Admissions
Bendigo Hospital ICU is a 'closed unit' meaning admission is decided by the intensivist on duty after discussion with the treating team. Patients are admitted from multiple sources: ED, wards, operating theatres, and direct transfer from other hospitals. They might be elective or emergency admissions. See the ICU Referral and Admission Policy (PROMPT) for more information on what types of patients would be considered for ICU and how to facilitate admission into the unit. Also, refer to the ICU Junior Doctor Orientation Manual, and below in 'Routine Care', for a guide on the details expected on clerking admissions and progress notes.
Guideline to Surgical Admissions - including planning elective admissions
Even if the ICU is full DISCUSS THE PATIENT WITH THE INTENSIVIST as consideration of transfer of other patients may still be considered to facilitate admission to Bendigo ICU. However:
- In general, the ACCESS nurse is not to be used to care for patients referred from ED or OR. These patients must either be transferred to another hospital, the ward or be admitted once a bed has been made available.
- For patients already on the ward requiring emergent ICU transfer, the ACCESS nurse can be utilized to facilitate care of patients in ICU.
Discharges
Once a patient no longer requires intensive medical input, they can be discharged to the ward. Though stable, they may still be very unwell requiring ongoing input from multiple teams. Communication is key! A thorough and accurate discharge summary cannot be overstated, especially after a long and complicated ICU admission. There must also be a medical handover to the parent team. See Intensive Care Unit (ICU) Discharge and Transfer Protocol (PROMPT) for more information on how to facilitate a safe and efficient discharge. All patients discharged from ICU are followed up by the ICU Outreach Consultant and ICU Liaison Nurse team.
All patients MUST be accompanied by an ICU discharge summary when discharged from ICU. Please ensure these are completed in a timely manner. All discharge summaries are checked by the ICU consultants and returned to the ICU junior doctors on duty if corrections need to be made (not necessarily the author who may have finished his/her block of shifts).
Patients that are discharged after-hours must be followed up by the ICU registrar within 4 hours of leaving the ICU.
All patients MUST be accompanied by an ICU discharge summary when discharged from ICU. Please ensure these are completed in a timely manner. All discharge summaries are checked by the ICU consultants and returned to the ICU junior doctors on duty if corrections need to be made (not necessarily the author who may have finished his/her block of shifts).
Patients that are discharged after-hours must be followed up by the ICU registrar within 4 hours of leaving the ICU.