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

Propofol Laboratory Monitoring - Adult - Inpatient [160]

Propofol Laboratory Monitoring - Adult - Inpatient [160] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Inpatient Delegation Protocols



Delegation Protocol Number: 160

Delegation Protocol Title:
Propofol Laboratory Monitoring – Adult – Inpatient

Delegation Protocol Applies To:
UW Health Hospitals

Target Patient Population:
Any adult intensive care (ICU) patient receiving a continuous infusion propofol for greater than 72
hours

Delegation Protocol Champions:
Pierre Kory, MD – Medical Director, Trauma and Intensive Care
Ann O’Rourke, MD – Director, Surgical Intensive Care

Delegation Protocol Reviewer:
Jeff Fish, PharmD – Department of Pharmacy
Aaron Steffenhagen, PharmD – Department of Pharmacy

Responsible Department:
Department of Pharmacy

Purpose Statement:
To delegate from the ordering provider to pharmacists the authority for ordering labs necessary to
monitor propofol therapy (Triglycerides, CK Total and Lactate).

Who May Carry Out This Delegation Protocol:
Pharmacists who have been trained in the use of this delegation protocol.

Guidelines for Implementation:
1. This protocol is initiated when a continuous propofol infusion is ordered by a provider.
2. A pharmacist will evaluate the duration of propofol continuous infusion therapy daily.
3. If the infusion has been running for 72 hours or longer, the pharmacist will place orders for the
laboratory tests needed to monitor for propofol infusion syndrome (Triglycerides, CK Total and
Lactate) if not obtained in the previous 72 hours.
4. Prior to placing any orders the pharmacist will review the medical record to avoid placing
duplicate orders.
5. If any of the lab results are outside of the normal range, the medical team will be notified by a
pharmacist.

Order Mode: Cosign Required, Protocol/Policy

References:
1. Krajcova A, Waldauf P, Andel M, Duska F. Propofol infusion syndrome: a structured review of
experimental studies and 153 published case reports. Crit Care. 2015; 19:398. doi 10.1186/s13054-
015-1112-5.

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


Collateral Documents:
UW Health Assessment and Treatment of Pain, Agitation, and Delirium in the Mechanically Ventilated
Intensive Care Unit Patient – Adult – Inpatient Clinical Practice Guideline

Approved By:
UWHC Pharmacy Practice Committee: June 2017
UW Health Laboratory Practices Committee: August 2017
UWHC Pharmacy & Therapeutics Committee: June 2017
UWHC Medical Board: September 2017

Effective Date: September 2017

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