Table 3.
Trigger | Trigger Logic |
---|---|
Creat | [New order or increase in (direct GFR reducer OR volume reducer OR nephrotoxin) within (1–5 days OR 1 day to last creatinine measure)
AND (No new trimethoprim within 5 days)] AND (No decrease in any meds above since the last creatinine measure OR no repeat order for creatinine) AND (>25% reduction in creatinine clearance since initiation or increase of above med AND resulting creatinine clearance < 50) |
Klow | Use of potassium reducer
AND [K <3.0 OR (K < 3.5 AND K decreased by >15%) versus previous measurement] AND (No new potassium raiser OR decreased potassium reducer) within 5 days of triggering potassium result |
Khigh | [(K+>5.5 and up by >10% since last measurement)
OR (K+>6.0)] AND (Potassium raiser active OR Potassium reducer discontinued 1 day to 4 weeks days prior) AND No new potassium reducer OR decrease in potassium raiser within 5 days of triggering result |
BMT | (On bone-marrow-toxic drug with a course more than 2 weeks AND No chemotherapy within 2 weeks)
AND [(WBCs<2,500 AND decrease from before course by more than 2,000) OR (WBCs<2,000 AND decrease from before course by more than 1,000) OR (Platelets<50k AND decrease by 75k within 1 week)] AND (no repeat CBC OR no decrease in drug) within 5 days of triggering result |
Warf | [Started on warfarin within 14 days AND (INR>3.0 AND INR increased by 1 within 2 days) AND no repeat INR within 2 days]
OR (Started in warfarin longer than 14 days prior AND INR>4 AND no repeat INR within 2 weeks) OR (INR>6 AND no repeat INR within 2 days) Note: INR stands for International Normalized Ratio |
Gork | Active prescription of sedative hypnotic including anticholinergic
AND Subsequent diagnosis of (dementia, fall, delirium) |