What is a protocol drug order?

Nurses General Nursing

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(I posted this thread in the Nursing Student Assistance forum, but I'm not getting any replies, so I'm posting it here too.)

Can someone please explain to me exactly what a protocol drug order is? Is a standing order the same thing? Also, would you mind giving some examples? I have the general definition my Pharm. book gives me, but I'm not grasping it as specifically as I'd like to.

Thanks, in advance!

Angel

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I believe this is for example like a K+ protocol which depends on the patients lab values. If the patients lab values are too low there is a K+ protocol with choices of proper dosages to replace K+.

I am not sure if this helps

Frez

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I believe this is for example like a K+ protocol which depends on the patients lab values. If the patients lab values are too low there is a K+ protocol with choices of proper dosages to replace K+.

I am not sure if this helps

Frez

That sorta helps, Frez, and I thank you. However, I'm still a little confused. Is a protocol order specific to each floor/unit? Is a standing order the same thing? I'm assuming a protocol order isn't necessarily one prescribed by the doctor?

I'm just trying to get this concept straight in my head before my Pharm. exam.

Angel

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Specializes in ICU, Psych.

That will most likely depend on your hospitals or MDs orders, as well as what drug we are talking about. It could also be a combined order for a certain process.

For example: MD XYZ at our facility has post surgery protocol that statas for N/V use Phenergan 12.5 mg IV Q4hrs, for temp above 101 F give Tylenol 650mg PO or Supp q 4hrs AND complete feverworkup inc. chest X-R, Blood cultures times 2, sputum culture.....and so on

there is realy no defined limit on what a protocol may include, I doubt you will find any protocol listings in any drug guides.

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(I posted this thread in the Nursing Student Assistance forum, but I'm not getting any replies, so I'm posting it here too.)

Can someone please explain to me exactly what a protocol drug order is? Is a standing order the same thing? Also, would you mind giving some examples? I have the general definition my Pharm. book gives me, but I'm not grasping it as specifically as I'd like to.

Thanks, in advance!

Angel

At least where I am a protocol order requires nursing changes in the dose of the drug. It differs from a standing order in that the standing order is an order done for all patients.

For example standing order: Zofran 4mg IV for N/V for all of Dr. Smith's patients.

A protocol order puts the patient in the pathway. For example I might write initiate heparin protocol. The protocol lays out the amount of drug to give. Ie. Initiate protocol with bolus of cc's heparin then x cc's per hour. Check heparin level if level is x then increase to x cc's per hour. If 1.5x then decrease to x cc's per hour.

Hope this helps.

David Carpenter, PA-C

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Specializes in Critical Care, Emergency, Education, Informatics.
(I posted this thread in the Nursing Student Assistance forum, but I'm not getting any replies, so I'm posting it here too.)

Can someone please explain to me exactly what a protocol drug order is? Is a standing order the same thing? Also, would you mind giving some examples? I have the general definition my Pharm. book gives me, but I'm not grasping it as specifically as I'd like to.

Thanks, in advance!

Angel

SOme of that is going to depend on were you are. Protocols and standing orders ahve different legal meanings in different states. i.e. in KS only APRN's follow protocols. In other places they mean the same thing.

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Specializes in med-surg, telemetry,geriatrics.

where I am at drug protocols are as coreO has stated. Heparin gtt protocol. It is specifically spelled out exactly what to give,how much drug and when to increase or decrease. Or in the situation of DVT prophylaxis drug protocol heparin subQ 5000units q 8hrs, or lovenox 40mg subQ daily. Some Dr.'s have certain drug protocols for bowel preps that are specific to the drugs, how much and when to give them and they will write an order to start bowel prep protocol which might be golytely or phospho soda and bisacodyl ect. , or for an abdominal surgery ancef, vancomycin ect. ect prior to surgery. Or if you have a renal pateint needing a spiral CT scan with contrast there is a PE (pulmonary emboli) drug protocol to give mucomyst....and start IVF of HCO3 ect. Hope this was helpful.

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I thank you all for your help! You guys are awesome!! I guess I shouldn't have asked for specific examples though, because you all gave me such detailed info. with some terms that I don't understand yet. (Pharm. is my first nursing class. I won't be in clinicals until next semester.)

I'm understanding that protocol orders are definitely specific to whatever floor you're working on. My Pharm. book says a standing order is a type of protocol order. The way you're all explaining it...it sounds like standing orders and protocol orders are the same thing. Am I right?

Angel

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I always understood protocols to be hospital wide policies (like the DVT prophylaxis and heparin protocols described above), while standing orders are physician/unit specific. But go with whatever your book says; that's what you'll be graded on ;)

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