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ummc:va:orders [2024/04/19 15:26] – adminummc:va:orders [2025/06/27 20:28] (current) – [Medications] admin
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-=====At the VA, How Do I Order [item]?=====+# At the VA, How Do I Refer for [cause]? 
 + 
 +==== Pulmonary Transplant Evaluation ==== 
 +  * Determine if YOU think the veteran requires potential consideration 
 +  * staff with Drs. Keller or Todd 
 +    * in the event that neither are available, or if time constraints exist, the veteran will need to be rescheduled in a time fitting manner for this evaluation and discussion 
 +  * for approach candidates, the patient will need to complete the TRACER evaluation 
 +    * Mindy Conklin, APRT, has taken the role of facilitating TRACER evaluation and will need to be contacted when the veterans care dictates 
 + 
 +# At the VA, How Do I Order [item]? 
 + 
 + 
 +====Infusion therapies==== 
 + 
 +  * NF consult for approval 
 +  * Clinic orders  
 +    * <code>Clinic Medication Quick Order > Pulmonary Service Clinic Orders Menu</code> 
 +  * Infusion clinic consult 
 +    * <code>Consult > Additional Services > Infusion Clinic</code> 
 +  
 + 
 +====Radiology==== 
 + 
 +=== Sniff Test ===
  
-==== Radiology ==== 
-===Sniff Test === 
   - Radiograph   - Radiograph
   - abdominal radiograph   - abdominal radiograph
   - in comments, write <code>sniff test</code>   - in comments, write <code>sniff test</code>
  
-==== Lab Tests ==== +## Lab Tests 
-=== Myositis Panel === + 
 +===Myositis Panel=== 
   - Misc order   - Misc order
   - in comments, write <code>sent out myositis panel, code 10257</code>   - in comments, write <code>sent out myositis panel, code 10257</code>
-=== Cystic Fibrosis Genetic Test ===+ 
 +===Cystic Fibrosis Genetic Test=== 
   - Misc order   - Misc order
   - in Comments, write <code>send out CFTR gene, code 10458</code>   - in Comments, write <code>send out CFTR gene, code 10458</code>
  
-=== Body Fluid Samples=== +===Body Fluid Samples=== 
-  - Cytology +__Cytology__ 
-    - collect sample into sample cup +  * collect sample into sample cup 
-    - paper lab order form +  * paper lab order form
-      - MICU nurses have this +
-  - Micro, chemistries +
-    - collect samples into purple- and red-top tubes  +
-    - place orders +
-    - attach patient label to samples +
-    - walk to lab on 4F near MICU+
  
-==== Diagnostic Tests ==== +__Micro, chemistries__ 
-=== Pulmonary Function Tests === +  * collect samples into purple- and red-top tubes  
-  - Orders +  * place orders 
-  - Consult Menu +  * attach patient label to samples 
-  - Pulmonary, Respiratory & HOME O2 +  * walk to lab on 4F near MICU 
-  - Pulmonary Function Test Outpt - BT+ 
 +## Diagnostic Tests 
 + 
 +===Pulmonary Function Tests=== 
 + 
 +  - ''Orders'' 
 +  - ''Consult Menu'' 
 +  - ''Pulmonary, Respiratory & HOME O2'' 
 +  - ''Pulmonary Function Test Outpt - BT'' 
 + 
 +===EKG, outpatient=== 
 + 
 +  - ''Admission order'' 
 +  - ''pre op'' 
 +  - ''ekg now'' 
 +  - Personally walk the patient to EKG area 
 +## Medications 
 +===Ordering tPA and dornase===
  
-=== EKG, outpatient === 
-  - Admission order 
-  - pre op 
-  - ekg now 
-  - then take the patient to EKG area 
-  -  
-==== Medications ==== 
-=== Ordering tPA and dornase=== 
   - send Teams message to [[mailto:faryal.qureshi@va.gov|Faryal Qureshi]]   - send Teams message to [[mailto:faryal.qureshi@va.gov|Faryal Qureshi]]
   - Orders, High-alert medication   - Orders, High-alert medication
  
-=== Non-Formulary Medication === +===Non-Formulary Medication===
-  - Orders +
-  - Meds Outpatient Quick Orders +
-  - #12 Controlled Substances (non formulary) +
-  - (CLICK HERE FOR CONSULT) +
-  - Attention: Faryal Qureshi+
  
-=== Asthma Biologics === +  - ''Orders'' 
-At the VA, Fasenra (benralizumab) is the only biologic for severe asthma on formulary. +  - ''Meds Outpatient Quick Orders'' 
-It appears Dupixent (dupilumab) is not yet available for [[https://www.nejm.org/doi/full/10.1056/NEJMoa2303951|eosinophilic COPD]].+  - ''#12 Controlled Substances (non formulary)'' 
 +  - ''(CLICK HERE FOR CONSULT)'' 
 +  - ''Attention: Qureshi,Faryal''
  
-  - **REQUIRED**: EpiPens x2 +===Asthma Biologics=== 
-    - Must order when getting benralizumab  + 
-    - Patient must bring to infusion clinic +At Baltimore VA, Fasenra (benralizumab) is the only on-formulary biologic for severe asthma. 
-  - Options to order benralizumab + 
-    - [[#Non-Formulary Medication|Non-Formulary Order]]+  * Order EpiPens x2 
 +  * Place order for Infusion clinic 
 +  * Place [[#Non-Formulary Medication|Non-Formulary Order]] for Fasenra 
 + 
 +## DME 
 +===Inhaler Adjuncts=== 
 + 
 +Includes: incentive spirometer, PEP device (Acapella), pulse oximeter
  
-==== DME ==== 
-=== Inhaler Adjuncts === 
 For more significant support equipment (oxygen, nebulizers, suction equipment, ventilators, etc.) see [[#Home O2 Consult|Home O2 Consult]].  For more significant support equipment (oxygen, nebulizers, suction equipment, ventilators, etc.) see [[#Home O2 Consult|Home O2 Consult]]. 
  
 For ordering flutter valves, spacers, peak flow meters, incentive spirometry, etc. For ordering flutter valves, spacers, peak flow meters, incentive spirometry, etc.
-  - Orders +  - ''Orders'' 
-  - Consult +  - ''Consult'' 
-  - Additional Services → Prosthetics +  - ''Additional Services → Prosthetics'' 
-  - Prosthetics Request Non-Implant- Baltimore+  - ''Prosthetics Request Non-Implant- Baltimore'' 
 + 
 +===Home O2 Consult===
  
-==== Home O2 Consult ==== 
 Below is how to order a 6MWT (to qualify for home oxygen), qualify for nebulizers, obtain suction equipment, obtain ventilators. Below is how to order a 6MWT (to qualify for home oxygen), qualify for nebulizers, obtain suction equipment, obtain ventilators.
  
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   - Consult   - Consult
   - Pulmonary, Respiratory & Home O2   - Pulmonary, Respiratory & Home O2
-  - Home Oxygen Request-VAMHCS+  - Home Oxygen Request 
 +  - VAMHCS
  
-**To expedite home O2, contact [[mailto:richard.farr@va.gov | Richard Farr]] or Kimberley. +To expedite home O2, contact [[mailto:richard.farr@va.gov | Richard Farr]] or Kimberley.
-** +
-==== Referrals ====+
  
-=== Refer for Lung Transplant === +## Referrals 
-  - Write a VACO note+ 
 +===Refer for Lung Transplant=== 
 +  * Write a VACO note
     - <code>Shared Template > Medical Care > Transplant > VACO</code>     - <code>Shared Template > Medical Care > Transplant > VACO</code>
-=== Refer to Subspecialty Clinics ===+ 
 +===Refer to Subspecialty Clinics=== 
 For lung cancer screening, lung mass clinic, pulmonary hypertension, pulmonary rehab, 6MWT, home oxygen assessment, qualify for nebulizers, suction equipment, ventilators. For lung cancer screening, lung mass clinic, pulmonary hypertension, pulmonary rehab, 6MWT, home oxygen assessment, qualify for nebulizers, suction equipment, ventilators.
 +
   - Orders   - Orders
   - Consult    - Consult 
   - Pulmonary, Respiratory & Home O2    - Pulmonary, Respiratory & Home O2 
  
-=== Sleep Disordered Breathing === +===Sleep Disordered Breathing=== 
-  - Refer to Sleep Clinic + 
-    - Orders Tab +  * Refer to Sleep Clinic 
-    - Consult +    - ''Orders'' 
-    - Neurology +    - ''Consult'' 
-    - Sleep +    - ''Neurology'' 
-    - Neurology Sleep Disorders Clinic Outpt +    - ''Sleep'' 
-  - NIPPV Equipment (CPAP, BIPAP) +    - ''Neurology Sleep Disorders Clinic Outpt'' 
-    - Orders Tab + 
-    - Consult +  * NIPPV Equipment (CPAP, BIPAP) 
-    - Neurology +    - ''Orders'' 
-    - Sleep +    - ''Consult'' 
-    - Sleep therapy outpt+    - ''Neurology'' 
 +    - ''Sleep'' 
 +    - ''Sleep therapy outpt''
ummc/va/orders.1713540366.txt.gz · Last modified: by admin

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