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Treatment of Anxiety Prior to Liver Biopsy - Adult - Ambulatory [30]

Treatment of Anxiety Prior to Liver Biopsy - Adult - Ambulatory [30] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols


Delegation Protocol Number: 30

Delegation Protocol Title:
Treatment of Anxiety Prior to Liver Biopsy - Adult - Ambulatory

Delegation Protocol Applies To:
UWHC Transplant Clinic
Target Patient Population:
Adult outpatients undergoing a liver biopsy

Delegation Protocol Champion:
Arjang DJamali, MD, Department of Surgery – Transplant

Delegation Protocol Reviewer:
Nancy Jones, RN, Clinic Manager - Transplant

Responsible Department:
Department of Surgery - Transplant

Purpose Statement:
To delegate authority from the provider performing the biopsy to registered nurses (RNs) in the Transplant Clinic
to order treatment for the management of anxiety in patients undergoing liver biopsy.

Who May Carry Out This Delegation Protocol:
Registered Nurses (RNs) in the Transplant Clinic who are trained in the use of this delegation protocol.

Guidelines for Implementation:
1. This protocol is initiated by the patient requesting treatment for anxiety prior to liver biopsy.
2. The RN will review the patient’s medication list, allergy history and problem list. If the patient is on chronic
controlled substance therapy, has a history of allergies to diazepam or other benzodiazepines, or has active
pulmonary disease the provider will be consulted prior to placing any orders for anxiolytic therapy.
3. The RN will enter an order in Health Link for diazepam 5 mg PO x1 to be administered up to one hour prior
to procedure.
4. The RN will administer the diazepam, no more than one hour prior to the procedure and document the
administration on the MAR.

Order Mode: Protocol/Policy, Cosign Required

References: N/A

Collateral Documents/Tools: N/A

Approved By:
UW Health Ambulatory Protocol Committee: December 2012; *August 2015
UW Health Nursing Practice Council – February 2013; *August 2015
UWHC Pharmacy and Therapeutics Committee – February 2013; *August 2015
UWHC Medical Board – March 2013; *August 2015
UW Health Chief Medical Officer; *August 2015

Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

Effective Date: August 2015

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