Acute Mi Care Map Standard Pre-Printed Orders (Page 2 of 4) in pdf

Acute Mi Care Map Standard Pre-Printed Orders Page 2

GUIDELINES FOR USE

Standard orders are identified with a solid black box ( ). These are initiated on all patients

placed on the Care Map and are pre-printed on the Care Map.

To individualize the orders:

- Check (

) the order(s) you wish to activate, where empty boxes ( ) are provided.

[

- Add other orders in blank spaces provided.

- If not in agreement with the standard orders (defined with a solid black box) cross out,

initial the order and write variance.

Orders written after these initial orders will be on the standard facility order form.

The Standard Order form is placed in the Physician Order Form section of the chart.

TRANSCRIPTION OF ORDERS

Transcribe the orders onto the Care Map by placing a “

” in the box ( ) before the item on

[

the Care Map.

Additional orders written on this form or on standard facility order form are transcribed onto

the Care Map in the appropriate time frame. Make a “

” inside a box ( ) to indicate a

[

physician’s order.

Enter your signature, date and time when the orders have been transcribed.

Process medication orders, treatments and tests.

Acute Mi Care Map Standard Pre-Printed Orders Page 2