1 Document Title: STN002-Inter Facility atient Transfer Standard-V3 age: 1 of 5 Document Owner: Brian ower Approved by: Council Date: 11/12/2014 Inter facility patient transfer The transferring of patients between facilities (hospitals Local Injury Units), must be carried out with due regard to patient clinical needs. atient clinical needs may be; 1 ; Critical care requiring expert medical and/ nursing care to manage, monit and perfm interventions as needed. 2 ; Acute emergent care requiring moniting and/ active management, interventions are anticipated. 3 Medium; Acute non emergent care requires moniting and may require active management and/ interventions. 4 Low; Non acute care planned transpt, active moniting management not anticipated. 5 Nil planned transpt, no requirement f moniting active management. If providing a clinical esct, it is the responsibility of the transferring hospital to ensure that the appropriate clinical suppt is available f the patient during the transfer. Definitions; Intervention, means any treatment, which may be perfmed by practitioners involved. Moniting, in relation to the observation/treatment of a patient, includes moniting of cardiac, respiraty, metabolic, neurological fluid status any combination thereof, and moniting of equipment used f same. Examples of patient clinical needs Multi system trauma, gan failure, respiraty distress, head injury GCS 8, IMEWS 5. Medium STEMI, stroke, mild SoB, GCS 9 < 13, IMEWS 2 4. Low Scheduled therapy, isolated fracture, simple trauma, stable chronic conditions, IMEWS 0 1. Uncontrolled Document when printed copied
2 To request interfacility patient transpt the following questions need to be answered. age 2 of 5 1. Does the transfer Yes No require a national retrieval team involvement? Refer caller to Retrieval team Q2 Time critical 2. Is the transfer time Yes No critical? rotocol 37 Q3 system 3. Is the transfer system urgent? priity Low priity 4. What are the patient s clinical needs during transfer? Medium Low Nil Mental health Q4 mobility 5. What is the patient s mobility? Mobility Nonambulatambulaty Non- (stretcher) (wheelchair) 6. Is a clinical esct (nurse/ doct) accompanying the patient? Note* 7. What timeframe is required f initiation/ completion of the transfer? Ambulaty type EA ICV ICV ICV NAV NAV NAV As per EM guideline Time critical = The requirement to complete a clinical procedure, to reduce mtality and/ mbidity, within a finite timeframe. System urgent = The need to transfer a patient to avail of a clinical procedure, which is not time critical, to optimise bed management. EA = (paramedic lead) ICV = ( lead) NAV = Non-ambulance EM = National Clinical rogramme f Medicine NTM = National Transpt Medicine rogramme rotocol 37 = Inter-Hospital Transfer * Note If the patient s clinical needs are high and a medical and nursing team is maintaining care during transpt the ambulance may be crewed by one practitioner, provided that the medical nursing team are familiar with the ambulance equipment.
3 age 3 of 5 Clinical needs Contact Crew (minimum) type (minimum) Critical care With patient; minimum of two; combination of specialist doct, design emergency ambulance Acute emergent care (time critical; Inter- Hospital Transfer rotocol 37) Acute emergent care (time not critical) Acute non emergent care Non acute care (Non ambulaty - stretcher) Non acute care (Non ambulaty wheelchair Ambulaty) Nil 999 (HSE control) specialist nurse/midwife paramedic With patient; a combination of doct, nurse/midwife paramedic as With patient; paramedic. With patient; paramedic as With patient; FAR (driver) Driver ambulance (if design appropriate) ambulance (if design appropriate) ambulance Non-ambulance Non-ambulance Mental health care needs As outlined in the Clinical Guidance issued by Medicine As outlined in the Clinical Guidance issued by rogramme Medicine rogramme Note: The equipment and medication to enable full scope of practice must be available to match the practitioner clinical lead.
4 A guide to assist matching staff clinical level to patient s clinical requirement during transpt V3 age 4 of 5 Acuity Level (atient) Definition Clinical Requirement Minimum type Mobile Critical Care May require (in addition to column two): ally designed circulaty suppt Time may be critical. ventilaty suppt Moniting and interventions ongoing. Minimum Staff Clinical Level a combination of M RN/M Acute Emergent Care (Time critical, Inter-Hospital Transfer - rotocol 37) Requires moniting and interventions are anticipated. Anticipate will require (in addition to column two): observation and moniting of I.V. infusion administration of medications as per HECC aramedic CGs. interventions as per HECC aramedic CGs. M and/ RN/M if additional medications interventions (minimum two) as required a combination of M RN/M as required Acute Emergent Care (Time not critical) Requires moniting and interventions are anticipated. Anticipate will require (in addition to column two): observation and moniting of I.V. infusion. administration of medications as per HECC aramedic CGs. interventions as per HECC aramedic CGs. Medium Low Acute Non Emergent Care Requires moniting and may require interventions. Non Acute Care (Non ambulaty - stretcher) Non-emergency planned and routine transpt. Interventions not anticipated. May require (in addition column two): observation and moniting of I.V. infusion administration of medications as per HECC CGs. interventions as per HECC CGs. aramedic if additional medications interventions required May require: oxygen therapy. supervision without restraint. administration of medications as per HECC CGs. interventions as per HECC CGs. as required Low Non Acute Care May require: Non-ambulance (Non ambulaty - wheelchair ambulaty) assistance entering and alighting from. Non-emergency planned and routine transpt. assistance with own medications. assistance with check in at destination. Interventions not anticipated. carer to accompany the patient. Nil Ambulaty No requirement f moniting interventions. Non-ambulance FAR NIL requirement FAR M RN/M = First Aid = = aramedic = Medical = Registered Responder Medical Technician ractitioner Nurse / Midwife Design appropriate = a) access to patient s head, b) brackets fitted to take NTM trolley stretcher, c) other requirements specified by NTM
5 Interfacility patient transfer f patients with mental health care needs. age 5 of 5