Free Standing Order Template - Free Download
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Free Standing Order Template
Standing Order Template
Standing Order: General statement of the situation or condition for which the standing order
is to be used. Include who may perform the standing order (e.g., RN, LPN) and any training
required prior to utilizing the standing order.
Assessment: Criteria used to determine the situation or condition for which the standing
Order may be carried out.
1. Subjective Findings: State complaints reported by the client which are consistent
with the identified health care problem. Specify as indicated the number of findings
required to support the criteria for using the standing order. Example: subjective
findings to support a set of routine clinic labs or immunizations would be to state client
presents for the service e.g., need for immunization, pregnant woman requesting
prenatal care.
2. Objective Findings: State those findings noted on assessment which support the
Presence of the Identified health care Problem (e.g., lab test results, vital signs or
Measures Discharge etc.). Example: Objective findings to support a set of routine
Labs on any client for a specific clinic would be to state the Clinic type, e.g., initial
Prenatal visit for pregnant woman or Client age appropriate and has not yet received
This immunization which is indicated based on ACIP guidelines.
Plan of Care:
1. Implementation: State the medical treatment/pharmaceutical or lab testing
procedures to be carried out based on the Subjective and objective findings listed above.
List any known contraindications to the treatment or procedure.
2. Nursing Actions: State interventions which focus on the client’s self-care regarding
response to illness, potential
illness and/or treatment. Teaching may include awareness of side effects of treatment and criteria for
contacting the
physician.
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