Order Entry Process for Antimicrobial Surgical Prophylaxis
Operating Rooms Open (Mon-Fri, South 0600-1730, North 0600-1600)
Order comes to OR pharmacist
The OR pharmacist enters the entire order (pre-op and post-op
antibiotics), timed according to the patient-specific case, and types
“SURGICAL PROPHY” in the text field.
All the labels will print in the OR, but only the 1st dose will be made in the
When the patient goes to the floor, the floor pharmacist will see the
antibiotic with “SURGICAL PROPHY” in the text field on the profile.
The pharmacist will then confirm that the time entered for the next
antibiotic dose is correct. If the times are correct, use the “P” function to
print the labels in the IV room. If the times have changed, modify the order
to provide the adjusted times and generate labels in the IV room. If the
order is modified, please remember that the doses that were not given
need to be returned to stock, in order to prevent extra charges to the
Order comes to floor pharmacist
The floor pharmacist calls the OR pharmacist and gives them the order for
pre-op and post-op antibiotics (as is currently done now for pre-op orders).
From here on, the OR pharmacist and floor pharmacist follow the same
procedure as detailed above.
Operating Rooms Closed
Order comes to central pharmacy
The pharmacist keeps the forms (does not enter them) and gives them to
the OR pharmacist in the morning (put in OR bin in the fridge).
The process for “Order comes to OR pharmacist”, detailed above, is
followed once the OR pharmacist gets the orders.
Emergent After Hours Cases
Typically, the order is called to the IV room pharmacist. Thus, no form will
IV room pharmacist will fill out form and file it in the OR order file in unit
This form is part of the clinical protocols in the System Policies and Procedures
and must be used for antibiotics for surgical prophylaxis, with the exception of
pediatric cases and solid organ transplants. The form will be available in the pre-
op packets for The Nebraska Medical Center and on all the floors.
o Extras will be kept in the OR pharmacies and on the rolling shelves in UD.
The pharmacist can automatically make the weight and renal function
adjustments. Renal function adjustments should be recorded in the medical
record by the pharmacist.
o The renal dosage guidelines will be posted on the intranet.
If the physician orders an agent to which they have also documented a true
allergy (at the top of the form), the pharmacist can automatically order the
“allergy” option without having to call the physician.