Standing Orders for LPNs, RNs, MAs
Nursing Policy N 001
Note: All test results will be shown to provider for review. This policy and procedure shall remain in effect for all patients of CrossOver Healthcare Ministry until rescinded.
Perform a glucose test on patients showing symptoms of hypoglycemia or hyperglycemia.
Perform a pulse oximetry on patients who are on home oxygen, are actively wheezing, experiencing chest pain, complain of fatigue, or are in respiratory distress.
Perform a PPD on patients who require testing for school, shelter needs, or employment, who deny a past positive PPD. Give it within a three day time frame for a return visit to get the spot read recorded.
Please see nursing policy N-XXX for standing order for flu shots.
Check hemoglobin on patients who are anemic, and have not had hemoglobin checked in the last 6 months. Also check hemoglobin on patients who complain of unusual, excessive bleeding or complain of fatigue.
Perform an A1C test if the patient is diabetic and an A1C test has not been performed in the last 3 months. Check the progress note, Pharm D form, and the lab section of the chart for previous results
Perform a urine pregnancy test on women who have missed a period, report a positive home pregnancy test, and prior to a depo provera injection. Be sure to record the date of their LMP.
Perform a urine dip for patients with dysuria, gross hematuria, frequent urination, or other urinary tract symptoms, or TIPS patients who have not had this test in the past year. Keep and hold the urine sample.
Perform an INR on all new patients that are on Warfarin. For existing CrossOver patients that are on Warfarin, perform an INR only on patients that are being followed by CrossOver. Do not perform an INR on patients being followed by an outside Warfarin clinic unless instructed to do so by a clinician.
Perform an EKG on any patient that presents with chest pain.
Nursing Roles at CrossOver
RNs and LPNs may perform triage duties on their own without consulting with a clinician, although consultation is encouraged when possible. A MA could only do triage if they report to a NP/MD/PA to finalize the disposition. A MA would only be used in this manner if a RN or LPN is not available.
These higher order invasive procedures will be done only by competently trained and credentialed RN/ LPN / MA. Phlebotomists may perform phlebotomy, but not injections or immunizations. PharmDs perform immunizations.
A competently trained and credentialed RN/ LPN /MA/CNA performs the following procedures:
- Finger-stick tests: hemoglobin, Hemoglobin A1c, blood sugar, INR
- Urine tests: pregnancy, urinalysis
- Vital signs (including height, weight, temperature, pulse, respirations, blood pressure)
Medical Histories and Medication Lists
A staff nurse coordinator will orient and credential the various nursing health professionals with respect to various procedures and information gathering activities in the clinical setting. A credentialing document will be maintained by the staff nurse.
Certified EMTs, Paramedics, and other health professionals will be considered for service in the nursing setting on a case by case basis by the Medical Director of the clinic site, and if approved credentialed by the process listed above.
Please refer to CrossOver’s policy on students of the health professions.
Attend eClinicalWorks FREE Webinars to Earn Your CME/CE Credits while you learn! Over 30 live webinar classes are approved for CME/CE credit. Look for the CME/CE icon next to the webinar information.
Other Online Opportunities
- Carilion Clinic
- Virginia Mason
- CEU for nurses online
- Virginia Nurses Association–Cultivating Diversity
- Free Classes for NPs & PAs
- Blood Pressure Refresher
- Medicare Intensive Behavioral Therapy for Obesity
- Happiness: The Evidence Behind Emotion
- Real or Magic?: The Power of Positive Thinking in Outcomes
- Low-Calorie Sweeteners & Weight Management
- The Two Sides of Stroke
- Various Courses through Medscape.
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