TPIAT Admission Job Aid

Statements in this guideline

1. Patients are admitted to the hospital prior to total pancreatectomy with islet auto-transplantation to ensure readiness for surgery.

   Established

2. The Pancreas Care Center nurse practitioner enters all admission orders using the order set TPIAT pre-op Total Pancreatectomy with Islet Auto-transplantation.

   RecommendationPrior to admission

3. The Pancreas Care Center surgeon enters all intra-op orders using the order set TPIAT intra-op Total Pancreatectomy with Islet Auto-transplantation.

   RecommendationPrior to admission

4. The admitting floor releases all admission orders on the day of admission.

   RecommendationDay of admission

5. A peripheral intravenous line is placed on admission.

   RecommendationDay of admission

6. Labs as ordered are obtained on admission, including urine pregnancy test if applicable.

   RecommendationDay of admission

7. An EKG is obtained on admission, performed by the EKG tech Monday through Friday or by the surgery resident Saturday and Sunday.

   RecommendationDay of admission

8. Incentive spirometer teaching is provided on admission.

   RecommendationDay of admission

9. Bowel prep with Miralax 2 caps three times daily is administered on admission.

   RecommendationDay of admission

10. A CHG bath or shower is performed the evening prior to the operating room.

    RecommendationDay of admission

11. A clear liquid diet is given until midnight before surgery.

    RecommendationDay of admission

12. Patients are made NPO with intravenous fluids (D5 ½ NS 10 mEq/L at maintenance rate) starting at midnight before surgery.

    RecommendationDay of admission

13. The PICU educator or designee releases all intra-op orders on the day of admission after the admission orders are active.

    RecommendationDay of admission

14. Releasing intra-op orders after admission orders allows sufficient time for pharmacy to prepare all medications, antibiotics and drips required for surgery.

    EstablishedDay of admission

15. Medications are dispensed to the OR and PICU for the case.

    RecommendationDay of admission

16. The admitting floor should not do anything with the intra-op orders.

    RecommendationDay of admission

17. Lovenox is administered as ordered at 0530 the morning of surgery.

    RecommendationDay of surgery

18. On call antibiotics (fluconazole, Meropenem and Vancomycin) are sent to the OR with the patient.

    RecommendationDay of surgery

19. Meropenem may be stored in the medication refrigerator.

    RecommendationDay of surgery

20. The Pancreas Care Center nurse practitioner enters all post op orders using the order sets Post op TPIAT Total Pancreatectomy with Islet Auto-transplantation and TPIAT Post op Labs First 48 Hours Total Pancreatectomy with Islet Auto-transplantation.

    RecommendationDay of surgery