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Addressing a Common Hospital Problem with Smart Dosing Guidance in Epic

Nurses at El Camino Health address symptoms of low potassium using in-system guidance for each dose

One in five hospitalized patients has low potassium, which can cause weakness, fatigue, and heart palpitations. A nurse needs to strike just the right balance when giving potassium, however, because too much potassium given too fast can cause cardiac arrest. The complex calculus can sometimes cause delays.

At El Camino Health in California, there’s no guesswork. Clinical decision support in Epic helps nurses choose the optimal dose based on standard clinical guidelines and patient-specific needs. Just four months after rolling out the automatic dosing guidance, El Camino reduced delayed administrations by 50%.

If a physician notices symptoms of low potassium, she can order a lab test to check the patient’s potassium levels, as well as a potassium replacement protocol. Based on the lab result, clinical decision support in Epic calculates how much potassium the patient needs according to the sliding scale protocol. At the bedside, the nurse can see how much to give and when the next dose is planned instead of manually checking the result and calculating the appropriate amount.

“By reducing the manual calculations and scheduling needed for each dose, we free up nurses to focus on patient recovery,” said clinical pharmacist Lian Chang, PharmD, who led El Camino Health’s project. “Patients get the potassium they need when they need it.”

Epic community members can learn more about El Camino Health’s approach on the UserWeb and have Epic staff install it as part of Epic’s Services.