Harbor:Pediatric admission guidelines - Revision history

Kyoung: clarified protected time

2016-10-02T04:17:06Z

clarified protected time

← Older revision		Revision as of 04:17, 2 October 2016
Line 23:		Line 23:
	==Contacting the admitting resident==		==Contacting the admitting resident==
	*Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)		*Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)
	*Protected time		*Protected time for ward admissions
	**Weekdays 6:45am-7:30am		**Weekdays 6:45am-7:30am
	**Weekends 7:45am-8:30am		**Weekends 7:45am-8:30am
			***From 7am to 7:45am call the admitting resident from the night before
	**All evenings 7pm-7:30pm		**All evenings 7pm-7:30pm
	*For ward and step-down		*For ward and step-down
	**Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)		**Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)
	**Mon-Fri 7p-7a: Pediatrics PM Ward Senior		**Mon-Fri 7p-7a: Pediatrics PM Ward Senior
	***Note: mn-7a: look at the previous day's shifts (not the column in yellow)		***Note: mn-7a: look at the previous day's shifts (not the column in yellow on MedHub)
	**Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident (see note above)		**Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident (see note above)
	**If unsure, can call Peds ward at x2333 to ask for admitting resident		**If unsure, can call Peds ward at x2333 to ask for admitting resident
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	**Mon-Fri 7p-7a: Pediatrics PM PICU (see note below)		**Mon-Fri 7p-7a: Pediatrics PM PICU (see note below)
	**Sat-Sun 24 hours: Pediatrics PM PICU		**Sat-Sun 24 hours: Pediatrics PM PICU
	***Note: mn-7a: look at the previous day's shifts (not the column in yellow)		***Note: mn-7a: look at the previous day's shifts (not the column in yellow on MedHub)
	**If unsure, can call PICU at x2480 to ask for admitting resident		**If unsure, can call PICU at x2480 to ask for admitting resident
	*If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub		*If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub

Kyoung: added decisions re: pregnant patients

2016-10-02T04:14:23Z

added decisions re: pregnant patients

← Older revision		Revision as of 04:14, 2 October 2016
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	***For trauma patients, location of admission for 18-21 year old patients is at the discretion of the trauma attending		***For trauma patients, location of admission for 18-21 year old patients is at the discretion of the trauma attending
	***If another service besides trauma is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting		***If another service besides trauma is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting
			***Pregnant patients < 18 years old with a pre-viable infant should be admitted (eg for hyperemesis) to pediatrics with an OB consult
			***Pregnant patients 18 years old and older to be admitted with an OB condition and all pregnant patients with a viable infant should be admitted to OB
			****Pregnant patients requiring ICU level care should be discussed with the critical care attending
	**Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery		**Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery
	***Discuss with admitting nursery (x2311) or NICU (x2340) resident		***Discuss with admitting nursery (x2311) or NICU (x2340) resident

Rossdonaldson1 at 04:25, 25 September 2016

2016-09-25T04:25:55Z

← Older revision		Revision as of 04:25, 25 September 2016
Line 46:		Line 46:
	**Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED		**Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED
	*For any delays in patient going upstairs, have nursing contact Patient Flow		*For any delays in patient going upstairs, have nursing contact Patient Flow

			[[Category:Admin]]

Kyoung: add mn-7a look at previous column on medhub

2016-08-29T09:02:48Z

add mn-7a look at previous column on medhub

← Older revision		Revision as of 09:02, 29 August 2016
Line 27:		Line 27:
	**Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)		**Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)
	**Mon-Fri 7p-7a: Pediatrics PM Ward Senior		**Mon-Fri 7p-7a: Pediatrics PM Ward Senior
	**Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident		***Note: mn-7a: look at the previous day's shifts (not the column in yellow)
			**Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident (see note above)
	**If unsure, can call Peds ward at x2333 to ask for admitting resident		**If unsure, can call Peds ward at x2333 to ask for admitting resident
	*For PICU		*For PICU
	**Mon-Fri 7a-7p: Pediatrics PICU		**Mon-Fri 7a-7p: Pediatrics PICU
	**Mon-Fri 7p-7a: Pediatrics PM PICU		**Mon-Fri 7p-7a: Pediatrics PM PICU (see note below)
	**Sat-Sun 24 hours: Pediatrics PM PICU		**Sat-Sun 24 hours: Pediatrics PM PICU
			***Note: mn-7a: look at the previous day's shifts (not the column in yellow)
	**If unsure, can call PICU at x2480 to ask for admitting resident		**If unsure, can call PICU at x2480 to ask for admitting resident
	*If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub		*If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub

Kyoung: refined policy re 18-21yo

2016-08-23T17:31:26Z

refined policy re 18-21yo

← Older revision		Revision as of 17:31, 23 August 2016
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	*Patient age		*Patient age
	**Pediatric ward and PICU admit patients up to age 21 years and 364 days old		**Pediatric ward and PICU admit patients up to age 21 years and 364 days old
	***If another service is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting		***For trauma patients, location of admission for 18-21 year old patients is at the discretion of the trauma attending
			***If another service besides trauma is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting
	**Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery		**Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery
	***Discuss with admitting nursery (x2311) or NICU (x2340) resident		***Discuss with admitting nursery (x2311) or NICU (x2340) resident

Rossdonaldson1 at 02:26, 15 August 2016

2016-08-15T02:26:20Z

← Older revision		Revision as of 02:26, 15 August 2016
Line 1:		Line 1:
			==Admitting guideance and rules==
	*Patient age		*Patient age
	**Pediatric ward and PICU admit patients up to age 21 years and 364 days old		**Pediatric ward and PICU admit patients up to age 21 years and 364 days old
Line 15:		Line 16:
	*Peds does not have isolation areas, so if patient needs isolation (eg active TB, meningococcemia, measles, varicella), discuss with admitting resident		*Peds does not have isolation areas, so if patient needs isolation (eg active TB, meningococcemia, measles, varicella), discuss with admitting resident
	**Patient may need to be admitted to an adult area and followed by peds, or transferred		**Patient may need to be admitted to an adult area and followed by peds, or transferred
	*Contacting admitting resident
	**Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)		==Contacting the admitting resident==
	**Protected time		*Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)
	***Weekdays 6:45am-7:30am		*Protected time
	***Weekends 7:45am-8:30am		**Weekdays 6:45am-7:30am
	***All evenings 7pm-7:30pm		**Weekends 7:45am-8:30am
	**For ward and step-down		**All evenings 7pm-7:30pm
	***Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)		*For ward and step-down
	***Mon-Fri 7p-7a: Pediatrics PM Ward Senior		**Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)
	***Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident		**Mon-Fri 7p-7a: Pediatrics PM Ward Senior
	***If unsure, can call Peds ward at x2333 to ask for admitting resident		**Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident
	**For PICU		**If unsure, can call Peds ward at x2333 to ask for admitting resident
	***Mon-Fri 7a-7p: Pediatrics PICU		*For PICU
	***Mon-Fri 7p-7a: Pediatrics PM PICU		**Mon-Fri 7a-7p: Pediatrics PICU
	***Sat-Sun 24 hours: Pediatrics PM PICU		**Mon-Fri 7p-7a: Pediatrics PM PICU
	***If unsure, can call PICU at x2480 to ask for admitting resident		**Sat-Sun 24 hours: Pediatrics PM PICU
	**If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub		**If unsure, can call PICU at x2480 to ask for admitting resident
			*If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub

	==After admission==		==After admission==

Rossdonaldson1 at 02:25, 15 August 2016

2016-08-15T02:25:28Z

← Older revision		Revision as of 02:25, 15 August 2016
Line 32:		Line 32:
	***If unsure, can call PICU at x2480 to ask for admitting resident		***If unsure, can call PICU at x2480 to ask for admitting resident
	**If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub		**If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub
	*After admission
	**Once the ED staff puts in a "Request for Admit" order, the pediatrics team is managing the patient		==After admission==
	***ED staff should have all ED orders in and completed prior to putting in Request for Admit		*Once the ED staff puts in a "Request for Admit" order, the pediatrics team is managing the patient
	****Make sure nursing has had a chance to complete ED orders prior to putting in Request for Admit		**ED staff should have all ED orders in and completed prior to putting in Request for Admit
	**As part of their admission orders, pediatric residents may order additional labs, imaging, etc.		***Make sure nursing has had a chance to complete ED orders prior to putting in Request for Admit
	***These do NOT need to be done in the ED prior to the patient going upstairs		*As part of their admission orders, pediatric residents may order additional labs, imaging, etc.
	***Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED		**These do NOT need to be done in the ED prior to the patient going upstairs
	**For any delays in patient going upstairs, have nursing contact Patient Flow		**Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED
			*For any delays in patient going upstairs, have nursing contact Patient Flow

Kyoung: Moved content to linked page

2016-08-13T21:04:49Z

Moved content to linked page

New page

*Patient age
**Pediatric ward and PICU admit patients up to age 21 years and 364 days old
***If another service is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting
**Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery
***Discuss with admitting nursery (x2311) or NICU (x2340) resident
*ED attendings have admitting privileges
**Admissions will be accepted by pediatric residents regardless
***Pediatric residents, in conjunction with their attending, may evaluate the patient and perform an immediate discharge if they so desire
*ED attendings determine, with admitting resident input, the appropriate location: ward, step-down, PICU
*ED should have done all of the following prior to contacting the admitting resident
**Complete necessary work-up and treatment for stabilization that should occur acutely in the ED
**Make sure with Utilization Review that the patient can be admitted to Harbor
***If the attending says patient is not stable for transfer, then the patient will be admitted
***The Interqual icon does NOT have to be green prior to contacting admitting resident IF ED staff are sure the patient will be admitted to Harbor
*Peds does not have isolation areas, so if patient needs isolation (eg active TB, meningococcemia, measles, varicella), discuss with admitting resident
**Patient may need to be admitted to an adult area and followed by peds, or transferred
*Contacting admitting resident
**Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)
**Protected time
***Weekdays 6:45am-7:30am
***Weekends 7:45am-8:30am
***All evenings 7pm-7:30pm
**For ward and step-down
***Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)
***Mon-Fri 7p-7a: Pediatrics PM Ward Senior
***Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident
***If unsure, can call Peds ward at x2333 to ask for admitting resident
**For PICU
***Mon-Fri 7a-7p: Pediatrics PICU
***Mon-Fri 7p-7a: Pediatrics PM PICU
***Sat-Sun 24 hours: Pediatrics PM PICU
***If unsure, can call PICU at x2480 to ask for admitting resident
**If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub
*After admission
**Once the ED staff puts in a "Request for Admit" order, the pediatrics team is managing the patient
***ED staff should have all ED orders in and completed prior to putting in Request for Admit
****Make sure nursing has had a chance to complete ED orders prior to putting in Request for Admit
**As part of their admission orders, pediatric residents may order additional labs, imaging, etc.
***These do NOT need to be done in the ED prior to the patient going upstairs
***Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED
**For any delays in patient going upstairs, have nursing contact Patient Flow