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Heart Failure and Hypertension Lab Ordering in Cardiology - Adult - Ambulatory [78]

Heart Failure and Hypertension Lab Ordering in Cardiology - Adult - Ambulatory [78] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols





Delegation Protocol Number: 78

Delegation Protocol Title:
Heart Failure and Hypertension Lab Ordering in Cardiology – Adult – Ambulatory

Delegation Protocol Applies To:
UW Health Heart & Vascular Care Clinics

Target Patient Population:
Adult cardiology patients with heart failure and/or hypertension

Delegation Protocol Champion:
Ravi Dhingra, MD – Department of Medicine ‐ Cardiology
Heather Johnson, MD – Department of Internal Medicine, UW Health Preventive Cardiology

Delegation Protocol Authors:
Bethany Westerfeldt, NP – Department of Medicine ‐ Cardiology
Orly Vardeny, PharmD – Department of Pharmacy

Responsible Department:
Department of Medicine ‐ Cardiology

Purpose Statement:
To delegate authority from the patient’s cardiology provider to Registered Nurses (RNs), Medical Assistants
(MAs) and Pharmacists (RPhs) to place orders for due heart failure and/or hypertension‐related laboratory
tests.

Who May Carry Out This Delegation Protocol:
Registered Nurses (RNs), Medical Assistants (MAs) and clinic‐based Pharmacists (RPhs) trained in
the use of this delegation protocol

Guidelines for Implementation:
1. Authorized staff will identify patients needing heart failure and/or hypertension‐related labs either by (1)
chart review as part of an encounter; (2) previsit planning or (3) during outreach.
2. The staff will review the patient’s medical record to identify any needed tests.
2.1. If the information in the patient’s UW Health medical record is incomplete or unavailable the staff will
review other available medical records for needed tests. NOTE: the standard procedure for obtaining
and abstracting outside records will be followed.
2.2. If the information is still not sufficient to determine if lab tests are due, staff will consult with
provider prior to placing orders.
2.3. Clinic staff will review the patient’s medical record to identify previously entered orders to minimize duplication.
2.4. The staff will use the attached tables to determine which laboratory tests are needed.
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org


Table 1: Heart Failure and Hypertension Labs

Creatinine (CR) Potassium (K) BUN
Heart Failure Every 6 Months Every 6 Months Every 6 Months
Hypertension Every 12 Months only if
taking diuretics, ACE, ARB
or spironolactone
Every 12 Months only
if taking diuretics, ACE,
ARB or spironolactone


Order Mode: Cosign Required, Protocol/Policy

References:
1. UW Health Management of Chronic Left Ventricular Systolic Heart Failure – Adult – Inpatient/Ambulatory
Clinical Practice Guideline. Accessed December 7, 2016. https://uconnect.wisc.edu/clinical/cckm‐
tools/content/?path=/content/cpg/cardiovascular/name‐97485‐en.cckm
2. UW Health Diagnosis and Management of Hypertension – Adult – Ambulatory Clinical Practice Guideline.
Accessed December 7, 2016. https://uconnect.wisc.edu/clinical/cckm‐
tools/content/?path=/content/cpg/cardiovascular/name‐97486‐en.cckm

Collateral Documents/Tools: UW Health Diagnosis and Management of Hypertension – Adult – Ambulatory
Clinical Practice Guideline
UW Health Management of Chronic Left Ventricular Systolic Heart Failure – Adult – Inpatient/Ambulatory Clinical
Practice Guideline

Approved By:
UW Health Ambulatory Protocol Committee: December 2013; *January 2017
UWHC Nursing Practice Council: February 2013; *January 2017
UW Health Lab Practice Committee: April 2013; *January 2017
UW Health Clinical Knowledge Management Council: May 2013; *January 2017
UWHC Medical Board: June 2013; *January 2017
UW Health Chief Clinical Officer: *January 2017

Effective Date: January 2017

Scheduled for Review: January 2020
* Expedited Review
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org