RN Playbook

Nurse Clinic
Playbook

 
 

Preface:

The Nurse Clinic Playbook was developed to:
1. Provide context, history, and background of Nurse Clinics within Kaiser Permanente.
2. Be a reference guide to assist with the operation, workflows, clinical practice, and professional
development of the staff.
3. Open communication channels within your area and with other areas within Kaiser Permanente to
support the Nurse Clinics work.

   
I.
II. Table of Contents
III.
Executive Summary
IV. Background: Ambulatory Care Nursing
V.
Overview – Setting the Context
VI. Definition
Purpose
Workgroup – Reference Contacts

Operational Tools
Services Provided
Operating Hours
Leveling System
South Bay Medical Center Wound Care Service Levels
Orange County Medical Center Wound Care Service Levels
Staffing Model
Scheduling System
Appointment/Office Visit Routine (OVR) Templates
Orange County Call Center Nurse Clinic Appointment OVR
Regional Appointment OVR
San Diego Nurse Clinic Appointment OVR
Floor Plans
List of Supplies and Medications – Antelope Valley Nurse Clinics
Nurse Clinic Supplies
Nurse Clinic Medications
Nurse Clinic Flyer – services provided, hours of operation, etc

Clinical Practice Tools
Scope of Practice – MA vs. LVN vs. RN
Ambulatory Services
KP Health Connect
Standardized Policy and Procedures

Professional Development Tools
KP Competency Model
Expected Core Values Checklist
Validation Checklist for Core Nurse Clinic SP, Protocols, Policies
RN
RN, LVN, MA
Process Validation Tools
Skills Validation Tools

Appendix
Definition of Terminology
Reference Contacts

 

Executive Summary

Kaiser Permanente has a duty to fulfill its mission…. “To provide high quality, affordable health care
services and to improve the health of our members and the communities we serve.”
With the U.S. health care system undergoing a dramatic change and the implementation of the Affordable
Care Act, Kaiser Permanente has experienced tremendous membership growth over the past few years.
Further, changes in patient population and disease demographics with limited healthcare providers have
greatly impacted healthcare access. These challenging circumstances mark a crucial tipping point for the
organization to expand the roles of nursing practice and redesign of the models of health care.
Nurse Clinics provide our members an easier and more convenient way to access health care. Furthermore,
it highlights the value of nursing and expands the nursing role to their full scope of practice. This playbook
provides the overview of Nurse Clinics and serves as a practical guide for operation, clinical practice, and
professional development.

Background: Ambulatory Care Nursing
The American Academy of Ambulatory Nursing defines Ambulatory Care Nursing as a "unique realm of
nursing practice. It is characterized by rapid, focused assessments of patients, long-term
nurse/patient/family relationships, and teaching and translating prescriptions for care into doable activities
for patients and their caregivers. Ambulatory care nursing is a specialty practice area that is characterized by
nurses responding rapidly to high volumes of patients in a short span of time while dealing with issues that
are not always predictable."
Current settings for Ambulatory Nursing Practice at Kaiser Permanente include Nurse Clinics, Chronic Care
Management, Prevention, Screening, Telehealth, Episodic Care, Retail Clinics, and others.

OVERVIEW

Overview – Setting the Context

Definition of Nurse Clinics
Outside Kaiser Permanente, some nurse clinics are defined as Nurse Practitioner (NP)-run. Southern
California Kaiser Permanente (SCAL KP) NP visits are ‘provider visits’, so will not be included in this
definition (7/21/11: Definition reviewed and endorsed by SCAL Ambulatory Care Practice Committee).
SCAL KP SCPMG Adult Primary (family and internal medicine) Nurse Clinics Operational Definition is as
follows:

What They Are What They Are NOT

 RN – led ¹  NP/PA run clinic
 Staffing may be supplemented by LVNs,  A nursing procedure (nurse visit) done by a
MAs, NPs, PAs, and MDs nurse associated with a provider visit (ie,
 LVNs and MAs, where present, work under injection, ECG, wound care)
the direct supervision of an RN.  Telephone advice
 Walk in or Appointment-based,  POE-related clinic only, where the main
independent schedule purpose is to address care gaps
 Separate independent encounter not  Health education classes
associated with a provider visit  Healthy Bones Clinic
 Defined patient care space for nursing
procedures and activities
 Cold and Flu assessment, treatment and
Advice - move to other side
 Includes ‘nurse visits’
 May perform 1:1 patient education or
medication titration for patients with
chronic conditions (i.e., diabetes,
hypertension)
 No co-pay (with exception of Wound Care
Services)
**Institue of Medicine Report: The Future of Nursing, Leading Change Advancing Health, Report Recommendations
Key Message: “Nurses should practice to the full extent of their education and training”. 2011.

Purpose of Nurse Clinics
Nurse Clinics offer assessment, triage, and advice for patients in ambulatory setting by experienced
Registered Nurses. The purpose is to contain costs and to better integrate the pathway of care from the
acute to the rehabilitative phase (Wong & Chung, 2006). This aligns with the mission of Kaiser Permanente
“to provide high quality, affordable health care services and to improve the health of our members and the
communities we serve.”

Nurse Clinics Workgroup – Reference Contact
The workgroup has collected local best practices and policies in order to compile this playbook. For
questions or inquiries regarding the content or recommendations contained in this document, please contact
the appropriate parties below:

Workgroup Member Title
Sylvia Everroad, RN MSN Project sponsor/ Regional Chief Administrative Officer, SCPMG
Aileen Oh, RN MSN Director of Ambulatory Care Services, SCPMG
Hazel Torres, RN MS Assistant Director of Professional Development and Research, SCPMG
Lucy Hong, RN MSN Administrative Fellow

OPERATIONAL TOOLS

Operational Tools

Services provided

The Nurse Clinics provide the following services including but not limited to:

 Dressing changes  Ear Wash
 Immunization  Throat cultures
 Skin Tests (Tb)  Antibiotics IV procedures
 Travel Immunization  IV hydration
 Blood pressure checks  Therapeutic Phlebotomy
 Wound Care  Diabetes and blood pressure management & education
 Suture Removal  Injection Teaching
 Retinal Screening  Birth Control – Depo Provera
 Triage  Pregnancy Tests

Operating Hours

Depending on the needs of population in the service area, each Nurse Clinic may have different operating
hours. The following table provides few, not all, examples of current Nurse Clinic operating hours in
different service areas. This serves as a guide, not a mandatory rule.

Service Area Location (MOB) Operating Hours
Antelope Valley Palmdale Mon-Fri 8:30am – 9:00pm
Orange County Mon-Sun 8:00am – 5:00pm
Garden Grove (Usually open until 9PM due to volume)
San Diego Santa Ana Mon-Fri 8:30am – 5:00pm
All Mon-Fri 8:30am – 4:30pm
Closed 12:15pm – 1:30pm for lunch

Leveling System

Nurse Clinics vary in sizes and services provided. Nurse Clinics may provide various types of wound care
services that are at different levels of care – basic, advanced, or complex care. The following examples
provide two different Nurse Clinic leveling systems on wound care services – two level systems at South
Bay and three level systems at Orange County. Members are cared for at a specific nurse clinic depending on
the level of wound care.

South Bay Medical Center Wound Care Service Levels

Level 1: Basic Wound Care Level 2: Advanced and Complex Wound Care
Primary Care Nurse Clinics General Surgery Wound Clinic (Harbor City)
(Carson, Gardena, Long Beach, & Torrance) 1. Wound assessment (higher acuity)
1. Wound assessment (simple) 2. Stage 2, 3, and 4 pressure ulcers (complex and
2. Dressing change (simple) multiple sites, stable/healing, and deep tissue
3. Stage 1 and 2 pressure ulcers (simple) injuries)
4. Post-operative wounds (uncomplicated, no 3. All ostomy patients
infection, tubes, drains, or retention sutures) 4. Wound VAC therapy
5. Scalp sutures and staples (simple) Facial sutures 5. Burn patients including irradiated wounds
and complicated scalp sutures are removed by 6. Vascular patients - DM/Neuropathic, Arterial,
department who performed surgery. Trauma Venous
facial sutures from the ER, UCC or outside KP 7. Atypical wounds that are non-healing > 1
are removed by a PCP or UCC Provider. month
6. Burn care (simple) 8. Layered Compressions - initial evaluation with
7. Wound packing < 2 cm, (no undermining, first application. Schedule for Level 1 clinic for
tunneling, or infections) continued treatment
8. Follow-up care for layered compression wraps 9. Vascular post-operative wounds
and Tubigrip 10. Post-operative dehisced, non-healing > 30 days,
Follow-up dressing change for chronic venous infected and complex wounds
stasis ulcers (Patients with established wound 11. Chronic wounds
treatment plan by vascular surgeon and/or 12. Fistulas
wound care RN. Initial evaluation by
VAS/study to determine perfusion and
treatment plan)

Level 2 Consultation: Need photo of wound, measurements and encounter routed.
Vascular Surgery Referral: Any Lower extremity wound with no evidence of healing > 2 weeks
All wound care Nurse Clinic level 1 must have Orders and Treatment plan from referring provider.

Orange County Medical Center Wound Care Service Levels

Staffing Models

Depending on the services provided, each Nurse Clinic may have a different staffing model. Nurse Clinics
are usually staffed with Registered Nurses (RNs) and Licensed Vocational Nurses (LVNs). Level 3 Nurse
Clinics or Wound Care Clinics are usually staffed with Wound Ostomy Continence certified Nurses
(WOCNs). The following table provides few, not all, examples of current Nurse Clinic staffing models. This
serves as a guide, not a mandatory rule.

Service Area Location (MOB) Scheduling System
Antelope Valley Palmdale 1 RN and 2 LVNs for am/pm
1 RN and 1 LVN for evening
Orange County Santa Ana (Level 1)
Garden Grove (Level 2) 1 RN and 1 LVN
San Diego 2 RNs
South Bay Kramer (Level 3)
Carlsbad 1 WOCN
Oceanside 2 RNs and 1 LVN
1 RN and 1 LVN
Long Beach 2 RNs and 1 LVN

Scheduling System

Depending on the needs of population in the service area, each Nurse Clinic may have different scheduling
system. The scheduling system includes: 1) Appointment only, 2) Walk-in only, or 3) Both appointment and
walk-in. Appointments can be scheduled through call center, back office staff, message nurses, and
reception.

The following table provides few, not all, examples of current Nurse Clinic scheduling. This serves as a
guide, not a mandatory rule.

Service Area Location (MOB) Scheduling System
Antelope Valley Palmdale Appointments only (10 minutes in length)
Orange County Both appointments and walk-in
Garden Grove Both appointments and walk-in
San Diego Santa Ana Walk-In only
South Bay Carlsbad Appointments only
Oceanside Also take walk-Ins
Long Beach Both Appointments and walk-in

Appointment/Office Visit Routine (OVR) templates
The following example is the template used by the call center to book Nurse Clinic Office Visit Routine (OVR) appointments in Orange
County.

Orange County Call Center Nurse Clinics Appointment OVR

Purpose Visit Block Duration Provider Booked By Conversion Parameters
Any PEDs Types NURSE 20min Type
appointment OVR20 VISIT RN ALL PEDS: Any PEDs patient being seen for a RN CLINIC problem, be sure to enter the
10min REASON in appointment remarks.
Except for NURSE
pregnancy test for VISIT 10min If patient is coming in for immunization update, confirm that patient has been seen in
under 12yo. PED’s w/in the last yr. If not, scheduled w/PCP and not in the RN Clinic.
NURSE
Blood pressure OVR10 VISIT Immunizations :
check w/o FPLAN10 WB must be current before booking OVR20 to update on immunizations. See
symptoms “Guidelines for Well Baby Immunization Timeframes.”
RN ALL ONLY for BP check.
BP Machine -
Please see Patient should not express any symptoms of High Blood Pressure NOW. If so, schedule
guidelines for in PC department or transfer to KPOC if appropriate.
instructions. (See Red Flag list)
Depo Injection
If patient requires BP RX only:
1. New RX - schedule w/PCP.
2. RX refill - send message to pharmacy pool.
RN ALL Book as needed.

If no appointments available within timeframe for injection, OK to advance patient to
walk in when due for next injection

Please check Fac Info RN Clinic hours.

Please see "Guidelines" for further info or "General Info/Depo Provera/Calendar for
injections."
Ear Wash OVR20 NURSE 20min RN ALL Patient CANNOT have ear pain or foreign body in ear or any ear problems.
VISIT
The Call Center no longer directs patients to use wax softener prior to the appt. This
direction needs to be given by a Provider.

If patient has been directed by Provider to use wax softener, then make sure the
member has been using at least 3 days & schedule appointment.

If patient has NOT been directed by Provider to use wax softener book patient at least
5 days out & send message to RN Clinic:
Reason for Call – Other
In message – Patient has an ear wash appointment, Date & Time.

Any PEDs patient (0-14) MUST have MD order for ear wash appointment. Please
message PCP.
Education Time OVR30 NURSE 30min RN ALL If patient is diabetic, book as needed.
for Diabetic VISIT
patients or Instruct patient to bring glucometer & insulin to appointment. Advise patient to bring
Education Time all supplies that were ordered at the time of PCP visit.
with Insulin/
Glucometer

Glucometer
Machine-
Please see
guidelines for
instructions.
Electro- EKG20 NURSE 20min RN ALL MD order required. Call center will not see the order, please take member's word that
cardiogram VISIT their doctor placed the order.

LPM does not do EKG's.

Document "EKG" in appointment notes.
HIV Test OVR20 NURSE 20min RN ALL Book as needed.
VISIT Please refer to RN Clinic - Guidelines under HIV for further info.

Injection & INJ10 / NURSE 10min RN ALL Patient may have appointments
Immunization IMMU10 VISIT Weekly or monthly.

Injection Series AVO does not do Procrit/
Examples: Hep, Neupogen and Testosterone injection
Vitamin B, Procrit,
etc... If patient’s first KP RN Clinic appointment, ask to bring in Immunization records.
* Offer to schedule multiple appointments if due weekly / monthly.
IV/PICC Line OVR20 w/o NURSE 20min RN : ALL This appointment can ONLY be booked at the 4 locations listed.
Dressing Change labs VISIT or

or 30min GAR, Ask member if he/she needs lab to be drawn for this appointment. (if yes, book OVR30
OVR30 HBM, if no, book OVR20). Please document in appointment notes whether labs are needed or
w/labs 10min LMO, MVJ not.
20min ONLY EX: PICC Line / Dressing Change w/labs.

Pediatric weight Walk In 30min If no available appointments, please message whichever of the 4 RN Clinics the patient
check No appt 10min requests. Pleases refer to RN Clinic Guidelines under messaging for correct provider
needed name.
RN WALK IN No appointment needed for pediatric weight checks. Please check RN Clinic hours.
Pregnancy test OVR10 NURSE PLS ADV
Retinal eye exam Walk In VISIT PT'S
for diabetics No appt THERE
(photos) needed NURSE MIGHT BE
If patient VISIT A SLIGHT
Self-injections has an appt NURSE WAIT.
BP/Asthma scheduled VISIT RN ALL Book as needed for 12yo and older.
teaching, and needs
Hypertension RN WALK IN Diabetic photography screening may be done at all Kaiser facilities that have a Primary
Meds to WE NO Care Department.
Skin test: reschedule, LONGER
PPD, schedule a NEED TO **ADVISE PATIENT DILATED EXAM. DRIVER NOT REQUIRED**
TB Test
TB Test reading DRS20 / SCHED Hours
NURSE AN APPT. Monday - Friday
VISIT block
OVR30 PLS ADV 8:30 am -12:00 pm
PT'S 1:30 pm - 4:00 pm
TBTEST10 THERE
MIGHT BE
A SLIGHT
WAIT.

RN ALL Schedule in any MOB.

M – F ONLY

RN ALL Book as needed.

PLS ADV TB TEST READING:
PT'S

THERE

For PPD Test MIGHT BE You may schedule an appointment for a TB Test Reading, but if NO available
done outside of A SLIGHT appointment within time-frame the reading needs to be done by, patient may walk into
Kaiser, please refer WAIT. RN Clinic.
to Guidelines for
additional If TB test is booked on Thursday, advise patient they will need TB test read over the
information weekend at one of the After Hours locations. Patient may walk into After Hours or
weekend RN clinic if available. Please check RN clinic hours.

TB Reading MUST be 48-72hrs.
Inquire, if this is the 1st test or follow-up to read results.

Suture Removal OVR20 NURSE 20min Confirm if test had been done in last 48-72 hrs. If test was over 72hrs, and has not been
VISIT 30min read, patient will need to restart process. So schedule a PPD. Inform patient that this is
CDC standard.
and RN ALL Adults/PED’s - Anywhere on body below head/face.
10min Head/Face MUST be booked in Primary Care with MD ONLY.
10min
If, no OVR20 appointment available, send a message.
20min
Please refer to RN Clinic Guidelines under messaging for correct provider name.
Travel First patient TRAVEL RN - SPECIALT DO NOT BOOK CANCEL OR RESCHEDULE.
Immunizations OVR30 SHOTS STEVEN Y
SERVICES MONDAY-FRIDAY:
Additional or ABAD ONLY Transfer to Specialty Services Help using VAD / Phone Book / OC Queue selection /
patients NURSE
OVR10 VISIT Specialty Services Help 4029

SAT, SUN & HOLIDAYS:
Appointment Clerk will fill out TRAVEL FORM.
Travel PHONE10 TELEPHON RN - SPECIALT DO NOT BOOK CANCEL OR RESCHEDULE.
Immunizations E VISIT STEVEN Y
Phone Visit SERVICES MONDAY-FRIDAY:
ABAD ONLY Transfer to Specialty Services Help using VAD / Phone Book / OC Queue selection /

Specialty Services Help 4029

SAT, SUN & HOLIDAYS:
Appointment Clerk will fill out TRAVEL FORM.
Dressing Change OVR20 NURSE RN : GAR, By MD's order only. For burns/wounds, etc.
VISIT GAR, HBM, Excludes: PICC line dressings.
HBM, LMO, MVJ
LMO, MVJ MEDICAL Ask patient, "Is this an IV Dressing Change?"
ONLY

OFFICE If YES: See "IV/PICC Line Dressing Change" for appointment information.
ONLY If for PICC Line Dressing Change, also see "IV/PICC Line Dressing Change" for
appointment information
MSG: Please refer to RN Clinic Guidelines under messaging for correct provider name.
Implantable OVR30 NURSE VISIT 30min RN : GAR, HBM, DO NOT BOOK, CANCEL, or RESCHEDULE.
device: 60min GAR, HBM, LMO, MVJ
Port-a-Cath, LMO, MVJ MEDICAL MSG: Please refer to RN Clinic Guidelines under messaging for correct provider name.
CADD pump ONLY OFFICE
changes ONLY
Infusion / Home INFUS60 NURSE RN RN DO NOT BOOK, CANCEL, or RESCHEDULE.
Health VISIT CLINIC
ONLY MSG: Please refer to RN Clinic Guidelines under messaging for correct provider name.
Unna boot OVR20 / NURSE 20min / RN RN DO NOT BOOK, CANCEL, OR RESCHEDULE.
F/U Visit or Re- OVR40 VISIT 40min GAR, CLINIC
Application HBM, ONLY
Also known as LMO, MVJ GAR, Ask patient, “Do you have them on now?”
Compression wrap HBM, YES: Which location would you like to be seen at, GAR, HBM, LMO or MVJ?
ONLY Message patient’s location of choice.

LMO, MVJ MSG: Please refer to RN Clinic Guidelines under messaging for correct provider name.
MEDICAL
OFFICE
ONLY NO: Please refer to RN Clinic Guidelines for further information.
Synagis Clinic IMM10 NURSE 10min RN MEDICAL DO NOT BOOK, CANCEL, OR RESCHEDULE.
For RSV OVO20 VISIT 20min OFFICE
Seasonal Only: NURSE ONLY Direct members to call : PEDs Special Care 714-279-4667
Oct - Mar VISIT
LMO only DO NOT BOOK, CANCEL, or RESCHEDULE.
Tue Afternoon See UROLOGY Department – Appointments for further information.
1:30p - 4:30p RN RN DO NOT BOOK, CANCEL, OR RESCHEDULE.
Education Time CLINIC
for Self Catheter ONLY
Foley
Walk-ins

Last Update : 3/3/14

Regional Appointments OVR



San Diego Nurse Clinics Appointment OVR

Visit Type Duration Code Conversion Parameters
BP-20 20 min 8911 RN B/P Machine Check OR S/S
10 min 3098 Depo Injection
FPLAN-10 60 min 3132 IV hydration, phlebotomy
INF-60 30 min 67 Infusion (IV meds)
INF-30 10 min 1716 Injection
INJ-10 10 min 3118 Immunization/Travel
IMM-10 10 min 104 Rapid Strept Testing
OVR-10 20 min 106 Suture removal, ear wash, minor dressing change
OVR-20 30 min 108 Insulin start, Patient teaching
OVR-30 40 min 109 Major dressing change (Unna boot, Profore)
OVR-40 10 min 2747 TB testing & reading
TB-10 344 Walk in patients
SCR

Floor Plans
The following provides three different examples of floor plans for small, medium, and large sized Nurse Clinics.

Small Nurse Clinics Floor Plans

Medium Nurse Clinics Floor Plans

Medium Nurse Clinics Floor Plans

Large Nurse Clinics Floor Plans

Supplies and Medication

Antelope Valley Medical Center

Depending on the needs of population in the service area, each Nurse Clinic may be stocked with
different supplies and medications. The following document provides a general list of supplies and
medications from Antelope Valley Nurse Clinics.

Count Item ID Nurse Clinics Supplies MPN UOM UOM
Seq #
10131322 Item Description PK Stockless
1 10131314 PK Stockless
2 SPNG GAUZE 4X4IN 8 PLY NON25408
SPONGE GAUZE L3 IN X W3 IN 12 PLY WOVEN NON25312 PK Stockless
3 10131313 COTTON NONSTERILE LA EA Stockless
4 10000347 SPNG GAUZE 2X2IN 12 PLY WOVN NON25212
STRIP 4X.25IN STRSTRP ADHERNT HYPOALL R1546 EA Stockless
5 10131330 POROUS REINF SKN CLSR EA Stockless
6 10131331 DRESSING CONFORMING 3PLY 3INX75IN STERILE NON25497 RL Stockless
7 10000096 DRESSING CONFORMING 3PLY 4INX75IN STERILE NON25498
TAPE DRSG MICROPOR 10YDX1IN ADHERNT 1530-1 RL Stockless
8 10000097 HYPOALL POROUS LTX FREE
TAPE DRSG MICROPOR 10YDX2IN ADHERNT 1530-2 EA Stockless
9 10000175 HYPOALL POROUS LTX FREE
TAPE DRSG 10YDX2IN ADHERNT HYPOALL EZ 2950-2 PK Stockless
10 10000346 TEAR LTX FREE CLOTH
STRIP 1.5X.25IN STRSTRP ADHERNT HYPOALL R1542 PK Stockless
11 10000345 POROUS REINF SKN
STRIP 3X.25IN STRSTRP ADHERNT HYPOALL R1541 PK Stockless
12 10000348 POROUS REINF SKN CLSR
STRIP 4X.5IN STRSTRP ADHERNT HYPOALL R1547 PK Stockless
13 10000344 POROUS REINF SKN CLSR
STRIP 3X1/8IN STRSTRP ADHERNT HYPOALL R1540 RL Stockless
14 10133861 POROUS REINF SKN CLSR RL Stockless
15 10133866 BANDAGE 1 IN X 5YDS SELFADHE LATEX FR TAN 9100TN-030
BANDAGE 2IN X 5YD SELFADHE LATEX FREE NON 9200TN-036 BX Stockless
16 10134642 STERILE TAN
BANDAGE CURITY FBRC ABSORBENT FLXIBLE 6403LF BX Stockless
17 10131415 HYPOALL SPOT SHEER LTX BX Stockless
18 10134385 ADHSV BANDAGES COMFORT CLOTH FINGER TIP NON25513
ADHESIVE BANDAGES COMFORT CLOTH 3/4IN X NON25650 BX Stockless
19 10022296 3IN
DRESSING TELFA 3.75X2IN ABSORBENT NONADH 7539LF RL Stockless
20 10000095 OUCHLS ISLAND
TAPE DRSG MICROPOR 10YDX.5IN ADHERNT 1530-0 EA Stockless
21 10133930 HYPOALL POROUS LTX FREE
BANDAGE 4IN X 5YD FOAM SELFADHE LATEX 9400TN-018 EA Stockless
22 10058485 FREE NON STERILE BX Stockless
23 10131315 CONTAINER SPECI LID STRL 3OZ M4937 PK Stockless
24 10131308 SPNG GAUZE 3X3IN 12 PLY STRL NON21422 EA Stockless
25 10022053 SPNG 4X4IN GAUZE KERLIX DRSG NON25844
DRESSING TELFA 8X3IN ABSORBENT NONADH 1238
OUCHLS WOUND COTN STRL

26 10131335 PAD 2 5/8INX1 5/8IN COTN DRSG NON21600 EA Stockless
EA Stockless
27 10044745 DRESSING PETRO 3X3IN NONADH ADAPT STRL 2012
LTX FREE DISP CELLU EA Stockless
28 10044746 DRESSING PETRO 8X3IN NONADH ADAPT STRL 2013
LTX FREE DISP CELLU EA Stockless
29 10000093 TAPE DRSG MICROFOAM 5.5YDX3IN ADHERNT 1528-3
HYPOALL POROUS ELAS RL Stockless
30 10058334 RETAINER TUBEGAUZ 1 50YDX5/8IN WHITE ELAS 58200
TUBLR NET APPLCATR RL Stockless
31 10058339 RETAINER TUBEGAUZ 2 50YDX7/8IN WHITE ELAS 61036
TUBLR NET W/O RL Stockless
32 10058335 RETAINER TUBEGAUZ 12 50YDX1IN WHITE ELAS 58201
TUBLR NET APPLCATR EA Stockless
33 10131310 DRESSING GUAGE 4.5INX4.1YD STERILE LT FR NON25865 PK Stockless
BX Stockless
34 10130088 APPLCATR FBR TIP 6IN NS LTX MDS202055 BX Stockless

35 10060891 OB TOWELETTE D74800 BX Stockless
EA Stockless
36 10060784 WIPE PREP MED PVP IODINE SKIN ANTISEPTC B40600 EA Stockless
CLEAN PK NONWVN PDI EA Stockless
37 10130173 PAD ALCHOL MED STRL APP102 BX Stockless

38 10032659 SOLUTION ANTISEPTC 70% ISOPROPANL 16OZ IA7016 BX Stockless
BG Stockless
39 10032658 DRUG 3% HYDRGN PEROXIDE 16OZ ANTISEPTIC HP0316 EA Stockless
40 10017192 SOLUTION PREP SCRB CARE 10% PVP IODINE 16OZ 29906-016
41 10079249 DEPRESSOR 5.5IN NS FINE GRAIN SMTH TASTLES WOD3001 EA Stockless
TONGUE JR WOOD
42 10017903 COVER PROBE DIGTL TEMP CORE-CHK DISP P-90 BX Stockless

43 10131396 BALL COTN MED ABSORBENT 1IN NS MDS21461 BX Stockless

44 10007672 NEEDLE HYPO SFTYGLD 1.5IN 18GA REG BVL REG 305918 EA Stockless
WAL SFTY SHIELD
45 10007669 NEEDLE HYPO SFTYGLD 1IN 21GA REG BVL REG 305915 EA Stockless
WAL SFTY SHIELD
46 10007573 NEEDLE HYPO PRECSN GLD 1.5IN 21GA REG BVL 305167 EA Stockless
STRL DISP
47 10007557 NEEDLE HYPO PRECSN GLD .5IN 30GA REG BVL 305106 EA Stockless
REG WAL LTX FREE
48 10007660 NEEDLE HYPO SFTYGLD 5/8IN 25GA REG BVL REG 305901 BX Stockless
WAL LTX FREE STRL
49 10007718 SYRINGE BD 5ML LTX FREE STRL LL TIP MEDCL 309603 EA Stockless
DISP
50 10007661 NEEDLE HYPO SFTYGLD 1IN 23GA REG BVL REG 305902 EA Stockless
WAL LTX FREE STRL
51 10007675 SYRINGE U100 .5IN 29GA 1ML INSLN PERM 305930 EA Stockless
ATTACHD NDL INTEGRA
52 10007679 SYRINGE TB .5IN 27GA 1ML PERM ATTACHD NDL 305945
SHIELD REG BVL
53 10007719 SYRINGE BD 10ML LTX FREE STRL LL TIP MEDCL 309604
DISP
54 10007733 SYRINGE BD 20ML LTX FREE STRL LL TIP BRRL 309661
TAPR PLUNGR ROD
55 10007729 SYRINGE BD 30ML LTX FREE STRL LL TIP BRRL 309650
TAPR PLUNGR ROD

56 10007731 SYRINGE BD 60ML LTX FREE STRL LL TIP MEDCL 309653 EA Stockless
DISP
57 10007720 SYRINGE CATH TIP BD 60ML STRL LTX FREE 309620 EA Stockless

58 10007659 NEEDLE HYPO SFTYGLD 1.5IN 22GA REG BVL REG 305900 EA Stockless
WAL LTX FREE STRL
59 10058446 CUP MED 18.25X9.25X13.25IN GRAD PLYPROP 02301 PK Stockless
TRANSPRNT LTX FREE
60 10029777 TOURNIQUET 18X1IN TIE TYPE LTX PHLEBTMY PC6003 EA Stockless
DISP
61 10131317 PK WOUND 5YDX.5IN GAUZE STRIP NON255125 EA Stockless

62 10022314 PACKING WOUND 5YDX.25IN GAUZE IODOFORM 7831 EA Stockless
CURITY STRIP SELVG
63 10131424 DRESSING COMBINE 8IN X 7.5IN STERILE NON21453 TY Stockless

64 10000121 DRESSING TRANSPRNT 2.75INX2 3/8IN PLYURTH 1624W BX Stockless
ADHERNT HYPOALL
65 10061990 ARMBOARD IV ADLT 18X3.25IN FOAM LEG SLV DISP 01315MPF EA Stockless
LTX FREE GREEN
66 10032521 PAD SANITRY MAXITHIN FOLD 00147A EA Stockless

67 10022203 CATHETER SUCT SAF-T-VAC 8FR CNTRL VALV 2 36826 EA Stockless
GLV POP UP CUP W/O
68 10016254 CAP IV MALE/FMALE LL DUAL FUNCTN STRL LTX 2C6250 EA Stockless
FREE
69 10006169 TRAY CATH BARD 15FR FOLEY UNDRPAD SPECI 772415 EA Stockless
CUP LTX
70 10017272 GLOVE EXAM + TCH SM 9.3IN PF BEAD CUFF 8841 BX Stockless
TXTURE LDP PLYURTH
71 10017273 GLOVE EXAM + TCH MED 9.3IN PF BEAD CUFF 8842 BX Stockless
TXTURE LDP PLYURTH
72 10021694 GLOVE EXAM + TCH LG PF LTX NS 8843 BX Stockless

73 10060342 GLOVE SURG BIOGEL SENSOR 6 PF BEAD CUFF 30660 PR Stockless
MICROTXD MICROPTC
74 10060343 GLOVE SURG BIOGEL SENSOR 6.5 PF BEAD CUFF 30665 PR Stockless
MICROTXD MICROPTC
75 10060288 GLOVE SURG BIOGEL SENSOR 7 PF BEAD CUFF 030670 PR Stockless
MICROTXD MICROPTC
76 10079356 GLOVE SURG BIOGEL SENSOR 7.5 PF BEAD CUFF 30675 PR Stockless
MICROPTC MICROTXD
77 10060344 GLOVE SURG BIOGEL SENSOR 8 PF BEAD CUFF 30680 PR Stockless
MICROTXD MICROPTC
78 10060345 GLOVE SURG BIOGEL SENSOR 8.5 PF BEAD CUFF 30685 PR Stockless
MICROTXD MICROPTC
79 10061282 TISSUE FACIAL 8X5IN 2 PLY T-540 BX Stockless

80 10058458 BEDPAN PTNT PLST GOLD FX CONVNTL STYLE H100-05 EA Stockless
SEAT HIGH FRNT DISP
81 10058464 URINAL PTNT SMTH EDGE GRAD MALE DISP 1L H140-01 EA Stockless
PLST TRANSLUCNT LTX
82 10131409 BASIN EMESIS 500ML 9IN GRAD KIDNEY HVYDTY H30005 EA Stockless
DISP GOLD PLST LTX
83 10055933 CUP DRNK INSULTD COLD HOT STYRFOAM 8OZ DCC 8J8 TB Stockless

84 10056365 TRAY PROC INCIS DRN 7527-48CGSA EA Stockless

85 10131814 PK INSTANT COLD NONSTER HAZMAT 6"X6.5" 11445-020 EA Stockless

86 10058964 MASK SURG STD TIE LTX FREE PROHBT BLUE DISP NON27376 BX Stockless

87 10029742 BANDAGE 4.5YDX2IN COMPR LTX FREE ELAS 79-98583 EA Stockless
REMV CLIP COTN RUB
88 10097839 CANNULA NASL 7FT OVER THE EAR CRV NONFLR 1103 EA Stockless
TIP STD CONNCTR
89 10097826 MASK O2 VNYL ADLT ELNGAT MED CONCENT 1041 EA Stockless
TUBNG LTX FREE DISP7FT
90 10030312 NEBULIZER AERSL VIXONE SM VOL TEE ADPTR 210 CA Stockless
KINK RESISTNT TUBNG
91 10097825 MASK O2 VNYL PEDI MED CONCENT TUBNG NOSE 1035 EA Stockless
CLIP 7FT CLR
92 10097835 MASK AERSL PEDI ELNGAT CONNCTR ADJTABLE 1085 EA Stockless
NOSE CLIP VNYL CLR
93 10125975 STAPLER SKIN ROYAL WIDE 35 COUNT STAINLS 54887 BX Stockless
STEEL LTX FREE STRL
94 10125782 REMOVER STAPLE PREMIUM STRL LTX FREE DISP 150462 EA Stockless

95 10007747 LANCET MICROTAINER 1.8MM 21GA AUTORETRCT 366593 BX Stockless
MED FLO CNTCT
EA Stockless
96 10059800 SCALPEL SURG 11 FUTURA SFTY SMS211B
EA Stockless
97 10059798 SCALPEL SURG 10 FUTURA SFTY SMS210B
CATHETER IV INSYTE AUTOGARD 1IN 22GA 381423 EA Stockless
98 10007832 RADIOPQ SFTYSHLD VIALON
99 10137434 JELLY LUBRICATING STERILE TB FLP TOP 4OZ 4067063041 EA Stockless

100 10016879 KIT FREPP/SEPP APPLCATR BENZN TINCTR DISP 260619 EA Stockless

101 10131383 DRSG PETRO 72X.5IN ABSORBENT NON251272 EA Stockless

102 10134506 DRESSING VASELINE 3X18 STERILE NON251318 EA Stockless

103 10021484 ANOSCOPE EXAM 3 3/8IN 9/10IN SANI-SCOPE STD 82420 EA Stockless
PLST 1 SPCLA OBT
104 10056356 TRAY SUTR REMVL FINE POINT SCSR 7127CG EA Stockless

105 10056362 TRAY SUTR LACERAT STRL 7512SA CA Stockless

106 10099553 SPECULUM OTOSCP KLEENSPEC 4.25MM PLST ADLT 52434-U BG Stockless
DX NONTOXC LTX
107 10099363 COVER PROBE DIGTL WALL THERMOMTR PLST 05031101 BX Stockless
LTX FREE NS MODL 600
108 10007710 SYRINGE BD 3ML LTX FREE STRL LL TIP MEDCL 309585 EA Stockless
DISP
109 10006167 TRAY IRR PISTON SYR LUER ADPTR GRAD FLASK 750307 EA Stockless
UNDRPAD 70ML STRL
110 10000089 TAPE DRSG TRANSPR 10YDX1IN ADHERNT 1527-1 RL Stockless
HYPOALL POROUS EZ
111 10058708 10058708 DRESSING SZ 2 30YD ELAS TUBLR NET NETBND02 BX Stockless
RTNR LTX FREE
112 10015811 RETAINER MEDICHOICE 3 30YD ELAS TUBLR NET NETBND03 BX Stockless
DRSG LTX FREE
113 10058709 RETAINER MEDICHOICE 4 30YD ELAS TUBLR NET NETBND04 BX Stockless
DRSG LTX FREE
114 10058710 RETAINER MEDICHOICE 5 30YD ELAS TUBLR NET NETBND05 BX Stockless
DRSG LTX FREE
115 10058716 DRESSING SZ6 30YD ELAS TUBLR NET LTX FREE NONNET06 BX Stockless

116 10058711 RETAINER MEDICHOICE 7 30YD ELAS TUBLR NET NETBND07 BX Stockless
DRSG LTX FREE
117 10016304 SOLUTION IRR 0.9% NA CHL PLST POUR BTL 1L LTX 2F7124 EA Stockless
FREE

118 10016166 SOLUTION IV 30 MEQ K CHL 5% DEX 0.45% NA CHL 2B1664X EA Stockless
VIAFLX 1L LTX EA Stockless
119 10016167 SOLUTION IV 40 MEQ K CHL 5% DEX 0.45% NA CHL 2B1674X EA Stockless
VIAFLX 1L LTX EA Stockless
120 10016136 SOLUTION IV 5% DEX 0.45% NA CHL 1L VIAFLX LTX 2B1074X EA Stockless
FREE EA Stockless
121 10016099 SOLUTION IV 5% DEX 500ML VIAFLX LTX FREE 2B0063Q EA Stockless
EA Stockless
122 10016180 SOLUTION IV LACT RINGRS 1L VIAFLX LTX FREE 2B2324X EA Stockless
EA Stockless
123 10016173 SOLUTION IV 5% DEX LACT RINGRS 1L VIAFLX LTX 2B2074X BX Stockless
FREE BX Stockless
124 10016101 SOLUTION IV 5% DEX 1L VIAFLX LTX FREE 2B0064X EA Stockless
BX Stockless
125 10016155 SOLUTION IV 0.9% NA CHL 500ML VIAFLX LTX 2B1323Q EA Stockless
FREE EA Stockless
126 10016154 SOLUTION IV 0.9% NA CHL 250ML VIAFLX LTX 2B1322Q EA Stockless
FREE EA Stockless
127 10000122 DRESSING TRANSPRNT 4.75X4IN PLYURTH 1626 PK Stockless
ADHERNT HYPOALL WTRPROF EA Stockless
128 10007834 CATHETER IV INSYTE AUTOGARD 1.16IN 20GA 381434 EA Stockless
RADIOPQ SFTYSHLD EA Stockless
129 10007831 CATHETER IV INSYTE AUTOGARD .75IN 24GA 381412
RADIOPQ SFTYSHLD EA Stockless
130 10016277 SET ADMNISTRTN 92IN 10 GTT IV CLRLNK PRIMRY 2C8419 BX Stockless
INFUS MALE LL EA Stockless
131 10007836 CATHETER IV INSYTE AUTOGARD 1.16IN 18GA 381444 BX Stockless
RADIOPQ SFTYSHLD BX Stockless
132 10016314 SET ADMNISTRTN 76IN 10 GTT IV CLRLNK 2H8401 BX Stockless
BURETROL PRIMRY INFUS
134 10016364 SET XTENS .6ML 6.8IN IV MALE LL ADPTR PLUS 2N9068
DISPLC DEVICE
135 10005960 CATHETER URETHRL BARDEX LBR 12FR FOLEY 2 0165L12
WAY RND TIP 2 OPPS
137 10022058 BAG DRN MED ANTIRFLUX VALV STRAP 19OZ STRL 145514
LTX
138 10030160 BATTERY PRODCT SPECFC 1.5V AA MERCURY FREE EN91
ALKALN
139 10030159 BATTERY ALKALN 9V MERCURY FREE EN22

140 10099348 BULB SCOPE HALGN 3.5V STD REPLCMNT OTOSCP 03100-U
REPLCMNT OTOSCP
141 10098411 RESUSCITATOR MANL PEDI O2 RSRV PRESS 7330
MANMTR PORT SWVL ELBW PRESS MANMTR PORT
SWVL ELBW
143 10097829 MASK O2 VNYL ADLT NONREBREATH TUBNG SFTY 1059
VENT DISP MULTIVNT
144 10008244 NEEDLE BLD COLL ECLIPSE 1.25IN 21GA THINWL 368607
LUER ADPTR GREEN
145 10008216 SET BLD COLL 23GA 12IN VACTNR WING TUBNG 367342
PUSH BUTTN LUER
146 10133798 TUBE COLLECT VACTNR + HEMOGRD CLOT ACTV 367986
SERM SEP SILCN GOLD
147 10008222 TUBE COLLECT VACTNR + CONVNTL CLSR K2 367835
EDTA LVNDR 3ML
148 10133806 TUBE COLLECT VACTNR + CONVNTL CLSR 3.2% NA 363083
CITRT LT BLUE 2.7

149 10008219 TUBE COLLECT VACTNR PLUS HEMOGRD CLOT 367812 BX Stockless
ACTV SILCN RED 4ML
150 10056349 CONTAINER SPECI 280UM CALCULI STRAIN FINE 010713 EA Stockless
MESH CLOTH FILTR
151 10058745 CONTAINER SPECI SPECIPAN GRAD PAN DYND36600 EA Stockless
TRANSLUCNT 900ML
152 10060788 APPLICATOR PVP IODINE SWBSTK PDI MED STRL S41125 PK Stockless
LTX FREE DISP
153 10007546 CANNULA VIAL NDLS ACCES INTERLNK STRL LTX 303367 EA Stockless
FREE 15GA
154 10016160 SOLUTION IV 20 MEQ K CHL 5% DEX 0.2% NA CHL 2B1614X EA Stockless
VIAFLX 1L LTX
155 10022096 ELECTRODE 1 7/8INX1 3/8IN ADHESVE CONDCTV 22855 BG Stockless
TAB RADIOLCNT ADLT
156 10029939 WIPE CLEAN AS-WP2 DISP 63306725 EA Stockless

157 10058936 BAG PTNT 20X18X3.5IN BELNG GUSSET WHITE LTX NON026320 CA Stockless
FREE
158 10019319 TIP SUCT YANKAUR OPEN CNTRL VENT PEDI 1825003873 EA Stockless

159 10022174 ELECTRODE 1X7/8IN ADHESVE REST TAB ADLT 31433538 CA Stockless
160 10016146 GEL EKG LTX FREE 2B1306 EA Stockless
161 10016147 SOLUTION IV 0.9% NA CHL 50ML SNGL PK VIAFLX 2B1307 EA Stockless
162 10016876 LTX FREE 260299 CT Stockless
163 10015927 SOLUTION IV 0.9% NA CHL 100ML SNGL PK VIAFLX 45548 RL Stockless
164 10060782 LTX FREE B16400 BX Stockless
165 10058479 APPLICATOR FREPP/SEPP CHLORAPREP 70% H97000 EA Stockless
166 10061287 ISOPROPANL 2% CHG AMP H30010 EA Stockless
167 10097834 BANDAGE CVRL 2YDX4IN STRCH NONWVN 1083 EA Stockless
168 10016132 POROUS LTX FREE DISP 2B1064X EA Stockless
169 10022205 REMOVER ADHESVE WIPE PAD PDI SKIN NS DISP 37024 EA Stockless
170 10131496 LTX FREE 8896N BX Stockless
171 10017295 CONTAINER SPECI GENT L KARE GRAD CYL 8897N BX Stockless
172 10017296 POLYSTRN LTX FREE DISP 8898N BX Stockless
173 10005635 UNDERPAD INCONT LIGHT ABSORBENT LAYER 011102 EA Stockless
EZ-SORB BLUE 24X17IN
MASK AERSL ADLT ELNGAT CONNCTR ADJTABLE
NOSE CLIP DISP VNYL
SOLUTION IV 5% DEX 0.9% NA CHL 1L VIAFLX LTX
FREE
CATHETER SUCT SAF-T-VAC 10FR CNTRL VALV
COIL 2 GLV POPUP
GLOVE EXAM ESTEEM TRU BLU SM PF NTRL BLUE
LTX FREE
GLOVE EXAM ESTEEM TRU BLU MED PF NTRL
BLUE LTX FREE
GLOVE EXAM ESTEEM TRU BLU LG PF NTRL BLUE
LTX FREE
PAPER TBL EXAM SMTH 225FTX18IN WHITE DISP

174 10131320 DRSG PETRO 9X5IN NONADH ON253590 EA Stockless

175 10016165 SOLUTION IV 20 MEQ K CHL 5% DEX 0.45% NA CHL 2B1654X EA Stockless
VIAFLX 1L LTX EA Stockless
176 10019274 TUBING SUCT 6FT 3/16IN PLST NONCDTV MOLD 34280 EA Stockless
CONNCTR STRL
177 10005866 KIT CATH 8FR CLSD SYS GLV SWAB LABL RIGID PK 0035380
LTX FREE INFNT

178 10056387 CONTAINER SPECI U-BAG SNGL POROUS CLOTH 7531 EA Stockless
ADHERNT STRL 200ML
179 10017662 DEPRESSOR 6IN REG STRL BLDE CLEAN EDGE C1560-006 BX Stockless
SMTH FINSH TONGUE
180 10079246 APPLICATOR FBR TIP 6IN STRL COTN WOOD STEM WOD1004 BX Stockless
.5IN
181 10006235 DEVICE SECUR STATLCK PICC + CRSCNT PAD VPPCSP EA Stockless
SLIDE POST PICC LTX
182 10132687 DRESSING GERMCIDL 1IN 4MM BIOPTCH CHG 4150 EA Stockless
ADHERNT CENTR HOLE
183 10134323 DRESSING SPONGE GAUZE 8 PLY WOVEN 2IN X NON21420 PK Stockless
2IN STERILE
184 10016878 APPLICATOR FREPP/SEPP CHLORAPREP 70% 260449 EA Stockless
ISOPROPANL 2% CHG AMP
185 10007564 NEEDLE HYPO BD 1.5IN 25GA REG BVL REG WAL 305127 EA Stockless
LTX FREE STRL
186 10016156 SOLUTION IV 0.9% NA CHL 1L VIAFLX LTX FREE 2B1324X EA Stockless
188 10016357 ADAPTER VIAL UNIVRSL MULITDOS DEHP FREE 2N8395 CA Stockless
CLRLNK STRL
189 10007935 DEVICE PHLEBTMY LL NDLS MALE LUER ADPTR 364902 BX Stockless
CLR LTX FREE STRL
190 10017151 GOWN STAFF UNIVRSL BLUE CONVRT IMPRVIOS 5210PG BX Stockless
THMBHK HALF BACK
191 10059803 SCALPEL SURG 15 FUTURA RETRCTBL YELLOW SMS215A BX Stockless
192 10120988 TUBE NG 48IN LONG 16FR PRVNT 2 LUM 56160 EA Stockless
ANTIRFLUX VALV FILTR
193 10120987 TUBE NG 48IN 14FR LOPEZ 2 LUM ANTIRFLUX 56140 EA Stockless
VALV FILTR LOPEZ
194 10120989 TUBE NG 48IN LONG 18FR PRVNT 2 LUM 56180 EA Stockless
ANTIRFLUX VALV FILTR
195 10016063 SOLUTION IV 5% DEX 0.2% NA CHL 1L VIAFLX LTX 07062B1094X EA Stockless
FREE
196 10016151 SOLUTION IV 0.45% NA CHL 1L VIAFLX LTX FREE 2B1314 EA Stockless
197 10062509 BAG 8X8IN 3 WALL PCH THK2 MIL CLR TRANSPRT Q604 PK Stockless
198 10134213 MASTISOL SURGICAL ADHESIVE 2/3 CC VIAL 0523-48 EA Stockless
199 10059011 WIPE METER 3X3IN TOWLET DISINFECTNT GC110 BX Stockless
PREMOISTND GLUCO CHLR
200 10031325 STICK SILVER NIT 3 6IN GRAFCO LTX FREE 1590 BX Stockless
APPLCATR HAZRD
201 10016093 SOLUTION IV 5% DEX 50ML MINIBAG + LTX FREE 2B0040 PK Stockless
202 10016095 SOLUTION IV 0.9% NA CHL 50ML MINIBAG + LTX 2B0042 PK Stockless
FREE
203 10055168 BANDAGE 10YDX4IN CALAMINE ZINC OXIDE 099904C EA Stockless
NONADH DOME PASTE
204 10045797 CONTROL CHEM HIGH SURSTP PRO 01079325CH EA Stock
205 10008129 SWAB CULT FALCON SWUBE DBL COTN TIP SCRW 281130 EA Stock
CAP STRL
206 10007937 SWAB CULT REG ESWAB COLLECT KIT 220245 EA Stock
207 10059803 SCALPEL SURG 15 FUTURA RETRCTBL YELLOW SMS215A EA Stock
208 10045789 CONTROL CHEM LOW GLUC SURSTP PRO 01079525CH EA Stock
209 10045799 STRIP SURSTP PRO GLUC CHEM TST 50 TEST 10797 BX Stock

210 10003583 RAZOR SURG PREP 2 EDGE DISP 754003 EA Stock
PK Stock
211 10062509 BAG 8X8IN 3 WALL PCH THK2 MIL CLR TRANSPRT Q604 EA Stock
EA Stock
212 10002021 ELECTRODE MONOPLR OPTH 005-5-101
EA Stockless
213 10117219 KIT MOLECLR BIOLOGY HYBRD CPTR 2 COLLECT 5126-1220
DEVICE CRVCL SMPL
214 10006174 TRAY CATH 16FR BIOCATH W/O DRN BAG 800061
UNDRPAD DRP

QTY Nurse Clinic Medications
EXTERNAL
Drug Description
1 box
1 Bacitracin ointment Packets
1 Mineral Oil 473ml bottle
2 Double-antibiotic ot. Pkts. #144/bx (gen. for Polysporin)
3 Ferric Subsulfate topical 1oz (gen. for Monsels)
1 Fleet Enema (Adult)
1 Hydrocortisone 1% cream 1 oz.
Caderomer Iodine Gel (gen. for Iodosorb) 42g
10pkts Nitroglycerin 2% ot. - pkts.
1 Silversulfdiazine cream 50gm/jar (gen. for Silvadene)
1 Surgilube Pkts 144/box topical Pkts. (gen. for KY Jelly)
1 Tropicamide 0.5% Opth soln 15ml
1 Erythromycin Opth. Oint. 3.5gm tube
1 Neomycin - Polymyxin B Sulf - HC Otic Soln 10ml

INJECTABLE Heparin Lock Flush sol.100Units/ml 3ml Syr.
2 syr Lidocaine 1% inj. 50ml/mdv (gen. for Xylocaine)
2 Lidocaine 0.5%/Epi inj.50ml/MDV (gen. for Xylocaine)
1 Lidocaine 1% w/ epi.inj. 30ml/mdv (gen. for Xylocaine)
1 Lidocaine 2% inj. 20ml/mdv. (gen. for Xylocaine)
1 Medroxyprogesterone 150mg inj. 1ml (gen. for Depo-Provera)
10 Clindamycin 300mg/2ml inj. 150mg/ml (gen. for Cleocin)
15 Sumitriptan Statdose Kit (gen.for Imitrex)
1 Sumitriptan Statdose refill (gen. for Imitrex)
1 CeFazolin 1gm inj. Aprox. 3.0 ml vial (gen. for Ancef)
10 CeFtriaxone 1gm inj. 10ml vial (gen. for Rocephin)
30 CeFtriaxone 2gm inj. 10ml vial (gen. for Rocephin)
30 Sodium Chloride 0.9% sdv. 10ml/vial
25 Sterile water 20ml/sdv
25
LupronDepo kit 11.25mg/single dose kit injectable
3 LupronDepo kit 22.5mg/single dose kit injectable
8 Enoxaparin Sodium 100mg/ml inj. 1ml (gen. for Lovenox)
1 syr
Aspirin 81mg u/d tabs PO (Baby Aspirin)
ORALS Aspirin 325mg u/d tabs PO
15 Azithromycin 1Gm Susp packets PO(gen. for Zithromax)
15 Nitroglycerin 0.4mg. Sl . Tabs. (#25 tabs)
1bx Prednisone 20mg UD tablet PO
2 Rizatriptan Benzoate 10mg-ml PO (gen. for Maxalt-MLT)
10
4

1 Aminophyllin 500mg Inj. 20ml

2 Cortrosyn 0.25mg vial inj.

15** Cyanocobalamin 1000mcg/ml 1ml inj

3 Dexamethasone 4mg/ml inj.5ml/mdv (gen. for Decadron)

1 Methylprednisolone 80mg inj. 5ml/vial (gen. for Depo-Medrol)

10 Diphenhydramine 50mg/ml inj.1ml (gen. for Benadryl)

2 Epinephrine 1:1000 1ml inj. (gen .for Adrenaline)

1 Estradiol Cypionate 5mg/ml inj. 5ml (gen. for Depo-Estradiol)
1 Estradiol Valerate 10mg/ml inj. 5ml/vial (gen. for Delestrogen)

2 Estradiol Valerate 40mg/ml inj. 5ml/vial (gen. for Delestrogen)

1 Flumazenil 0.1MG/ML-5ML MDV 10/box

2 Furosemide 10mg/ml inj. 40mg (4ml vial)(gen. for Lasix)

25 Gentamicin 40mg/ml inj. 2ml (gen. for Garamycin)

1 Hydrocortisone Sodium Succinate 250mg inj. 2ml (gen. for Solu-Cortef)
3 Hydroxyzine 50mg/ml 10ml/mdv (gen. for Atarax)

10 Ketoralac 30mg inj. 1ml sdv (gen. for Toradol)

20 Ketoralac 60mg inj. 2ml sdv (gen. for Toradol)

1 Methylprednisolone Acetate 80mg/ml inj.5ml mdv (gen. for Depo-Medrol)

5 Methylprednisolone Sodium Succinate 125mg inj. 2ml (gen. for Solu-Medrol)

5 Metoclopramide 10mg inj. 2ml (gen. for Reglan)
1 Naloxone 0.4mg/ml inj.1ml vial (gen. for Narcan)

20 Odansetron 2mg/ml inj. 2ml/sdv (gen. for Zofran)

1 Terbutaline 1mg/ml inj. 1ml (gen. for Brethine)

5 Triamcinolone 40mg inj. 5ml/mdv (gen. for Kenalog)

2 Vitamin-K inj. 10mg/1ml inj. (Gen. for Aqua-Mephyton)

INHALANTS Ipratropium Bromide Sol 2.5ml/vial inhalant UD (gen. for Atrovent)

1 box

1 box Albuterol 2.5mg/3ml U/D 25/BX (gen. for Proventil)

1 Ammonia Inhalants 0.3ml inh. 10/box

ENT TRAY

1 Acetic Acid Otic solution USP Drops (gen. for Vosol )

1 Acetic Acid 2% in Aluminum Acetate Otic Sol.60ml (gen. for Domeboro)

1 Benzocaine -Tetracaine Hydrochloride 2% spray (gen. for Exactacaine)

1 PID Emergency Bag

REFRIGERATOR

1 Candida Albicans 0.1ml/dose inj. 1ml/MDV (gen. for Candin)

1 Proparacaine Hydrochloride opth.sol 0.5% 15ml (gen. for Alcaine)

20 Tetanus and Diphtheria Toxoids (adult) (Tenivac)

10 Tetanus and Diphtheria Toxoids (pediatric) (gen. for Td)

40 Hepatitis B Vaccine 10mcg/0.5ml pediatric dose (gen. for Engerix-b)
20 Hepatitis-A vaccine (adult) inj. 1.0ml

10 Hepatitis-A vaccine (pediatric) inj. 0.5ml
1 Interferon beta-1a 30mcg inj. 4pak syr.(gen. for Avenox)
6 boxes Meningococcal Poly. Vaccine inj. 0.5ml (gen. for Menomune)
10 Menactra A-C-Y-W135 Dip SDV inj
5 Measles,Mumps, Rubella Vaccine inj. 0.5ml (gen. for MMR)
6 Pneumococcal Vaccine inj. 0.5ml/5 dose MDV (gen. for Pneumovax)
3 Poliovirus vaccine inj.0.5ml/10 dosesMDV (gen. for Polio)
40 Sterile diluent #10/box
30 Tetnus Toxoid - Diphtheria Toxoid - Pertussis Vaccine inj. 1ml syr (gen. for Adacel)
5 Tuberculin Purified Protein Derivative. 0.1ml vial (gen. for Tubersol/PPD)
2 Typhoid Vi Polysaccharid inj.10ml/MDV (gen. for Typhim)
20 Quadrivalent Human Papillomavirus inj. 0.5ml (types 6,11,16,18) 10 vials/box (gen. for
Gardasil)
20 Energix B ( Hepatitis B 20mcg/ml syr) ADULT
1 box Yellow Fever Vaccine SDV 5 doses

FREEZER Varicella Virus Vaccine inj. 0.5ml/SDV (gen. for Varivax)
20 Zoster Vaccine inj. 0.65 ml/SDV (gen. for Zostavax)
30
OVERSTOCK: FRIDGE
1 Candida Albicans 0.1ml/dose inj. 1ml/MDV (gen. for Candin)
1bx Hepatitis B Vaccine 10mcg/0.5ml pediatric dose (gen. for Engerix-b)
1bx Haemophilus b Conjugate Vaccine inj. 0.5ml (gen.for Act Hib)
5 Hepatitis-A vaccine (pediatric) inj. 0.5ml
5 Diphtheria-Tetanus -Pertussis Vaccine inj. 0.5ml sdv (gen. for Infanrix/DTaP)
5 Diphtheria-Tetanus-Pertussis/ Hep. B- Polio Vaccine (gen. for Pediarix)
2 Measles,Mumps, Rubella Vaccine inj. 0.5ml (gen. for MMR)
1bx Pneumococcal 13-valent Conjugate Vaccine 0.5ml inj. (gen. for Prevnar)
3bx Rotarix Vaccine PO 1ml
5 Penicillin G Benzathine LA 1.2MU TUBEX inj.(gen. for Bicillin-LA)
5 Penicillin G Benzathine CR 1.2MU TUBEX inj. (gen. for Bicillin-CR)
5 Penicillin G Benzathine Susp 2.4MU TUBEX Inj. (gen. for Bicillin-LA)
9BX Tetnus Toxoid - Diphtheria Toxoid - Pertussis Vaccine inj. 1ml syr (gen. for Adacel)
5bx Energix B ( Hepatitis B 20mcg/ml syr) ADULT
3BX Quadrivalent Human Papillomavirus inj. 10 vials/box (gen. for Gardasil)
4bx Menactra A-C-Y-W135 Dip SDV inj
15bx Pneumococcal Vaccine inj. 0.5ml syr. (gen. Pneumovax)
6 Tuberculin Purified Protein Derivative. 0.1ml vial (gen. for Tubersol/PPD)
3bx Tetanus and Diphtheria Toxoids (adult) (Tenivac)

1 Papain Urea ointment (gen. for Accuzyme Ointment)

Nurse Clinics Flyer

A one-page flyer is a practical way to inform the members about the Nurse Clinics. The following
document is a template of a Nurse Clinic flyer including the basic information about Nurse Clinics,
offering services, important tips, locations, operating hours, and contact information. It was created
based on the San Diego Nurse Clinic flyer. Please add your own Nurse Clinic(s) location, operating
hours, and contact number prior to use.

CLINICAL PRACTICE TOOLS

Clinical Practice Tools

Scope of Practice – MA vs. LVN vs. RN
The Scope of Nursing Practice describes the “who,” “what,” “where,” “when,” “why,” and “how” of
nursing practice. Each of these questions must be answered to provide a complete picture of the dynamic
and complex practice of nursing and its evolving boundaries and membership. Knowledge of the respective
scope of practice of Medical Assistant (MA), Licensed Vocational Nurse (LVN), and Registered Nurse (RN)
is important in determining which activities overlap medical practice and therefore require standardized
procedures.
Acceding to the Medical Board of California, Medical Assistant (MA) are unlicensed individuals who
perform non-invasive routine technical support services under the supervision of a licensed physician and
surgeon, podiatrist, physician assistant, nurse practitioner, or nurse midwife in a medical office or clinic
setting. The supervisor must be on the premises in order for the medical assistant to perform those non-
invasive technical support services.
According to California Correlational Health Care Services, Licensed Vocational Nurses (LVNs) are not
independent practitioners. It is not within the scope of LVN practice to function independently. The LVN
must practice under the direction of a licensed physician or Registered Nurse (RN) at all times. Such
direction may be provided verbally, telephonically, or by written order.
According to the Board of Registered Nursing, the practice of nursing means those functions, including
basic health care, which help people cope with difficulties in daily living which are associated with their
actual or potential health or illness problems, or the treatment thereof, which require a substantial amount
of scientific knowledge or technical skills.
The following grid is based on pertinent State of California Statutes and Regulations and was verified by
SCPMG and KFH/HP Legal Departments. Job duties cannot exceed California statutes and regulations,
but can be limited by Kaiser Permanente. Each Medical Center/Department must define the tasks and
procedures that the ambulatory care staff can perform based on these regulations, job descriptions, location
of practice and evidence of individual competency.
Please refer to https://www.ambulatorypractice.org for the most updated version for the Scope of Practice
grids.

AMBULATORY SERVICES
MA, LVN, RN - Tasks and Procedures Grid

Please note:

• This grid is based on pertinent State of California Statutes and Regulations and was verified by SCPMG and KFH/HP Legal Departments.
• Job duties cannot exceed California statutes and regulations, but can be limited by Kaiser Permanente.
• Each Medical Center/Department must define the tasks and procedures that the ambulatory care staff can perform based on these

regulations, job descriptions, location of practice and evidence of individual competency.

TASK/PROCEDURE MA LVN RN

1 AED (Automated External Defibrillator), initiate care with XX X
2 Ambulate / transfer, assist XX X
3 Amniotic Fluid Index (AFI), perform X
4 Assessments, perform XX X
5 Auditory screening test, perform X X
6 Bladder, urinary, irrigation, non-chemotherapy, perform procedure X X
7 Catheter, urinary, insert/remove straight or indwelling catheter; perform catheter care X* X
8 Catheter, suprapubic, insert/remove indwelling catheter (*no earlier than 8 weeks post-op) X X
9 Catheter, suprapubic, perform catheter care X
10 Crash cart, check and order supplies and test defibrillator XX X
11 Data, collect and document (height, weight, TPR, BP, exercise vitals, smoking, alcohol, allergies, XX X

chief complaint, medications, previous conditions, family history, head circumference, blood X* X* X
glucose meter reading, pulse oximetry, etc.) X* X
12 Ear irrigation, perform (*requires pre and post assessment by RN or provider) X
13 Eye irrigation, perform (*requires pre and post assessment by RN or provider)
14 Eye irrigation with Morgan Lens, perform X XX
15 EEG, perform test X XX
16 EKG, perform test X XX
17 Enema, administer X XX
18 Eye, perform visual tests (simple noninvasive visual acuity, automated visual field testing,
electrodiagnostic tests, keratometry, ophthalmic photography/digital imaging, non-subjective X* X* X
auto refraction, pachymetry, pupil/ocular motility, tensometry, tonometry, A/B scans, optical X XX
device for ocular exercises) X* X* X
19 Fetal monitoring (antepartum) and non-stress test (*MA, LVN: may only hook up for test) X XX
20 Gait analysis testing, prepare patient
21 Hot and cold applications (*MA, LVN: per order of NP, PA or MD) X*
22 Laboratory tests, perform “Point of Care” and quality control tests (blood glucose, urine chemistry
test strips, pregnancy test, rapid strep test etc.)
23 Laser, removal of hair, wrinkles, scars, moles, tattoos, spider veins, other blemishes (*requires
standardized procedures per BRN)

24 Light therapy, perform procedure (*MAs and LVNs can prepare and place patients in the light box, X* X* X
turn on the light box following a patient specific order for the specific length of time and intensity
of light for ultraviolet therapy, but not make adjustments independently based on patient X X X
assessment or by protocol) (* MA, LVN - requires RN/provider pre and post assessment) X* X* X
X
25 Nails, cut, for healthy patient X X
X X X
26 Nails, cut, for patients with known peripheral vascular disease and diabetes X X X
*X X X
27 Orthopedic appliances: Remove casts, splints, or other external devices; MA X X
Select / adjust / instruct crutch and cane use (*MA, LVN: use pre-printed, approved material); X X
Obtain impressions orthotics, padding, and custom molded shoes; LVN X
Apply pre-made knee immobilizers, envelope slings, wrist guards (OTC products), pre-made X
orthotics, and similar devices. RN
X X
28 Orthopedic appliances: Apply customized, molded appliances X
X X
29 Oxygen, apply via mask or nasal cannula XX
X X
30 Peak flow spirometry, perform X X
X
31 Specimen (anterior nares swab), collect X* X

32 Specimen (nasopharyngeal swab culture), collect X X
X X
33 Specimen (throat/wound culture, sputum, urine, semen, stool, finger-stick blood glucose), collect
(*MA: throat culture requires prior RN/provider assessment) LVN X
X
Dressings, Wound Care, and Assisting with Minor and Major Surgery X
X X
34 Dressings/bandages, simple, sterile and non sterile, apply or remove for closed surgical incisions or X X
X
stage 1 and 2 wounds.i
RN
35 Dressings, complex, apply and remove for open surgical incisions or stage 3+ and unstageable
X
wounds.ii
X
36 Dressings, compression, apply (*MA: RN/provider must assess the patient after dressing is applied) X*

37 Dressing, vascular compression, apply (e.g. Unna Boot)

38 Examinations and procedures, prepare patients, position, drape X

39 Penrose drain, removal (*MA.LVN: RN/provider must assess the patient after drain has been X*

removed)

40 Procedures (colposcopy, D&C, hysteroscopy, LEEP etc.), specimen collection, assist X

41 Surgery, minor, assist and prepare sterile field, prep site (skin antisepsis), position and drape X

patient, collect specimen from provider (excludes cutting, clamping, suturing incision or dissecting

tissue)

42 Surgical case, circulating nurse

43 Suture and staples, removal (*MA/LVN: must have wound assessed by RN/provider prior to removal X*

and use written post-removal care instructions)

44 Wounds, deep, clean and pack

45 Wounds, superficial, clean with ordered solution(s) X

46 Wounds, topical medication/specialized wound care products, apply

Medication Administration MA

47 Allergy skin test/challenges, perform

48 Medication, administer

(MA: each medication and dosage must be verified by a physician, NP, CNM, PA, RN, or LVN) X*

Oral, Subcutaneous, Intramuscular, Intradermal (skin test), Vaginal, Rectal, Topical (*MA: may not

apply topical anesthetics except eye drops), Inhalation (*MA: only if it is a routine medication for

patient)

49 Narcotics, administer (Refer to the Regional P & P: Medication Administration by Medical X XX
Assistants)
X XX
50 Narcotics, count with a licensed person, witness wasting by a licensed person XX
51 Narcotics, sign-out
52 TB skin test, administer and measure results (*MA: can only measure results, may not interpret X* X X

result as positive or negative) ( No verification needed for MA administration) X X
53 TB skin test, interpret as positive or negative and document resultsif n
MA LVN RN
IV Therapy and Blood Withdrawal
X* X
54 Blood and blood products, administer (*LVN: with IV certification) X
56 Blood withdrawal, arterial or from central vascular access X* X
57 Central line, catheter care and dressing change X*
58 Chemotherapy, administer (*with ONS chemotherapy provider card) X
59 IV, administer fluids with or without additives, regulate flow, flush peripheral devices, monitor
X* X
peripheral site and systematic effects of IV therapy (*LVN: with IV certification) (*LVN: additives X
restricted to vitamins, nutrients and electrolytes only) X* X* X
60 IV, administer medications X
61 IV, start and disconnect peripheral (*LVN: with IV certification) MA LVN X*
62 Phlebotomy, therapeutic, perform X
63 PICC line, care and removal X* X*
64 PICC line, insert, repair or declot (*with PICC didactic course with PICC insertion experience) RN
65 Venipuncture/withdraw blood (*MA, LVN: with phlebotomy certification) XX
X
Message Management/ Task Delegation/ Role Delineation MA LVN X
X
66 Call patient to give information (*MA, LVN: delegated by RN or MD/provider) X* X X
65 Care management, systematically manage a defined population via standardized procedure X
66 Care plan, nursing and multidisciplinary, based on assessment, develop/initiate/coordinate X
65 Case management, coordinate/facilitate patient care on a case by case basis X
66 Delegate task/procedure, assign MA/LVN messages that require further data collection X
67 Health status, assessment and evaluation
68 Messages, take and collect data from the patient RN
69 Nursing advice, provide
X
Message Management/ Task Delegation/ Role Delineation con’t X

70 Nursing diagnosis, develop X* X* X
71 Orders, standing, follow (*MAs: for routine procedures for clearly identified patient populations
X
that does not require the MA to implement based on symptom or use of a protocol)
72 Orders, take verbal/phone orders (*LVN: only for medications they are allowed to administer and X
XX
for actions within their scope of job responsibilities)
(*MA: on-site physician supervision is requirediii) X
73 Patient assessment, perform with independent clinical judgment and development of nursing X XX

diagnoses and a plan of care
74 Patient education plan, develop; assess/identify learning needs
75 Patient education, provide health promotion and prevention teaching
76 Patient education, provide health teaching and counseling specific to patient’s condition/status
77 Patient education, reinforce and provide instruction/information per provider – pre-printed and

approved

78 Procedural sedation, administer and monitor X
79 Standardized procedure, use to initiate and provide care X
80 Title “Nurse” (RN may use “professional nurse”), use of XX
81 Triage, perform X

This list is a guide for ambulatory departments and is not inclusive of all tasks and procedures.

MAs, LVNs or RNs with questions regarding a specific task or procedure should discuss them with their managers. Managers may refer questions to the
Ambulatory Clinical Practice Leader.

i Definition of stage 1 and 2 wounds:
Stage I:
Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible
blanching; its color may differ from the surrounding area.
Stage II:
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or
open/ruptured serum-filled blister.

ii Definition of stage 3 and 4 and unstageable wounds:
Stage III:
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscles are not exposed. Slough may be present but does not
obscure the depth of tissue loss. May include undermining and tunneling.
Stage IV:
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often
includes undermining and tunneling.
Unstageable:
Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or
black) in the wound bed.
(National Pressure Ulcer Advisory Panel, 2007)

iii The supervising licensed physician and surgeon/licensed podiatrist authorizes the Medical Assistant to perform services and is responsible
for the patient’s treatment and care. RNs may supervise the Medical Assistant in the performance of certain procedures. The
physician/podiatrist shall be physically present in the treatment facility during the performance of procedures performed by the Medical
Assistant (B & P Code 2069 (a)(3).

Regional ACPC 5/12/05, revised 7/8/05, 4/07, 9/11, 5/12, 3/14, 11/14, 1/15, 7/15
KFH Legal Department approved 7/25/05
SCPMG Legal Department approved 7/25/05

AMBULATORY SERVICES
RN, LVN, MA, Tech, Provider
KP HealthConnect (KPHC) Tasks and Procedures

Competency validation is required before performing all tasks and procedures

Schedule RN LVN MA Tech Provider

1 Flag a patient on the schedule X XX X X

2 Move a patient’s appointment changed to another provider within the X XX X
department

3 View a provider’s schedule X XX X X
Patient Intake/Encounter
RN LVN MA Tech Provider

4 Allergens: document the type and severity X
5 Allergies: remove previously documented allergy from Allergy Section X

6 Allergies: add new allergy and reaction X XX X X
X XX X X
7 Allergies: review and mark as reviewed if no new allergies X XX X X
X XX X
8 After Visit Summary (AVS): print and review with patient X XX X X
X XX X X
9 Best Practice Alert (BPA) SmartSets: pend orders

10 Best Practice Alerts (BPA): view and respond to

11 Document: chief complaint (duration, location), nursing notes (head
circumference, past medical/surgical history, social history, family
history, sexual activity), vital signs (height, weight, Temperature,
Pulse, Respirations, Blood Pressure, pulse oximetry, peak flow,
tobacco, drug, alcohol history, Activities of Daily Living or exercise
vitals), interpreter services, pain information, Last Menstrual Period,
patient questionnaires

12 Document: orthostatic blood pressure readings in the Doc Flowsheet X XX X X
X
13 Document: repeat vitals in New Set of Vitals or Doc Flowsheet X XX X X
X XX X X
14 Document: use SmartLinks, SmartPhrases, SmartLists X XX X X
X
15 Document: verify a patient’s preferred pharmacy via order entry X
activity
X
16 History: add medical, surgical or family history to the history section of X XX
the visit navigator

17 Medications: add over-the-counter medications to historic medication X XX X
list or Med Doc Tool

18 Medications: add prescription medications to Med Doc Tool for X XX X
provider review if transcribing directly from a patient’s prescription
label or other written documentation

19 Medications: add prescription medications to medication list per
discussion with patient

Patient Intake/Encounter cont RN LVN MA Tech Provider

20 Medications: discontinue meds from the medication list (*RN, RN X* X
Case/Care Manager per Standardized Procedure)

21 Medications: document patient-reported medications in Nursing Notes X XX X

22 Medications: document with reviewed button (Reviewed signifies that X XX X X

the staff have reviewed the medication list with the patient)

23 Medications: verify what patient is currently taking on Med Doc tool X XX X X

24 Proactive Care Support (POS): place orders for patient care gaps via X X
the sign function per POS standing orders

25 Proactive Office Encounter (POE) Care Tab: review POE check list X XX X X

26 Proactive Office Encounter (POE): pend POE SmartSets X XX X X
XX
27 Proactive Office Encounter (POE): sign POE SmartSets X*

28 Problem list: add diagnoses (*RN, RN Case/Care Managers per
standardized procedure)

29 SmartPhrases personal: create and edit X XX X X
X*
30 V-codes or Kaiser codes: added to the Encounter Diagnosis (*RN,
RN Case/Care Managers per standardized procedure)

31 V-codes: enter and pend an Encounter based on information from a X XX X
patient

32 V-codes: pend smoking Cessation Counseling V-code X XX X
X
33 V-codes: review and close
RN LVN MA Tech Provider
Orders X XX X

34 Activity Rx Form: enter the patient-specific information in the Activity
Rx according to provider's instructions and print for the provider to
sign and then give to the patient. If no provider instructions were
given, then stage the Activity Rx form for the provider to review.

35 Activity Rx Form: sign according to provider’s patient specific order X XX X X
XX
36 Durable Medical Equipment DME: pend X
37 Durable Medical Equipment (DME): sign per provider order (must X XX X X

include diagnosis) X XX

38 Durable Medical Equipment DME: validate order priority and order XX
class

39 Immunizations: administer and document in KPHC Immunization
Module

40 Immunizations: sign per standing order

41 Medication refills: approve active medications X
X
42 Medications: convert an order from non-formulary to formulary
medications X XX X
XX
43 Medications: pend order if formulary medication
RN LVN MA Tech Provider
Medications: verify and document verified medications given by
44 Medical Assistants (MAs) X* X* X

Orders cont X XX X X

45 Orders expired: sign orders for tests (*per department standing
orders)

46 Order priority, order class or order status (future or standing), change

47 Orders signed: cancel per provider direction X XX X X
X
48 Orders unsigned: remove X XX X X

49 Point of Care Testing (POCT): perform and document quality control X X X X
tests (blood glucose, urine chemistry test strips, pregnancy test, etc.)

50 Preference Lists (departmental or personal), use X XX X X
51 Proactive Office Encounter (POE): sign per standing orders XX
XX X
52 Tapestry: Health Education Referrals: sign
53 Tapestry: Health Education Referrals: pend XX X
54 Tapestry: Health Education Referrals: co-sign X
X
55 Tapestry: Medical Consult Referrals: sign
56 Tapestry: Specialty Consult Referrals: sign as directed by specialty X XX X
X* X* X** X**
physician via Doctor Advice
X X*
57 Tapestry: Medical Consult Referrals: pend
RN LVN MA Tech Provider
58 Tests: sign (*RN – per standardized procedure or standing order,
LVN per standing order) (*RN/LVN – also see POE standing orders) X XX X X
(**Ortho tech or MA in Ortho/Pod Dept - must follow regional policy
and procedure for ordering approved back office imaging and DEXA X XX X X
orders)
RN LVN MA Tech Provider
Verbal/Phone orders: sign & document in Nurses Notes (*LVN may
only take a Verbal Order or Telephone Order for medications they X
can administer)
59 X XX X

Allied Health/Nurse Visit Encounter X XX X X

60 Addendum: add as needed to a closed encounter

Document: complete patient instructions and any needed follow-up

61
In-basket/Message Management

62 Advice/Assessment: provide to patient/family

63 Appointment request: if routine, book and document
64 Attach to another user’s in-basket and manage per KPHC grid

65 Cancelled Orders: Staff can attach to Provider's In Basket, Cancelled X X X
Orders folder and address most cancelled lab order messages by
conducting a chart review:
* If order is cancelled due to order of duplication in patient chart,
“Done” the message
* If test is still needed, and not included in a standing order policy,
pend test and route to Physician/Provider for signing
* If test is still needed and is included in a standing order policy,
cosign sign order
* If test is not needed, “Done” the message
* If unsure if test is still needed, refer to Physician/Provider for next
steps

66 Data collection: obtain information on medical problem/concern X XX X
X
67 Education for patient/family: assess, identify learning needs and X
develop education plan X XX X X
XX
68 Education for patient/family: use pre-approved documents

69 Expired Orders: Staff can attach to Provider's In Basket, Expired
Orders folder and address most expired lab order messages by
conducting a chart review:
* If test is still needed, and not included in a standing order policy,
pend test and route to Physician/Provider for signing
* If test is still needed and is included in a standing order policy,
cosign sign order
* If test is not needed, “Done” the message
* If unsure if test is still needed, refer to Physician/Provider for next
steps

70 Forms: gather and prepopulate data (Department of Motor Vehicles X XX X
(DMV), DME, etc) requiring provider certification and forward to
provider for signature X* X

71 Letters to patients: independently create (*RN, RN Care/Case X XX X
Managers)
RN LVN MA Tech Provider
72 Letters to patients: per provider instructions, use pre-approved
templates in the Letter Encounter X XX X X

In-basket/Message Management cont X XX X X
X X
73 Medication refills: gather data, clarify patient’s request, check
medication order status, pend refill request to preferred pharmacy,
and create telephone encounter

74 Message: change status to done

75 Message: manage if reasons for call are: medical problems, request
for same day appointment or flu-like symptoms

76 Message: manage if reasons for call are: routine appointment X XX X X

requests, diagnostic tests requested, Immunizations, Medication X
X
request, New Member Entry Call, Other, Referral request, Request X

Form Completion, Second message to health care team, Test results X

77 Message Encounter: create X X XX X

78 Message kp.org email: manage according to KPHC Grid X XX X X
X
79 Open Encounters: Staff can attach to Provider's In Basket, Open X XX X X
X
Encounters folder and review open encounters for any message ≥ X

14 days old

* If care has been completed, close encounter

* If care has not been completed, take action as needed to complete

care or route to appropriate person that needs to resolve/close

encounter

80 Pathology results, benign/normal: inform patient per provider's X XX
instructions or if already released to kp.org or KPNS for final results
that are benign/normal with no other modifications on the report

81 Referral request: gather data, clarify patient’s request, inform patient X X X X
of self-referral depts. (i.e., Psychiatry, Dermatology for moles and
spots, Ob-Gyn, Ortho for known fractures), pend Tapestry referral
and route to provider for approval

82 Surgery: sign request form X XX X
83 Telephone Encounter: create X XX X
84 Test results, abnormal: inform patient per provider’s instructions or
X XX X
standing orders or if already released to kp.org
X
85 Test results, normal: inform patient per provider's instructions or
standing orders or if auto released to kp.org

86 Triage: assess with clinical judgment or provide medical advice

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