Mary do you know who we need to contact to find out the ...€¦ · credentialed it was Dena Read....

From: Holden, Mary

Sent: Wednesday, September 10, 2014 1:42 PM To: Chamberlain, Krystal R; Newsome, Franklin; Ornelas, David; Heissel, Jaclyn J

Subject: RE: Credentialing

The policy is on declaring brain death that needs renewal Mary Holden, RN, MS, CCRN Nurse Manager Burn/Trauma ICU, Neuro ICU University of Colorado Hospital 26015 E. 16th Avenue Aurora, Colorado 80045 Phone: (720)848-0944 Pager: (303)266-0227 [email protected]

From: Heissel, Jaclyn J

Sent: Wednesday, September 10, 2014 5:40 PM To: Holden, Mary; Chamberlain, Krystal R; Newsome, Franklin; Ornelas, David

Subject: Re: Credentialing

Mary do you know who we need to contact to find out the key stakeholders of this policy? When I credentialed it was Dena Read. Is she still in this role or is there someone else on 4Ps and a C we need to get in touch with? Jaclyn Heissel BSN, RN, CCRN

Neuro ICU

[email protected]

From: Holden, Mary

Sent: Thursday, October 16, 2014 6:04 AM To: Ornelas, David

Subject: Re: Brain Death Policy

No we update policies every 3 years and it is due for revision is all. Evidence based recent articles are needed that are recent. Hope this helps thanks for asking Sent from my iPhone, please excuse any spelling and grammar errors. On Oct 16, 2014, at 3:00 AM, Ornelas, David <[email protected]> wrote:

Mary, I am working with Jaclyn tonight on the policy revision portion of credentialing. During our prior conversations you noted wanting the Brain Death Policy looked at. My question is was there a specific portion of the policy needing revision? I have a current article from 2013 on Brain Death Criteria and am just wondering if there is something specific that needed to be updated. Thank you, David Ornelas RN, BSN Charge Nurse Neuro-Surgical ICU University of Colorado Hospital

mailto:[email protected]



From: Ornelas, David Sent: Monday, November 24, 2014 6:05 AM

To: UCH-Professional Practice Policy Proc Committee

Cc: Heissel, Jaclyn J; Chamberlain, Krystal R Subject: Brain Death Policy

To Whom It May Concern: My name is David Ornelas and I work in the Neuro Surgical ICU. I am credentialing this year and was given the Brain Death policy by my manager for possible revision. I am looking for information including the stakeholders and who authored the current version. Any help with this would be much appreciated. Thank you for your time, David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: UCH-Professional Practice Policy Proc Committee

Sent: Tuesday, November 25, 2014 2:07 PM

To: Ornelas, David Cc: Heissel, Jaclyn J; Chamberlain, Krystal R; Lenz, Kristy

Subject: RE: Determination of Death by Neurologic Criteria (Brain Death)

David I listed the official name of the policy in the subject line. Please make sure that this title is always listed in future email correspondence in the subject line to aid me in tracking this policy. I got an email from an employee who wanted to revise this policy (Kristy Lenz). I have her down as working on this policy. Has this changed? Let me know. Shelly Response to your questions:

- Policy Owner- NeuroICU Manager - Policy Stakeholders- NeuroICU Manager, NeuroICU Medical Director, CCQI

Shelly Limon RN, MS, CNRN University of Colorado Hospital Nurse Manager Neuroscience Office- 720-848-4746 Pager- 303-266-2610


Sent: Tuesday, February 17, 2015 1:14 AM To: Chamberlain, Krystal R; Ornelas, David

Subject: Re: Policy

David I also made some revisions. We talked about listing the article number after specific changes such as changing the SBP parameter from 90 to 100 so you can be prepared to discuss where you found that in the literature. If you want your checklist to replace the old one, let's try to get that built. Also are you still planning on putting this into EPIC? I think that is a good idea, we'll have to get started on that soon. Jaclyn Heissel BSN, RN, CCRN Charge Nurse, Level III RN, Neuro ICU

[email protected]


From: Chamberlain, Krystal R Sent: Friday, February 13, 2015 5:37 PM To: Ornelas, David; Heissel, Jaclyn J Subject: RE: Policy Hi David, I have attached your policy with some revisions. I started to correct your references, but noticed that they are not in APA format. Also, they are very dated. Did you do a new lit search for new references by chance? Also the policy needs to be put in the new format. The template is on PPPPC’s website. Please let me know if you need help locating it or if you need additional clarification. Thanks David! Krystal Chamberlain, RN, BSN, CCRN Neuro ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006 Pager 303-266-1823 [email protected] The Department of Professional Resources improves lives by empowering healthcare professionals to influence quality care through education, discovery and navigation of change. From: Ornelas, David

Sent: Monday, February 09, 2015 4:34 AM To: Heissel, Jaclyn J; Chamberlain, Krystal R

Subject: Policy What do you think? I want to make the Documentation part look more like the original “worksheet” still. And get rid of the previous one. Think I can do that? David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital


Sent: Tuesday, February 17, 2015 7:02 AM

To: Ornelas, David Subject: PPPPC Template and Updates to Brain Death Policy

David, Here's a copy of the updated format for policies and procedures from the PPPPC. I started to update it with the changes made so far, let's ask Krystal about the best way to do this. I think we can just update it at the end and send them the final copy with the updated format and all your drafts can be left in the old format. Also I attached more changes I made to the draft of the policy. Jaclyn Heissel BSN, RN, CCRN

Charge Nurse, Level III RN, Neuro ICU

[email protected]

From: Heissel, Jaclyn J Sent: Tuesday, February 17, 2015 7:05 AM



To: Ornelas, David

Subject: Stakeholder Letter

David, Here's a sample letter that you can use to format your letter requesting review by your stakeholders. Use this to send to Mary, Bob, and CCQI committee. Make sure you include a timeline of when you would like revisions by. Jaclyn Heissel BSN, RN, CCRN Charge Nurse, Level III RN, Neuro ICU

[email protected]

From: Ornelas, David

Sent: Friday, February 27, 2015 7:46 AM To: Jeppson, Kerri A; Holden, Mary; Neumann, Robert T

Cc: Chamberlain, Krystal R; Heissel, Jaclyn J Subject: Brain Death Policy Revision

Good Morning Team, As part of my credentialing portfolio I am revising the Brain Death Policy. This policy was last revised in 2010 and currently up for revision. The current stakeholders for this policy are Mary and Bob along with the other committees like CCQI and PPPPC. I have been working on several revisions to the policy which are attached. My main focus was expanding on the original policy, adding more detail and specifics to definitions and tests. The current research does not show new tests or additional ways to determine brain death. However, said research looks to empower physicians and nurses that do not regularly perform the test by making a detailed checklist and developing policies that are easy to follow with little grey area. Moreover, the current research stresses strict adherence to the examination protocol so as to limit the room for misinterpretation. This can be accomplished through the use of a detailed, chronological check list. Another area of change to the policy is in regards to the apnea test. Current articles look to decrease complications by instituting a prerequisite checklist that if strictly followed produce higher success rates of the apnea test. The importance of this lies in this particular test being a gold standard for brain death determination. Outlining clear values and parameters will again cut down on complications and increase physicians confidence with the results obtained. Updating the current policy and procedure to include a more uniform, step-by-step checklist with updated parameters will lead to increased RN knowledge and confidence in recognizing a patient’s worsening neurological status and initiate formal evaluation for brain death (Arbour, 2013). Providing a clear definition of brain death and ensuring the family’s understanding before organ donation is discussed are vital to avoid later misunderstanding (Arbour, 2013). Earlier declaration of brain death after brain stem herniation can decrease futile care and decrease costs of a prolonged intensive care stay. When editing, please utilize the “Track Changes” feature in the toolbar of the document. Thank you for your help and feedback. David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Chamberlain, Krystal R

Sent: Tuesday, March 03, 2015 3:31 PM

To: Ornelas, David


Cc: Heissel, Jaclyn J; Newsome, Franklin; Jeppson, Kerri A

Subject: RE: Brain Death Policy Revision

Hi David, It does not look like you have put this on the correct template. I have attached the new template from PPPPC’s website. Also be sure to update your resources to include LOEs for each (& some are still highlighted). Nice work! Krystal Chamberlain, RN, BSN, CCRN Neuro ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006 Pager 303-266-1823 [email protected]

From: Johnson-Bortolotto, Shannon Sent: Monday, March 16, 2015 1:48 PM

To: Chamberlain, Krystal R; Ornelas, David

Subject: RE: Epic Question

Hi, Yes Melanie and Leighann are your contacts for clinical consensus regarding brain death. Any EPIC changes will require system practice consensus—Mel, Leighann and I can offer you CNS critical care consensus, so please email us as a group with your content. Chaleen Gillum or Kristin Tallis have been great EPIC contacts for documentation changes……once you have system consensus, which is what Mel, Leighann and I can offer your work so it transitions smoothly! Shannon Johnson Bortolotto MS RN APN CCNS Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945 [email protected]

The department of Professional Resources improves lives by empowering healthcare professionals to influence quality care through education, discovery and navigation of change.

From: Chamberlain, Krystal R Sent: Monday, March 16, 2015 1:37 PM

To: Ornelas, David

Cc: Johnson-Bortolotto, Shannon Subject: FW: Epic Question

David, Please see the correspondence below. Shannon, can you help us with contacts at North & South regarding brain death? I still have the CNS contacts you gave me. Should we start there?

CNS contacts: [email protected] & [email protected] Krystal Chamberlain, RN, BSN, CCRN Neuro ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006 Pager 303-266-1823





[email protected] The Department of Professional Resources improves lives by empowering healthcare professionals to influence quality care through education, discovery and navigation of change.

From: Knippa, Sara M

Sent: Monday, March 16, 2015 1:31 PM To: Chamberlain, Krystal R

Subject: RE: Epic Question

Million dollar question! There doesn’t seem to be a single point person for Epic, they all work on different parts. So there’s a report person, a doc flowsheet person, a MAR person, etc. Kathy Smith from Epic helps to run the Inpatient Informatics Committee, so she might be a good person to point you in the direction of the right person! The Epic Central request is a good place to start. He will get further a lot faster if he gets some consensus from North and South before he even talks to Epic… that’s the first thing they are going to ask him. Ask Shannon who the best people from North and South would be to discuss brain death. Thanks, see you at 4!

Sara Knippa MS, RN, CCRN, CNS

Clinical Nurse Educator, CICU

From: Chamberlain, Krystal R Sent: Monday, March 16, 2015 12:53 PM

To: Knippa, Sara M Subject: Epic Question

Happy Monday, Mentor! Do you know how I could find out if our unit or division has an Epic contact person? One of our nurses is working on the brain death policy and would like to work with Epic to build a new tool. I’ve told him to put in a request through Epic Central, but I’m curious if there is someone he should talk to. Thanks Sara! (See you at 4:00) Krystal Chamberlain, RN, BSN, CCRN Neuro ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006 Pager 303-266-1823 [email protected]


Sent: Wednesday, April 01, 2015 11:58 PM To: Roberts, Melanie; Jock, Leighann; Johnson-Bortolotto, Shannon

Cc: Chamberlain, Krystal R; Heissel, Jaclyn J; Newsome, Franklin; Neumann, Robert T; Cava, Luis

Subject: Brain Death Policy

Melanie, Leighann, and Shannon, Thank you for taking the time to work with Krystal in getting myself the appropriate information to successfully work on my credentialing. As mentioned by Krystal, as part of my credentialing I am reviewing and revising the current Brain Death policy. While there are not many major policy changes, the current research looks to make brain death policies more uniform, include a step by step checklist, and update parameters leading to increased understanding and



confidence of the entire team performing a brain death exam. A major part of this was expanding parts of the policy to give clear definitions and hopefully eliminate potential grey areas. My thoughts and hopes are to add a section in epic under Flowsheets where this process can be thoroughly and properly documented. Physicians have a particular template under their notes section to dictate said test, however, the RN and RT involved have to piece together flowsheets to accomplish this documentation in the EMR. I have completely done away with the current form in the policy and simplified it in a new step by step process based on current research. Again, my hope is to take this current form and make a similar epic flowsheet. Please see the attached document and make changes/suggesting utilizing the “track changes” function and by “reply all” to this email so we can assure we are all current with progress. Thank you, David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital


Sent: Thursday, April 02, 2015 7:53 PM To: Badal, Juan F

Cc: Heissel, Jaclyn J

Subject: Fw: Brain Death Policy

Hey Juan, Sorry I forgot to add you to the list last night. The email below kind of gives you an overview of where I was going with the changes made to the policy. My question for you was regarding the apnea test of course. Currently we are using a t-piece to provide 100% oxygen when off vent, however, some articles speak to using an insufflation cannula inserted through the et tube to the level of the carina providing 100% o2 this way as well. It appears via this delivery method more o2 is "available" for diffusion at the alveoli. My concern is that speaking with some of the other RTs, we do not have these particular o2 catheters available nor do the RTs have adequate training in these methods. Based on this, I went ahead and just left the t-piece use in the policy. If you have any ideas on this or think the training and acquisition of said catheters could be a smooth process I would love to add that to the policy as well. Thanks, David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Badal, Juan F

Sent: Sunday, April 05, 2015 2:05 PM To: Ornelas, David


Thanks David for all of your work. I have attached an article from the respiratory care journal that supports the changes, if you want to use it for a reference. I am fine with all the changes. Juan

From: Roberts, Melanie

Sent: Tuesday, April 07, 2015 10:55 AM To: Ornelas, David; Jock, Leighann; Johnson-Bortolotto, Shannon

Cc: Chamberlain, Krystal R; Heissel, Jaclyn J; Newsome, Franklin; Neumann, Robert T; Cava, Luis Subject: RE: Brain Death Policy

David-

Currently in the North region we use these criteria and have a similar policy so I don’t see any issues from that perspective. The problem is we do not require that it be a neurosurgeon, neurologist or neuro-Intensivist. Our trauma surgeons are sometime the provider who is making

the decision about brain death. I will send this to our Surgical Trauma ICU Director and get his thoughts about that component of the policy.

Melanie Roberts MS, APRN, CCRN,CCNS Critical Care Clinical Nurse Specialist University of Colorado Health Poudre Valley Hospital and Medical Center of the Rockies 2500 Rocky Mountain Avenue Loveland, CO 80538 970-624-2154 (office) [email protected]

From: Jock, Leighann

Sent: Tuesday, April 07, 2015 2:42 PM

To: Ornelas, David; Roberts, Melanie; Johnson-Bortolotto, Shannon Cc: Chamberlain, Krystal R; Heissel, Jaclyn J; Newsome, Franklin; Neumann, Robert T; Cava, Luis

Subject: RE: Brain Death Policy

I am wondering if anyone from Donor Alliance has reviewed this. Thanks!

Leighann Jock RN, MSN, CCNS Clinical Nurse Specialist for Critical Care Memorial Hospital, University of Colorado Health 719-365-2934 [email protected] From: Kristy Plenter [mailto:[email protected]]

Sent: Thursday, April 09, 2015 11:59 AM

To: Jeppson, Kerri A Cc: Ornelas, David


Hi Kerri and David, Thanks for passing this along. Looks like there were minor changes. Is the form or page 6 going to be the actual electronic note used in EPIC? Or printed off and placed in chart? Here are a few questions I have:

On the old/current form, there is room to document the Apnea test findings:

D. Document Confirmatory Test Utilized (minimum of 1)

1. Apnea Test: (with physician

PaCO2 at start of test

PaCO2 at end of test



present) pH at end of test

I am not sure if this is always necessary but it does show the results which can be a helpful thing to reference

when on case. We can always look up those values of course. The current form is an easy to reference.

Secondly, I notice that the Systolic pressure must be greater or equal to 110, it used to be 90. Will you let me know what prompted that change. I know many of our donors have pressures in the 90’s so I just want to be sure and pass this along tour clinical staff here.

The most important area is that the form no longer has the statement of declaration included:

Having considered the above findings, I hereby certify brain death pronounced by:

Attending Physician Signature ______________________________ Date_______________ Time _______________ Name Printed ____________________________ UPI#__________

Regardless of donor, I would think that this would be pertinent to declaration based on the standards of practice- date, time, and statement of death with MD signature. We could not move forward without this on a donor.

Let me know if this is the policy and if the actual document is different than in the EMR. I might be jumping to conclusions here, sorry. I really appreciate the inclusion on this and let me know what the final product is so that we can have it in our system for reference when we have a case. Thanks again, Kristy From: Jeppson, Kerri A [mailto:[email protected]] Sent: Wednesday, April 08, 2015 9:26 AM

To: Kristy Plenter

Cc: Ornelas, David Subject: Fw: Brain Death Policy

Hey there, I was wondering if you wouldn't mind looking over this revision of the brain death policy and see if you might have any suggestions. Thanks, Kerri

From: Ornelas, David Sent: Wednesday, April 8, 2015 8:01 AM To: Jeppson, Kerri A Subject: Brain Death Policy


Kerri, Thanks for passing this along. Let me know if there are any questions or concerns. David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Johnson-Bortolotto, Shannon Sent: Thursday, April 09, 2015 1:38 PM

To: Ornelas, David; Roberts, Melanie; Jock, Leighann

Cc: Chamberlain, Krystal R; Heissel, Jaclyn J; Newsome, Franklin; Neumann, Robert T; Cava, Luis Subject: RE: Brain Death Policy

HI David; First, great work on updating and revising! I’ve attached my thoughts in track changes for the team to review. With regard to working out defining who is the approved provider for each region, we may need to be region specific in the policy, depending on consensus. What needs to be extremely clear is that providers perform brain death diagnostic tests….RNs do not. (The apnea test is the only blend, with provider presence.) Since this will be a system policy, UCH PPPPC is not the group that will review and approve. This will now be going to Clinical Practice Governance Group (CPGG). That group has a different system policy template—once final consensus is attained with this content group, it will be easier to place in the system policy template. I’ve attached the CPGG template w/ instructions for you. When your policy is nearing completion, JoAnn DelMonte is the UCH co-chair for CPGG and who you will notify to be placed on their agenda to present the system policy for final review & approval. Shannon Johnson Bortolotto MS RN APN CCNS Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945 [email protected]

From: Johnson-Bortolotto, Shannon

Sent: Thursday, April 09, 2015 1:45 PM

To: Ornelas, David Cc: Chamberlain, Krystal R; Newsome, Franklin


David; . Here is the CPGG screening tool as well; to be sent to JoAnn DelMonte with finalized policy. If you need help in any way with the CPGG process, please do not hesitate! Shannon Johnson Bortolotto MS RN APN CCNS Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945


Sent: Monday, April 13, 2015 2:20 AM


To: Kristy Plenter; Jeppson, Kerri A

Cc: Heissel, Jaclyn J; Chamberlain, Krystal R Subject: Re: Brain Death Policy

Kristy, First, thank you for taking the time to read over the policy revisions and give your input. The form itself is going to be used as a tool to help direct the physician and nurses during the actual brain death test. My thought is to not have it be a part of the chart and the reason being; I have seen 2 brain death tests performed here since I started two years ago and both times the current form was used a reference tool and never signed by the physician nor was it placed in the chart. Speaking with our Neuro Intensivists, they also view the sheets as a tool and they have a place to document a brain death exam in their notes and do not see the need to have a paper sheet in the chart when their conclusion will be in the EMR. Thank you for pointing out the apnea test findings section. I will incorporate this into the new form. The idea behind the SBP being > or = to 100 is all related to the Apnea test itself. The peripheral vasodilation effects of CO2 buildup frequently result in hypotension. The thought is that by starting the test with a "higher" sbp gives us more room during the test. Case in point, the 2 tests I have seen here, the docs wanted the sbp prior to apnea test closer to 140. Furthermore, Goudreau et al found that cardiovascular complications were noted in approximately 1 in 4 apnea tests. This rate nearly doubled in tests performed in patients with unstable or borderline baseline blood pressure or Spo2. The authors emphasized that a majority (85%) of apnea testing can be performed without complications when adequate precautions are taken. Lastly, in regards to the declaration portion, as mentioned above, our physicians use a particular section in the notes to document all findings of the brain death test. I will follow up with our docs to clarify the use/necessity of having a paper portion and EMR version. Krystal, what do you think? Kristy, thank you again so much for your input and taking the time to review this. David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Chamberlain, Krystal R Sent: Monday, April 20, 2015 4:51 PM

To: Ornelas, David; Kristy Plenter; Jeppson, Kerri A Cc: Heissel, Jaclyn J


Hi David, I know we spoke briefly on this subject when I saw you last week, but I wanted to send you an email stating what we discussed. Perhaps you’d like to put something large, in bold on top of the checklist like “NOT PART OF PATIENT’S PERMANENT RECORD.” This might take care of the ‘confusing’ issue mentioned. I understand that you would not want to put this in Epic, as there is already a place for the MDs to chart; however, they are currently utilizing the checklist during brain death testing. Nice work! Please let me know if I can help in any way. Krystal Chamberlain, RN, BSN, CCRN Neurosurgical ICU Clinical Nurse Educator

University of Colorado Hospital Office 720-848-7006 [email protected]

From: Jock, Leighann Sent: Tuesday, May 26, 2015 4:15 PM

To: Ornelas, David Subject: RE: Brain Death Policy

I know that I am way behind the 8-ball with this, but I have given it to our Neurosurgery physician for review. I will send on the results when I hear back.

Leighann Jock RN, MSN, CCNS Clinical Nurse Specialist for Critical Care Memorial Hospital, University of Colorado Health 719-365-2934 From: Roberts, Melanie Sent: Friday, June 05, 2015 12:38 PM

To: Ornelas, David


David- I am so sorry, I completely forgot. Could you please send it to me one more time? As I recall my only concern was the provider issue. I don’t know if I would say healthcare provider because we discussed it should be a provider not an NP or PA. Melanie Roberts MS, APRN, CCRN,CCNS Critical Care Clinical Nurse Specialist University of Colorado Health Poudre Valley Hospital and Medical Center of the Rockies 2500 Rocky Mountain Avenue Loveland, CO 80538 970-624-2154 (office) [email protected]


Sent: Wednesday, June 03, 2015 6:20 PM To: Roberts, Melanie


Melanie, I am just checking in on the progress of your Surgical Trauma ICU Director’s thoughts on the policy revision. Some new light has been shed on the use of specific physicians being listed. As this is going to be a system wide policy the verbage the policy and procedure committee would like to use is “healthcare provider.” This would eliminate any confusion in that area. Thanks for your time and I look forward to your feedback. Thank you,



David Ornelas RN, BSN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Ornelas, David Sent: Friday, June 12, 2015 10:41 PM

To: Jock, Leighann; Roberts, Melanie Cc: Chamberlain, Krystal R; Heissel, Jaclyn J


Leighann, Absolutely. I have received feedback from our Neurology team, both of our Critical Care Neuro-Intensivists, and our Chair of Neurosurgery. I have also had our lead Respiratory Therapist look over the proposed changes and received the ok from him as well. Melanie, In regards to the "Healthcare Provider," I spoke with my educator about this and she informed me the Clinical Practice Governance Group (CPGG) have set forth a policy outline indicating these terms to be used. I imagine I can place specifics in the policy as to no NP/PA to administer brain death testing and will thoroughly go over these concerns with the CPGG when I present this policy. Thanks for all your input and feedback! I look forward to wrapping this up and submitting. Please let me know if there are any other issues that arise. David Ornelas RN, BSN, CCRN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Jock, Leighann Sent: Tuesday, June 9, 2015 3:48 PM To: Ornelas, David Subject: RE: Brain Death Policy

Hi David, can you tell me if your proposed changes were reviewed by any of your neurologists, neurosurgeons, critical care intensivists? This is one policy that I thinks needs to involve review from physicians. I have given it to our Neurosurgeon for review but wonder if any other docs have reviewed.

Leighann Jock RN, MSN, CCNS

Clinical Nurse Specialist for Critical Care

Memorial Hospital, University of Colorado Health

719-365-2934

[email protected]


From: Chamberlain, Krystal R

Sent: Sunday, June 14, 2015 7:11 AM To: Ornelas, David; Jock, Leighann; Roberts, Melanie

Cc: Heissel, Jaclyn J Subject: Re: Brain Death Policy

Hi Melanie, After thinking more about it, It would make sense to use "physician" instead of "healthcare provider" in this policy. I have gotten so aware of the new verbiage that I didn't stop to think that for THIS policy, it would not necessarily make sense. Do you actually sit on CPGG? David, my apologies. I didn't think of this until now. I am happy to verify if Melanie isn't on the committee. Thanks! Krystal Chamberlain

From: Moore, Jennifer L - RN

Sent: Monday, June 15, 2015 2:45 PM To: Chamberlain, Krystal R

Cc: Ornelas, David Subject: RE: CPGG question

Hi Krystal, If it is only a physician you can use “physician”. You might need to offer that clarification when you present to CPGG just so they do not want you to change it. Healthcare provider definition should be deleted from your template if you do not use it anywhere else. Do you have a CPGG champion assigned to you yet? The champion reviews the policy prior to presenting to CPGG to look at formatting etc. and assists you through the approval process. I can either take a look at it or you can request another champion through JoAnn DelMonte. Thanks, Jen From: Chamberlain, Krystal R Sent: Monday, June 15, 2015 2:09 PM

To: Moore, Jennifer L - RN Cc: Ornelas, David

Subject: CPGG question

Hi Jen, One of our nurses is working on the Brain Death system policy. I have a question about verbiage. Should he be using the terms “healthcare provider” or “physician?” We only allow physicians to perform the brain death testing procedures, so this seems like an appropriate time to only use “physician.” What are your thoughts? Thanks! Krystal Chamberlain, RN, BSN, CCRN Neurosurgical ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006 [email protected]

From: Ornelas, David Sent: Tuesday, June 16, 2015 2:31 PM


To: UCH-Professional Practice Policy Proc Committee Subject: RE: Determination of Death by Neurologic Criteria (Brain Death) Darby, My apologies for the delay in response. I am currently wrapping up the policy to submit, however, it will be going to the CPGG as it is now considered a "system policy." Would it be beneficial to "cc" you with the submission and results or is this a whole seperate issue? Thank you and again sorry for the delay. David Ornelas RN, BSN, CCRN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital ________________________________________ From: UCH-Professional Practice Policy Proc Committee Sent: Monday, April 27, 2015 2:36 PM To: UCH-Professional Practice Policy Proc Committee; Ornelas, David Cc: Lenz, Kristy; Chamberlain, Krystal R; Newsome, Franklin Subject: RE: Determination of Death by Neurologic Criteria (Brain Death) Hi David, Shelly has been out since the beginning of January. We are working on updating our databases for PPPPC. We would like an update as to where you are at in the revision of this policy. Please give us an expected date when you will have this completed. We will need the screening tool and policy sent to us. Thank you so much, Darby & Shelly! Thank you, Darby Root Program Support Assistant Neurosciences & Dialysis Professional Practice Policy and Procedure Committee Phone: 720-848-8018 [email protected] Mail Stop: F778

From: UCH-Professional Practice Policy Proc Committee Sent: Wednesday, June 17, 2015 3:30 PM To: Ornelas, David; UCH-Professional Practice Policy Proc Committee Cc: Limon, Shelly Subject: RE: Determination of Death by Neurologic Criteria (Brain Death) Hi David, If you are moving this policy towards a system wide policy we will not need to review the policy, it should go directly to CPGG to review. We will update our database to reflect this information. Thanks for letting us know! Thank you,


Darby Root Program Support Assistant Neurosciences & Dialysis Professional Practice Policy and Procedure Committee Phone: 720-848-8018 [email protected] Mail Stop: F778

From: Newsome, Franklin Sent: Monday, March 9, 2015 2:57 PM To: Ornelas, David Subject: FW: Brain Death Policy Revision I can’t remember if I got back to you on the Brain death Policy or not. I will have to approve on the unit level. Did Dr Neumann receive a copy to sign off? Is it in the correct format yet?


Sent: Thursday, July 02, 2015 8:09 AM To: Ornelas, David

Subject: Re: CCPG process?

Hi David, Yes, you will present the policy to the CPGG committee. The other 2 authors from North and South can be on the call as well to help you answer questions. You will only need to attend your time slot, 10-15 min, but will not likely know that until Mon. Or Tues. when the agenda comes out. Typically start with a very short SBAR, include who you worked with on the policy and who this applies to. Then the committee, who has seen the final draft, provides you with feedback for changes. If the policy only needs minor changes then we will vote on approval. I will continue to work with you after to ensure all changes are made and get your final policy posted. Education in all 3 regions has to be completed prior to posting. It is the responsibilities of the authors to figure out what that looks like and ensure it is complete. My experience is this can take a while. Please share this with the other authors on the policy. We are a welcoming group and look forward to working with you all. I will review it today and get back to you. Please let me know if you have any more questions!! Thanks, Jen Sent from my iPhone On Jul 2, 2015, at 4:58 AM, "Ornelas, David" <[email protected]> wrote:

Jen, Thank you for getting back to me and filling me in on the process. Attached is the most current draft of the policy. Thank you for filling me in on the details of this process. Sorry for another question, however, what exactly takes place on 7.9 at the meeting? Is this when I present it to the committee? I’m sure we will touch base prior to this date but just want to find out what I am in for. Thanks again! David Ornelas RN, BSN, CCRN



Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital From: Hopkins, Kathie

Sent: Wednesday, July 01, 2015 4:15 PM

To: Moore, Jennifer L - RN; Chamberlain, Krystal R; Waterman, Kari S Cc: Ornelas, David

Subject: RE: CCPG process? I am not the champion for this policy and haven’t heard it mentioned during meetings so don’t think there has been one assigned. It is all yours Jen! Kathie From: Moore, Jennifer L - RN

Sent: Wednesday, July 01, 2015 3:13 PM To: Chamberlain, Krystal R; Waterman, Kari S

Cc: Ornelas, David; Hopkins, Kathie Subject: RE: CCPG process? Hi David, Thank you so much for taking on this policy with our system partners. Below is the link for the CPGG sharepoint website where you will find the algorithm and screening tool. The screening tool and the final rough draft of the policy needs to be submitted to the CPGG submission inbox listed on the screening tool. We do have policy champions for each policy. I have cc’d Kathie Hopkins, another CPGG member, on this email. Either she or I will likely be the champion to review the rough draft prior to submission. We look for formatting issues, etc. so that the approval process is faster. Can you email us the latest rough draft of that policy so we can return it to you by Monday 7/6. You will then need to submit it with the screening tool on Monday 7/6 to receive agenda time on the 7/9 meeting from 10-1200. Please let me know if you have any further questions. https://spsites.uchealth.org/sites/Home/CPGG/SitePages/Home.aspx Kathie, Do you know if JoAnn reached out for a champion on this policy? I thought it might be you, but I can take this one if we do not have someone assigned to it. Thanks, Jen From: Chamberlain, Krystal R

Sent: Wednesday, July 01, 2015 2:37 PM To: Waterman, Kari S; Moore, Jennifer L - RN

Cc: Ornelas, David Subject: CCPG process? Hi ladies, David Ornelas has completed the Brain Death Policy and wishes to submit it to CCPG. However, I am unsure of the process and I’m unable to find an algorithm on the HUB. He has received approval from all stakeholders at North, Central, and South. Will one of you guide us to the next necessary steps (or give us the proper contact to do so)? Thank you for your time! Krystal Chamberlain, RN, BSN, CCRN Neurosurgical ICU Clinical Nurse Educator University of Colorado Hospital Office 720-848-7006

https://spsites.uchealth.org/sites/Home/CPGG/SitePages/Home.aspx

[email protected]

From: Chamberlain, Krystal R Sent: Friday, July 03, 2015 8:26 AM

To: Moore, Jennifer L - RN; Ornelas, David Cc: Heissel, Jaclyn J

Subject: Re: CCPG process?

David, Jen and I spoke yesterday. She is working hard to get you on the agenda for next week. In the event you are unable to get all of this together by Monday, she did say you could be moved to the August meeting. I am happy to sit in on the conference call for the meeting if my schedule allows. Please let me know when you are scheduled to present (once you have that info). As she mentioned, you will need someone from both North and South to agree to be authors/representatives for their prospective regions (I'm learning this process with you). Great job!! Please let me know if I can do anything to help. Jen, THANK YOU for taking the reins on this! Krystal Sent from Outlook On Fri, Jul 3, 2015 at 7:00 AM -0700, "Moore, Jennifer L - RN" <[email protected]> wrote:

Hi David, Really great job on the policy! Attached is the revised copy. I did need to transfer it to the CPGG template. It is a little different from Central's PPPPC template, mostly that we have a set scope statement developed by legal explaining what facilities the policy applies to. I moved the information that you had in the scope section on your rough draft to the intro section. I put in a few comments and did a few formatting changes. Please review and address changes where appropriate. There are a few items we need to ask CPGG for direction on, such as the Healthcare Provider definition revision. If you have any further questions please let me know. You will need to submit the final rough draft with no track changes along with the screening tool to the CPGG submissions inbox. Please do so no later than Monday so that it can be distributed the committee. At least one of the 3 authors will need to be present or on the call for the CPGG meeting. Please send the name(s) of who that will likely be with your submission. If you don't mind cc'ing me on that email, I would appreciate it! Thanks again for all of your teams hard work! Jen

From: Moore, Jennifer L - RN Sent: Friday, July 03, 2015 2:24 PM To: Ornelas, David Subject: Re: Determination of Death by Neurologic Criteria policy Hi David, Just make sure you cc me on your submissions email. I will have to forward on the documents to our committee in JoAnn's absence. Thanks! Sent from my iPhone


http://taps.io/outlookmobile


> On Jul 3, 2015, at 11:09 AM, "DelMonte, Jo Ann" <[email protected]> wrote: > > Hello David - I apologize for my delayed response! First, thank you for taking on the task of working on a UCHealth system wide policy, this is such important work. As I understand, Jenn Moore has agreed to work with you as our CPGG champion for this policy. She indicated your group might be ready for our July 9th meeting...this would be fantastic! Please reach out to Jenn for further guidance as I will be out of the office on Mon, Tues and Wed. Again, thank you for your strong work on this! > > JoAnn DelMonte, RN-BC, MSN > Senior Director, Professional Development - University of Colorado > Health University of Colorado Hospital Department of Professional > Resources Phone (720) 848-6646

From: Jock, Leighann Sent: Monday, July 06, 2015 12:36 PM

To: Ornelas, David Subject: RE: Brain Death Policy Submission

David, Stakeholders for South are, Dr. McVicker, Neurosurgeon, Tamera Dunseth-Rosenbaum, Director of Critical Care, Jennifer Tatro, Patient Safety Officer, and Leighann Jock, Critical Care Clinical Nurse Specialist. This would replace the policy “Brain Death Declaration for Adult Patients” here at Memorial. I am already part of CPGG, so I will be on the call.

Leighann Jock RN, MSN, CCNS Clinical Nurse Specialist for Critical Care Memorial Hospital, University of Colorado Health 719-365-2934 [email protected] A Clinical Nurse Specialist (CNS) is a Master's or Doctorate prepared Advanced Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a

consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists

From: Ornelas, David Sent: Monday, July 06, 2015 10:20 AM

To: Roberts, Melanie; Jock, Leighann

Cc: Chamberlain, Krystal R Subject: Brain Death Policy Submission

Good morning ladies, I am in the process of submitting the brain death policy to the CPGG, however, I am in need of some further information from your facilities.



Could I get the names of the stakeholders for your current brain death policies? These need to be on the screening tool prior to submission.

If possible, may I ask you to be present as respresentatives/co-authors from your facility during the submission conference call? It would be this week 7.9.15 for roughly 15 minutes between the hours of 1000-1200. I understand this is a big window but I will receive more information from the CPGG today if I can get all this information to them and they will give me a more concrete timeframe. I enjoyed working with you and this would be a great opportunity to finalize some of our questions/concerns about the practices at different facilities and incorporate them into the new policy. If you are unavailable or would rather not get involved, can you provide me the name(s) of anyone who would be?

I did include you on an email from this morning. This was not an official submission as the information mentioned above is still needed. I just wanted everyone to have a most current copy of the policy. Thanks again for all your help and I do apologize for the last minute requests. David Ornelas RN, BSN, CCRN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Roberts, Melanie Sent: Tuesday, July 07, 2015 8:00 AM

To: Ornelas, David; Jock, Leighann Cc: Chamberlain, Krystal R

Subject: RE: Brain Death Policy Submission

David- I am sorry to be the one slowing the process down. I did not realize the goal was CPGG in

July. I am still waiting for provider approval and on this policy I don’t feel comfortable signing off without provider approval.

Our stakeholders will be Lari Walter and Christine Thorkildsen. I am passing this project to them so they can dedicate the time that it needs. I have too many projects right now to do this

one. I apologize. Melanie Roberts MS, APRN, CCRN,CCNS Critical Care Clinical Nurse Specialist

From: Johnson-Bortolotto, Shannon Sent: Tuesday, July 07, 2015 1:35 PM

To: Ornelas, David; Roberts, Melanie

Cc: Jock, Leighann; Moore, Jennifer L - RN; Chamberlain, Krystal R Subject: RE: Brain Death UCHealth System Policy

This would be an adult policy for the system. If there are patients cared for in ICUs who are less than 18 years of age, would recommend an addendum or a separate policy to specifically guide practice. Leighann & Melanie—how do you currently address this patient population in your current brain death policies? For Memorial, do your TCH policies cover children? Shannon Johnson Bortolotto MS RN APN CCNS Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945 [email protected]


A Clinical Nurse Specialist (CNS) is a Master's or Doctorate prepared Advanced Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists

The department of Professional Resources improves lives by empowering healthcare professionals to influence quality care through education, discovery and navigation of change.

From: Ornelas, David Sent: Tuesday, July 07, 2015 12:04 PM

To: Roberts, Melanie Cc: Jock, Leighann; Moore, Jennifer L - RN; Chamberlain, Krystal R; Johnson-Bortolotto, Shannon

Subject: Re: Brain Death UCHealth System Policy

I will check with my educator but adolescents are considered adults regarding treatment if they are post pubescent. Sent from my iPhone On Jul 7, 2015, at 12:01, Roberts, Melanie <[email protected]> wrote:

It could apply to adolescents here in the north as well.

Sent from my iPhone, please excuse any typos.

Melanie Roberts MS, APRN, CCRN,CCNS Critical Care Clinical Nurse Specialist A Clinical Nurse Specialist (CNS) is a Master's or Doctorate prepared Advanced Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists University of Colorado Health Poudre Valley Hospital and Medical Center of the Rockies 2500 Rocky Mountain Avenue Loveland, CO 80538 970-624-2154 (office) [email protected] On Jul 7, 2015, at 11:54 AM, Jock, Leighann <[email protected]> wrote:

Does any other facility care for patients less than 18? Would this policy include children or is this purely an adult policy? If it is only for adults we should clarify that in the name. We do care for children and will also care for patients as young as 14 in the adult ICU, so we need to be clear as to who this applies to.





x-apple-data-detectors://2/0

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tel:970-624-2154



719-365-2934

[email protected]

From: Roberts, Melanie Sent: Tuesday, July 07, 2015 5:16 PM

To: Ornelas, David; Johnson-Bortolotto, Shannon Cc: Jock, Leighann; Moore, Jennifer L - RN; Chamberlain, Krystal R

Subject: RE: Brain Death UCHealth System Policy

We do not have a pediatric policy. I am fine adding adult, but it would be our stakeholders

decision what to do with adolescents. Melanie Roberts MS, APRN, CCRN,CCNS Critical Care Clinical Nurse Specialist A Clinical Nurse Specialist (CNS) is a Master's or Doctorate prepared Advanced Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists University of Colorado Health Poudre Valley Hospital and Medical Center of the Rockies 2500 Rocky Mountain Avenue Loveland, CO 80538 970-624-2154 (office) [email protected]

CONFIDENTIALITY NOTICE: The information contained in this e-mail is privileged and confidential, and is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are notified that any disclosure, copying, distribution, electronic storage or use of this communication is prohibited. If you received this communication in error, please notify us immediately by e-mail, attaching the original message, and delete the original message from your computer and any network to which your computer is connected.

From: Ornelas, David Sent: Tuesday, July 07, 2015 3:37 PM

To: Johnson-Bortolotto, Shannon Cc: Jock, Leighann; Roberts, Melanie; Moore, Jennifer L - RN; Chamberlain, Krystal R

Subject: Re: Brain Death UCHealth System Policy

Absolutely. Thank you so much! David O Sent from my iPhone On Jul 7, 2015, at 15:24, Johnson-Bortolotto, Shannon <[email protected]> wrote:

I think that’s reasonable. David—please add adult to the system policy title. Does that work for you, Mel? Shannon Johnson Bortolotto MS RN APN CCNS




http://ow.ly/kEkhd

Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945 [email protected] A Clinical Nurse Specialist (CNS) is a Master's or Doctorate prepared Advanced Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists The department of Professional Resources improves lives by empowering healthcare professionals to influence quality care through education, discovery and navigation of change. <image001.jpg> <image002.jpg> From: Jock, Leighann

Sent: Tuesday, July 07, 2015 3:05 PM

To: Johnson-Bortolotto, Shannon; Ornelas, David; Roberts, Melanie Cc: Moore, Jennifer L - RN; Chamberlain, Krystal R

Subject: RE: Brain Death UCHealth System Policy

We currently have a separate policy for patients less than 18, which applies to them regardless of whether they are in the adult or Peds ICU. We strictly go by age. We are fine with keeping our pediatric policy but I would like to see the word Adult in the title of this policy so that there is no confusion.




719-365-2934

[email protected]

From: Johnson-Bortolotto, Shannon

Sent: Tuesday, July 14, 2015 11:57 AM To: Chamberlain, Krystal R; Ornelas, David

Subject: RE: RE: Brain Death Policy Submission

HI Davie & Krystal; Agree with all of Krystal’s stellar recommendations. With regard to pediatric care, this policy will not cover pediatric or adolescent practice. At Central, we do not care for this population, but for our system partners who do, they will need other policies or guidelines for these specific populations (pediatric or adolescents). This is why I requested that you add ‘adult’ to the policy name. So, a recommendation for your system policy name is ‘Determination of Death by Neurologic Criteria / Brain Death for Adults’. Shannon Johnson Bortolotto MS RN APN CCNS Critical Care Clinical Nurse Specialist University of Colorado Hospital Department of Professional Resources 720-848-0945 [email protected]




From: McVicker, John

Sent: Saturday, August 01, 2015 9:32 PM To: Jock, Leighann

Cc: Pacheco, Kristine; Tatro, Jennifer; Dunseth Rosenbaum, Tamera; Ornelas, David Subject: Re: Brain Death Policy

This brain death document is acceptable. I do have an issue with the following: "A diagnosis of brain death is supported when a patient’s ICP is ≥ the patient’s mean arterial pressure (MAP)." The literature actually supports the concept of critical closing pressure, the cerebral perfusion pressure below which perfusion can no longer be supported. This is typically a CPP of <10mmHg, not zero. With that one friendly edit I am ok with this.

John H. McVicker, M.D., F.A.C.S. Neurosurgery/Neurocritical Care Director, Neurosciences Memorial Hospital University of Colorado Health 1725 E. Boulder Street, Suite 101 Colorado Springs, Colorado 80909 [email protected] On Jul 31, 2015, at 10:13, Jock, Leighann <[email protected]> wrote:

Here is what the purposed final draft looks like. I have not yet reviewed, but wanted to get this to you ASAP, so you have time to review. They are asking for approval or corrections prior to 8/7. They are planning to submit final policy on 8/13. Let me know what you think.

Leighann Jock MSN, RN, CCNS

From: McVicker, John

Sent: Monday, August 03, 2015 5:04 PM To: Ornelas, David; Neumann, Robert T

Cc: Jock, Leighann; Pacheco, Kristine; Tatro, Jennifer; Dunseth Rosenbaum, Tamera Subject: Re: Brain Death Policy

David- I chatted with Bob Neumann and we agree regarding this. "A diagnosis of brain death is supported in ancillary fashion when a patient’s ICP is within 10mmHg of the patient’s mean arterial pressure.” John H. McVicker, M.D., F.A.C.S. Neurosurgery/Neuro-critical Care Director Neurosciences Memorial Hospital- University of Colorado Health [email protected] cell/text: 303-589-8313 Sent from my iPhone 3G On Aug 3, 2015, at 13:51, Ornelas, David <[email protected]> wrote:

Dr. McVicker,





After some more thought and discussion with my educator I was hoping to clarify a couple things regarding your feedback. Are you wanting to remove the statement “A diagnosis of brain death is supported when a patient’s ICP is ≥ the patient’s mean arterial pressure (MAP)?” I spoke with our Medical Director Dr. Robert Neumann. His suggestion would be to include “A diagnosis of brain death is supported in ancillary fashion when a patient’s ICP is ≥ the patient’s mean arterial pressure.” The idea is that ICP ≥ MAP is not used as diagnosis but more of a supportive ancillary tool. Would this edit be admissible? In regards to the critical closing pressure, do you have the name of the literature this was gathered from? How would you want this displayed in the policy? Again, thank you for getting back to me and I appreciate the feedback. David Ornelas RN, BSN, CCRN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital

From: Thorkildsen, Christine Sent: Monday, August 10, 2015 9:28 AM To: Ornelas, David Subject: RE: Brain Death Thanks for tackling this! Good luck and I will look forward to finding out once I return. I'm sure my trip will be great and am excited for my daughter's new chapter in life! Christine Christine Thorkildsen, RN, CCRN Trauma Program Manager Medical Center of the Rockies 2500 Rocky Mountain Avenue (970)624-4168 [email protected] -----Original Message----- From: Ornelas, David Sent: Monday, August 10, 2015 9:25 AM To: Thorkildsen, Christine Subject: RE: Brain Death Thank you so much Christine and I will make sure these concerns are voiced. I look forward to bringing the policy to the committee and back to you. Have a great week and congratulations on your daughter's current adventure! I'll be in touch. Thank you, David Ornelas RN, BSN, CCRN Charge Nurse, Neuro-Surgical ICU University of Colorado Hospital -----Original Message-----


From: Thorkildsen, Christine Sent: Monday, August 10, 2015 9:22 AM To: Ornelas, David Subject: RE: Brain Death Hi David, I have reviewed the policy and have one concern. MCR has multiple providers that can determine brain death. Trauma surgery, neurology, neurosurgery and pulmonology. I would like that to be stated somehow in the policy for the north region. Otherwise, I approve the policy. Christine Christine Thorkildsen, RN, CCRN Trauma Program Manager Medical Center of the Rockies 2500 Rocky Mountain Avenue (970)624-4168 [email protected]

From: Moore, Jennifer L - RN Sent: Monday, August 10, 2015 2:22 PM

To: UCHealth CPGG Submissions

Cc: Ornelas, David Subject: FW: Brain Death Policy

Attached is the Brain Death Policy and Screening Tool for presentation at the August 12th 2015 meeting on behalf of David Ornelas. Approved stakeholder emails to follow.


Sent: Thursday, August 13, 2015 7:02 AM

To: Ornelas, David Subject: Re: Brain Death Policy

Hi David, We meet in Leprino 612. Your time slot is at 1015 and you have 20 minutes. Sorry for the late notice. The door will likely be closed so I will step out to get you at 1015. The normal process is to provide a short SBAR on the policy and review quickly who you worked with to develop. The committee will then go through the document to provide you with feedback. Thanks and see you then! Jen


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