Integrated Care Pathway

Transcription

1 APPENDIX 3 CHILDRENS Failure to Thrive Integrated Care Pathway PATIENT DETAILS NAME Age Hospital number NHS No Address Tel no Patient likes to be known as Next of Kin Relationship to child Tel No Each professional making an entry in this ICP must complete the signature record below after which they should use only their initials when making an entry When activities are completed you must initial in the space provided and enter the time if required Any extra care provided to the patients should be entered on the multidisciplinary notes pages of this ICP If you have any queries regarding this ICP, please contact your line manager

2 SIGNATURE RECORD ACTION PLAN All Staff using this ICP MUST complete this section NAME DESIGNATION SIGNATURE BLEEP INITIALS DATE NO Is the child breastfed? Yes No If yes include Infant Feeding Co-ordinator Yes Jenny Larkins Michaela Bryan Date and time contacted Who is going to be responsible for making up the feeds during this admission? Parent/Carer Under nursing supervision? Nurse

3 What are the aims for admission? Type of feed to be used during admission. How often will the child require weighing?... Admission weight Centile Admission height Centile

4 NURSING CARE and ASSESSMENT Initials Correct patient name band applied Observations of child (difficulty in feeding? Refusing? Spitting?) Observations of child with parent/carers

5 Patient/carer aware of reason for admission and plan of care Patient demographics checked and correct Patient/carer orientated to ward Measure weight, height and head circumference and record. Weights should be recorded naked. GP informed of admission by Phone Fax Letter HV informed of admission by Phone Fax Letter Complete fluid balance chart daily Effective information sharing is essential to ensure the safety of the child and can be achieved by Accurate and comprehensive record keeping including statements made by the parents that cause concern. Information about the interaction between the infant/child and carer. If there is any action that is out of the normal sphere these must be recorded clearly and explicitly, then share with other agencies as appropriate. Before discharge from hospital a discharge planning meeting must be called to ensure that there is an accepted and agreed plan of follow up after discharge from hospital. This is a multi-agency plan and requires attendance from all agencies involved. This plan should include: A clear feeding plan, including what to be fed, by whom and frequency. When the child is to be weighed, by whom and frequency. Out patients follow up. To be clear about when and whom. Other agencies involvement needs to be clearly outlined. A clear statement of actions with time limits and a named person responsible for that action. What will happen if the plan is not adhered to? A date for follow up meeting to ensure that progress is being made. If you are concerned about significant harm to the child, use the Hertfordshire Child Protection Procedures: This will include a referral to Children Schools and Families clarifying you are making a child protection (section 47) referral.

6 l Intake for day Date Total Output for the day

7 Low level concern The health visitor will initially discuss weight gain issues with the infant feeding Co-ordinator / GP / Paediatrician. After this consultation if there is not felt to be the need for referral into any other agencies then a plan to be drawn up for appropriate advice and monitoring with a review date. If concerns about weight progress are resolved then the child can be returned to the universal services on offer. Medium level concerns If the assessment shows that there are some what higher levels of concerns due to physical or family/social factors, then there is a need for referral to the Consultant paediatrician, as well as to Children's social care. The Consultant paediatrician should be contacted to decide on the best course of action. This can be Seen In OPD Clinic Admitted to the ward High level Concerns If there are significant safeguarding concerns, even in the absence of specific health concerns, then a referral is to be made to Children's Social care along with a referral to Consultant Paediatrician. The referral to social care should be fully documented in the child's records. After referral to Children's social care an assessment will be made by them as to their course of action.

8 Moderate health concerns Safeguarding concern Referral to Paediatrician for discussion on how to proceed. Consultant Paediatrician Refer to Children's S care Higher level child in need / safeguarding / welfare concerns ed If failure to thrive persists Seen in outpatients clinic Admission to the children's ward Full / medical social family assessment l Manage as health concern Assessment reveals welfare concern

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