Area where people requiring urgent and regular treatment beyond

regular duty hours receive medical treatment care; Is staffed by

emergency room physicians and nurses 24 hours day all year long

The pre-admission screening process includes:

A full history and full physical examination;

Nursing assessment; Diagnostic testing (as per patient’s

condition).

RIGHT FOR TREATMENT RIGHT FOR INFORMED CONSENT RIGHT FOR GET PRIVACY CONFIDENTIALITY INVOLVEMENT IN CARE DECISIONS ACCESS TO PROTECTIVE SERVICES RESPONSIBLE ABOUT GIVING

CLAER INFORMATIONS AND FOLLOWING ORDERS

WHEN SERVICE ISNOT AVAILABLE IN MOUWASAT HOSPITAL

OBTAIN PHYSICIAN ORDER INFORMING PATIENTS AND

FAMILIES PREPARE A FULL MEDICAL REPORT SEND TO RECEIVING FACILITY AND

GET ACCEPTANCE FAX ARRANGE THE TYPE OF

TRANSPORTATION THAT MATCH THE PATIENT NEEDS

DIAGNOSIS REASON FOR TRANSFER PHYSICAL STATE OF THE PATIENTS SUMMARY OF THE CARE GIVEN MEDICATIONS RECEIVED

DETECTED AND ORDERED BY ATTENDING PHYSICIAN

THE STAFF MUST BE ACLS /NALS/PALS

CERTIFIED

OBTAIN A WRITTEN ORDER INFORM THE NURSING SUPERVISOR ON

DUTY; 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.

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.

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 FACILITY. 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.

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; Dietary 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; Transportation Needs Recommendations

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.

ATTENDING PHYSICIAN REGISTERED NURSE PHARMACIST SOCIAL WORKERS REHABILITATION UNITS

INDIVIDUALS PAIN SPECIALIST NURSE RESPIRATORY THERAPIST NURSE PATIENT TEACHING CENTRE

WHEN BEING PHYSICALLY OUT OF THE HOSPITAL

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 DIFFICULTY IN MANAGING ACTIVITIES OF DAILY LIVING;

DIETICIAN FOR DIETARY INSTRUCTION AND CONSULT;

PAIN SPECIALIST NURSE FOR EVALUATION AND INSTRUCTION;

RESPIRATORY CARE SERVICES FOR EXTENDED RESPIRATORY NEEDS.

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

Legal Guardian; Husband; Father; Oldest other male relative; Mother; Oldest other female relative

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;

30 DAYS UNLESS OTHERWISE MENTIONED

The patient’s condition, assessment of patient understanding; The type of anesthesia proposed; A description of the proposed treatment or procedure acceptance of the intervention 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 transport: -

Stable patient with IV line only – staff to be determined by head nurse or charge nurse in consultation with physician

Stable Patient with Arterial 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 Artificial Airway – RN / RT.

It is palliative care, the shift from the treating the pathological process to the patient and emphasis on assessment and controlling of symptoms related to the disease process or the secondary to the treatments provided as pain, nausea and respiratory distress.

A designating family member/watcher to stay with the patient, Food and comfort measures to be brought in by the family; Support of the family (physical, psychologically and

spiritually); Support 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

supported whenever possible; Pain management, comfort measures treatment of primary and secondary symptoms related to the

disease process Patients and families shall be given sufficient information

needed to participate 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 offer prayers. The social worker and or nursing shift supervisor on duty can facilitate such visits upon request.

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.

THROUGH ADMISSION OFFICE WHICH EXPLAIN THE PATIENTS

SERVICES AND RIGHTS AND RESPONSIBLITIS

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.

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

PPG ICU 18

ONLY HEALTH CARE PROFFESIONALS AND

PATIENT AND SELECTED FAMILY MEMBERS

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

ASSESS THIER DESIRE FOR SUCH SERVICES AND

INFORM SOCIAL WORKERS TO DISCUSS WITH THE

PATIENT

PATIENT ASKED ABOUT PAIN LEVEL, LOCATION

AND DESCRIPTION.

USE PAIN TOOL TO MEASURE THE PAIN

INTENSITY

FACIAL PAIN INTENSITY COLOURED ANALOGUE SCALE NUMERIC RATING SCALE