General
W-00737 Physician’s Order Sheet Post-Parathyroidectomy Renal Health/Peritoneal Dialysis/Hemodialysis
Hemodialysis
W-00109 (SAP 295044) Chronic Hemodialysis Physician’s Order Sheet
W-00598 Addendum to Manitoba Renal Program, Chronic Hemodialysis Physician’s Order Sheet for HSC
W-00641 Physician’s Order Sheet – Post Hemodialysis Tunnelled Central Venous Catheter Insertion
Catheter-related Bacteremia
W-00522 Identified Central Venous Catheter Related Bacteremia Order Sheet
W-00569 Local Renal Health Centres Identified Central Venous Catheter Related Bacteremia Order Sheet
W-00582 (SAP 295070) Suspected Central Venous Catheter Related Bacteremia Order Sheet
Home Hemodialysis
Local Centres
W-00569 Local Renal Health Centres Identified Central Venous Catheter Related Bacteremia Order Sheet
Peritoneal Dialysis
W-00130 Physician’s Order Sheet for Peritoneal Dialysis (PD)
W-00542 Pre-printed Orders – Peritoneal Dialysis Infection Protocols (70.30.05f) *Effective December 9, 2020*
W-00663 Physician’s Order Sheet for Oral Iron Renal Health Clinic-Peritoneal Dialysis Outpatients
Peritonitis
W-00543 Physician’s Order Sheet Peritoneal Dialysis OUTPATIENTS Confirmed Pathogen Peritonitis (70.30.05e) *Effective December 9, 2020*
W-00624 Physician’s Order Sheet – Peritoneal Dialysis Outpatients Empiric Treatment of Peritonal Dialysis Related Peritonitis (70.30.05a) *Effective December 9, 2020*
W-00680 Part 3 Guideline for Empiric Antibiotic Treatment Guidelines for Rural Outpatients with Peritonitis (70.30.05d) *Effective December 9, 2020*
Renal Health Clinics
W-00199 Chronic Kidney Disease Preprinted Orders
W-00476 Cyclophosphamide Order Sheet
W-00493 HSC Renal Biopsy Order Sheet
W-00495 Intravenous Iron Preprinted Order Sheet for Chronic Renal Insufficiency
W-00663 Physician’s Order Sheet for Oral Iron Renal Health Clinic-Peritoneal Dialysis Outpatients
Transplant Referral
W-00398 Manitoba Renal Program Standing Orders for Transplant Referral
Disclaimer: The information and data in this document (“Information”) is based on scientific evidence current as of the date issued and is subject to change without notice. The Information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Any person consulting or applying the Information is expected to use independent medical judgment and expertise in the context of individual clinical circumstances. Winnipeg Regional Health Authority and the Manitoba Renal Program make no representation or guarantees of any kind whatsoever regarding the content or use or application of the Information and specifically disclaim any responsibility for its application or use in any way.
