Resident Handbook - UC Davis Health System

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2. Give the patient educational material, including Anticoagulation Patient Education andWarfarin – Effects of Foods and Supplements.3. Have the patient sign the Warfarin Therapy Agreement which addresses the use ofwarfarin, including risks and benefits and the need to take as directed and perform bloodtesting as directed.4. Initiate a Warfarin Flow Sheet which will be added to the patient’s chart. The flow sheetwill be used to document• each PT/INR result• date drawn• any adjustment made to the warfarin dose• time for the next draw• patient current phone number• patient notification.The provider will fill the following information on the Warfarin Flow Sheet:1. Indications for warfarin2. INR goals for therapy3. Duration of use4. Initial warfarin dose5. Time for next PT/ INR drawProviders will also give patients a six month standing lab order for Protime (PT/INR) with3x/week maximum frequency.Once patients are entered into the Warfarin Log, the nursing staff will track patients on a weeklybasis to see which patients are in need of PT/INR.The data coordinator will send out a quarterly report to providers so they can verify that all oftheir patients who take warfarin have been entered into the log. Nursing staff will also receive acopy.PT/INR lab results will be processed as follows:1. When patients have their PT/INR drawn, nursing staff will put lab results in the patient’schart along with a pink Warfarin Chart Flag.2. <strong>Resident</strong> chart will then go to the C1 Clinic doc for review.3. The C1 Clinic Doc will indicate any warfarin dose adjustments and when the nextPT/INR should be drawn.4. The chart will then go to the Nursing Desk.5. The Desk Nurse will contact the patient and provide instructions for the patient, anddocument in the Warfarin Flow Sheet.6. Faculty patient results will be processed in the same fashion, with faculty covering theirown patients and those assigned to other faculty members who are unavailable (accordingto the “Faculty Covering Labs for Faculty” schedule).7. All patients residing in a care facility must have a physician signed ‘MEDICATIONORDERS/CHANGES’ sheet that will be faxed to the facility.Page 126 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc
All new warfarin patients will be given an Rx for Vitamin K 5 mg to be filled only as advised bya MFHC physician. The following guidelines may be used for the management of significantlyelevated warfarin:1. For PT/INR 5.0 to 8.9 and no significant bleeding: Omit 1 to 2 doses of warfarin; reducedose 10 to 20 percent; monitor frequently. Alternately consider Vitamin K: 2.5 mgorally.2. For PT/INR >/= 9.0 and no significant bleeding: Hold warfarin therapy; give Vitamin K:5 mg to 10 mg orally; monitor frequently. Resume at lower dose when INR istherapeutic.3. Serious bleeding, any INR: Hold warfarin and refer to Emergency Department.Although warfarin management can be done by phone, patients must be seen for evaluation noless than once every 6 months.Mercy Family <strong>Health</strong> Center2480 Sonoma StreetRedding, CA 96001(530) 225-7800MEDICATION ORDERS/CHANGESFor Patients Residing in Care FacilitiesPatient Name:Date:Care Facility:MFHC Medical Record Number:New Medication:Dose:Existing Medication:Current dose:Change dose to:Page 127 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc
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Resident HandbookMercy Redding Fami
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PEDIATRICS/OB......................
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MASTER SCHEDULE:...................
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Resident HandbookMercy Redding Fami
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efore the start of the rotation tha
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Cardiology Competencies - PGY3Cogni
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Understand and describe Home care a
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Page 15 of 1532. OBRA "87 & "94 Reg
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Skills1. Monitor interpretation for
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Page 19 of 153Skills1. Diagnosis an
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1. Management of well child care2.
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3. Lab interpretation of joint flui
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5. Hemorrhoid I & D6. Fluid and Ele
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B. Service DescriptionC. DutiesA tw
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C. DutiesAttendance at the cardiolo
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Dermatology Clinic (C1 and C2 - MFH
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Vasectomy Clinic (C1 - FPI)Resident
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ability to maximize their health/he
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hospital care of common ENT conditi
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viii. Resident may be responsible f
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Rawlings or Dr. Bland so we can mak
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for EM occur once a month(on the th
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Emergency Medicine Rotation Require
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HOME VISITSEach resident is to make
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Practice preceptors who rotate onto
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A. Service GoalsAs a second and thi
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attending re: the patient’s statu
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Attending duties:• Be the attendi
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11-15: the night shift resident rou
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ED, and admitted, must be discussed
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D. Service Guidelines: OBSTETRICS S
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OPHTHALMOLOGYA. Service GoalsThe go
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CLIA testing & LunchEpisiotomy Trai
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10) Concussion11) Athlete’s heart
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Significant training continues duri
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. Hospital Leadership TrainingResid
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• Health systems training• Prac
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Page 83 and 84: CHIEF RESIDENTS:The Chief Residents
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Page 97 and 98: must protect itself from possible s
Page 99 and 100: MEDICAL STAFF BYLAWS / RULES AND RE
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Page 121 and 122: Page 121 of 153WORK HOURSResidency
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Page 129 and 130: MANAGEMENT OF SIGNIFICANTLY ELEVATE
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Page 137 and 138: pertinent information. Dr. DeVlamin
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Page 148 and 149: chart holder that corresponding to
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Resident Handbook - UC Davis Health System

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