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ATTN:  PHYSICIANS & STAFF

 -o0o-

 

** CAUTION **

 

Please be sure to place all Medication Orders in the Medications Section in MedsTracker. Medication orders, notes, changes to meds in any other Order section will not be processed by the Pharmacy. To improve Pharmacy turnaround time, Pharmacists will no longer receive ALL order pages. They will only receive the Medication Orders placed in the Medications Order section.


 ALERT -- ALERT -- ALERT

Updated 1/25/16

 

The supply of Hydromorphone PCAs has been depleted. We currently have 105 Morphine PCAs. Please use Morphine for PCA orders. We are working on bringing in a new pump so that we can continue to use the PCA format to deliver pain control. If Hydromorphone has to be utilized, then you may order Hydromorphone IV Push Scheduled and prn in the interim.

 

Aztreonam is on manufacturer backorder with no release date. There is a limited amount in house that will quickly be depleted. Please consider alternatives for patients with severe penicillin allergies (ID consult recommended).

 

Piperacillin/Tazobactam is also on manufacturer backorder with no release date.

 


 

MASSIVE TRANSFUSION PROTOCOL

 

In an effort to decrease morbidity and mortality, the Blood Management Committee has developed three massive transfusion protocols: a general Massive Transfusion Protocol, OB Massive Transfusion Protocol Level 1 and OB Massive Transfusion Protocol Level 2.

 

If an emergency blood situation arises, please order the MTP rather than individual blood products. OneBlood, Inc. makes the MTP orders their highest priority.

 

These protocols are included in the CPOE order set "Blood Product Administration" beginning January 18, 2016.

 

Please note:

  • Massive Transfusion Protocols are to be initiated by ED Physicians, Intensivists, Anesthesiologists, Surgeons, or OB/Gyn ONLY.
  • Please see the document titled "Massive Transfusion Protocol (MTP) Blood Products" on the home tab of the Portal for details of blood products included in the MTPs.

 


 


** REMINDER **

 

  Just a 'Friendly Reminder' that all documentation needs to be completed before leaving for the Holiday. 


 Is It Time to Reassess a New Blood Pressure Target?

The SPRINT trial (NEJM 2015;373:2103) found improved survival and clinical outcomes when treatment was instituted at a threshhold of 130 mmHg. Please note that diuretics were recommended as first-line therapy and that chlorthalidone was the recommended diuretic in the trial. 


 

 

CPOE COMMITMENT AS OF AUGUST 4TH

 

Please review the policy in detail on the Home tab of the Portal. Click "Computerized Provider Order Entry Participation Policy". You can still schedule your one-on-one training with the Education Dept. by calling 351-7394 or x7394. 


 


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Do you need help with CPOE / On-line Orders??

Help is available in several ways:

  • Schedule one-on-one training, contact Organizational Development at x7394.
  • Immediate assistance, see your floor's "Super User" or contact Brenda or Michelle at x7340.
  • Night time, contact the House Supervisor.



 

Society of Hospital Medicine's Choosing Wisely Adult Hospital Medicine Recommendations

 

  1. Do not place, or leave in place, urinary catheters for incontinence or convenience or monitoring of output for non-critically ill patients.
  2. Do not prescribe medications for stress ulcer prophylaxis to medical inpatients unless at high risk for gastrointestinal (GI) complications.
  3. Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke.
  4. Do not order continuous telemetry monitoring outside of the intensive care unit without using a protocol that governs continuation.
  5. Do not perform repetitive complete blood count (CBC) and chemistry testing in the face of clinical and lab stability.

 

 


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