We at Sutter Health use this approach. We have 2 Nursing Standardized Procedures: one for ED and one for RRT (IP) to cover initial lactate draw Reflex orders (redraw for elevation) are fine if they are approved by MEC and lab.
Thanks, MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience Sutter Health -2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| [email protected]<mailto:[email protected]> All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves. Anatole France [https://newsplus.sutterhealth.org/peninsula-coastal/files/2017/04/SH_Pride_Plus400-002-177x177.gif] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Rutherford, Richard Sent: Monday, January 08, 2018 2:54 PM To: [email protected] Subject: [**External**] [Sepsis Groups] Automated Lactate Orders WARNING: This email originated outside of the Sutter Health email system! DO NOT CLICK links if the sender is unknown and never provide your User ID or Password. 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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