Protocol Orders

Greeting! A bit of a change to protocol orders, Dr Poage and I discussed this and are in agreement…

Prior instructions were that protocol orders are for when all the rooms are full or a provider is unable to see a patient expeditiously.  We are changing this to a more robust front end process where they are ordered by the triage nurse (or RN if only 2 on duty) in order to get ahead and assist with throughput and more prompt care of patients.   Obviously we would not want the triage nurse detaining a patient to place protocol orders when the provider is in the room waiting; use your best judgement about this but know you are empowered to order them following the approved guidelines.  Only RNs can place protocol orders.

This is especially important for getting that UA and an hcg on patients with N/V, abdominal pain, flank pain…this should be the standard and a priority.   For example, a female with abdominal pain is an ectopic until ruled out otherwise.  If the chief complaint indicates, as just mentioned, or if you suspect imaging is a probability,  order and obtain a UA and / or hcg as appropriate.   This is should be for all females of “child bearing years” which can be a variable range – taking a good history in this area will be important.

Also, if there are three nurses on duty, it is an expectation that one is assigned to triage.  The CN will do this when there is one; otherwise, the three on duty should determine who it will be and they will reside in the front to expedite triage and protocol orders.

Thank you and let me know if you have questions or problems!  

Andrea