Provider Forms

				Anesthesia Pre-op Orders
				Extubation Post Heart Surgery Orders
				Intrathecal Narcotic Orders
				OB Epidural Orders
				Pain Protocol-Continuous Nerve Block
				Pain Protocol-No PCA
				Pain Protocol-Orthopedic Surgical with PCA
				Pain Protocol-Shoulder Nerve Block
				Pain Protocol-Single Injection Peripheral Nerve Block
				Pain Protocol-Surgical With PCA
				Pain Protocol-With PCA
				PICC/Midline Catheter Placement Orders
				Ventilator Adult Admission Orders

				Cancer Center Admission Orders
				Consent To Receive Anti-Cancer Medications
				Hypersensitivity Reaction to Chemotherapy or Biotherapy Orders

				Acute Coronary Syndrome Admission Orders
				Aquapheresis Ultrafiltration Heparin Orders
				Aquapheresis Ultrafiltration Orders
				CABG-Valve Transfer Orders
				Cardiac CT Angiography Orders
				Cardioversion Orders
				Code STEMI Inpatient Orders
				CT Cardiac Angiography Worksheet
				Definity Contrast Echo Orders
				Heart Cath Pre-Procedure Orders
				Heart Failure Orders
				Heart Surgery Intraoperative Orders
				Heart Surgery Post-Op Orders
				Heart Surgery Pre-Op Orders
				ICD/CRT-D Pre-Admission Data Worksheet
				Pacemaker-ICD Insertion Pre-Op Orders
				Regadenoson (Lexiscan) Stress Cardiolite Orders
				Thoracic Surgery Post Procedure Orders
				Thoracic Surgery Pre-Procedure Orders
				Transesophageal Echocardiogram Post Procedure Orders
				Transesophageal Echocardiogram Pre Procedure Orders
				Treadmill Cardiolite Orders

Informed Consent for Treatment/Procedure

				Coronary Syndrome Acute or STEMI Emergency Department Orders
				ER Heart Failure Orders
				ICU/Critical Care Trauma Admission Orders
				Non-ICU Trauma Admission Orders
				Pneumonia ER Orders
				Psychiatry Guideline Orders for GSH Admissions
				Stroke Acute ER Initial Assessment Order
				Ventilator Sedation/Analgesia ER Orders

Discharge Order Form

				Comfort Care Order
				Hospice Order

				12 Hour MAR
				8 Hour MAR
				Alcohol and Drug Detox Pathway MAR
				Anemia Management-Adult Erythropoietin (Epogen/Procrit) Therapy MAR
				Anemia Management-Adult IV Iron Administration MAR
				Anesthesia/Surgical AM Admission MAR
				Antepartum MAR
				Aquapheresis Ultrafiltration Heparin MAR
				CABG/Valve Transfer MAR
				Cancer Center - Intrathecal Pump Refill MAR
				Cancer Center - Orencia MAR
				Cancer Center - Port Flush MAR
				Cancer Center - Remicade MAR
				Cancer Center - Tysabri MAR
				CAPD MAR
				CCPD MAR
				Cesarean General Post-Op MAR
				Cesarean Post-Op Immediate MAR
				Code STEMI Inpatient MAR
				Comfort Care MAR
				Continuous Renal Replacement Therapy (CRRT) NxStage MAR
				Diltiazem (Cardizem) IV Drip MAR
				Endoscopy MAR
				Extubation Post Heart Surgery MAR
				Heart Cath Pre-Procedure MAR
				Heart Failure MAR
				Heart Surgery Post-Op MAR
				Heart Surgery Pre-Op MAR
				Hemodialysis Treatment MAR
				Heparin Protocol MAR
				Hospice MAR
				Hypothermia Post Cardiac Arrest MAR
				Hysterectomy Laparoscopy Robotic MAR
				Insulin Intravenous Infusion MAR
				Insulin Sliding Scale MAR
				Intrathecal Narcotic MAR
				Neurointensive Care MAR
				Newborn Admission MAR
				Outpatient - Blood Transfusion MAR
				Outpatient - MAR
				PACU MAR
				Pain Protocol-Continuous Nerve Block MAR
				Pain Protocol-No PCA MAR
				Pain Protocol-Orthopedic Surgical with PCA MAR
				Pain Protocol-Shoulder Nerve Block MAR
				Pain Protocol-Surgical With PCA MAR
				Pain Protocol-With PCA MAR
				Plastic Surgery Post-Op MAR
				Postpartum MAR
				Sepsis Resuscitation/Management MAR
				Stroke with Alteplase (tPA) MAR
				Thoracic Surgery Post Procedure MAR
				Total Hip and Revision Post-Op MAR
				Total Hip SAMA MAR
				Total Knee and Revision Post-Op MAR
				Total Knee SAMA MAR
				Total Shoulder and Revision Post-Op MAR
				Ventilator Adult Admission MAR

				Antepartum Orders
				Cesarean General Post-Op Initiate First Day Orders
				Cesarean Post-Op Immediate Orders
				Cesarean Pre-Op and Intra-Op Orders
				Consent for Elective Induction of Labor
				Elective Induction Information Sheet
				External Version Protocol
				Hypothermia for Hypoxic/Ischemic Encephalopathy Orders
				Magnesium Sulfate Administration Protocol
				Misoprostol (Cytotec) for Delivery after Second Trimester Fetal Demise Orders
				Misoprostol (Cytotec) for Induction Orders
				Newborn Admission Orders
				Newborn Circumcision Orders/Procedure Note
				Newborn Circumsion Orders/Procedure Note
				NICU Admission Orders
				NICU Retina Examination Orders
				OB Triage Orders
				Oxytocin (Pitocin) Chanllenge Test Protocol
				Oxytocin (Pitocin) Induction/Augmentation Protocol
				Postpartum Orders
				PreEclampsia/HELLP Orders with Magnesium Sulfate Levels
				Prostaglandin Gel Protocol for Induction Orders
				Prostin E2 Suppository Protocol
				Terbutaline (Brethine) IV Protocol

Dialysis   CAPD (Manual Exchange) Orders   CAPD (Manual) In/Out Flush Orders   CCPD (Cycler) Orders   Continuous Renal Replacement Therapy (CRRT) NxStage Orders   Hemodialysis Routine Orders   Hemodialysis Treatment Orders   Peritoneal Dialysis Admission Orders

				Alcohol and Drug Detox Pathway Orders
				C-Diff (Clostridium Difficile) Orders
				Diabetic Ketoacidosis Adult/HHNK Orders
				Hypothermia Post Cardiac Arrest Orders
				Outpatient Diabetes Skills and Management Training Orders
				Peripheral IV Starts with 1% Buffered Lidocaine Orders
				Physicians Orders and Progress Notes Post Procedure
				Physicians Orders and Progress Notes with Risks and Benefits
				Physicians Orders and Progress Notes
				Rapid Response Team Orders
				Restraint Orders
				Sepsis Management Orders
				Sepsis Resuscitation Orders
				Sepsis Severe Screening Tool for Adult Patients
				TCU Admission Orders from Other Facilities

				Neurointensive Care Orders
				Spinal Cord Admission Orders
				Spine Injury Orders

				Fractured Hip Post-Op Orders
				Orthopedic Admission Orders
				Orthopedic Post-Op Orders
				Orthopedic Pre-Op Orders
				Total Hip and Revision Post-Op Orders
				Total Hip Pre-Op Clinic Orders
				Total Hip SAMA Orders
				Total Knee and Revision Post-Op Orders
				Total Knee Pre-Op Clinic Orders
				Total Knee SAMA Orders
				Total Shoulder and Revision Post-Op Orders

				Anemia Management-Adult Erythropoietin (Epogen/Procrit) Therapy Orders
				Anemia Management-Adult IV Iron Administration Orders
				Beta Blocker PACU Orders
				Beta Blocker Post-Op/Transfer Orders
				Beta Blocker Pre-Op IV Orders
				Heparin Protocol
				Insulin Intravenous Infusion Orders
				Insulin Pump Orders
				Insulin Subcutaneous Orders
				Medtronic Intrathecal Pump Orders
				Methylprednisolone (Solu-Medrol)/Spinal Cord Protocl
				Naloxone (Narcan) Infusion Protocol
				Total Parenternal Nutrition (TPN) Adult Orders
				Total Parenternal Nutrition (TPN) Routine Orders

Podiatry Pre-Op Orders

MAR   RY 12 Hour MAR   RY Adult/Subacute Admission MAR   RY Youth Admission MAR

				RY Adult/Subacute Admission Orders
				RY Alcohol and Drug Withdrawal Orders
				RY Electrical Convulsive Therapy (ECT) Orders
				RY Physical Hold Orders
				RY Physicians Orders and Progress Notes
				RY Pre-ECT Evaluation Orders
				RY Restraint Orders
				RY Seclusion Orders
				RY Youth Admission Orders

Pneumonia Orders

				Angiography Post Procedure Orders
				Cardiac Stress MRI Orders
				CT IV Contrast Inpatient Safety Orders
				CT IV Contrast Inpatient Safety Screening
				CT IV Contrast Outpatient Safety Orders
				CT IV Contrast Outpatient Safety Screening
				Education and Informed Consent for Magnetic Resonance Imaging-Angiography Contrast
				Fibrinolytic Therapy Radiology Orders
				Moderate Sedation Radiology Intra-Procedural Orders
				MRI/MRA IV Contrast (Gadolinium) Inpatient Safety Screening
				MRI/MRA IV Contrast (Gadolinium) Outpatient-Emergent Safety Screening
				Radiology Post Procedure Orders
				Radiology Pre-Procedure Orders
				Renal Biopsy Post Procedure Orders

Inpatient Rehab Orders

				Intracerebral Hemorrhage Orders
				Stroke Acute Initial Order
				Stroke Evaluation Acute Criteria for Thrombolytic Therapy
				Stroke Orders Acute WITH Alteplase (tPA)
				Stroke-Transfer Out of ICU Orders
				Stroke-Transient Ischemic Attack (TIA) Discharge Orders
				Stroke-Transient Ischemic Attack (TIA) Orders Without Alteplase (tPA)

				Adjustable Gastric Band/Sleeve Gastrectomy Admission Orders
				Adjustable Gastric Band/Sleeve Gastrectomy Post-Op Orders
				Bronchoscopy Intra-/Post-Procedure Orders
				Bronchoscopy Pre-Procedure Orders
				Cystoscopy Post-Op Orders
				Dental Repair Pre and Post Orders
				Endovenous Radiofrequency Ablation/Ambulatory Phlebectomy Pre-Op/Intra-Op/Post-Op Orders
				Extracorporeal Shock Wave Lithotripsy Post-Op Orders
				Extracorporeal Shock Wave Lithotripsy Pre-Op Orders
				GYN Major First Post-Op Day Orders
				GYN Major Post-Op Orders
				GYN Minor Pre-Op and Post-Op Orders
				Hysterectomy Laparoscopy Robotic Orders
				Laser PVP Urology Post-Op Orders
				OB GYN Admission Orders
				PACU Orders
				Plastic Surgery Post-Op Orders
				Tonsillectomy Post-Op Orders
				Tonsillectomy Pre-Op Orders
				Urology Post-Op Orders

				Fractured Rib Admission Orders
				Massive Transfusion Protocol
				Partial Trauma Code Orders
				Trauma I Orders.pdf
				Trauma II Orders