Newsletter

Upcoming CME Events

IU Health CME Events

To attend virtual events or add to your calendar visit https://live.iuhcpe.org/

Sat, Nov. 4^th, 7:00am-12:00pm - Skull Base Surgery Conference (In-person/Virtual)

Location: Neuroscience Center Conference Room

Mon, Nov. 6^th, 8:00am-10:00am - Riley Error Prevention Training

Amy Birchfield, MSN, RN, NE-BC, CPPS and Amy Roseboom, RRT

Wed, Nov. 8^th, 11:45am-1:00pm - Riley Maternity and Newborn Health Perinatal Webinar Series - TBD - Neuro NICU

Beatrice M. Stefanescu, MD

Wed, Nov. 8^th, 12:00pm-1:00pm - Living Liver Donor Transplant (In-person/Virtual)

James Butler, MD

IU Health Southern Indiana Physicians - General & Trauma Surgery, Bloomington, IN

Fri, Nov. 10^th, 12:00pm-1:00pm - Conversations with Riley Cardiology - Murmurs and When to Refer

Anne Farrell, MD and Parisa Mansoori, MD

Fri, Nov. 10^th, 12:00pm-1:00pm - Mistakes, Bad Outcomes, and Lawsuits

Douglas Tannas, MD

Wed, Nov. 15^th, 12:00pm-1:00pm - Integrated Behavioral Health

Chad Schultheis, MD and Gena Carney, MSW LCSW

To view previously recorded presentations from the On Demand Videos and earn CME's Click here

To view the list of your completed CME's Click here

Visit The Center for Physician Education - Main Page (iuhcpe.org)

Announcements

Opioid Tolerance Level Order Sets

On October 17, 2023 new Opioid Tolerance Level order sets will go live across the system. This is an effort to support evidence-based pain management.

As you know, patients have different tolerances to opioids based on the previous usage of opioids. By using this patient care tool, our goal is to ensure that the right patient gets the right medication at the right time in their care at IU Health. We are asking that all clinicians incorporate OTL pathways when treating their patient's pain to ensure we meet their need for effective pain control that they deserve.

Opioid Tolerance Level Order Set FAQs:

1. Why should physicians and advanced practice providers use the order set? The Opioid Tolerance Level order sets were modified by a multidisciplinary team of physicians, pharmacists, CNSs, and other system and regional experts. It brings the best practice to one order set and is geared toward getting appropriate medications to the patient in the most expeditious means possible.
2. What order sets are being retired?

CH-20680 Opioid Management - Naive to Tolerant

CH-20678 Opioid Management-Naive to Tolerant Pre Op Orders

CH-21226 Pain Management:  Opioid Tolerance Level (OTL) 1 (Naive)

CH-21227 Pain Management:  Opioid Tolerance Level (OTL) 2

CH-21228 Pain Management:  Opioid Tolerance Level (OTL) 3

3. What will happen to my favorites?

All saved favorites will be retired when new order sets are live.  Any power plan that is already planned prior to retirement will continue to be valid and can be initiated. 

Providers can create new favorites if needed.  Please consult your local clinical informatics staff for assistance in saving new favorites. 

Each favorite owner is being notified individually about this upcoming change.

Uplift Blood Orders CPOE Updates for Clarification

Why the change?

• To align with national standards and guidelines
• Reduce inappropriate ordering
• Increase order clarity
  • Allow for weight based dosing for pediatric patients
• Eliminate the need for paper charting by nursing

Blood product PowerPlans

All products are contained in each PowerPlan

• Will still be able to search for individual product and select the PowerPlan
  • Search synonyms – *blood products*, blood, prbcs, plasma, cryo, ffp, platelets, red cells

1. Outpatient blood products
   1. Multiphase plan similar to current state
   2. Transfuse order is in the second phase and must be selected
2. Routine blood products
   1. Inpatient, ED routine (crossmatched) blood
3. OR/procedural blood products
   1. Allows for multiple units despite weight
   2. No age or weight flexing applied

Click here to view JobAid more information.

Clinical Council Updates

Inpatient Sepsis Initiative: Council received updates on work to improve the care of inpatients with Sepsis at IU Health. See attached PowerPoint for specific details.

Key dates:

• August 1: System-wide go-live of Inpatient Sepsis and Septic Shock Order Sets
• October 3: Nursing and Provider Education Assigned
• November 14: System-wide go-live of Alert & Screening Process

Opioid Education Toolkit Now Available:

What: Resource documents with definitions, current regulations, standard work examples, etc.)

Why: Offers support and education for providers on the treatment of Chronic Opioid Therapy.

Where does it live: IU Health Portal > Patient Care> Safety and Quality>  Safety and Quality (myiuhealth.org)

Go-Live: September 1, 2023

What is changing: Deeper education and support are being offered to providers.

Request to Change Enoxaparin Dosing: The Council approved the recommendation to update the enoxaparin rounding rule to round doses to manufacturer syringe sizes. This change will facilitate improved transitions of care and the likelihood that patients receive the ordered dose while inpatient.

Change Heparin Drip's Upper aPTT Limit: The Council approved a request from IU Health Lab to modify the heparin nomogram's upper aPTT limit from 225 seconds to 170 seconds. This change will not impact providers and is aimed to cut down on delays in lab results.

Neurology Council

ENOLOW Recruitment is Live: At the Q2 meeting, Dr. Kaustubh Limaye presented information on a pilot taking place at IU Health Methodist. The study will test efficacy & safety of immediate mechanical thrombectomy (iMT) given within 8 hours in patients with proximal large vessel occlusions and low baseline NIHSS scores (NIHSSS 0-5). Vascular Neurology, via the transfer center, will guide Neurology/Emergency Medicine providers on the process/enrollment of patients into the ENDOLOW study between 8 am-4 pm. Please contact Dr. Kaustubh Limaye with specific questions about the study.

Antibiotic Awareness Week

Improve Antibiotic Use, Improve Health Equity

Kick off U.S. Antibiotic Awareness Week (USAAW) with CDC on Saturday, November 18!

Every year, CDC recognizes USAAW to raise awareness and share information on the importance of improving antibiotic and antifungal use. Any time antibiotics or antifungals are used—in people, animals, or plants—they can cause side effects and contribute to antimicrobial resistance (AR). The USAAW observance is aligned with World Antimicrobial Resistance Awareness Week (WAAW) during the same week.

Join CDC November 18-24 as we recognize the importance of improving antibiotic and antifungal prescribing and use, improving health equity, and slowing the spread of antimicrobial resistance. Learn how you can take action this week and the rest of the year.

Mark your calendar for upcoming webinars: 

• November 14, 2-3 p.m. EST: Urgent Care Association webinar on common myths and new successes in urgent care antibiotic stewardship.
• November 14, 3-4 p.m. EST: CDC and Federal Office of Rural Health Policy webinar on the National Healthcare Safety Network Antimicrobial Use Option and using data for action in critical access hospitals.

Sepsis Core Elements Webinars with Free CE

In October, CDC’s Project Firstline began a five-part webinar series for healthcare professionals in collaboration with the American Medical Association to introduce the Hospital Sepsis Program Core Elements, a framework to help U.S. hospitals implement, monitor, and optimize institutional sepsis programs and sepsis outcomes. Each year, about 1.7 million adults in America develop sepsis, which is why it's so important to take steps to reduce your patients' risk of sepsis. 

The Sepsis Core Elements complement existing sepsis guidelines and help facilitate implementation of guideline-recommended care practices at a wide variety of hospitals and healthcare systems in the United States.

• Action, Nov. 2: The third webinar is coming up on November 2 at 1 p.m. ET and will dive into how to implement effective structures and processes to improve sepsis identification, management, and recovery.
• Tracking and Reporting, Nov. 16: A fourth webinar is scheduled for November 16 at 1 p.m. ET and will discuss tracking and reporting. Experts will discuss how to measure sepsis epidemiology, management, and outcomes to assess the impact of sepsis initiatives and progress toward program goals. They will also offer guidance on how to provide information on sepsis management and outcomes to relevant partners.

During each one-hour webinar, sepsis subject matter experts will provide an overview of the Hospital Sepsis Program Core Elements, and partners will share real-life examples, strategies, and best practices about how they have successfully implemented specific Sepsis Core Elements at their organization. Each webinar topic is independent, and all webinars will be recorded. Free Continuing Education (CE)* will be offered upon successful completion of a post-test.

A final webinar will be held on December 7 at 1 p.m. ET and will discuss education.

Click here to register.

Flu Shot Due by November 9th

Get your shot by Thursday, Nov. 9

Vaccines received through an Employee Occupational Health Services (EOHS) flu clinic or Employee Health location are documented automatically. If you receive a flu shot elsewhere, you must submit documentation by Thursday, Nov. 9. This includes:

• IU Health Urgent Care
• IU Health Retail Pharmacy
• IU Health Primary Care provider office
• Outside IU Health

EOHS will offer free vaccines to team members. Find a flu vaccine clinic near you and mark your calendar.