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Anesthesiology
- APS - Epidural Catheter Infusion Orders
- APS - Fentanyl Patient Controlled Analgesia Orders
- APS - Ketamine Drip Orders
- APS - Neuraxial Opioid Monitoring Orders
- APS - OB Neuraxial Opioid Monitoring Orders
- APS - Patient Controlled Analgesia (PCA) Orders
- APS - Peripheral Nerve Block Orders
- Anesthesiology - Post Anesthesia Physician Paper Orders, Adult
- Anesthesiology - Post Anesthesia Physician Paper Orders, Pediatric
- APS - Side Effect Medications
- Chronic Pain Service - Patient Controlled Intrathecal Analgesia
- Pain Medicine and Palliative Care Service - Patient Controlled Analgesia (PCA) Orders
- Primary Service Patient Controlled Analgesia (PCA) Orders
- Same Day Surgery - Post-Op Orders
- UOC Anesthesiology - Peripheral Nerve Block Orders
Anticoagulation
- Argatroban Orders - for Heparin Induced Thrombocytopenia
- Argatroban Orders - for Heparin Induced Thrombocytopenia - in patients with Hepatic Dysfunction/Critical Illness
- Daily Warfarin Flow Sheet and Anticoagulation Referrral Form
- Heparin Protocol - Acute DVT or PE
- Heparin Protocol - Acute MI or ACS
- Heparin Protocol - Anti-Xa
- Heparin Protocol - Brain Injury - High Dose
- Heparin Protocol - Brain Injury - Low Dose
- Heparin Protocol - CT Surgery/LVAD - High Dose
- Heparin Protocol - CT Surgery/LVAD - Low Dose
- Heparin Protocol - Other
- Heparin Protocol ACT - ECMO-Centrimag Paper Version
- Heparin Protocol - Vascular Surgery
- Warfarin Orders
Behavioral Health
- CIWA-Ar
- COWS
BTICU
- BTICU - Adult - Fluid Resuscitation Orders
- BTICU - Pediatric - Fluid Resuscitation Orders
Cardiology
- Cardiac Cath Lab Pre-Procedure Inpatient Order
- Cardiology Admission Order
- Cardioversion Orders for CVMU
- Dofetilide (Tikosyn) Orders - 4N
- Electrophysiology Lab Pre-Procedure Inpatient Order
- Sotalol Order for 4N
Cardiothoracic Surgery
- Cardiothoracic Surgery Post-Operative Admit to SICU Orders
- Cardiothoracic Surgery Pre-Operative Orders
- Cardiothoracic Surgery Transfer Orders
- Independent Driving Test Orders Left Ventricular Assistive Device (LVAD)
- Ventricular Assistive Device (VAD) Post-Operative Orders
- Ventricular Assistive Device (VAD) Pre-Implant Orders
- Ventricular Assistive Device (VAD) Transfer Orders
Endocrine
- Adult DKA Orders
- Adult Insulin Infusion Protocol
- Adult Subcutaneous Insulin Orders
ENT
- Mitomycin for Laryngotracheal Stenosis
General Medicine
- GM - Admission Template
- GM - Cellulitis Treatment Algorithm - Diagram
General Surgery
- GS - Admission Template
Hematology-Oncology
- ESA-Chemotherapy Induced Anemia
- ESA-Chronic Kidney Disease
- ESA-Myelodysplastic Syndrome
- Intravenous Iron Replacement
- Neutropenic Fever Order Sheets
- Romiplostim - NPlate
- Urine Alkalinization Protocol
Imaging
- MRI Inpatient History and Safety Screening
- MRI Outpatient History and Safety Screening
- PET Dementia Evaluation Scheduling Request
- PET Epilepsy Evaluation Scheduling Request
- PET Registry Form
- PET Scheduling Ordering Request
Infusion Center
- Abatacept (Orencia) Order
- ACTH High Dose Stimulation Test Orders Cosyntropin/Cortrosyn
- Acute Management of Allergic Reaction Order
- Albumin Infusion Order
- Alpha1-Protinase Inhibitor (Human) Orders
- Antibiotic/Antifungal/Antiviral Infusion Orders
- Aredia (Pamidronate) Order
- Blood Product Transfusion Order
- Cytoxan (Cyclophosphamide) Order
- Iron Dextran Order
- Feraheme (Ferumoxytol) Order
- Gastrin-Secretin Procedure Orders
- Hyperemesis Infusion Order
- Ibandronate Sodium (Boniva) Order
- Iron Sucrose/Venofer Infusion Order
- IV Fluids Infusion Order
- IVIG Solution Order
- Methylprednisolone (Solumedrol) Order
- Mitoxantrone/Novantrone Dose Tracking Sheet
- Mitoxantrone (Novantrone) for Multiple Sclerosis Order
- Natalizumab (Tysabri) Infusion
- Reclast/Zoledronic Acid Infusion Order
- Remicade (Infliximab) Order
- Rituximab Rituxan FOR NON-RA Patients
- Rituximab (Rituxan) for Rheumatoid Arthritis Order
- Sodium Ferric Gluconate Complex (Ferrlecit) Order
- Therapeutic Phlebotomy Order
- Tocilizumab (Actemra) Infusion Order
- Zometa/Zoledronic Acid Infusion Order
Interventional Oncology
- Post Procedure Visceral and Embolization Orders
- Post Procedure Yttrium 90 Administration Orders
- Pre Procedure Yttrium 90 Administration Orders
Interventional Radiology
- Post Procedure Visceral and Embolization Orders
- Post Procedure Yttrium 90 Administration Orders
- Pre Procedure Yttrium 90 Administration Orders
MICU
- Aquadex Standing Orders
- MICU Dialysis Catheter Protocol
Miscellaneous
- Adult DKA Orders
- Adult Insulin Infusion Protocol
- Adult Parenteral Nutrition (TPN) 3-in-1 Order
- Adult Subcutaneous Insulin Orders
- Alcohol Withdrawal Assessment Scale Monitoring Form
- Alcohol Withdrawal Prevention Guideline
- Patient Caloric Intake Sheet
- Change In Patient Identifiers Checklist
- Leaving Against Medical Advice Acknowledgement Form
- Nausea and Vomiting Treatment Form
- Patient Acute Change Orders
- Patient Caloric Intake Sheet
- PICC Associated Upper Extremity Venous Thrombosis Orders Prevention Study: Enoxaparin (Lovenox) vs. Heparin
- PICC Associated Upper Extremity Venous Thrombosis Transfer Orders Prevention Study: Enoxaparin (Lovenox) vs. Heparin
- PICC Line Placement Orders
- Sodium Bicarbonate Solution Orders (for patients receiving IV Contrast)
NBICU
- Initiation of Whole Body Cooling
- ROP Screening Guidelines
- Whole Body Cooling Protocol
Nephrology
- Continuous Renal Replacement Therapy (CRRT) Orders - During Injectable Calcium Shortage
- ESA Continuation Therapy for Anemia of Chronic Kidney Disease
- ESA Initiation Therapy for Anemia of Chronic Kidney Disease
- Inpatient Hemodialysis Orders
Neurology - Neurosurgery
- Adult Dihydroergotamine Mesylate (DHE) Protocol Order Sheet Maintenance Dosing
- Adult Dihydroergotamine Mesylate (DHE) Protocol Order Sheet Test Dose
- Brain Attack Orders
- Heparin Protocol - Brain Injury - High Dose
- Heparin Protocol - Brain Injury - Low Dose
- ICP Management Protocol
- Interventional Neuroradiology for Intra-arterial (IA) Administration
- NCC Fever Protocol
- Neuro Bowel Protocol
- Neurology IV Cyclophosphamide
- Post t-PA Blood Pressure Parameters Protocol
- Stroke Orders - No Tissue Plasminogen Activator (t-PA) given
- Stroke Orders - Post IV Tissue Plasminogen Activator (t-PA)
- Tissue Plasminogen Activator (t-PA) Order
Nursery
- Neonatal Parenteral Nutrition Orders
- Newborn Infant Physician's Order Sheet
OB
- OB - Antepartum
- OB - Immediate Postpartum Care
- OB - Labor and Delivery Insulin Orders
- OB - Labor and Delivery Labor Phase
- OB - Postpartum Cesarean Delivery
- OB - Postpartum Mg/Labetalol/Recovery
- OB - Postpartum Vaginal Delivery
Orthopaedics
- Ortho - Adult Reconstruction Service Tranexemic Acid Protocol
- Hip Osteotomy Orders
- Pre-Operative Orders
- Total Hip Arthroplasty Postoperative Orders
- Total Hip Arthroplasty Revision Postoperative Orders
- Total Knee Arthroplasty Postoperative Orders
- Total Knee Arthroplasty Revision Postoperative Orders
- Post-Op Orders: Foot and Ankle Reconstruction
Pain Medicine and Palliative Care
- Pain Medicine and Palliative Care Service - Patient Controlled Analgesia (PCA) Orders
Pre-Surgery and Same Day Surgery
- Outpatient Post Op/Procedure Orders
- Surgical Pre-Admission Order Sheet
Protocols
- BTICU Electrolyte Protocol Managed by Pharmacy
- AIMS65 Mortality Data
- CIWA-Ar
- Close Supervision Behavioral Documentation
- Close Supervision Decision Tree
- Close Supervision Delirium vs. Dementia
- Close Supervision HCA Quick Guide
- Close Supervision Talking Point Suggestions
- COWS
- Dofetilide (Tikosyn) Orders - 4N
- IDS Open Lung Protocol
- Non-Variceal Upper GI Bleeding Care Pathway
- Post t-PA Blood Pressure Parameters Protocol
- SICU Wean Ventilator Protocol
Rehabilitation Medicine
- Autonomic Dysreflexia (AD) Protocol
- Baclofen Protocol - Outpatient
- Baclofen Trial Protocol - Inpatient
- Rehabilitation Admission Orders
SICU
- Cardiothoracic Surgery Post-Op Admit to SICU
- SICU NMBA Protocol
- SICU Sedation Protocol
- SICU Electrolyte Protocol
- SICU Enteral Nutrition Order Set
- SICU Post-Op Atrial Fibrillation Protocol
- SICU Wean Ventilator Protocol
Transplant Services
- Heart Transplant Admit Orders
- Heart Transplant Eval Orders
- Heart Transplant Post-Op Orders
- Kidney Transplant Admit Orders
- Kidney Transplant Post-Op Orders
- Liver Transplant Admit Orders
- Liver Transplant Eval Orders
- Liver Transplant Post-Op Orders
- Lung Transplant Admit Orders
- Lung Transplant Eval Orders
- Lung Transplant Post-Op Orders
- Pancreas Transplant Admit Orders
- Pancreas Transplant Post-Op Orders
Vascular
- Continuous Alteplase Infusion Orders

Standard Orders Home

Standard Orders used at University of Utah Healthcare may be developed by any group that identifies a need to have a standard process for ordering therapy for a given situation or disease state. Please refer to the Order Sets: Electronic Ordersets and Preprinted Orders Policy for questions or concerns.

Please use the request page for submission of content, changes or to propose new standard orders. If you have any questions please contact Amanda Keller, General Internal Medicine, at amanda.keller@hsc.utah.edu or by phone at ext. 1-7818.

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