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Discharge from ITU/HDU. Group 3. Introduction…. Consultant decision based on the MEWS score. The patient should only be discharged when system support is not required. Respiratory Cardiovascular Central Nervous System. Pain Fluids Urine output Transferring. Introduction…. Respiration.
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Discharge from ITU/HDU Group 3
Introduction…. • Consultant decision based on the MEWS score. • The patient should only be discharged when system support is not required.
Respiratory Cardiovascular Central Nervous System Pain Fluids Urine output Transferring Introduction….
Respiration • Patient able to maintain airway • Respiratory rate 9-14 breaths per min
Cardiovascular • If the patient is hypertensive, the cause should be identified and treated • Systolic blood pressure 101-199 • Heart rate 51-100
Central Nervous System • This system of the body should be stable • AVPU score should be alert • If patient has a high temperature the cause should be identified and treated
Pain • Pain should be assessed, treated and under control.
Fluid balance • Fluids should be running and a prescription ready if more is needed once transferred • Urine output should be normal unless the patient has been diagnosed with renal impairment
Modified Early Warning Score(MEWS) • MEWS identify patients at risk or who have deteriorating status. This triggers an immediate response through scoring points for abnormal physiological values. • The score should be 3 or less before discharge
Transferring • Personnel - availability adequately skilled staff • Equipment - ensuring equipment is checked and taken in the event of a situation • Distance - patient safety and staff preparation in line with distance • Mode of transfer - most rapid mode • Family - full explanation of transfer
Transferring cont…. • Communication - verbal and written between transferring and receiving areas to be clear, accurate and concise • demographic pt details, problem, condition • pt previous medical and nursing history • treatment given, NOK • vital signs, investigation results • names of medical and nursing staff in charge of transfer and at receiving points
References Sheppard, M., Wright, M. (2003) Principles and practice in High Dependency Nursing. London:Elsevier Limited Subbe, C., Kruger, M., Rutherford, P., Gemmel, L. (2001) Validation of a modified early warning score in medical admissions. QJM: An international journal of medicine. 94, 10, 521-526. Stenhouse, C. and Cunningham, M. (2002) Guidelines for the introduction of outreach services. Intensive Care Society Standards. London: Intensive Care Society