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OP - Influenza Screening and Treatment Delegation Protocol - Adult/Pediatric - Ambulatory [5573]

OP - Influenza Screening and Treatment Delegation Protocol - Adult/Pediatric - Ambulatory [5573] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Pulmonary


OP - Influenza Screening and Treatment Delegation Protocol - Adult/Pediatric -
Ambulatory [5573]
Influenza Screening and Treatment Delegation
Protocol - Adult/Pediatric - Ambulatory
URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/?path=/content/delegationpractice-
protocols/ambulatory-delegation-protocols/name-
97438-en.cckm
CDC Influenza Information URL: http://www.cdc.gov/flu/professionals/index.htm
Documentation
Nurse Documentation [185094]
Influenza RN Assessment INFLUENZA DELEGATION PROTOCOL
Prescriptions
Patients 5 to 13 years of age and with normal renal function (i.e., eGFR or CrCl > 60 mL/min) (Single
Response) [185097]
Oseltamivir Phosphate 6 MG/ML SUSR - 30 mg
2x/d x 5d [146620]
30 mg, 50 mL, 0, starting 2/13/17 until 2/18/17,
Normal
oseltamivir (TAMIFLU) 30 MG cap - 2x/d x 5d
[126615]
30 mg, 10 cap, 0, starting 2/13/17 until 2/18/17,
Normal
oseltamivir (TAMIFLU) 45 MG cap - 2x/d x 5d
[126616]
45 mg, 10 cap, 0, starting 2/13/17 until 2/18/17,
Normal
oseltamivir (TAMIFLU) 30 MG cap - 60 mg dose
2x/d x 5d [126615]
60 mg, 20 cap, 0, starting 2/13/17 until 2/18/17,
Normal
oseltamivir (TAMIFLU) 75 MG cap - 2x/d x5d
[62994]
75 mg, 10 cap, 0, starting 2/13/17 until 2/18/17,
Normal
Adult Patients (age 13 years or older), including those with known renal impairment (i.e. eGFR or CrCl
If the patient has not had a recent Cr (i.e., eGFR or Cr in the last 3 months), a provider will be contacted prior to
placing any orders
oseltamivir (TAMIFLU) 75 MG cap - 2x/d x 5d
[62994]
75 mg, 10 cap, 0, starting 2/13/17 until 2/18/17,
Normal
oseltamivir (TAMIFLU) 75 MG cap - 1x/d x 5d
[62994]
75 mg, 5 cap, 0, starting 2/13/17 until 2/18/17, Normal
oseltamivir (TAMIFLU) 75 MG cap - Post
Hemodialysis [62994]
5 cap, 0, starting 2/13/17, Normal
Patient Instructions
Patient Instructions [185134]
INFLUENZA (ENGLISH) INFLUENZA (ENGLISH)
INFLUENZA : TEEN (ENGLISH) INFLUENZA: TEEN (ENGLISH)
INFLUENZA : PEDIATRIC (ENGLISH) INFLUENZA: PEDIATRIC (ENGLISH)
INFLUENZA (SPANISH) INFLUENZA (SPANISH)
INFLUENZA : TEEN (SPANISH) INFLUENZA: TEEN (SPANISH)
Weight Dose
15 kg or less 30 mg PO 2x/day x 5 days
>15 to 23 kg 45 mg PO 2x/day x 5 days
>23 to 40 kg 60 mg PO 2x/day x 5 days
>40 kg 75 mg PO 2x/day x 5 days
eGFR or CrCl Dose
>30 mL/min 75 mg PO 2x/day x 5 days
11-30 mL/min 75 mg PO once daily x 5 days
0-10 mL/min and not on
hemodialysis
Contact physician before placing any orders
Hemodialysis 75 mg PO after dialysis (no dose on non-dialysis days) x5
doses
Page 1 of 2
Printed by STRAKA, KEVIN F [KFS1] at 2/13/2017 2:59:27 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 02/2017CCKM@uwhealth.org

INFLUENZA : PEDIATRIC (SPANISH) INFLUENZA: PEDIATRIC (SPANISH)
Page 2 of 2
Printed by STRAKA, KEVIN F [KFS1] at 2/13/2017 2:59:27 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
02/2017CCKM@uwhealth.org