Hello All,

We are having a debate in our organization about whether automatic lactate 
orders violate nursing standard of practice.  Currently if a patient in ED or 
on floor screens in for sepsis, the nurse follows hospital protocol and orders 
a lactate which is then routed to the attending physician for cosignature 
(after drawn).   We also have an automated order to repeat lactate at 4 hours 
for admitted patients with an initial lactate>2.    I believe our initial 
lactate order in ER is covered by Standardized Nursing Procedures.  We are 
having more debate around the initial lactate ordered on inpatients and the 
automated second lactate on all patients with lactate>2 without a prior 
physician order.


I am interested in knowing if other hospitals use our approach, and if so is 
nursing leadership feeling comfortable that nursing standards of practice are 
not being violated.


Thanks,


Rick Rutherford

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