New fluid-restriction orders coming soon

By Michael Tieu, MS, RD, Clinical Nutrition Manager

Issue #1: Lately we’ve noticed an increasing number of issues with physicians not using the Diet Order to choose the correct selectable options for fluid restriction. The current options available are 1000, 1500, 2000 ml fluid restriction, but physicians are inputting 1200 and 1800 in the Comments Section. Comments do not cross over into our Food Service program correctly. As a result, the fluid restriction orders are not followed.

After speaking with some of our cardiologists and nephrologist, it’s clear we need more options. Our Clinical Nutrition Leadership Council has voted to approve the addition of two more fluid-restriction options in Epic: 1200 and 1800 ml. It may take a little time to get this added into Epic as we are working through many optimization requests, but these new options will be available soon.

In the meantime, please choose from the options available in the Epic Diet Order so we can ensure our patients receive the appropriate nutrition for their condition and status.

Issue #2: We have noticed physicians are altering Enteral Feed orders in Epic and not properly updating all elements of the enteral feed, which, as a result, are not interfacing correctly with our Food Service program. We encourage our physicians to consult our dietitian team when there are any enteral feed changes including rate, formula and volume given to a patient. We are available seven days a week, with on-call from 8 a.m. to 4 p.m. on Sundays, to tackle any enteral feed or TPN questions. Our weekend/on-call number for our department is 303-897-4245.

Thank you for your attention to these issues!