Standing House Order Sets

     We are happy to announce that the Metro Alliance has standardized Standing House Order (SHO) sets. This joint initiative is intended to improve the quality of care for patients and increase nursing staff abilities by decreasing wide variation and inefficiencies of multiple approaches to common care issues in skilled nursing facilities. We encourage Directors of Nursing (DON) and Medical Directors (MD) to use these along side their facility policies and protocols. We look forward to keeping current practice updates by a yearly review and revisions. They were last updated January 2018. 

      We acknowledge that starting and instituting SHO takes time and work from the DON, MD, and facility administration to make them part of the facility practice, teaching staff, and reconciling with current facility policies and protocols. We do believe they elevate quality care to patients by expediting services. We encourage the use of them. 
     In July 2017 we combined the LTC and TCU SHOs to have one robust Skilled Nursing Facility (SNF) set that can be used facility wide. Facility DONs/Medical Directors are able to pick and choose what works best for their facility based on patient needs.  
     The goal of SHOs are to allow the nurse a set of orders for patient care until a more patient specific treatment plan is available if needed. These do not take the place of an individualized treatment plan. Please feel free to comment on the blog for any recommended changes.  We appreciate all the recommendations that went in to making the updated 2018 version. We look to update yearly in January. 

We ask that if you make changes to the document, please add the addendum, "Adapted from the Metro Alliance of Geriatric Primary Care Providers" and make a footnote of the revised items. 

1.  Metro Alliance SNF SHO set
2.  Metro Alliance TCU SHO set
3.  Metro Alliance LTC SHO set

Our publication in Annals of Long-Term Care is below. 
Standardization of Standing Orders in Long-Term Care