Admitting/Discharging Patients

Admitting Patients

1. Review prior to admission medications
2. Reorder Pertinent prior to admission medications
3. Enter New Admission Orders
4. Utilize pertinent Order Sets

All ICU Patients Need ICU Admission Order Set

High Yield ICU Order Sets

• TTM: Targeted Temperature Management
• Post-cardiac arrest cooling order set
• ICU: Adult Electrolyte Replacement Protocol
  • Nursing driven replacement of electrolytes
  • Exclusion Criteria:
    1. urine output < 0.5 mL/kg/hour
    2. Serum creatinine > 2.0 mg/dL
    3. Any form of dialysis
    4. Body weight less than 40 kg

• NEU: Stroke Admission – ICU

Discharging Patients

• Proceed to the Discharge Navigator
• Accurate Medication Reconciliation is Critical
• All Patients Need a Discharge Summary – DEAD or ALIVE!
• Discharge Summary:
  • Note Type is Discharge Summary
  • CUH IP DISCHARGE SUMMARY – MEDICAL
  • Make sure you Refresh Note or write note after Med-Rec to ensure accurate DC medications populate!

Click Discharge and then Order Reconciliation

First Reconcile Discharge Medications

New Orders for DC – General DC Order Set

Select Appropriate Disposition

Expired Patients Need a Short Death Note in EPIC

Apneic and Pulseless

Pupils Fixed and Dilated

No Heart/Lung Sounds

No Response to Pain

Asystole on Monitor

Time of Death

Autopsy or Not?

If a Patient Expires They are Discharged the Same Way: Expired with or without Autopsy