0 Ratings
ID

16926

Description

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

Keywords

Versions (2)
  1. 6/27/16 6/27/16 -
  2. 8/14/16 8/14/16 -
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August 14, 2016

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Creative Commons BY-NC 3.0
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    AAFP: DVT Discharge

    English

    AAFP: DVT Discharge

    1 forms  
    1. StudyEvent: ODM
      1. AAFP: DVT Discharge
    Default Itemgroup
    Description

    Default Itemgroup

    Name
    Description

    Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C0027365
    Age
    Description

    Age

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0001779
    Date of Birth
    Description

    Date of Birth

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451
    Medical record
    Description

    Medical record

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1301894
    Status
    Description

    Status

    Discharge home
    Description

    Discharge

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0030685
    If discharge home, please specify date
    Description

    Date of discharge

    Data type

    date

    Alias
    UMLS CUI [1]
    C2361123
    Attending
    Description

    Attending

    Name of attending physician
    Description

    Name of attending physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C2361125
    Phone number of attending physician
    Description

    Phone number of attending physician

    Data type

    integer

    Alias
    UMLS CUI [1]
    C3262226
    Discharge Diagnosis
    Description

    Discharge Diagnosis

    DVT___lower extremity
    Description

    DVT of lower extremity

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0340708
    If DVT ___ lower extremity please specify
    Description

    If DVT ___ lower extremity please specify

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0340708
    UMLS CUI [1,2]
    C2348235
    Other DVT
    Description

    Other DVT

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0149871
    UMLS CUI [1,2]
    C0205394
    If Other, please specify
    Description

    If Other, please specify

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0149871
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C2348235
    Status
    Description

    Status

    Status
    Description

    Clinical Status

    Data type

    text

    Alias
    UMLS CUI [1]
    C0449440
    Allergies
    Description

    Allergies

    Allergies
    Description

    Allergies

    Data type

    text

    Alias
    UMLS CUI [1]
    C0020517
    Diet
    Description

    Diet

    Diet
    Description

    Diet

    Data type

    text

    Alias
    UMLS CUI [1]
    C0012155
    Activity
    Description

    Activity

    As tolerated
    Description

    Activity

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0026606
    Elevate affected leg as much as possible
    Description

    Elevate affected leg as much as possible

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0204853
    No driving or prolonged standing
    Description

    driving, prolonged standing

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0004379
    UMLS CUI [2,1]
    C0231472
    UMLS CUI [2,2]
    C0439590
    Medications
    Description

    Medications

    Lovenox___mg subcutaneously BID for ___days
    Description

    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.

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0728963
    If Lovenox, please specify amount
    Description

    Levonex drug dose

    Data type

    integer

    Measurement units
    • mg
    Alias
    UMLS CUI [1,1]
    C0728963
    UMLS CUI [1,2]
    C0678766
    mg
    If Lovenox, please specify duration in days
    Description

    Lovenox duration

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0728963
    UMLS CUI [1,2]
    C0449238
    Coumadin__mg by mouth every day
    Description

    Coumadin

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0699129
    If Coumadin, please specify amount
    Description

    Coumadin drug dose

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0699129
    UMLS CUI [1,2]
    C0678766
    Additional medications
    Description

    Medication

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0013227
    If additional medications, please specify
    Description

    If additional medications, please specify

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0013227
    UMLS CUI [1,2]
    C2348235
    Patient Education
    Description

    Patient Education

    Lovenox self-injection
    Description

    Lovenox self-injection

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0728963
    UMLS CUI [1,2]
    C3880392
    Dietician counseling for food-drug interactions
    Description

    Dietician counseling for food-drug interactions

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0204932
    UMLS CUI [1,2]
    C0242785
    Signs and symptoms of abnormal bleeding that need to be reported
    Description

    patient education of abnormal bleeding

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0030688
    UMLS CUI [1,2]
    C0019080
    UMLS CUI [1,3]
    C0205161
    Avoidance of NSAID medications (aspirin, ibuprofen, Aleve, etc.)
    Description

    NSAID avoidance

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0030688
    UMLS CUI [1,2]
    C0003211
    UMLS CUI [1,3]
    C0870186
    Follow-up
    Description

    Follow-up

    Date and Time of Appointment already set
    Description

    Date and Time of follow-up

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C2193198
    If Appointment set, please specify date and time
    Description

    date and time of follow-up

    Data type

    datetime

    Alias
    UMLS CUI [1,1]
    C1522577
    UMLS CUI [1,2]
    C0011008
    UMLS CUI [1,3]
    C0040223
    Call for an appointment in the next 3 days
    Description

    Call for an appointment

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1522577
    UMLS CUI [1,2]
    C0003629
    Call for an appointment with Dr.____in the next ___days
    Description

    Call for an appointment with Dr.____in the next ___days

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1522577
    UMLS CUI [1,2]
    C0003629
    Please specify name of doctor
    Description

    Name of doctor

    Data type

    text

    Alias
    UMLS CUI [1]
    C0027365
    Please specify amount of days
    Description

    Amount of days

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C1265611
    UMLS CUI [1,2]
    C0439228
    Other
    Description

    Other

    Please fax the attached Coumadin Clinic Referral
    Description

    Please fax the attached Coumadin Clinic Referral

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0085205
    UMLS CUI [1,2]
    C1546430
    UMLS CUI [1,3]
    C0699129
    Please fax the attached Discharge Summary
    Description

    Please fax the attached Discharge Summary

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0085205
    UMLS CUI [1,2]
    C0743221
    Signature
    Description

    Signature

    Data type

    text

    Alias
    UMLS CUI [1]
    C1519316
    Date and Time
    Description

    Date and Time

    Data type

    datetime

    Alias
    UMLS CUI [1,1]
    C0011008
    UMLS CUI [1,2]
    C0040223
    Back to the top of the page

    Similar models

    AAFP: DVT Discharge

    1 forms
    1. StudyEvent: ODM
      1. AAFP: DVT Discharge
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Name
    Item
    Name
    text
    C0027365 (UMLS CUI [1])
    Age
    Item
    Age
    integer
    C0001779 (UMLS CUI [1])
    Date of Birth
    Item
    Date of Birth
    date
    C0421451 (UMLS CUI [1])
    Medical record
    Item
    Medical record
    integer
    C1301894 (UMLS CUI [1])
    Item Group
    Status
    Discharge
    Item
    Discharge home
    boolean
    C0030685 (UMLS CUI [1])
    Date of discharge
    Item
    If discharge home, please specify date
    date
    C2361123 (UMLS CUI [1])
    Item Group
    Attending
    Name of attending physician
    Item
    Name of attending physician
    text
    C2361125 (UMLS CUI [1])
    Phone number of attending physician
    Item
    Phone number of attending physician
    integer
    C3262226 (UMLS CUI [1])
    Item Group
    Discharge Diagnosis
    DVT of lower extremity
    Item
    DVT___lower extremity
    boolean
    C0340708 (UMLS CUI [1])
    If DVT ___ lower extremity please specify
    Item
    If DVT ___ lower extremity please specify
    text
    C0340708 (UMLS CUI [1,1])
    C2348235 (UMLS CUI [1,2])
    Other DVT
    Item
    Other DVT
    boolean
    C0149871 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    If Other, please specify
    Item
    If Other, please specify
    text
    C0149871 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Item Group
    Status
    Item
    Status
    text
    C0449440 (UMLS CUI [1])
    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
    C0020517 (UMLS CUI [1])
    Item Group
    Diet
    Diet
    Item
    Diet
    text
    C0012155 (UMLS CUI [1])
    Item Group
    Activity
    Activity
    Item
    As tolerated
    boolean
    C0026606 (UMLS CUI [1])
    Elevate affected leg as much as possible
    Item
    Elevate affected leg as much as possible
    boolean
    C0204853 (UMLS CUI [1])
    driving, prolonged standing
    Item
    No driving or prolonged standing
    boolean
    C0004379 (UMLS CUI [1])
    C0231472 (UMLS CUI [2,1])
    C0439590 (UMLS CUI [2,2])
    Item Group
    Medications
    Lovenox
    Item
    Lovenox___mg subcutaneously BID for ___days
    boolean
    C0728963 (UMLS CUI [1])
    Levonex drug dose
    Item
    If Lovenox, please specify amount
    integer
    C0728963 (UMLS CUI [1,1])
    C0678766 (UMLS CUI [1,2])
    Lovenox duration
    Item
    If Lovenox, please specify duration in days
    integer
    C0728963 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Coumadin
    Item
    Coumadin__mg by mouth every day
    boolean
    C0699129 (UMLS CUI [1])
    Coumadin drug dose
    Item
    If Coumadin, please specify amount
    integer
    C0699129 (UMLS CUI [1,1])
    C0678766 (UMLS CUI [1,2])
    Medication
    Item
    Additional medications
    boolean
    C0013227 (UMLS CUI [1])
    If additional medications, please specify
    Item
    If additional medications, please specify
    text
    C0013227 (UMLS CUI [1,1])
    C2348235 (UMLS CUI [1,2])
    Item Group
    Patient Education
    Lovenox self-injection
    Item
    Lovenox self-injection
    boolean
    C0728963 (UMLS CUI [1,1])
    C3880392 (UMLS CUI [1,2])
    Dietician counseling for food-drug interactions
    Item
    Dietician counseling for food-drug interactions
    boolean
    C0204932 (UMLS CUI [1,1])
    C0242785 (UMLS CUI [1,2])
    patient education of abnormal bleeding
    Item
    Signs and symptoms of abnormal bleeding that need to be reported
    boolean
    C0030688 (UMLS CUI [1,1])
    C0019080 (UMLS CUI [1,2])
    C0205161 (UMLS CUI [1,3])
    NSAID avoidance
    Item
    Avoidance of NSAID medications (aspirin, ibuprofen, Aleve, etc.)
    boolean
    C0030688 (UMLS CUI [1,1])
    C0003211 (UMLS CUI [1,2])
    C0870186 (UMLS CUI [1,3])
    Item Group
    Follow-up
    Date and Time of follow-up
    Item
    Date and Time of Appointment already set
    boolean
    C2193198 (UMLS CUI [1])
    date and time of follow-up
    Item
    If Appointment set, please specify date and time
    datetime
    C1522577 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    C0040223 (UMLS CUI [1,3])
    Call for an appointment
    Item
    Call for an appointment in the next 3 days
    boolean
    C1522577 (UMLS CUI [1,1])
    C0003629 (UMLS CUI [1,2])
    Call for an appointment with Dr.____in the next ___days
    Item
    Call for an appointment with Dr.____in the next ___days
    boolean
    C1522577 (UMLS CUI [1,1])
    C0003629 (UMLS CUI [1,2])
    Name of doctor
    Item
    Please specify name of doctor
    text
    C0027365 (UMLS CUI [1])
    Amount of days
    Item
    Please specify amount of days
    integer
    C1265611 (UMLS CUI [1,1])
    C0439228 (UMLS CUI [1,2])
    Item Group
    Other
    Please fax the attached Coumadin Clinic Referral
    Item
    Please fax the attached Coumadin Clinic Referral
    boolean
    C0085205 (UMLS CUI [1,1])
    C1546430 (UMLS CUI [1,2])
    C0699129 (UMLS CUI [1,3])
    Please fax the attached Discharge Summary
    Item
    Please fax the attached Discharge Summary
    boolean
    C0085205 (UMLS CUI [1,1])
    C0743221 (UMLS CUI [1,2])
    Signature
    Item
    Signature
    text
    C1519316 (UMLS CUI [1])
    Date and Time
    Item
    Date and Time
    datetime
    C0011008 (UMLS CUI [1,1])
    C0040223 (UMLS CUI [1,2])
    Back to the top of the page 

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