For All Providers, Inpatient Nurses and Pharmacists
Titratable Medication Orders Changes in Epic
In response to DNV findings related to the titration of medications and to be more in line with standard practices, starting Thursday, June 1, the following changes will be made to the medication orders in Epic:
Nicardipine
- Initial dose options added of 5 mg/hr, 5 mg/hr, or *** (previously only 5 mg/hr).
- Addition of MAP *** to *** mmHg to existing titration parameters.
- Titration dose changed to a range of 1 to 2.5 mg/hr within 15 minutes (previously was 2.5 mg/hr every 5 or 15 minutes).
Norepinephrine
- Initial dose options added/changed to 5mcg/min, 10 mcg/min, or *** (previously 4 mcg/min).
- Titration parameters option expanded to MAP 60 to 70mmHg (previously was MAP 60-65mmHG).
- Titration frequency changed to 1-5 mcg/minute within 10 minutes (previously was 2-5mcg/minute every 5 minutes).
Epinephrine
- Initial dose option added of ***mcg/min (previously only 2 mcg/min).
- Titration parameters option expanded to MAP 60 to 70mmHg (previously was MAP 60-65mmHG).
- Titration frequency changed to 1-5 mcg/minute within 10 minutes (previously was 2-5mcg/minute every 5 minutes).
- Added Do not titrate option.
Phenylephrine
- Initial dose option added of ***mcg/min (previously only 20 mcg/min).
- Titration parameters option expanded to MAP 60 to 70mmHg (previously was MAP 60-65mmHG).
- Titration frequency changed to 10-50 mcg/min within 10 minutes (previously 5-10 mcg/min every 5 minutes).
Dopamine
- Initial dose option added of 2 mcg/kg/min (previously only *** mcg/kg/min).
- Titration parameters option expanded to MAP 60 to 70mmHg (previously was MAP 60-65mmHG).
- Titration frequency changed to 1-2 mcg/kg/min within 10 minutes (previously 2 mcg/kg/min every 5 minutes).
Propofol (in the ED/ICU order set)
- Changed reassessment timeframe to Reassess RASS/BIS within 30 minutes until at goal (previously was within 15 minutes until at goal).
