Peninsula Health

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About Peninsula Health

<PH>

 

Frankston Hospital

-  Hastings Rd

-  PO Box 52

-  Frankston VIC 3199

-  (03) 9784 7777

 

CREATOR: gd-jpeg v1.0 (using IJG JPEG v62), quality = 70

 

-  Major provider of acute secondary & tertiary hospital services on Mornington Peninsula

-  336 beds

-  General & speciality medical & surgical services

-  Surgical Units

-  Maternity, mental health & paedatric services

 

Wonthaggi Hospital

-  Graham St

-  Wonthaggi VIC

-  Part of Bass Coast Regional Health & GetGP RTP

-  53 acute beds

-  No ICU or HDU

-  Paeds, gynae, Sx & Med

-  6 bay ED

 

 

 

Admin

<PH>

 

D/C Sum ---- Scripts ---- Consults

 

Med Record ---- Admissions

 

Ward Lists ---- Requests

 

Death

 

Med Charts --- New Ward

 

Work Cover

 

 

 

Discharge Summaries

<Up>

 

Features

-  Summary of pts admission

-  Written for LMO = handover to GP

-  +/- consultant for F/U in out-pt

-  Info for next admission

-  Start as soon as practical

-  Completed for within 24hrs of D/C

-  Every pt

-  Discharged

-  Death

-  D/C against medical advice

-  Absconding

-  If not done HIS places file in Drs box

-  Michelle 8595

-  HIS on level 2

-  Access PCs 0700-1630 Mon-Fri & 0700-1500 weekends

-  Regular reporting to Clinical Directors

-  Check HIS each week for D/C

-  Email sent periodically (Mon) to alert

 

Procedure

-  Concerto

-  Open pt record --> Doors in top right menu

-  Ensure correct pt

-  Check correct recipients

-  Ensure fax number & or postal address

-  Search as needed

-  Select template

-  Medications

-  PETS if possible for script

-  Add allergies

-  Double check meds before ordering

-  Print script on PBS paper

-  Sign all D/C summaries

 

Content

-  Add Ix as relevant

-  Most recent, relevant

-  F/U plan

-  Typically w LMO

-  +/- out-pt clinic

-  In-pt Consults & recommendations

-  Medication changes & why

-  Presenting S/S

-  Include Obs & PE

 

 

Consults

<Up>

 

Prepare

-  Have pt notes, med chart, recent results

-  Know

-  Why consult?

-  What consult usual tests are?

-  Sell the case

-  Document in the notes

-  Conversation & result

-  Attempt to contact if unsuccessful

 

ISBAR

-  Identify

-  Who talking to

-  Yourself: name, position, location

-  Pt: name, age, sex, location (ward & bed)

-  Situation

-  The reason I am calling is..

-  If urgent say so

-  Background

-  Relevant Hx, Ex, Ix, Mx

-  If urgent: obs, Mx

-  Assessment

-  What is going on

-  Request

-  Id like you to r/v this pt

-  Your opionion on Mx, Ix

-  Help urgently

 

 

Medical Record

<Up>

 

Procedure

-  Correct pt file

-  Legible in black/blue

-  Each page labeled w Bradma

-  Date & time all entries

-  Record

-  Date: dd/mm/yy & time

-  Team: discipline/speciality & members

-  Frequency

-  Acute pts x1 entry/day+

-  Sub-acute pts x1 entry/week+

-  Errors ruled through w single line & signed +/- explanation

-  Dont leave gaps or empty lines

-  Rule though gaps

-  Sign all entries w pager number

-  Student entries countersigned

 

Entries

-  Ward Rounds

-  New Admissions

 

Ward Rounds

<Up>

 

-  Upto date

-  Recent results (folder if applicable)

-  Copies of imaging

-  Consults & recommendations

-  Overnight

-  Nursing input

-  SOAP

-  Subjective

-   Current state

-   HPI +/-

-   New S/S

-  Objective

-  Obs: HR, BP, RR, O2Sat, Temp

-  Team notes

-  Chest +/- abdo

-  Chief complaint related

-  Assessment (Impression)

-  Dx +/- complications

-  Issues

-  Ongoing Mx

-  New onset problems

-  Waiting for consults/Ix

-  Allied health

-  Plan

-  Ix times

-  R/V by ..

-  D/C (or date)

-  Clear plan for nurses/allied health

-  Alert nurses to plan if not in attendance

-  Fill in requests on the go

-  Reg/Consultant to sign CT/MRI slips

-  Record consults & results to chase

 

New Admission

<Up>

 

-  SCN Admission

 

-  Open: x yr old male presents w..

-  HPI w detail: SOCRATES..

-  Known to Dr

-  Recent admissions

-  From home/NH/transfer..

-  Sx Pts

-  Last meal

-  Tetanus if skin injury

-  PMH: w results & dates

-  Sx Pts

-  GA & reactions

-  Meds & Allergies (include reaction)

-  Family & Social Hx

-  Systems R/V

-  DM, AMI, Stroke, HTN, COPD

-  Ex

-  General: distress, unwell..

-  Vitals

-  Systems

-  Comment on analgesia

-  Ix

-  Bloods, X-rays

-  Impression

-  Working Dx

-  2o to if known

-  Note if stable

-  List complications

-  Plan

-  Admit under..

-  Ix

-  Mx

-  R/V & Consults

-  Sx Pts

-   Bloods: G&H

-   Abx: dose, freq

-   Fluids

-   Fast from when

-   For OT?

-  Alert nurses

 

Special Care Nursery (SCN) Admission

-  Indication for admission + age

-  +/- why T/F

-  Maternal Hx

-  Age

-  Gravida, Para

-  Blood group

-  GBS status

-  Immunisations: Hep B/C, HIV, Rubella, Symphilis

-  Previous obstetric Hx

-  PMH

-  Meds, drugs, addictions

-  +/- paternal Hx

-  Pregnancy details

-  Birth details

-  DOB

-  Gestation at birth

-  Exam

-  Weight, length, HC

-  Alertness, gross motor, Moro

-  Movements, spine, fontanelle

-  HR, RR, Temp

-  Murmur

-  Abdo, genitalia, anus patent

-  Dysmorphisms, umbilicus

-  +/- = new born examination

-  Issues

-  Mx

-  Feeds +/- BSLs

-  Ix: SBR

 

 

 

Ward List <Up>

 

Features

-  List of pts under care

-  Use Concerto

-  Select ward or team in search

-  Bottom of page: Printer Friendly..

-  Print .pdf

-  Ensure PBS not selected

-  Keep old lists for next day

-  Highlight jobs not completed

 

 

Requests <Up>

 

Bloods

-  Ensure blood bank tubes are hand written

-  For add ons ring to confirm possibility then fax add on request

 

Imaging

-  Ultrasound requests

-  If faxed --> receptionist adds to next available slot

-  If urgent need to speak to Sonographer

-  CT requests

-  Signed by Reg

-  MRI requests

-  Signed by Consultant

-  Safery questionairre

 

 

 

Patient Death

<Up>

 

-  Pronouncing death

-  Death Certificate

-  Coroners Case

 

Pronouncing Death <Up>

 

Features

-  Certify death

-  Patient may be unknon to you

-  Be aware of coroners cases

 

Procedure

-  Physcially Examine

-  Pupil response: fixed dilated

-  Heart sounds: absent

-  Breath sounds: absent

-  Pulse: absent at carotids

-  Document findings in notes

-  As above

-  Date & time

-  Declared deceased

-  Notify consultant

-  Notify family 

-  D/C summary needs to be done

 

Death Certificate (Non-coroners) <Up>

 

Procedure

-  Certify/pronounce death

-  Green form

-  Cause of death

-  Cannot use cardiac or respiratory arrest

-  Include registraton number

 

Coroners Case <Up>

 

Features

-  Cases which require investigation & autopsy by the coroner

-  Reportable deaths are

-  Unexpected, unnatural or violet deaths

-  Directly or indirectly from an accident or injury

-  Occurred during a medical procedure or following a medical procedure where the death is or may be causally related to the procedure and a registered medical practitioner would not, immediately before the procedure was undertaken, have reasonably expected the death to occur

-  Pt of unknown identity

-  Deaths in custody or care (incl mental health)

-  Patient must be left as is: no tampering

 

Procedure

-  Certify/pronounce death

-  Inform coroners office

-  Medical deposition online

-  www.coronerscourt.vic.gov.au/meddep

-  Print copy for pt file

-  Coroners office informs Police to attend once submitted

-  Family/staff to complete Statement of ID

-  Copy the medical records for hospital as notes will accompany pt to coroners

-  D/C summary needs to be done

 

 

 

Med Charts

<Up>

 

Content

-  When canceling orders

-  Sinus wave through order

-  Sign, date

-  Reason why ceased

-  If opiates PRN anti-emetics

-  Always check allergies prior to writing med

-  Use generic names

-  Preceding 0s but not trailing (0.5, not 5.0)

-  Rewrite orders rather than alter

-  Phone orders

-  Must confirm with second nurse

-  Sign order when possible

 

 

 

New Ward

<Up>

 

- Introduce to staff (record names)

-NUM

-Nurses

-Pharmacists

- Locations of

-Amergency assist buttons

-ALS cart

-Patient notes, bed charts

-Pathology & Imaging forms

-Fax/electronic..

-Access to images

-Other forms: consent..

- Protocols

- Bosses: who, what like, preferences

- Pager numbers

- Computer access

-Passwords

-Programs

-Patient information

-PACS

-Discharge summaries..

-Printer

 

 

 

Work Cover

<Up>

 

-  Injury/illness must be directly linked to work place

-  ED: attendance certificate --> 14/7 modified duties

-  GP: dates as required

-  Illegal to cover under Medicare if work related injury

 

 

 

Communications

<PH>

 

Emergency 444 or A/H 000

 

Paging

Contacts

 

 

 

 

General

-  External line: 0

-  Switch: 99

-  Extensions: last 4 digits

-  Page: 21

-  Prefix: 9784

-  4 digit numbers = extensions

-  3 digit numbers = pager numbers

 

 

 

Paging

<Comms>

 

Features

-  Used for contact throughout hospital

-  Delete all pages prior to starting shift

-  Ensure battery not empty & secure

-  Loss of power = loss of pages

-  Ensure correct time & date

-  Text page gets better results w Regs

 

Procedure

- Alert Page

-  Dial 21

-  Enter pager number --> #

-  Enter extension/pager --> #

-  Wait for confirmation

- Text Page

-  Use ePulse

-  PH Web Pager

-  Pager number

-  Text message

-   Ensure return pager number/extension

 

 

Contacts

<Comms>

 

Emergency 444 or A/H 000

 

 

Medical ---- Surgical ---- A/H

 

Wards ---- Services ---- Fax #s

 

 

 

Medical <Up>

-  GMA: Reg: 454; HMO: 457, 462

-  GMC: Reg: 453; HMO: 258, 455

-  Endo: Reg: 464

-  ID/Rheum: Reg: 182

-  Cardio: Reg: 459/450

-  Neuro: Reg: 386

-  Gastro: Reg: 452

-  Renal: Reg: 257

-  Resp: Reg: 243/469

-  Onc: Reg: 467/259

-  Gynae: Reg:

-  Derm: Dr Heskett (external)

-  Haem: Dr Catalano (external)

 

Surgical <Up>

-  Surgical Units

-  GS1 (Up GI): Reg 471; HMO 475

-  GS2 (Colorec): Reg 473; HMO 476

-  GS3 (Breast, Endo): Reg 474; HMO 477

-  Vascular: Reg 301, 302; HMO 347

-  Plastics: Reg 443; HMO 380, 236

-  Uro: Reg 296; HMO

-  ENT: Reg 312

-  Ortho: Reg 472, 340, 468; HMO 175

-  Paeds: Reg 295; HMO 461

 

A/H <Up>

-  Med Reg: 7482

-  Med Night HMO > 2200hrs: 390

-  Med pm Intern 1600-2200: 455 (G), 462 (F)

-  Level 3 Intern: 178

-  Sx Reg: 396

-  Sx pm HMO: 247, 248

-  Sx Night Intern: 412

 

Wards <Up>

-  Level 3

-  ED:

-  AOW: 8274/5/6/7

-  SSU: 7254

-  Level 4

-  4GS: 7748, 8504, 7240, 7271

-  4GN: 7272, 7280, 7748, 7313

-  Paeds: 7460

-  Level 5

-  5FS: 8531, 7676

-  5FS – CCU: 7676, 7430

-  5FN: 8201/2/5/6

-  5GS: 7532, 7351

-  5GN: 7360, 7391

 

Services <Up>

-  Switch: 99

-  Page: 21

-  Rad: 7501

-  MRI: 7524

-  CT: 7518

-  Path: 7555

-  Spec Reception:  7477

-  Cath/Neuro Lab: 7050

-  Pharm: 7602

-  PETS: 8548

-  iGuide: 645

-  IT Help: 7815

 

Fax #s <Up>

-  Prefix for FH 9784..

-  Rad: 7644

-  Path: 9781 2884

-  Endoscopy: 7331

-  Cath/Neuro Lab: 7479

-  Wards

-  5FS: 7027

-  SAAS/Del: 7729

-  Psych

-  Neuro Psych: 7613

-  CL Psych: 7192