Asthma — Pathway Documentation — Clinical Pathway: Inpatient

Asthma Clinical Pathway — Inpatient

History

Severe pathway

  • RN/RT should speak at the beginning of the shift and decide on even vs odd hours of assessment so the patient gets what they need.
  • All assessments need to be documented on the asthma flowsheet identifying the assessment and level of pathway.

Moderate pathway

  • RT does the assessments with the treatments every two hours and documents on asthma flowsheet in Epic.
  • RN needs to be aware of the patient’s progress every two hours.
  • RN should either co-sign the RT documentation stating they agree with the assessment that was done at that time or write a note in the column where the RT documented their assessment at that time.

A patient transitioning from moderate to mild

  • RT does assessment with treatments and documents on asthma flowsheet in Epic.
  • RN needs to be aware of the patient’s progress every two hours
  • RN should either co-sign the RT documentation stating they agree with the assessment that was done at that time or write a note in the column where the RT documented their assessment at that time. If assessment indicates possible regression in pathway RN should contact provider and RT to discuss. If regression is needed RN should do full assessment on asthma flowsheet and highlight the assessment change as significant data.
  • Once the patient receives one mild/moderate assessment with a treatment, the RT then does the second Q2 hour assessment and holds the treatment if appropriate. The RN then does the next hour (third hour) assessment and the RT does the fourth hour assessment with a treatment at the hospital acute dosing (weight-based) dose — mild asthma pathway order sets are then entered at this time. All assessments and treatment given are documented on the asthma flowsheet in Epic.

Mild Pathway

  • RT does the assessment and treatment every 4hrs and documents on the asthma flowsheet.
  • RN needs to be aware of the patient’s progress every 4hrs.
  • RN should either co-sign the RT documentation stating they agree with the assessment that was done at that time or write a note in the column where the RT documented their assessment at that time.