The New Perioperative Cardiac Risk Reduction Therapy
Clinical Reminder
If your patient has pending or recent surgery and has significant risk factors for perioperative cardiac ischemia, then their Clinical Reminders DUE NOW list will include the Periop Cardiac Risk Assessment reminder.
The reminder is triggered only for patients who have surgery pending within the next 30 days (or have had surgery in the past 30 days) and who have a combination of cardiac ischemia risk factors. Risk factors evaluated include:
- Age over 60
- A history of CAD and/or PVD
- A history of Diabetes (or 2 Glucose lab tests in the past year with a value of >140mg/dl)
- A history of Hyperlipidemia (or 2 Cholesterol lab tests in the past year with a value of >240 mg/dl),
- A history of Hypertension
- A history of Smoking.
To learn more about why your patient has the reminder due, click on it in the Clinical Reminders box on the Coversheet and the reminder logic and findings will display. The reminder will not show due if the patient doesn’t meet the pending/recent surgery criteria, doesn’t have the risk factors or if they do meet the surgery and risk factor criteria but are already on beta blocker or Clonidine medication.
Processing the
Reminder
You process the PCRRT reminder just as you would any other Clinical Reminder. While writing a progress note you can open the Reminder’s drawer and click on the reminder to process it.
To resolve the reminder, use the dialog to either order cardiac anti-ischemia medications, note that the patient is already on therapy or mark the therapy as not medically indicated and/or not appropriate for the patient.
If the patient is not on cardiac anti-ischemia medications, and you would like to start them on medications, you can use the dialog to view the recommended treatment and order the recommended medications. To order, just click on the option you’d like to use.
When you complete the progress note, you be able to sign and release the medication orders.
Resources
More information about the PCRRT reminder is available on the CPRS Help Web (first item on the CPRS Tools menu) in the Reminders folder. Here is a web link for more information about the protocol: http://www.betablockerprotocol.com .
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SFVAMC CAC 10/2007