The Inpatient review admissions order Flashcards
what is the disposition in the ER?
where the patient goes next
what are the levels of care in the hospital
observation status
inpatient status
what level of care is typically less than 24-48 hrs in the hospital
observation status
what level of care is typically more the 24-48 hrs in the hospital
inpatient status
if a patient is needing to be admitted for basic needs what floor will they go to
med/surg
if a patient needs continuous cardiac monitoring what floor what they need to be on?
telemetry
if the patient is intubated, needs IV vasopressors or etc. what floor would they need to be on
critical care (ICU/step down)
what is the rationale behind patient transfer
we want to stabilize the patient and assess the need for definitive care
consider the needs of the patient and if there are limitations at the current hospital transfer
**transfer to the nearest appropriate hospital
tertiary care-
larger hospital with wide variety of specialty care
trauma level category levels
I-V
level 1 is the highest level of care with 24 hour immediate care from specialty services
level 2- 24 hour immediate surgical care (not specialty)
level 3- 24 hour emergency ER physician
trauma level category levels
I-V
level 1 is the highest level of care with 24 hour immediate care from specialty services
level 2- 24 hour immediate surgical care (not specialty)
level 3- 24 hour emergency ER physician
what is the emergency medical treatment active labor act?
EMTALA
this is a requirement of all hospitals to screen and treat emergencies - to at least stabilize their condition no matter their race, insurance, or ability to pay
**hospitals must treat if they can, if not must transfer. (hospitals that can take care of the situation MUST accept the transfer)
what are hand offs/reports
verbal communication during any transfer of care that reduces the risk of medical errors and improves patient safety
examples of handoffs and reports
I-PASS
SBAR
beware of _ _ which is the tendency to lock onto first piece of information
anchoring bias
with anchoring bias you can overlook?
important considerations
(can lead to incorrect primary diagnosis, missed secondary diagnosis)
ROS in _ systems
physical screens in _ systems
10
8
what is the mnemonic for admission orders
ADC VANDALISM
what does ADC VANDALISM stand for
admit to
diagnosis
condition
vitals
allergies
nursing orders
diet
activity
labs
IV fluids
studies/special instructions
medications
admit to should have what components
level of care (telemetry/ICU)
service (internal medicine) including the admitting physician cell phone and contact info
code status (full code, DNR, DNI)
what should diagnosis include?
primary diagnosis for admission
secondary diagnosis/chronic conditions that are listed as present on admission
what categories does condition include
good
fair
serious
critical
good condition
vitals are stable and WNL the patient is conscious and the indicators are excellent
