Nursing Treatment Protocols     

Introduction   

Oregon laws allow nurses to use Nursing Treatment Protocols.  Oregon DOC Health Services has written Nursing Treatment Protocols consistent with the guidelines set by the Oregon Board of Nursing and the Oregon Board of Medical Examiners.  Oregon DOC Health Services chooses to use this accepted practice to enhance inmate health care.

Oregon DOC Health Services wants to ensure that the use of Nursing Treatment Protocols enhances medical care directed by a physician and does not replace it. Implementation of the Nursing Protocols involves another application of the general concept of nursing triage practice.  The protocols are designed to assist and educate nursing staff in this triage process.

Oregon DOC Health Services requires additional training in physical assessment and the use of treatment protocols for the nurses who use them.  It is recognized that nursing staff are responsible to review the changes that have been implemented, and understand the proper use of the Nursing Protocols.  Oregon DOC Health Services requires that all nurses that use the protocols are supervised for this privilege by the Health Services Manager and the Chief Medical Officer of the institution that the nurse works at.

Key concepts apply.  If an individual is seen for the same problem twice without expected resolution or improvement, they are referred to a medical provider.  All applications of Nursing Treatment Protocols that apply to the use of prescription medications are reviewed and signed off by the practitioner on the next working day (and within 72 hours). 

There is more to the art of nursing than the use of medication.  The majority of the Nursing Treatment Protocols actually result in using educational materials or self-care treatments.  Sometimes over the counter or prescription medication will be suggested. 

While some patients seen by the nurse will require an immediate referral to a practitioner, the inmate patient’s first access to health care is the initial encounter with the nursing staff during the sick call/triage process.  This encounter is the first chance to intervene and often resolves the inmate patient’s health concern.  Review has found that 80% of the inmate patient’s health concerns can be addressed during the sick call visit and resolved through the use of the nursing treatment protocols. 

It’s also clear that the Protocols are not intended as the cure for every ailment in every patient.  The effectiveness of the health care team is enhanced by empowering nurses to apply their knowledge and skills through the use of the nursing treatment protocols. 
Sometimes, no nursing protocol will or should apply to the patient that the nurse is evaluating.  In this case the patient usually is referred for evaluation and treatment by a Provider.

The Nursing Treatment Protocols have been in place for many years.  The inception and subsequent reviews and revisions of the nursing treatment protocols have been the concerted effort of many staff within the health services program.  Nursing staff are encouraged to work with and offer feedback to the current work group for the Nursing Protocols.  Your input into the ongoing revision process is a valuable resource to the group in helping with continuous quality improvement of the protocols.

Assessment Protocols

Abdominal_Pain_Level_I_Revised_2009.pdf    
Abdominal_Pain_Level_II_Revised_2009.pdf    
Acne_Level_I_Revised_2009.pdf    
Alcohol_Withdrawal_Syndrome_Level_II_Revised_2009.pdf    
Allergic_Rhinitis_Hay_Fever_Level_I_Revised_2009.pdf    
Anxiety_Severe_Level_II_Revised_2009.pdf    
Bee_Wasp_Sting_Level_I_Revised_2009.pdf    
Bee_Wasp_Sting_Level_II_Revised_2009.pdf    
Blood_Borne_Pathogen_Exposure_Revised_2009.pdf    
Bloody_Stool_Rectal_Pain_Level_I_Revised_2009.pdf    
Bloody_Stool_Rectal_Pain_Level_II_Revised_2010.pdf    
Burns_Level_I_Revised_2009.pdf    
Burns_Level_II_Revised_2009.pdf    
Cardiac_Rhythm_Abnormalities_Level_II.pdf    
Cerumen_Impacted_Ear_Level_II_Revised_2009.pdf    
Chronic_Disease_Scheduling_Laboratory_Revised_2009.pdf    
Conjunctivitis_Level_II_Revised_2009.pdf    
Constipation_Level_I_Revised_2009.pdf    
Constipation_Level_II_Revised_2009.pdf    
Contraband_Medical_Observation_Revised_2009.pdf    
Corns_Calluses_Warts_Level_II_Revised_2009.pdf    
Dermatitis_Chronic_Level_I_Revised_2009.pdf    
Dermatitis_Contact_Acute_Level_I_Revised_2009.pdf    
Dermatitis_Contact_Acute_Level_II_Revised_2009.pdf    
Diabetic_Foot_Care_Level_I_CCCF_Revised_2010.pdf    
Epistaxis_Level_II_Revised_2009.pdf    
Epistaxis_Nose_Bleed_Level_I_Revised_2009.pdf    
Eye_Pain_Chemical_Burn_Foreign_Body_Corneal_Abrasion_Level_II_Revised_2009.pdf    
Fractures_Level_II_Revised_2009.pdf    
H1N1_IIVvisSp.pdf    
H1N1_Purple_sheet_example.pdf    
H1N1_vaccination_protocol_ODOC.pdf    
H1N1_Vaccine_LAV_Level_I_2009_2010.pdf    
H1N1_vis_inact.pdf    
Head_Injuries_Level_II_Revised_2009.pdf    
Headaches_Level_I_Revised_2009.pdf    
Headaches_Level_II_Revised_2009.pdf    
Hepatitis_A_and_B_Vaccination_for_Inmates_TwinRix_3_dose_Level_II_Revised_2010.pdf    
Human_Animal_Bites_Level_I_Revised_2009.pdf    
Human_Animal_Bites_Level_II_Revised_2009.pdf    
Human_Papillomavirus_Vaccine_Level_II_Revised_2010.pdf    
Hyperglycemia_Level_II_Revised_2009.pdf    
Influenza_2010_Seasonal_Influenza_Vaccine_Level_I_Revised_2010.pdf    
Insect_Bite_Level_I_Revised_2009.pdf    
Insect_Bite_Level_II_Revised_2009.pdf    
Laceration_Level_II_Revised_2009.pdf    
Meningococcal_Vaccine_CD_Summary_Oregon_Update_2010.pdf    
Monilial_Vaginitis_Candida_Level_I_Revised_2009.pdf    
Nausea_Vomiting_Diarrhea_Level_II_Revised_2009.pdf    
Nursing_Treatment_Protocols_Intro_September_2009.pdf    
Opiate_Withdrawal_Level_II.pdf    
Otitis_Externa_Acute_Level_II_Revised_2009.pdf    
Otitis_Media_Level_I_Revised_2009.pdf    
Otitis_Media_Level_II_Revised_2009.pdf    
Oxygen_Delivery_Options_2009.pdf    
Parasitic_Infestations_Level_II_Revised_2009.pdf    
Pepper_Spray_Tear_Gas_Level_I_Rev_0909.pdf    
Pharyngitis_Bacterial_Viral_Level_I_Revised_2009.pdf    
Pharyngitis_Bacterial_Viral_Level_II_Revised_2009.pdf    
Respiratory_Infection_Mild_Level_I_Revised_2009.pdf    
Respiratory_Infections_Level_II_Revised_2009.pdf    
Seizure_Activity_Level_II_Revised_2009.pdf    
Self_Care_Procedures.pdf    
Sinusitis_Level_I_Revised_2009.pdf    
Sinusitis_Level_II_Revised_2009.pdf    
Skin_Infections_Bacterial_Level_I.pdf    
Skin_Infections_Bacterial_Level_II.pdf    
Skin_Infections_Fungal_Level_I_Rev_2009.pdf    
Skin_Infections_Fungal_Level_II_Rev_2009.pdf    
Strains_Sprains_Back_Neck_Trunk_Level_I_Revised_2009.pdf    
Strains_Sprains_Back_Neck_Trunk_Level_II_Revised_2009.pdf    
Strains_Sprains_Extremity_Level_I_Revised_2009.pdf    
Strains_Sprains_Extremity_Level_II_Revised_2009.pdf    
Temporary_Extension_of_Necessary_Medication_Intake_Revised_2010.pdf    
Temporary_Extension_of_Necessary_Medication_Revised_2009.pdf    
Tetanus_Prophylaxis_Level_I_Revised_2010.pdf    
Urinary_Tract_Infection_Level_II_Revised_2009.pdf    
Urticaria_Level_I_Revised_2009.pdf    
Urticaria_Level_II_Revised_2009.pdf    

Dental Protocols

Avulsed_Tooth_Level_2.pdf    
Dental_Pain_Level_1.pdf    
Dental_Pain_Level_2.pdf    
Fractured_Mandible_Level_2.pdf    
Fractured_Tooth_acute_Level_2.pdf    
Injuries_To_The_Mouth_Level_1.pdf    
Injuries_To_The_Mouth_Level_2.pdf    
Oral_Infections_Level_1.pdf    
Oral_Infections_Level_2.pdf    
Oral_Lacerations_Level_2.pdf    

Emergency Protocols

Anaphylaxis.pdf   
Angina.pdf    
Asthma.pdf    
Cardiac_Arrest.pdf    
Childbirth.pdf    
CVA.pdf    
Diabetic_Keto_Acidosis.pdf    
Foreign_Body_In_Eye.pdf    
Hypoglycemia.pdf    
Looks_Critically_Ill.pdf    
Myocardial_Infarction.pdf    
Poisoning_Overdose.pdf    
Puncture_Wound.pdf    
Shock.pdf    
Sucking_Chest_Wound.pdf    
Suicide_Prevention.pdf    

Page updated: April 04, 2011

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