/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/delegationpractice-protocols/,/clinical/cckm-tools/content/delegationpractice-protocols/ambulatory-delegation-protocols/,

/clinical/cckm-tools/content/delegationpractice-protocols/ambulatory-delegation-protocols/name-97427-en.cckm

20180103

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Delegation/Practice Protocols,Ambulatory Delegation Protocols

Growth Hormone Stimulation Test in Endocrinology - Pediatric - Ambulatory [105]

Growth Hormone Stimulation Test in Endocrinology - Pediatric - Ambulatory [105] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols



Delegation Protocol Number: 105

Delegation Protocol Title:
Growth Hormone Stimulation Test in Endocrinology - Pediatric - Ambulatory

Delegation Protocol Applies To:
AFCH Diagnostic and Therapeutic Services

Target Patient Population:
Pediatric patients undergoing growth hormone stimulation testing

Delegation Protocol Champion:
David Allen, MD – Department of Pediatrics - Endocrinology

Delegation Protocol Workgroup:
Kelly Dunphy, RN – AFCH Pediatric Specialties Clinics
Betsy Bazur-Leidy, RN – AFCH Pediatric Specialties Clinics
Amy Groener, RN – AFCH Pediatric Specialties Clinics

Responsible Department:
Department of Pediatrics - Endocrinology

Purpose Statement:
To delegate authority from the Endocrinology Provider to Registered Nurses (RNs) and pharmacists
(RPHs) to place orders for Growth Hormone Stimulation testing.

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

Guidelines for Implementation:
1. This protocol is initiated when the patient is scheduled for a Growth Hormone Stimulation test.
2. The RN enters orders for appropriate lab orders as indicated with the OP – Growth Hormone
Stimulation Test – Peds Diagnostics – Supplemental order set. (See Appendices)
3. RN will determine from physician if patient is receiving a glucagon or clonidine injection.
4. The RN enters orders for either glucagon or clonidine and additional appropriate medications
for IV placement and maintenance.
Order Mode: Protocol/Policy, Cosign Required

References:
Obara-Morzynska M, Kedzia A, Korman E, Niedziela M. Usefulness of growth hormone (GH) stimulation
tests and IGF-I concentration measurement in GH deficiency diagnosis. Journal of Pediatric
Endocrinology & Metabolism; JPEM. 208 Jun;21(6):569-79

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

Böttner A, Kratzsch J, Liebermann S, Keller A, Pfaffle RW, Kiess W, Keller E. Comparison of adrenal
function tests in children—the glucagon hormone response in children. Journal of Pediatric
Endocrinology & Metabolism; JPEM. 2005 May;19(5):433-42

Collateral Documents/Tools:
1. OP – Growth Hormone Stimulation Test – Peds Diagnostics – Supplemental [5250]
Approved By:
UW Health Ambulatory Protocol Committee: August 2014
UWHC Nursing Practice Council: October 2014
UWHC Laboratory Practices Committee: October 2014
Pharmacy and Therapeutics Committee: November 2014
UWHC Medical Board: November 2014

Effective Date: November 2014

Scheduled for Review: November 2016



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