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Let’s rely on a nurse’s judgment for vasopressor titration

12 Sep 2021

Changes affect several infusions, increases leeway

By: Matthew Tanner, PharmD, BCPS

Starting Tuesday, Sept. 14, titration increments for nurse-titrated infusions will get a makeover to encompass an increased reliance on their clinical skills and judgment. This change will affect:

  • Norepinephrine infusions
  • Epinephrine infusions
  • Dopamine infusions
  • Phenylephrine infusions

Previous guidance from regulatory bodies has mandated very tight guidance and minimal leeway for nurses in titrating medications. We are grateful to reverse this trend somewhat, starting with vasopressor orders.

Current state (norepinephrine infusion for example):
current state vasopressor 

Future state (starting Sept. 14):
future state vasopressor 

This change will allow the person closest to the patient to more properly titrate the infusion by allowing not only a larger titration increment, but allowing smaller titrations within that increment.

This change will be coming to other infusion groups as well: sedatives, neuromuscular blockers, anti-hypertensive and miscellaneous cardiac infusions.

If you would like to have input on these changes, or have questions about them, please contact Matt Tanner in Pharmacy (