Unique Plan Description: Enhanced Recovery Surgery Prep Clinic
Plan Selection Display: Enhanced Recovery Surgery Prep Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2016-06-15 13:43:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-04-05 10:45:57
Available at all facilities: Yes

Enhanced Recovery Surgery Prep Clinic
Medications
		Pick both an oral and mechanical regimen(NOTE)*
		Oral Antibiotic Bowel Prep - Pick one of the two regimens-(NOTE)*
		Erythromycin/Neomycin(NOTE)*
	erythromycin 500 mg oral tablet
		See Instructions, By Mouth, PREOP, Take 2 TAB BY MOUTH at 1pm, 2pm, and 10pm the day before surgery., # 6 TAB, 0 Refill(s), Hard Stop
	neomycin 500 mg oral tablet
		See Instructions, By Mouth, PREOP, Take 2 tabs by mouth at 1pm, 2pm, and 10 pm, # 6 TAB, 0 Refill(s), Hard Stop
		Flagyl/Neomycin(NOTE)*
	metroNIDAZOLE 500 mg oral tablet
		See Instructions, By Mouth, PREOP, Take 2 tab at 1pm, 2pm and 10pm, # 6 TAB, 0 Refill(s)
	neomycin 500 mg oral tablet
		See Instructions, By Mouth, PREOP, Take 2 tabs by mouth at 1pm, 2pm, and 10 pm, # 6 TAB, 0 Refill(s), Hard Stop
		Pick one of the 3 options Mechanical Bowel Prep - 3 options(NOTE)*
	polyethylene glycol electrolyte oral powder for reconstitution
		See Instructions, By Mouth, PREOP, By Mouth, PREOP, Mix according to label. Begin drinking at 12nn day before surgery; drink 240ml (8 oz) every 20 minutes until gone or rectal output is clear
		If patient unable to tolerate Nulytely Prep and no evidence of impaired renal function (creatinine < 2.0, eGFR >25-30) magnesium citrate/bisacodyl prep may be used:(NOTE)*
	magnesium citrate 8.85% oral liquid
		300 mL, By Mouth, PREOP, Begin drinking one bottle (300ml) at 2pm the day before surgery. Drink the whole 	bottle within 2 hours., # 300 mL
	Senokot 8.6 mg oral tablet
		4 TAB, By Mouth, PREOP, Take 4 tablets at 4pm the day before surgery, # 4 TAB, 0 Refill(s)
	Dulcolax Laxative 5 mg oral delayed release tablet
		4 TAB, By Mouth, PREOP, Take four tablets (20mg) at 6pm the day before surgery, # 4 TAB, 0 Refill(s)
		**If patient unable to tolerate Nulytely Prep and evidence of impaired renal function (creatinine >2.0, eGFR <25-30) Miralax/bisacodyl prep may be used:(NOTE)*
		2 TAB, By Mouth, PREOP, Take two tablets (10mg) at 12noon the day before surgery; take another two tablets 			(10mg) 2 hours after completion of Miralax prep, # 4 TAB, 0 Refill(s)
	MiraLax oral powder for reconstitution
		238 gm, By Mouth, PREOP, Mix with 64 oz clear cold Gatorade. Begin drinking by 12nn day before surgery. Drink 8 oz every 20 min until gone or rectal output is clear, 1 EA, 0 Refill(s)
		Diabetic patient:(NOTE)*
		238 gm, By Mouth, PREOP, MIx with 64 oz Crystal Light. No red. Begin drinking by 12nn day before surgery. Drink 8 oz every 20 min until gone or rectal output is clear
Patient Care
	Patient Instructions
		Enhanced Recovery 4 teaching sheets: Enhance your recovery, Preparing for your hospital visit checklist, Colon Resection Care Path, Earn your ticket home after colon surgery.
		Verbal teaching by surgery office staff
		Schedule H&P with primary care provider
Charges/Supplies
Est. Pt Visit
	99211 EVM - OP visit estab patient, minimal care < 10 min
		T;N
	99212 EVM - OP VISIT ESTAB PATIENT, STRAIGHTFORWARD 10 MIN
		T;N
	99213 EVM - OP VISIT ESTAB PATIENT, LOW LEVEL 20 MIN
		T;N
	99214 EVM - OP VISIT ESTAB PATIENT, MODERATE 30 MIN
		T;N
	99215 EVM - OP VISIT ESTAB PATIENT, HIGH LEVEL 40 MIN
		T;N
New Pt Visit
	zz99201 EVM-New Pt Visit Problem focused 10m
		T;N
	99202 EVM - OP VISIT NEW PATIENT, STRAIGHTFORWARD 15 MIN
		T;N
	99203 EVM - OP VISIT NEW PATIENT, LOW LEVEL 30 MIN
		T;N
	99204 EVM - OP VISIT NEW PATIENT, MODERATE LEVEL 45 MIN
		T;N
	99205 EVM - OP VISIT NEW PATIENT, HIGH LEVEL 60 MIN
		T;N

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase