TABLE 3

Order Set Updates and Clinical Initiatives Addressed

GoalAction
Acetaminophen safetyEliminate all acetaminophen combination orders
Opioid safetyStandards including oxycodone only for patients aged ≥6 months
Consistent management of seizuresAcute seizure medications moved to separate embeddable order set from multiple order sets
Improve ordering for chronic seizure medicationsChronic seizure medications moved to separate embeddable order set from multiple order sets; removed nonformulary medications
Consistent management of anaphylaxisAcute anaphylaxis medications moved to embeddable order sets for acute use and for potential use
Consistent monitoringMonitor orders with appropriate discontinuation protocol specified
Consistent caution parametersAligned vital sign parameters with modified pediatric early warning scale
Consistent urine output parameters created
Consistent oxygen parameters created to match policy
Reduce unneeded laboratory testsEnsure end dates on recurring laboratory tests
Consistent safe fluid managementStandards for intravenous fluids running up to standard maintenance fluid rate
Reduction of catheter-associated urinary tract infectionAdd orders to discontinue Foley catheters where they are ordered
Consistent management for transplantStandardized blood orders and starting immunosuppression for cardiac transplants
Decreased volume of blood drawn for cardiac transplant hold studies
Consistent perioperative antibioticsStandardized approach to penicillin allergy and methicillin-resistant Staphylococcus aureus for perioperative antibiotic orders
Consistent postoperative pain managementAcetaminophen, oxycodone, morphine; with ketorolac and ibuprofen if clinically acceptable
Consistent management for necrotizing enterocolitisSimplified antibiotic choices based on evidence
Safe sedationMoved all neonatal sedation infusions to 1 place