Report to PRU upon completion of morning conference/lecture as outpatients will need consent

Determine who is the PRU Charge nurse and notify them of any specific patient needs for the day:

• • • Lab orders (also helpful to indicate this on the schedule)

    • Pre-medications

    • Overnight admissions

    • Planned radial access

    • Procedural order clarifications needed

Determine if there are any overnight patients from the day prior that need to be seen and approved for discharge (i.e. G tube placements)

• • • After assessing these patients, write & quot "OK to discharge” order unless they require continued care

Work up IR outpatients:

• • • Obtain Informed Consent for all procedures (only exception is for tunneled line removals and drain removals done in PRU)

    • Assessment of airway, heart, lungs

      • • • Notify the nurse/attending if Mallampati is IV OR if you assess the ASA as 4 or 5 (does patient need admission if yes?)

    • Mark the site during your assessment when appropriate

    • Place H&P in EPIC with the ASA and Mallampati included & the results of the Barbeau test if radial access

      • • • Indicate if patient will accept blood/blood products

          • Include pt’s code status

    • Place pre-procedure orders using pre-procedure order set in EPIC after consent and assessment (including order for POC glucose if pt is diabetic)

    • Assess for radial versus femoral access for arterial access when indicated by attending

    • Any possible problems with the patient should be discussed with the Charge and an attending prior to patient being taken to procedure

Place ADT1 order for any patient needing overnight admissions:

For patients staying overnight for a planned admission to the PRU (i.e. s/p gastrostomy tube placement, UAE, etc.), the admitting service will be Radiology and the admitting physician will be the No. 1 Radiology attending for that day

• • • Patient will be “Extended Recovery” status

It is your responsibility to enter overnight orders for these patients (i.e. fluids, anti-emetics, pain meds, home meds)

In the event the Radiology attending wants to keep a patient longer than planned (i.e. difficult recovery, not doing as well as anticipated, poor pain control, n/v), the patient will be “Observation” status under Radiology service.

For patients being admitted to the floor (i.e s/p TACE, TIPS, etc.) under the medicine service:

• • • Discuss the case with the medical admitting officer and/or the hospitalist or OBS provider

    • The MAO can be reached at 123-7086

See the pre-procedural work-up guidelines for possible antibiotic prophylaxis and/or other types of pre-medications needed, depending on procedure and attending and enter EPIC orders accordingly

Post-procedure orders should be placed by the procedural physician. If they are not placed, you may be asked to place them as the PRU physician.

Be available and/or return pages in a timely manner for any medication orders that may be needed post-procedure, or for new patients arriving needing consent, assessment, pre-procedure orders. Entering these orders is your responsibility as the PRU physician.

Communicate with the Charge nurse if you plan to leave the PRU outside of your scheduled conference time.