Order "Patient Voiding Prior to Discharge Instructions"
In October, the final draft for the addendum to the PACU discharge order set was completed and approved by the Phase II committee. The order would be automatically selected when the physician enters the Post Anesthesia Care Discharge Order Set. In other words, the physician would have to unselect the voiding order to remove it.
The order reads:
Patient voiding prior to discharge instructions
Patient must void due to: (Hard Stop - physician must select one of the following)
o Spinal Block
o Hernia Repair
o Rectal Procedure
o Urologic Procedure
o Gynecologic/Laparoscopic Procedure
o Past Medical History
o Other (Specify):
If unable to void within ____ hours post procedure, bladder scan and notify surgeon.
The order reads:
Patient voiding prior to discharge instructions
Patient must void due to: (Hard Stop - physician must select one of the following)
o Spinal Block
o Hernia Repair
o Rectal Procedure
o Urologic Procedure
o Gynecologic/Laparoscopic Procedure
o Past Medical History
o Other (Specify):
If unable to void within ____ hours post procedure, bladder scan and notify surgeon.
I also emailed certain surgical attendings who perform surgeries that place patients at a high risk for POUR (general surgeons, urologist, gynecologists). I explained the need for standardization, while seeking feedback and approval of the voiding algorithm and new order.
In February 2014, the new order went live in Epic.
PACU nurses were reeducated about the new order.
Order screenshot created in SME environment (not actual patient information)
PACU nurses were reeducated about the new order.
Order screenshot created in SME environment (not actual patient information)
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