ID

16008

Beskrivning

AAFP: CVA Admission Order, Standardizes Admission Orders, Author: Robert M. Wiprud, MD The primary purpose of these Ordersets is to decrease unnecessary variability and to improve quality through standardized Admission Orders. Developed by the Scott & White Clinic at College Station, Texas. Copyright © 2006 American Academy of Family Physicians. Physicians may photocopy or adapt for use in their own practices; all other rights reserved. Wiprud RM. Providing consistent care with standardized admission orders. Fam Pract Manag. September 2006: 49-52 See http://www.aafp.org/fpm/2006/0900/p49.html This ODM Form includes the tenth section ("CVA Admission Order").

Länk

http://www.aafp.org/fpm/2006/0900/p49.html

Nyckelord

Versioner (1)
  1. 2016-06-26 2016-06-26 -
Uppladdad den

26 juni 2016

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

AAFP: CVA Admission Order

Engelsk

AAFP: CVA Admission Order

1 Formulär  
Default Itemgroup
Beskrivning

Default Itemgroup

Name
Beskrivning

Name

Datatyp

text

Age
Beskrivning

Age

Datatyp

integer

Date of Birth
Beskrivning

Date of Birth

Datatyp

date

Medical record
Beskrivning

Medical record

Datatyp

integer

Status
Beskrivning

Status

Status
Beskrivning

Status

Datatyp

text

Attending
Beskrivning

Attending

Name of attending physician
Beskrivning

Name

Datatyp

text

Phone number of attending physician
Beskrivning

Phone number

Datatyp

integer

Admitting Diagnosis
Beskrivning

Admitting Diagnosis

CVA Associated Diagnoses
Beskrivning

Admitting Diagnosis

Datatyp

text

Condition
Beskrivning

Condition

Condition
Beskrivning

Condition

Datatyp

text

Code Status
Beskrivning

Code Status

Datatyp

text

Diet
Beskrivning

Diet

NPO
Beskrivning

Diet

Datatyp

boolean

Clear liquid
Beskrivning

Diet

Datatyp

boolean

AHA step 2
Beskrivning

Diet

Datatyp

boolean

ADA___calories
Beskrivning

Diet

Datatyp

boolean

If diet according to ADA, please specify amount of calories
Beskrivning

ADA specification

Datatyp

integer

Other
Beskrivning

Diet

Datatyp

boolean

If Other, please specify
Beskrivning

Specification of Other

Datatyp

text

Activity
Beskrivning

Activity

Activity
Beskrivning

Activity

Datatyp

text

Nursing
Beskrivning

Nursing

Vital signs with neuro checks every 4hrs for 24 hrs then per routine
Beskrivning

Nursing

Datatyp

boolean

Notify MD for: BP systolic < 90 or > 180 or > 105 diastolic; P < 60 or > 120; declining mental status or worsening of neurological symptoms
Beskrivning

Nursing

Datatyp

boolean

Weigth on arrival
Beskrivning

Nursing

Datatyp

boolean

I&O every shift
Beskrivning

Nursing

Datatyp

boolean

O2 @ 2,4,6 L/min via NC or FM
Beskrivning

Nursing

Datatyp

boolean

Check pulse ox on arrival and pen to maintain O2 sat > 92%
Beskrivning

Nursing

Datatyp

boolean

Medications
Beskrivning

Medications

ASA 81 mg PO daily
Beskrivning

Medications

Datatyp

boolean

Folate 1 mg PO daily
Beskrivning

Medications

Datatyp

boolean

IV
Beskrivning

IV

Dextrose 5% in 1/2 normal saline with 20 mEq KCl/L at 80 mL/hr
Beskrivning

IV

Datatyp

boolean

Hep lock
Beskrivning

IV

Datatyp

boolean

Other
Beskrivning

IV

Datatyp

boolean

If other, please specify
Beskrivning

Specification of Other

Datatyp

text

Lab
Beskrivning

Lab

Admission: CBC, PT/INR, comp med profile, cardiac profile
Beskrivning

Lab

Datatyp

boolean

a.m.: lipid profile, TSH
Beskrivning

Lab

Datatyp

boolean

Diagnostic Studies
Beskrivning

Diagnostic Studies

CT Head without contrast (if not done in ER)
Beskrivning

Diagnostic Studies

Datatyp

boolean

ECG (if not done in ER)
Beskrivning

Diagnostic Studies

Datatyp

boolean

Portable CXR (if not done in ER)
Beskrivning

Diagnostic Studies

Datatyp

boolean

Echocardiogram - to be read by__
Beskrivning

Diagnostic Studies

Datatyp

boolean

If Echocardiogram, please specify: to be read by___
Beskrivning

Echocardiogram specification

Datatyp

text

Diagnostic Studies
Beskrivning

Other

Datatyp

boolean

If Other, please specify
Beskrivning

Specification of Other

Datatyp

text

If Other, please specify
Beskrivning

Specification of Other

Datatyp

text

Consult
Beskrivning

Consult

PT evaluation
Beskrivning

Consult

Datatyp

boolean

OT evaluation
Beskrivning

Consult

Datatyp

boolean

Speech/swallow evaluation
Beskrivning

Consult

Datatyp

boolean

Signature
Beskrivning

Signature

Datatyp

text

Print Name
Beskrivning

Print Name

Datatyp

text

Date and Time
Beskrivning

Date and Time

Datatyp

datetime

Tillbaka till toppen

Similar models

AAFP: CVA Admission Order

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Name
Item
Name
text
Age
Item
Age
integer
Date of Birth
Item
Date of Birth
date
Medical record
Item
Medical record
integer
Item Group
Status
Item
Status
text
Status
Code List
Status
CL Item
Observation (1)
CL Item
Admission (2)
CL Item
Medical floor (3)
CL Item
Monitored bed (4)
CL Item
Other (5)
Item Group
Attending
Name
Item
Name of attending physician
text
Phone number
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Admitting Diagnosis
Item
CVA Associated Diagnoses
text
Item Group
Condition
Item
Condition
text
Condition
Code List
Condition
CL Item
Stable (1)
CL Item
Fair (2)
CL Item
Serious (3)
CL Item
Critical (4)
Item
Code Status
text
Code Status
Code List
Code Status
CL Item
full status (1)
CL Item
DNR (2)
Item Group
Diet
Diet
Item
NPO
boolean
Diet
Item
Clear liquid
boolean
Diet
Item
AHA step 2
boolean
Diet
Item
ADA___calories
boolean
ADA specification
Item
If diet according to ADA, please specify amount of calories
integer
Diet
Item
Other
boolean
Specification of Other
Item
If Other, please specify
text
Item Group
Activity
Item
Activity
text
Activity
Code List
Activity
CL Item
Bed rest (1)
CL Item
Bed rest with bedside commode (2)
CL Item
Bathroom privileges with assistance (3)
Item Group
Nursing
Nursing
Item
Vital signs with neuro checks every 4hrs for 24 hrs then per routine
boolean
Nursing
Item
Notify MD for: BP systolic < 90 or > 180 or > 105 diastolic; P < 60 or > 120; declining mental status or worsening of neurological symptoms
boolean
Nursing
Item
Weigth on arrival
boolean
Nursing
Item
I&O every shift
boolean
Nursing
Item
O2 @ 2,4,6 L/min via NC or FM
boolean
Nursing
Item
Check pulse ox on arrival and pen to maintain O2 sat > 92%
boolean
Item Group
Medications
Medications
Item
ASA 81 mg PO daily
boolean
Medications
Item
Folate 1 mg PO daily
boolean
Item Group
IV
IV
Item
Dextrose 5% in 1/2 normal saline with 20 mEq KCl/L at 80 mL/hr
boolean
IV
Item
Hep lock
boolean
IV
Item
Other
boolean
Specification of Other
Item
If other, please specify
text
Item Group
Lab
Lab
Item
Admission: CBC, PT/INR, comp med profile, cardiac profile
boolean
Lab
Item
a.m.: lipid profile, TSH
boolean
Item Group
Diagnostic Studies
Diagnostic Studies
Item
CT Head without contrast (if not done in ER)
boolean
Diagnostic Studies
Item
ECG (if not done in ER)
boolean
Diagnostic Studies
Item
Portable CXR (if not done in ER)
boolean
Diagnostic Studies
Item
Echocardiogram - to be read by__
boolean
Echocardiogram specification
Item
If Echocardiogram, please specify: to be read by___
text
Diagnostic Studies
Item
boolean
Specification of Other
Item
If Other, please specify
text
Specification of Other
Item
If Other, please specify
text
Item Group
Consult
Consult
Item
PT evaluation
boolean
Consult
Item
OT evaluation
boolean
Consult
Item
Speech/swallow evaluation
boolean
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial