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/clinical/cckm-tools/content/order-sets/inpatient/transplant/name-123011-en.cckm

201711332

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UWHC,UWMF,

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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Transplant

IP - Abdominal Transplant - Live Liver Donor - Adult - Discharge [5460]

IP - Abdominal Transplant - Live Liver Donor - Adult - Discharge [5460] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Transplant


IP - Abdominal Transplant - Live Liver Donor - Adult - Discharge [5460]
Patient Care Orders
Confirmed Discharge Date/Time [151653]
Confirmed Discharge Date/Time [ADT0013] Confirmed Discharge Date:
Confirmed Discharge Time:
Conditions for Discharge:
Provider to be Present at Discharge?
Reason For Hospitalization [129829]
Why You Were Hospitalized [NURCOM0073] Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine
Activity [198270]
Lifting Restriction: Do not lift greater than 10
pounds for 8 weeks [NURACT0011]
Routine
Bathing Restrictions [NURACT0011] Routine, You may shower. No tub baths until cleared
by surgeon. Do not immerse incisions until fully
healed, about 4-6 weeks.
Activity: Daily, low impact aerobic exercise such
as walking. [NURACT0008]
Routine
Discharge Activity: See Instructions
Daily, low impact aerobic exercise such as walking.
Do Not Drive Until Given Permission by Surgeon
[NURACT0011]
Routine
Other Restrictions [NURACT0011] Routine
Return to Work - [DC0014] Routine
Return to Work:
Nutrition [197466]
High Protein Diet [NUT8888] Routine
General:
Diet Modifications: High Protein
Other Diet Modifications:
Wound Care [119658]
Wound Care [NURWND0018] Routine, Wash incision daily with soap and water. Do
not rub the site. Do not use lotions and/or ointments
on the incision. Monitor wounds for signs and
symptoms of infection (redness, swelling, drainage, or
odor). Call your Transplant Coordinator if you notice
these symptoms.
Line and Drain Care [119660]
Line and Drain Care [NURTAD0046] Routine, For Lines: Your dressing needs to be
changed every 7 days. Your line should be flushed
daily with ***. This will be done by {staff
options:30021404}. Your line should be removed ***,
by ***.
For Drains: Dressing change ***. You will need to
flush your drain with 10mL of Normal Saline *** times
per day. Your drain should be removed ***, by ***. If
you have questions about your line or drain, contact
your Transplant Coordinator.
Bowel Care [123361]
Bowel Care [NURELM0068] Routine
Bladder Care [123379]
Bladder Care [NURELM0067] Routine
Other Patient Care Instructions [197467]
Page 1 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Discharge Medication Monitoring [NURCOM0072] Details
Home Health [105685]
Home Health Information [NURCOM0022] Routine, Home Health Agency:
@FLOWREFRESH[330601@
@FLOWREFRESH[330607@
When to Call Your Doctor [132307]
When to Call Your Doctor [NURCOM0079] Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan.
You should include specific instructions on when and
who to call.
You should include actual provider names (i.e. not
'PCP').
You should NOT include the discharging unit as a
contact., Routine, CALL 911 FOR EMERGENCIES
Contact Information:
Transplant office at: (608) 263-1384
Transplant Coordinator: @TXPCOORD@
Transplant Clinic at: (608) 262-5420
For URGENT issues on weekends, evenings, and
holidays call (608) 263-6400 and ask for the
Abdominal Transplant Coordinator on call.
Call Your Transplant Coordinator if you have any of
the following symptoms:
• Increased Pain
• Fever
• ***
Follow Up Care
Follow Up Appointments [197469]
Discharge Appointment Instructions
[NURCOM0083]
This order should be used by providers to
communicate appointment instructions directly to the
patient. This order will appear on the After Hospital
Care Plan. This orders does NOT go to the HUC for
follow-up. If you would like the HUC to schedule an
appointment, you should use the Schedule
Appointment order., Routine, Always go to Lab at least
90 minutes prior to your Transplant Clinic
appointments to have labs obtained so results are
known at the time of your clinic visit. See Health Facts
for You in your binder for clinic instructions. Bring your
medication box and medications with you to be
reviewed by the Transplant Clinic Pharmacist.
Schedule Follow Up Appointment with Transplant
Surgeon [NURCOM0026]
Reason for Hospital Follow Up Appointment: Surgery
Follow-Up
Which Provider: Other Provider or Specialist
When do you want appointment:
Which Clinic or Specialty: Transplant Surgeon
Schedule Appointment [197470]
Schedule Appointment [NURCOM0026] Reason for Hospital Follow Up Appointment:
Which Provider:
Page 2 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Schedule Appointment [NURCOM0026] Reason for Hospital Follow Up Appointment:
Which Provider:
Follow Up Appointments - Diabetes (Single Response) [148552]
*** RESPONSE REQUIRED *** This order facilitates documentation (only) about follow-up
appointments for patients with diabetes. Scheduling an appointment before discharge with a
provider who will manage a patient’s diabetes care (e.g., primary care physician, endocrinologist,
etc.) is a Joint Commission requirement. Exclusions are allowed based upon patient situation
(e.g., discharge to a skilled nursing facility, patient refusal, etc.). Only select “Appointment
Scheduled” if an appointment has already been scheduled, and use the Schedule Appointment
order as needed to request assistance in scheduling
No appointment: Patient does not have diabetes
[COR0064]
ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): No appointment: Patient
does not have diabetes
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Appointment scheduled (with provider who can
manage diabetes) [COR0064]
ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): Appointment scheduled
(with provider who can manage diabetes)
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Page 3 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Appointment scheduled per patient report
(ENTER DATE IN COMMENTS) [COR0064]
ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): Appointment scheduled per
patient report (ENTER DATE IN COMMENTS)
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Appointment pending: patient discharged on
weekend; follow-up information provided
[COR0064]
ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): Appointment pending:
patient discharged on weekend; follow-up information
provided
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Free clinic information provided [COR0064] ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): Free clinic information
provided
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Page 4 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

No appointment: Patient discharging to a facility
(e.g., skilled nursing facility, correctional facility,
etc.) [COR0064]
ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): No appointment: Patient
discharging to a facility (e.g., skilled nursing facility,
correctional facility, etc.)
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
No appointment: Patient refusal [COR0064] ONCE, Starting today For 1 Occurrences, Routine
Documentation (required): No appointment: Patient
refusal
1. This order facilitates documentation (only) about
follow-up appointments for patients with diabetes.
2. Scheduling an appointment before discharge with a
provider who will manage a patient's diabetes care
(e.g., primary care physician, endocrinologist, etc.) is a
Joint Commission requirement. Exclusions are
allowed based upon patient situation (e.g., patient
discharging to a skilled nursing facility, patient refusal,
etc.)
3. Only select "Appointment Scheduled" if an
appointment has already been scheduled with a
provider who can manage patient's diabetes.
4. Use the Schedule Appointment order as needed to
request assistance in scheduling an appointment.
Recommended Labs [197471]
Discharge Labs Workflow URL: https://uconnect.wisc.edu/growth/training--
education/health-link/10-minutes/inpatient-
discharge-consult/resources/name-82993-en.file
Recommended Discharge Labs
[NURCOM0075]
With the exception of HLA and other Desensitization labs, all lab
results should be FAXED to the UW Hospital transplant office at
608-262-5624. HLA and other Desensitization lab samples will
have special processing instructions provided by the transplant
coordinator.
This patient's transplant coordinator is @TXPCOORD@.
{Abdominal Transplant Monitoring Labs -
Kidney/Panc/Liver/Immuno/Desensitization/Anticoag/Misc:21293}
Labs [197478]
HEMATOCRIT [HCT] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
WHITE CELL COUNT [WBC] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
MAGNESIUM [MAG] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
Page 5 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

PHOSPHATE [PHOS] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
GGT [GGT] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
AST/SGOT [AST] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
ALT/SGPT [ALT] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
BILIRUBIN, TOTAL [TBIL] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
ALKALINE PHOSPHATASE [ALKP] Status: Future, Expected: 8/6/2017 Approximate,
Expires: 9/3/17, Normal, Routine, 2 times weekly
Page 6 of 6
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:19:36 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org