ID

16038

Descripción

AAFP: DVT Discharge, 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 twelfth section ("DVT Discharge").

Link

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

Palabras clave

Versiones (2)
  1. 27/6/16 27/6/16 -
  2. 14/8/16 14/8/16 -
Subido en

27 de junio de 2016

DOI

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Licencia

Creative Commons BY-NC 3.0
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AAFP: DVT Discharge

Inglés

AAFP: DVT Discharge

1 formularios  
  1. StudyEvent: ODM
    1. AAFP: DVT Discharge
Default Itemgroup
Descripción

Default Itemgroup

Name
Descripción

Name

Tipo de datos

text

Age
Descripción

Age

Tipo de datos

integer

Date of Birth
Descripción

Date of Birth

Tipo de datos

date

Medical record
Descripción

Medical record

Tipo de datos

integer

Status
Descripción

Status

Discharge home
Descripción

Status

Tipo de datos

boolean

If discharge home, please specify date
Descripción

Status

Tipo de datos

date

Attending
Descripción

Attending

Name of attending physician
Descripción

Attending

Tipo de datos

text

Phone number of attending physician
Descripción

Attending

Tipo de datos

integer

Discharge Diagnosis
Descripción

Discharge Diagnosis

DVT___lower extremity
Descripción

Discharge Diagnosis

Tipo de datos

boolean

If DVT ___ lower extremity please specify
Descripción

Discharge Diagnosis

Tipo de datos

text

Other
Descripción

Discharge Diagnosis

Tipo de datos

boolean

If Other, please specify
Descripción

Discharge Diagnosis

Tipo de datos

text

Status
Descripción

Status

Status
Descripción

Status

Tipo de datos

text

Allergies
Descripción

Allergies

Allergies
Descripción

Allergies

Tipo de datos

text

Diet
Descripción

Diet

Diet
Descripción

Diet

Tipo de datos

text

Activity
Descripción

Activity

As tolerated
Descripción

Activity

Tipo de datos

boolean

Elevate affected leg as much as possible
Descripción

Activity

Tipo de datos

boolean

No driving or prolonged standing
Descripción

Activity

Tipo de datos

boolean

Medications
Descripción

Medications

Lovenox___mg subcutaneously BID for ___days
Descripción

Provide patient with prescription for Lovenox or call the pharmacy. Lovenox is dispensed in prefilled syringes in the following doses: 30 mg, 40 mg, 60 mg, 80 mg, 100 mg. There are no pre-authorization requirements.

Tipo de datos

boolean

If Lovenox, please specify amount
Descripción

Lovenox specification

Tipo de datos

integer

Unidades de medida
  • mg
mg
If Lovenox, please specify duration in days
Descripción

Lovenox specification

Tipo de datos

integer

Coumadin__mg by mouth every day
Descripción

Medications

Tipo de datos

boolean

If Coumadin, please specify amount
Descripción

Medications

Tipo de datos

integer

Additional medications
Descripción

Medications

Tipo de datos

boolean

If additional medications, please specify
Descripción

Medications

Tipo de datos

text

Patient Education
Descripción

Patient Education

Lovenox self-injection
Descripción

Patient Education

Tipo de datos

boolean

Dietician counseling for food-drug interactions
Descripción

Patient Education

Tipo de datos

boolean

Signs and symptoms of abnormal bleeding that need to be reported
Descripción

Patient Education

Tipo de datos

boolean

Avoidance of NSAID medications (aspirin, ibuprofen, Aleve, etc.)
Descripción

Patient Education

Tipo de datos

boolean

Follow-up
Descripción

Follow-up

Date and Time of Appointment already set
Descripción

Follow-up

Tipo de datos

boolean

If Appointment set, please specify date and time
Descripción

Follow-up

Tipo de datos

datetime

Call for an appointment in the next 3 days
Descripción

Follow-up

Tipo de datos

boolean

Call for an appointment with Dr.____in the next ___days
Descripción

Follow-up

Tipo de datos

boolean

Please specify name of doctor
Descripción

Follow-up

Tipo de datos

text

Please specify amount of days
Descripción

Follow-up

Tipo de datos

integer

Other
Descripción

Other

Please fax the attached Coumadin Clinic Referral
Descripción

Other

Tipo de datos

boolean

Please fax the attached Discharge Summary
Descripción

Other

Tipo de datos

boolean

Signature
Descripción

Signature

Tipo de datos

text

Signature
Descripción

Signature

Tipo de datos

text

Date and Time
Descripción

Date and Time

Tipo de datos

datetime

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Similar models

AAFP: DVT Discharge

1 formularios
  1. StudyEvent: ODM
    1. AAFP: DVT Discharge
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
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
Status
Item
Discharge home
boolean
Status
Item
If discharge home, please specify date
date
Item Group
Attending
Attending
Item
Name of attending physician
text
Attending
Item
Phone number of attending physician
integer
Item Group
Discharge Diagnosis
Discharge Diagnosis
Item
DVT___lower extremity
boolean
Discharge Diagnosis
Item
If DVT ___ lower extremity please specify
text
Discharge Diagnosis
Item
Other
boolean
Discharge Diagnosis
Item
If Other, please specify
text
Item Group
Status
Item
Status
text
Status
Code List
Status
CL Item
Stable (1)
CL Item
Fair (2)
CL Item
Serious (3)
CL Item
Critical (4)
Item Group
Allergies
Allergies
Item
Allergies
text
Item Group
Diet
Diet
Item
Diet
text
Item Group
Activity
Activity
Item
As tolerated
boolean
Activity
Item
Elevate affected leg as much as possible
boolean
Activity
Item
No driving or prolonged standing
boolean
Item Group
Medications
Medications
Item
Lovenox___mg subcutaneously BID for ___days
boolean
Lovenox specification
Item
If Lovenox, please specify amount
integer
Lovenox specification
Item
If Lovenox, please specify duration in days
integer
Medications
Item
Coumadin__mg by mouth every day
boolean
Medications
Item
If Coumadin, please specify amount
integer
Medications
Item
Additional medications
boolean
Medications
Item
If additional medications, please specify
text
Item Group
Patient Education
Patient Education
Item
Lovenox self-injection
boolean
Patient Education
Item
Dietician counseling for food-drug interactions
boolean
Patient Education
Item
Signs and symptoms of abnormal bleeding that need to be reported
boolean
Patient Education
Item
Avoidance of NSAID medications (aspirin, ibuprofen, Aleve, etc.)
boolean
Item Group
Follow-up
Follow-up
Item
Date and Time of Appointment already set
boolean
Follow-up
Item
If Appointment set, please specify date and time
datetime
Follow-up
Item
Call for an appointment in the next 3 days
boolean
Follow-up
Item
Call for an appointment with Dr.____in the next ___days
boolean
Follow-up
Item
Please specify name of doctor
text
Follow-up
Item
Please specify amount of days
integer
Item Group
Other
Other
Item
Please fax the attached Coumadin Clinic Referral
boolean
Other
Item
Please fax the attached Discharge Summary
boolean
Signature
Item
Signature
text
Signature
Item
Signature
text
Date and Time
Item
Date and Time
datetime
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