IV cefazolin prescribing and administration resources
In response to the ongoing sentinel event cases (hospitalisation with or without subsequent amputation and AKI) with use of community IV cefazolin, the POAC regional clinical governance group endorsed the development of flow charts for both prescribers and administrators.
These have been designed to be printed and laminated, and placed in clinicians workstations and on Nursing drug cupboards. They highlight the HealthPathways "red flag" presentations, such as:
· Severe or spreading foot infection in Diabetes
· Breast abscess
· Dental abscess
and considerations for dose adjustment with impaired renal function to reduce the risk of AKI.
These resources will be distributed by PHO and Urgent Care clinics and are hosted on the cellulitis HealthPathway and the POAC clinical page:
IV iron HealthPathway –updated dosing, June 2022. Single dose 1000mg for all patients over 35kg –see here . This has been confirmed as a safe and effective dose for all patients, irrespective of weight or degree of anaemia. Multiple doses are no longer funded.
Completion of the on-line referral form is no longer required when Ferinject is given within the referring practice.
Funding is available for all patients in Tamaki Makaurau, where clinical funding criteria met.
POAC-funded investigations and management options for winter planning
With winter approaching, consider utilisation of POAC whenever you are considering a referral to the hospital. POAC funds a suite of investigations and management options to avoid same day hospital referrals. If you do not have capacity within your clinic to deliver this model of care, call us to discuss alternative options, for example an urgent care referral.
Asthma exacerbations POAC funds cares for children and adults where initial trial of routine care (x2 initial treatment, usually with inhaler/spacer, over 30 minutes) does not settle symptoms and hospital referral would otherwise be indicated. This includes additional spacers/nebulisers where indicated and direct Nursing observation time. Include supporting documentation.
Note in the management of bronchiolitis in children <1 year old there is no role for salbutamol, corticosteroids or antibiotics –see here
See also acute respiratory illness in children aged <2yrs HealthPathway. This is an excellent resource for assessing signs and symptoms and differentiating between croup, pertussis, viral bronchiolitis, asthma, infant wheeze and foreign body inhalation. See here.
Acute chest X-Ray for pneumonia or exacerbation COPD is only indicated if the diagnosis is uncertain and the findings will alter acute clinical management. For further information click here
Utilisation of local community pharmacy
Community pharmacies provide services for patients and can be utilised for a range of standing orders. Examples include UTI, cough and cold remedies. They offer vaccinations, BP monitoring, point of care Hep C and INR and smoking cessation support. See HealthPathway here