The OB APS note has been live for a few weeks now but was a little difficult to find. The OB APS note template has now been renamed and moved just below the regular APS admission note in Sunnycare to allow ease of access (please see images below). Please remember that an OB APS admission note is required for all patients receiving intrathecal or epidural morphine; you are still required to fill out the paper intrathecal opioid monitoring order set as usual.
To dispel any remaining misconceptions, please note that completion of either the main APS note or OB APS note templates DOES NOT add a patient to any APS list – this is only accomplished through the electronic order set. OB APS patients are not required to be added to any list except in extenuating circumstances on a case-by-case basis (chronic pain, SUD, etc.) where the main APS service may be providing some assistance.
Hi everyone,
Just a reminder for how APS is currently designed to work on the M5 unit:
Neuraxial morphine:
Please complete an APS note [on Sunnycare] for any patient for whom you are filling out a neuraxial morphine orderset – bill A215
You still must complete the paper neuraxial morphine orderset and fill out time, date, dose, and route of morphine administration
These patients should not be added to the main APS list, nor does creating an APS note add them to this list
GA C-sections:
For GA C-sections requiring PCA, +/- single shot TAP, please DO NOT use the printable Sunnycare orders online. These patients should have PAPER ORDERSET ONLY. This is a safety issue for several reasons:
The orderset on OB is different from the standard set in Sunnycare
The nurses do not look at, and are not aware of, the online orders
There is no easily accessible printer in the M5 ORs to print these orders
The standard NSAIDs currently used on OB are different from the main OR orderset and risk double administration of two different NSAIDs
The OB anesthesiologist on M5 is responsible for following up with these patients as needed. Typically no follow up is actually required and the paper orderset has an auto-discontinue option for 0600 on POD#1
The actual APS team should only be involved with patients who have complex pain needs, have SUD, or will otherwise require multiple days of follow up
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