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/clinical/cckm-tools/content/order-sets/inpatient/hospital-wide/name-98270-en.cckm

20180112

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Hospital-wide

IP - Pneumonia, Community Acquired (CAP) - Adult - Supplemental [831]

IP - Pneumonia, Community Acquired (CAP) - Adult - Supplemental [831] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Hospital-wide


IP - Pneumonia, Community Acquired (CAP) - Adult - Supplemental [831]
for Adult Patients OnlyIntended
Patient Care Orders
Respiratory [153200]
Respiratory Care for Community Acquired Pneumonia
[151742]
Respiratory Therapy per Protocol [RT0035] Routine
Protocol Type:
Incentive Spirometry [NURTRT0018] EVERY 2 HOURS, Routine, While awake.
Cough And Deep Breathe [NURTRT0019] EVERY 2 HOURS, Routine, While awake.
Anti-infectives
Infectious
Diseases Society
of
America/American
Thoracic Society
Guidelines: CID
2007;44:S27-72
URL: http://workspaces.uconnect.wisc.edu/download/attachments/10327345/CAP+Guidelines+-+IDSA%
2C+2007.pdf?version=1&modificationDate=1297119316363
Anti-infectives [150144]
patients with a history of data suggests a lower incidence of Clostridium difficile infection in Preliminary
based regimenusing a doxycycline -C.difficile infection
Infectious
Diseases Society
of
America/American
Thoracic Society
Guidelines
URL: http://workspaces.uconnect.wisc.edu/download/attachments/10327345/CAP+Guidelines+-+IDSA%
2C+2007.pdf?version=1&modificationDate=1297119316363
Ceftriaxone and Doxycycline - 1st Line [228345]
ceftriaxone (ROCEPHIN) intraVENOUS [800027] 1 g, Intravenous, EVERY 24 HOURS
doxycycline hyclate tab [67296] 100 mg, Oral, EVERY 12 HOURS
Ceftriaxone and Azithromycin - 2nd Line [228343]
ceftriaxone (ROCEPHIN) intraVENOUS [800027] 1 g, Intravenous, EVERY 24 HOURS
azithromycin (ZITHROMAX) tab [57023] 500 mg, Oral, EVERY 24 HOURS For 5 Days
azithromycin (ZITHROMAX) intraVENOUS [800011] 500 mg, Intravenous, EVERY 24 HOURS
Fluoroquinolone - 3rd Line (Single Response)
[234230]
administration and therefore preferred. moxifloxacin achieves similar serum levels as the intravenous Oral
moxifloxacin (AVELOX) tab [63314] 400 mg, Oral, EVERY 24 HOURS
moxifloxacin (AVELOX) 400 mg in sodium chloride
0.8% 250 mL bag [168649]
400 mg, Intravenous, EVERY 24 HOURS, for 60 Minutes
Probiotic [200227]
spectrum -therapeutic broadconsider the use of probiotics in immunocompetent patients receiving Please
lactamase -lactam/beta-4th generation cephalosporins, betaantibiotics, such as fluoroquinolones, 3rd and
diarrhea clindamycin to prevent antibiotic associated inhibitors, and
lactobacillus rhamnosus GG (CULTURELLE) cap
[152674]
1 cap, Oral, 1 X DAILY
Laboratory
Best Practices for Blood Culturing URL: https://uconnect.wisc.edu/clinical/references/laboratory-
services/blood/
Draw STAT (If Not Done in ER) [34163]
Page 1 of 3
Printed by WILLIAMS, HEATHER R [HRS0] at 1/11/2018 11:23:47 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
STAT, Starting today For 1 Occurrences, Routine, For
optimum diagnosis of sepsis, sample 3-4 sites only on the
first day of a septic episode. Cultures on subsequent days
are of minimal diagnostic value. Culture detects bacteria,
Candida and Cryptococcus. If filamentous fungi are
suspected see Culture, Blood, Filamentous Fungi.
Patient's Active Lines:
No Active Lines Found.
If Conditional, What Condition? if patient febrile and
temperature >38.2C
Draw before antibiotics are administered.
CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
STAT, Starting today For 1 Occurrences, Routine, For
optimum diagnosis of sepsis, sample 3-4 sites only on the
first day of a septic episode. Cultures on subsequent days
are of minimal diagnostic value. Culture detects bacteria,
Candida and Cryptococcus. If filamentous fungi are
suspected see Culture, Blood, Filamentous Fungi.
Patient's Active Lines:
No Active Lines Found.
If Conditional, What Condition? if patient febrile and
temperature >38.2C
Draw before antibiotics are administered.
Draw Now (If not Done in ER) [152341]
PROCALCITONIN [HCPRCTON] NEXT AM For 1 Occurrences, Routine, Accepted uses:
1. Diagnosis of community acquired pneumonia
2. Antibiotic de-escalation/discontinuation in patients
improving from bacterial pneumonia or culture-negative
sepsis
It should NOT be ordered in the following conditions:
1. Evaluation of aspiration as it cannot differentiate chemical
from bacterial pneumonitis
2. Immunosuppressed patients
3. Culture-positive septicemia
4. Decompensated heart failure
5. Infectious disease syndromes other than pneumonia or
sepsis
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Next draw
CULTURE, SPUTUM WITH GRAM STAIN
[HCSPUCS]
ONCE, Starting today For 1 Occurrences, Routine, For
patients with an ET tube or tracheostomy, quantitative mini-
BAL by RT or bronchoscopic BAL are the preferred
methods of specimen collection.
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Collect before antibiotics are administered. Do not delay
antibiotics to obtain specimen. If unable to obtain
expectorated sample within 4 hours, RN or Pharmacist
should place order for RT to Induce Sputum.
LEGIONELLA URINARY AG [GM4910] ONCE For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
STREP PNEUMONIAE AG, URINE [GM4545] ONCE For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Page 2 of 3
Printed by WILLIAMS, HEATHER R [HRS0] at 1/11/2018 11:23:47 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

Influenza Testing (Seasonal Testing: October - March) [9017]
RESPIRATORY VIRUS DETECTION [HCVIRUSD] ONCE, Starting today For 1 Occurrences, Routine, Includes
Influenza A and B by PCR, RSV by PCR, and Parainfluenza
1,2, 3 by PCR. May also include rapid antigen tests during
season.
UWHC: Collect Nasopharyngeal Minitip swab (flocked
swab) and place in UTM. BAL is also acceptable. Room
temperature M4 (M4RT) is not acceptable.
UWMF: Collect Nasopharyngeal (flocked swab) and place
in refrigerated M4 viral media. BAL is also acceptable.
Room temperature M4 (M4RT) is not acceptable.
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Page 3 of 3
Printed by WILLIAMS, HEATHER R [HRS0] at 1/11/2018 11:23:47 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org