Unique Plan Description: OB Labor Admission
Plan Selection Display: OB Labor Admission
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-22 19:23:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-07-29 10:32:14
Available at all facilities: Yes

OB Labor Admission
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N, Anticipated LOS 2 midnight or more
Vital Signs
	Vital Signs
		Routine Labor Vital Signs
Activity
	Ambulate
		T;N
			Comment: as tolerated prn.
Diet
	Clear Liquid Diet
		T;N
			Comment: low risk laboring patients may have moderate amount of clear liquids.
		Select NPO for patients with the following risk factors: attempting VBAC, morbid obesity (BMI > 40), severe reflux, diabetes, known difficult airway, planned or probable operative delivery.(NOTE)*
	NPO
		
Laboratory
	Type and Screen (No Product on hold)
		Routine, spec type = Blood
		Order CBC if patient attempting VBAC.(NOTE)*
	CBC with Diff
		T;N, Routine, spec type = Blood
	Glucose POC - RN
		T;N, Q1H, Notify MD if less than 70 or greater than 120.
		T;N, Q2H, Notify MD if less than 70 or greater than 120.
	Glucose Level, patient to do own
		
		No Prenatal Care or Prenatal labs unavailable, enter Rapid GBS and Prenatal Panel(NOTE)*
	Group B Strep by PCR
		T;N, Routine
IV Solutions
	Lactated Ringers Injection
		1,000 mL, IV, 125 ml/hr
			Comment: if Type 1 Diabetic, use Normal Saline instead of Lactated Ringers for main IV
		1,000 mL, IV, PRN, labor, 999 ml/hr
			Comment: give 1000mL prior to initiation of epidural, may give 1000mL for category II or III tracing as needed
	Sodium Chloride 0.9%
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, PRN, labor, 999 ml/hr
			Comment: give 1000mL prior to initiation of epidural, may give 1000mL for category II or III tracing as needed
	Pitocin 30 units/lactated ringers 500 mL Premix IV
		30 units, EVERY BAG, 59.94 units/hr
		500 mL, IV, Routine, T;N, 48 hr
			Comment: Comment: Infuse 15 units over 15 minutes (999mL/hr) immediately post partumFollowed by 15 units over 3 hours (83.3mL/hr) immediately after first bolus dose is completed - The Initial postpartum infusion rate may be decreased prior to 15 minutes based on patient's clinical status and communication between the surgeon and anesthesia provider. - RN will be responsible to adjust IV rate.
Medications
	fentaNYL
		50 mcg, Injection, IV Push, Q1H, PRN, pain-moderate
		100 mcg, Injection, IV Push, Q1H, PRN, pain-severe
			Comment: not relieved by 50 mcg
	butorphanol
		1 mg, Injection, IV Push, Q1H, PRN, pain-moderate, 2 Dose(s)/Time(s)
	Narcan
		0.4 mg, Injection, IV Push, Once, PRN, respirations < ....
			Comment: prn respiratory rate <8, then call anesthesia
	lidocaine 1% preservative-free injectable solution
		30 mL, Injection, SUBCUTANEOUS, Once, PRN, see comment
			Comment: for episiotomy repair.
	terbutaline
		0.25 mg, Injection, SUBCUTANEOUS, Q20MIN, PRN for uterine relaxation
			Comment: Do not repeat dose if pulse is > 120.  Notify MD if administered and remove Cervidil and/or stop oxytocin, if applicable.
Patient Care
	Resuscitation Status
		T;N, Full Code
		T;N, No Code
	Fetal Scalp Electrode
		Apply fetal scalp electrode prn if no history of HIV.
	Fetal Monitoring
		T;N
			Comment: Obtain baseline fetal monitoring for 30 minutes. May use continuous fetal monitoring, intermittent EFM or Intermittent Auscultation as appropriate per policy and patient preference. If Category II or III tracing identified perform intrauterine resuscitation while notifying provider. Category I tracing prior to use of induction agents.
	Straight Catheter
		Insert, unable to void
			Comment: PRN
	Notify MD
		if mother HBsAG positive or unknown
		Anesthesia if patient is a VBAC
		Obstetric Call Parameters: SBP >160 mmHg and/or DBP >110 mmHg, P: >120 or <50, O2 Sat: <95%, RR: <10 or >30, Oliguria: <60 mL in 2 hours, Single Temp > 39.0C (102.2F), OR 2 temps between 38.0C (100.4F) and 39C (102.2F), at least 30 min apart
		T;N, if terbutaline is administered
	Oxygen Therapy, Nurse to Administer
		Via Non-rebreathing Mask, O2 @ 10-15L/min, PRN
	Foley Catheter
		Insert, Acute urinary retention, Once, insert with epidural
	Sequential Compression Device Pre Procedure
		T;N, Apply, Once
			Comment: knee high
	Delivery Indication
		T;N
	Peripheral Lock-Insert
		T;N, May saline lock IV until active labor. Enter Peripheral Lock - Access
	Intake and Output
		Q12H-Sch
		Q2H-Sch
		Q4H-Sch
Consults/Follow-up
	Consult Neonatologist
		Reason for Referral: NNP for pending delivery
	Consult Anesthesiologist
		Reason for Referral: patient may have epidural upon request prn severe pain

Prenatal Panel
Laboratory
	CBC with Diff
		T;N, Routine, spec type = Blood
	Rubella Ab IgG Screen - MH/WH/JE
		T;N, Routine, spec type = Blood
	Rubella IgG Ab Quantitative - FH
		T;N, Routine, spec type = Blood
	RPR
		T;N, Routine, spec type = Blood
	Hepatitis B Surface Antigen
		T;N, Routine, spec type = Blood
	Type and Screen (No Product on hold)
		T;N, Routine, spec type = Blood
	HIV-1/2 Ag/Ab Combo - MH/WH/JE
		T;N, Routine, spec type = Blood
	HIV 1/2 Screen w/ p24 Antigen - FH
		T;N, Routine, spec type = Blood
	Hepatitis C Virus (HCV) Antibody with Rflx to PCR Confirmation
		T;N, Routine, spec type = Blood

Peripheral Lock - Access
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL Syringe IV PUSH BID
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	lidocaine 1% injectable solution (MH/WH/FH)
		0.1 mL, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start, use if patient has lidocaine allergy.
	Sodium Chloride 0.9% IVPB Flush
		25 mL, IVPB, Q1H, PRN, IV line flush, 5 min(s)
			Comment: Use if medication not compatible with primary line or there is no primary line;  infuse 25mL.
Patient Care
	Peripheral Lock-Insert
		T;N

PIH Panel
Laboratory
Urine Studies
	Creatinine Clearance
		T;N, Routine, Routine, Urine Timed, spec type = Urine
	C. Clearance Serum
		T;N, Routine, spec type = Blood
	Protein Urine Timed Set
		T;N, Routine, Routine, spec type = Urine
	Protein Creatinine Ratio Urine
		T;N, Routine, Routine, Urine Random, spec type = Urine
General Labs
	CBC with Diff
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood

OB Cervical Ripening Balloon Catheter
Vital Signs

	Vital Signs
		Routine labor vital signs
Activity
	Ambulate
		T;N+120
			Comment: Patient may ambulate after insertion of cervical ripening balloon catheter with intermittent auscultation
Diet
	Regular Diet
		T;N+120
			Comment: as tolerated, after cervical ripening balloon inserted and/or no active labor
	NPO
		T;N, After Midnight, Except for Ice
Medications
	Ambien
		5 mg, Tab, By Mouth, QHS, PRN, insomnia
Patient Care
	Vaginal Exam
		T;N
			Comment: prior to administration of cervical ripening balloon catheter. Document Bishop Score
	Fetal and Uterine Contraction Monitoring
		T;N, intermittent or continuous based on the presence of risk factors/CONTINUOUSLY after cervical ripening medication administration and for 15 minutes after removal.
	Notify
		T;N, MWH Only: Provider/Resident to perform bedside US to check for vertex
	Cervical Ripening Balloon Catheter
		T;N, Insert once, by provider
		T;N, remove 12 hours after insertion if catheter has not fallen out
	Foley Catheter
		T;N, Once, Transcervical, to be inserted by provider. Use all silicone foley catheter
	Shower
		T;N, QHS, 1, Dose(s)/Time(s)
			Comment: with chlorhexidine gluconate

Nausea Protocol EKM
Medications
	ondansetron
		4 mg, Injection, IV PUSH, Q24H, PRN for nausea and/or vomiting
			Comment: Administer for nausea if not previously administered by anesthesia, PACU, or ED and unable to take oral meds.
		4 mg, Injection, IV PUSH, Q6H, PRN for nausea and/or vomiting
			Comment: Administer for nausea if not previously administered by anesthesia, PACU, or ED and unable to take oral meds.
		4 mg, Tablet-Disintegrating, By Mouth, Q6H, PRN for nausea and/or vomiting
			Comment: Administer for nausea if not previously administered by anesthesia, PACU, or ED
		Select either promethazine or prochlorperazine orders:(NOTE)*
	prochlorperazine
		10 mg, Injection, IV PUSH, Q6H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures
		25 mg, Suppository, RECTALLY, BID, PRN, nausea
			Comment: Give if ondansetron ineffective and if no history of seizures, give if IV access not available
	Phenergan (JE)
		25 mg, Tab, By Mouth, BID, PRN, nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures
		25 mg, Suppository, RECTALLY, BID, PRN, nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures, give if IV access not available
	Phenergan (MH/WH)
		25 mg, Tab, By Mouth, BID, PRN, nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds.
		25 mg, Suppository, RECTALLY, BID, PRN, nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds.
		6.25 mg, Injection, IM-Intramuscular, Q6H, PRN for nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds
	Phenergan (FH)
		25 mg, Tab, By Mouth, BID, PRN for nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds.
		25 mg, Suppository, RECTALLY, BID, PRN for nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds.
		12 mg, INT, IVPB, Q6H, PRN for nausea and/or vomiting
			Comment: Give if ondansetron ineffective and if no history of seizures; give if unable to take oral meds.
	Benadryl
		12.5 mg, Injection, IV PUSH, Q6H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron and phenothiazine ineffective
	Ativan
		1 mg, Tab, BY MOUTH, Q8H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron, phenothiazine, or other anti-nausea medications ineffective
		1 mg, Injection, IV PUSH, Q8H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron, phenothiazine, or other anti-nausea medications ineffective
	Reglan
		10 mg, Injection, IV PUSH, Q6H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron, phenothiazine, or other anti-nausea medications ineffective; avoid in patients > 65yo
		10 mg, Injection, IM-Intramuscular, Q6H, PRN, nausea and/or vomiting
			Comment: Give if ondansetron, phenothiazine, or other anti-nausea medications ineffective; avoid in patients > 65yo

OB Hemorrhage Meds (FH)
Laboratory
	Type and Screen (No Product on hold)
		Routine, spec type = Blood
Medications
	Cytotec
		800 mcg, Tab, RECTALLY, Once, PRN, bleeding
	Methergine
		0.2 mg, Injection, IM-IntraMUSCULAR, Q2H, PRN, uterine relaxation
			Comment: Avoid in hypertensive patients
	Hemabate
		250 mcg, Injection, IM-IntraMUSCULAR, Q15MIN, PRN, uterine relaxation, 8 Dose(s)/Time(s)
			Comment: Avoid in asthmatic patients.  Relative contraindication if hepatic, renal and cardiac disease
	tranexamic acid
		1,000 mg, Solution, IV Push, Once, PRN for see comment
			Comment: Hemorrhage management, push slowly over 10 minutes to avoid hypotension.

OB Oxytocin Protocol EKM
IV Solutions
	Pitocin 30 units/lactated ringers 500 mL Premix IV
		30 units, EVERY BAG, 1 milliunits/min
		500 mL, IV, Routine, T;N
			Comment: (MJE/MWH) Start at 1milliunit/min and may increase by 1milliunit/min at a minimum interval of every 15 minutes
		30 units, EVERY BAG, 1 milliunits/min
		500 mL, IV, Routine, T;N
			Comment: (FH) Start at 1milliunit/min and may increase by 1milliunit/min at a minimum interval of every 30 minutes
Patient Care
	Oxytocin Protocol
		T;N
			Comment: 1. Titrate oxytocin according to maternal and fetal response, labor progress, and the "Oxytocin in Use" checklist. Components of the “Oxytocin In Use” Checklist include the following: 	• Fetal Assessment parameters		o At least one acceleration of 15 bpm x 15 seconds in 30 minutes or minimal to moderate variability for 10 of the previous 30 minutes.		o No more than one late deceleration occurred.		o No more than two variable decelerations exceeding 60 seconds in duration and decreasing greater than 60 bpm from the baseline within the previous 30 minutes. 		o Absence of prolonged decelerations(s).	• Uterine Contraction Assessment parameters		o No more than 5 uterine contractions in 10 minutes for any 30 minute interval.		o No more than one contraction lasting greater than 120 seconds duration.		o Uterus palpates soft between contractions. 		o If IUPC is in place, MVU must calculate less than 300 mm Hg and the baseline resting tone must be less than 25 mm Hg.2.  If adequate progress of labor cannot be determined by external monitors, notify healthcare provider for specific order for internal pressure catheter. 3.  If dilation is 5-6cm with adequate labor progress, oxytocin may be decreased in increments of 1 milliunit/minute. 4.  If the oxytocin infusion has been discontinued for less than 30 minutes and when fetal and uterine assessment parameters have been met, per the “Oxytocin In Use” Checklist components, oxytocin may be restarted at not more than one-half of the rate at which it was discontinued and then increased by 1 milliunit/minute at a minimum of every 15 minutes. 5.  If the oxytocin infusion has been discontinued for more than 30 minutes, and when fetal & uterine assessment parameters have been met, per the “Oxytocin In Use” Checklist components, oxytocin may be restarted at 1 milliunit/minute and then increased by 1 milliunit/minute at a minimum of every 15 minutes. 6.  Once oxytocin is at 20 milliunits/minute and contraction pattern fails to result in cervical effacement and dilation, a nurse should call the healthcare provider for specific orders for oxytocin.7.  When there is a Category II tracing, the following interventions may be considered: decrease or discontinue oxytocin, reposition patient, administer oxygen, assess hydration status, and consider IV bolus and notify the healthcare provider.  If no resolution and uterine tachysystole is present or the need to reduce uterine contraction activity is present, the RN will consider Terbutaline administration per order in the Oxytocin Power Plan. 8.  When there is a Category III tracing, the following interventions are recommended:  discontinue oxytocin, reposition patient, administer oxygen, consider IV bolus, and notify the healthcare provider for prompt evaluation / delivery.  If no resolution and if uterine tachysystole is present, the RN will consider Terbutaline administration per order in the Oxytocin Power Plan.

OB Cervical Ripening Prostaglandin
Vital Signs
	Vital Signs
		T;N, Q1H, 2, Dose(s)/Time(s)
		T;N, Q4H, 3, Dose(s)/Time(s)
Activity
	Ambulate
		T;N+30
			Comment: Patient may ambulate 30 minutes after cervical ripening medication administration, with continuous monitor
	Bedrest
		T;N, Supine
			Comment: Supine, with hip wedge, for 30 minutes after administration
Diet
	Regular Diet
		T;N+120
			Comment: as tolerated, after cervical ripening medication administration and/or no active labor
	NPO
		T;N, After Midnight, NPO Except for: NPO Except For Ice
Medications
		Select medication  below for Cervical Ripening Vaginal-Misoprostol(NOTE)*
	Cytotec
		25 mcg, Tab, VAGINAL, Q4H, PRN, cervical ripening, 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol; use 50mcg dosage with caution.  Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		50 mcg, Tab, VAGINAL, Q4H, PRN, cervical ripening, 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol; use 50mcg dosage with caution.  Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		Select medication below for Cervical Ripening Oral-Misoprostol(NOTE)*
		50 mcg, Tab, By Mouth, Q4H, PRN, cervical ripening, 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol.  Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		100 mcg, Tab, By Mouth, Q4H, PRN, cervical ripening, 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol.  Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		Select medication  below for Cervical Ripening Vaginal-Cervidil(NOTE)*
	Cervidil 0.3 mg/hr vaginal insert
		10 mg, Insert, VAGINAL, Once, T;N
	cervidil removal
		Removal, Insert, VAGINAL, Once, PRN, see comment
			Comment: 12 hours after insertion or when active labor begins, and /or if Category III FHR pattern occurs.  Oxytocin should not be administered for 30-60 minutes after removal of Cervidil.  PRN, after consultation with HCP, may remove Cervidil if tachysystole (more than 5 uterine contractions in 10 minutes, averaged over a 30 minute window present and/or Category II FHR pattern)
PRN
	Ambien
		5 mg Tab BY MOUTH QHS, PRN insomnia
Patient Care

	Vaginal Exam
		T;N
			Comment: prior to administration of cervical ripening medication. Document Bishop score
	Fetal and Uterine Contraction Monitoring
		T;N
			Comment: Intermittent or continuous based on the presence of risk factors. CONTINUOUSLY, after cervical ripening medication administration.
	Shower
		T;N, QHS, 1, Dose(s)/Time(s)
			Comment: with chlorhexidine gluconate
	Notify
		T;N, MWH only: Provider/Resident to perform bedside US to check for vertex

OB Cervical Ripening Prostaglandin and Balloon Cat
Vital Signs
	Vital Signs
		T;N, Q1H, 2, Dose(s)/Time(s)
		T;N, Q4H, 3, Dose(s)/Time(s)
Activity
	Ambulate
		T;N+30
			Comment: Patient may ambulate 30 minutes after cervical ripening medication administration, with continuous monitoring
	Bedrest
		T;N, Supine
			Comment: with hip wedge, for 30 minutes after administration
Diet
	Regular Diet
		T;N+120
			Comment: as tolerated, after cervical ripening medication administration and/or no active labor
	NPO
		T;N, After Midnight, Except for Ice
Medications
		Select medication  below for Cervical Ripening Vaginal-Misoprostol(NOTE)*
	Cytotec
		25 mcg, Tab, VAGINAL, Q4H, PRN cervical ripening, duration: 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol; use 50mcg dosage with caution. Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		50 mcg, Tab, VAGINAL, Q4H, PRN cervical ripening, duration: 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol; use 50mcg dosage with caution. Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		Select medication below for Cervical Ripening Oral-Misoprostol(NOTE)*
		50 mcg, Tab, By Mouth, Q4H, PRN cervical ripening, duration: 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol. Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		100 mcg, Tab, By Mouth, Q4H, PRN cervical ripening, duration: 24 hr
			Comment: Oxytocin should not be administered for at least 4 hours after last dose of Misoprostol.  Nurse may administer Misoprostol if baseline reactive NST and ongoing fetal heart rate monitoring tracing Category I, Bishop score is < 8 and fewer than 5 contractions in 30 minutes.
		Select medication  below for Cervical Ripening Vaginal-Cervidil(NOTE)*
	Cervidil 0.3 mg/hr vaginal insert
		10 mg =, Insert, VAGINAL, Once, T;N
	cervidil removal
		Insert Removal, Insert, VAGINAL, Once, PRN, see comment
			Comment: 12 hours after insertion or when active labor begins, and /or if Category III FHR pattern occurs.  Oxytocin should not be administered for 30-60 minutes after removal of Cervidil.  PRN, after consultation with HCP, may remove Cervidil if tachysystole (more than 5 uterine contractions in 10 minutes, averaged over a 30 minute window present and/or Category II FHR pattern)
PRN
	Ambien
		5 mg, Tab, By Mouth, QHS, PRN insomnia
Patient Care

	Vaginal Exam
		T;N
			Comment: prior to administration of cervical ripening medication. Document Bishop score
	Fetal and Uterine Contraction Monitoring
		T;N
			Comment: Intermittent or continuous based on the presence of risk factors. CONTINUOUSLY, after cervical ripening medication administration
	Shower
		T;N, QHS, 1, Dose(s)/Time(s)
			Comment: with chlorhexidine gluconate
	Notify
		T;N, MWH only: Provider/Resident to perform bedside US to check for vertex
	Cervical Ripening Balloon Catheter
		T;N, Insert once, by provider
		T;N, remove 12 hours after insertion if catheter has not fallen out
	Foley Catheter
		T;N, Once, Transcervical, to be inserted by provider. Use all silicone foley catheter

OB GBS Prophylaxis Protocol
Medications
	penicillin G potassium
		6 millionunits, Injection-Premix, IVPB, Once, GBS prophylaxis, STAT
		3 millionunits, Injection-Premix, IVPB, Q4H, GBS prophylaxis
		Low Risk penicillin Allergy--If patient has a penicillin allergy and is at low risk for anaphylaxis, select the 2 ceFAZolin (Ancef) orders below:(NOTE)*
	Ancef IVPB
		2,000 mg, Injection-Premix, IVPB, Once, Other- type in, GBS prophylaxis, STAT, 100 ml/hr
		1,000 mg, Injection-Premix, IVPB, Q8H, Other- type in, GBS prophylaxis, 100 ml/hr
	Ancef IVPB (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Other- type in, GBS Prophylaxis, STAT, 100 ml/hr
		1,000 mg, INT, IVPB, Q8H, Other- type in, GBS Prophylaxis, 100 ml/hr
		High Risk Penicillin Allergy  WITH documented sensitivity--If patient has a high risk Penicillin allergy AND there is documented GBS sensitivity to Clindamycin select order below:(NOTE)*
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Q8H, Other- type in, GBS prophylaxis, STAT
		High Risk Penicillin Allergy with resistance OR no sensitivity testing--If patient has a high risk Penicillin allergy AND there is documented Clindamycin resistance OR no sensitivity testing completed, select the vancomycin order below:(NOTE)*
	vancomycin IVPB
		20 mg/kg, Injection-Premix, IVPB, Q8H, Indication: Other- type in, GBS prophylaxis, STAT
			Comment: Maximum single dose is 2000mg; please ensure doses greater than 1000mg are infused no faster than 500mg/30 min to prevent infusion related reactions.
	vancomycin IVPB (FH)
		20 mg/kg, Injection-Premix, IVPB, Q8H, Indication: Other- type in, GBS Prophylaxis, STAT
			Comment: Comment: Maximum single dose is 2000mg; please ensure doses greater than 1000mg are infused no faster than 500mg/30 min to prevent infusion related reactions

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase