Nurse Initiated Order Sets

Specialties Ob/Gyn

Published

Specializes in Interventional Pain Mgmt NP; Prior ICU and L/D RN.

Hi all... I'm currently working on getting a nurse initiated pre-op order set for our scheduled C-sections. Surgeries are being delayed; thus backed up; because the dr's are legit busy and can't physically put pre-op lab orders, VTE orders, shave/prep. etc in. Unfortunately many people I work with do not feel it is their "job" to place these orders in the EMR for the drs; and thus getting the labs, etc done to keep the surgery on time.

We have a protocol for newborn admission orders that works AWESOME (the nurse places the order set in the EMR and it does not require a MD signature; but we also order the simple "order to implement newborn protocol which the DR does sign...

So I am asking if anyone out there has a standard pre-op orders that the nurse initiates upon patient arrival??????

THANKS!

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Specializes in Nurse Manager, Labor and Delivery.

Yes we have them. They are generally initiated when the section is scheduled and sent over with consents. If they aren't signed we generally initate as a verbal and the MD signs pre-op, or when they are writing post op orders. Its a relatively easy fix. Would just have to go thru your facility's order set/forms committee for approval, then approved by department chair.

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Specializes in L&D.

Yes we have them as well. We enter the order set when the patient is admitted (we already have a paper from the OB's office "ordering" the c-section). We can check and uncheck components as needed (e.g. antibiotics, retype, etc). I'm shocked that your surgeries are being delayed because the nurses won't enter orders :wideyed: That would not go over as an excuse at my facility. Nurses enter the majority of orders into our computer system (cerner). Our scheduled sections arrive 2 hours before their surgery so there's no reason why everything shouldn't have been ordered and completed.

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We also have order sets, particularly for the scheduled sections. The patients are prepped and ready before the physician even steps foot in the room. Also, many of the scheduled sections come in the previous day to have blood work drawn and get registered

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