ID

16045

Description

AAFP: Endometritis 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 fourteenth section ("Endometritis Admission Order").

Link

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

Keywords

Versions (1)
  1. 6/27/16 6/27/16 -
Uploaded on

June 27, 2016

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License

Creative Commons BY-NC 3.0
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AAFP: Endometritis Admission Order

English

AAFP: Endometritis Admission Order

1 forms  
Default Itemgroup
Description

Default Itemgroup

Name
Description

Name

Data type

text

Age
Description

Age

Data type

integer

Date of Birth
Description

Date of Birth

Data type

date

Medical record
Description

Medical record

Data type

integer

Status
Description

Status

Status
Description

Status

Data type

text

If Other, please specify
Description

Status

Data type

text

Attending
Description

Attending

Name of attending physician
Description

Name

Data type

text

Phone number of attending physician
Description

Phone

Data type

integer

Admitting Diagnosis
Description

Admitting Diagnosis

Post-Partum Endometritis Associated Diagnoses
Description

Admitting Diagnosis

Data type

text

Condition
Description

Condition

Condition
Description

Condition

Data type

text

Code Status
Description

Condition

Data type

text

Allergies
Description

Allergies

Allergies
Description

Allergies

Data type

text

Diet
Description

Diet

NPO
Description

Diet

Data type

boolean

Clear liquid
Description

Diet

Data type

boolean

AHA step 2
Description

Diet

Data type

boolean

ADA__calories
Description

Diet

Data type

boolean

If Diet according to ADA, please specify amount of calories
Description

Diet

Data type

integer

Other
Description

Diet

Data type

boolean

If Other, please specify
Description

Diet

Data type

text

Activity
Description

Activity

Bed rest with bedside commode
Description

Activity

Data type

boolean

Bathroom privileges
Description

Activity

Data type

boolean

Up ad lib
Description

Activity

Data type

boolean

Nursing
Description

Nursing

Vital signs ever 4 hrs for 24 hrs then every shift
Description

Nursing

Data type

boolean

Notify MD for: T > 101.5, P > 120, BP < 90/60 or > 180/110
Description

Nursing

Data type

boolean

Daily weight
Description

Nursing

Data type

boolean

I&O
Description

Nursing

Data type

boolean

Medications
Description

Medications

Unasyn 3 mg IVPB every 6 hrs
Description

Medications

Data type

boolean

Clindamycin 900mg IVPB every 8 hrs (if patient PCN sensitive)
Description

Medications

Data type

boolean

If patient is toxic add to the above:
Description

Medications

Data type

text

If Metronidazole please specify 15 mg/kg load =___mg
Description

Medications

Data type

integer

If Metronidazole, please specify 7.5 mg/kg(up to 500 mg)=____mg
Description

Medications

Data type

integer

Tylenol 500 mg 2 tabs PO every 4 hrs prn fever/pain
Description

Medications

Data type

boolean

Prenatal vitamin 1 PO daily if breast-feeding
Description

Medications

Data type

boolean

IV
Description

IV

IV lock; flush per routine
Description

IV

Data type

boolean

IV___at mL/hr
Description

IV

Data type

boolean

If IV____at mL/hr, please specify amount
Description

IV

Data type

integer

Lab
Description

Lab

Admission: CBC, basal metabolic profile
Description

Lab

Data type

boolean

Culture
Description

Lab

Data type

boolean

If culture: lochia
Description

Lab

Data type

boolean

If culture: blood x2
Description

Lab

Data type

boolean

If culture: urine
Description

Lab

Data type

boolean

If culture: abdominal incision
Description

Lab

Data type

boolean

Daily CBC
Description

Lab

Data type

boolean

Other
Description

Other

Signature
Description

Signature

Data type

text

Print Name
Description

Print Name

Data type

text

Date and Time
Description

Date and Time

Data type

datetime

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Similar models

AAFP: Endometritis Admission Order

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
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)
Status
Item
If Other, please specify
text
Item Group
Attending
Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Admitting Diagnosis
Item
Post-Partum Endometritis 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
Condition
Code List
Code Status
CL Item
Full Code (1)
CL Item
DNR (2)
Item Group
Allergies
Allergies
Item
Allergies
text
Item Group
Diet
Diet
Item
NPO
boolean
Diet
Item
Clear liquid
boolean
Diet
Item
AHA step 2
boolean
Diet
Item
ADA__calories
boolean
Diet
Item
If Diet according to ADA, please specify amount of calories
integer
Diet
Item
Other
boolean
Diet
Item
If Other, please specify
text
Item Group
Activity
Activity
Item
Bed rest with bedside commode
boolean
Activity
Item
Bathroom privileges
boolean
Activity
Item
Up ad lib
boolean
Item Group
Nursing
Nursing
Item
Vital signs ever 4 hrs for 24 hrs then every shift
boolean
Nursing
Item
Notify MD for: T > 101.5, P > 120, BP < 90/60 or > 180/110
boolean
Nursing
Item
Daily weight
boolean
Nursing
Item
I&O
boolean
Item Group
Medications
Medications
Item
Unasyn 3 mg IVPB every 6 hrs
boolean
Medications
Item
Clindamycin 900mg IVPB every 8 hrs (if patient PCN sensitive)
boolean
Item
If patient is toxic add to the above:
text
Medications
Code List
If patient is toxic add to the above:
CL Item
Gentamycin 80 mg IVPB every 8 hrs obtain trough before 4th dose OR (1)
CL Item
Metronidazole 15 mg/kg load = ____mg x1 dose and Metroidazole 7.5 mg/kg (up to 500mg)=___mg IVPB every 8 hrs (2)
Medications
Item
If Metronidazole please specify 15 mg/kg load =___mg
integer
Medications
Item
If Metronidazole, please specify 7.5 mg/kg(up to 500 mg)=____mg
integer
Medications
Item
Tylenol 500 mg 2 tabs PO every 4 hrs prn fever/pain
boolean
Medications
Item
Prenatal vitamin 1 PO daily if breast-feeding
boolean
Item Group
IV
IV
Item
IV lock; flush per routine
boolean
IV
Item
IV___at mL/hr
boolean
IV
Item
If IV____at mL/hr, please specify amount
integer
Item Group
Lab
Lab
Item
Admission: CBC, basal metabolic profile
boolean
Lab
Item
Culture
boolean
Lab
Item
If culture: lochia
boolean
Lab
Item
If culture: blood x2
boolean
Lab
Item
If culture: urine
boolean
Lab
Item
If culture: abdominal incision
boolean
Lab
Item
Daily CBC
boolean
Item Group
Other
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime
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