • 72 hour read - Measure & report results in millimeters of induration.
    • ❑ tuberculin purified protein derivative 5 tuberculin units/0.1 mL intradermal solution
      • 5 TU, Injection, Intradermal, Once
    • ❑ tuberculin purified protein derivative 5 tuberculin units/0.1 mL intradermal solution
      • 5 TU, Injection, Intradermal, Once, Start date: T+7;1000
    • ❑ PPD Reading
      • 72 hour read - Measure & report results in millimeters of induration
    • ❑ PPD Reading
      • T+9;1000, For HB/SNF Only - REPEAT TEST OPPOSITE ARM - 48 hour test read - Measure & report results in millimeters of induration.
    • ❑ PPD Reading
      • T+10;1000, For HB/SNF Only - REPEAT TEST OPPOSITE ARM - 72 hour read - Measure & report results in millimeters of induration.
    • ❑ Candida Skin Test
      • 0.1 mL, Injection, Intradermal, Once
  • Special
    • ❑ Nursing Communication
      • Follow-Up for Positive TB Reaction: Notify attending MD and follow facility policy.
MED - Medication PRN Order Set - IMH
  • Medications
    • Analgesics: Non-Opioids
      • ❑ Tylenol
        • 650 mg, Tab, Oral, q4hr, PRN for Pain - Mild, 14 day(s)
    • Antiemetics
      • ❑ ondansetron
        • 4 mg, Tab-Dispers, Oral, q8hr, PRN for Nausea/Vomiting, 14 day(s)
      • ❑ promethazine
        • 25 mg, Tab, Oral, Once, PRN for Nausea/Vomiting, 1 dose(s)/time(s)
    • ❑ Chloraseptic 1.4% spray
      • 3 spray(s), Spray, Oral, q2hr, PRN for Sore Throat, 14 day(s)
    • ❑ aluminum hydroxide/magnesium hydroxide/simethicone 400 mg-400 mg-40 mg/5 mL oral suspension
      • 10 mL, Susp, Oral, 6x/Day, PRN for Indigestion, 14 day(s)
MED - Midline / Extended Dwell Catheter (EDC) Order Set - IMH
  • Patient Care
    • ❑ Midline Dressing Change
      • T+7;0900, qWeek, Change midline / EDC dressing q7day and change PRN if drainage present
    • ❑ Midline Dressing Change
      • T;N, PRN, Change midline / EDC dressing if drainage present.
    • ❑ Midline Dressing Change
      • T;N, Once, 24 hours after midline /EDC catheter insertion, remove gauze dressing and replace with transparent dressing and antimicrobial disc per protocol.
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, 3x/Day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, UD, PRN Other (see comment)
MED - Nasogastric / Orogastric Tube Insertion Order Set - IMH
  • Medications
    • ❑ Afrin 0.05% nasal spray
      • 2 spray(s), Spray-Nasal, Nasal, UD, PRN for Other (see comment)
    • ❑ Lidocaine Viscous
      • 15 mL, Liquid, Oral, UD, PRN for discomfort
    • ❑ Lidocaine Jelly
      • 1 app, Gel, Nasal, UD, PRN for discomfort
MED - Nicotine Replacement Order Set - IMH
  • Medications
    • ❑ nicotine 7 mg/24 hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nicotine 14 mg/24 hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nicotine 21 mg/24 hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
  • Patient Care
    • ❑ Patch/Paste Removal
      • T+1;N, Daily, remove patch Daily
MED - Nitroglycerin Ointment / Patch & Patch / Paste Removal Order Set - IMH
  • Medications
    • ❑ nitroglycerin 2% topical ointment
      • ❑ 0.5 in, Ointment, TOP, BID
      • ❑ 1 in, Ointment, TOP, BID
      • ❑ 2 in, Ointment, TOP, BID
    • ❑ Patch/Paste Removal
      • T;1900, Q24hr, Remove Nitroglycerin Ointment at 7 pm
    • ❑ Patch/Paste Removal
      • HS, Remove Nitroglycerin Patch at Bedtime.
    • ❑ nitroglycerin 0.1 mg/hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nitroglycerin 0.2 mg/hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nitroglycerin 0.3 mg/hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nitroglycerin 0.4 mg/hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
    • ❑ nitroglycerin 0.6 mg/hr patch, extended release
      • 1 patch(es), Patch-24, Transdermal, Daily
MED - Nursing Protocol Phase 1 Order Set - IMH
  • Activity
    • ❑ Mobility Protocol
      • T;N, TID, Follow Mobility Guidelines unless otherwise specified by the provider in a written order.
  • Communication
    • ❑ Report / Handoff
      • T;N, As Directed, PRN
    • ❑ Report / Handoff
      • T;1900, q12hr
  • Patient Care
    • ❑ Admission Assessment Adult
      • T;N
    • ❑ Admission Assessment Adult ICU
      • T;N
    • ❑ Admission Assessment Pediatric
      • T;N
    • ❑ Suicide Screening Adult
      • T;N, Once
    • ❑ Suicide Screening Pediatric
      • T;N, Once, For patients 12 to 17 years old
    • ❑ Misc Nursing Task
      • T;N, VTE Prophylaxis Reminder, qShift 8 hr VS, 24 hr
    • ❑ Height & Weight POC
      • T;N, Once, Stat
    • ❑ Height & Weight POC
      • T;0730, qMonth
    • ❑ Color Alert Armband
      • T;N, 3x/Day
    • ❑ Chart Check
      • T;N, 6x/Day, Paper & Electronic Chart Check
    • ❑ Patient Education
      • Orient to room, call bell system & fall reduction
    • ❑ Patient Education
      • Gave "Taking Antibiotics in the Hospital" brochure and discussed with patient/family.
    • ❑ Provider Notification
      • T;N, Constant order, Document as needed
    • ❑ Education General
      • qShift - 8 hour, Document patient education
    • ❑ Skin Assessment
      • T;N, QWednesday
    • ❑ Nursing Communication Order
      • T;N
    • ❑ Nursing Dysphagia Screening.
      • T;N, See Comment
    • ❑ Vital Signs POC
      • As Directed, PRN
    • ❑ Blood Glucose POC
      • As Directed, PRN
    • ❑ I&O POC
      • PRN
    • ❑ Height & Weight POC
      • As Directed, PRN
    • ❑ ADL's POC
      • As Directed, PRN
    • ❑ Bladder Scan.
      • T;N, As Directed, PRN, For urinary retention
    • ❑ FYI Booklet
      • INPT - See Order Comment
    • ❑ Misc Nursing Task
      • Reminder: If Braden score < 18: Initiate the MED - Skin Breakdown Prevention / Treatment Order Set.
    • ❑ Misc Nursing Task
      • T+3;0700, Mobility Protocol: If patient has not returned to baseline by hospital day # 3 enter an order for Physical Therapy Evaluation and Treatment
MED - Nursing Protocol Phase 2 Order Set - IMH
  • Consults
    • ❑ Notify Provider
      • T+1;0700, on rounds if PT/OT/ST needs exist
    • ❑ Consult to Dietitian
      • ❑ T;N, Unable to eat 3 days or greater prior to Admission
      • ❑ T;N, Unintentional weight loss of 10lbs or greater in 1 month (Adult)
      • ❑ T;N, Albumin <3.0/HD patients <4.0
      • ❑ T;N, NPO/clear liquid diet 3 or more days
      • ❑ T;N, New Onset Diabetes
      • ❑ T;N, Unintentional weight loss (Peds)
      • ❑ T;N, Admission diagnosis of failure to thrive (Peds)
      • ❑ T;N, Weight >90th% or <10th% on growth chart (Peds)
    • ❑ Consult to Diabetic Nurse Specialist
      • ❑ T;N, New onset Diabetes
      • ❑ T;N, Uncontrolled Diabetes
      • ❑ T;N, Diabetes in Pregnancy
      • ❑ T;N, Patient on Insulin Pump
      • ❑ T;N, Elevated A1C
      • ❑ T;N, Diabetes Diet Instruction
    • ❑ Consult Wound/Ostomy RN
      • ❑ T;N, Skin Breakdown
      • ❑ T;N, New Ostomy
      • ❑ T;N, Ostomy pouching problems
      • ❑ T;N, Stage 3, 4, unstageable and SDTI wounds
      • ❑ T;N, Wound Vac
      • ❑ T;N
    • ❑ Consult to Discharge Planning Services (CM)
      • ❑ T;N, Admitted from Extended Care Facility and the name of the facility
      • ❑ T;N, Initial Diagnosis of Cancer or Reoccurence
      • ❑ T;N, Alcohol/Drug Abuse
      • ❑ T;N, Fractures over 65 years
      • ❑ T;N, Change in Mental Status/Dementia
      • ❑ T;N, Equipment needed. (Hospital Bed, Bedside Commode, Wheelchair, Walker, etc. at home)
      • ❑ T;N, Financial/Environmental resources inadequate; No Insurance
      • ❑ T;N, Follow by Community Agency (Home Health, Meals on Wheels, Sitters, etc.)
      • ❑ T;N, Victim of Abuse/Neglect
      • ❑ T;N, Readmission to Hospital within 30 days
      • ❑ T;N, Patient traveling when illness/accident occurred
      • ❑ T;N, Hospice Patient
      • ❑ T;N, Unable to return home
      • ❑ T;N, Status Post Code STEMI (this admission)
      • ❑ T;N
    • ❑ Consult to Pastoral Care
      • ❑ T;N, Depression
      • ❑ T;N, First diagnosis/recurrent cancer
      • ❑ T;N, Recent Amputation
      • ❑ T;N, Recent loss in family (within last year)
      • ❑ T;N, Terminal illness
      • ❑ T;N, Request from patient/family for hospital chaplain to visit
      • ❑ T;N, Patient traveling when illness/accident occurred
      • ❑ T;N, Hospice Patient
    • ❑ Nursing Supervisor Communication
      • ❑ T;N, DNR
      • ❑ T;N, Refuse Blood
      • ❑ T;N
    • ❑ Core Measure Specialist Communication
      • T;N
    • ❑ Cardiovascular Clinician / Certification Coordinator Communication
      • ❑ T;N, Chest Pain
      • ❑ T;N, MI
      • ❑ T;N, Possible stroke diagnosis
      • ❑ T;N, Stroke diagnosis
    • ❑ Dialysis Communication
      • ❑ T;N, Dialysis patient admitted today
      • ❑ T;N
    • ❑ Lactation Nurse Communication
      • T;N, Patient Lactating
  • Non Categorized
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Quality Measures in In-Patient Summary
  • Patient Care
    • ❑ Resuscitation Status
      • T;N, Full Resuscitation
    • ❑ Turn Patient POC
      • 12x/Day, q2hr
    • ❑ Nursing Communication
      • ❑ Assist with meals
      • ❑ Feed patient
      • ❑ Visually impaired
      • ❑ Blind left eye
      • ❑ Blind right eye
      • ❑ Hard of hearing
      • ❑ Does not speak English
      • ❑ Sign Language
    • ❑ Elopement Risk Precautions
    • ❑ Vital Signs POC
      • ❑ BIDAC, Routine: 0730 & 1630
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ q1hr
      • ❑ q2hr
      • ❑ q1hr, for 4 hr
      • ❑ q4hrVS, for 72 hr
      • ❑ BID, for 72 hr, 0800 & 2000
      • ❑ T;N, qWeek, 0800
    • ❑ I&O POC
      • ❑ T;N, 3x/Day, q 8 hours
      • ❑ T;N, 6x/Day, q 4 hours
      • ❑ T;N, q 2 hours
      • ❑ T;N, q 1 hours
      • ❑ T;N, q2hr, CHEMO
      • ❑ T;N, 6x/Day, CHEMO q 4 hours
    • ❑ Weight POC
      • T+1;0500, Q24hr
    • ❑ Weight POC
      • Once a Day (before meals), If patient less than 13 years of age and a running IV
    • ❑ Tobacco Cessation Instruction
MED - Ostomy (Colostomy, Ileostomy, or Urostomy) Order Set - IMH
  • Patient Care
    • ❑ Ostomy Bag/Wafer Change
      • q4day, See Comment
    • ❑ Ostomy Bag/Wafer Change
      • PRN
MED - Outpatient Nursing Protocol IMH
  • Patient Care
    • ❑ ADL's POC
      • T;N, PRN
    • ❑ Intake & Output POC
      • T;N, PRN
    • ❑ Accucheck POC
      • T;N, PRN
    • ❑ Height & Weight POC
      • T;N, PRN
  • Vital Signs
    • ❑ Vital Signs POC
      • T;N, PRN
MED - Palliative Care Pain Medication Order Set - IMH
  • Medications
    • ❑ Ativan
      • ❑ 0.5 mg, Tab, Oral, q4hr, PRN Anxiety
      • ❑ 1 mg, Tab, Oral, q4hr, PRN Anxiety
      • ❑ 2 mg, Tab, Oral, q4hr, PRN Anxiety
      • ❑ 0.5 mg, Tab, Sublingual, q4hr, PRN Anxiety
      • ❑ 1 mg, Tab, Sublingual, q4hr, PRN Anxiety
      • ❑ 2 mg, Tab, Sublingual, q4hr, PRN Anxiety
    • ❑ Ativan
      • ❑ 0.5 mg, Injection, Subcutaneous, q2hr, PRN Anxiety
      • ❑ 0.5 mg, Injection, Subcutaneous, q4hr, PRN Anxiety
      • ❑ 0.5 mg, Injection, IV Push, q2hr, PRN Anxiety
      • ❑ 0.5 mg, Injection, IV Push, q4hr, PRN Anxiety
      • ❑ 1 mg, Injection, Subcutaneous, q2hr, PRN Anxiety
      • ❑ 1 mg, Injection, Subcutaneous, q4hr, PRN Anxiety
      • ❑ 1 mg, Injection, IV Push, q2hr, PRN Anxiety
      • ❑ 1 mg, Injection, IV Push, q4hr, PRN Anxiety
    • ❑ morphine 5 mg/mL PCA 200 mg/NS qs 40 mL
      • 20 mL, IV, Pt Adm Bolus (mg): 3, Lockout Interval (min): 10, 4-hour Limit (mg): 24, Cont Basal Rate (mg/hr): 5
    • ❑ HYDROmorphone 0.5 mg/mL PCA 20 mg/NS qs 40 mL
      • 10 mL, IV, Pt Adm Bolus (mg): 0.5, Lockout Interval (min): 20, 4-hour Limit (mg): 8, Cont Basal Rate (mg/hr): 1.5
MED - Palliative Extubation/Terminal Ventilator Wean Order Set - IMH
  • Consults
    • ❑ Consult to Pastoral Care
      • for bedside support
  • Medications
    • ❑ morphine
      • ❑ 5 mg, Syringe, IV Push, Once, NOW
      • ❑ 10 mg, Syringe, IV Push, Once, NOW
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, q10min, PRN Other (see comment)
      • ❑ 5 mg, Syringe, IV Push, q10min, PRN Other (see comment)
      • ❑ 10 mg, Syringe, IV Push, q10min, PRN Other (see comment)
    • ❑ fentaNYL
      • ❑ 50 mcg, Injection, IV Push, Once, NOW
      • ❑ 75 mcg, Injection, IV Push, Once, NOW
      • ❑ 100 mcg, Injection, IV Push, Once, NOW
    • ❑ fentaNYL
      • ❑ 50 mcg, Injection, IV Push, q10min, PRN Other (see comment)
      • ❑ 75 mcg, Injection, IV Push, q10min, PRN Other (see comment)
      • ❑ 100 mcg, Injection, IV Push, q10min, PRN Other (see comment)
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, Once, NOW
      • ❑ 2 mg, Syringe, IV Push, Once, NOW
    • ❑ HYDROmorphone
      • ❑ 1 mg, Syringe, IV Push, q10min, PRN Other (see comment)
      • ❑ 2 mg, Syringe, IV Push, q10min, PRN Other (see comment)
    • ❑ LORazepam
      • ❑ 1 mg, Injection, IV Push, Once, NOW
      • ❑ 2 mg, Injection, IV Push, Once, NOW
    • ❑ LORazepam
      • ❑ 1 mg, Injection, IV Push, q10min, PRN Other (see comment)
      • ❑ 2 mg, Injection, IV Push, q10min, PRN Other (see comment)
    • ❑ midazolam
      • ❑ 2 mg, Soln, IV Push, Once, NOW
      • ❑ 4 mg, Soln, IV Push, Once, NOW
    • ❑ midazolam
      • ❑ 2 mg, Soln, IV Push, q5min, PRN Other (see comment)
      • ❑ 4 mg, Soln, IV Push, q5min, PRN Other (see comment)
    • ❑ glycopyrrolate
      • 0.4 mg, Vial, IV Push, Once, NOW
    • ❑ glycopyrrolate
      • 0.4 mg, Vial, IV Push, q6hr, PRN Other (see comment)
  • Respiratory
    • ❑ Oxygen Therapy
      • Hi-flow nasal cannula, Titrate as appropriate for comfort of patient
MED - Paracentesis Pre-Procedure Order Set - IMH
  • Condition
    • ❑ Procedure / Consent
      • ❑ Paracentesis
      • ❑ Paracentesis at Beside
    • ❑ Nursing Communication Order
      • Place at Bedside: (1) Disposable Paracentesis Tray or Paracentesis Kit from Endo (2) Appropriate sized sterile gloves (3) Bottle of Betadine Solution (4) Lidocaine 2% injectable solution (5) Bottle for Fluid Collection
MED - Patient Care Order Set - IMH
  • Patient Care
    • ❑ Nursing Communication Order
      • Order & Initiate "MED - Hypoglycemic Treatment Order Set - IMH" for blood sugars less than 70 mg/dL (N/A for ICU/CCU patient on Glycemic Control Protocol)
    • ❑ Nursing Communication Order
      • Order & Initiate "MED - Nicotine Replacement Order Set - IMH" - for patients using tobacco products and Nicotine replacement needed.
    • ❑ Nursing Communication Order
      • Order & Initiate "Skin Breakdown Prevention / Treatment Order Set - IMH" for Braden scale less than or equal to 18 or with a wound present (Pressue or otherwise).
    • ❑ Nursing Communication Order
      • Order & Initiate "MED - Phase 1 - Acute Alcohol Withdrawal CIWA Order Set - IMH" - for patients who are identified as having alcohol use disorder or have a history of alcohol abuse.
    • ❑ Nursing Communication Order
      • RN to digitally remove stool PRN. ***Notify Physician prior to, if patient is immunocompromised or if less than 5 days post-MI.
    • ❑ Nursing Communication Order
      • Refer to C-diff testing algorithm. Must have physician order after day 3 of admission for C-diff testing. See Order Comments.
    • ❑ Nursing Communication Order
      • Order & Initiate "MED/PED - IV Insertion & Care Order Set - IMH" if needed.
    • ❑ Nursing Communication Order
      • Order & Initiate "MED - Nasogastric / Orogastric Tube Insertion Order Set - IMH" if needed.
    • ❑ Nursing Communication Order
      • Order & Initiate "CRIT CARE - Glycemic Order Set - IMH" if needed and in the ICU.
MED - PCA - Patient Controlled Analgesia Order Set - IMH
  • IV Solutions
    • ❑ LR
      • 1000 mL, IV, 10 mL/hr
    • ❑ morphine 1mg/mL PCA 30 mL
      • ❑ 30 mL, IV, Pt Adm Bolus (mg): 1, Lockout Interval (min): 10, 4-hour Limit (mg): 24
      • ❑ 30 mL, IV
    • ❑ HYDROmorphone 0.2mg/mL PCA 30 mL
      • ❑ 30 mL, IV, Pt Adm Bolus (mg): 0.2, Lockout Interval (min): 10, 4-hour Limit (mg): 4.8
      • ❑ 30 mL, IV
    • ❑ fentaNYL 10 mcg/mL PCA 500 mcg/NS qs 50 mL
      • ❑ 10 mL, IV, Pt Adm Bolus (mcg): 10, Lockout Interval (min): 6, 4-hour Limit (mcg): 400
      • ❑ 10 mL, IV
  • Medications
    • ❑ Nursing Communication
      • Discontinue all narcotics and sedatives not prescribed on PCA order set.
    • ❑ Pharmacy Communication Order.
      • Once, See Comment
    • ❑ Narcan
      • 0.4 mg, Vial, IV Push, UD, for Respiratory Depression
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q8hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q8hr, PRN for Nausea/Vomiting
    • ❑ prochlorperazine
      • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ Benadryl
      • 12.5 mg, Vial, IV Push, q6hr, PRN Itching
  • Patient Care
    • Patient Education
      • ❑ Patient Education
        • PCA Handout
      • ❑ Patient Education
        • Family members and health care providers are not permitted to press PCA button.
    • ❑ Notify Provider
      • PCA Order: For inadequate pain relief, excessive sedation, respiratory rate < 10/min, and / or SPO2 92% or less.
    • ❑ Ambu Bag Available
      • PCA Order
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • Respiratory to set alarms
    • ❑ Oxygen Therapy
      • 2 L, Nasal Cannula, 92%
  • Vital Signs
    • ❑ Vital Signs POC
      • Respiratory Rate, Analgesia, and Sedation Levels every 4 hours or per MD orders.
MED - Peripheral IV Insertion & Care Order Set - IMH
  • Medications
    • ❑ lidocaine 1% preservative-free injectable solution
      • 0.1 mL, Vial, Intradermal, As Directed, PRN for discomfort
    • ❑ NS Flush Bag
      • FLUSH BAG, IV Flush, As Directed, for Other (see comment)
  • Patient Care
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, 3x/Day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, UD, PRN for Other (see comment)
    • ❑ Change IV
      • ❑ T;N, PRN, as clinically indicated
      • ❑ T+7;1000, q7day, Portacath Needle Change Q7days & PRN
    • ❑ Change IV Tubing
      • T+4;1000, q4day, Q4days & PRN
    • ❑ Change IV Tubing
      • T+1;0500, Q24hr, Daily & PRN
MED - Phase 1 - Acute Alcohol Withdrawal / CIWA Order Set - IMH
  • Communication
    • ❑ Notify Provider
      • If CIWA score is greater than or equal to 8, notify MD and obtain order for initiation of phase 2 of CIWA protocol, unless phase 2 and medications for withdraw are already ordered.
  • Medications
    • ❑ thiamine
      • ❑ 100 mg, Tab, Oral, BID, NOW
      • ❑ 100 mg, Vial, IV Piggyback, BID, NOW
      • ❑ 100 mg, Vial, IM, BID, NOW
    • ❑ folic acid
      • ❑ 1 mg, Tab, Oral, Daily
      • ❑ 1 mg, IV Piggyback, Daily
    • ❑ multivitamin
      • 1 tab(s), Tab, Oral, Daily
  • Patient Care
    • ❑ CIWA Assessment
      • T;N
    • ❑ CIWA Assessment
      • 6x/Day, for 72 hr, May awaken patient to complete CIWA assessment and VS.
    • ❑ CIWA Assessment
      • 6x/Day, May awaken patient to complete CIWA assessment and VS. After initial 72 hours of CIWA assessments, complete an additional 24 hours of CIWA assessments.
    • ❑ Suction Setup
      • T;N, CIWA: Ensure wall suction is set up and functioning properly.
    • ❑ Aspiration Precautions
      • T;N, CIWA Protocol
    • ❑ Precautions
      • T;N, Fall Precautions for CIWA Protocol
  • Vital Signs
    • ❑ Vital Signs POC
      • q4hrVS, May awaken patient to complete CIWA assessment and VS.
    • ❑ Notify Provider Vital Signs
      • CIWA, HR > 130, SBP > 180, DBP > 110
MED - Phase 2 - Acute Alcohol Withdrawal / CIWA Order Set - IMH
  • Communication
    • ❑ Misc Nursing Task
      • Discontinue CIWA assessments and vital signs from phase 1.
    • ❑ Misc Nursing Task
      • Verify that the CIWA Phase 1 has been ordered.
    • ❑ Notify Provider
      • IF CIWA score is greater than or equal to 15. (Only notify provider first time score is 15 or greater)
    • ❑ Notify Provider
      • CIWA: If patient requires greater than or equal to 8mg of Lorazepam in 4 hours or uncontrolled behavior.
    • ❑ Notify Provider Vital Signs
      • HR > 130, SBP > 180, DBP > 110
  • IV Solutions
    • ❑ Precedex 400 mcg-NS 100 mL IV PM
    • ❑ lorazepam 20mg in NS 90mL
      • 20 mg
    • ❑ Rally Pack
      • 1,000 mL
      • 10 mL
      • 100 mg, IV Piggyback, Daily, Infuse over 4 hr
  • Medications
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ chlordiazePOXIDE
      • ❑ 25 mg, Tab, Oral, BID
      • ❑ 25 mg, Tab, Oral, TID
      • ❑ 25 mg, Tab, Oral, QID
      • ❑ 50 mg, Tab, Oral, BID
      • ❑ 50 mg, Tab, Oral, TID
      • ❑ 50 mg, Tab, Oral, QID
    • ❑ LORazepam
      • ❑ 2 mg, Tab, Oral, q2hr, PRN Symptoms of alcohol withdrawal
      • ❑ 2 mg, Injection, IV Push, q2hr, PRN Symptoms of alcohol withdrawal
      • ❑ 2 mg, Injection, IM, q2hr, PRN Symptoms of alcohol withdrawal
      • ❑ 1 mg, Tab, Oral, q2hr, PRN Symptoms of alcohol withdrawal
      • ❑ 1 mg, Injection, IV Push, q2hr, PRN Symptoms of alcohol withdrawal
      • ❑ 1 mg, Injection, IM, q2hr, PRN Symptoms of alcohol withdrawal
    • ❑ LORazepam
      • ❑ 2 mg, Tab, Oral, q1hr
      • ❑ 2 mg, Injection, IV Push, q1hr
      • ❑ 2 mg, Injection, IM, q1hr
      • ❑ 2 mg, Injection, IV Push, q30min
      • ❑ 1 mg, Tab, Oral, q1hr
      • ❑ 1 mg, Injection, IV Push, q1hr
      • ❑ 1 mg, Injection, IM, q1hr
      • ❑ 1 mg, Injection, IV Push, q30min
      • ❑ 4 mg, Injection, IV Push, q1hr
  • Patient Care
    • ❑ CIWA Assessment
      • Constant Indicator
    • ❑ Suction Setup
      • T;N, CIWA: Ensure wall suction is set up and functioning properly.
  • Vital Signs
    • ❑ Vital Signs POC
      • As Directed
MED - Post Fall Assessment Order Set- IMH
  • Patient Care
    • ❑ Focused Post Fall Assessment
      • T;N
    • ❑ Focused Post Fall Assessment
      • T;N, q1hr, for 4 hr
    • ❑ Focused Post Fall Assessment
      • q4hr, for 20 hr
    • ❑ Focused Post Fall Assessment
      • q8hr, for 40 hr
    • ❑ Nursing Communication Order
      • T;N, Notify Provider post fall if increase in pain, acute changes, bruising, wounds, or any abnormality
    • ❑ Skin Assessment
      • T;N, Daily, for 3 day(s), Post Fall: Document full skin assessment daily for 3 days. Notify provider of bruising, wounds, or any abnormality
    • ❑ Neurological Assessment
      • T;N
    • ❑ Neurological Assessment
      • T;N, q1hr, for 4 hr
    • ❑ Neurological Assessment
      • q4hr, for 20 hr
    • ❑ Neurological Assessment
      • q8hr, for 40 hr
MED - Post-Procedure Body Fluid Order Set - IMH
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • T;N, 0
  • Laboratory
    • ❑ Cell Count Body Fluid
      • ❑ Body Fluid, Right Side
      • ❑ Body Fluid, Left Side
    • ❑ LDH, BODY FLUID
      • Body Fluid
    • ❑ GLUCOSE, BODY FLUID
      • Body Fluid
    • ❑ PROTEIN, BODY FLUID
      • Body Fluid
    • ❑ AMYLASE, BODY FLUID
      • Body Fluid
    • ❑ ALBUMIN, BODY FLUID
      • Body Fluid
    • ❑ TRIGLYCERIDE, BODY FLUID
      • Body Fluid
    • ❑ pH Body Fluid
      • Body Fluid
    • ❑ Body Fluid Culture
      • ❑ Body Fluid, Right Side
      • ❑ Body Fluid, Left Side
    • ❑ Nursing Communication Order
      • Cytology - Refer to Cytology paper form.
    • ❑ Nursing Communication Order
      • Flow Cytometry - Refer to Cytology paper form.
MED - Preliminary Admission Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Surgical, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Surgical, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
  • Patient Care
    • ❑ Saline Lock Insertion
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
MED - Pulmonary Medication Protocol Order Set - IMH
  • Medications
    • ❑ Consult to Respiratory Therapy
      • ❑ Pulmonary Medication Protocol q6hr
      • ❑ Pulmonary Medication Protocol q4hr
      • ❑ Pulmonary Medication Protocol TID
      • ❑ Pulmonary Medication Protocol BID
    • ❑ Perforomist
      • 2 mL, Soln-Inh, NEB, BID
    • ❑ Pulmicort Respules
      • 0.5 mg, Soln-Inh, NEB, BID
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • 3 mL, Soln, NEB, 4x/Day
    • ❑ Perforomist
      • 2 mL, Soln-Inh, NEB, BID
    • ❑ Pulmicort Respules
      • 0.5 mg, Soln-Inh, NEB, BID
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • 3 mL, Soln, NEB, 6x/Day
MED - Restraint - Forensic Order Set - IMH
  • Patient Care
    • ❑ Restraints - Non-Violent
      • Police custody, Handcuffs | Shackles, Bilateral lower extremities | Bilateral upper extremities, Upon presentation to the hospital, arrived in forensic restraints. Forensic restraints are applied, maintained and discontinued by law enforcement.
    • ❑ Restraints Monitoring
      • T;N, q2hr, Document forensic restraint monitoring per hospital policy.
MED - Restraint - Non-Violent Order Set - IMH
  • Patient Care
    • ❑ Restraints - Non-Violent
      • Order received at date/time Evaluate patient and discontinue or renew orders per hospital policy.
    • ❑ Restraints Monitoring
      • T;N, q2hr, Document restraint monitoring per hospital policy.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • T+1;0500, Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Seclusion 18 Years and Older Order Set - IMH
  • Patient Care
    • ❑ Restraints Seclusion
      • Seclusion, Room, Order received at date/time Order valid for 4 hours. Evaluate patient and discontinue or renew orders., 4, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Seclusion 8 Years and Younger Order Set - IMH
  • Patient Care
    • ❑ Restraints Seclusion
      • Seclusion, Room, Order received at date/time Order valid for 1 hour. Evaluate patient and discontinue or renew orders., 1, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Seclusion 9 to 17 Years Old Order Set - IMH
  • Patient Care
    • ❑ Restraints Seclusion
      • Seclusion, Room, Order received at date/time Order valid for 2 hours. Evaluate patient and discontinue or renew orders., 2, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Violent 18 Years and Older Order Set - IMH
  • Patient Care
    • ❑ Restraints Violent 18 Years and Older
      • Order received at date/time Order valid for 4 hours. Evaluate patient and discontinue or renew orders., 4, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Violent 8 Years and Younger Order Set - IMH
  • Patient Care
    • ❑ Restraints Violent 8 Years and Younger
      • Order received at date/time Order valid for 1 hours. Evaluate patient and discontinue or renew orders., 1, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Restraint - Violent 9 to 17 Years Old Order Set - IMH
  • Patient Care
    • ❑ Restraints Violent 9 to 17 Years
      • Order received at date/time Order valid for 2 hours. Evaluate patient and discontinue or renew orders., 2, hr
    • ❑ Restraints Monitoring
      • T;N, Constant order, Document restraint monitoring per hospital protocol.
    • ❑ Restraints Review Prior to Expiration - Contact Physician
      • Remind physician to renew order per hospital policy.
    • ❑ Review Care Plan
      • T;N, Once, Reminder to order the "Restraints Plan of Care IRDL" and document RESTRAINT goals and interventions within that care plan.
MED - Sepsis Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
    • ❑ Transfer Patient to
      • ❑ Critical Care
      • ❑ Intermediate Care, Progressive Care
      • ❑ Cardiac Telemetry
      • ❑ Medical Telemetry
  • Consults
    • ❑ Consult to Intensivist
      • Sepsis
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
    • ❑ Core Measure Specialist Communication
      • T;N, Sepsis
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • T;N, Stat
    • ❑ XR Chest 1 View Portable
      • T;N, Stat, Transport Mode: Portable, 0
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Pureed
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ NS Bolus
      • 30 mL/kg, IV, Once, 999 mL/hr
    • ❑ LR Bolus
      • 30 mL/kg, IV, Once, 999 mL/hr
    • ❑ NS
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ Cortisol Level.
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ Phosphorus Level
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Procalcitonin
      • Blood, Stat collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N
    • ❑ Culture - Wound
      • Micro Specimen, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
  • Medications
    • ❑ Consult to Anesthesia
      • T;N, central line placement
    • ❑ Consult to PICC Nurse
      • T;N, PICC Placement
    • ❑ Peripheral IV Insertion
      • T;N, Start second IV line with large bore needle.
    • ❑ norepinephrine 4 mg/250 mL
      • 4 mg
      • 250 mL, IV, Routine, See Comments
    • ❑ Vasopressin 20 units/NS 100 mL Premix
      • 20 unit(s)
      • 100 mL, IV, Routine, 9 mL/hr
  • Patient Care
    • ❑ Insert Foley Catheter
      • T;N, Indwelling
    • ❑ Peripheral IV Insertion
      • T;N, Initiate large bore IV
    • ❑ I&O POC
      • T;N, Q1hr output, urine output goal 0.5ml/kg/hour
    • ❑ Notify Provider Vital Signs
      • Notify provider after IVF bolus if patient has a decrease in BP by 40 points, SBP less than 90, MAP less than 65 or lactate level is above 4. If fluid bolus ineffective; discuss administration of vasopressor.
    • ❑ Sepsis Severity Identification Order
      • Neither, Source Unclear, T;N
  • Respiratory
    • ❑ ABG Draw (Resp)
      • T;N, Stat
    • ❑ Oxygen Therapy
      • ❑ T;N, 2 L, Nasal Cannula
      • ❑ T;N, 3 L, Nasal Cannula
      • ❑ T;N, 4 L, Nasal Cannula, Humidified
      • ❑ T;N, 5 L, Nasal Cannula, Humidified
      • ❑ T;N, 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ T;N, 94
      • ❑ T;N, 93
      • ❑ T;N, 92
      • ❑ T;N, 91
      • ❑ T;N, 90
      • ❑ T;N, 89
    • ❑ Pulse Oximetry Continuous
      • T;N
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
MED - Skin Breakdown Prevention/Treatment Order Set - IMH
  • Communication
    • ❑ Notify Provider
      • Notify provider of presence of any wound(s) due to pressure and document communication details in iView under "Clinician notification".
  • Laboratory
    • ❑ Wound Culture
      • Micro Specimen, Nurse collect
  • Patient Care
    • ❑ Turn Patient POC
      • 12x/Day, Remind and/or assist patient in repositioning every 2 hours.
    • ❑ Offload Heels
      • qShift - 8 hour, Elevate heels continuously when in bed.
    • ❑ Rental Bed
      • qAM, Rental Bed Type:______________ Use specialty bed algorithm to determine which specialty surface to order.
    • ❑ Skin Care
      • qShift - 8 hour, For intact skin at risk for breakdown related to incontinence, apply Aloe Vesta #3 protective ointment until it turns from white to clear after bathing and any cleansing for incontinence.
    • ❑ Skin Care
      • qShift - 8 hour, For open shallow wounds at risk for contact with incontinence, cleanse gently with bath wipes, pat dry well, apply visible layer of Sensicare or Triad barrier cream to entire affected area. Repeat q8 hours and PRN to maintain a visible ba
    • ❑ Skin Care
      • Daily, Other - See Comments
    • ❑ nystatin 100,000 units/g topical powder
      • 1 app, Powder-Top, TOP, TID, Antibiotic Indication Candidiasis
    • ❑ Dressing Change
      • q3day, Cleanse skin tear with normal saline, replace skin flap (if applicable and possible) to natural position, cover with Mepilex dressing, label dressing with date/time/initials. Repeat q3 days.
    • ❑ Dressing Change
      • Every other day, Every other day, Cleanse wound with normal saline and cover with Mepilex, label dressing with date/time/initials. Repeat every other day and PRN for soiled or dislodged dressing.
    • ❑ Dressing Change
      • Daily, Cleanse wound with normal saline, apply layer of Aquacel. Cover with secondary dressing as appropriate, label dressing with date/time/initials. Repeat daily and PRN for soiled or dislodged dressing
    • ❑ Consult Dietitian
      • Skin breakdown - Patient has wound with depth or copious exudate.
    • ❑ Dressing Change
      • Daily, Cleanse wound with normal saline, fill wound void with saline moistened gauze, cover with secondary dressing as appropriate. Label dressing with date/time/initials. Repeat daily and PRN for soiled or dislodged dressing
    • ❑ Consult Dietitian
      • Skin breakdown - Patient has wound with depth.
MED - TPN (Total Parenteral Nutrition) Order Set - IMH
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+5;0500, MWF
    • ❑ Lipid Panel
      • Blood, AM Draw collect, T+1;0500, qWeek
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500, Once
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+4;0500, Once
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+8;0500, qWeek
  • Medications
    • ❑ Central Line TPN 5%-D20%-Lytes
      • 1,000 mL, IV, mL/hr
    • ❑ Clinimix E 8/14
      • 1,000 mL, IV, mL/hr
    • ❑ Central Line TPN 5%-D20%-W/O Lytes
      • 1,000 mL, IV, mL/hr
    • ❑ Central Line TPN 8%-D14%-W/O Lytes
      • 1,000 mL, IV, mL/hr
    • ❑ Peripheral TPN 2.75%-D5%-Lytes
      • 1,000 mL, IV, mL/hr
    • ❑ lipids 20% intravenous emulsion
      • ❑ 250 mL, Emulsion, IV Piggyback, Daily
      • ❑ 250 mL, Emulsion, IV Piggyback, MWF
      • ❑ 500 mL, Emulsion, IV Piggyback, MWF
MED - Tube Feeding Order Set - IMH
  • Activity
    • ❑ Head of Bed up
      • 6x/Day, Elevated greater than 30 degrees at all times. Monitor for appropriate positioning at least every 4 hours and PRN
  • Communication
    • ❑ Notify Provider
      • See Comments
    • ❑ Notify Provider
      • FOR DIABETIC PATIENTS USING INSULIN: Notify MD if frequency of Blood Glucose POC and correction insulin do not match.
    • ❑ Notify Provider
      • NOTIFY MD for new insulin orders when feeding discontinued.
  • Consults
    • ❑ Consult to Dietitian
      • Receiving Tube Feedings, Nutritional assessment via chart review to determine baseline or ongoing metabolic needs. As long as tube feeding is being tolerated, the Dietitian will make adjustments to the rate to meet 90% of patient's estimated need by Day 3
    • ❑ Pharmacy Communication Order.
      • Daily, Receiving Tube Feedings - Evaluate medication route of administration requirements for each medication.
  • Diagnostic Tests
    • ❑ XR Abdomen AP
      • Routine, Reason: Feeding Tube Placement, Transport Mode: Portable
  • Diet
    • ❑ Diet Order
      • ❑ Custom (See Spec. Inst), Room Service Eligible: No, Tube Feeding Formula: Osmolite 1.2 (Standard)
      • ❑ Custom (See Spec. Inst), Room Service Eligible: Yes, Diabetic, Tube Feeding Formula: Glucerna 1.5 (Diabetics - 1.5 kcal/ml)
      • ❑ Custom (See Spec. Inst), Room Service Eligible: Yes, Tube Feeding Formula: Jevity 1.2 (High Fiber - 1.2 kcal/ml)
      • ❑ Custom (See Spec. Inst), Room Service Eligible: No, Tube Feeding Formula: Osmolite 1.2 (High Calorie/High Protein)
      • ❑ Custom (See Spec. Inst), Room Service Eligible: No, Tube Feeding Formula: Vital 1.5 (Elemental, Wounds)
      • ❑ Custom (See Spec. Inst), Room Service Eligible: No, Tube Feeding Formula: Nepro (Renal)
      • ❑ Regular | Custom (See Spec. Inst), Room Service Eligible: Yes, Regular Diet & Tube Feeding Formula: Ensure Plus (Oral) Osmolite 1.2 (Tube Feeding) (Standard)
      • ❑ Diabetic | Custom (See Spec. Inst), Room Service Eligible: Yes, Diabetic, 1800 kcal, Diabetic Diet & Tube Feeding Formula: Glucerna Shake (Oral) Glucerna 1.5 (Tube Feeding) (Diabetics - 1.5 kcal/mL)
  • Patient Care
    • ❑ Dressing Change
      • Daily, Cleanse around feeding tube with normal saline and apply dry dressing daily
    • ❑ Feeding Tube Start Feedings
      • ❑ Target Rate Enteral Feeding:________mL/hr. Start enteral feedings at 20mL/hr and increase by 10mL/hr every 2 hours until target rate reached.
      • ❑ Bolus Feeds: ______
    • ❑ Tube Placement Check
      • Verify placement by ordering XR Abdomen AP
    • ❑ Gastrointestinal Assessment
      • 6x/Day, Assess the patient's GI status and risk for aspiration
    • ❑ Assessment Skin
      • Check for intact skin around insertion site q shift
    • ❑ Tube Feeding Protocol
      • See Lippincott
    • ❑ Feeding Tube Care
      • Open Bag System - Change feeding bag and formula q8hours. Closed System- Change tubing system each time the infusion is complete.
    • ❑ Check residual
      • Replace gastric residual back into the stomach each time residual is checked - Per Protocol
    • ❑ Oral Care
      • 6x/Day, Perform oral care every 4 hours and PRN while patient is NPO and receiving enteral feedings
MED - VTE Prophylaxis Order Set - IMH
  • Communication
    • ❑ Reason VTE Prophylaxis Not Received
      • ❑ Active major bleeding
      • ❑ Hypertensive crisis
      • ❑ Severe thrombocytopenia
      • ❑ HIT
      • ❑ Severe trauma to the head
      • ❑ Risk of Bleeding
      • ❑ Other
    • ❑ Reason VTE Prophylaxis Not Received
      • ❑ LP, SP INJ, or remove epi
      • ❑ Indwelling epidural cath
  • Medications
    • ❑ Ambulate
      • early and aggressive ambulation
    • ❑ Ambulate with Assistance
      • early and aggressive ambulation
    • ❑ heparin
      • ❑ 5,000 unit(s), Injection, Subcutaneous, 3x/Day
      • ❑ 5,000 unit(s), Injection, Subcutaneous, BID
    • ❑ Lovenox
      • ❑ 40 mg, Syringe, Subcutaneous, Daily
      • ❑ 30 mg, Syringe, Subcutaneous, Daily
    • ❑ heparin
      • 5,000 unit(s), Injection, Subcutaneous, 3x/Day
    • ❑ Arixtra
      • 2.5 mg, Syringe, Subcutaneous, q24hr
    • ❑ Lovenox
      • ❑ 40 mg, Syringe, Subcutaneous, Daily
      • ❑ 30 mg, Syringe, Subcutaneous, Daily
    • ❑ Arixtra
      • 2.5 mg, Syringe, Subcutaneous, q24hr
    • ❑ Lovenox
      • ❑ 40 mg, Syringe, Subcutaneous, Daily
      • ❑ 30 mg, Syringe, Subcutaneous, Daily
  • Patient Care
    • ❑ SCDs
      • Knee High: Apply bilateral SCDs (to unaffected legs)
    • ❑ Nursing Communication
      • Do NOT apply SCDs
MED - Weight Based Heparin Protocol Order Set - IMH
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Heparin Anti - Xa
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500, Every other day
  • Medications
    • ❑ heparin
      • 80 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Per DVT/PE Protocol
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Per ACS Protocol
    • ❑ heparin
      • 60 unit/kg, Injection, IV Push, Once, Start date: T;N
    • ❑ heparin 25,000 units/D5W 250 mL-Premix
      • 25,000 unit(s)
      • 250 mL, IV, Per Thrombolytic/GP IIb/IIIa Protocol
  • Patient Care
    • ❑ Notify Provider
      • See Comments
  • Vital Signs
    • ❑ Height & Weight POC
MED - Wound Vac Order Set - IMH
  • Consults
    • ❑ Consult Wound/Ostomy RN
      • Wound Vac
    • ❑ Consult to Discharge Planning Services (CM)
      • Possible Home Wound Vac
  • Medications
    • ❑ Santyl 250 units/g topical ointment
      • ❑ 1 app, Ointment, TOP, MWF
      • ❑ 1 app, Ointment, TOP, TuThSa
    • ❑ Santyl 250 units/g topical ointment
      • 1 app, Ointment, TOP, UD, PRN for Other (see comment)
    • ❑ nystatin 100,000 units/g topical powder
      • ❑ 1 app, Powder-Top, TOP, MWF
      • ❑ 1 app, Powder-Top, TOP, TuThSa
    • ❑ nystatin 100,000 units/g topical powder
      • 1 app, Powder-Top, TOP, UD, PRN for Rash
  • Patient Care
    • ❑ Dressing Change
      • ❑ MWF, Wound Vac Dressing
      • ❑ TuThSa, Wound Vac Dressing
    • ❑ Suction
      • ❑ Continuous - 125 mm/Hg
      • ❑ Continuous - 150 mm/Hg
      • ❑ Continuous - 175 mm/Hg
      • ❑ Continuous - 100 mm/Hg
      • ❑ Continuous - 75 mm/Hg
      • ❑ Continuous - 200 mm/Hg
    • ❑ Suction
      • Intermittent - 5 minutes ON
    • ❑ Suction
      • Intermittent - 2 minutes OFF
    • ❑ Nursing Communication
      • Wound Vac: May change dressing prn if foam is loosened.
    • ❑ Nursing Communication
      • May disconnect suction from wound VAC pump for short intervals prn, but not greater than 2 hours in 24 hour period (e.g., x-rays, transfers) DO NOT TILT PUMP.
    • ❑ Notify Provider
      • Wound Vac: At next AM rounds if Normal Saline Therapy initiated related to inability to maintain therapy.
    • ❑ Nursing Communication
      • Wound Vac: Notify Clinician via "Wound/Ostomy Nurse Communication" order that Normal Saline Therapy initiated related to inability to maintain therapy.
    • ❑ Dressing Change
      • 3x/Day, Normal Saline Dressing
    • ❑ Gauze Pack
      • PRN, Vaseline Gauze - Place gauze over bowel or blood vessel.
    • ❑ Nursing Communication
      • Place Ostomy Paste around wound edges.
    • ❑ Nursing Communication
      • Place Adapt Ring around wound edges.
    • ❑ Nursing Communication
      • Use Hollister Skin - Gel Protective Wipes to peri-wound area and underneath any areas of drape. Allow to dry.
    • ❑ Nursing Communication
      • If foam dressing adheres to wound, moisten area with normal saline and remove gently after 15-30 minutes. May use a single layer of Adaptic or Mepitel between dressing and wound if continues to adhere to wound bed.
    • ❑ Nursing Communication
      • Bridge from wound on ____________ to wound on _______ by using drape on intact skin between the 2 wounds then Black Foam from one piece to the other. All foam must be touching.
    • ❑ Nursing Communication
      • Use "Y" connector from wound _____ to wound on __________.
    • ❑ Dressing Change
      • ❑ MWF, for 3 dose(s)/time(s), Use Silver foam dressing for 3 dressing changes then go back to Black foam.
      • ❑ TuThSa, for 3 dose(s)/time(s), Use Silver foam dressing for 3 dressing changes then go back to Black foam.
    • ❑ Nursing Communication
      • Place White Foam into tunneled / underminded area @ _________________. Do not stack pieces on White Foam.
    • ❑ Nursing Communication
      • Use Hollister Medical Adhesive Spray to seal powder. Spray 10 - 12 inches away from skin, let dry for 3 minutes (sealant will go from shinny to dull).
    • ❑ Nursing Communication
      • Use Ostomy Powder to rash / open area around wound. Seal with skin prep, no-sting prep, or hollister Medical Adhesive Spray (if spray used, spray 10-12 inches away from skin, let dry for 3-4 minutes until spray turns from shinny to dull).
    • ❑ Nursing Communication
      • Use Arglase Powder to wound bed prior to Black foam application.
    • ❑ Nursing Communication
      • Label the drape with the number of pieces of Adapt, Mepitel, White Foam, Black Foam, Silver Foam, or Vaseline Gauze used for vac application / change.
    • ❑ Wound Vac Rental
      • T;N, qAM
MED / ED - Idarucizumab (Praxbind) for Emergency Reversal of DABIGATRAN (Pradaxa) Order Set - IMH
  • Communication
    • ❑ Nursing Communication Order
      • Discontinue dabigatran (Pradaxa).
    • ❑ Nursing Communication Order
      • Discontinue antiplatelet agents and NSAIDs.
    • ❑ Nursing Communication Order
      • Notify Pharmacy of time of last dose of dabigatran (Pradaxa).
    • ❑ Notify Provider
      • Notify provider of time of last dose of dabigatran (Pradaxa).
    • ❑ Pharmacy Communication Order.
      • Discontinue dabigatran (Pradaxa).
    • ❑ Pharmacy Communication Order.
      • Discontinue antiplatelet agents and NSAIDs.
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Creatinine
      • Blood, Stat collect, T;N
    • ❑ Misc Nursing Task
      • Order timed PTT to start one hour after and four hours after and 24 hours after infusion of idarucizumab (Praxbind) completed, if not already ordered by ED staff.
    • ❑ PTT
      • Blood, Timed Study collect, T;N, q3hr, for 2 dose(s)/time(s), 1, 4, & 24 hrs after both Praxbind doses infused
  • Medications
    • ❑ charcoal - sorbitol
      • ❑ 50 gm, Susp-Oral, Oral, Once
      • ❑ 50 gm, Susp-Oral, Tube, Once
    • ❑ Praxbind
      • 2.5 gm, Soln, IV Piggyback, q10min, STAT, 2 dose(s)/time(s)
MED / ED - KCentra for Emergency Reversal of ORAL FACTOR Xa INHIBITORS Order Set - IMH
  • Communication
    • ❑ Nursing Communication Order
      • Discontinue Factor Xa inhibitors (e.g. apixaban, betrixaban, edoxaban, rivaroxaban).
    • ❑ Nursing Communication Order
      • Discontinue antiplatelet agents and NSAIDs.
    • ❑ Nursing Communication Order
      • Notify Pharmacy of time of last dose of Factor Xa inhibitors (e.g. apixaban, betrixaban, edoxaban, rivaroxaban).
    • ❑ Notify Provider
      • Notify provider of time of last dose of Factor Xa inhibitors (e.g. apixaban, betrixaban, edoxaban, rivaroxaban).
    • ❑ Pharmacy Communication Order.
      • Discontinue Factor Xa inhibitors.
    • ❑ Pharmacy Communication Order.
      • Discontinue antiplatelet agents and NSAIDs.
    • ❑ Notify Provider
      • Immediately if allergic reaction to KCentra.
    • ❑ Nursing Communication Order
      • After KCentra administration, monitor for signs / symptoms of arterial or venous thrombosis such as DVT, PE, stroke, ischemia
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Fibrinogen.
      • Blood, Stat collect, T;N
    • ❑ Creatinine
      • Blood, Stat collect, T;N
  • Medications
    • ❑ charcoal - sorbitol
      • ❑ 50 gm, Susp-Oral, Oral, Once
      • ❑ 50 gm, Susp-Oral, Tube, Once
    • ❑ Kcentra
      • 50 unit/kg, IV Piggyback, Once, STAT
    • ❑ Kcentra
      • ❑ 2,000 unit(s), IV Piggyback, Once, STAT
      • ❑ 50 unit(s), IV Piggyback, Once, STAT
    • ❑ Kcentra
      • 1,000 unit(s), IV Piggyback, Once, STAT
    • ❑ Benadryl
      • ❑ 25 mg, IV Push, Once, PRN Allergy symptoms
      • ❑ 50 mg, IV Push, Once, PRN Allergy symptoms
    • ❑ Vitamin K1
      • 10 mg, IV Piggyback, Once, STAT
MED / ED - KCentra for Emergency Reversal of WARFARIN (Coumadin) Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Discontinue warfarin and any other anticoagulant.
    • ❑ Nursing Communication
      • Discontinue antiplatelet agents and NSAIDs.
    • ❑ Pharmacy Communication Order.
      • Discontinue warfarin and any other anticoagulant.
    • ❑ Pharmacy Communication Order.
      • Discontinue antiplatelet agents and NSAIDs.
    • ❑ Notify Provider
      • Immediately if allergic reaction to KCentra.
    • ❑ Notify Provider Laboratory Results
      • With INR result drawn 30 minutes after KCentra administration.
    • ❑ Notify Provider Laboratory Results
      • If any q6hr post KCentra administration INR results are greater than previous level.
    • ❑ Nursing Communication Order
      • After KCentra administration, monitor for signs / symptoms of arterial or venous thrombosis such as DVT, PE, stroke, ischemia
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ Fibrinogen.
      • Blood, Stat collect, T;N
    • ❑ Misc Nursing Task
      • Order timed INR labs to start after infusion of KCentra. Order for 30 minutes after and every 6 hours x 24 hours after infusion of KCentra completed, if not already ordered by ED staff.
    • ❑ INR
      • Blood, Timed Study collect, T;N, q6hr, for 5 dose(s)/time(s), Start 30 min after infusion of KCentra then q6hrs
  • Medications
    • ❑ Kcentra
      • ❑ 25 unit/kg, IV Piggyback, Once, STAT
      • ❑ 35 unit/kg, IV Piggyback, Once, STAT
      • ❑ 50 unit/kg, IV Piggyback, Once, STAT
    • ❑ Benadryl
      • ❑ 25 mg, IV Push, Once, PRN Allergy symptoms
      • ❑ 50 mg, IV Push, Once, PRN Allergy symptoms
    • ❑ Vitamin K1
      • 10 mg, IV Piggyback, Once, STAT
Meningitis Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Meningitis Plan of Care
Mental Status Change (Acute) Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Mental Status Change (Acute) Plan of Care
Mental Status Change (Chronic) Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Confusion (Chronic) Plan of Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Mental Status Change (Chronic) Plan of Care
 N
Nausea Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Nausea Plan of Care
NEPH - Hemodialysis Order Set - IMH
  • Laboratory
    • ❑ CBC w/Auto Diff
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Renal Function Panel
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Hemoglobin & Hematocrit
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Comprehensive Metabolic Panel
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Basic Metabolic Panel
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ PT/INR
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Potassium Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Magnesium Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Vancomycin Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Dialysis Communication
      • ❑ T+1;0600, Give vancomycin 1.5 gm for vanc level < 10 Give vancomycin 1 gm for vanc level 10-15 Give vancomycin 500 mg for vanc level 15-20 Give no vancomycin for level > 20
      • ❑ Give vancomycin 1.5 gm for vanc level < 10 Give vancomycin 1 gm for vanc level 10-15 Give vancomycin 500 mg for vanc level 15-20 Give no vancomycin for level > 20
    • ❑ Gentamicin Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Phosphorus Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ NT-proBNP
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ PTT
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Albumin Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Culture - Blood
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Culture - Blood
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Hep B Surface Ab
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Hepatitis Panel
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, T;N, Nurse collect
    • ❑ HIV 1,2 Combo AgAb
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, T;N, Nurse collect
    • ❑ TSH
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Digoxin Lvl
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Iron Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ PTH Intact Level
      • ❑ Blood, Routine collect, T+1;0600, Nurse collect
      • ❑ Blood, Routine collect, Nurse collect
    • ❑ Dialysis - Blood Transfusion
      • T+1;0600, q30min, for 2 dose(s)/time(s), if hgb < 8.5, transfuse 2 units packed red blood cells, each unit 30 minutes apart
  • Medications
    • ❑ Heparin
      • 5,000 unit(s), into the affected catheter, As Directed, PRN for Other (see comment), Start date: T+1;0600
    • ❑ Heparin
      • 5,000 unit(s), into the affected catheter, As Directed, PRN for Other (see comment), Start date: T+1;0600
    • ❑ Epogen
      • ❑ 10,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 10,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 15,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 15,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 20,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 20,000 unit(s), IV Push, On Call, Start date: T+1;0600
      • ❑ 10,000 unit(s), IV Push, On Call
      • ❑ 10,000 unit(s), IV Push, On Call
      • ❑ 15,000 unit(s), IV Push, On Call
      • ❑ 15,000 unit(s), IV Push, On Call
      • ❑ 20,000 unit(s), IV Push, On Call
      • ❑ 20,000 unit(s), IV Push, On Call
    • ❑ albumin human 25% intravenous solution
      • ❑ 25 gm, IV Piggyback, On Call, Start date: T+1;0600
      • ❑ 25 gm, IV Piggyback, On Call
    • ❑ mannitol
      • ❑ 12.5 gm, IV Piggyback, On Call, Start date: T+1;0600
      • ❑ 12.5 gm, IV Piggyback, On Call
    • ❑ vancomycin
      • ❑ 1 gm, IV Piggyback, Once, NOW
      • ❑ 500 mg, IV Piggyback, Once, NOW
      • ❑ 1.5 gm, IV Piggyback, Once, NOW
      • ❑ 1.25 gm, IV Piggyback, Once, NOW
    • ❑ gentamicin
      • ❑ 60 mg, IV Piggyback, Once, NOW
      • ❑ 80 mg, IV Piggyback, Once, NOW
      • ❑ 120 mg, IV Piggyback, Once, NOW
  • Patient Care
    • ❑ Dialysis Communication
      • T;N, CPOE order
    • ❑ Nursing Communication Order
      • T;N, Dialysis nurse to flush with NS 200 mL PRN for cramping or hypotension.
    • ❑ Notify Provider
      • T+1;0600, Dialysis Nurse to notify Nephrologist at onset
    • ❑ Hemodialysis
      • ❑ T+1;0600, Once, for tomorrow
      • ❑ T;N, Once, Notify Dialysis Nurse
      • ❑ T;N, Once, Emergency, CALL DIALYSIS UNIT. If after hours, have operator page Dialysis Nurse on call.
    • ❑ Dialysis Treatment
      • ❑ T+1;0600, 4 Hours
      • ❑ T+1;0600, 3.5 Hours
      • ❑ T+1;0600, 3 hours
      • ❑ T+1;0600, 2.5 Hours
      • ❑ T+1;0600, 2 hours
      • ❑ T+1;0600, Ultrafiltration: ____hrs
      • ❑ T+1;0600, Ultrafiltration: ____hrs, Hemodialysis: ____hrs
      • ❑ T;N, 4 Hours
      • ❑ T;N, 3.5 Hours
      • ❑ T;N, 3 hours
      • ❑ T;N, 2.5 Hours
      • ❑ T;N, 2 hours
      • ❑ T;N, Ultrafiltration: ____hrs
      • ❑ T;N, Ultrafiltration: ____hrs, Hemodialysis: ____hrs
    • ❑ Dialyzer
      • ❑ T+1;0600, 200
      • ❑ T+1;0600, 250
      • ❑ T+1;0600, 160
      • ❑ T+1;0600, 180
      • ❑ T;N, 200
      • ❑ T;N, 250
      • ❑ T;N, 160
      • ❑ T;N, 180
    • ❑ Dialysate
      • ❑ T+1;0600, 3K
      • ❑ T+1;0600, 2K
      • ❑ T+1;0600, 4K
      • ❑ T+1;0600, 1K x ______ hours, then ______ K+
      • ❑ T+1;0600, 0K x ______ hours, then ______ K+
      • ❑ T;N, 3K
      • ❑ T;N, 2K
      • ❑ T;N, 4K
      • ❑ T;N, 1K x ______ hours, then ______ K+
      • ❑ T;N, 0K x ______ hours, then ______ K+
    • ❑ QD - Quantitative Dialysate Flow
      • ❑ T+1;0600, 800
      • ❑ T+1;0600, 700
      • ❑ T+1;0600, 600
      • ❑ T+1;0600, 500
      • ❑ T;N, 800
      • ❑ T;N, 700
      • ❑ T;N, 600
      • ❑ T;N, 500
    • ❑ QB - Quantitative Blood Flow
      • ❑ T+1;0600, 350
      • ❑ T+1;0600, 400
      • ❑ T+1;0600, 300
      • ❑ T+1;0600, 250
      • ❑ T+1;0600, 200
      • ❑ T;N, 350
      • ❑ T;N, 400
      • ❑ T;N, 300
      • ❑ T;N, 250
      • ❑ T;N, 200
    • ❑ Weight Removal
      • ❑ T+1;0600, EDW (Per Estimated Dry Weight)
      • ❑ T+1;0600, Kilograms ___________
      • ❑ T+1;0600, Challenge per Crit Line
      • ❑ T;N, EDW (Per Estimated Dry Weight)
      • ❑ T;N, Kilograms ___________
      • ❑ T;N, Challenge per Crit Line
    • ❑ Nursing Communication Order
      • ❑ T+1;0600, Heparin 3/1/1 with Dialysis
      • ❑ T+1;0600, Heparin 2/1/1 with Dialysis
      • ❑ T+1;0600, Heparin 4/1/1 with Dialysis
      • ❑ T+1;0600, Heparin 5/1/1 with Dialysis
      • ❑ T+1;0600, No Heparin with Dialysis
      • ❑ T;N, Heparin 3/1/1 with Dialysis
      • ❑ T;N, Heparin 2/1/1 with Dialysis
      • ❑ T;N, Heparin 4/1/1 with Dialysis
      • ❑ T;N, Heparin 5/1/1 with Dialysis
      • ❑ T;N, No Heparin with Dialysis
    • ❑ Nursing Communication Order
      • ❑ T+1;0600, Sodium Modeling: ________
      • ❑ T;N, Sodium Modeling: ________
  • Respiratory
    • ❑ ABG Draw (Resp)
      • ❑ T+1;0600, Routine, Nurse Collect with Hemodialysis
      • ❑ T+1;0600, Routine, Nurse Collect after 2 hours of Hemodialysis
      • ❑ T;N, Routine, Nurse Collect with Hemodialysis
      • ❑ T;N, Routine, Nurse Collect after 2 hours of Hemodialysis
NEPH - Peritoneal Dialysis (PD) Order Set - IMH
  • Laboratory
    • ❑ Cell Count Body Fluid
      • Body Fluid, Routine collect, T;N, Nurse collect
    • ❑ Gram Stain Only
      • Other, Routine collect, T;N, Nurse collect
    • ❑ Culture - Body Fluid
      • Body Fluid, Routine collect, T;N, Nurse collect
  • Patient Care
    • ❑ Dialysis Communication
      • ❑ PD: 1.5%, 2000 mL, manifold, 4 exchanges only.
      • ❑ PD: 2.5%, 2000 mL, manifold, 4 exchanges only.
      • ❑ PD: 1.5% alternating with 2.5%, 2000 mL, manifold, 4 exchanges only.
      • ❑ PD: 1.5%, 2000 mL, cycler, 4 exchanges over 9 hours.
      • ❑ PD: 2.5%, 2000 mL, cycler, 4 exchanges over 9 hours.
      • ❑ PD:
      • ❑ SNF PD: 1.5%, 2000 mL, manifold, 4 exchanges each day (QID)
      • ❑ SNF PD: 2.5%, 2000 mL, manifold, 4 exchanges each day (QID)
      • ❑ SNF PD: 1.5%, 2000 mL alternating with 2.5%, 2000 mL, manifold, 4 exchanges each day (QID)
      • ❑ SNF PD: 1.5%, 2000 mL, cycler, 4 exchanges over 9 hours each day
      • ❑ SNF PD: 2.5%, 2000 mL, cycler, 4 exchanges over 9 hours each day
      • ❑ SNF PD:
    • ❑ Weight POC
      • Once a Day (before meals), Weigh full (wet) and record on Peritoneal Flow Sheet
    • ❑ Weight POC
      • Once a Day (before meals), Weigh empty (dry) and record on Peritoneal Flow Sheet
    • ❑ Notify Provider
      • Call MD or Dialysis Nurse if cloudiness or fiber seen in effluent fluid
NEPH - Renal Routine Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ Nursing Communication Order
      • Order ECG PRN for chest pain and call MD.
  • Diet
    • ❑ Diet Order
      • ❑ Renal, Room Service Eligible: Yes, Fluid: 1500 ml
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Fluid: 1500 ml
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1500 kcal, Fluid: 1500 ml
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Medications
    • ❑ !-Zofran
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ Tylenol
      • 500 mg, Tab, Oral, q6hr, PRN Pain
    • ❑ Restoril
      • 15 mg, Cap, Oral, HS, PRN Sleep
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, q5min, PRN Chest Pain
    • ❑ Kristalose
      • 20 gm, Packet, Oral, q8hr, PRN Constipation
    • ❑ sorbitol
      • 30 mL, Soln-Oral, Oral, q8hr, PRN Constipation
    • ❑ Dulcolax Laxative
      • 10 mg, Supp, Per rectum, q12hr, PRN Constipation
    • ❑ Nursing Communication Order
      • No fleets enema or Milk of Magnesia
  • Patient Care
    • ❑ Weight POC
      • Once a Day (before meals), by 0800, Weigh empty and record on Peritoneal Flow Sheet
    • ❑ Nursing Communication Order
      • Use Peritoneal Flow Sheet
    • ❑ Notify Provider
      • Call Nephrologist or Dialysis Nurse if cloudiness or fibrin seen in effluent fluid
    • ❑ Nursing Communication Order
      • No BP, No IV on Dialysis Access Extremity.
    • ❑ Nursing Communication Order
      • DO NOT access Dialysis Catheters unless otherwise specified. (Dialysis catheter trained RN only).
    • ❑ Notify Provider
      • if no bruit or thrill over fistula or graft
    • ❑ Notify Provider Vital Signs
      • Notify Nephrologist: If patient spikes temperature greater than 100.5'F/38.1'C or if patient develops rigors with or without fever, call MD at once., HR > 120, HR < 55, SBP > 180, SBP < 90
    • ❑ Notify Provider
      • if blood oozing at Dialysis Catheter site or from the puncture sites of the fistula or graft.
    • ❑ I&O POC
      • ❑ 3x/Day, (q 8 hours)
      • ❑ 6x/Day, (q 4 hours)
    • ❑ Enema Administration
      • PRN, Tap water enema for severe constipation.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Defibrillate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals)
NEPH - SNF Hemodialysis Order Set - IMH
  • Laboratory
    • ❑ CBC w/Auto Diff
      • ❑ Blood, Routine collect, MWF, Nurse collect
      • ❑ Blood, Routine collect, TuThSa, Nurse collect
    • ❑ Renal Function Panel
      • ❑ Blood, Routine collect, MWF, Nurse collect
      • ❑ Blood, Routine collect, TuThSa, Nurse collect
    • ❑ Hemoglobin & Hematocrit
      • ❑ Blood, Routine collect, MWF, Nurse collect
      • ❑ Blood, Routine collect, TuThSa, Nurse collect
    • ❑ PT/INR
      • ❑ Blood, Routine collect, MWF, Nurse collect
      • ❑ Blood, Routine collect, TuThSa, Nurse collect
    • ❑ Potassium Level
      • ❑ Blood, Routine collect, MWF, Nurse collect
      • ❑ Blood, Routine collect, TuThSa, Nurse collect
  • Medications
    • ❑ Heparin
      • 5,000 unit(s), into the affected catheter, As Directed, PRN for Other (see comment), Start date: T+1;0600
    • ❑ Heparin
      • 5,000 unit(s), into the affected catheter, As Directed, PRN for Other (see comment), Start date: T+1;0600
    • ❑ Epogen
      • ❑ 10,000 unit(s), IV Push, MWF
      • ❑ 10,000 unit(s), IV Push, TuThSa
      • ❑ 10,000 unit(s), IV Push, MWF
      • ❑ 10,000 unit(s), IV Push, TuThSa
  • Patient Care
    • ❑ Dialysis Communication
      • T;N, CPOE order
    • ❑ Nursing Communication Order
      • T;N, Dialysis nurse to flush with NS 200 mL PRN for cramping or hypotension.
    • ❑ Notify Provider
      • Dialysis Nurse to notify Nephrologist at onset
    • ❑ Hemodialysis
      • ❑ MWF
      • ❑ TuThSa
    • ❑ Dialysis Treatment
      • ❑ 4 Hours
      • ❑ 3.5 Hours
      • ❑ 3 hours
    • ❑ Dialyzer
      • ❑ 200
      • ❑ 250
      • ❑ 160
      • ❑ 180
    • ❑ Dialysate
      • ❑ 3K
      • ❑ 2K
      • ❑ 4K
    • ❑ QD - Quantitative Dialysate Flow
      • ❑ 800
      • ❑ 700
      • ❑ 600
      • ❑ 500
    • ❑ QB - Quantitative Blood Flow
      • ❑ 350
      • ❑ 400
      • ❑ 300
    • ❑ Weight Removal
      • ❑ EDW (Per Estimated Dry Weight)
      • ❑ Kilograms ___________
      • ❑ Challenge per Crit Line
    • ❑ Nursing Communication Order
      • ❑ Heparin 3/1/1
      • ❑ Heparin 2/1/1
      • ❑ Heparin 4/1/1
      • ❑ Heparin 5/1/1
      • ❑ No Heparin
    • ❑ Communication Order
      • Sodium Modeling: ________
NEURO - Acute (Phase 1) Stroke / TIA Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Nursing Communication Order
      • CALL CODE STROKE
    • ❑ Nursing Communication Order
      • ACTIVATE STROKE TEAM BY PAGING CODE STROKE.
    • ❑ Nursing Communication Order
      • Notify CT of CODE STROKE
    • ❑ Nursing Communication Order
      • Establish exact onset of symptoms and document in EMR.
    • ❑ Nursing Communication Order
      • Consult Telestroke Robot if patient qualifies
    • ❑ Nursing Communication Order
      • Place on Stroke Clinical Pathway
  • Diagnostic Tests
    • ❑ ECG
      • Stat
    • ❑ XR Chest 1 View Portable
      • Stat
    • ❑ CT Head or Brain w/o Contrast
      • Stat, Reason: Ischemic / Hemorrhagic Stroke / TIA
    • ❑ CT Angio Head w/ + w/o Contrast
      • Stat, Reason: Ischemic / Hemorrhagic Stroke / TIA
    • ❑ CT Angio Neck w/ Contrast
      • Stat, Reason: Ischemic / Hemorrhagic Stroke / TIA
  • IV Solutions
    • ❑ NS
      • 1000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ hCG Qual Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ PT
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N
  • Medications
    • ❑ labetalol
      • 10 mg, IV Push, Once, for Other (see comment)
    • ❑ labetalol
      • 20 mg, IV Push, q5min, PRN Other (see comment)
    • ❑ niCARdipine 25 mg/250 mL - IV Sol IVS (Stroke)
      • 250 mL, IV, Routine, See Comments
    • ❑ hydrALAZINE
      • ❑ 10 mg, Vial, IV Push, Once, PRN for Other (see comment)
      • ❑ 20 mg, Vial, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 1.25 mg, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 2.5 mg, IV Push, Once, PRN for Other (see comment)
    • ❑ Nitroprusside 50 mg/250 mL (Stroke)
      • 250 mL, IV, Routine, See Comments
      • 50 mg
    • ❑ labetalol
      • 10 mg, IV Push, q15min, for Other (see comment), 2 dose(s)/time(s)
    • ❑ labetalol
      • 20 mg, IV Push, q15min, for Other (see comment), 2 dose(s)/time(s)
    • ❑ niCARdipine 25 mg/250 mL - IV Sol IVS (Stroke)
      • 250 mL, IV, Routine, See Comments
    • ❑ Reason IV Thrombolytic Therapy Not Initiated
      • ❑ Mild non-disabling stroke (NIHSS score 0-5)
      • ❑ Active internal bleeding
      • ❑ Within the last 7 days, arterial puncture at non-compressible site
      • ❑ Within the last 3 months, major head trauma or previous stroke
      • ❑ Within the last 3 months, intra-cranial or intra-spinal surgery
      • ❑ Previous intracranial hemorrhage
      • ❑ Current intracranial hemorrhage
      • ❑ Known or suspected subacute bacterial endocarditis
      • ❑ Any known unsecured intracranial aneurysms >10mm or AVM's
      • ❑ Presence of intra-axial/parenchymal neoplasms
      • ❑ Symptoms suggestive of subarachnoid hemorrhage
      • ❑ SBP >185 or DBP >110 at the time of treatment despite anti-hypertensive tx
      • ❑ Acute bleeding diathesis
      • ❑ Glucose <50 and/or resolution of deficits with normalization
      • ❑ Platelet count <100,000/mm
      • ❑ Heparin received within the last 48 hours resulting in abnormally elevated aPTT
      • ❑ Current use of a direct thrombin or factor Xa inhibitors (NOACS) within last 48 hours
      • ❑ CT brain with evidence of hemorrhage or multilobar infarction(hypodensity >1/3 cerebral hemisphere)
    • ❑ Reason IV Thrombolytic Therapy Not Initiated
      • ❑ Moderately severe stroke symptoms demonstrating early improvement
      • ❑ Pregnancy
      • ❑ Seizure at onset with postictal residual neurological impairments
      • ❑ Within the last 14 days, major surgery or trauma
      • ❑ Within the last 21 days, gastrointestinal or urinary tract hemorrhage
      • ❑ Within the last 3 months, myocardial infarction
    • ❑ Reason IV Thrombolytic Therapy Not Initiated
      • ❑ Prior Stroke and Diabetes
      • ❑ Any anticoagulant use prior to admission (even if INR <1.7)
      • ❑ NIHSS > 25
  • Patient Care
    • ❑ Cardiac Monitoring.
      • Place on Monitor
    • ❑ Blood Glucose POC
      • Once, Stat
    • ❑ Notify Provider
      • For BS below 70 or above 140
    • ❑ NIH Stroke Scale
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Titrate
      • O2 at 2L/min if O2 sat less than 94% on room air
  • Vital Signs
    • ❑ Weight POC
      • Stat
NEURO - Acute (Phase 2) Stroke / TIA Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemtry
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ CT Head or Brain w/ + w/o Contrast
      • Routine
    • ❑ CT Head or Brain w/o Contrast
      • Routine
    • ❑ MRI Brain w/ + w/o Contrast
      • Routine
    • ❑ MRA Head w/o Contrast
      • Routine
    • ❑ US Carotid Doppler Bilateral
      • Routine
    • ❑ CT Angio Neck w/ Contrast
      • Routine
    • ❑ CT Angio Head w/ + w/o Contrast
      • Routine
    • ❑ Echocardiogram for Heart Station
      • Routine
    • ❑ Consult to Cardiology
      • TEE
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ NPO, until Dysphagia Screening complete
      • ❑ Regular, Room Service Eligible: Yes, Pureed
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
      • ❑ Dysphagia, Room Service Eligible: Yes, Honey Thick
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • 1000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Routine collect, T;N
    • ❑ Hgb A1C
      • Blood, Routine collect, T;N
    • ❑ Fasting Lipid Profile
      • Blood, AM Draw collect, T+1;0500, If not done in the ED
  • Medications
    • DVT Prophylaxis
      • ❑ Reason Stroke VTE Mechanical Prophylaxis Not Ordered
        • ❑ IV heparin day of or day after admission
        • ❑ Patient/Family refused
        • ❑ Patient is ambulatory
        • ❑ Patient low risk for VTE
        • ❑ Warfarin therapy on hold due to high INR
        • ❑ Other: _________
      • ❑ Reason Stroke VTE Pharmacological Prophylaxis Not Ordered
        • ❑ IV heparin day of or day after admission
        • ❑ Patient/Family refused
        • ❑ Patient is ambulatory
        • ❑ Patient low risk for VTE
        • ❑ Warfarin therapy on hold due to high INR
        • ❑ Other _________
    • ❑ Hold Med
      • Hold anticoagulants, anti-thrombotics, and anti-platelets for 24 hours, if Alteplase (Activase) administered.
    • ❑ aspirin
      • ❑ 81 mg, Tab-Chew, Chewed, Daily
      • ❑ 325 mg, Tab, Oral, Daily
      • ❑ 300 mg, Supp, Per rectum, Daily
    • ❑ Plavix
      • 75 mg, Tab, Oral, Daily
    • ❑ ticagrelor
      • 90 mg, Tab, Oral, BID
    • ❑ Reason Antithrombotics Not Given by End Day 2
      • ❑ Allergy/Complication to antithrombotics
      • ❑ Aortic dissection
      • ❑ Bleeding disorder
      • ❑ Brain/CNS cancer
      • ❑ CVA, hemorrhagic
      • ❑ Extensive/Metastatic cancer
      • ❑ Hemorrhage, any type
      • ❑ Intracranial surgery/biopsy
      • ❑ Patient/Family refusal
      • ❑ Peptic ulcer
      • ❑ Planned surgery w/in 7 days after DC
      • ❑ Risk of bleeding
      • ❑ Unrepaired intracranial aneurysm
      • ❑ Other: _________________
    • ❑ Hold Med
      • Hold Coumadin for INR above 3 and notify MD.
    • ❑ Lipitor
      • ❑ 80 mg, Tab, Oral, Daily
      • ❑ 40 mg, Tab, Oral, Daily
    • ❑ Crestor
      • ❑ 20 mg, Tab, Oral, Daily
      • ❑ 40 mg, Tab, Oral, Daily
    • ❑ atropine
      • 1 mg, Syringe, IV Push, As Directed, PRN Other (see comment)
  • Patient Care
    • ❑ Blood Glucose POC
      • 6x/Day, for 24 hr, Notify provider for blood sugar below 70 or above 140.
    • ❑ Blood Glucose POC
      • QIDACHS, Notify provider for blood sugar below 70 or above 140.
    • ❑ Notify Provider
      • Blood Sugar below 70 or above 140. Avoid hypoglycemia / hyperglycemia.
    • ❑ NIH Stroke Scale
      • Within 2 hours of admission. Repeat at 24 hours and 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • Repeat at 24 hours and 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • Repeat at 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • PRN, Repeat with any neurological change. Notify MD for worsening symptoms.
    • ❑ Notify Provider
      • Worsening NIHSS.
    • ❑ I&O POC
      • ❑ 6x/Day, Strict I&O (q 4 hours)
      • ❑ 3x/Day, Strict I&O (q 8 hours)
    • ❑ Patient Education
      • See Comment
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ Sequential Compression Device
      • T;N, Daily, Knee High SCDs
  • Respiratory
    • ❑ Oxygen Titrate
      • O2 at 2L/min if O2 sat less than 94% on room air.
    • ❑ Notify Provider
      • Call MD for respiratory distress.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • 12x/Day, for 4 dose(s)/time(s)
    • ❑ Vital Signs POC
      • q4hrVS, for 48 hr
    • ❑ Neurological Check
      • 12x/Day, for 4 dose(s)/time(s)
    • ❑ Neurological Check
      • 6x/Day, for 48 hr
NEURO - Alteplase (Activase) - Stroke Order Set - IMH
  • Diagnostic Tests
    • ❑ MRA Head w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
    • ❑ CT Head or Brain w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
    • ❑ MRI Brain w/o Contrast
      • Routine, Reason: 24 hours post Alteplase
  • Medications
    • ❑ Nursing Communication Order
      • Use dosing chart on reference text for Alteplase (Activase) for Acute Ischemic Stroke to determine Alteplase (Activase) bolus & maintenance infusion dosage based upon weight (Maximum total dose cannot exceed 90mg).
    • ❑ Nursing Communication Order
      • NOTE:Pharmacist or Ordering Physician & 2nd RN must verify dosage, including bolus dose & maintenance infusion, prior to administration. Document in EMR.
    • ❑ labetalol
      • 10 mg, IV Push, Once, for Other (see comment)
    • ❑ labetalol
      • 20 mg, IV Push, q5min, PRN Other (see comment)
    • ❑ niCARdipine 25 mg/250 mL - IV Sol IVS (Stroke)
      • 250 mL, IV, Routine, See Comments
    • ❑ Nitroprusside 50 mg/250 mL (Stroke)
      • 50 mg
      • 250 mL, IV, Routine, See Comments
    • ❑ alteplase.
      • Per Protocol for Stroke, Kit, IV, Once, STAT
    • ❑ Sodium Chloride 0.9% Intermittent
      • 50 mL, IV, 100 mL/hr
    • ❑ hydrALAZINE
      • ❑ 10 mg, Vial, IV Push, Once, PRN for Other (see comment)
      • ❑ 20 mg, Vial, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 1.25 mg, IV Push, Once, PRN for Other (see comment)
    • ❑ enalapril
      • 2.5 mg, IV Push, Once, PRN for Other (see comment)
  • Patient Care
    • ❑ Saline Lock Insertion
      • 2 large bore Angiocaths, 1 for IV Alteplase (Activase)
    • ❑ Hold Med
      • Do not give aspirin, heparin, or warfarin or other anticoagulants for 24 hours post Alteplase (Activase) infusion.
    • ❑ Precautions
      • Bleeding Precautions
    • ❑ Notify Provider
      • Notify Provider & STOP Alteplase (Activase) if patient complains of severe headache, patient becomes lethargic, or if patient begins to experience hematemesis, hematuria, hemoptysis, seizures or signs of orolingual angioedema
    • ❑ Patient Education
      • Alteplase (Activase) patient education completed and handout provided
  • Vital Signs
    • ❑ Weight POC
    • ❑ Vital Signs POC
      • every 15 minutes during treatment, then q 15 minutes x 2 hours, then q 30 minutes x 6 hour, then q 1 x 24 hours after treatment - Document on Alteplase (Activase) flow sheet.
    • ❑ Neurovascular Checks
      • every 15 minutes during treatment, then q 15 minutes x 2 hours, then q 30 minutes x 6 hours, then q 1 hour x 24 hours after treatment- Document on Alteplase (Activase) flow sheet.
NEURO - Cerebral Hemorrhage Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Diagnostic Tests
    • ❑ MRI Brain w/ + w/o Contrast
      • Routine, 0
    • ❑ MRA Head w/o Contrast
      • Routine, 0
    • ❑ CT Angio Head w/ + w/o Contrast
      • Routine, 0
    • ❑ US Carotid Doppler Bilateral
      • Routine, 0
    • ❑ Echocardiogram for Heart Station
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Pureed
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
      • ❑ Dysphagia, Room Service Eligible: Yes, Honey Thick
  • IV Solutions
    • ❑ NS
      • ❑ 1,000 mL, IV, 10 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 10 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Routine collect, T;N
    • ❑ Hgb A1C
      • Blood, Routine collect, T;N
    • ❑ Fasting Lipid Profile
      • Blood, AM Draw collect, T+1;0500
  • Patient Care
    • ❑ Blood Glucose POC
      • 6x/Day, for 24 hr, Notify provider for blood sugar below 60 or above 140.
    • ❑ Blood Glucose POC
      • QIDACHS, Notify provider for blood sugar below 60 or above 140.
    • ❑ Notify Provider
      • Blood Sugar below 60 or above 140.
    • ❑ SCDs
      • Knee High
    • ❑ I&O POC
      • ❑ 6x/Day, Strict
      • ❑ 3x/Day, Strict
    • ❑ NIH Stroke Scale
      • Within 2 hours of admission. Repeat at 24 hours and 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • Repeat at 24 hours and 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • Repeat at 72 hours and with any neurological change. Notify MD for worsening symptoms.
    • ❑ NIH Stroke Scale
      • PRN, Repeat with any neurological change. Notify MD for worsening symptoms.
    • ❑ Notify Provider
      • For worsening NIHSS.
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
    • ❑ Patient Education
      • Place Patient on Stroke Pathway
  • Respiratory
    • ❑ Oxygen Titrate
      • O2 at 2L/min if O2 sat less than 94% on room air
    • ❑ Notify Provider
      • Call MD for respiratory distress.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • 12x/Day, for 4 dose(s)/time(s), (q 2 hours)
    • ❑ Vital Signs POC
      • q4hrVS, on telemetry or med/surg or per Critical Care routine, & as needed.
    • ❑ Notify Provider Vital Signs
      • Temperature less than or equal to 96.8F/36.0C or greater than or equal to 100.5F/38.1C, RR > 24, RR < 12
    • ❑ labetalol
      • 10 mg, IV Push, q15min, for Other (see comment), 2 dose(s)/time(s)
    • ❑ labetalol
      • 20 mg, IV Push, q15min, for Other (see comment), 2 dose(s)/time(s)
    • ❑ niCARdipine 25 mg/250 mL - IV Sol IVS (Stroke)
      • 250 mL, IV, Routine, See Comments
    • ❑ Neurological Check
      • 12x/Day, for 4 dose(s)/time(s)
    • ❑ Neurological Check
      • 6x/Day, on telemetry or med/surg or per Critical Care routine, & as needed.
    • ❑ Glasgow Coma Scale
      • 12x/Day, for 4 dose(s)/time(s)
    • ❑ Glasgow Coma Scale
      • 6x/Day, on telemetry or med/surg or per Critical Care routine, & as needed.
NEURO - Neurology General Order Set - IMH
  • Activity
    • ❑ Elevate Head of Bed
      • 30-45 degrees
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Hospitalist
      • Medical Management
    • ❑ Consult to Discharge Planning Services (CM)
      • Discharge Planning
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Routine
    • ❑ XR Chest 1 View Frontal
      • Routine
    • ❑ CT Head or Brain w/o Contrast
      • Routine
    • ❑ CT Head or Brain w/o Contrast
      • Routine, follow-up CT
    • ❑ MRI Brain w/ + w/o Contrast
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Regular
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ NPO
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1200 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1500 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal, Fluid: 2000 ml
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
      • ❑ Dysphagia, Room Service Eligible: Yes, Honey Thick
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, Soln-IV, IV, 50 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 75 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 100 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 125 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 200 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 250 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, Soln-IV, IV, 50 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 75 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 100 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 125 mL/hr
      • ❑ 1000 mL, Soln-IV, IV, 10 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ C-Reactive Protein
      • Blood, Routine collect, T;N
    • ❑ TSH
      • Blood, Routine collect, T;N
    • ❑ ANA.
      • Blood, Routine collect, T;N
    • ❑ Carbamazepine Level
      • Blood, Routine collect, T;N
  • Medications
    • ❑ morphine
      • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
      • ❑ 4 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
    • ❑ aspirin
      • ❑ 325 mg, Tab, Oral, Daily
      • ❑ 81 mg, Tab-Chew, Oral, Daily
    • ❑ clopidogrel
      • 75 mg, Tab, Oral, Daily
    • ❑ ondansetron
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
  • Patient Care
    • ❑ Neurological Assessment
      • ❑ 6x/Day, q4h
      • ❑ 12x/Day, q2h
    • ❑ Insert Foley Catheter
      • Indwelling
    • ❑ I&O POC
      • ❑ 3x/Day, q8h
      • ❑ 6x/Day, q4h
  • Respiratory
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ BIDAC, Routine
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
NURS - Newborn Circumcision Order Set - IMH
  • Condition
    • ❑ Procedure / Consent
      • Circumcision (by Obstetrician) if male infant, and mother signs consent.
  • Medications
    • ❑ Little Fevers Infant Fever/Pain Reliever
      • 12 mg/kg, Soln-Oral, Oral, On Call
    • ❑ Little Fevers Infant Fever/Pain Reliever
      • 12 mg/kg, Soln-Oral, Oral, Once, PRN for Pain
    • ❑ Vaseline topical ointment
      • 1 app, Gel, TOP, UD, PRN for Other (see comment)
  • Patient Care
    • ❑ Dressing Change
      • PRN, Apply Vaseline and gauze to circumcision area PRN diaper changes. If bleeding excessive, apply Gelfoam dressing and apply pressure for 5 minutes. If bleeding continues, notify provider.
NURS - Nursery Hyperbilirubinemia Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Radiant Warmer
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Isolette
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Open Crib
  • Communication
    • ❑ Isolation Precautions
      • Contact Precautions, Reason: Per Protocol, Until Culture Results are reported (if begin readmitted)
  • Laboratory
    • ❑ Culture Other
      • Micro Specimen, Stat collect, T;N, Nurse collect
    • ❑ Nasal Culture
      • Nasal, Stat collect, T;N, Nurse collect
    • ❑ Neonatal Bilirubin Panel
      • Blood, Stat collect, T;N
    • ❑ Neonatal Bilirubin
      • Blood, Timed Study collect, q8hr
    • ❑ Neonatal Bilirubin
      • Blood, Timed Study collect, q12hr
    • ❑ Neonatal Bilirubin
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ Mylicon
      • 20 mg, Drops-Oral, Oral, q2hr, PRN for Gas
    • ❑ vitamin A & D topical ointment
      • 1 app, Ointment, TOP, UD, PRN for diaper rash
    • ❑ glycerin infant rectal enema
      • 4 mL, Enema, Per rectum, Q24hr, PRN for Constipation
  • Patient Care
    • ❑ Nursing Communication
      • Isolette
    • ❑ Phototherapy
      • ❑ Phototherapy Lights x1, Overhead Phototherapy
      • ❑ Fiber-Optic Blanket, Wallaby Phototherapy
      • ❑ Double Phototherapy, (Overhead and Wallaby)
    • ❑ I&O POC
      • PRN, Record all intake, number of voids and stools.
    • ❑ Nursing Communication
      • Radiant warmer if unable to maintain temperature > 36.1 degrees Celsius (97 degrees Fahrenheit)
    • ❑ Nursing Communication
      • Feed every 2 hours. May continue to breast feed.
    • ❑ Nursing Communication
      • Eye care every 8 hours (if overhead phototherapy used).
    • ❑ Nursing Communication
      • Bilimask over eyes if overhead phototherapy used.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Heart Rate
      • q4hrVS
    • ❑ Respiratory Rate
      • q4hrVS
    • ❑ Temperature
      • ❑ Q 2 hours if Overhead Phototherapy
      • ❑ Q 4 hours if Wallaby Phototherapy
      • ❑ Q 2 hours if Double Therapy (Overhead and Wallaby)
    • ❑ Weight POC
      • Once a Day (before meals)
NURS - Nursing Protocol Phase 1 Order Set - IMH
  • Patient Care
    • ❑ Chart Check
      • T;N, 6x/Day, Paper & Elctronic Chart Check
    • ❑ Education General
      • qShift - 8 hour, Document patient education
    • ❑ Communication Order
      • T;N, REMINDER: Initiate appropriate Care Plan, be sure all Problems are being addressed by a care plan.
    • ❑ Review Care Plan
      • 3x/Day
    • ❑ Vital Signs POC
      • As Directed, PRN
    • ❑ Blood Glucose POC
      • As Directed, PRN
    • ❑ I&O POC
      • PRN
    • ❑ Height & Weight POC
      • As Directed, PRN
    • ❑ ADL's POC
      • As Directed, PRN
NURS - Transfer Back Infants Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Special Care Nursery, Anticipated LOS 2 midnights or more, Isolette
  • Communication
    • ❑ Isolation Precautions
      • Contact Precautions, Reason: Per Protocol, Until culture results are reported.
  • Laboratory
    • ❑ Culture Other
      • Micro Specimen, Stat collect, T;N, Nurse collect, Umbilical Culture
    • ❑ Hematocrit
      • Blood, AM Draw collect, QMonday
    • ❑ Nasal Culture
      • Nasal, Stat collect, T;N, Nurse collect
  • Medications
    • ❑ zinc oxide 40% topical ointment
      • 1 app, Ointment, TOP, As Directed, PRN for Other (see comment)
    • ❑ simethicone
      • 20 mg, Drops-Oral, Oral, TIDPC, PRN for Other (see comment)
    • ❑ glycerin infant rectal enema
      • 4 mL, Enema, Per rectum, Q24hr, PRN for Constipation
  • Patient Care
    • ❑ I&O POC
      • Strict record all intake and output.
  • Vital Signs
    • ❑ Height & Weight POC
      • On Admission
    • ❑ Weight POC
      • Once a Day (before meals), Weigh Daily
    • ❑ Height & Weight POC
      • QMonday, Length QMonday
    • ❑ Head Circumference
      • On Admission
    • ❑ Head Circumference
      • QMonday
    • ❑ Vital Signs POC
      • Pulse and respirations every 4 hrs, blood pressure every 8 hours, temperature every 2 hours until normal range (97°-98.6°F / 36.1° - 37°C) for 8 hours.
    • ❑ Heart Rate
      • Continuous Heart Rate Monitor
    • ❑ Nursing Communication
      • Continuous respiratory monitoring
NURS - Well Newborn Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Nursery, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Bottle Feeding
      • Custom (See Spec. Inst), Room Service Eligible: No, Formula 20 cal / oz
    • ❑ Breast Feeding
      • Custom (See Spec. Inst), Room Service Eligible: No, No Supplement with Formula
    • ❑ Breast Feeding
      • Custom (See Spec. Inst), Formula 20 cal / oz
  • Laboratory
    • ❑ Cord Blood - Hold
      • Blood, Routine collect, T;N
    • ❑ Cord Blood Profile - BB
      • Blood, Routine collect, Nurse collect
    • ❑ Bilicheck Screen POC
      • Routine Transcutaneous Bilirubin (TCB) at 24 hours of age and any other time jaundice observed. If results greater than 8, order Bilirubin Panel, and report results to MD.
    • ❑ Bilicheck Screen POC
      • PRN, Routine Transcutaneous Bilirubin (TCB) any time jaundice observed. If results are in High Risk Zone, order Bilirubin Panel. If Bilirubin Panel already completed, order a Neonatal Bilirubin, and report results to MD.
    • ❑ Nursing Communication
      • T;N, Obtain umbilical cord and urine drug screen IF maternal history of drug abuse during pregnancy, no prenatal care, placental abruption, uterine rupture, or mother currently undergoing treatment for drug addiction.
    • ❑ Drug Screen Urine
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Umbilical Cord Drug Detection Panel
      • Routine collect, T;N, Nurse collect
    • ❑ CMV by PCR, Fluid
      • Fluid, Routine collect, Nurse collect, Urine
    • ❑ Misce Lab Test
      • Other, Routine collect, T;N, Meconium Drug Screen
  • Medications
    • ❑ hepatitis B pediatric vaccine 10 mcg/0.5 mL intramuscular suspension
      • 10 mcg, IM, Once, PRN for Other (see comment)
    • ❑ erythromycin 0.5% ophthalmic ointment
      • 1 app, Oint-Opth, Eye-Both, Once, NOW
    • ❑ Vitamin K1
      • 1 mg, Syringe, IM, Once, NOW
    • ❑ hepatitis B immune globulin
      • 0.5 mL, Syringe, IM, Once
  • Patient Care
    • ❑ Bathe Patient
      • After 8-24 hours of age unless requested earlier by the parents.
    • ❑ Nursing Communication Order
      • Cord Care - Keep dry and remove cord clamp at 24 hours of age if dry.
    • ❑ Nursing Communication Order
      • See Comments
    • ❑ Notify Provider
      • If mother's history is positive for Hepatitis or Unknown - Obtain order for HBIG if not already ordered.
    • ❑ Hearing Screen
      • Prior to Discharge. Order a CMV by PCR, Fluid test if patient refers hearing screen.
    • ❑ Newborn Metabolic Screen
      • T+1;N, PKU by heelstick after 24 hours of age.
    • ❑ Nursing Communication Order
      • After admission exam and patient voided, MD will initiate Newborn Circumcision Protocol Order Set if infant is a male and mother signs consent.
    • ❑ Notify Provider
      • T;N
    • ❑ CCHD Screening
      • Congenital Heart Screening prior to discharge
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • PRN, Per Unit Protocol
    • ❑ Weight POC
      • T+1;0000, q24hr, Weight Daily
Nutritional Deficit Plan of Care
  • Consults
    • ❑ Consult to Dietitian
      • Nutritional Deficit Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Nutritional Deficit Plan of Care
 O
OB - Amniocentesis Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Have amniocentesis tray/kit at the bedside
    • ❑ Nursing Communication
      • Perform a pre-procedure time out
    • ❑ Message Lab
      • Other, Amniocentesis, Fetal Lung Maturity being collecte
  • Laboratory
    • ❑ Misce Lab Test
      • Other, Stat collect, T;N, Nurse collect, Fetal Lung Maturity
    • ❑ L/S Ratio Amniotic Fluid
      • Fluid, Routine collect, T;N
  • Patient Care
    • ❑ Procedure / Consent
      • Amniocentesis
    • ❑ Fetal monitoring
      • Prior to Anmiocentesis - Continuous for 20 minutes. Post Amniocentesis procedure - Monitor for at least 30 mins and until FHR is reactive.
  • Vital Signs
    • ❑ Vital Signs POC
      • PRN, Before and after procedure
OB - Cesarean Section - Post-Operative Order Set - IMH
  • Activity
    • ❑ Dangle at Bedside
      • On Operative Day
    • ❑ Ambulate
      • T+1;0700, QID, Beginning first post-op day
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Labor and Delivery, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, Ice Chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes, Advance as Tolerated
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Soft diet
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ pitocin 20 units/NS 1000 mL Premix
      • 1,000 mL, IV, Routine, 2 dose(s)/time(s), 125 mL/hr
      • 20 unit(s)
    • ❑ LR
      • 1,000 mL, IV, 125 mL/hr
    • ❑ Discontinue IV
      • Discontinue IV access 24 hours post op if patient is stable and/or single dose epidural orders are complete and no other IV meds ordered.
    • ❑ Pitocin 10 units/ LR 1000 mL
      • 1,000 mL, IV, Routine, 1 dose(s)/time(s), 125 mL/hr
      • 10 unit(s)
  • Laboratory
    • ❑ Notify Provider Laboratory Results
      • Call H&H results to office.
    • ❑ Hemoglobin & Hematocrit
      • Blood, Timed Study collect, for 1 dose(s)/time(s)
    • ❑ Hemoglobin & Hematocrit
      • Blood, Timed Study collect, for 1 dose(s)/time(s)
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ meperidine
        • 50 mg, Syringe, IM, q3hr, PRN for Pain - Severe
      • ❑ morphine
        • 10 mg, Syringe, IM, q3hr, PRN for Pain - Severe
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, 3x/Day
      • ❑ ketorolac
        • 15 mg, Vial, IV Push, q6hr, 4 dose(s)/time(s)
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, 3x/Day, Start date: T+1
    • Antiemetics
      • ❑ prochlorperazine
        • 10 mg, Vial, IM, q6hr, PRN for Other (see comment)
    • Laxatives
      • ❑ bisacodyl
        • 10 mg, Supp, Per rectum, Q24hr, PRN for Gas
    • ❑ medroxyPROGESTERone 150 mg/mL intramuscular suspension
      • 150 mg, Susp-Inj, IM, Once, PRN for Other (see comment)
    • ❑ hydrogen peroxide 3% topical solution
      • 1 app, Soln-Top, TOP, BID
    • ❑ simethicone
      • 80 mg, Tab-Chew, Oral, QID
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once, PRN for Other (see comment)
    • ❑ Misc Nursing Task
      • Order Rhogam Workup, if eligible
    • ❑ measles/mumps/rubella virus vaccine
      • 0.5 mL, Subcutaneous, Once, PRN for Other (see comment)
    • ❑ varicella virus vaccine
      • 0.5 mL, Subcutaneous, Once, PRN Other (see comment)
    • ❑ Adacel (Tdap)
      • 0.5 mL, Susp-Inj, IM, Once, PRN Other (see comment)
    • ❑ lanolin topical cream
      • 1 app, Cream, TOP, As Directed, PRN for Pain
  • Patient Care
    • ❑ Staple Removal
      • ❑ Day of discharge and steri-strip incision
      • ❑ Return to office in 4 days for staple removal.
      • ❑ Return to office in 3 days for staple removal.
      • ❑ Return to office in 2 days for staple removal.
    • ❑ Breast Binder
      • If not breast feeding.
    • ❑ Ice Pack
      • for 24 hr, PRN, to incision
    • ❑ Duramorph Assessment
      • T;N, Constant Indicator
    • ❑ Shower
      • PRN
    • ❑ I&O POC
      • 3x/Day, until Foley and IV out
    • ❑ Turn Cough Deep Breathe
      • 12x/Day, for 12 hr
    • ❑ Incentive Spirometry RT
      • 12x/Day, for 12 hr, while awake
    • ❑ Dressing Change
      • T+1;1000, Remove dressing on first post-op day.
    • ❑ Discontinue Foley Cath
      • T+1;0600, Morning of First Post-Op Day
    • ❑ SCDs
      • Until fully ambulatory
    • ❑ Misc Nursing Task
      • Discontinue Pre OP orders
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • Per unit protocol
OB - Cesarean Section - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Labor and Delivery, Anticipated LOS 2 midnights or more
  • Condition
    • ❑ Procedure / Consent
      • Cesarean Section
    • ❑ Procedure / Consent
      • Tubal Ligation
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • NPO
  • IV Solutions
    • ❑ LR
      • 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ Rubella Antibodies IgG
      • Blood, Stat collect, T;N
    • ❑ HIV Rapid Screen
      • Blood, Stat collect, T;N
    • ❑ Group B Strep Culture
      • Micro Specimen, Stat collect, T;N, Nurse collect
    • ❑ Chlamydia GC PCR
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Blood Bank Orders
      • Blood, Stat collect, T;N
    • ❑ Tube for Blood Bank
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ RPR
      • Blood, Stat collect, T;N
    • ❑ Hepatitis B Surface Antigen
      • Blood, Stat collect, T;N
    • ❑ Creatinine
      • Blood, Stat collect, T;N
  • Medications
    • ❑ lidocaine 1% injectable solution
      • 0.1 mL, Vial, Intradermal, UD, PRN Other (see comment)
    • ❑ ceFAZolin.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ clindamycin
      • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ gentamicin
      • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • ❑ Fetal Heart Tones
      • Once, Pre-op
    • ❑ Notify Provider
      • For severe allergy (anaphylaxis, urticaria, hives, angioedema) to beta-lactams (penicillin, cephalosporins, ertapenem or Invanz, meropenem or Merrem, doripenem or Doribax) if ordered.
    • ❑ Foley Catheter Insertion
      • Indwelling, To be inserted in the OR unless STAT C-Section
    • ❑ Urine Dipstick POC
      • For Protein x 1 on admission.
    • ❑ Clip Prep
      • Abdominal Prep with clippers
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
OB - External Cephalic Version Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Perform a pre-procedure time out
    • ❑ Nursing Communication
      • Auscultate FHR every two minutes with interruption of the procedure if bradycardia occurs
  • Diagnostic Tests
    • ❑ BP US Preg Uterus Ab 1 or More Fetus
      • T;N
  • Medications
    • ❑ terbutaline
      • 0.25 mg, Injection, Subcutaneous, Once
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once
  • Patient Care
    • ❑ Procedure / Consent
      • External Cephalic Version
    • ❑ Fetal monitoring
      • Prior to External Cephalic Version - Continuous for 20 minutes. Post Version procedure - Monitor for at least 30 mins and until FHR is reactive.
  • Vital Signs
    • ❑ Vital Signs POC
      • PRN, Before and after procedure
OB - Lab Profile - IMH
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ RPR
      • Blood, Stat collect, T;N
    • ❑ Tube for Blood Bank
      • Blood, Stat collect, T;N
    • ❑ Hep B Surface Ag
      • Blood, Stat collect, T;N
    • ❑ HIV Rapid Screen
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Rubella Antibodies IgG
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture, Group B Strep
      • Micro Specimen, Stat collect, T;N, Nurse collect
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Chlamydia GC PCR
      • Urine, Stat collect, T;N, Nurse collect
OB - Labor Order Set - IMH
  • Activity
    • ❑ Up to Chair
      • as desired
    • ❑ Ambulate
      • ad lib if fetal heart reassuring
    • ❑ Nursing Communication Order
      • Encourage side-lying position when in bed.
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Labor and Delivery, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
  • IV Solutions
    • ❑ LR
      • 1,000 mL, IV, 125 mL/hr
    • ❑ NS
      • 1,000 mL, Intrauteral, Per Protocol
  • Laboratory
    • ❑ HIV Rapid Screen
      • Blood, Stat collect, T;N
    • ❑ GBS Culture
      • Micro Specimen, Stat collect, T;N
    • ❑ Blood Typing (ABO/Rh)
      • Blood, Stat collect, T;N
    • ❑ Rubella Antibodies IgG
      • Blood, Stat collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Chlamydia GC PCR
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Tube for Blood Bank
      • Blood, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ RPR
      • Blood, Stat collect, T;N
    • ❑ Hep B Surface Ag
      • Blood, Stat collect, T;N
  • Medications
    • Analgesics
      • ❑ OB Nitrous Oxide
        • T;N, Patient to administer as needed for labor pain.
      • ❑ butorphanol
        • ❑ 1 mg, Vial, IV Push, q2hr, PRN for Pain
        • ❑ 2 mg, Vial, IV Push, q2hr, PRN for Pain
      • ❑ nalbuphine
        • 10 mg, Vial, IV Push, q2hr, PRN for Pain
      • ❑ Consult to Anesthesia
        • ❑ Patient request
        • ❑ Anesthesia Services to pre-place Epidural Cath. and dose when in active labor.
        • ❑ Anesthesia Services to pre-place epidural cath and notify MD for order to dose.
        • ❑ Epidural per Anesthesia Services
        • ❑ Epidural with Narcotics only per Anesthesia Services.
        • ❑ Epidural per Anesthesia Services when cervical change to _____cm.
        • ❑ Epidural per Anesthesia Services when cervical change to 3 cms.
    • Other Meds
      • ❑ diphenhydrAMINE
        • 50 mg, Vial, IV Push, Once, PRN for Allergy symptoms
      • ❑ pitocin 20 units/NS 1000 mL Premix
        • 1,000 mL, IV, Routine, See Comments
        • 20 unit(s)
      • ❑ miSOPROStol
        • ❑ 25 mcg, Tab, VAG, q4hr, PRN for Other (see comment)
        • ❑ 25 mcg, Tab, Buccal, q4hr, PRN for Other (see comment)
      • ❑ miSOPROStol
        • ❑ 50 mcg, Tab, VAG, q6hr, PRN for Other (see comment)
        • ❑ 50 mcg, Tab, Buccal, q6hr, PRN for Other (see comment)
      • ❑ dinoprostone 10 mg vaginal insert
        • 10 mg, Insert, VAG, Once, PRN for Other (see comment)
      • ❑ Misc Nursing Task
        • Remove Cervadil (dinoprostone) 12 hours after insertion or if tachysystole, or fetal intolerance.
    • Prophylactic Antimicrobials
      • ❑ Nursing Communication Order
        • Group B Strep negative or Not Indicated
      • ❑ penicillin G potassium
        • 5,000,000 unit(s), IV Piggyback, Once, Antibiotic Indication Prophylaxis- other, non-surgical
      • ❑ penicillin G potassium
        • 2,500,000 unit(s), IV Piggyback, q4hr, Antibiotic Indication Prophylaxis- other, non-surgical
      • ❑ ceFAZolin
        • 2 gm, IV Piggyback, Once, Antibiotic Indication Prophylaxis- other, non-surgical
      • ❑ ceFAZolin
        • 1 gm, IV Piggyback, q8hr, Antibiotic Indication Prophylaxis- other, non-surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, q8hr, Antibiotic Indication Prophylaxis- other, non-surgical
      • ❑ vancomycin
        • 20 mg/kg, IV Piggyback, q8hr, Antibiotic Indication Prophylaxis- other, non-surgical
    • ❑ lidocaine 1% injectable solution
      • 0.1 mL, Vial, Intradermal, UD, PRN Other (see comment)
  • Patient Care
    • ❑ Nursing Communication Order
      • Call for pain medicine.
    • ❑ Procedure / Consent
      • Vaginal Delivery and Perineal Anesthesia
    • ❑ Urine Dipstick POC
      • For protein x 1 on admission
    • ❑ Nursing Communication
      • Nitrazine POC if needed to determine status of membranes
    • ❑ I&O POC
      • Strict if patient is hypertensive, or has cardiac, pulmonary, or kidney disease. Otherwise, IV intake while IV infusing.
    • ❑ Straight Cath
      • PRN, If not voiding every 4-6 hours
    • ❑ Vaginal exam
      • T;N, PRN, Sterile vaginal exams PRN nursing judgement
    • ❑ Nursing Communication Order
      • May place scalp electrode for non-reassuring patterns, if vertex presentation and ROM.
    • ❑ Fetal monitoring
      • Intermittent if tracing reassuring and reactive.
    • ❑ Notify Provider
      • If allergic to Penicillin and Clindamycin
    • ❑ Notify Provider
      • ❑ When cervical changes are NOT noted on 2 consecutive exams at least 2 hours apart in active labor or any abnormal findings; membranes ruptured 18 hours or greater anytime during labor; Temp greater than or equal to 38.0 degrees Celsius (100.4 degrees F)
      • ❑ When cervical changes are NOT noted on 2 consecutive exams at least 2 hours apart in active labor or any abnormal findings; membranes ruptured 18 hours or greater anytime during labor; Temp greater than or equal to 37.7 degrees Celsius (100.0 degrees F)
    • ❑ Nursing Communication Order
      • Treat repetitive late decelerations, repetitive variable deceleration or prolonged variable decelerations with position changes, an IV bolus (as ordered) and enter order for Oxygen Therapy at 10 L/min via face mask. Notify MD.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
OB - Magnesium Sulfate Administration Order Set - IMH
  • Activity
    • ❑ Patient Activity Misc
      • Encourage side lying, preferably left side.
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • Labor and Delivery, Anticipated LOS 2 midnights or more
    • ❑ Place in Observation
      • Labor and Delivery, Anticipated LOS 1 midnight or less
  • Diet
    • ❑ Diet Order
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Room Service Eligible: Yes, Soft diet
  • IV Solutions
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ magnesium sulfate
      • ❑ 4 gm, Injection, IV Piggyback, Once
      • ❑ 6 gm, Injection, IV Piggyback, Once
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, IV, Routine, 25 mL/hr
      • 40 gm
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, IV, 50 mL/hr
      • 40 gm
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, IV, 75 mL/hr
      • 40 gm
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, IV, 100 mL/hr
      • 40 gm
  • Laboratory
    • ❑ Nursing Communication Order
      • NURSE TO ORDER - Magnesium level ___ hour(s) after loading dose infused, then q6hrs for 24 hours.
    • ❑ Magnesium Level
      • ❑ Blood, Timed Study collect, q6hr, for 5 dose(s)/time(s)
      • ❑ Blood, Timed Study collect, q6hr
  • Patient Care
    • ❑ Fetal monitoring
      • Fetal heart rate monitoring per policy depending on patient's stage of labor
    • ❑ Notify Provider
      • if labored respirations or absent deep tendon reflexes.
    • ❑ Nursing Communication Order
      • Keep room dimly lit and quiet. Limit visitors to 1-2 at a time.
    • ❑ Nursing Communication Order
      • Calcium Gluconate at bedside.
    • ❑ Nursing Communication Order
      • Do NOT call provider for magnesium level 4.8-8.4 mg/dL
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Special
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Nursing Communication Order
      • Assess contraction pattern every 15 minutes until contractions space out to 4-5 per hour, then assess hourly.
    • ❑ I&O POC
      • 3x/Day, q8hr
    • ❑ Nursing Communication Order
      • Deep Tendon Reflexes every 2 hours, or with vital sign assessment
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Nursing Communication Order
      • Assess contraction pattern hourly, unless patient is having more than 4-5 contractions per hour, then every 15 minutes.
    • ❑ Foley Catheter Insertion
      • Indwelling, With urometer
    • ❑ I&O POC
      • q1hr
    • ❑ Notify Provider
      • If urine output less than 30ml/hr.
    • ❑ Urine Dipstick POC
      • q4hr, For Protein
    • ❑ Nursing Communication Order
      • Deep Tendon Reflexes every hour and evaluate for clonus if deep tendon reflexes greater than +2
    • ❑ Height & Weight POC
      • On Admission.
    • ❑ Weight POC
      • Once a Day (before meals)
    • ❑ Nursing Communication Order
      • No phone calls into room.
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ Pulse, Resp., Blood Pressure every 15 minutes.
      • ❑ Pulse, Resp and BP q 15 minutes x 2 hours, then hourly
      • ❑ Pulse, Resp and BP hourly
      • ❑ Pulse, Resp and BP q 4 hours
      • ❑ Pulse, Resp and BP q 2 hours
    • ❑ Temperature
      • q4hr, (every 1 hour for temp 100.4 degrees F - 38 degrees C and over)
OB - Maternal IV Insulin Order Set - IMH
  • IV Solutions
    • ❑ Sodium Chloride 0.45%
      • 1,000 mL, IV, 100 mL/hr
    • ❑ Insulin human 100 units/100 mL Premix
      • 100 mL, IV, Routine, See Comments
      • 100 unit(s)
  • Patient Care
    • ❑ Blood Glucose POC
      • PRN, While on IV insulin drip, BG q1hr and call provider for two consecutive POC BG levels <,= 70 mg/dL or > 200 mg/dL. After placental delivery and IV insulin infusion stopped, begin BG q2hr for 2 doses/times, and contact provider for further orders.
    • ❑ Peripheral IV Insertion
      • For insulin drip infusion.
OB - Non-Stress Test (NST) Order Set - IMH
  • Diagnostic Tests
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Contract Stress Test
      • T;N
    • ❑ US Fetal Biophysical Profile w/o N-Str
      • T;N
  • Patient Care
    • ❑ Vaginal exam
      • T;N, PRN, If no bleeding
    • ❑ Urine Dipstick POC
      • T;N
    • ❑ Notify Provider
      • T;N, At the completion of NST and/or PRN
  • Vital Signs
    • ❑ Vital Signs POC
      • T;N, On arrival and PRN
    • ❑ Vital Signs POC
      • PRN
OB - Nursing Protocol Phase 1 Order Set - IMH
  • Patient Care
    • ❑ Color Alert Armband
      • T;N, 3x/Day
    • ❑ Chart Check
      • T;N, 6x/Day, Paper & Elctronic Chart Check
    • ❑ Patient Education
      • Orient to room, call bell system, infant safety, & fall prevention
    • ❑ Education General
      • qShift - 8 hour, Document patient education
    • ❑ Patient Education
      • Gave "Taking Antibiotics in the Hospital" brochure and discussed with patient/family.
    • ❑ Provider Notification
      • T;N, Constant order, Document as needed
    • ❑ Communication Order
      • T;N, REMINDER: Initiate appropriate Care Plan, be sure all Problems are being addressed by a care plan.
    • ❑ Vital Signs POC
      • As Directed, PRN
    • ❑ Blood Glucose POC
      • As Directed, PRN
    • ❑ I&O POC
      • PRN
    • ❑ Height & Weight POC
      • As Directed, PRN
    • ❑ ADL's POC
      • As Directed, PRN
    • ❑ FYI Booklet
      • INPT - See Order Comment
    • ❑ Review Care Plan
      • 3x/Day
OB - Nursing Protocol Phase 2 Order Set - IMH
  • Consults
    • ❑ Consult to Dietitian
      • ❑ T;N, Unable to eat 3 days or greater prior to Admission
      • ❑ T;N, NPO/clear liquid diet 3 or more days
      • ❑ T;N
    • ❑ Consult to Diabetic Nurse Specialist
      • ❑ T;N, New onset Diabetes
      • ❑ T;N, Uncontrolled Diabetes
      • ❑ T;N, Diabetes in Pregnancy
      • ❑ T;N, Patient on Insulin Pump
      • ❑ T;N, Elevated A1C
      • ❑ T;N, Diabetes Diet Instruction
    • ❑ Consult to Discharge Planning Services (CM)
      • ❑ T;N, Financial/Environmental resources inadequate; No Insurance
      • ❑ T;N, Alcohol/Drug Abuse
      • ❑ T;N, Followed by Community Agency, Open DSS case
      • ❑ T;N, Victim of Abuse/Neglect
      • ❑ T;N, Readmission to Hospital within 30 days of giving birth
      • ❑ T;N, Unable to return home
      • ❑ T;N, No custody of other children
      • ❑ T;N, Homeless
      • ❑ T;N
    • ❑ Consult to Pastoral Care
      • ❑ T;N, Depression
      • ❑ T;N, Request from patient/family for hospital chaplain to visit
      • ❑ T;N, Fetal Loss
    • ❑ Nursing Supervisor Communication
      • ❑ T;N, DNR
      • ❑ T;N, Refuse Blood
      • ❑ T;N, Fetal Loss (Call within 1 hour of birth)
      • ❑ T;N
  • Patient Care
    • ❑ Resuscitation Status
      • T;N, Full Resuscitation
    • ❑ Nursing Communication
      • ❑ Does not speak English
      • ❑ Visually Impaired
      • ❑ Blind left eye
      • ❑ Blind right eye
      • ❑ Hard of hearing
      • ❑ Sign Language
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ I&O POC
      • T;N, 3x/Day, q 8 hours
    • ❑ Elopement Risk Precautions
OB - Obstetrical Adult Insulin Order Set - IMH
  • Diet
    • ❑ Diet Order
      • ❑ Diabetic, Room Service Eligible: Yes, 3CHO Choices/Meal (1200-1500 cal)
      • ❑ Diabetic, Room Service Eligible: Yes, 4CHO Choices/Meal (1600-1900 cal)
      • ❑ Diabetic, Room Service Eligible: Yes, 5CHO Choices/Meal (2000-2200 cal)
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes
  • Medications
    • ❑ Levemir
      • unit(s), Injection, Subcutaneous, qAM-WM
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, qAM-WM
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, qPM-WM
    • ❑ Levemir
      • unit(s), Injection, Subcutaneous, HS
    • ❑ HumuLIN N
      • unit(s), Susp-Inj, Subcutaneous, HS
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qAM-WM
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qNoon-WM
    • ❑ HumaLOG
      • unit(s), Injection, Subcutaneous, qPM-WM
    • ❑ Insulin Humalog sliding scale
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Mild Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Mild / Moderate Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Moderate Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Moderate / Severe Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Regular Sliding Scale
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, TIDAC
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, 6x/Day
      • ❑ Severe Insulin Need Correction, Injection, Subcutaneous, BIDAC
    • ❑ Insulin Humalog sliding scale
      • Custom Correction, Injection, Subcutaneous, TIDAC
    • ❑ Insulin Regular Sliding Scale
      • Custom Correction, Injection, Subcutaneous, TIDAC
  • Patient Care
    • ❑ Blood Glucose POC
      • ❑ TIDAC, Notify provider if BG > 200 mg/dl
      • ❑ QIDACHS, Notify provider if BG > 200 mg/dl
      • ❑ Daily, Notify provider if BG > 200 mg/dl
      • ❑ 4x/Day, Notify provider if BG > 200 mg/dl. (q 6 hours) Recommended for patient NPO.
      • ❑ AC Breakfast, Notify provider if BG > 200 mg/dl
      • ❑ BIDAC, Notify provider if BG > 200 mg/dl
    • ❑ Blood Glucose POC
      • ❑ TIDPC, Two hours after meals. Notify provider if BG > 200 mg/dl
      • ❑ PC Breakfast, Two hours after one meal per day. Notify provider if BG > 200 mg/dl
OB - Postpartum Vaginal Delivery Order Set - IMH
  • Activity
    • ❑ Up ad Lib w/ assist
      • Assist PRN
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • IV Solutions
    • ❑ LR
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 175 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ pitocin 20 units/NS 1000 mL Premix
      • 20 unit(s)
      • 1,000 mL, IV, Routine, 8 hr, 125 mL/hr
    • ❑ Pitocin 10 units/ LR 1000 mL
      • 1,000 mL, IV, Routine, 125 mL/hr
      • 10 unit(s)
    • ❑ oxytocin
      • ❑ 10 unit(s), Vial, N/A, Once
      • ❑ 20 unit(s), Vial, N/A, Once
  • Laboratory
    • ❑ Nursing Communication Order
      • ❑ No pathology needed
      • ❑ Placenta to Pathology STAT, Indication:______
    • ❑ Magnesium Level
      • Blood, Timed Study collect
    • ❑ Magnesium Level
      • Blood, Timed Study collect, q6hr
    • ❑ CBC
      • Blood, Timed Study collect, T+1;0500
    • ❑ CMP
      • Blood, Timed Study collect, T+1;0500
    • ❑ Glucose Fasting
      • Blood, Timed Study collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ acetaminophen
        • 650 mg, Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Severe
      • ❑ ibuprofen
        • 800 mg, Tab, Oral, 3x/Day
      • ❑ ketorolac
        • 30 mg, Vial, IV Push, q6hr, 2 day(s)
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • ❑ medroxyPROGESTERone 150 mg/mL intramuscular suspension
      • 150 mg, Susp-Inj, IM, Once, PRN for Other (see comment)
    • ❑ zolpidem
      • 5 mg, Tab, Oral, Once, PRN for Insomnia
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once, PRN for Other (see comment)
    • ❑ Misc Nursing Task
      • Order Rhogam Workup, if eligible
    • ❑ measles/mumps/rubella virus vaccine
      • 0.5 mL, Subcutaneous, Once, PRN for Other (see comment)
    • ❑ varicella virus vaccine
      • 0.5 mL, Subcutaneous, Once, PRN Other (see comment)
    • ❑ Adacel (Tdap)
      • 0.5 mL, IM, Once, PRN Other (see comment)
    • ❑ lanolin topical cream
      • 1 app, Cream, TOP, As Directed, PRN for Pain
    • ❑ docusate
      • 100 mg, Cap, Oral, 2x/Day
    • ❑ glycerin-witch hazel 50% topical pad
      • 1 app, Pad, TOP, BID
    • ❑ glycerin-witch hazel 50% topical pad
      • 1 app, Pad, TOP, q6hr, PRN for Hemorrhoids
    • ❑ benzocaine 20% topical spray
      • 1 spray(s), Spray, TOP, BID
    • ❑ benzocaine 20% topical spray
      • 1 spray(s), Spray, TOP, q12hr, PRN for discomfort
    • ❑ hydrocortisone 0.5% topical cream
      • 1 app, Cream, TOP, BID
    • ❑ hydrocortisone 0.5% topical cream
      • 1 app, Cream, TOP, q12hr, PRN discomfort
    • ❑ Fleet Enema
      • 133 mL, Enema, Per rectum, q24hr, PRN Constipation
  • Patient Care
    • ❑ Shower
      • May Shower
    • ❑ I&O POC
      • 3x/Day, Strict if patient is hypertensive, has cardiac, pulmonary, or kidney disease, or is on magnesium sulfate infusion. Otherwise, calculate IV intake while IV infusing.
    • ❑ Saline Lock Removal
      • D/C IV when VS stable & bleeding stabilized
    • ❑ Breast Binder
      • if not breastfeeding
    • ❑ Nursing Communication Order
      • See Comment
    • ❑ Notify Provider
      • If bleeding excessive or unable to maintain fundal tone with massage, then increase rate of pitocin to wide open and notify physician.
    • ❑ Ice Pack
      • To perineum X 12 hours, then PRN
    • ❑ Sitz Bath
      • BID, and PRN
    • ❑ Straight Cath
      • PRN, Inability to Void every 4-6 hours. Call if required more than twice.
    • ❑ Misc Nursing Task
      • Discontinue labor orders
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Special
    • ❑ magnesium sulfate
      • ❑ 4 gm, Injection, IV Piggyback, Once
      • ❑ 6 gm, Injection, IV Piggyback, Once
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 40 gm
      • 1,000 mL, IV, 25 mL/hr
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 40 gm
      • 1,000 mL, IV, 50 mL/hr
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 40 gm
      • 1,000 mL, IV, 75 mL/hr
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 40 gm
      • 1,000 mL, IV, 100 mL/hr
    • ❑ Vital Signs POC
      • Blood Pressure, Pulse, Respirations, & Deep Tendon Reflexes _____________ while on magnesium sulfate infusion.
  • Vital Signs
    • ❑ Vital Signs POC
      • As per protocol
OB - Triage Order Set - IMH
  • Diet
    • ❑ Diet Order
      • ❑ NPO, NPO except ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes
  • IV Solutions
    • ❑ NS Bolus
      • 1,000 mL, IV, Once, NOW, 1 dose(s)/time(s)
    • ❑ LR
      • 1,000 mL, 125mL/hr
    • ❑ magnesium sulfate
      • 4 gm, Injection, IV Piggyback, Once, NOW, 1 dose(s)/time(s), Infuse over 30 minute(s)
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, Routine, 50mL/hr
      • 40 gm
  • Laboratory
    • ❑ Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s)
      • Amniotic Fluid, Stat collect, T;N
    • ❑ Fetal Fibronectin
      • Swab, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
    • ❑ Protein Urine Random
      • Urine, Stat collect, T;N
    • ❑ Urine Protein/Creatinine Ratio
      • Urine, Stat collect, T;N
    • ❑ Wet Prep for Trich
      • Vaginal, Stat collect, T;N, Nurse collect
    • ❑ Group B Strep Culture
      • Micro Specimen, Routine collect, T;N
  • Medications
    • Analgesics
      • ❑ acetaminophen
        • ❑ 650 mg, Tab, Oral, Once, NOW
        • ❑ 325 mg, Tab, Oral, Once, NOW
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • ❑ 1 tab(s), Tab, Oral, Once
        • ❑ 2 tab(s), Tab, Oral, Once
      • ❑ morphine
        • ❑ 1 mg, Syringe, IV Push, Once
        • ❑ 2 mg, Syringe, IV Push, Once
        • ❑ 10 mg, Syringe, IM, Once
      • ❑ meperidine
        • ❑ 25 mg, Syringe, IM, Once
        • ❑ 25 mg, Syringe, IV Push, Once
        • ❑ 50 mg, Syringe, IM, Once
        • ❑ 50 mg, Syringe, IV Push, Once
    • Antiemetics
      • ❑ prochlorperazine
        • ❑ 10 mg, Vial, IM, Once
        • ❑ 10 mg, Vial, IV Push, Once
        • ❑ 5 mg, Vial, IV Push, Once
      • ❑ promethazine
        • 25 mg, Tab, Oral, Once
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, Once
        • ❑ 4 mg, Vial, IV Push, Once
    • Steroids
      • ❑ betamethasone
        • 12 mg, Susp-Inj, IM, Once, NOW
    • Tocolytic Agents
      • ❑ terbutaline
        • 0.25 mg, Injection, Subcutaneous, Once, NOW
      • ❑ NIFEdipine
        • 10 mg, Cap, Oral, Once, NOW
      • ❑ NIFEdipine extended release
        • 30 mg, Tab-24, Oral, Once, NOW
      • ❑ indomethacin
        • 50 mg, Cap, Oral, Once, NOW
  • Patient Care
    • ❑ Fetal monitoring
      • ❑ Continuous
      • ❑ Intermittent, recheck cervix in 1 hour
      • ❑ Intermittent, recheck cervix in 2 hours
    • ❑ Urine Dipstick POC
      • On Arrival
    • ❑ Vaginal exam
      • Sterile Vaginal Exam: PRN unless vaginal bleeding
    • ❑ Nursing Communication
      • Nitrazine POC if needed to determine status of membranes
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ T;N, pulse, respiration, and blood pressure every 1 hour
      • ❑ T;N, pulse, respiration, and blood pressure every 30 mins
      • ❑ T;N, pulse, respiration, and blood pressure every 15 mins
    • ❑ Temperature
      • T;N, Once
OB - Tubal Ligation Order Set - IMH
  • Communication
    • ❑ Procedure / Consent
      • Tubal Ligation
    • ❑ Nursing Communication Order
      • Chlorhexidine bath wipes night before and morning of surgery.
    • ❑ Nursing Communication Order
      • Complete pre-operative checklist.
    • ❑ Nursing Communication Order
      • Complete transfer sheet (Trip ticket).
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 NPO, after midnight
      • ❑ T;N NPO
  • IV Solutions
    • ❑ Saline Lock Convert From IV
    • ❑ LR
      • 1,000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
OB - Unscheduled Cesarean Section - Pre-Operative Order Set - IMH
  • Condition
    • ❑ Procedure / Consent
      • Cesarean Section
    • ❑ Procedure / Consent
      • Tubal Ligation
    • ❑ Communication Order
      • ❑ ASAP Cesarean Section
      • ❑ STAT Cesarean Section
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Laboratory
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Creatinine
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • ❑ ceFAZolin.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ azithromycin
      • 500 mg, IV Piggyback, On Call, Medication Indication Prophylaxis- surgical
    • ❑ Notify Provider
      • For severe allergy (anaphylaxis, urticaria, hives, angioedema) to beta-lactams (penicillin, cephalosporins, ertapenem or Invanz, meropenem or Merrem, doripenem or Doribax, imipenem or Primaxin) if ordered.
    • ❑ clindamycin
      • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ gentamicin
      • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • ❑ Misc Nursing Task
      • T;N, Vaginal Prep for membranes ruptured. To be completed in the OR unless STAT C-Section
    • ❑ Foley Catheter Insertion
      • Indwelling, To be inserted in the OR unless STAT C-Section
    • ❑ Clip Prep
      • Abdominal Prep with clippers
OB Lactation Support IPOC
  • Patient Care
    • ❑ Follow Up Appointment
      • Establish home appointment with Lactation Consultant
OB Late Preterm 34 - 36 6/7 weeks IPOC
  • Communication
    • ❑ Notify Provider
      • Notify of presenting signs of infection
  • Vital Signs
    • ❑ Temperature
      • q30min, Until temperature is stable for 2 hours
OB Preterm Labor Management IPOC
  • Patient Care
    • ❑ Tobacco Cessation Instruction
      • Once, Smoking exacerbates preterm labor
ONC - Oncology Routine Order Set
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Dietitian
      • Evaluate nutrition needs
    • ❑ Consult to Discharge Planning Services (CM)
      • ❑ Hospice of Iredell County
      • ❑ Hospice of ________ County
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Neutropenic, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ Culture - Blood
      • Blood, Routine collect, T;N, Lab Collect, Draw from Central Line if applicable
    • ❑ Culture - Blood
      • Blood, Routine collect, T;N, Draw Peripherally
    • ❑ Culture - Sputum..
      • Sputum, Routine collect, T;N, Nurse collect
    • ❑ C.Difficile_EPI by PCR
      • Stool, Routine collect, T;N, Nurse collect
  • Patient Care
    • ❑ Isolation Precautions
      • Neutropenic Precautions, Reason: Neutropenic
    • ❑ Isolation Precautions
      • Contact Precautions
    • ❑ Nursing Communication Order
      • Notify Chemotherapy nurses for possible treatment in am.
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
    • ❑ I&O POC
      • ❑ 6x/Day, CHEMO q4h, Strict Intake and Output
      • ❑ 12x/Day, CHEMO Q2hr Strict Intake and Output
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal to 89%
      • ❑ keep O2 Sat greater than or equal patients baseline.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS, Every 4 hours except for 0400.
      • ❑ q4hrVS
OPHTH - Post Operative Order Set - IMH
  • Special
    • ❑ Tylenol
      • ❑ 650 mg, Tab, Oral, Once, PRN for Headache
      • ❑ 650 mg, Tab, Oral, q4hr-WA, NOW, 24 hr
    • ❑ Saline Lock Removal
      • when taking po fluids well.
OPHTH - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
  • Diet
    • ❑ Diet Order
      • T+1;0001 | NPO, Room Service Eligible: No, NPO after midnight
  • Medications
    • ❑ tetracaine 0.5% ophthalmic solution
      • ❑ 1 drop(s), Soln, Eye-Right, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln, Eye-Left, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln, Eye-Right, Once
      • ❑ 1 drop(s), Soln, Eye-Left, Once
      • ❑ 1 drop(s), Soln, Eye-Both, Once
    • ❑ Cyclogyl 2% ophthalmic solution
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 4 dose(s)/time(s)
    • ❑ phenylephrine 2.5% ophthalmic solution
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Both, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Both, q5min, 4 dose(s)/time(s)
    • ❑ lidocaine opth 4% soln
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Both, q5min, 3 dose(s)/time(s)
    • ❑ Mydriacyl 1% ophthalmic solution
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Both, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 4 dose(s)/time(s)
    • ❑ phenylephrine 10% ophthalmic solution
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 2 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Both, q5min, 3 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Right, q5min, 4 dose(s)/time(s)
      • ❑ 1 drop(s), Soln-Opth, Eye-Left, q5min, 4 dose(s)/time(s)
    • ❑ moxifloxacin 600 mcg/0.4 mL ophthalmic solution
      • ❑ 600 mcg, Soln, Eye-Right, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ 600 mcg, Soln, Eye-Left, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ mitoMYcin 0.2 mg ophthalmic kit
      • ❑ 1 EA, Soln-Opth, Eye-Right, On Call
      • ❑ 1 EA, Soln-Opth, Eye-Left, On Call
  • Patient Care
    • ❑ Procedure / Consent
      • ❑ Cataract Extraction of the RIGHT eye with an intraocular lens implant
      • ❑ Cataract Extraction of the LEFT eye with an intraocular lens implant
      • ❑ Other
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
    • ❑ Nursing Communication Order
      • Have patient void preoperatively
ORTHO - Auto-Transfusion Drain Order Set - IMH
  • IV Solutions
    • ❑ NS
      • 500 mL, IV, Titrate per Protocol
  • Patient Care
    • ❑ Auto-Transfusion Drain
      • ❑ Vacuum control dial to setting 1 (Low)
      • ❑ Vacuum control dial to setting 2 (Medium)
      • ❑ Vacuum control dial to setting 3 (High)
    • ❑ Reinfusion
      • See Order Comment
    • ❑ Auto-Transfusion Drain
      • Convert the Auto-Transfusion Drain to a drainage unit at the end of the initial 6 hour collection period
ORTHO - Post-Op Total Hip Replacement Order Set - IMH
  • Activity
    • ❑ Nursing Communication Order
      • Soft pillow between legs
    • ❑ Precautions
      • Hip
    • ❑ Nursing Communication Order
      • Folded blanket under calves of each leg to keep heels off bed.
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Medical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Cardiac Telemetry, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Medical Telemetry, Anticipated LOS 1 midnight or less
      • ❑ Intermediate Care, Progressive Care Unit, Anticipated LOS 1 midnight or less
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Discharge Planning Services (CM)
      • Evaluate for home needs
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
  • IV Solutions
    • ❑ Convert IV to Saline Lock
      • Saline lock IV when patient tolerating PO's well.
    • ❑ KCl 20 mEq in 1/2 NS 1000 mL
      • 20 mEq
      • 1,000 mL, IV, mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 80 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+2;0500, Daily, for 2 day(s)
  • Medications
    • Analgesics: Opioids
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • DVT Prophylaxis
      • ❑ fondaparinux
        • 2.5 mg, Syringe, Subcutaneous, Q24hr, Start date: T+1;0800
      • ❑ enoxaparin
        • ❑ 40 mg, Syringe, Subcutaneous, Daily, Start date: T+1;0800
        • ❑ 30 mg, Syringe, Subcutaneous, Daily, Start date: T+1;0800
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other:____________
    • Laxatives
      • ❑ docusate
        • 100 mg, Cap, Oral, Daily, Start date: T+1;1000
      • ❑ bisacodyl
        • 10 mg, Supp, Per rectum, Once, Start date: T+2;1000
      • ❑ bisacodyl
        • 5 mg, Tab-EC, Oral, Once, Start date: T+2;1000
      • ❑ magnesium citrate
        • 300 mL, Soln-Oral, Oral, Once, Start date: T+3;1000
  • Patient Care
    • Drain Management
      • ❑ Jackson-Pratt Drain to
        • bulb suction
      • ❑ Notify Provider
        • Drain Output > 400cc/shift
      • ❑ Deactivate Drain
        • if > 400cc/shift, turn off for 2 hours, then restart.
      • ❑ Discontinue Drain
        • ❑ T+2;0900, Post-op day #2.
        • ❑ T+1;0900, Post-op day #1.
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+2;0900, Daily, Dry dressing change daily to incision, begin POD # 2.
        • ❑ T+1;0900, Daily, Dry dressing change daily, begin POD # 1.
        • ❑ T+1;0900, Daily, Begin dry dressing change daily after drain discontinued.
      • ❑ Triple Antibiotic
        • 1 app, Ointment, TOP, Daily
    • DVT Prophylaxis
      • ❑ Sequential Compression Device
        • ❑ Knee High - To Non-Operative Leg
        • ❑ Thigh High - To Non-Operative Leg
        • ❑ Knee High - Bilateral Legs
        • ❑ Thigh High - Bilateral Legs
      • ❑ Ted Hose
        • ❑ Thigh High - To Non-Operative Leg
        • ❑ Knee High - To Non-Operative Leg
        • ❑ Thigh High - Bilateral Legs
        • ❑ Knee High - Bilateral Legs
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other:____________
    • Patient Education
      • ❑ Patient Education
        • Hip Precautions - Do not cross legs. Do not sit in low chair. Do not stoop to pick things up. Use high commode. Keep pillow between knees.
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • Discontinue 4 hours after arrival to floor, unless patient had a fracture. If patient had a fracture, discontinue when able to stand & pivot.
      • ❑ Reason Urinary Catheter Not Removed
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Monitoring of urinary output is required due to hemodynamic instability
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Inability to void
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Immobilization due to one or more of the following: Sedation/Paralysis or Pelvic/Hip fracture or orthopedic procedure necessitating immobilization
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Urinary incontinence or poor cooperation AND one or more of the following: Strict fluid input/output monitoring required or Skin breakdown in sacral/groin region
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term epidural catheter in place
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Bladder irrigation (e.g. for chemotherapy, blood clots)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term catheterization (greater than 28 days)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Patient refusal to remove catheter
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Other:_________
  • PT/OT/ST
    • ❑ Weight Bearing
      • ❑ Non-Weight Bearing
      • ❑ Partial
      • ❑ Full
    • ❑ Physical Therapy Evaluation and Treatment
      • Evaluation & Treatment, Begin Rehab Protocol
    • ❑ Occupational Therapy Evaluation and Treatment
      • Evaluation & Treatment, Begin Rehab Protocol
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
    • ❑ Neurovascular Checks
      • 6x/Day, for 24 hr
ORTHO - Post-Op Total Knee Replacement Order Set - IMH
  • Activity
    • ❑ Nursing Communication Order
      • Do not gatch knees
    • ❑ Nursing Communication Order
      • Folded blanket under calves of each leg to keep heels off bed.
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Medical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Cardiac Telemetry, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Medical Telemetry, Anticipated LOS 1 midnight or less
      • ❑ Intermediate Care, Progressive Care Unit, Anticipated LOS 1 midnight or less
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Discharge Planning Services (CM)
      • T;N, Evaluate for home needs.
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
  • IV Solutions
    • ❑ Convert IV to Saline Lock
      • Saline lock IV when patient tolerating PO's well.
    • ❑ KCl 20 mEq in 1/2 NS 1000 mL
      • 20 mEq
      • 1,000 mL, IV, mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 80 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+2;0500, Daily, for 2 day(s)
  • Medications
    • Analgesics: Opioids
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • DVT Prophylaxis
      • ❑ fondaparinux
        • 2.5 mg, Syringe, Subcutaneous, Q24hr, Start date: T+1;0800
      • ❑ enoxaparin
        • ❑ 30 mg, Syringe, Subcutaneous, BID, Start date: T+1;0800
        • ❑ 30 mg, Syringe, Subcutaneous, Daily, Start date: T+1;0800
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other: ____
    • Laxatives
      • ❑ docusate
        • 100 mg, Cap, Oral, Daily, Start date: T+1;1000
      • ❑ bisacodyl
        • 10 mg, Supp, Per rectum, Once, Start date: T+2;1000
      • ❑ bisacodyl
        • 5 mg, Tab-EC, Oral, Once, Start date: T+2;1000
      • ❑ magnesium citrate
        • 300 mL, Soln-Oral, Oral, Once, Start date: T+3;1000
  • Patient Care
    • Drain Management
      • ❑ Jackson-Pratt Drain to
        • bulb suction
      • ❑ Notify Provider
        • Drain Output > 400cc/shift
      • ❑ Deactivate Drain
        • if > 400cc/shift, turn off for 2 hours, then restart.
      • ❑ Discontinue Drain
        • ❑ T+1;0900, Post-op day #1.
        • ❑ T+2;0900, Post-op day #2.
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, Dry dressing change daily, begin POD # 1.
        • ❑ T+2;0900, Daily, Dry dressing change daily to incision, begin POD # 2.
        • ❑ T+1;0900, Daily, Begin dry dressing change daily after drain discontinued.
      • ❑ Triple Antibiotic
        • 1 app, Ointment, TOP, Daily
    • DVT Prophylaxis
      • ❑ Sequential Compression Device
        • ❑ Knee High - To Non-Operative Leg
        • ❑ Thigh High - To Non-Operative Leg
        • ❑ Knee High - Bilateral Legs
        • ❑ Thigh High - Bilateral Legs
      • ❑ Ted Hose
        • ❑ Thigh High - To Non-Operative Leg
        • ❑ Knee High - To Non-Operative Leg
        • ❑ Thigh High - Bilateral Legs
        • ❑ Knee High - Bilateral Legs
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other: _____
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • Discontinue 4 hours after arrival to floor, unless patient had a fracture. If patient had a fracture, discontinue when able to stand & pivot.
      • ❑ Reason Urinary Catheter Not Removed
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Monitoring of urinary output is required due to hemodynamic instability
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Inability to void
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Immobilization due to one or more of the following: Sedation/Paralysis or Pelvic/Hip fracture or orthopedic procedure necessitating immobilization
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Urinary incontinence or poor cooperation AND one or more of the following: Strict fluid input/output monitoring required or Skin breakdown in sacral/groin region
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term epidural catheter in place
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Bladder irrigation (e.g. for chemotherapy, blood clots)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term catheterization (greater than 28 days)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Patient refusal to remove catheter
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Other: _____
  • PT/OT/ST
    • ❑ CPM Application
      • ❑ Set 0-50' initially & increase by 5'-10' daily as tolerated.
      • ❑ 0-90' as tolerated.
    • ❑ Weight Bearing
      • ❑ Full
      • ❑ Non-Weight Bearing
      • ❑ Partial
    • ❑ Physical Therapy Evaluation and Treatment
      • Evaluation & Treatment, Begin Rehab Protocol
    • ❑ Occupational Therapy Evaluation and Treatment
      • Evaluation & Treatment, Begin Rehab Protocol
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
    • ❑ Neurovascular Checks
      • 6x/Day, for 24 hr
ORTHO - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management
  • Diet
    • ❑ Diet Order
      • ❑ T+1; 0001 | NPO, Room Service Eligible: No, after midnight
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, except medications
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Urine Culture
      • Urine, Routine collect, T;N, Nurse collect, Include Sensitivity
    • ❑ Uric Acid
      • Blood, Routine collect, T;N
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N, Nurse Collect
  • Medications
    • Antibiotics
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ciprofloxacin
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight., IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ gentamicin
        • 5 mg/kg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • Pre-Op
      • ❑ Clip Prep
        • Clip hair for surgical site - in pre-op holding.
      • ❑ Hibiclens Scrub
        • ❑ Scrub: Hibiclens wash (concentrating on operative site) night before and morning of surgery X 3 minutes & wrap with sterile towel (OPS)
        • ❑ Scrub: Hibiclens wash (concentrating on operative site) night before surgery (In-Pt)
      • ❑ Betadine Scrub
        • ❑ Other See Special Instructions, Operative area with betadine morning of surgery x 10 minutes and wrap with sterile towel. (OPS)
        • ❑ Other See Special Instructions, Operative area with betadine day of surgery X 10 minutes and wrap with sterile towel & repeat X 1 (In-Pt)
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
ORTHO - Upper Extremity Post-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
    • ❑ Discharge Patient
      • Discharge when meets criteria. *Out-patient Order*
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes
  • IV Solutions
    • ❑ LR
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 150 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
    • ❑ NS
      • 500 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% with 0.2% NaCl
      • ❑ 500 mL, IV, 50 mL/hr
      • ❑ 500 mL, IV, 75 mL/hr
      • ❑ 500 mL, IV, 100 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500, Daily
  • Medications
    • Analgesics
      • ❑ ketorolac
        • 15 mg, Vial, IV Push, 4x/Day, 24 hr
      • ❑ acetaminophen
        • 650 mg, Tab, Oral, q4hr, PRN for Fever
    • Analgesics: Opioids
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-7.5 mg oral tablet
        • 2 tab(s), Tab, Oral, q6hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe
    • Antibiotic Therapy
      • ❑ Triple Antibiotic
        • 1 app, Ointment, TOP, Daily
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
    • DVT Prophylaxis
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other:______________
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other:______________
    • Laxatives
      • ❑ bisacodyl
        • 10 mg, Supp, Per rectum, Q24hr, PRN for Constipation
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • ❑ 6x/Day, Empty & Record Output q4hrs.
        • ❑ 3x/Day, Empty & Record Output q8hrs.
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
      • ❑ Jackson-Pratt Drain to
        • bulb suction
      • ❑ Notify Provider
        • Drain Output > 300cc/shift
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, Dry dressing change daily, start post-op day #1.
        • ❑ T+1;0900, Daily, PRN, Dry dressing change PRN daily.
      • ❑ Dressing Reinforce
        • PRN, Reinforce dressing PRN with dry dressing.
    • Notification
      • ❑ Notify Provider Vital Signs
        • Temp > 100.5F/38C if not responsive to antipyretics, T > 38, HR > 150, HR < 50, SBP > 180, SBP < 90, DBP > 100, DBP < 45, RR > 30, RR < 12, O2 sat < 92
    • Urinary Catheter Management
      • ❑ Straight Cath
        • PRN, Inability to Void
      • ❑ Discontinue Foley Cath
        • Before discharge from PACU
      • ❑ Reason Urinary Catheter Not Removed
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Monitoring of urinary output is required due to hemodynamic instability
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Inability to void
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Immobilization due to one or more of the following: Sedation/Paralysis or Pelvic/Hip fracture or orthopedic procedure necessitating immobilization
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Urinary incontinence or poor cooperation AND one or more of the following: Strict fluid input/output monitoring required or Skin breakdown in sacral/groin region
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term epidural catheter in place
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Bladder irrigation (e.g. for chemotherapy, blood clots)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term catheterization (greater than 28 days)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Patient refusal to remove catheter
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Other:___________
    • ❑ Sling Apply
      • ❑ to affected arm when out of bed & at HS
      • ❑ to affected arm when out of bed
      • ❑ PRN, discomfort
    • ❑ Sling and Swath
      • at all times.
    • ❑ Elevate Extremity (upper)
      • ❑ Commercial Arm Elevator at all times.
      • ❑ above heart
      • ❑ On pillows
    • ❑ Tie Arm Above Head
      • ❑ Tie arm up 45 minutes & down 15 minutes q1h.
      • ❑ as much as tolerated.
    • ❑ Saline Lock Convert From IV
      • PRN, Saline Lock IV when tolerating POs well.
    • ❑ Neurovascular Checks
      • ❑ 6x/Day, for 72 hr, Q4h
      • ❑ 6x/Day, Q4h
      • ❑ 3x/Day, Q8h
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
    • ❑ Ice Pack
      • PRN, Ice Pack to Operative Site PRN
    • ❑ Turn Cough Deep Breathe
      • q2hr, While Awake
  • PT/OT/ST
    • ❑ Occupational Therapy Evaluation and Treatment
      • Begin Rehab Protocol - POD #1
    • ❑ Physical Therapy Evaluation and Treatment
      • Begin Rehab Protocol - POD # 1
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ q4hrVS
ORTHO PED - Pediatric Orthopedic Post-Operative Order Set - IMH
  • Activity
    • ❑ Chair
      • TID, with assistance.
    • ❑ Ambulate with Assistance
      • TID
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • Pediatrics
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at Home
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • ❑ PT/INR
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
  • Medications
    • Analgesics: Opioids
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg/15 mL oral solution
        • ❑ 5 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 10 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 15 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • ❑ 0.25 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 0.05 mg/kg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 0.1 mg/kg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 0.05 mg/kg, Syringe, IV Push, q6hr, PRN Pain - Severe
        • ❑ 0.1 mg/kg, Syringe, IV Push, q6hr, PRN Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
        • ❑ 0.1 mg, Vial, IV Piggyback, q6hr, PRN for Nausea/Vomiting
    • Laxatives
      • ❑ bisacodyl
        • ❑ 5 mg, Per rectum, Q24hr, PRN for Constipation
        • ❑ 10 mg, Per rectum, Q24hr, PRN for Constipation
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • ❑ 6x/Day, Empty & Record Output q4hrs.
        • ❑ 3x/Day, Empty & Record Output q8hrs
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
      • ❑ Jackson-Pratt Drain to
        • bulb suction
      • ❑ Notify Provider
        • Drain Output > 400cc/shift
      • ❑ Deactivate Drain
        • if > 400cc/shift, turn off for 2 hours, then restart.
      • ❑ Drain Removal
        • ❑ T+1;0900, Post-op day #1
        • ❑ T+2;0900, Post-op day #2
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, Dry dressing change daily, start post-op day #1.
        • ❑ T+2;0900, Daily, Daily, Dry dressing change daily to incision, begin POD # 2
        • ❑ T+1;0900, Daily, Begin dry dressing change daily after drain discontinued.
      • ❑ Triple Antibiotic
        • 1 app, Ointment, TOP, Daily
    • Notification
      • ❑ Notify Provider
        • Newborns to 12 months: HR < 70 or >150, Resp. Rate <30 or > 80, O2 sat < 92%.
      • ❑ Notify Provider
        • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 92%.
      • ❑ Notify Provider
        • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 92%.
      • ❑ Notify Provider
        • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 92%.
      • ❑ Notify Provider
        • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 92%
    • Patient Education
      • ❑ Patient Education
        • Patient & Family Education - on exposure to second hand smoke if applicable.
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • When patient able to stand and pivot.
    • ❑ Sling Apply
      • ❑ HS, and when out of bed - To Operative Shoulder
      • ❑ PRN - To Operative Shoulder
    • ❑ Elevate Extremity (upper)
      • ❑ Left
      • ❑ Right
    • ❑ Ice Pack
      • PRN, to Operative Site
    • ❑ Neurovascular Checks
      • ❑ 6x/Day, (q 4 hours)
      • ❑ 6x/Day, for 72 hr, (q 4 hours for 72 hours)
      • ❑ 3x/Day, (q 8 hours)
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
  • PT/OT/ST
    • ❑ Occupational Therapy Evaluation and Treatment
      • Begin Rehab Protocol - POD # 1
    • ❑ Physical Therapy Evaluation and Treatment
      • Begin Rehab Protocol - POD # 1
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
    • ❑ Turn Cough Deep Breathe
      • q2hr, While Awake
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with Vital Signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
      • ❑ 12x/Day, q2hrs
ORTHO SPINE - Post-Operative Order Set - IMH
  • Activity
    • ❑ Patient Activity Misc
      • Sit / Stand / Ambulate as soon as tolerated, with assistance. Limit sitting to less than 10 minutes at a time if status post discectomy.
    • ❑ Dangle at Bedside
      • T+1;0900, POD#1: HOB up as tolerated, dangle at bedside 3-4 times/day
    • ❑ Up to Chair
      • ❑ And ambulate with assistance TID
      • ❑ T+2;0900, POD#2: Up in chair / stand at bedside with assistance 3-4 times/day
    • ❑ Ambulate with Assistance
      • ❑ TID
      • ❑ Progressive ambulation with assistance and up in chair / stand at bedside with assistance 3-4 times/day
    • ❑ Weight Bearing
      • ❑ Non-Weight Bearing Right Lower Extremity
      • ❑ Non-Weight Bearing Left Lower Extremity
      • ❑ Non-Weight Bearing Right Upper Extremity
      • ❑ Non-Weight Bearing Left Upper Extremity
      • ❑ Partial Weight Bearing Right Lower Extremity
      • ❑ Partial Weight Bearing Left Lower Extremity
      • ❑ Partial Weight Bearing Right Upper Extremity
      • ❑ Partial Weight Bearing Left Upper Extremity
      • ❑ TDWB Right Lower Extremity
      • ❑ TDWB Left Lower Extremity
    • ❑ Patient Activity Misc
      • No lifting greater than ____ lbs.
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Mechanical soft, Endentulous
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Clear Liquid, Regular Diet, Clears when awake and then advance to Regular diet as tolerated
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ NPO, NPO except ice chips and sips with meds
  • IV Solutions
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ KCl 20 mEq/NS 1000 mL
      • 20 mEq
      • 1,000 mL, IV, mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
    • ❑ D5LR
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
  • Laboratory
    • ❑ CBC
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ Hemoglobin & Hematocrit
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ Basic Metabolic Panel
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ Magnesium Level
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ PT
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
    • ❑ PTT
      • ❑ Blood, AM Draw collect, T+1;0500
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 2 day(s)
      • ❑ Blood, AM Draw collect, T+1;0500, Daily, for 3 day(s)
  • Medications
    • Analgesics
      • ❑ ketorolac
        • 30 mg, Vial, IV Push, q6hr, hr
      • ❑ cyclobenzaprine
        • 10 mg, Tab, Oral, q8hr, PRN for Spasm
      • ❑ carisoprodol
        • 350 mg, Tab, Oral, q8hr, PRN for Spasm
      • ❑ traMADol
        • 100 mg, Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-10 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ acetaminophen-oxycodone 325 mg-5 mg oral tablet
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ oxyCODONE immediate release
        • ❑ 5 mg, Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 10 mg, Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN for Pain - Severe, 10 day(s)
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • ❑ 5 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
        • ❑ 10 mg, Vial, IM, q6hr, PRN for Nausea/Vomiting
      • ❑ promethazine
        • 12.5 mg, Tab, Oral, q6hr, PRN for Nausea/Vomiting
      • ❑ promethazine
        • 12.5 mg, Supp, Per rectum, q6hr, PRN for Nausea/Vomiting
    • Anti-pyretics
      • ❑ acetaminophen
        • 650 mg, Tab, Oral, q4hr, PRN Fever
    • DVT Prophylaxis
      • ❑ Sequential Compression Device
        • ❑ Knee High - Bilateral Legs
        • ❑ Knee High - Left Lower Extremity
        • ❑ Knee High - Right Lower Extremity
        • ❑ Thigh High - Bilateral Legs
        • ❑ Thigh High - Left Lower Extremity
        • ❑ Thigh High - Right Lower Extremity
      • ❑ Ted Hose
        • ❑ Thigh High - Bilateral Legs
        • ❑ Thigh High - Left Lower Extremity
        • ❑ Thigh High - Right Lower Extremity
        • ❑ Knee High - Bilateral Legs
        • ❑ Knee High - Left Lower Extremity
        • ❑ Knee High - Right Lower Extremity
    • Other Meds
      • ❑ diphenhydrAMINE
        • ❑ 25 mg, Oral, q6hr, PRN for Itching
        • ❑ 12.5 mg, Oral, q6hr, PRN for Itching
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • 3x/Day, and PRN
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, 4X4 gauze and paper tape
        • ❑ T+1;0900, Daily, 4X4 gauze, ABD pad and paper tape
        • ❑ T+1;0900, Daily, 4X4 gauze and tegaderm dressing
        • ❑ T+1;0900, Daily, 4X4 gauze, ABD pad and tegaderm
        • ❑ T+1;0900, Daily, Band-Aid dressing
      • ❑ Dressing Change
        • ❑ PRN, 4X4 gauze and paper tape
        • ❑ PRN, 4X4 gauze, ABD pad and paper tape
        • ❑ PRN, 4X4 gauze and tegaderm dressing
        • ❑ PRN, 4X4 gauze, ABD pad and tegaderm
        • ❑ PRN, Band-Aid dressing
    • Urinary Catheter Management
      • ❑ Insert Foley Catheter
        • Indwelling
      • ❑ Discontinue Foley Cath
        • ❑ when able to stand and pivot
        • ❑ When able to tolerate sitting (female) / standing (male)
    • ❑ I&O POC
      • ❑ 3x/Day, Q8hr
      • ❑ 6x/Day, Q4hr
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift - 8 hour
      • ❑ q4hrVS
    • ❑ Neurovascular Checks
      • ❑ qShift - 8 hour, Monitor motor, sensory, and vascular function of upper / lower extremities
      • ❑ 6x/Day, with each vital sign
ORTHO SPINE - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Condition
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Physical Therapy Evaluation and Treatment
      • For crutch and / or postop exercises
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diagnostic Tests
    • ❑ ECG
      • Stat
    • ❑ Nursing Communication Order
      • All x-rays with patient to OR
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, NPO after midnight
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, except medications
    • ❑ Diet Order
      • ❑ Clear Liquid, No solids or milk products (cheese), etc. 8 hours before surgery
      • ❑ Clear Liquid, No more than 8oz up to 2 hrs before surgery (coffee, no cream, water, juice, no pulp)
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
  • Medications
    • ❑ ceFAZolin.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
    • ❑ Cipro
      • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • Pre-Op
      • ❑ Hibiclens Scrub
        • Scrub: Operative area with Hibiclens night before or morning of surgery x 3 minutes & wrap with sterile towel
      • ❑ Betadine Scrub
        • Other See Special Instructions, Operative area with betadine morning of surgery x 10 minutes and wrap with sterile towel.
    • ❑ Nursing Communication Order
      • Have patient void immediately prior to going to holding room.
    • ❑ Brace
      • Lumbar Brace with patient to OR.
    • ❑ Ted Hose
      • ❑ Knee High
      • ❑ Thigh High
Orthopedic Surgery Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Orthopedic Surgery Plan of Care
Ostomy Plan of Care
  • Patient Care
    • ❑ Colostomy Care
      • q12hr
    • ❑ Ileostomy Care
      • q12hr
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Ostomy Plan of Care
 P
PACU - GU Post-Mitomycin C Order Set - IMH
  • Patient Care
    • ❑ Nursing Communication
      • Unclamp and drain into foley bag
    • ❑ Continuous Bladder Irrigation
      • Drain Bladder, then NS CBI x 1000 mL
    • ❑ Discontinue Foley Cath
      • 1 hour after mitomycin instilled.
PACU - Post-Operative Surgical Order Set - IMH
  • Diagnostic Tests
    • ❑ EKG
      • Stat, in PACU
    • ❑ XR Ankle 3 Views Min Rt
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Ankle 3 Views Min Lt
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Chest 1 View Portable
      • Stat, Transport Mode: Portable
    • ❑ XR Foot 3 Views Min Rt
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Foot 3 Views Min Lt
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Hip 1 View Rt w/ Pelvis
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Hip 1 View Lt w/ Pelvis
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Knee 2 Views Right
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Knee 2 Views Left
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Shoulder 1 View Right
      • Stat, Reason: Post-Op, Transport Mode: Portable
    • ❑ XR Shoulder 1 View Left
      • Stat, Reason: Post-Op, Transport Mode: Portable
  • IV Solutions
    • ❑ NS Bolus
      • 1,000 mL, IV, Once
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ H&H
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Glucose Fasting
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Magnesium Level
      • Blood, Stat collect, T;N
    • ❑ PT/INR
      • Blood, Stat collect, T;N
    • ❑ PTT
      • Blood, Stat collect, T;N
    • ❑ High Sensitivity Troponin
      • Blood, Stat collect, T;N
    • ❑ RHo (D) immune globulin 300 mcg intramuscular solution
      • 300 mcg, Soln, IM, Once, PRN for Other (see comment)
    • ❑ RHo (D) immune globulin 50 mcg intramuscular solution
      • 50 mcg, Soln, IM, Once, PRN for Other (see comment)
  • Patient Care
    • ❑ Discontinue Foley Cath
      • before discharge from PACU
    • ❑ Fetal Heart Tones
      • OB to check Fetal Heart Tones in PACU
    • ❑ Straight Cath
      • in PACU for bladder distention.
    • ❑ Post-op Healing Shoe
      • to operative foot.
    • ❑ Crutches
      • ❑ Crutch training with non-weight bearing operative extremity.
      • ❑ Crutch training with partial weight bearing operative extremity
Pain (Acute) Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Pain (Acute) Plan of Care
Pain (Chronic) Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Pain (Chronic) Plan of Care
Pain Management Acute EBP Pediatric IPOC
  • ❑ Consult to Pharmacy
    • Routine
  • ❑ Pain Assessment Pediatric
    • q4hr
  • ❑ Pulse Oximetry Continuous
    • Constant Indicator
PED - Pediatric & Adolescent (0-17) PRN Order Set - IMH
  • Activity
    • ❑ Ambulate
      • ❑ As tolerated. Up in room.
      • ❑ BID
      • ❑ TID
  • Medications
    • ❑ zinc oxide 40% topical ointment
      • 1 app, Ointment, TOP, q6hr, PRN for diaper rash, 14 day(s)
    • ❑ ibuprofen
      • ❑ 10 mg/kg, Soln-Oral, Oral, q6hr, PRN for Pain/Fever, 14 day(s)
      • ❑ 400 mg, Tab, Oral, q4hr, PRN for Pain/Fever, 14 day(s)
    • ❑ Chloraseptic 1.4% spray
      • 2 spray(s), Spray, Oral, q2hr, PRN for Sore Throat, 14 day(s)
    • ❑ glycerin infant rectal enema
      • 4 mL, Enema, Per rectum, Q24hr, PRN for Constipation, 14 day(s)
    • ❑ simethicone
      • 20 mg, Drops-Oral, Oral, q8hr, PRN for Other (see comment), 14 day(s)
    • ❑ Tylenol
      • ❑ 15 mg/kg, Soln-Oral, Oral, q4hr, PRN for Pain/Fever, 14 day(s)
      • ❑ 650 mg, Tab, Oral, q4hr, PRN for Pain/Fever, 14 day(s)
    • ❑ Tylenol
      • ❑ 15 mg/kg, Supp, Per rectum, q4hr, PRN for Pain/Fever, 14 day(s)
      • ❑ 325 mg, Supp, Per rectum, q4hr, PRN for Pain/Fever, 14 day(s)
    • ❑ lidocaine-prilocaine 2.5%-2.5% topical cream
      • 1 app, Cream, TOP, As Directed, PRN for Other (see comment), 14 day(s)
  • Patient Care
    • ❑ Blood Glucose POC
      • PRN, For suspected Hi / Low
    • ❑ Blood Glucose POC
      • PRN, For infants - suspected Hi / Low. Heelstick.
    • ❑ Suctioning
      • PRN, Oro-Nasal suction PRN (Bulb syringe / suction set-up) in all rooms with respiratory diagnosis
    • ❑ Bathe Patient
      • May bathe patient or patient may shower as appropriate.
PED - Pediatric Abdominal Pain Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Routine
    • ❑ XR Chest 1 View Frontal
      • Routine
    • ❑ CT Abdomen w/ + w/o Contrast
      • Routine
    • ❑ CT Abdomen w/o Contrast
      • Routine
    • ❑ US Liver (Hepatic)
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at home
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ NPO, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ Amylase Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ Lipase Level
        • Blood, AM Draw collect, T+1;0500
      • ❑ Neonatal Bilirubin
        • Blood, AM Draw collect, T+1;0500
      • ❑ Direct Bilirubin
        • Blood, AM Draw collect, T+1;0500
      • ❑ GGT
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ Hepatic Function Panel
      • Blood, Stat collect, T;N
    • ❑ Amylase Level
      • Blood, Stat collect, T;N
    • ❑ Lipase Level
      • Blood, Stat collect, T;N
    • ❑ Neonatal Bilirubin
      • Blood, Stat collect, T;N
    • ❑ Direct Bilirubin
      • Blood, Stat collect, T;N
    • ❑ GGT
      • Blood, Stat collect, T;N
    • ❑ Culture Stool
      • Stool, Routine collect, T;N
    • ❑ Stool WBC
      • Stool, Routine collect, T;N, for 1 dose(s)/time(s)
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ !-Zofran
      • ❑ 1 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 1 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Tab, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Supp, Per rectum, q6hr, PRN Nausea/Vomiting
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
    • ❑ Patient Education
      • If patient has smoked cigarettes within last 12 months
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hr
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric Acute Constipation in Children 12 Years and Older Order Set - IMH
  • Communication
    • ❑ Notify Provider
      • Fever, vomiting, poor feeding, bloody diarrhea, anal stenosis, tight empty rectum, or perirectal abscess.
  • Medications
    • ❑ MiraLax
      • 1 packet(s), Packet, Oral, q1hr, Start date: T;N, 8 dose(s)/time(s)
    • ❑ MiraLax
      • 1 packet(s), Packet, Oral, 8x/Day, Start date: T+1;0800
    • ❑ GoLYTELY
      • 4,000 mL, Soln-Oral, Oral, Once
    • ❑ Fleet Enema
      • 133 mL, Enema, Per rectum, q12hr
    • ❑ glycerin suppository (adult)
      • 1 supp, Supp, Per rectum, Once
  • Special
    • ❑ Disimpaction of Bowel
      • q12hr, ONLY DONE AFTER ENEMA IS ADMINISTERED. Attempt disimpaction after each enema if no results. Discontinue when Fleet's Enema discontinued.
PED - Pediatric Asthma Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at Home
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ Immunoglobulin E Total
      • Blood, Stat collect, T;N
    • ❑ Southeast Allergy Profile
      • Blood, Stat collect, T;N
    • ❑ Southeast Food Allergy Profile
      • Blood, Stat collect, T;N
    • ❑ Southeast Mold Allergy Profile
      • Blood, Stat collect, T;N
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ racepinephrine 2.25% inhalation solution
      • ❑ 0.25 mL, Soln-Inh, INH, q2hr, PRN Other (see comment)
      • ❑ 0.5 mL, Soln-Inh, INH, q2hr, PRN Other (see comment)
    • ❑ predniSONE
      • ❑ 1 mg/kg, Soln-Oral, Oral, q12hr
      • ❑ 2 mg/kg, Soln-Oral, Oral, q24hr
    • ❑ SoluMEDROL
      • 1 mg/kg, IV Piggyback, q6hr, STAT
    • ❑ montelukast
      • ❑ 4 mg, Tab-Chew, Chewed, qPM
      • ❑ 5 mg, Tab-Chew, Chewed, qPM
      • ❑ 10 mg, Tab, Oral, qPM
  • Patient Care
    • Patient Education
      • ❑ Patient Education
        • Patient and family on asthma
      • ❑ Patient Education
        • Patient + family education on exposure to second hand smoke if applicable
      • ❑ Patient Education
        • If patient has smoked cigarettes within last 12 months
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
    • ❑ Consult to Respiratory Therapy
      • Asthma Education
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hrs
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric Bronchiolitis Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at home
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ prednisoLONE
      • ❑ 1 mg/kg, Soln-Oral, Oral, q12hr
      • ❑ 10 mg, Tab-Dispers, Oral, q12hr
      • ❑ 15 mg, Tab-Dispers, Oral, q12hr
    • ❑ racepinephrine 2.25% inhalation solution
      • ❑ 0.25 mL, Soln-Inh, INH, q2hr, PRN Other (see comment)
      • ❑ 0.5 mL, Soln-Inh, INH, q2hr, PRN Other (see comment)
    • ❑ Sodium Chloride 3% inh solution
      • ❑ 3 mL, Soln-Inh, INH, q2hr, dose(s)/time(s)
      • ❑ 3 mL, Soln-Inh, INH, q3hr, dose(s)/time(s)
      • ❑ 3 mL, Soln-Inh, INH, q4hr, dose(s)/time(s)
      • ❑ 3 mL, Soln-Inh, INH, q6hr, dose(s)/time(s)
      • ❑ 3 mL, Soln-Inh, INH, q8hr, dose(s)/time(s)
      • ❑ 3 mL, Soln-Inh, INH, q12hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q2hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q3hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q4hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q6hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q8hr, dose(s)/time(s)
      • ❑ 4 mL, Soln-Inh, INH, q12hr, dose(s)/time(s)
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ Isolation Precautions
      • Droplet Precautions, Reason: RSV Precautions
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • If patient has smoked cigarettes within last 12 months
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hr
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric Fever Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at home
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ ampicillin
      • 50 mg/kg, IV Piggyback, q6hr, 7 day(s), Infuse over 30 minute(s)
    • ❑ cefotaxime
      • 50 mg/kg, IV Piggyback, q6hr, 7 day(s)
    • ❑ gentamicin
      • 2.5 mg/kg, IV Piggyback, q8hr, 7 day(s)
    • ❑ cefTRIAXone
      • 750 mg/kg, IV Piggyback, q24hr, 7 day(s)
    • ❑ Unasyn
      • 50 mg/kg, IV Piggyback, q6hr, 7 day(s)
    • ❑ clindamycin
      • 10 mg/kg, IV Piggyback, q8hr, 7 day(s)
    • ❑ vancomycin
      • 15 mg/kg, IV Piggyback, q6hr, 7 day(s)
    • ❑ Zithromax
      • 10 mg/kg, IV Piggyback, q24hr, 3 day(s)
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
    • ❑ Patient Education
      • If patient has smoked cigarettes within last 12 months
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hr
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric Gastroenteritis Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at Home
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ NPO, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ WBC Stool/Yeast
      • Stool, Routine collect, T;N
    • ❑ Ova and Parasites, Fecal
      • Stool, Routine collect, T;N
    • ❑ Stool Culture
      • Stool, Routine collect, T;N, Stool for Yersinia & Campylobacter
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ !-Zofran
      • ❑ 1 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 1 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Tab, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Supp, Per rectum, q6hr, PRN Nausea/Vomiting
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ Isolation Precautions
      • Enteric Precautions
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
    • ❑ Patient Education
      • If patient has smoked cigarettes within last 12 months
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hrs
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric General Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at Home
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC w/Auto Diff
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ ESR
        • Blood, AM Draw collect, T+1;0500
      • ❑ C-Reactive Protein
        • Blood, AM Draw collect, T+1;0500
      • ❑ Fasting Glucose
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ Amylase Level
      • Blood, Stat collect, T;N
    • ❑ Lipase Level
      • Blood, Stat collect, T;N
    • ❑ C-Reactive Protein
      • Blood, Stat collect, T;N
    • ❑ CPK
      • Blood, Stat collect, T;N
    • ❑ Fasting Glucose
      • Blood, Stat collect, T;N
    • ❑ C.Difficile_EPI by PCR
      • Stool, Routine collect, T;N, Nurse collect
    • ❑ Stool WBC
      • Stool, Routine collect, T;N, for 1 dose(s)/time(s)
    • ❑ Stool Culture
      • Stool, Routine collect, T;N, for 1 dose(s)/time(s)
    • ❑ SARS-CoV-2 Flu RSV PCR Panel (Cepheid) IRDL.
      • Nasopharyngeal, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Medications
    • ❑ !-Zofran
      • ❑ 1 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 1 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 2 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, IV Piggyback, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Soln-Oral, Oral, q6hr, PRN Nausea/Vomiting
      • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Tab, Oral, q6hr, PRN Nausea/Vomiting
    • ❑ promethazine
      • 12.5 mg, Supp, Per rectum, q6hr, PRN Nausea/Vomiting
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Notify Provider
      • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 90%.
    • ❑ Notify Provider
      • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 90%.
    • ❑ Notify Provider
      • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 90%
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • If patient has smoked cigarettes within last 12 months
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
    • ❑ Consult to Respiratory Therapy
      • Asthma Education
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hr
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric HyperBilirubinemia Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 2 midnights or more
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at Home
      • ❑ NPO, Room Service Eligible: No
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Room Service Eligible: Yes, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • AM Labs
      • ❑ CBC
        • Blood, AM Draw collect, T+1;0500
      • ❑ Basic Metabolic Panel
        • Blood, AM Draw collect, T+1;0500
      • ❑ Neonatal Bilirubin
        • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Stat collect, T;N
    • ❑ ESR
      • Blood, Stat collect, T;N
    • ❑ Neonatal Bilirubin
      • Blood, Stat collect, T;N
    • ❑ Neonatal Bilirubin Panel
      • Blood, Stat collect, T;N
    • ❑ Reticulocyte Count
      • Blood, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Stat collect, T;N, Nurse collect
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N, Nurse Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
    • ❑ Culture - Blood
      • Blood, Stat collect, T;N, Lab Collect
  • Patient Care
    • ❑ Notify Provider
      • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 90%.
    • ❑ Phototherapy
      • ❑ Phototherapy Lights x1, Overhead and Wallaby, Out from under lights no more than 30 minutes for feeding every 2 hours
      • ❑ Double Phototherapy, Out from under lights no more than 30 minutes for feeding every 2 hours
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O (q 8 hours)
      • ❑ 6x/Day, Strict I&O (q 4 hours)
    • ❑ Patient Education
      • Patient + family education on exposure to second hand smoke if applicable
  • Respiratory
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ Keep O2 SAT greater than or equal to 93%.
      • ❑ Respiratory to titrate greater than or equal to 94%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
      • ❑ 12x/Day, q2hrs
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
PED - Pediatric Influenza Vaccine Order Set - IMH
  • Medications
    • ❑ influenza virus vaccine, inactivated
      • 0.25 mL, Susp-Inj, IM, Once
    • ❑ influenza virus vaccine, inactivated
      • 0.5 mL, Susp-Inj, IM, Once
    • ❑ influenza virus vaccine, inactivated
      • 0.5 mL, Susp-Inj, IM, Once
    • ❑ influenza virus vaccine, inactivated
      • 0.5 mL, Susp-Inj, IM, Once
PED - Pediatric IV Fluid Order Set - IMH
  • IV Solutions
    • ❑ NS Bolus
      • ❑ mL, IV, Once
      • ❑ 20 mL/kg, IV, Once
    • ❑ KCL 5 mEq/D5-1/4 NS 500 mL
      • 5 mEq
      • 500 mL, IV, mL/hr
    • ❑ KCL 5 mEq/ D5-1/2 NS 500 mL
      • 5 mEq
      • 500 mL, IV, mL/hr
    • ❑ Dextrose 5% with 0.2% NaCl
      • 500 mL, IV, mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • 500 mL, IV, mL/hr
    • ❑ NS
      • 250 mL, IV, mL/hr
    • ❑ NS
      • 500 mL, IV, mL/hr
    • ❑ D10W
      • 250 mL, IV, mL/hr
    • ❑ D10W
      • 500 mL, IV, mL/hr
    • ❑ KCL 10 mEq/D5-1/4 NS 500 mL
      • 10 mEq
      • 500 mL, IV, mL/hr
    • ❑ KCL 10 mEq/D5-1/2 NS 500 mL
      • 10 mEq
      • 500 mL, IV, Routine, mL/hr
    • ❑ KCL 10 mEq/D5-1/4 NS 1000 mL
      • 1,000 mL, IV, mL/hr
      • 10 mEq
    • ❑ Dextrose 5% with 0.2% NaCl
      • 1,000 mL, IV, mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • 1,000 mL, IV, mL/hr
    • ❑ NS
      • 1,000 mL, IV, mL/hr
    • ❑ D10W
      • 500 mL, IV, mL/hr
PED - Pediatric Patient Care Order Set - IMH
  • Patient Care
    • ❑ Nursing Communication Order
      • Order & Initiate "MED - Nicotine Replacement Order Set - IMH" - for patients using tobacco products and Nicotine replacement needed.
    • ❑ Nursing Communication Order
      • Order & Initiate "PED - Pediatric IV Insertion & Care Order Set - IMH" if needed.
    • ❑ Nursing Communication Order
      • Order & Initiate "CRIT CARE - Glycemic Order Set - IMH" if needed and in the ICU.
PED - Pediatric Peripheral IV Insertion & Care Order Set - IMH
  • Medications
    • ❑ NS Flush Bag
      • FLUSH BAG, IV Flush, As Directed, for Other (see comment)
  • Patient Care
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, 3x/Day
    • ❑ Normal Saline Flush
      • 1 EA, IV Flush, As Directed, PRN Other (see comment)
    • ❑ Change IV
      • ❑ T;N, PRN, as clinically indicated
      • ❑ T+7;1000, q7day, Portacath Needle Change Q7days & PRN
    • ❑ Change IV Tubing
      • T+4;1000, q4day, Q4days & PRN
    • ❑ Change IV Tubing
      • T+1;0500, Q24hr, Daily & PRN
    • ❑ Nursing Communication Order
      • Notify Nursing Supervisor for Consult to Anesthesia after two IV attempts.
PED - Pediatric RT Nebulizer Treatments Order Set - IMH
  • Medications
    • ❑ albuterol
      • ❑ 2.5 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, Once
      • ❑ 1.25 mg, Soln-Inh, NEB, 12x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, q3hr
      • ❑ 2.5 mg, Soln-Inh, NEB, Once
      • ❑ 2.5 mg, Soln-Inh, NEB, 12x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, 2x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, 3x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, q3hr
      • ❑ 5 mg, Soln-Inh, NEB, Once
      • ❑ 5 mg, Soln-Inh, NEB, 12x/Day
      • ❑ 5 mg, Soln-Inh, NEB, 2x/Day
      • ❑ 5 mg, Soln-Inh, NEB, 3x/Day
      • ❑ 5 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 5 mg, Soln-Inh, NEB, q3hr
    • ❑ albuterol
      • ❑ 1.25 mg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q8hr, PRN for Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q12hr, PRN for Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q8hr, PRN for Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q12hr, PRN for Shortness of Breath or wheezing
      • ❑ 5 mg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ 5 mg, Soln-Inh, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 5 mg, Soln-Inh, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 5 mg, Soln-Inh, NEB, q8hr, PRN for Shortness of Breath or wheezing
      • ❑ 5 mg, Soln-Inh, NEB, q12hr, PRN for Shortness of Breath or wheezing
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • ❑ 500 mcg, Soln-Inh, NEB, 6x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, Once
      • ❑ 500 mcg, Soln-Inh, NEB, 12x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, 2x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, 3x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, 4x/Day
    • ❑ racepinephrine 2.25% inhalation solution
      • ❑ 0.5 mL, Soln-Inh, NEB, Once
      • ❑ 0.5 mL, Soln-Inh, NEB, BID
      • ❑ 0.5 mL, Soln-Inh, NEB, 3x/Day
      • ❑ 0.5 mL, Soln-Inh, NEB, 4x/Day
      • ❑ 0.5 mL, Soln-Inh, NEB, 6x/Day
      • ❑ 0.25 mL, Soln-Inh, NEB, Once
      • ❑ 0.25 mL, Soln-Inh, NEB, BID
      • ❑ 0.25 mL, Soln-Inh, NEB, 3x/Day
      • ❑ 0.25 mL, Soln-Inh, NEB, 4x/Day
      • ❑ 0.25 mL, Soln-Inh, NEB, 6x/Day
    • ❑ Pulmicort Respules
      • ❑ 0.25 mg, Soln-Inh, NEB, BID
      • ❑ 0.5 mg, Soln-Inh, NEB, BID
      • ❑ 0.5 mg, Soln-Inh, NEB, Daily
PIH Panel IRDL
  • Laboratory
    • ❑ Creatinine
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ Uric Acid
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ ALT
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ AST
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ LDH
      • Blood, Stat collect, T;N, Once, Lab Collect
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N, Once, Lab Collect
Plateletpheresis, Leukoreduced IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Leukoreduced Platelets
      • Blood
PT Mixing Study IRDL
  • Laboratory
    • ❑ PT
      • Blood, Lab Collect
    • ❑ Protime Mixing Study
      • Blood, Lab Collect
PT/PTT IRDL
  • Laboratory
    • ❑ PT
      • Blood, Lab Collect
    • ❑ PTT
      • Blood, Lab Collect
PTT Mixing Study IRDL
  • Laboratory
    • ❑ PTT
      • Blood, Lab Collect
    • ❑ PTT Mixing Study
      • Blood, Lab Collect
PULM - Chronic Obstructive Pulmonary Disease (COPD) Education Order Set - IMH
  • Consults
    • ❑ Consult Pulmonary Rehab - IMH
      • T;N, COPD Education
    • ❑ Consult to Respiratory Therapy
      • T;N, COPD Inhaler Education
    • ❑ Patient Education
      • T;N, Provide green COPD education folder.
    • ❑ Consult to Discharge Planning Services (CM)
      • T;N, COPD
PULM - Chronic Obstructive Pulmonary Disease (COPD) Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Palliative Care
      • End Stage COPD
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac, Fluid: 1000 ml
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Renal, Fluid: 1000 ml
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Pureed
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
  • IV Solutions
    • ❑ NS
      • 1,000 mL, IV, mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • 1000 mL, IV, 100 mL/hr
    • ❑ D5NS
      • 1,000 mL, IV, 100 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ NT-proBNP
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ Albumin Level
      • Blood, Routine collect, T;N
    • ❑ Culture - Sputum..
      • Sputum, Routine collect, T;N
    • ❑ Fasting Lipid Profile
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Antibiotics
      • ❑ azithromycin
        • ❑ 500 mg, Tab, Oral, Q24hr, Antibiotic Indication COPD exacerbation, 3 dose(s)/time(s)
        • ❑ 500 mg, IV Piggyback, Q24hr, Antibiotic Indication COPD exacerbation, 3 dose(s)/time(s)
      • ❑ doxycycline
        • ❑ 100 mg, Tab, Oral, q12hr, Antibiotic Indication COPD exacerbation, 5 day(s)
        • ❑ 100 mg, IV Piggyback, q12hr, Antibiotic Indication COPD exacerbation, 5 day(s)
    • Anticoagulants
      • ❑ Lovenox
        • ❑ 40 mg, Syringe, Subcutaneous, Daily
        • ❑ 30 mg, Syringe, Subcutaneous, Daily
      • ❑ heparin
        • 5,000 unit(s), Injection, Subcutaneous, 3x/Day
      • ❑ Arixtra
        • 2.5 mg, Syringe, Subcutaneous, Q24hr
    • Bronchodilators
      • ❑ albuterol 0.083% inhalation solution
        • ❑ 2.5 mg, Soln-Inh, NEB, 4x/Day
        • ❑ 2.5 mg, Soln-Inh, NEB, Q6hr-WA RT
        • ❑ 2.5 mg, Soln-Inh, NEB, 6x/Day
        • ❑ 2.5 mg, Soln-Inh, NEB, Q4hr-WA RT
        • ❑ 2.5 mg, Soln-Inh, NEB, TID
        • ❑ 2.5 mg, Soln-Inh, NEB, BID
        • ❑ 2.5 mg, Soln-Inh, NEB, QID
      • ❑ albuterol 0.083% inhalation solution
        • ❑ 2.5 mg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
        • ❑ 2.5 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
      • ❑ albuterol 0.042% inhalation solution
        • ❑ 1.25 mg, Soln-Inh, NEB, 4x/Day
        • ❑ 1.25 mg, Soln-Inh, NEB, Q6hr-WA RT
        • ❑ 1.25 mg, Soln-Inh, NEB, 6x/Day
        • ❑ 1.25 mg, Soln-Inh, NEB, Q4hr-WA RT
        • ❑ 1.25 mg, Soln-Inh, NEB, TID
        • ❑ 1.25 mg, Soln-Inh, NEB, BID
        • ❑ 1.25 mg, Soln-Inh, NEB, QID
      • ❑ albuterol 0.042% inhalation solution
        • ❑ 1.25 mg, Soln-Inh, NEB, q2hr, PRN Shortness of Breath or wheezing
        • ❑ 1.25 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • ❑ 3 mL, Soln, NEB, Q6hr-WA RT
        • ❑ 3 mL, Soln, NEB, 4x/Day
        • ❑ 3 mL, Soln, NEB, BID
        • ❑ 3 mL, Soln, NEB, 3x/Day
        • ❑ 3 mL, Soln, NEB, 6x/Day
        • ❑ 3 mL, Soln, NEB, Q4hr-WA RT
        • ❑ 3 mL, Soln, NEB, TID
        • ❑ 3 mL, Soln, NEB, QID
        • ❑ 3 mL, Soln, NEB, Once, STAT
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • ❑ 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
        • ❑ 3 mL, Soln, NEB, q6hr, PRN for Shortness of Breath or wheezing
        • ❑ 3 mL, Soln, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
        • ❑ 500 mcg, Soln-Inh, NEB, 4x/Day
        • ❑ 500 mcg, Soln-Inh, NEB, Q6hr-WA RT
        • ❑ 500 mcg, Soln-Inh, NEB, 6x/Day
        • ❑ 500 mcg, Soln-Inh, NEB, Q4hr-WA RT
      • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
        • 500 mcg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
      • ❑ Perforomist 20 mcg/2 mL inhalation solution
        • 20 mcg, Soln-Inh, NEB, BID
      • ❑ Pulmicort Respules
        • ❑ 0.5 mg, Soln-Inh, NEB, BID
        • ❑ 0.25 mg, Soln-Inh, NEB, BID
    • Corticosteroids
      • ❑ SoluMEDROL
        • ❑ 125 mg, Vial, IV Push, Once
        • ❑ 40 mg, Vial, IV Push, Once
      • ❑ SoluMEDROL
        • ❑ 40 mg, Vial, IV Push, 4x/Day
        • ❑ 40 mg, Vial, IV Push, 3x/Day
        • ❑ 40 mg, Vial, IV Push, 2x/Day
        • ❑ 60 mg, Vial, IV Push, 4x/Day
        • ❑ 60 mg, Vial, IV Push, 3x/Day
        • ❑ 60 mg, Vial, IV Push, 2x/Day
        • ❑ 80 mg, Vial, IV Push, 4x/Day
        • ❑ 80 mg, Vial, IV Push, 3x/Day
        • ❑ 80 mg, Vial, IV Push, 2x/Day
        • ❑ 125 mg, Vial, IV Push, 4x/Day
        • ❑ 125 mg, Vial, IV Push, 3x/Day
        • ❑ 125 mg, Vial, IV Push, 2x/Day
      • ❑ predniSONE
        • ❑ 20 mg, Tab, Oral, BID
        • ❑ 40 mg, Tab, Oral, Daily
        • ❑ 60 mg, Tab, Oral, Daily
    • Other Meds
      • ❑ Mucinex
        • ❑ 1,200 mg, Tab-12, Oral, 2x/Day
        • ❑ 600 mg, Tab-12, Oral, BID
        • ❑ 600 mg, Tab-12, Oral, BID, PRN Cough
      • ❑ guaiFENesin
        • 200 mg, Oral, q4hr, PRN Cough
      • ❑ Xanax
        • ❑ 0.25 mg, Tab, Oral, 3x/Day
        • ❑ 0.5 mg, Tab, Oral, 3x/Day
      • ❑ Xanax
        • ❑ 0.25 mg, Tab, Oral, q4hr, PRN Anxiety
        • ❑ 0.5 mg, Tab, Oral, q4hr, PRN Anxiety
  • Patient Care
    • ❑ I&O POC
      • ❑ 6x/Day, (q 4 hours)
      • ❑ 3x/Day, (q 8 hours)
    • ❑ Notify Provider Vital Signs
      • T > 39, HR > 120, HR < 50, SBP > 180, SBP < 90, DBP > 100, RR > 24, RR < 12, O2 sat < 92
    • ❑ Notify Provider
      • ❑ For 2 consecutive hours, UO less than 25
      • ❑ For 2 consecutive hours, UO less than 50
    • ❑ Blood Glucose POC
      • QIDACHS, for 48 hr, Notify provider for blood glucose greater than 150
  • PT/OT/ST
    • ❑ Occupational Therapy Evaluation and Treatment
      • Teach energy conservation techniques
  • Respiratory
    • ❑ ABG Draw (Resp)
      • Stat, On room air if tolerated
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • ❑ keep O2 Sat greater than or equal to 88%
      • ❑ keep O2 Sat greater than or equal to 92%.
      • ❑ keep O2 Sat greater than or equal to 91%
      • ❑ keep O2 Sat greater than or equal to 90%
      • ❑ keep O2 Sat greater than or equal patients baseline.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
PULM - Pneumonia (PNA) Education Order Set - IMH
  • Communication
    • ❑ Patient Education
      • T;N, Provide blue pneumonia education folder.
  • Consults
    • ❑ Consult to Discharge Planning Services (CM)
      • T;N, Pneumonia
PULM - Pneumonia Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
    • ❑ Consult Dietitian
      • Nutrition Consult
    • ❑ Occupational Therapy Evaluation and Treatment
      • Energy Conservation
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • Routine, Transport Mode: Stretcher
    • ❑ XR Chest 1 View Frontal
      • Routine, Transport Mode: Portable
    • ❑ CT Chest w/ Contrast
      • Routine
    • ❑ CT Chest w/o Contrast
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Honey Thick
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ D5NS
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Culture - Sputum..
      • Sputum, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T+1;0500
    • ❑ CBC
      • Blood, AM Draw collect, T+2;0500
  • Medications
    • Antibiotics
      • ❑ cefTRIAXone
        • 1 gm, IV Piggyback, Q24hr, Antibiotic Indication Pneumonia- CAP, 5 day(s)
      • ❑ azithromycin
        • ❑ 500 mg, Oral, Q24hr, Antibiotic Indication Pneumonia- CAP, 3 day(s)
        • ❑ 500 mg, IV Piggyback, Q24hr, Antibiotic Indication Pneumonia- CAP, 3 day(s)
      • ❑ doxycycline
        • ❑ 100 mg, Oral, q12hr, Antibiotic Indication Pneumonia- CAP, 5 day(s)
        • ❑ 100 mg, IV Piggyback, q12hr, Antibiotic Indication Pneumonia- CAP, 5 day(s)
      • ❑ levoFLOXacin
        • ❑ 750 mg, Oral, Q24hr, Medication Indication Pneumonia- CAP, 5 day(s)
        • ❑ 750 mg, IV Piggyback, Q24hr, Medication Indication Pneumonia- CAP, 5 day(s)
      • ❑ Pharmacy Communication Order.
        • Daily, for 7 day(s)
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Pneumonia- CAP, PRN for Other (see comment), Routine, 7 day(s)
      • ❑ Zosyn
        • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Pneumonia- CAP, 7 day(s), Infuse over 4 hr
      • ❑ Zosyn
        • 3.375 gm, IV Piggyback, q8hr, Antibiotic Indication Pneumonia- HAP/VAP, 7 day(s), Infuse over 4 hr
      • ❑ aztreonam
        • 2 gm, IV Piggyback, q8hr, Antibiotic Indication Pneumonia- HAP/VAP, 7 day(s)
      • ❑ Cipro
        • 400 mg, IV Piggyback, q8hr, Antibiotic Indication Pneumonia- HAP/VAP, 7 day(s)
      • ❑ Pharmacy Communication Order.
        • Daily, for 7 day(s), Vancomycin IV - Pharmacy to dose
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Pharmacy to Dose, IV Piggyback, See Instructions, Antibiotic Indication Pneumonia- HAP/VAP, PRN for Other (see comment), Routine, 7 day(s)
    • Anticoagulants
      • ❑ Lovenox
        • ❑ 40 mg, Syringe, Subcutaneous, Daily
        • ❑ 30 mg, Syringe, Subcutaneous, Daily
      • ❑ heparin
        • 5,000 unit(s), Injection, Subcutaneous, 3x/Day
      • ❑ Arixtra
        • 2.5 mg, Syringe, Subcutaneous, Q24hr
    • ❑ homatropine-hydrocodone 1.5 mg-5 mg/5 mL oral syrup
      • 5 mL, Syrup, Oral, q4hr, PRN for Cough
    • ❑ albuterol 0.083% inhalation solution
      • ❑ 2.5 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 2.5 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, Q4hr-WA RT
      • ❑ 2.5 mg, Soln-Inh, NEB, TID
      • ❑ 2.5 mg, Soln-Inh, NEB, BID
      • ❑ 2.5 mg, Soln-Inh, NEB, QID
    • ❑ albuterol 0.083% inhalation solution
      • ❑ 2.5 mg, Soln-Inh, NEB, q2hr, PRN Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
    • ❑ albuterol 0.042% inhalation solution
      • ❑ 1.25 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 1.25 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, Q4hr-WA RT
      • ❑ 1.25 mg, Soln-Inh, NEB, TID
      • ❑ 1.25 mg, Soln-Inh, NEB, BID
      • ❑ 1.25 mg, Soln-Inh, NEB, QID
    • ❑ albuterol 0.042% inhalation solution
      • ❑ 1.25 mg, Soln-Inh, NEB, q2hr, PRN Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, Q6hr-WA RT
      • ❑ 3 mL, Soln, NEB, 4x/Day
      • ❑ 3 mL, Soln, NEB, BID
      • ❑ 3 mL, Soln, NEB, 3x/Day
      • ❑ 3 mL, Soln, NEB, 6x/Day
      • ❑ 3 mL, Soln, NEB, Q4hr-WA RT
      • ❑ 3 mL, Soln, NEB, TID
      • ❑ 3 mL, Soln, NEB, QID
      • ❑ 3 mL, Soln, NEB, Once, STAT
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q2hr, PRN for Shortness of Breath or wheezing
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • ❑ 500 mcg, Soln-Inh, NEB, 4x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 500 mcg, Soln-Inh, NEB, 6x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, Q4hr-WA RT
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • 500 mcg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
    • ❑ Perforomist 20 mcg/2 mL inhalation solution
      • 20 mcg, Soln-Inh, NEB, BID
    • ❑ Pulmicort Respules
      • ❑ 0.5 mg, Soln-Inh, NEB, BID
      • ❑ 0.25 mg, Soln-Inh, NEB, BID
  • Patient Care
    • ❑ Head of Bed
      • Elevate greater than or equal to 30 when in bed.
    • ❑ Core Measure Specialist Communication
      • ❑ Antibiotic Selection Exclusion: Patient Immunocompromised: ___________
      • ❑ Antibiotic Selection Exclusion: Secondary Suspected Infection: ___________
      • ❑ Antibiotic Selection Exclusion: Other Antibiotic: ___________
    • ❑ I&O POC
      • ❑ 3x/Day, Routine, q 8 hours
      • ❑ 6x/Day, Routine, q 4 hours
    • ❑ Nursing Dysphagia Screening.
      • T;N, Once, Stat
  • Respiratory
    • ❑ Oxygen Titrate
      • 92, Keep O2 Sat greater than or equal to 92%. When O2 Sat > 92% on room air, discontinue O2 & repeat O2 Sat on room air in 4 hours. Then order Pulse Ox Ambulatory. If known CO2 retainer, target O2 sat = 88%.
    • ❑ Respiratory Assessment
      • Daily, RT to assist patient's response to therapy and contact physician as needed for adjustments to treatment.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
PULM - Pulmonary General Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Observation
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Infectious Disease Specialist
      • ARYEETEY, ROBERT MD
    • ❑ Occupational Therapy Evaluation and Treatment
      • Energy Conservation
  • Diagnostic Tests
    • ❑ CT Angio Pulmonary
      • Stat
    • ❑ EKG
      • Stat
  • Diet
    • ❑ Diet Order
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes, Fluid: 1000 ml
      • ❑ Cardiac | Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
      • ❑ Dysphagia, Room Service Eligible: Yes, Nectar Thick
      • ❑ Dysphagia, Room Service Eligible: Yes, Honey Thick
  • IV Solutions
    • ❑ NS
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ D5W 1/2 NS
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
    • ❑ D5NS
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Thyroid Stimulating Hormone
      • Blood, Routine collect, T;N
    • ❑ ESR
      • Blood, Routine collect, T;N
    • ❑ Culture - Sputum..
      • Sputum, Routine collect, T;N, Nurse collect
  • Medications
    • Anticoagulants
      • ❑ Lovenox
        • ❑ 40 mg, Syringe, Subcutaneous, Daily
        • ❑ 30 mg, Syringe, Subcutaneous, Daily
      • ❑ heparin
        • 5,000 unit(s), Injection, Subcutaneous, 3x/Day
      • ❑ Arixtra
        • 2.5 mg, Syringe, Subcutaneous, Q24hr
    • ❑ SoluMEDROL
      • ❑ 40 mg, Vial, IV Push, 4x/Day
      • ❑ 40 mg, Vial, IV Push, 6x/Day
      • ❑ 40 mg, Vial, IV Push, 3x/Day
      • ❑ 40 mg, Vial, IV Push, 2x/Day
      • ❑ 60 mg, Vial, IV Push, 4x/Day
      • ❑ 60 mg, Vial, IV Push, 6x/Day
      • ❑ 60 mg, Vial, IV Push, 3x/Day
      • ❑ 60 mg, Vial, IV Push, 2x/Day
      • ❑ 80 mg, Vial, IV Push, 4x/Day
      • ❑ 80 mg, Vial, IV Push, 6x/Day
      • ❑ 80 mg, Vial, IV Push, 3x/Day
      • ❑ 80 mg, Vial, IV Push, 2x/Day
    • ❑ Mucinex
      • ❑ 1,200 mg, Tab-12, Oral, BID
      • ❑ 600 mg, Tab-12, Oral, BID
      • ❑ 600 mg, Tab-12, Oral, BID, PRN Cough
    • ❑ Protonix
      • 40 mg, Tab-EC, Oral, Daily
    • ❑ albuterol 0.083% inhalation solution
      • ❑ 2.5 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 2.5 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 2.5 mg, Soln-Inh, NEB, Q4hr-WA RT
      • ❑ 2.5 mg, Soln-Inh, NEB, TID
      • ❑ 2.5 mg, Soln-Inh, NEB, BID
      • ❑ 2.5 mg, Soln-Inh, NEB, QID
    • ❑ albuterol 0.083% inhalation solution
      • ❑ 2.5 mg, Soln-Inh, INH, q2hr, PRN Shortness of Breath or wheezing
      • ❑ 2.5 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
    • ❑ albuterol 0.042% inhalation solution
      • ❑ 1.25 mg, Soln-Inh, NEB, 4x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 1.25 mg, Soln-Inh, NEB, 6x/Day
      • ❑ 1.25 mg, Soln-Inh, NEB, Q4hr-WA RT
      • ❑ 1.25 mg, Soln-Inh, NEB, TID
      • ❑ 1.25 mg, Soln-Inh, NEB, BID
      • ❑ 1.25 mg, Soln-Inh, NEB, QID
    • ❑ albuterol 0.042% inhalation solution
      • ❑ 1.25 mg, Soln-Inh, NEB, q2hr, PRN Shortness of Breath or wheezing
      • ❑ 1.25 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, Q6hr-WA RT
      • ❑ 3 mL, Soln, NEB, 4x/Day
      • ❑ 3 mL, Soln, NEB, BID
      • ❑ 3 mL, Soln, NEB, 3x/Day
      • ❑ 3 mL, Soln, NEB, 6x/Day
      • ❑ 3 mL, Soln, NEB, Q4hr-WA RT
      • ❑ 3 mL, Soln, NEB, TID
      • ❑ 3 mL, Soln, NEB, QID
      • ❑ 3 mL, Soln, NEB, Once, STAT
    • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
      • ❑ 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q6hr, PRN for Shortness of Breath or wheezing
      • ❑ 3 mL, Soln, NEB, q2hr, PRN for Shortness of Breath or wheezing
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • ❑ 500 mcg, Soln-Inh, NEB, 4x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, Q6hr-WA RT
      • ❑ 500 mcg, Soln-Inh, NEB, 6x/Day
      • ❑ 500 mcg, Soln-Inh, NEB, Q4hr-WA RT
    • ❑ ipratropium 500 mcg/2.5 mL inhalation solution
      • 500 mcg, Soln-Inh, NEB, q2hr, PRN for Shortness of Breath or wheezing
    • ❑ Perforomist 20 mcg/2 mL inhalation solution
      • 20 mcg, Soln-Inh, NEB, BID
    • ❑ Pulmicort Respules
      • ❑ 0.5 mg, Soln-Inh, NEB, BID
      • ❑ 0.25 mg, Soln-Inh, NEB, BID
  • Patient Care
    • ❑ Ted Hose
      • ❑ Knee High
      • ❑ Thigh High
    • ❑ SCDs
      • ❑ Knee High
      • ❑ Thigh High
    • ❑ Blood Glucose POC
      • QIDACHS, for 48 hr, Notify provider for blood glucose greater than 150
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
    • ❑ Flutter Valve
      • ❑ PRN, With Nebs
      • ❑ 6x/Day, (q4hrs)
      • ❑ TID
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
    • ❑ Oxygen Titrate
      • ❑ keep sats greater than or equal to 90%
      • ❑ keep sats greater than or equal to 88%
      • ❑ keep sats greater than or equal to 92%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ q4hrVS
      • ❑ qShift 8 hr VS
    • ❑ Weight POC
      • Once a Day (before meals), Weigh Daily
PULM - Routine Adult Ventilator Order Set - IMH
  • Activity
    • ❑ Elevate Head of Bed
      • 30-45 degrees unless contraindicated
  • Consults
    • ❑ Consult to Anesthesia
      • Stat, Intubation
    • ❑ Speech Language Pathology Eval and Treat
      • Keep NPO until cleared by ST post intubation.
    • ❑ Consult to Intensivist
      • Patient on Ventilator
    • ❑ Consult to Infectious Disease Specialist
      • Patient on Ventilator, ARYEETEY, ROBERT MD
  • Diagnostic Tests
    • ❑ XR Chest 1 View Frontal
      • Stat
    • ❑ XR Chest 1 View Frontal
      • ❑ T+1;0500, Timed, Daily
      • ❑ T+1;0500, Timed, Daily
    • ❑ Nursing Communication
      • Nursing: Place order for XR Chest 1 View Frontal daily for patients on high PEEP (15 or higher)
  • IV Solutions
    • ❑ Nursing Communication Order
      • If multiple agents are being titrated, obtain order from provider for sequence of titration.
    • ❑ RASS
      • q1hr
    • ❑ Propofol 1000 mg/100 mL drip
      • 100 mL, IV, Routine, See Comments
      • 1,000 mg
    • ❑ Triglycerides
      • Blood, Routine collect, T;N, Once
    • ❑ Triglycerides
      • Blood, AM Draw collect, T+3;0500, Once
    • ❑ Triglycerides
      • Blood, AM Draw collect, T+10;0500, qWeek, Lab Collect
    • ❑ Versed
      • 2 mg, Soln, IV Push, q15min, PRN for Other (see comment)
    • ❑ Versed Drip
      • 100 mL, IV, Routine, See Comments
      • 100 mg
    • ❑ Ativan
      • 2 mg, Injection, IV Push, q15min, PRN Agitation
    • ❑ morphine
      • 2 mg, Syringe, IV Push, q15min, PRN Pain
    • ❑ Fentanyl Drip
      • 2,500 mcg
      • 250 mL, IV, Routine, See Comments
  • Laboratory
    • ❑ Culture - Sputum..
      • Sputum, Stat collect, T;N
  • Medications
    • ❑ chlorhexidine 0.12% mucous membrane liquid
      • 15 mL, Mouthwash, Oral, Daily
    • ❑ Protonix
      • 40 mg, Vial, IV Push, Daily
    • ❑ NexIUM
      • 40 mg, Packet, GTUBE, Daily
  • Patient Care
    • ❑ Ventilator Oral Care
      • 6x/Day, (q4hours) and PRN
    • ❑ Teeth brushing
      • BID
    • ❑ Suction Patient
      • PRN, As condition indicates.
    • ❑ Nursing Communication Order
      • Discontinue Ventilator order set after patient is extubated.
    • ❑ Daily Awakening Trial
      • Daily, If hemodynamically stable or sedation level unchanged after 15 minutes, continue to hold sedation infusions until provider contacted for further orders. If hemodynamically unstable after 15 minutes, resume sedation and notify provider of patient r
  • Respiratory
    • ❑ Ventilator Settings
      • ❑ AC, VC (Volume Control)
      • ❑ AC, PC (Pressure Control)
      • ❑ SIMV/IMV, VC (Volume Control)
      • ❑ SIMV/IMV, PC (Pressure Control)
      • ❑ PRVC (Pressure Regulated Volume Control)
    • ❑ Consult to Respiratory Therapy
      • Place patient on ventilator settings dictated by patient's condition and / or physician's order.
    • ❑ Nursing Communication
      • May order ABG Draw (resp) PRN or Sputum Culture PRN.
    • ❑ ABG Draw (Resp)
      • T+1;0500, q24hr, for 3 day(s), AM Draw Collect
    • ❑ ABG Draw (Resp)
      • Timed, 30 minutes after patient placed on ventilator
PULM - Thoracentesis Pre-Procedure Order Set - IMH
  • Condition
    • ❑ ENDO - Thoracentesis
      • At Bedside
    • ❑ Procedure / Consent
      • ❑ Thoracentesis - Right
      • ❑ Thoracentesis - Left
  • Diagnostic Tests
    • ❑ US Chest
      • Routine
    • ❑ Hold Med
      • Hold anticoagulants on the morning of the procedure
  • Laboratory
    • ❑ PT
      • Blood, AM Draw collect, T+1;0500, on morning of procedure
  • Patient Care
    • ❑ Nursing Communication Order
      • Place at Bedside: (1) Disposable Thoracentesis Tray (2) Size 8 and 8-1/2 sterile gloves (3) Thoracentesis Extension Tubing Set from Storeroom (4) Bottle of Betadine Solution (5) Lidocaine 1% inj soln (6) Two (2) vacutainer bottles for Fluid Collection
PULM - Ventilator Weaning Protocol Order Set - IMH
  • Respiratory
    • ❑ Ventilator Weaning Protocol
      • CPAP, PS, Fi02: 40%, PEEP: 5, PS: 10, qAM, See Comments
    • ❑ Negative Inspiratory Force
      • qAM
    • ❑ Rapid Shallow Breathing Index
      • qAM
    • ❑ ABG Draw (Resp)
      • qAM
 R
RAD - Myelogram Order Set - IMH
  • Activity
    • ❑ Supine Bedrest
      • for 6 hours - then up ad lib
    • ❑ Head of Bed
      • 30-45 degrees
  • Admission/Transfer/Discharge
    • ❑ Discharge Patient
      • Patient may be discharged at the indicated time if patient is experiencing no headache, no leg cramps, and no nausea or vomiting
    • ❑ Discharge Patient
      • Patient may be discharged at the indicated time if patient is experiencing no headache, no leg cramps, and no nausea or vomiting
    • ❑ Place in Extended Recovery
      • ❑ Medical/Acute, Medical
      • ❑ Surgical
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN for Pain/Fever
    • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
      • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Severe
  • Patient Care
    • ❑ Blood Glucose POC
      • As Directed, PRN
    • ❑ Notify Provider
      • IF patient experiences headache, leg cramps, and / or nausea / vomiting.
RAD - Post - CT Guided Percutaneous Liver Biopsy Order Set - IMH
  • Activity
    • ❑ Nursing Communication Order
      • Have patient lie on right side for 1 hour, if tolerated.
    • ❑ Bedrest
      • for 2 hr, Strict - for 2 hours
    • ❑ Bedrest with Bathroom Privileges
      • After 2 hours of strict bedrest.
  • Admission/Transfer/Discharge
    • ❑ Discharge Patient
      • Patient may be discharged at the indicated time if vital signs stable with systolic BP > 100, temperature < 37.7'C/100'F, HR < 120, no abdominal pain, no chest pain
    • ❑ Discharge Patient
      • Patient may be discharged at the indicated time if vital signs stable with systolic BP > 100, temperature < 37.7'C/100'F, HR < 120, no abdominal pain, no chest pain.
    • ❑ Place in Extended Recovery
      • ❑ Medical/Acute, Medical
      • ❑ Surgical
  • Communication
    • ❑ Patient Education
      • Give Post Liver Biopsy Discharge Instructions to patient / family.
  • Diet
    • ❑ Diet Order
      • Clear Liquid, Room Service Eligible, See Special Instructions, Clear Liquids for 2 hours - then diet of choice.
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible
      • ❑ NPO, Room Service Eligible
      • ❑ Clear Liquid, Room Service Eligible
      • ❑ Full Liquid, Room Service Eligible
      • ❑ Cardiac, Room Service Eligible
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1600 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 2000 kcal
  • Medications
    • ❑ acetaminophen
      • 650 mg, Tab, Oral, q4hr, PRN Pain/Fever
    • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
      • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Severe
  • Patient Care
    • ❑ Notify Provider
      • Shortness of breath, chest pain, abdominal distention, hematuria or severe abdominal pain.
    • ❑ Notify Provider Vital Signs
      • Temp > 38.3'C/101'F, HR > 120, SBP < 100
    • ❑ Notify Provider
      • Notify physician if patient does not meet discharge criteria.
  • Vital Signs
    • ❑ Vital Signs POC
      • every 15 minutes x 4, then every 30 minutes x 2, then every 4 hours.
RAD - Pre - CT Guided Percutaneous Liver Biopsy Order Set - IMH
  • Condition
    • ❑ Procedure / Consent
      • Computed Tomography Guided Liver Biopsy
RAD - Radiology General Order Set - IMH
  • Medications
    • ❑ SoluMEDROL
      • 125 mg, Vial, IV Push, On Call
    • ❑ Benadryl
      • 25 mg, Vial, IV Push, On Call
    • ❑ Pepcid
      • 20 mg, Vial, IV Push, On Call
    • ❑ Ativan
      • 1 mg, Injection, IV Push, q5min, PRN for Other (see comment), 2 dose(s)/time(s)
    • ❑ metoprolol
      • 5 mg, Vial, IV Push, q5min, PRN, 3 dose(s)/time(s)
    • ❑ esmolol
      • 20 mg, Vial, IV Push, q3min, PRN for Other (see comment), 5 dose(s)/time(s)
    • ❑ SoluMEDROL
      • 125 mg, Vial, IV Push, Once, NOW
    • ❑ Benadryl
      • 25 mg, Vial, IV Push, q5min, PRN for Other (see comment), 2 dose(s)/time(s)
    • ❑ Pepcid
      • 20 mg, Vial, IV Push, Once, NOW
    • ❑ EPINEPHrine 1 mg/mL injectable solution
      • 1 mg, Injection, Subcutaneous, Once, NOW
    • ❑ nitroglycerin
      • 0.4 mg, Tab-SL, Sublingual, PRN for Chest Pain
RAD - Radiology Prep Order Set - IMH
  • Medications
    • ❑ Diet Order
      • NPO, CT Prep
    • ❑ Readi-Cat 2
      • ❑ 450 mL, Susp-Oral, Oral, q1hr, 2 dose(s)/time(s)
      • ❑ 225 mL, Susp-Oral, Oral, q1hr, 2 dose(s)/time(s)
    • ❑ Gastroview
      • 15 mL, Soln-Oral, Oral, q15min, 2 dose(s)/time(s)
    • ❑ Diet Order
      • Clear Liquid
    • ❑ Diet Order
      • T+1;0001 NPO, Barium Enema Prep: NPO after midnight.
    • ❑ magnesium citrate
      • 300 mL, Soln-Oral, Oral, Once, Start date: T;1400
    • ❑ Dulcolax Laxative
      • 15 mg, Tab-EC, Start date: T;1800
Rehab Impaired Mobility IPOC
  • ❑ Education Discharge Planning
    • Constant order
Rehab Self-Care Deficit IPOC
  • ❑ Education Discharge Planning
    • Constant order
Rehab Swallowing Impairment IPOC
  • ❑ Respiratory Assessment
    • Daily
  • ❑ Education Discharge Planning
    • Constant order
Renal Disorders Plan of Care
  • Patient Care
    • ❑ Notify Provider
      • of any acute changes , as occur
    • ❑ Notify Provider
      • of any signs of anxiety & incr restless
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Renal Disorders Plan of Care
Restraints Plan of Care IRDL
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Restraints Plan of Care
Rhogam Workup IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Collected, T;N, Once, Lab Collect
    • ❑ .Rhogam Workup
      • Blood, T;N, Once
Risk for Aspiration/Impaired Communication Plan of Care IRDL
  • Consults
    • ❑ Consult to Social Services
      • Risk for Aspiration/Impaired Communication Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Risk for Aspiration Plan of Care
Risk for Falls Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Risk for Falls Plan of Care
Risk for Impaired Tissue Integrity Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Risk for Impaired Tissue Integrity Plan of Care
 S
Seizures Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Seizures Plan of Care
Self Care Deficit Plan of Care IRDL
  • Consults
    • ❑ Consult to Social Services
      • Self Care Deficit Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Self Care Deficit Plan of Care
Sjogrens Antibody (SSA/SSB) IRDL
  • Laboratory
    • ❑ SSA (RO) (ENA) Ab IgG
      • Blood, Lab Collect
    • ❑ SSB (LA) (ENA) Ab IgG
      • Blood, Lab Collect
SPEC NURS - Newborn Feeding Order Set - IMH
  • Diet
    • ❑ Nursing Communication
      • Formula Feed Ad Lib
    • ❑ Nursing Communication
      • NPO
    • ❑ Bottle Feeding
      • ❑ Custom (See Spec. Inst), Similac 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Soy 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac 19 cal / oz
      • ❑ Custom (See Spec. Inst), Alimentum 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac with added Rice 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Neosure 22 cal / oz
      • ❑ Custom (See Spec. Inst), Similac 24 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Human Milk Fortifier 1 packet to 25 mL of breast milk.
      • ❑ Custom (See Spec. Inst), Similac Human Milk Fortifier 1 packet to 50 mL of breast milk.
      • ❑ Custom (See Spec. Inst), Enfamil 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamili Prosobee 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil Nutramigen 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil AR 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil 22 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil 24 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil Human Milk Fortifier 1 packet to 25 mL of breast milk.
      • ❑ Custom (See Spec. Inst), Enfamil Human Milk Fortifier 1 packet to 50 mL of breast milk.
      • ❑ Custom (See Spec. Inst), Good Start Gentle 20 cal /oz
      • ❑ Custom (See Spec. Inst), Good Start Soy 20 cal /oz
      • ❑ Custom (See Spec. Inst)
    • ❑ Nursing Communication
      • ❑ Breast Feed Ad Lib
      • ❑ Breast Feed every 2 hours
      • ❑ Breast Feed every 3 hours
    • ❑ Nursing Communication
      • Expressed breast milk ______mL every ______ hours.
    • ❑ Weight POC
      • PRN, Weigh before and after breast feeding
    • ❑ Breast Feeding
      • Custom (See Spec. Inst), No Supplement with Formula
    • ❑ Weight POC
      • PRN, Weigh before and after breast feeding
    • ❑ Breast Feeding
      • ❑ Custom (See Spec. Inst), Similac 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Soy 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac 19 cal / oz
      • ❑ Custom (See Spec. Inst), Alimentum 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac with added Rice 20 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Neosure 22 cal / oz
      • ❑ Custom (See Spec. Inst), Similac 24 cal / oz
      • ❑ Custom (See Spec. Inst), Similac Human Milk Fortifier 1 packet to 25 mL of breast milk
      • ❑ Custom (See Spec. Inst), Similac Human Milk Fortifier 1 packet to 50 mL of breast milk
      • ❑ Custom (See Spec. Inst), Enfamil 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil Prosobee 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil Nutramigen 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil AR 20 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil 22 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil 24 cal / oz
      • ❑ Custom (See Spec. Inst), Enfamil Human Milk Fortifier 1 packet to 25 mL of breast milk
      • ❑ Custom (See Spec. Inst), Enfamil Human Milk Fortifier 1 packet to 50 mL of breast milk
      • ❑ Custom (See Spec. Inst), Good Start Gentle 20 cal /oz
      • ❑ Custom (See Spec. Inst), Good Start Soy 20 cal /oz
  • Patient Care
    • ❑ Nursing Communication
      • Nipple feed _____mL every ____ hours.
    • ❑ Nursing Communication
      • Gavage feed _______mL every _____hours.
    • ❑ Nursing Communication
      • Nipple as tolerated, then gavage for a total of ______mL every _____ hours.
SPEC NURS - Special Care Nursery Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Radiant Warmer
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Isolette
      • ❑ Special Care Nursery, Anticipated LOS 2 midnights or more, Open Crib
  • Diet
    • ❑ Diet Order
      • NPO, Room Service Eligible: No
  • IV Solutions
    • ❑ D10W
      • 250 mL, IV, mL/hr
  • Laboratory
    • ❑ CBC
      • Blood, Stat collect, T;N, Nurse collect
    • ❑ Manual Differential
      • Blood, Stat collect, T;N, Nurse collect
    • ❑ Blood Culture
      • Blood, Stat collect, T;N, Nurse collect
    • ❑ C-Reactive Protein
      • Blood, Stat collect, T;N, Nurse collect
    • ❑ Hematocrit
      • Blood, QMonday, Nurse collect
    • ❑ Cord Blood - Hold
      • Blood, Stat collect, T;N
    • ❑ Cord Blood Profile - BB
      • Blood, Routine collect, T;N, Nurse collect
    • ❑ Bilicheck Screen POC
      • Routine Transcutaneous Bilirubin (TCB) at 24 hours of age and any other time jaundice observed. If results greater than 8, order Bilirubin Panel, and report results to MD.
    • ❑ Bilicheck Screen POC
      • PRN, Routine Transcutaneous Bilirubin (TCB) any time jaundice observed. If results are in High Risk Zone, order Bilirubin Panel. If Bilirubin Panel already completed, order a Neonatal Bilirubin, and report results to MD.
    • ❑ Nursing Communication
      • T;N, Obtain umbilical cord and urine drug screen IF maternal history of drug abuse during pregnancy, no prenatal care, placental abruption, uterine rupture, or mother currently undergoing treatment for drug addiction.
    • ❑ Drug Screen Urine
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Umbilical Cord Drug Detection Panel
      • Routine collect, T;N, Nurse collect
    • ❑ CMV by PCR, Fluid
      • Fluid, Routine collect, Nurse collect, Urine
    • ❑ Misce Lab Test
      • Other, Routine collect, T;N, Nurse collect, Meconium Drug Screen
  • Medications
    • ❑ hepatitis B pediatric vaccine 10 mcg/0.5 mL intramuscular suspension
      • 10 mcg, IM, Once, PRN for Other (see comment)
    • ❑ erythromycin 0.5% ophthalmic ointment
      • 1 app, Oint-Opth, Eye-Both, Once
    • ❑ Vitamin K1
      • 1 mg, Syringe, IM, Once
    • ❑ ampicillin
      • mg, IV Piggyback, q8hr, 7 day(s), Infuse over 30 minute(s)
    • ❑ gentamicin
      • ❑ mg, IV Piggyback, Q24hr, 7 day(s), Infuse over 30 minute(s)
      • ❑ mg, IV Piggyback, q12hr, 7 day(s), Infuse over 30 minute(s)
    • ❑ zinc oxide 40% topical ointment
      • 1 app, Ointment, TOP, As Directed, PRN for Other (see comment)
    • ❑ glycerin infant rectal enema
      • 4 mL, Enema, Per rectum, Q24hr, PRN for Constipation
    • ❑ simethicone
      • 20 mg, Drops-Oral, Oral, TIDPC, PRN for Other (see comment)
    • ❑ hepatitis B immune globulin
      • 0.5 mL, Syringe, IM, Once
  • Patient Care
    • ❑ I&O POC
      • Strict record all intake, number of voids and stools.
    • ❑ Weight POC
      • T+1;0000, q24hr, Weigh Daily
    • ❑ Nursing Communication Order
      • Keep umbilical cord moist until determined whether or not umbilical catheter to be placed.
    • ❑ Nursing Communication Order
      • Remove cord clamp at 24 hours if dry.
    • ❑ Bathe Patient
      • When infant's condition stable and after 8-24 hours of age.
    • ❑ Blood Glucose POC
      • Once, Notify physician if blood glucose less than 50 mg/dL. Order "fasting glucose" if less than 30 mg/dL.
    • ❑ Notify Provider
      • If mother's history is positive for Hepatitis or Unknown - Obtain order for HBIG if not already ordered.
    • ❑ Hearing Screen
      • Prior to Discharge. Order a CMV by PCR, Fluid test if patient refers hearing screen.
    • ❑ Newborn Metabolic Screen
      • T+1;N, PKU by heelstick after 24 hours of age.
    • ❑ CCHD Screening
      • Congenital Heart Screening prior to discharge
  • Respiratory
    • ❑ Oxygen Titrate
      • Hood (Pedi Only), 93%, If baby not maintaining SaO2 above 93% in room air, start oxygen hood at 30% and increase as needed to maintain oxygen saturation above 93%.
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Head Circumference
      • On Admission
    • ❑ Head Circumference
      • QMonday
    • ❑ Blood Pressure
      • Obtain initial Blood Pressure in all extremities.
    • ❑ Blood Pressure
      • ❑ One Extremity every 8 hours
      • ❑ One Extremity every 24 hours
    • ❑ Temperature
      • ❑ Monitor every 15-30 minutes until stable, then every 4 hours.
      • ❑ Monitor every 15-30 minutes until stable, then every 2 hours.
      • ❑ Monitor every 15-30 minutes until stable, then every 8 hours.
    • ❑ Heart Rate
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 4 hours.
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 2 hours.
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 8 hours.
    • ❑ Respiratory Rate
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 4 hours.
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 2 hours.
      • ❑ Monitor continuously and document every 15-30 minutes until stable, then every 8 hours.
    • ❑ Pulse Oximetry Continuous
      • Monitor continuously and document every 15-30 minutes until stable, then every hour.
Suicide, Depression, Substance Abuse Plan of Care
  • Patient Care
    • ❑ Review Care Plan
      • Qshift - 12 hour, Review Suicide, Depression, Substance Abuse Plan of Care
SURG - General Surgery Post-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • ❑ Surgical
      • ❑ Medical/Acute, Medical
      • ❑ Telemetry, Cardiac Telemetry
      • ❑ Telemetry, Medical Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical, Anticipated LOS 1 midnight or less
      • ❑ Medical/Acute, Anticipated LOS 1 midnight or less, Medical
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 1 midnight or less, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ NPO, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Clear Liquid, Room Service Eligible: Yes, Advance to Regular as Tolerated.
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Low Residue, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Low Fat, Room Service Eligible: Yes
      • ❑ Room Service Eligible: Yes, Soft diet
  • IV Solutions
    • ❑ LR
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ NS
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
  • Laboratory
    • ❑ Transfuse Blood Product [IMH]
      • ❑ T;N, Routine, 2 Units PRBC
      • ❑ T;N, Routine, 1 Units PRBC
      • ❑ T;N, Routine, if hct < 27
      • ❑ T;N, Routine, if hgb<
      • ❑ T;N, Stat, Trauma Blood/ O Negative
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+1;0500
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500
  • Medications
    • Analgesics
      • ❑ Tylenol
        • 650 mg, Tab, Oral, q4hr, PRN Fever
      • ❑ !-Norco 5 mg-325 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q4hr, PRN Pain - Moderate
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN Pain - Moderate
      • ❑ morphine
        • ❑ 4 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 6 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 8 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 10 mg, Syringe, IV Push, q4hr, PRN Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
      • ❑ prochlorperazine
        • 5 mg, Vial, IV Push, q4hr, PRN for Nausea/Vomiting
      • ❑ famotidine
        • 20 mg, Vial, IV Push, BID
      • ❑ Protonix
        • ❑ 40 mg, Tab-EC, Oral, Once a Day (before meals)
        • ❑ 40 mg, Vial, IV Push, Once a Day (before meals)
    • DVT Prophylaxis
      • ❑ heparin
        • 5,000 unit(s), Injection, Subcutaneous, q12hr, Start date: T+1;0800
      • ❑ Lovenox
        • ❑ 40 mg, Syringe, Subcutaneous, Daily, Start date: T+1;0800
        • ❑ 30 mg, Syringe, Subcutaneous, Daily, Start date: T+1;0800
      • ❑ Arixtra
        • 2.5 mg, Syringe, Subcutaneous, Q24hr, Start date: T+1;0800
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other: __________
      • ❑ SCDs
        • ❑ Thigh High - Bilateral Legs
        • ❑ Knee High - Bilateral Legs
      • ❑ Ted Hose
        • ❑ Thigh High - Bilateral Legs
        • ❑ Knee High - Bilateral Legs
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other: __________
    • Sedatives
      • ❑ Restoril
        • 15 mg, Cap, Oral, HS, PRN Insomnia
      • ❑ Ambien
        • 5 mg, Tab, Oral, HS, PRN Insomnia
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • ❑ 6x/Day, Empty & Record Output q4hrs.
        • ❑ 3x/Day, Empty & Record Output q8hrs.
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, Dry dressing change daily, start post-op day #1.
        • ❑ T+1;0900, Daily, Wet to Dry dressing change daily, start post-op day #1.
        • ❑ T+1;0900, BID, Wet to Dry dressing change daily, start post-op day #1.
      • ❑ Dressing Change
        • ❑ T+1;0900, PRN, Dry dressing change PRN
        • ❑ T+1;0900, PRN, Wet to Dry dressing change PRN
    • Interventions
      • ❑ Nasogastric/Orogastric Tube Care
        • ❑ Low Intermittent Suction
        • ❑ Low Continuous Suction
        • ❑ Clamped
        • ❑ To Gravity
      • ❑ Nasogastric/Orogastric Tube Flush
        • ❑ PRN, 30ml Normal Saline
        • ❑ PRN, 60ml Normal Saline
      • ❑ Nasogastric/Orogastric Tube Clamping
        • 2 hours on, 2 hours off suction.
      • ❑ Nasogastric/Orogastric Tube Do NOT Manipulate
      • ❑ Nursing Communication Order
        • May reposition NG/OG tube if not draining.
    • Notification
      • ❑ Notify Provider Vital Signs
        • Temp > 100.5'F/38.0'C if not responsive to antipyretics., T > 38, HR > 150, HR < 50, SBP > 180, SBP < 90, DBP > 100, DBP < 45, RR > 30, RR < 12, O2 sat < 90
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • ❑ T+1;0600, Post-op Day #1 at 0600.
        • ❑ T+2;0600, Post-Op Day #2 at 0600
      • ❑ Straight Cath
        • PRN, per urinary retention algorithm
      • ❑ Reason Urinary Catheter Not Removed
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Monitoring of urinary output is required due to hemodynamic instability
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Inability to void
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Immobilization due to one or more of the following: Sedation/Paralysis or Pelvic/Hip fracture or orthopedic procedure necessitating immobilization
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Urinary incontinence or poor cooperation AND one or more of the following: Strict fluid input/output monitoring required or Skin breakdown in sacral/groin region
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term epidural catheter in place
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Bladder irrigation (e.g. for chemotherapy, blood clots)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term catheterization (greater than 28 days)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Patient refusal to remove catheter
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Other: ________
    • ❑ I&O POC
      • ❑ 3x/Day, Q8h
      • ❑ 6x/Day, Q4h
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
SURG - General Surgery Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, Room Service Eligible: No, after midnight
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, Room Service Eligible: No, except medications
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Hepatic Function Panel
      • Blood, Routine collect, T;N
    • ❑ Amylase Level
      • Blood, Routine collect, T;N
    • ❑ Lipase Level
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N, Nurse collect
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N
  • Medications
    • Antibiotics
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ neomycin
        • 1,000 mg, Tab, Oral, TID, Start date: T;1300, 3 dose(s)/time(s)
      • ❑ erythromycin
        • 1,000 mg, Tab-EC, Oral, TID, Antibiotic Indication Prophylaxis- surgical, Start date: T;1300, 3 dose(s)/time(s)
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ metroNIDAZOLE
        • 500 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Cipro
        • 400 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • Pre-Op
      • ❑ Clip Prep
        • Clip hair from surgical site in pre-op holding area.
      • ❑ Hibiclens Scrub
        • Scrub: Operative area with Hibiclens night before and morning of surgery x 3 minutes & wrap with sterile towel.
      • ❑ Betadine Scrub
        • Other See Special Instructions, Operative area with betadine morning of surgery x 10 minutes and wrap with sterile towel.
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
SURG - Outpatient Dental Post Procedure Order Set - IMH
  • Activity
    • ❑ 15 Minute Checks
      • Check oral hemorrhage every 15 minutes times 4 hours
  • Admission/Transfer/Discharge
    • ❑ Discharge Patient
      • Discharge when cleared by Anesthesiologist
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • Clear Liquid, Room Service Eligible: Yes, As tolerated
  • Medications
    • ❑ Vaseline topical ointment
      • 1 app, Gel, TOP, UD, for Other (see comment)
  • Vital Signs
    • ❑ Vital Signs POC
      • q30 minutes
SURG - Outpatient Dental Pre Procedure Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
  • Communication
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
SURG - Post-Operative Respiratory Order Set - IMH
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ 3 L, Nasal Cannula
      • ❑ 4 L, Nasal Cannula, Humidified
      • ❑ 5 L, Nasal Cannula, Humidified
      • ❑ 6 L, Nasal Cannula, Humidified
      • ❑ FIO2: 40%, Face Shield
      • ❑ FIO2: 50%, Face Shield
      • ❑ FIO2: 75%, Face Shield
      • ❑ FIO2: 100%, Face Shield
    • ❑ Titrate Oxygen
      • ❑ 0.92
      • ❑ 0.91
      • ❑ 0.9
      • ❑ 0.89
      • ❑ 0.88
      • ❑ 0.87
      • ❑ baseline
    • ❑ CPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: CPAP, HS
      • ❑ Mode: CPAP, PRN
      • ❑ Mode: CPAP, HS, May use home unit.
    • ❑ BIPAP
      • ❑ per Respiratory Therapy
      • ❑ Mode: BiPAP, HS
      • ❑ Mode: BiPAP, PRN
      • ❑ Mode: BiPAP, 4 hours on, 4 hours off
      • ❑ Mode: BiPAP, HS, May use home unit.
    • ❑ Ventilator Care
      • per Respiratory Therapy / MD order
    • ❑ Notify Provider Vital Signs
      • O2 sat < 92
SURG PED - Pediatric General Surgery Post-Operative Order Set - IMH
  • Activity
    • ❑ Ambulate with Assistance
      • ❑ BID
      • ❑ TID
    • ❑ Bedrest
      • Strict
  • Admission/Transfer/Discharge
    • ❑ Place in Extended Recovery
      • Pediatrics
    • ❑ Place in Observation
      • Pediatrics, Anticipated LOS 1 midnight or less
    • ❑ Admit to Inpatient
      • Pediatrics, Anticipated LOS 1 midnight or less
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • ❑ Age Appropriate | Regular, Room Service Eligible: Yes
      • ❑ Age Appropriate, Room Service Eligible: Yes, Diet as at home
      • ❑ NPO, Room Service Eligible: No
      • ❑ NPO, NPO except ice chips
      • ❑ NPO, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Custom (See Spec. Inst) | Clear Liquid, Pedialyte
      • ❑ Custom (See Spec. Inst), Breast Milk Only - No supplement with Formula
      • ❑ Custom (See Spec. Inst), Breast Milk - Supplement with Formula as at home
      • ❑ Custom (See Spec. Inst), Formula Feed - Specify Formula as at home
    • ❑ Diet Order
      • Custom (See Spec. Inst), Room Service Eligible: Yes, BRATTY - Banana, Rice, Applesauce, Toast, Tea and Yogurt.
    • ❑ Dietary Communication
      • Dietary Staff: Please enter BRATTY diet in CBord (Banana, Rice, Applesauce, Toast, Tea and Yogurt)
    • ❑ Dietary Communication
      • Regular Guest Trays
  • Laboratory
    • ❑ CBC
      • Blood, AM Draw collect, T+1;0500
    • ❑ Hemoglobin & Hematocrit
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT/INR
      • Blood, AM Draw collect, T+1;0500
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500
    • ❑ Urinalysis Complete
      • Urine, AM Draw collect, T+1;0500, Nurse Collect
    • ❑ Culture - Urine
      • Urine, AM Draw collect, T+1;0500, Nurse collect
  • Medications
    • Analgesics
      • ❑ ketorolac
        • ❑ 0.5 mg/kg, Vial, IV Push, q6hr, 24 hr
        • ❑ 15 mg, Vial, IV Push, q6hr, 24 hr
    • Analgesics: Opioids
      • ❑ acetaminophen-hydrocodone 325 mg-7.5 mg/15 mL oral solution
        • ❑ 5 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 10 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 15 mL, Soln-Oral, Oral, q4hr, PRN for Pain - Moderate
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • ❑ 0.25 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
        • ❑ 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
      • ❑ morphine
        • ❑ 0.05 mg/kg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 0.1 mg/kg, Syringe, IV Push, q4hr, PRN Pain - Severe
        • ❑ 0.05 mg/kg, Syringe, IV Push, q6hr, PRN Pain - Severe
        • ❑ 0.1 mg/kg, Syringe, IV Push, q6hr, PRN Pain - Severe
    • Antiemetics
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
        • ❑ 0.1 mg, Vial, IV Push, q6hr, PRN for Nausea/Vomiting
  • Patient Care
    • Drain Management
      • ❑ Record Drain Output
        • ❑ 6x/Day, Empty & Record Output q4hrs.
        • ❑ 3x/Day, Empty & Record Output q8hrs.
      • ❑ Dressing Change
        • Daily, Cleanse around drain insertion site with Normal Saline and apply dry dressing daily & prn.
      • ❑ Jackson-Pratt Drain to
        • bulb suction
    • Dressing Care
      • ❑ Dressing Change
        • ❑ T+1;0900, Daily, Dry dressing change daily, start post-op day #1.
        • ❑ T+1;1000, qShift - 8 hour, Normal Saline wet to dry
      • ❑ Triple Antibiotic
        • 1 app, Ointment, TOP, Daily
    • Notification
      • ❑ Notify Provider
        • Newborns to 12 months: HR < 70 or >180, Resp. Rate <30 or > 80, O2 sat < 92%.
      • ❑ Notify Provider
        • 12 months to 3 years: HR < 70 or > 150, Resp. Rate < 30 or > 60, O2 SAT < 92%.
      • ❑ Notify Provider
        • 3 yrs to 5 yrs: HR < 60 or > 110, Resp Rate < 23 or > 60, O2 SAT < 92%.
      • ❑ Notify Provider
        • 5 yrs to 10 yrs: HR < 60 or >110, Resp. Rate < 20 or > 50, O2 SAT < 92%.
      • ❑ Notify Provider
        • 10 yrs to 17 yrs: HR < 50 or > 100, Resp Rate < 16 or > 40, O2 SAT < 92%
    • Patient Education
      • ❑ Patient Education
        • Patient and family education on exposure to 2nd hand smoke if applicable
    • ❑ I&O POC
      • ❑ 3x/Day, Strict I&O Q8h
      • ❑ 6x/Day, Strict I&O Q4h
    • ❑ Nursing Communication Order
      • Enter Consult to Anesthesia if unable to start pediatric IV
  • Respiratory
    • ❑ Incentive Spirometry RT
      • q2hr-WA
    • ❑ Pulse Oximetry Continuous
      • ❑ Continuous
      • ❑ While asleep and with vital signs
    • ❑ Oxygen Therapy
      • ❑ 0.5 L, Blow-by
      • ❑ 1 L, Blow-by
      • ❑ 1.5 L, Blow-by
      • ❑ 2 L, Blow-by
      • ❑ 0.5 L, Nasal Cannula
      • ❑ 1 L, Nasal Cannula
      • ❑ 1.5 L, Nasal Cannula
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen Titrate
      • Keep sats greater than 92%
  • Resuscitation Status
    • ❑ Resuscitation Status
      • Full Resuscitation
  • Vital Signs
    • ❑ Weight POC
      • ❑ Once a Day (before meals)
      • ❑ qWeek
    • ❑ Vital Signs POC
      • q1hr, for 4 hr
    • ❑ Vital Signs POC
      • q4hrVS, for 72 hr
    • ❑ Vital Signs POC
      • ❑ BIDAC
      • ❑ qShift 8 hr VS
      • ❑ q4hrVS
      • ❑ 12x/Day, q2hr
SURG POD - Podiatry Outpatient Surgery Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Condition
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diet
    • ❑ Diet Order
      • T+1;0001 | NPO, NPO after midnight
  • Laboratory
    • ❑ CBC
      • Blood, Routine collect, T;N
    • ❑ BMP
      • Blood, Routine collect, T;N
    • ❑ CMP
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
    • ❑ hCG Qual Urine
      • Urine, Routine collect, T;N
  • Medications
    • Antibiotic Therapy
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • Patient Education
      • ❑ Patient Education
        • Give DVT patient educational information to patient at registration.
      • ❑ Patient Education
        • Limit blood thinners to 24 hours prior to surgery. Ex. Aspirin
    • Pre-Op
      • ❑ Hibiclens Scrub
        • Instruct the patient to scrub surgical area with Hibiclens 2 days prior to surgery.
      • ❑ Hibiclens Scrub
        • Scrub with Hibiclens in pre-op.
    • ❑ Nursing Communication Order
      • X-Ray op-site- 2 copies of actual x-ray (not true report) available in OR.
    • ❑ Nursing Communication Order
      • Ask patient if taking antibiotic prescribed by physician - make sure they are taking the medicine and document in Medical Record.
Surgical Drains Plan of Care
  • Patient Care
    • ❑ Drain Care
      • qShift - 8 hour
    • ❑ Drain Flush
      • As ordered
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Surgical Drains Plan of Care
 T
Testing - Amniocentesis Order Set - IMH
  • Communication
    • ❑ Nursing Communication
      • Have amniocentesis tray/kit at the bedside
    • ❑ Nursing Communication
      • Perform a pre-procedure time out
    • ❑ Message Lab
      • Other, Amniocentesis, Fetal Lung Maturity being collected
  • Diagnostic Tests
    • ❑ US OB 14 Weeks or Greater Limited Exam
      • Fetal Lung Maturity, 0
  • Laboratory
    • ❑ Misce Lab Test
      • Other, Stat collect, T;N, Nurse collect, Fetal Lung Maturity
    • ❑ L/S Ratio Amniotic Fluid
      • Fluid, Routine collect, T;N
  • Patient Care
    • ❑ Procedure / Consent
      • Amniocentesis
    • ❑ Fetal monitoring
      • Prior to Anmiocentesis - Continuous for 20 minutes. Post Amniocentesis procedure - Monitor for at least 30 mins and until FHR is reactive.
  • Vital Signs
    • ❑ Vital Signs POC
      • PRN, Before and after procedure
Testing - Non-Stress Test (NST) Order Set - IMH
  • Diagnostic Tests
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Non-Stress Test
      • T;N
    • ❑ BP Fetal Contract Stress Test
      • T;N
    • ❑ OB Fetal Bio Profile with Non-Stress Test
      • T;N
  • Patient Care
    • ❑ Vaginal exam
      • T;N, PRN, If no bleeding
    • ❑ Urine Dipstick POC
      • T;N
    • ❑ Notify Provider
      • T;N, At the completion of NST and/or PRN
  • Vital Signs
    • ❑ Vital Signs POC
      • T;N, On arrival and PRN
    • ❑ Vital Signs POC
      • PRN
Testing - Triage Order Set - IMH
  • Diet
    • ❑ Diet Order
      • ❑ NPO, NPO except ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes
  • IV Solutions
    • ❑ NS Bolus
      • 1,000 mL, IV, Once, NOW, 1 dose(s)/time(s)
    • ❑ LR
      • 1,000 mL, 125mL/hr
    • ❑ magnesium sulfate 40 gm/1000 mL IV Inj
      • 1,000 mL, Routine, 50mL/hr
      • 40 gm
  • Laboratory
    • ❑ Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s)
      • Amniotic Fluid, Stat collect, T;N
    • ❑ Fetal Fibronectin
      • Swab, Stat collect, T;N
    • ❑ CBC
      • Blood, Stat collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Stat collect, T;N
    • ❑ CMP
      • Blood, Stat collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Stat collect, T;N
    • ❑ Culture - Urine
      • Urine, Routine collect, T;N
    • ❑ Drug Screen Urine
      • Urine, Stat collect, T;N
    • ❑ Protein Urine
      • Urine, Stat collect, T;N
    • ❑ Group B Strep Culture
      • Micro Specimen, Routine collect, T;N
    • ❑ Lab Misce Test
      • Stat collect, T;N, Kleihauer-Betke test
  • Medications
    • Analgesics
      • ❑ Tylenol
        • ❑ 650 mg, Tab, Oral, Once, NOW
        • ❑ 325 mg, Tab, Oral, Once, NOW
      • ❑ morphine
        • ❑ 1 mg, Syringe, IV Push, Once
        • ❑ 2 mg, Syringe, IV Push, Once
        • ❑ 10 mg, Syringe, IM, Once
    • Antiemetics
      • ❑ Phenergan
        • ❑ 25 mg, Tab, Oral, Once
        • ❑ 25 mg, Vial, IM, Once
        • ❑ 25 mg, Vial, IV Push, Once
        • ❑ 12.5 mg, Vial, IV Push, Once
      • ❑ !-Zofran
        • ❑ 4 mg, Tab-Dispers, Oral, Once
        • ❑ 4 mg, Vial, IV Push, Once
    • Tocolytic Agents
      • ❑ !-Brethine
        • 0.25 mg, Injection, Subcutaneous, Once, NOW
      • ❑ !-Procardia
        • 10 mg, Cap, Oral, Once, NOW
      • ❑ Procardia XL
        • 30 mg, Tab-24, Oral, Once, NOW
      • ❑ Indocin
        • 50 mg, Cap, Oral, Once, NOW
  • Patient Care
    • ❑ Fetal monitoring
      • ❑ Continuous
      • ❑ Intermittent, recheck cervix in 1 hour
      • ❑ Intermittent, recheck cervix in 2 hours
    • ❑ Urine Dipstick POC
      • On Arrival
    • ❑ Vaginal exam
      • Sterile Vaginal Exam: PRN unless vaginal bleeding
    • ❑ Nursing Communication
      • Nitrazine POC if needed to determine status of membranes
  • Vital Signs
    • ❑ Vital Signs POC
      • ❑ T;N, pulse, respiration, and blood pressure every 15 mins
      • ❑ T;N, pulse, respiration, and blood pressure every 30 mins
      • ❑ T;N, pulse, respiration, and blood pressure every 1 hour
    • ❑ Temperature
      • T;N, Once
Therapeutic Phlebotomy IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Once, Lab Collect
    • ❑ Therapeutic Phlebotomy
      • Blood
Tobramycin IV - Pharmacy to Dose - IMH
  • Medications
    • ❑ Tobramycin IV - Pharmacy to Dose.
      • Pharmacy to Dose., IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Tobramycin IV - Pharmacy to Dose.
Tobramycin IV once daily - Pharmacy to Dose - IMH
  • Medications
    • ❑ Tobramycin IV once daily - Pharmacy to Dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Tobramycin IV once daily - Pharmacy to Dose.
Tracheostomy Plan of Care
  • Patient Care
    • ❑ Tracheostomy Care
      • Qshift - 12 hour
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Tracheostomy Plan of Care
TRANSFUSE - Cryoprecipitate 1 Unit Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, T;N, Lab Collect
    • ❑ 1 Unit Cryoprecipitate for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • 1 Unit Cryoprecipitate (1 Unit = 5 pooled units)
TRANSFUSE - FFP 2 Units Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ 2 Units FFP for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • q30min, for 2 dose(s)/time(s), 2 Units FFP
TRANSFUSE - FFP 4 Units Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ 4 Units FFP for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • q30min, for 4 dose(s)/time(s), 4 Units FFP
TRANSFUSE - Leuko Reduced Packed Red Cells 2 Units Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Crossmatch 2 Units for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • q30min, for 2 dose(s)/time(s), 2 Units Packed Red Blood Cells
TRANSFUSE - Leuko Reduced Packed Red Cells 4 Units Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ Crossmatch 4 Units for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • q30min, for 4 dose(s)/time(s), 4 Units Packed Red Blood Cells
TRANSFUSE - Plateletpheresis, Leukoreduced 1 Unit Transfusion Order Set - IMH
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood, Routine collect, Collected, T;N, Lab Collect
    • ❑ 1 Unit Leukoreduced Platelets for Transfusion
      • Blood, Routine collect
    • ❑ Transfuse Blood Product [IMH]
      • 1 Pack Leukoreduced Plateletpheresis
Transfusion Reaction IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ .Transfusion Reaction Workup
      • Blood
Tube for Blood Bank IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ Tube for Blood Bank
      • Blood
Type and Screen IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ .Type and Screen
      • Blood, T;N, Once
Type, Screen & Hold IRDL
  • Laboratory
    • ❑ Blood Bank Orders
      • Blood
    • ❑ Type/Screen/Hold
      • Blood
 U
Urinary Incontinence Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Urinary Incontinence Plan of Care
Urinary Retention Plan of Care
  • Patient Care
    • ❑ Review Plan of Care
      • Qshift - 12 hour, Review Urinary Retention Plan of Care
Urine Electrolytes Random IRDL
  • Laboratory
    • ❑ Potassium Urine
      • Urine, Nurse Collect
    • ❑ Sodium Urine
      • Urine, Nurse Collect
    • ❑ Urine Chloride
      • Urine, Nurse Collect
 V
Vancomycin IV - Pharmacy to Dose - IMH
  • Medications
    • ❑ Vancomycin IV - Pharmacy to dose.
      • Pharmacy to Dose, IV Piggyback, See Instructions, PRN for Other (see comment), Routine, 7 day(s)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Vancomycin IV - Pharmacy to dose.
VAS SURG - ICU Post-Operative Order Set - IMH
  • Activity
    • ❑ Overbed Frame / Trapeze
      • If status is post amputation
    • ❑ Cardiac Cath site check
      • Pre Sheath Removal assessments every hour (BP, Pulse, Groin site for hematoma, lower extremity for neurovascular changes)
    • ❑ Cardiac Cath site check
      • Post Sheath Removal assessments every 15 minutes X 4, every 30 minutes X 2, then every hour X 4, then every 4 hours (BP, Pulse, Groin site for hematoma, lower extremity for neurovascular changes)
    • ❑ Elevate Head of Bed
      • ❑ Constant order, Elevate no more than 30 degrees
      • ❑ Constant order, Elevate head of bed at or above 30 degrees for VAP preventions
      • ❑ Constant order, Elevate head of bed at or above 45 degrees for status post CEA
    • ❑ Bedrest
      • ❑ with Right leg straight for _____ hours. May log roll.
      • ❑ with Left leg straight for _____ hours. May log roll.
    • ❑ Bedrest
      • ❑ for ____ hours, then Up with Assistance
      • ❑ for ____ hours, then Up to chair twice daily
      • ❑ Lie flat for 6 hours. Call physician to see patient before raising HOB to 45 degrees (Status post CEA) for ____ hours then activity level ________
      • ❑ due to _____
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
    • ❑ Transfer Patient to
      • ❑ Critical Care
      • ❑ Intermediate Care, Progressive Care Unit
    • ❑ Place in Observation
      • ❑ Critical Care, Anticipated LOS 1 midnight or less
      • ❑ Intermediate Care, Anticipated LOS 1 midnight or less, Progressive Care Unit
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diagnostic Tests
    • ❑ EKG
      • T+1;0800, Routine, in the am
    • ❑ EKG
      • T+1;0800, Timed, qAM, for 3 day(s)
    • ❑ XR Chest 1 View Portable
      • T+1;0700, Timed, Daily
    • ❑ XR Chest 1 View Portable
      • Routine
    • ❑ XR Chest 1 View Portable
      • T+1;0700, Timed, Once
  • Diet
    • ❑ Diet Order
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes, NPO except ice chips
      • ❑ NPO, Room Service Eligible: Yes, NPO except sips and ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Mechanical soft
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Nectar Thick
  • IV Solutions
    • Vasopressors
      • ❑ esmolol 2500 mg/ 250 mL IV PM
        • 2,500 mg
        • 250 mL, IV, Routine, See Comments
      • ❑ nitroglycerin drip
        • 50 mg
        • 250 mL, IV, Routine, See Comments
      • ❑ DOPamine drip
        • 800 mg
        • 500 mL, IV, Routine, See Comments
      • ❑ phenylephrine 50 mg/NS 250 mL
        • 250 mL, IV, Routine, See Comments
        • 50 mg
    • ❑ Dextrose 5% with 0.9% NaCl
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ Arterial / CVP Line Flush
      • 500 mL, IV, Routine, 3 mL/hr
      • 1,000 unit(s)
  • Laboratory
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Lactic Acid
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
    • ❑ Basic Metabolic Panel
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
    • ❑ CBC
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
    • ❑ CBC w/Auto Diff
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
    • ❑ Magnesium Level
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
    • ❑ Phosphorus Level
      • ❑ Blood, AM Draw collect, T+1;0500, Daily
      • ❑ Blood, AM Draw collect, T;1700, BID
  • Medications
    • DVT Prophylaxis
      • ❑ Reason Surgical Care VTE Mechanical Prophylaxis Not Ordered
        • ❑ Bilateral amputations lower extremities
        • ❑ Bilateral lower extremity trauma
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ Patient refused
        • ❑ Other: _____
      • ❑ Reason Surgical Care VTE Pharmacological Prophylaxis Not Ordered
        • ❑ Active Bleeding
        • ❑ Bleeding Risk
        • ❑ Cont. IV heparin 24 hrs pre/post surg
        • ❑ GI bleed
        • ❑ Hemorrhage
        • ❑ Patient refusal
        • ❑ Thrombocytopenia
        • ❑ Other: _____
    • Gastrointestinal Agents
      • ❑ pantoprazole
        • ❑ 40 mg, Tab-EC, Oral, Daily
        • ❑ 40 mg, Tab-EC, Oral, BID
        • ❑ 40 mg, Vial, IV Push, Daily
        • ❑ 40 mg, Vial, IV Push, BID
      • ❑ esomeprazole
        • ❑ 40 mg, Packet, Oral, Daily
        • ❑ 40 mg, Packet, Oral, BIDAC
    • Nausea
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, IV Push, q6hr, PRN for Nausea/Vomiting
    • Other Meds
      • ❑ metoprolol
        • 5 mg, Vial, IV Push, q6hr, PRN Other (see comment)
      • ❑ hydrALAZINE
        • mg, Vial, IV Push, PRN for Other (see comment)
    • Pain Control
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q6hr, PRN for Pain - Mild
      • ❑ morphine
        • 2 mg, Syringe, IV Push, q2hr, PRN for Pain - Moderate
      • ❑ morphine
        • 4 mg, Syringe, IV Push, q2hr, PRN for Pain - Severe
    • Respiratory Medication
      • ❑ albuterol
        • 2.5 mg, Soln-Inh, NEB, q4hr, PRN Shortness of Breath or wheezing
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
    • Scheduled Medications
      • ❑ aspirin
        • ❑ 81 mg, Tab-Chew, Chewed, Daily
        • ❑ 325 mg, Tab, Oral, Daily
      • ❑ clopidogrel
        • 75 mg, Tab, Oral, Daily
  • Patient Care
    • Dressing Care
      • ❑ Dressing Change
        • qShift - 8 hour, NS wet to dry
    • Interventions
      • ❑ Nasogastric/Orogastric Tube Care
        • Low Intermittent Suction
      • ❑ Nasogastric/Orogastric Tube Care
        • Low Intermittent Suction, 6x/Day, Irrigate blue port of NG with 10 mL of air every 4 hours
      • ❑ Nasogastric/Orogastric Tube Flush
        • 6x/Day, Irrigate NG with 30 mL water every 4 hours
      • ❑ Dobhoff Care
        • PRN, Irrigate Dobhoff tube as needed
    • Notification
      • ❑ Notify Provider Vital Signs
        • ❑ Temp less than 96.8 F / 36.0 C or greater than 101.5 F / 38.6 C, HR > 110, HR < 60, SBP > 180, SBP < 100, DBP > 90, DBP < 50, MAP < 65, RR > 30, RR < 8, O2 sat < 93, UO < 30mL/hr for 2hr
        • ❑ Status Post CEA: Temp less than 96.8 F / 36.0 C or greater than 101.5 F / 38.6 C, HR > 110, HR < 60, SBP > 150, SBP < 100, DBP > 90, DBP < 50, MAP < 65, RR > 30, RR < 8, O2 sat < 93, UO < 30mL/hr for 2hr
    • Urinary Catheter Management
      • ❑ Discontinue Foley Cath
        • ❑ Post Op Day 1
        • ❑ Post Op Day 2
      • ❑ Reason Urinary Catheter Not Removed
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Monitoring of urinary output is required due to hemodynamic instability
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Inability to void
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Immobilization due to one or more of the following: Sedation/Paralysis or Pelvic/Hip fracture or orthopedic procedure necessitating immobilization
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Urinary incontinence or poor cooperation AND one or more of the following: Strict fluid input/output monitoring required or Skin breakdown in sacral/groin region
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term epidural catheter in place
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Bladder irrigation (e.g. for chemotherapy, blood clots)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Long-term catheterization (greater than 28 days)
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Patient refusal to remove catheter
        • ❑ Other See Special Instructions, Reason: Other (specify in Special Instructions), Other: _____
    • ❑ Warming Measures
      • for temp less than 97°F / 36.1°C
    • ❑ Elevate Up on Pillows
      • Constant order, Calves on pillow to keep heels off bed
    • ❑ Apply Heel Lift Boots
      • Constant order, Bilaterally
    • ❑ I&O POC
      • Strict
    • ❑ Weight POC
      • Once a Day (before meals), Weigh daily
    • ❑ Patient Education
      • Smoking Cessation Counseling if applicable
  • Respiratory
    • ❑ Oxygen Therapy
      • ❑ Face Shield
      • ❑ 2 L, Nasal Cannula
    • ❑ Oxygen - Wean per Nurse
      • On post operative day 1
    • ❑ Incentive Spirometry RT
      • q1hr-WA, and as needed
    • ❑ Turn Cough Deep Breathe
      • 12x/Day, every 2 hours while awake and as needed
    • ❑ ABG Draw (Resp)
      • T;N
    • ❑ ABG Draw (Resp)
      • T+1;0500, q24hr
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • Post Operative vital signs and hematoma check every 15 minutes X 4, then every 30 minutes X 4, then every hour.
    • ❑ Neurovascular Checks
VAS SURG - Non-ICU Post-Operative Order Set - IMH
  • Activity
    • ❑ Overbed Frame / Trapeze
      • If status is post ambulation
    • ❑ Cardiac Cath site check
      • Pre Sheath Removal assessments every hour (BP, Pulse, Groin site for hematoma, lower extremity for neurovascular changes)
    • ❑ Cardiac Cath site check
      • Post Sheath Removal assessments every 15 minutes X 4, every 30 minutes X 2, then every hour X 4, then every 4 hours (BP, Pulse, Groin site for hematoma, lower extremity for neurovascular changes)
    • ❑ Elevate Head of Bed
      • Constant order, Elevate no more than 30 degrees
    • ❑ Bedrest
      • ❑ with Right leg straight for _____ hours. May log roll.
      • ❑ with Left leg straight for _____ hours. May log roll.
    • ❑ Bedrest
      • ❑ for ____ hours, then Up with Assistance
      • ❑ for ____ hours, then Up to chair twice daily
  • Admission/Transfer/Discharge
    • ❑ Admit to Inpatient
      • ❑ Surgical
      • ❑ Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Transfer Patient to
      • ❑ Surgical
      • ❑ Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
    • ❑ Place in Observation
      • ❑ Surgical
      • ❑ Telemetry
      • ❑ Intermediate Care, Progressive Care Unit
      • ❑ Critical Care
  • Consults
    • ❑ Consult to Anesthesia
      • For post-op pain management, 0
  • Diagnostic Tests
    • ❑ XR Chest 1 View Portable
      • Routine
  • Diet
    • ❑ Diet Order
      • ❑ NPO, Room Service Eligible: Yes
      • ❑ NPO, Room Service Eligible: Yes, NPO with ice chips
      • ❑ Clear Liquid, Room Service Eligible: Yes
      • ❑ Full Liquid, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Mechanical soft
      • ❑ Bland, Room Service Eligible: Yes
      • ❑ Renal, Room Service Eligible: Yes
      • ❑ Cardiac, Room Service Eligible: Yes
      • ❑ Diabetic, Room Service Eligible: Yes, Diabetic, 1800 kcal
      • ❑ Regular, Room Service Eligible: Yes
      • ❑ Regular, Room Service Eligible: Yes, Nectar Thick
  • IV Solutions
    • ❑ Dextrose 5% with 0.9% NaCl
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
      • ❑ 1,000 mL, IV, 200 mL/hr
      • ❑ 1,000 mL, IV, 250 mL/hr
      • ❑ 1,000 mL, IV, 75 mL/hr
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 10 mL/hr
    • ❑ Dextrose 5% and 0.45% Sodium Chloride
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ LR
      • ❑ 1000 mL, IV, 125 mL/hr
      • ❑ 1000 mL, IV, 100 mL/hr
      • ❑ 1000 mL, IV, 75 mL/hr
      • ❑ 1000 mL, IV, 50 mL/hr
      • ❑ 1000 mL, IV, 10 mL/hr
    • ❑ KCl 20 mEq in D5-1/2 NS 1000 mL Premix
      • mL/hr
  • Laboratory
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Magnesium Level
      • Blood, Routine collect, T;N
    • ❑ Phosphorus Level
      • Blood, Routine collect, T;N
    • ❑ PT
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500
    • ❑ CBC w/Auto Diff
      • Blood, AM Draw collect, T+1;0500
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500
    • ❑ PT
      • Blood, AM Draw collect, T+1;0500
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500
    • ❑ Comprehensive Metabolic Panel
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ Basic Metabolic Panel
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ CBC w/Auto Diff
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ Magnesium Level
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ Phosphorus Level
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ PT
      • Blood, AM Draw collect, T+1;0500, Daily
    • ❑ PTT
      • Blood, AM Draw collect, T+1;0500, Daily
  • Medications
    • Constipation
      • ❑ bisacodyl
        • 10 mg, Supp, Per rectum, Q24hr, PRN for Constipation
    • Nausea
      • ❑ ondansetron
        • ❑ 4 mg, Tab-Dispers, Oral, q6hr, PRN for Nausea/Vomiting
        • ❑ 4 mg, IV Push, q6hr, PRN for Nausea/Vomiting
    • Pain Control
      • ❑ morphine
        • ❑ 2 mg, Syringe, IV Push, q1hr, PRN for Pain - Severe
        • ❑ 2 mg, Syringe, IV Push, q2hr, PRN for Pain - Severe
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 1 tab(s), Tab, Oral, q4hr, PRN for Pain - Mild
      • ❑ acetaminophen-hydrocodone 325 mg-5 mg oral tablet
        • 2 tab(s), Tab, Oral, q4hr, PRN for Pain - Moderate
    • Respiratory Medication
      • ❑ albuterol
        • 2.5 mg, Soln-Inh, NEB, q4hr, PRN for Shortness of Breath or wheezing
      • ❑ albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
        • 3 mL, Soln, NEB, q4hr, PRN for Shortness of Breath or wheezing
    • Scheduled Medications
      • ❑ aspirin
        • ❑ 81 mg, Tab-Chew, Chewed, Daily
        • ❑ 325 mg, Tab, Oral, Daily
      • ❑ clopidogrel
        • 75 mg, Tab, Oral, Daily
  • Patient Care
    • Dressing Care
      • ❑ Steri-Strips
        • Steri-strip Care
      • ❑ Dressing Change
        • qShift - 8 hour, NS wet to dry
    • Interventions
      • ❑ Nasogastric/Orogastric Tube Care
        • Low Intermittent Suction
      • ❑ Nasogastric/Orogastric Tube Care
        • Low Intermittent Suction, 6x/Day, Irrigate blue port of NG with 10 mL of air every 4 hours
      • ❑ Nasogastric/Orogastric Tube Flush
        • 6x/Day, Irrigate NG with 30 mL water every 4 hours
      • ❑ Dobhoff Care
        • PRN, Dobhoff tube as needed
    • Notification
      • ❑ Notify Provider Vital Signs
        • ❑ Temp less than 96.8 F / 36.0 C or greater than 101.5 F / 38.6 C, HR > 110, HR < 60, SBP > 180, SBP < 100, DBP > 90, DBP < 50, MAP < 65, RR > 30, RR < 8, O2 sat < 93, UO < 30mL/hr for 2hr
        • ❑ Status Post CEA: Temp less than 96.8 F / 36.0 C or greater than 101.5 F / 38.6 C, HR > 110, HR < 60, SBP > 150, SBP < 100, DBP > 90, DBP < 50, MAP < 65, RR > 30, RR < 8, O2 sat < 93, UO < 30mL/hr for 2hr
    • Urinary Catheter Management
      • ❑ Insert Foley Catheter
        • Indwelling, Foley Catheter to straight drain
      • ❑ Catheter Care POC
        • T;N, Daily
      • ❑ Catheter Care POC
        • PRN
      • ❑ Discontinue Foley Cath
        • ❑ Post Op Day 1
        • ❑ Post Op Day 2
    • ❑ Elevate Up on Pillows
      • Constant order, Calves on pillow to keep heels off bed
    • ❑ Apply Heel Lift Boots
      • Constant order, Bilaterally
    • ❑ I&O POC
      • ❑ 6x/Day, Strict
      • ❑ 3x/Day, Strict
    • ❑ Weight POC
      • Once a Day (before meals), Weigh daily
    • ❑ Check pulses
      • 6x/Day, to extremities
  • Respiratory
    • ❑ Oxygen Titrate
      • Maintain oxygen to keep saturation greater than or equal to 93%
    • ❑ Oxygen Therapy
      • ❑ 2 L, Nasal Cannula
      • ❑ Face Shield
    • ❑ Incentive Spirometry RT
      • q1hr-WA, and as needed
    • ❑ Turn Cough Deep Breathe
      • 12x/Day, every 2 hours while awake and as needed
  • Resuscitation Status
    • ❑ Resuscitation Status
      • ❑ Full Resuscitation
      • ❑ Do Not Resuscitate
      • ❑ Do Not Intubate
      • ❑ Do Not Perform Chest Compression
      • ❑ Do Not Treat Arrhythmias
      • ❑ Do Not Defibrillate
  • Vital Signs
    • ❑ Vital Signs POC
      • q4hrVS, Check vital signs and for hematoma
    • ❑ Vital Signs POC
      • q4hrVS, Post Operative vital signs and hematoma check every 15 minutes X 4, then every hour X 8, then q4hrVS
    • ❑ Neurovascular Checks
      • 6x/Day, For Carotid Endarterectomy: Neurovascular checks include: difficulty breathing, speaking, swallowing, swelling or evidence of bleeding, decrease mental status, sensory changes, visual changes, or voice changes.
VAS SURG - Pre-Operative Order Set - IMH
  • Admission/Transfer/Discharge
    • ❑ Outpatient Surgery
      • Surgical
    • ❑ Admit to Inpatient
      • ❑ Surgical, Anticipated LOS 2 midnights or more
      • ❑ Medical/Acute, Anticipated LOS 2 midnights or more, Medical
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Cardiac Telemetry
      • ❑ Telemetry, Anticipated LOS 2 midnights or more, Medical Telemetry
      • ❑ Intermediate Care, Anticipated LOS 2 midnights or more, Progressive Care Unit
      • ❑ Critical Care, Anticipated LOS 2 midnights or more
  • Condition
    • ❑ Communication Order
      • T;N, History and Physical Dictation #
  • Consults
    • ❑ Consult to Anesthesia
      • ❑ For Continuous Peripheral Nerve Block pain management
      • ❑ For Continuous Epidural Post Op pain management
      • ❑ For post-op pain management, 0
  • Diagnostic Tests
    • ❑ XR Chest 2 Views
      • T;N, Routine
    • ❑ ECG
      • If results not current and available within previous 72 hours.
  • Diet
    • ❑ Diet Order
      • ❑ T+1;0001 | NPO, Room Service Eligible: No, NPO after midnight except medications
      • ❑ NPO, Room Service Eligible: No, except medications
      • ❑ NPO, Room Service Eligible: No
    • ❑ Diet Order
      • Clear Liquid, Until Midnght
  • IV Solutions
    • ❑ Sodium Chloride 0.9%
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
    • ❑ Sodium Chloride 0.45%
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
    • ❑ LR
      • ❑ 1,000 mL, IV, 50 mL/hr
      • ❑ 1,000 mL, IV, 125 mL/hr
      • ❑ 1,000 mL, IV, 100 mL/hr
  • Laboratory
    • ❑ CBC w/Auto Diff
      • Blood, Routine collect, T;N
    • ❑ Basic Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ Comprehensive Metabolic Panel
      • Blood, Routine collect, T;N
    • ❑ PT/INR
      • Blood, Routine collect, T;N
    • ❑ PTT
      • Blood, Routine collect, T;N
    • ❑ Urinalysis Complete
      • Urine, Routine collect, T;N, Nurse Collect
  • Medications
    • Beta-Adrenergic Blockers
      • ❑ metoprolol
        • ❑ 12.5 mg, Tab, Oral, 2x/Day
        • ❑ 25 mg, Tab, Oral, 2x/Day
        • ❑ 50 mg, Tab, Oral, 2x/Day
    • Bowel Preparation
      • ❑ magnesium citrate
        • 300 mL, Oral, Once, Start date: T;2000
      • ❑ Enema
        • T;2000, Soap Suds
      • ❑ sodium biphosphate-sodium phosphate
        • 133 mL, Enema, Per rectum, Once, Start date: T;2000
      • ❑ polyethylene glycol 3350 with electrolytes
        • 4,000 mL, Oral, Once, Start date: T;1700
    • Other
      • ❑ acetylcysteine
        • 1,200 mg, Oral, BID, 2 dose(s)/time(s)
      • ❑ acetylcysteine
        • 1,200 mg, Oral, BID, Start date: T+1;N, 2 dose(s)/time(s)
      • ❑ Sodium Bicarbonate 150 mEq/D5W 1000 mL
        • 150 mEq
        • 1,000 mL, IV, Routine, Start date: T+1;0001, 75 mL/hr
      • ❑ Sodium Chloride 0.9%
        • ❑ 1,000 mL, IV, 75 mL/hr
        • ❑ 1,000 mL, IV, 100 mL/hr
        • ❑ 1,000 mL, IV, 125 mL/hr
    • Other Meds
      • ❑ aspirin
        • ❑ 81 mg, Tab-Chew, Chewed, On Call, Start date: T+1;N
        • ❑ 325 mg, Tab, Oral, On Call, Start date: T+1;N
      • ❑ chlorhexidine 0.12% mucous membrane liquid
        • 15 mL, Mouthwash, Oral, Once, Start date: T;2200
      • ❑ chlorhexidine 0.12% mucous membrane liquid
        • 15 mL, Mouthwash, Oral, On Call, Start date: T+1;N
    • Prophylactic Antibiotics
      • ❑ ceFAZolin.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ Vancomycin IV - Pharmacy to dose.
        • Per Weight, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
      • ❑ clindamycin
        • 900 mg, IV Piggyback, On Call, Antibiotic Indication Prophylaxis- surgical
  • Patient Care
    • Pre-Op
      • ❑ Hibiclens Scrub
        • Scrub: Shower or wash with chlorhexidine cleanser (Hibiclens) the evening before surgery and the morning of surgery.
    • ❑ Patient Education
      • Provide instructions on incentive spirometry
    • ❑ Patient Education
      • Provide _____ preoperative instruction
  • Vital Signs
    • ❑ Height & Weight POC
      • Obtain before procedure
 W
Warfarin (Coumadin) - Pharmacy to Dose. - IMH
  • Communication
    • ❑ Patient Education
      • Review Coumadin Education with patient / family with first dose of Coumadin.
  • Laboratory
    • ❑ INR
      • Blood, Routine collect, T;N, Once, Lab Collect, If not already ordered or resulted in prev 24 hrs
    • ❑ CBC
      • Blood, Routine collect, T;N, Once, Lab Collect, If not already ordered or resulted in prev 24 hrs
    • ❑ Notify Provider Laboratory Results
      • See Comments
    • ❑ Pregnancy Test Qual Urine
      • Urine, Routine collect, T;N
    • ❑ INR
      • Blood, AM Draw collect, T+1;0500, Daily, Lab Collect
  • Medications
    • ❑ Warfarin (Coumadin) - Pharmacy to Dose.
      • Pharmacy to Dose., Oral, See Instructions, PRN for Other (see comment)
  • Patient Care
    • ❑ Pharmacy Communication Order.
      • Daily, Warfarin (Coumadin) - Pharmacy to Dose.
    • ❑ Notify Provider Laboratory Results
      • if INR > 3.5 unless otherwise ordered.
    • ❑ Nursing Communication Order
      • Order a one-time Pregnancy Test Qual Urine if patient is female and not currently taking Coumadin, and is less than 55 years of age, and has no history of hysterectomy. Call physician and pharmacy if test is positive.
 ENDPowerPlan Count: 418  Item Count: 6,633

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



This site is intended for the staff of Iredell Memorial Hospital.
While others may view accessible pages, Iredell Memorial Hospital makes no warranty, express or implied,
as to the use of this information outside of Iredell Memorial Hospital.
The content of this policy and procedure document serves as guidance to the delivery of quality patient care.
Care providers are expected to exercise critical thinking and situational awareness skills,
and in specific situations to take such action as is necessary for the delivery of quality patient care.
Copyright © 2024 Rpharmy, LLC ­ All Rights Reserved