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Acc chapter presentation for JCI awarness week
Area where people requiring urgent and
 regular treatment beyond regular duty
 hours receive medical treatment care;
      Is staf fed by emergency room
 physicians and nurses 24 hours day all
                  year long
Acc chapter presentation for JCI awarness week
The pre-admission screening process includes:
 A full history and full physical examination;

 Nursing assessment;

 Diagnostic testing (as per patient’s condition).
Acc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness week
 RIGHT FOR TREATMENT
 RIGHT FOR INFORMED CONSENT

 RIGHT FOR GET PRIVACY

 CONFIDENTIALIT Y

 INVOLVEMENT IN CARE DECISIONS

 ACCESS TO PROTECTIVE SERVICES

 RESPONSIBLE ABOUT GIVING CLAER
  INFORMATIONS AND FOLLOWING
  ORDERS
Acc chapter presentation for JCI awarness week
 WHEN SERVICE ISNOT AVAILABLE IN
  MOUWASAT HOSPITAL
 OBTAIN PHYSICIAN ORDER

 INFORMING PATIENTS AND FAMILIES

 PREPARE A FULL MEDICAL REPORT

 SEND TO RECEIVING FACILIT Y AND
  GET ACCEPTANCE FAX
 ARRANGE THE T YPE OF
  TRANSPORTATION THAT MATCH THE
  PATIENT NEEDS
Acc chapter presentation for JCI awarness week
 DIAGNOSIS
 REASON FOR TRANSFER

 PHYSICAL STATE OF THE PATIENTS

 SUMMARY OF THE CARE GIVEN

 MEDICATIONS RECEIVED
Acc chapter presentation for JCI awarness week
DETECTED AND ORDERED
     BY ATTENDING
       PHYSICIAN
Acc chapter presentation for JCI awarness week
THE STAFF MUST BE ACLS
 /NALS/PALS CERTIFIED
Acc chapter presentation for JCI awarness week
   OBTAIN A WRITTEN ORDER
   INFORM THE NURSING SUPERVISOR ON
    DUT Y;
   NOTIFY ER DOCTORS TO ARRANGE
    AMBULANCE AND NOTIFY ER AND CHARGE
    NURSE TO ARRANGE EMERGENCY
    EQUIPMENT, EMERGENCY MEDICAL BAG
    AMBULANCE CONTENTS;
   CALL THE RECEIVING HOSPITAL AND INFORM
    THE CHARGE NURSE / HEAD NURSE THERE.
   ENSURE ALL RELEVANT DOCUMENTS AND
    EQUIPMENT ARE AVAILABLE AND
    FUNCTIONING.
   INFORM THE SOCIAL WORKER TO NOTIFY
    THE FAMILY SPONSOR REGARDING
    TRANSFER IF THEY ARE NOT AWARE;
   AFTER COMPLETE DOCUMENTATION SENT
    THE FILE FOR BILLING AND CLEARANCE.
Acc chapter presentation for JCI awarness week
   AMBULANCE WITH ALL SET-UP;
   CARDIAC MONITOR WITH DEFIBRILLATOR;
   EXTERNAL PACEMAKER IF PATIENT IS CARDIAC;
   PORTABLE VENTILATOR;
   OXYGEN CYLINDER;
   SUCTION EQUIPMENT;
   EMERGENCY MEDICINES;
   INTUBATIONS EQUIPMENT;
   IF PATIENT IS TRANSFERRING TO ANOTHER COUNTRY
    PASSPORT OF PATIENT AND THE ESCORT;
   TRANSFER FORM (PHYSICIAN, NURSE & RT);
   COPIES OF ALL RESULTS, IF NEEDED;
   LIST OF MEDICINE PATIENT IS TAKING;
   ACCEPTANCE LETTER;
   AMBULANCE FORM;
   PLEASE SEE THE ATTACHMENT FORM FOR TRANSFER;
   LIST OF SOME REFERRAL CENTERS.
Acc chapter presentation for JCI awarness week
 MEDICALLY- ADVISED        DISCHARGE is when
  the attending clinician considers that the patient
  no longer requires in-patient care and
  documents this in the patient’s medical record
 TRANFER TO OTHER FACILIT Y.
 DISCHARGE AGAINST MEDICAL ADVICE
  (DAMA DISCHARGE) includes one or both of
  the following:
    The  patient requests discharge and refuses
     further in-patient care
    The patient refuses to follow/accept the
     treatment plan recommended by the attending
     clinician.
Acc chapter presentation for JCI awarness week
   Date/time the patient is to be discharged;
   Convalescent period, if appropriate;
   Work restrictions, if appropriate;
   Follow-up/out-patient treatment required;
   Medications to take home, if appropriate;
   Instructions given to the patient, if any;
   Dietar y restrictions or requirements;
   Date of follow-up in the clinic;
   Discharge diagnosis;
   Reason for admission/treatment
   Pertinent physical, laboratory and x-ray findings;
   Condition on discharge;
   Transpor tation Needs
   Recommendations
Acc chapter presentation for JCI awarness week
 To minimize inappropriate use of hospital
  resources;
 To identify and use cost-effective care sites
  when clinically appropriate;
 To prevent unnecessary admission

 To avoid re-admission caused by incomplete
  course of treatment, or resource gaps.
Acc chapter presentation for JCI awarness week
 ATTENDING PHYSICIAN
 REGISTERED NURSE

 PHARMACIST

 SOCIAL WORKERS

 REHABILITATION UNITS INDIVIDUALS

 PAIN SPECIALIST NURSE

 RESPIRATORY THERAPIST NURSE

 PATIENT TEACHING CENTRE
Acc chapter presentation for JCI awarness week
   WHEN BEING PHYSICALLY OUT OF THE
    HOSPITAL
Acc chapter presentation for JCI awarness week
SOCIAL  SERVICES FOR SOCIAL NEEDS,
FOR MORE SPECIFIC EDUCATIONAL NEEDS THE
 PATIENT AND FAMILY MAY BE REFERRED TO
 THE PATIENT TEACHING CENTER;
PHARMACISTS FOR MEDICATION
 INSTRUCTIONS;
REHABILITATION UNIT (PHYSIOTHERAPIST,
 OCCUPATIONAL THERAPIST + ORTHOTIST) FOR
 DIFFICULT Y IN MANAGING ACTIVITIES OF DAILY
 LIVING;
DIETICIAN FOR DIETARY INSTRUCTION AND
 CONSULT;
PAIN SPECIALIST NURSE FOR EVALUATION AND
Acc chapter presentation for JCI awarness week
 NEXT OF KIN MUST BE INFORMED
 TREATING PHYSICIAN IS RESPONSIBLE
  TO INFORM THE PATIENT ABOUT ANY
  KNOWN LONG DELAY IN DIAGNOSTIC
  AND/OR TREATMENT SERVICES
 AVAILABLE ALTERNATIVES MUST BE
  EXPAINED
 UPON EXPLANATION AND ACCEPTANCE
  OF THIS DELAY THE PATIENT WILL SIGN
  THE DELAY OF CARE NOTIFICATION
  FORM INDICATING HIS NOTIFICATION
  AND APPROVAL
Acc chapter presentation for JCI awarness week
 Legal Guardian;
 Husband;

 Father;

 Oldest other male relative;

 Mother;

 Oldest other female relative
Acc chapter presentation for JCI awarness week
   Is a core clinical activity and is
    fundamental to patient care, best
    practice and clinical governance which
    can be informed or implied. Patients
    have a fundamental legal and ethical
    right to determine what happen to their
    own bodies; therefore valid consent to
    treatment is central in all forms of
    health care.
   19. WHAT IS THE IMPLIED CONSENT?
 In emergent condition when the
  conditions require alleviation of severe
  pain or immediate diagnosis and
  treatment of unforeseeable medical
  condition, which if not immediately
  treated, would lead to serious disability
  or death.
 The consent is only for the time frame
  of the emergency;
Acc chapter presentation for JCI awarness week
   30 DAYS UNLESS OTHERWISE
    MENTIONED
Acc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness week
 The patient’s condition,
 assessment of patient understanding;
 The type of anesthesia proposed;
 A description of the proposed treatment or procedure
 acceptance of the inter vention by the patient;
 The potential benefits
 The potential drawbacks
 Risk arising from the proposed procedure and anesthesia;
 The potential for death or serious harm;
 The risk arising from the patient’s condition;
 The possible results of the patient declining the
  recommended treatment
 The likelihood of success
 Reasonable alternatives
 The identity of the physician
23.  WHAT ARE Guidelines
 for intra hospital
 transpor t: -
 Stable patient with IV line only – staf f to be
  determined by head nurse or charge nurse in
  consultation with physician
 Stable Patient with Ar terial Line only – RN;

 Patient on Ventilator – RN, ICU Specialist, RT;

 Patient with VasoActive Infusion – RN / ICU
  Specialist;
 Unstable Patient – RN / ICU Specialist / RT;

 Patient with Ar tificial Air way – RN / RT.
Acc chapter presentation for JCI awarness week
   It is palliative care, the shif t from the
    treating the pathological process to the
    patient and emphasis on assessment
    and controlling of symptoms related to
    the disease process or the secondar y to
    the treatments provided as pain,
    nausea and respirator y distress.
Acc chapter presentation for JCI awarness week
 A designating family member/watcher to stay with the patient,
 Food and comfor t measures to be brought in by the family;

 Suppor t of the family (physical, psychologically and spiritually);

 Suppor t of end-of-life concerns, hopes, fears and expectations
  in an open, honest, and culturally sensitive manner,
 consider special wishes of the patients and family are
  suppor ted whenever possible;
 Pain management, comfor t measures

 treatment of primar y and secondar y symptoms related to the
  disease process
 Patients and families shall be given suf ficient information
  needed to par ticipate in decisions about care
 Spiritual Care: According to KSA rules and regulations patients/
  families who so desire may arrange for their spiritual
  representative to visit with the patient and of fer prayers. The
  social worker and or nursing shif t super visor on duty can
  facilitate such visits upon request.
Acc chapter presentation for JCI awarness week
 Maintain all invasive lines;
 IV pumps;

 ET tubes;

 Humidification;

 Foley catheter;

 Dressings;

 Medications;

 Oxygen therapy,

 Cardiac monitoring;

 Vital sign monitoring as ordered and as

  applicable to the patient.
Acc chapter presentation for JCI awarness week
THROUGH ADMISSION OFFICE WHICH

EXPLAIN THE PATIENTS SERVICES AND
    RIGHTS AND RESPONSIBLITIS
Acc chapter presentation for JCI awarness week
   DO NOT SHARE COMPUTER PASSWORD
   DO NOT DISCUSS PATIENTS IN OPEN AREAS
   USE CAUTION WHEN GIVE INFORMATION OVER
    THE PHONE
   SHARE INFORMATIONS ONLY WITH
    APPROPRIATE STAFF
   TEAR UP PAPERS THAT CONTAIN PATIENT
    INFORMATIONS
   DO NOT USE PATIENT NAME WHEN PAGING
   ONLY AUTHORIZED PERSONNEL HAVE THE
    ACCESS TO PATIENTS RECORDS
   ALWAYS CLOSE THE DOORSTO MAITAIN MUCH
    PRIVACY.
Acc chapter presentation for JCI awarness week
VERIFY   THAT THE PATIENT HAS EVERY
INFORMATION NEEDED REGARDING THE
              PROCEDURE
  IF THE PATIENT HAS QUESTIONS WE
   MUST HOLD THE PROCEDURE TILL
       ANSWERING ALL INQUIRIES
Acc chapter presentation for JCI awarness week
 PPG

 ICU   18
Acc chapter presentation for JCI awarness week
ONLY  HEALTH CARE
PROFFESIONALS AND PATIENT
   AND SELECTED FAMILY
        MEMBERS
Acc chapter presentation for JCI awarness week
 CLARIFY THE NATURE OF COMPLAIN
 CALL SUPERVISOR OR DEPARTMENT
  HEAD
 INVESTIGATE AND ANALYZE THE
  SITUATION
 INFORM SOCIAL WORKER AND P.I.

 INTERVENTION OCCURED WITHIN
  48 HOURS
Acc chapter presentation for JCI awarness week
 ASSESSTHIER DESIRE FOR
SUCH SERVICES AND INFORM
SOCIAL WORKERS TO DISCUSS
     WITH THE PATIENT
Acc chapter presentation for JCI awarness week
PATIENTASKED ABOUT PAIN
   LEVEL, LOCATION AND
      DESCRIPTION.

USE   PAIN TOOL TO MEASURE
       THE PAIN INTENSIT Y
Acc chapter presentation for JCI awarness week
 FACIAL PAIN INTENSIT Y
 COLOURED ANALOGUE SCALE

 NUMERIC RATING SCALE

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Acc chapter presentation for JCI awarness week

  • 2. Area where people requiring urgent and regular treatment beyond regular duty hours receive medical treatment care; Is staf fed by emergency room physicians and nurses 24 hours day all year long
  • 4. The pre-admission screening process includes:  A full history and full physical examination;  Nursing assessment;  Diagnostic testing (as per patient’s condition).
  • 7.  RIGHT FOR TREATMENT  RIGHT FOR INFORMED CONSENT  RIGHT FOR GET PRIVACY  CONFIDENTIALIT Y  INVOLVEMENT IN CARE DECISIONS  ACCESS TO PROTECTIVE SERVICES  RESPONSIBLE ABOUT GIVING CLAER INFORMATIONS AND FOLLOWING ORDERS
  • 9.  WHEN SERVICE ISNOT AVAILABLE IN MOUWASAT HOSPITAL  OBTAIN PHYSICIAN ORDER  INFORMING PATIENTS AND FAMILIES  PREPARE A FULL MEDICAL REPORT  SEND TO RECEIVING FACILIT Y AND GET ACCEPTANCE FAX  ARRANGE THE T YPE OF TRANSPORTATION THAT MATCH THE PATIENT NEEDS
  • 11.  DIAGNOSIS  REASON FOR TRANSFER  PHYSICAL STATE OF THE PATIENTS  SUMMARY OF THE CARE GIVEN  MEDICATIONS RECEIVED
  • 13. DETECTED AND ORDERED BY ATTENDING PHYSICIAN
  • 15. THE STAFF MUST BE ACLS /NALS/PALS CERTIFIED
  • 17. OBTAIN A WRITTEN ORDER  INFORM THE NURSING SUPERVISOR ON DUT Y;  NOTIFY ER DOCTORS TO ARRANGE AMBULANCE AND NOTIFY ER AND CHARGE NURSE TO ARRANGE EMERGENCY EQUIPMENT, EMERGENCY MEDICAL BAG AMBULANCE CONTENTS;  CALL THE RECEIVING HOSPITAL AND INFORM THE CHARGE NURSE / HEAD NURSE THERE.  ENSURE ALL RELEVANT DOCUMENTS AND EQUIPMENT ARE AVAILABLE AND FUNCTIONING.  INFORM THE SOCIAL WORKER TO NOTIFY THE FAMILY SPONSOR REGARDING TRANSFER IF THEY ARE NOT AWARE;  AFTER COMPLETE DOCUMENTATION SENT THE FILE FOR BILLING AND CLEARANCE.
  • 19. AMBULANCE WITH ALL SET-UP;  CARDIAC MONITOR WITH DEFIBRILLATOR;  EXTERNAL PACEMAKER IF PATIENT IS CARDIAC;  PORTABLE VENTILATOR;  OXYGEN CYLINDER;  SUCTION EQUIPMENT;  EMERGENCY MEDICINES;  INTUBATIONS EQUIPMENT;  IF PATIENT IS TRANSFERRING TO ANOTHER COUNTRY PASSPORT OF PATIENT AND THE ESCORT;  TRANSFER FORM (PHYSICIAN, NURSE & RT);  COPIES OF ALL RESULTS, IF NEEDED;  LIST OF MEDICINE PATIENT IS TAKING;  ACCEPTANCE LETTER;  AMBULANCE FORM;  PLEASE SEE THE ATTACHMENT FORM FOR TRANSFER;  LIST OF SOME REFERRAL CENTERS.
  • 21.  MEDICALLY- ADVISED DISCHARGE is when the attending clinician considers that the patient no longer requires in-patient care and documents this in the patient’s medical record  TRANFER TO OTHER FACILIT Y.  DISCHARGE AGAINST MEDICAL ADVICE (DAMA DISCHARGE) includes one or both of the following:  The patient requests discharge and refuses further in-patient care  The patient refuses to follow/accept the treatment plan recommended by the attending clinician.
  • 23. Date/time the patient is to be discharged;  Convalescent period, if appropriate;  Work restrictions, if appropriate;  Follow-up/out-patient treatment required;  Medications to take home, if appropriate;  Instructions given to the patient, if any;  Dietar y restrictions or requirements;  Date of follow-up in the clinic;  Discharge diagnosis;  Reason for admission/treatment  Pertinent physical, laboratory and x-ray findings;  Condition on discharge;  Transpor tation Needs  Recommendations
  • 25.  To minimize inappropriate use of hospital resources;  To identify and use cost-effective care sites when clinically appropriate;  To prevent unnecessary admission  To avoid re-admission caused by incomplete course of treatment, or resource gaps.
  • 27.  ATTENDING PHYSICIAN  REGISTERED NURSE  PHARMACIST  SOCIAL WORKERS  REHABILITATION UNITS INDIVIDUALS  PAIN SPECIALIST NURSE  RESPIRATORY THERAPIST NURSE  PATIENT TEACHING CENTRE
  • 29. WHEN BEING PHYSICALLY OUT OF THE HOSPITAL
  • 31. SOCIAL SERVICES FOR SOCIAL NEEDS, FOR MORE SPECIFIC EDUCATIONAL NEEDS THE PATIENT AND FAMILY MAY BE REFERRED TO THE PATIENT TEACHING CENTER; PHARMACISTS FOR MEDICATION INSTRUCTIONS; REHABILITATION UNIT (PHYSIOTHERAPIST, OCCUPATIONAL THERAPIST + ORTHOTIST) FOR DIFFICULT Y IN MANAGING ACTIVITIES OF DAILY LIVING; DIETICIAN FOR DIETARY INSTRUCTION AND CONSULT; PAIN SPECIALIST NURSE FOR EVALUATION AND
  • 33.  NEXT OF KIN MUST BE INFORMED  TREATING PHYSICIAN IS RESPONSIBLE TO INFORM THE PATIENT ABOUT ANY KNOWN LONG DELAY IN DIAGNOSTIC AND/OR TREATMENT SERVICES  AVAILABLE ALTERNATIVES MUST BE EXPAINED  UPON EXPLANATION AND ACCEPTANCE OF THIS DELAY THE PATIENT WILL SIGN THE DELAY OF CARE NOTIFICATION FORM INDICATING HIS NOTIFICATION AND APPROVAL
  • 35.  Legal Guardian;  Husband;  Father;  Oldest other male relative;  Mother;  Oldest other female relative
  • 37. Is a core clinical activity and is fundamental to patient care, best practice and clinical governance which can be informed or implied. Patients have a fundamental legal and ethical right to determine what happen to their own bodies; therefore valid consent to treatment is central in all forms of health care.
  • 38. 19. WHAT IS THE IMPLIED CONSENT?
  • 39.  In emergent condition when the conditions require alleviation of severe pain or immediate diagnosis and treatment of unforeseeable medical condition, which if not immediately treated, would lead to serious disability or death.  The consent is only for the time frame of the emergency;
  • 41. 30 DAYS UNLESS OTHERWISE MENTIONED
  • 44.  The patient’s condition,  assessment of patient understanding;  The type of anesthesia proposed;  A description of the proposed treatment or procedure  acceptance of the inter vention by the patient;  The potential benefits  The potential drawbacks  Risk arising from the proposed procedure and anesthesia;  The potential for death or serious harm;  The risk arising from the patient’s condition;  The possible results of the patient declining the recommended treatment  The likelihood of success  Reasonable alternatives  The identity of the physician
  • 45. 23. WHAT ARE Guidelines for intra hospital transpor t: -
  • 46.  Stable patient with IV line only – staf f to be determined by head nurse or charge nurse in consultation with physician  Stable Patient with Ar terial Line only – RN;  Patient on Ventilator – RN, ICU Specialist, RT;  Patient with VasoActive Infusion – RN / ICU Specialist;  Unstable Patient – RN / ICU Specialist / RT;  Patient with Ar tificial Air way – RN / RT.
  • 48. It is palliative care, the shif t from the treating the pathological process to the patient and emphasis on assessment and controlling of symptoms related to the disease process or the secondar y to the treatments provided as pain, nausea and respirator y distress.
  • 50.  A designating family member/watcher to stay with the patient,  Food and comfor t measures to be brought in by the family;  Suppor t of the family (physical, psychologically and spiritually);  Suppor t of end-of-life concerns, hopes, fears and expectations in an open, honest, and culturally sensitive manner,  consider special wishes of the patients and family are suppor ted whenever possible;  Pain management, comfor t measures  treatment of primar y and secondar y symptoms related to the disease process  Patients and families shall be given suf ficient information needed to par ticipate in decisions about care  Spiritual Care: According to KSA rules and regulations patients/ families who so desire may arrange for their spiritual representative to visit with the patient and of fer prayers. The social worker and or nursing shif t super visor on duty can facilitate such visits upon request.
  • 52.  Maintain all invasive lines;  IV pumps;  ET tubes;  Humidification;  Foley catheter;  Dressings;  Medications;  Oxygen therapy,  Cardiac monitoring;  Vital sign monitoring as ordered and as applicable to the patient.
  • 54. THROUGH ADMISSION OFFICE WHICH  EXPLAIN THE PATIENTS SERVICES AND RIGHTS AND RESPONSIBLITIS
  • 56. DO NOT SHARE COMPUTER PASSWORD  DO NOT DISCUSS PATIENTS IN OPEN AREAS  USE CAUTION WHEN GIVE INFORMATION OVER THE PHONE  SHARE INFORMATIONS ONLY WITH APPROPRIATE STAFF  TEAR UP PAPERS THAT CONTAIN PATIENT INFORMATIONS  DO NOT USE PATIENT NAME WHEN PAGING  ONLY AUTHORIZED PERSONNEL HAVE THE ACCESS TO PATIENTS RECORDS  ALWAYS CLOSE THE DOORSTO MAITAIN MUCH PRIVACY.
  • 58. VERIFY THAT THE PATIENT HAS EVERY INFORMATION NEEDED REGARDING THE PROCEDURE IF THE PATIENT HAS QUESTIONS WE MUST HOLD THE PROCEDURE TILL ANSWERING ALL INQUIRIES
  • 62. ONLY HEALTH CARE PROFFESIONALS AND PATIENT AND SELECTED FAMILY MEMBERS
  • 64.  CLARIFY THE NATURE OF COMPLAIN  CALL SUPERVISOR OR DEPARTMENT HEAD  INVESTIGATE AND ANALYZE THE SITUATION  INFORM SOCIAL WORKER AND P.I.  INTERVENTION OCCURED WITHIN 48 HOURS
  • 66.  ASSESSTHIER DESIRE FOR SUCH SERVICES AND INFORM SOCIAL WORKERS TO DISCUSS WITH THE PATIENT
  • 68. PATIENTASKED ABOUT PAIN LEVEL, LOCATION AND DESCRIPTION. USE PAIN TOOL TO MEASURE THE PAIN INTENSIT Y
  • 70.  FACIAL PAIN INTENSIT Y  COLOURED ANALOGUE SCALE  NUMERIC RATING SCALE