Simplified Outreach Targets for Flow Nurses

Here's a draft of a simple, one pager to help flow nurses go after patients with outstanding need for quality improvement.

Children's Immunizations

Children 2 years of age need the following shots:
• Diphtheria, tetanus, pertussis (DTaP) (4 doses)
• Inactivated polio virus (IPV) (3 doses)
• Measles, mumps, rubella (MMR) (1 dose)
• H. influenzae type B (Hib) (3 doses)
• Hepatitis B (HepB) (3 doses)
• Chickenpox (varicella) (1 dose) or documentation that they had chickenpox.

Diabetes
DM: HbA1c Test*
Get a hemoglobin A1C at least once a year
DM: HbA1c >9.0%*
Get the hemoglobin A1C <9
DM: LDL Screen*
Get an LDL once a year.
DM: LDL <100*
Get the LDL cholesterol <100
DM: Nephropathy Monitoring
Get a microalbuminuria test once a year.

Heart Care
CAD: Persistence of Beta Blocker Treatment
IF patient has had a heart attack, THEN the patient should be on a beta blocker (atenolol, metoprolol, or carvedilol).
CAD: Cholesterol Management – LDL Screen*
Get an LDL once a year.
CAD: Cholesterol Management – LDL<100*
Get the LDL cholesterol <100
Controlling High Blood Pressure*
Get the most recent blood pressure in clinic <140/90

Screening
Breast Cancer
Get a mammogram every two years for women 40-69.
Cervical Cancer
Get a pap smear every two years for women 21-65.
Colorectal Cancer
Get fecal occult blood test every year for patients OR get a colonoscopy every ten years for people 50-80.