Georgia Coastal Health District



TABLE OF CONTENTS FOR

NURSE PROTOCOLS

THIS PAGE INTENTIONALLY LEFT BLANK

DIVISION OF PUBLIC HEALTH

NURSE PROTOCOLS FOR REGISTERED PROFESSIONAL NURSES

for 2008

| |

|TABLE OF CONTENTS |

TAB/Page Number

|INTRODUCTION |1 |

|THE NURSE PROTOCOL PROCESS |2 |

|Mechanism for Development, Review and Revision |2.1 |

|General Time-Line for Annual Review and Update of Nurse Protocols |2.3 |

|Tool for Reviewing Nurse Protocols |2.4 |

|Standard Format for Nurse Protocols |2.5 |

|Word Processing for Nurse Protocols |2.6 |

|Certified Nurse Protocol Review Form |2.8 |

|Acknowledgments |2.9 |

|1. Nurse Protocol Committee |2.9 |

|2. Physician Consultants |2.11 |

|GUIDELINES FOR NURSE PROTOCOLS |3 |

|A. |Purpose |3.1 |

|B. |Definitions |3.1 |

|C. |Drugs to be Covered by Nurse Protocol |3.2 |

|D. |Drugs to be Covered by either Nurse Protocol or Policy/ Procedure |3.3 |

|E. |Requirements for a PHN Who Uses a Nurse Protocol |3.4 |

|F. |Licensed Practical Nurses |3.4 |

|G. |Requirements for Nurse Protocols |3.4 |

|H. |Delegated Authority for Ordering Dangerous Drugs |3.5 |

|I. |Dispensing Dangerous Drugs |3.5 |

|J. |Accountability |3.7 |

|K. |Signing Nurse Protocol Agreements |3.7 |

|L. |Retention of Nurse Protocols |3.10 |

|M. |Nurse Protocol Agreement Formats for Advanced Practice Registered Nurses |3.10 |

|Appendix 1 |Example for Women’s Health |3.14 |

|Appendix 2 |Example for HIV |3.16 |

|Appendix 3 |Example Drug Formulary for Advanced Practice Registered Nurses |3.19 |

|Appendix 4 |Texts/References Used/Recommended for Advanced Practice Registered Nurses |3.23 |

TAB/Page Number

|DRUG DISPENSING PROCEDURE |4 |

|The Drug Dispensing Procedure Signature Page |4.1 |

|A. |Definitions |4.2 |

|B. |General Requirements |4.4 |

|C. |Drug Storage and Record Keeping |4.4 |

|D. |Outdated, Deteriorated, Returned and Recalled Drugs |4.6 |

|E. |Inventory |4.7 |

|F. |Labeling and Appropriate Containers |4.8 |

|G. |Client Counseling Components |4.8 |

|H. |Additional Information |4.11 |

|ORIENTATION, TRAINING AND QUALITY ASSURANCE FOR NURSE PROTOCOLS |5 |

|A. |Initial Orientation and Training |5.1 |

|B. |Continuing Education/Training |5.1 |

|C. |Documentation of Training |5.1 |

|NURSE PROTOCOLS FOR SPECIFIC DISEASES AND CONDITIONS | |

|HYPERTENSION |6 |

|Primary Hypertension in Adults |6.1 |

|TABLE A: |SHAPP Program Drug Treatment Recommendations |6.15 |

|FIGURE 1: |Algorithm for the Treatment of Hypertension |6.16 |

|TABLE B: |SHAPP Antihypertensive Medications Drug Interactions/Pregnancy Category |6.17 |

|TABLE C: |Antihypertensive Medications Drug Interactions/Pregnancy Category |6.18 |

|DIABETES |7 |

|Diabetes Mellitus in Adults |7.1 |

| |Appendix A: |Continuum of Care Visits |7.13 |

| |Appendix B: |Summary of Recommendations |7.15 |

| |Appendix C: |Oral Hypoglycemic Agent and Oral Agent Adjustment Guidelines |7.17 |

| |Appendix D: |Oral Agents for Treatment of Type 2 Diabetes |7.18 |

| |Appendix E: |FDA Approved Indications for Combination Therapy |7.23 |

| |Appendix F: |Insulin Products Available in the United States |7.24 |

| |Appendix G: |Insulin Adjustment Guidelines |7.26 |

| |Appendix H: |Treatment Algorithm of Type 2 Diabetes |7.28 |

TAB/Page Number

|TUBERCULOSIS |8 |

|Uncomplicated Pulmonary TB (TB) (Age 18 And Over) |8.1 |

|Table 1: Regimen Options - Treatment Of Patients With Drug-Susceptible TB |8.4 |

|Table 2: First-Line TB Drugs |8.5 |

|Table 3: Drug Interactions |8.6 |

|Table 4: Treatment of TB - Drug Interactions |8.12 |

|Table 5: Drug Interactions - Rifampin |8.13 |

|Table 6: Drug Interactions - Isoniazid |8.15 |

|Latent TB Infection (LTBI) |8.17 |

|Table A: Treatment of Latent Tuberculosis Infection (LTBI) – First-Line Drug And Regimen Options |8.24 |

|Table B: Treatment of LTBI – Recommended Drug Regimens For Adults |8.25 |

|Table C: Treatment of LTBI – Drug Adverse Reactions And Monitoring |8.26 |

|Table D: Treatment of LTBI – Drug Interactions (Format 1) |8.27 |

|Table E: Treatment of LTBI – Drug Interactions (Format 2) |8.28 |

|Table F: Drug Interactions – Isoniazid |8.30 |

|Table G: Pediatric Dosage – Daily Dosage Of Isoniazid In Children and Adolescents |8.31 |

|SEXUALLY TRANSMITTED DISEASES (STD) |9 |

|Bacterial Vaginosis |9.1 |

|Chlamydia |9.4 |

|Epididymitis |9.8 |

|Genital Herpes |9.12 |

|Genital Ulcer, Possible Primary Syphilis |9.19 |

|Genital & Perianal Warts |9.23 |

|Gonorrhea |9.28 |

|Lymphogranuloma Venereum |9.37 |

|Mucopurulent Cervicitis |9.42 |

|Nongonococcal Urethritis |9.45 |

|Pediculosis Pubis |9.48 |

|Pelvic Inflammatory Disease |9.51 |

|Scabies |9.56 |

|Syphilis, Early Symptomatic |9.60 |

|Syphilis, Latent |9.67 |

|Trichomoniasis |9.76 |

|Vulvovaginal Candidiasis |9.79 |

TAB/Page Number

|CHILD HEALTH |10 |

|Acne, Mild |10.1 |

|Allergic Reactions/Anaphylaxis |10.5 |

|Allergic Rhinitis |10.6 |

|Animal Bites |10.13 |

|Asthma |10.16 |

|Burns, Minor—Pediatric/Adult |10.27 |

|Cerumen/Earwax, Impacted |10.33 |

|Chicken Pox (Varicella) |10.35 |

|Colic (Irritable Baby Syndrome) |10.39 |

|Conjunctivitis |10.42 |

|Constipation |10.47 |

|Cradle Cap |10.53 |

|Cutaneous Larva Migrans |10.55 |

|Dermatitis, Atopic (Eczema) |10.58 |

|Dermatitis, Contact |10.63 |

|Dermatitis, Diaper (Diaper Rash) |10.67 |

|Enuresis |10.70 |

|Epistaxis |10.74 |

|Erythema Infectiosum (Fifth Disease) |10.77 |

|Fever |10.79 |

| Acetaminophen & Ibuprofen Dosage Charts |10.81 |

|Gastroenteritis |10.85 |

|Giardiasis |10.94 |

|Human Bites |10.98 |

|Impetigo |10.101 |

|Influenza |10.106 |

|Intestinal Parasitic Worms: Roundworms, Whipworms, Hookworms |10.110 |

|Iron Deficiency Anemia in Children |10.113 |

|Labial Adhesions |10.120 |

|Nasolacrimal Duct Obstruction |10.122 |

|Nasolacrimal Duct Infection (Dacryocysitis) |10.124 |

|Otitis Externa |10.125 |

|Otitis Media |10.128 |

|Pediculosis Capitis (Head Lice) |10.137 |

|Pharyngitis |10.142 |

|Pinworms |10.149 |

|Pityriasis Rosea |10.152 |

|Ringworm: Non-hairy Skin (Tinea Corporis) |10.155 |

|Ringworm: Scalp (Tinea Capitis) |10.157 |

|Roseola (Exanthema Subitum) |10.160 |

|Rubella |10.162 |

|Rubeola/Measles |10.165 |

TAB/Page Number

|Rubral/Heat Rash |10.169 |

|Scabies |10.172 |

|Stye (Hordeolum) |10.177 |

|Teething |10.179 |

|Thrush (Oral Candidiasis) |10.181 |

|Tinea Pedis |10.184 |

|Upper Respiratory Infection (URI) Common Cold |10.187 |

|Vomiting |10.190 |

|WOMEN’S HEALTH |11 |

|World Health Organization Medical Eligibility Criteria for Contraceptive Use |11.1 |

|Combined Oral Contraceptives |11.11 |

|Abnormal Lipid Tests While Taking Oral Contraceptives |11.16 |

|Hypertension While Taking Oral Contraceptives |11.19 |

|Spotting or Breakthrough Bleeding While Taking Oral Contraceptives |11.22 |

|Progestin-Only Pill |11.25 |

|Emergency Contraceptive Pills |11.30 |

|Implanon: Insertion |11.35 |

|Implanon: Removal |11.39 |

|IUD Insertion: Copper T380A |11.42 |

|IUD Insertion: Mirena LNG IUD |11.47 |

|IUD-Related Dysmenorrhea |11.52 |

|Lost IUD Strings |11.55 |

|IUD-Related Menorrhagia |11.57 |

|Pregnancy With IUD In Place |11.60 |

|IUD Removal |11.62 |

|IUD Complications and Actions |11.65 |

|Medroxyprogesterone Acetate Injectable Contraceptive |11.67 |

|Ortho Evra Patch |11.74 |

|NuvaRing |11.79 |

|Diaphragm |11.84 |

|Norplant Removal |11.87 |

|Amenorrhea (Primary and Secondary) |11.90 |

|Bacterial Cystitis |11.94 |

|Dysmenorrhea |11.99 |

|Ectopic Pregnancy |11.102 |

|Nurse Protocol for Prophylactic Therapy with Folic Acid for Reproductive-Age Women | |

| |11.104 |

|Iron Deficiency Anemia In Non-Pregnant and Non-Lactating Women 18 and Over | |

| |11.108 |

|Osteoporosis in Women |11.112 |

|Sexual Abstinence Counseling |11.118 |

|Local Estrogen Therapy |11.121 |

TAB/Page Number

|HIV/AIDS-RELATED |12 |

| Recommendations for Use of The HIV/AIDS Related Nurse Protocols |12.1 |

| Continuation of Antiretroviral Therapy |12.3 |

| Diarrhea, New Onset (Acute) |12.8 |

| Diarrhea, Persistent (Chronic) |12.14 |

| DMAC Prophylaxis |12.21 |

| Herpes Zoster (Shingles) |12.26 |

| Oral Candidiasis |12.31 |

| Orolabial Herpes Simplex |12.36 |

| PCP Prophylaxis |12.40 |

| Seborrheic Dermatitis |12.45 |

| Toxoplasmosis Prophylaxis |12.49 |

|OTHER INFECTIOUS DISEASES |13 |

| |Amebiasis |13.1 |

| |Haemophilus Influenzae Meningitis, Preventive Treatment of Contacts |13.5 |

| |Invasive Meningococcal Disease, Including Meningitis, Preventive Treatment of Contacts |13.10 |

| |Pertussis, Preventive Treatment of Contacts |13.15 |

| |Presumptive Pertussis Cases, Identification and Treatment of |13.19 |

| |Drug Interactions |13.24 |

| |Rheumatic Fever – Prophylactic Antibiotic Therapy |13.26 |

| |Rifampin - Pediatric Drug Chart |13.29 |

|EMERGENCY PROTOCOLS AND PROCEDURES |14 |

| |Guidelines for Emergency Kits/Crash Carts |14.1 |

| |Vasovagal Syncope (Fainting) |14.4 |

| |Allergic Reactions including Acute Anaphylaxis, in Adults, Infants and Children |14.6 |

| |Allergic Reaction/Anaphylaxis Record |14.12 |

| |Policy for Reviewing Emergency Protocols/Procedures |14.14 |

| |Emergency Checklist |14.15 |

| |Evaluation Tool for Practice Drill |14.16 |

|APPENDICES: LEGAL REFERENCES |15 |

| |Appendices Index |15.1 |

|A. |Nurse Protocol Legislation, O.C.G.A. § 43-34-26.1. |15.3 |

|B. |Rules of Georgia Board of Nursing – Chapter 410-13: Regulation of Protocol Use by Registered Nurses |15.8 |

|C. |Rules of Georgia State Board of Pharmacy – Chapter 480-30: Dispensing of Drugs Under Authority of Job Description or Nurse|15.10 |

| |Protocol | |

|D. |Health Services Protocols, American Red Cross, August 2006 |15.13 |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download