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Abbott Northwestern Hospital

Medication Protocols

Medication protocols


For questions about medication protocols please contact Shelley Shepherd, PharmD MS
612-863-5149
or shelley.shepherd@allina.com.

Thank you for your interest in Abbott Northwestern Hospital's medication protocols. Direct questions about and problems with computer-related technical issues to your Information Services resources.

If you have questions about protocol content or operation, please contact Shelley Shepherd, PharmD MS at Abbott Northwestern Hospital, 612-863-5149, or email her at shelley.shepherd@allina.com.

How to view our files

The medication protocols are available in two formats: eMbedded Visual Basic for Pocket PC and Microsoft Excel. The protocol content is the same for both formats. Choose the format which best suits your needs.

eMbedded Visual Basic Runtime

eMbedded Visual Basic Runtime allows you to store the medication protocols in your Pocket PC. The files can be put where you want them in your Pocket PC. At Abbott Northwestern, our files are organized in folders in the Pocket PCs and accessed through hyperlinked menus.

To run the protocols, you need Microsoft eMbedded Visual Basic Runtime installed on your Pocket PC. If you use the electronic text, UpToDate, on your Pocket PC, you already have this file installed. Otherwise, access the internet and download the eMbedded Visual Basic Runtime installer onto your Pocket PC. eMbedded Visual Basic Runtime download site.

Microsoft Excel

At Abbott Northwestern Hospital, medication protocols formatted as Excel workbooks are centrally deployed to personal computers on nursing stations throughout the hospital for use by nursing and pharmacy staffs to dose and monitor medications.

Depending upon how your Excel software defaults are set, you may get a message stating,

"FILE NAME.xls contains macros. Macros may contain viruses. It is always safe to disable macros, but if the macros are legitimate, you may lose some functionality."

Please note that these medication protocol files will only function properly if you click the ENABLE MACROS button.


Source: Medication Protocols-Abbott Northwestern Hospital
Reviewed by: Shelley Shepherd, PharmD, MS; Terry Rosborough, MD
First Published: 06/24/2004
Last Reviewed: 03/16/2007

Enoxaparin (Lovenox®-low molecular weight heparin) protocols

File

Description

Prophylactic protocol

enoxprophinit.vb-link.vb

enoxprophadjust.vb-link.vb


Therapeutic protocol

enoxtherinit.vb-link.vb

enoxtheradjust.vb-link.vb

These Visual Basic files will allow you to store the Enoxaparin (Lovenox®-low molecular weight heparin) protocols on your Pocket PC.

  • The prophylactic (enoxproph) protocol targets a lower antifactor Xa activity range than does the therapeutic (enoxther) protocol.
  • Each protocol consists of two files: an "initiate" (init.vb) file and an "adjust" (adjust.vb) file.
    • The enoxprophinit.vb and enoxtherinit.vb files are used for the initiation of subcutaneous enoxaparin therapy in a patient.
    • The enoxprophadjust.vb and enoxtheradjust.vb files are used thereafter to adjust the enoxaparin subcutaneous dose based on antifactor Xa activity results in a patient receiving enoxaparin. 

Prophylactic protocol

enoxaparinPROPHY,SQ_female initiate.xls

enoxaparinPROPHY,SQ_male initiate.xls

enoxaparinPROPHY,SQ_adjust 1.xls

enoxaparinPROPHY,SQ_adjust 2.xls


Therapeutic protocol

enoxaparinTHERA,SQ_female initiate.xls

enoxaparinTHERA,SQ_male initiate.xls

enoxaparinTHERA,SQ_adjust 1.xls

enoxaparinTHERA,SQ_adjust 2.xls

enoxaparinTHERA,SQ_adjust 3.xls

The Enoxaparin (Lovenox®-low molecular weight heparin) protocols consist of several files each; 4 for the prophylactic (PROPHY, SQ) protocol and 4 for the therapeutic (THERA, SQ) protocol:

  • The prophylactic (PROPHY, SQ) protocol targets a lower antifactor Xa activity range than does the therapeutic (THERA, SQ) protocol.
  • The enoxaparinXXXXX, SQ_female initiate.xls and enoxaparinXXXXX,SQ_male initiate.xls files are used for the initiation of subcutaneous enoxaparin therapy and are identical with the exception that patient gender is "defaulted" into the appropriate spreadsheet. This saves the user a few keystrokes.
  • The enoxaparinXXXXX, SQ_adjust#.xls files are used subsequently for all patients, regardless of gender, to adjust the enoxaparin dose based on antifactor Xa activity results from a patient receiving enoxaparin.
    • The adjust 1.xls files are used to interpret an antifactor Xa result obtained after administration of the first dose of enoxaparin.
    • The adjust 2.xls files are used to interpret an antifactor Xa result obtained after administration of the second dose of enoxaparin, and in the case of the prophylactic protocol (PROPHY, SQ) after all subsequent enoxaparin doses.
    • When the therapeutic protocol (THERA, SQ) is used, the adjust 3.xls file is used to interpret an antifactor Xa result obtained after administration of the third and all subsequent doses of enoxaparin.



LMW Monitoring Flow Sheet.xls

Monitoring flow sheet

This monitoring flow sheet may be used to track and document patient demographics, enoxaparin doses, and antifactor Xa results.



SQ injection.doc




CareNotes Enoxaparin.doc






InjectionSites.pdf

Patient education materials

  • The SQ injection.doc outlines the step-by-step procedure for patient self-injection of subcutaneous enoxaparin.
  • Patient information about the purpose, use, storage, drug interactions, and side effects of enoxaparin are found in CareNotes Enoxaparin.doc (Thomson MICROMEDEX. All rights reserved. The CareNotes(TM) System).
  • A SQ injection site rotation record is found in InjectionSites.pdf.

Source: Medication Protocols-Abbott Northwestern Hospital
Reviewed by: Shelley Shepherd, PharmD, MS; Terry Rosborough, MD
First Published: 09/01/2004
Last Reviewed: 03/16/2007

Heparin (unfractionated) protocols

Prophylactic subcutaneous, prophylactic intravenous infusion, and therapeutic intravenous infusion

File

Description

Prophylactic subcutaneous protocol

UFHprophSQinit.vb-link.vb

UFHprophSQadjust.vb-link.vb



Prophylactic intravenous infusion protocol

UFHprophIVinit.vb

UFHprophIVadjust.vb

Therapeutic intravenous infusion protocol

UFHtherIVinit.vb-link.vb

UFHtherIVadjust.vb-link.vb

These Visual Basic files will allow you to store the Heparin (Unfractionated) protocols on your Pocket PC.

  • The prophylactic (UFHprophSQ) protocol targets a lower antifactor Xa activity range than does the therapeutic (UFHtherIV) protocol.
  • The prophylactic SQ protocol and therapeutic IV infusion protocol each consist of two files: an "initiate" (UFHXXXXinit.vb) file and an "adjust"(UFHXXXXadjust.vb) file.
    • The UFHprophSQinit.vb and UFHtherIVinit.vb files are used for the initiation of subcutaneous unfractionated heparin prophylaxis and intravenous infusion unfractionated heparin therapy, respectively, in a patient.
    • The UFHprophSQadjust.vb and UFHtherIVadjust.vb files are used thereafter to adjust the unfractionated heparin subcutaneous dose or infusion rate, respectively, based on antifactor Xa activity results in a patient receiving enoxaparin. 

Prophylactic subcutaneous protocol

hepPROPHY_SQ_initiate.xls

hepPROPHY_SQ_adjust_1.xls

hepPROPHY_SQ_adjust_2.xls
























Prophylactic intravenous infusion protocol

hepPROPHY_IV_female_initiate.xls

hepPROPHY_IV_male_initiate.xls

hepPROPHY_IV_adjust.xls

Therapeutic intravenous infusion protocol

hepTHERA_IV_female_initiate.xls

hepTHERA_IV_male_initiate.xls

hepTHERA_IV_adjust.xls

These Microsoft Excel files will allow you to store the Heparin (Unfractionated) protocols on your personal desktop computer.

  • The prophylactic (hepPROPHY, SQ) protocol targets an antifactor Xa activity lower than that of the therapeutic (hepTHERA, IV) protocol.
  • The Heparin (unfractionated) prophylactic subcutaneous protocol consists of 3 files.
    • The hepPROPHY_SQ_initiate.xls file is used for the initiation of subcutaneous unfractionated heparin prophylaxis in patients, regardless of patient sex.
    • The hepPROPHY_SQ_adjust_#.xls files are used subsequently for all patients to adjust the unfractionated heparin subcutaneous dose based on an antifactor Xa result from a patient receiving unfractionated heparin.
      • The hepPROPHY_SQ_adjust_1.xls file adjusts the second unfractionated heparin subcutaneous dose based on the results of the heparin activity level obtained following the first dose.
      • The hepPROPHY_SQ_adjust_2.xls adjusts all subsequent unfractionated heparin subcutaneous doses.


  • The Heparin (unfractionated) therapeutic and prophylactic infusion protocols consist of 3 files each. The prophylactic (hepPROPHY, IV) protocol targets an antifactor Xa activity lower than that of the therapeutic (hepTHERA, IV) protocol.
  • The hepTHERA/PROPHY_IV_female_initiate.xls and hepTHERA/PROPHY_IV_ male_initiate.xls files are used for the initiation of intravenous infusion unfractionated heparin therapy in female and male patients, respectively. The male and female files are identical with the exception that patient gender is "defaulted" into the appropriate spreadsheet. This saves the user a few keystrokes.
  • The  hepTHERA/PROPHY_IV_adjust.xls file is used subsequently for all patients receiving unfractionated heparin, regardless of gender, to adjust the unfractionated heparin intravenous infusion rate based on an antifactor Xa result.

References

Rosborough TK, Shepherd MF. Achieving target antifactor Xa activity with a heparin protocol based on sex, age, height, and weight. Pharmacotherapy 2004;24(6):713-9


Source: Medication Protocols-Abbott Northwestern Hospital
Reviewed by: Shelley Shepherd, PharmD, MS; Terry Rosborough, MD
First Published: 09/01/2004
Last Reviewed: 03/16/2007

Heparin (unfractionated) in pregnancy protocols

File

Description

Prophylactic protocol

UFHprophpregSCinit.vb-link.vb

UFHprophpregSCadjust.vb-link.vb


Therapeutic protocol

UFHtherpregSCinit.vb-link.vb

UFHtherpregSCadjust.vb-link.vb

These Visual Basic files will allow you to store the Heparin (Unfractionated) in pregnancy protocols on your Pocket PC.

  • The prophylactic (UFHprophpregSC) protocol targets a lower antifactor Xa activity range than does the therapeutic (UFHtherpregSC) protocol.
  • Each protocol consists of two files: an "initiate" (init.vb) file and an "adjust" (adjust.vb) file.
  • The UFHprophpregSCinit.vb and UFHtherpregSCinit.vb files are used for the initiation of unfractionated heparin subcutaneous therapy in a pregnant woman.
  • The UFHprophpregSCadjust.vb and UFHtherpregSCadjust.vb files are used thereafter to adjust the heparin subcutaneous dose based on antifactor Xa activity results from a pregnant woman receiving unfractionated heparin. 

Prophylactic protocol

hepPROPHY, SQ_pregnancy adjust.xls

hepPROPHY, SQ_pregnancy initiate.xls


Therapeutic protocol

hepTHERA, SQ_pregnancy adjust.xls

hepTHERA, SQ_pregnancy initiate.xls

The Heparin (unfractionated) in pregnancy protocol consists of 4 files:

  • The prophylactic (hepPROPHY, SQ) protocol targets a lower antifactor Xa activity range than does the therapeutic (hepTHERA, SQ) protocol.
  • Each protocol consists of two files: an "initiate.xls" file and an "adjust.xls" file.
  • The hepPROPHY, SQ_pregnancy initiate.xls and       hepTHERA, SQ_pregnancy initiate.xls files are used for the initiation of unfractionated heparin subcutaneous therapy in a pregnant woman.
  • The hepPROPHY, SQ_pregnancy adjust.xls and       hepTHERA, SQ_pregnancy adjust.xls files are used thereafter to adjust the heparin subcutaneous dose based on antifactor Xa activity results from a pregnant woman receiving unfractionated heparin. 



UFH Monitoring Flow Sheet.xls

Monitoring flow sheet

This monitoring flow sheet may be used to track and document patient demographics, heparin doses, and antifactor Xa results.



SQ injection.doc



CareNotes Heparin.doc



InjectionSites.pdf

Patient education materials

  • The SQ injection.doc outlines the step-by-step procedure for patient self-injection of subcutaneous heparin.
  • Patient information about the purpose, use, storage, drug interactions, and side effects of heparin are found in CareNotes Heparin.doc (Thomson MICROMEDEX. All rights reserved. The CareNotes(TM) System).
  • A SQ injection site rotation record is found in InjectionSites.pdf.

References

Rosborough TK, Shepherd MF. Achieving target antifactor Xa activity with a heparin protocol based on sex, age, height, and weight. Pharmacotherapy 2004;24(6):713-9.


Source: Medication Protocols-Abbott Northwestern Hospital
Reviewed by: Shelley Shepherd, PharmD, MS; Terry Rosborough, MD
First Published: 09/01/2004
Last Reviewed: 03/16/2007