A/E Admission/clinic Elective admission from SAL/or from home who attended pre op clinic

Change wrist band MRSA/MSU-urine dip Observations/ Intentional rounding Weight/Height Bed no/ expected date of discharge Lifestyle documents/Allergy Nursing assessment Nursing hand over Risk assessment Nursing evaluation(documentation) Activate care core plan Peripheral pathways/stool chart Referrals as needed Execute initial plan of care

Post op observations Check dressings, teds ,iv fluids, PCA or any attanchment Intentional rounding chart Change Wrist band Bed number/ expected date of discharge Transfer record in the system(c/o staff) Hand over Activate care core plan Update risk assessment Nursing assessment if patient will stay longer than 24-48 hours Nursing evaluation Peripheral/stool chart

A&E Inpatient discharge Elective nurse led discharge

Review by the team Discharge summary will be done by the HO Order medications to pharmacy- contact ward pharmacist Checked referrals made or ( if patient has been seen- physio, social worker etc) need referring( District nurse etc) Checked if no other issues before discharge Make sure patient met all discharge criteria Transport- checked patient needs Give Copy of discharge summary, give and explained medications to take home Give Leaflets and explained Remove cannula Complete discharge observations Complete discharge checklist OPD in the book Nursing evaluation Checked arrangements made for patient who are on anticoaugulant Referrals ex. patient going home with tinzaparin= district nurse needed, send patient with sharp bin and prescription chart, referrals to sunrise and on week end fax it to out of hours no Give and discuss copy of discharge summary, tto, necessary leaflet to take home Complete discharge checklist on pathways Complete nursing evaluation OPD in the book Nursing evaluation Review by the team or not as long as documented( home later, home when safe home meet discharge criteria) Trained Nurse will complete discharge summary and order analgesia as pgd, ring doctor to do discharge order for other medications need for discharge then order from pharmacy- ring ward pharmacist

Inpatient routine care

Hand over Medication rounds ( If you have an elective admission- first on list- admit the patient first before meds rounds) Attend to ward rounds

Transfer from ward to another

Basic nursing care= bed making/ bed bath Observations Execute new doctors order

Inform patient and NOK Review patient history and plan of care Make sure updated with orders Updated with your documents Updated with observations Assess if escort is needed on transfer Complete ward to ward transfer Verbal hand over to staff on the other ward Book for porter

Chase up orders- referrals ect.... Complete fluids balance chart/ intentional rouding Peripheral/care Catheter care/ stool chart per shift Check risk/ nursing care core plan has been completed Ducomentation- practice detailed/ informative documentation( updated as possible Handover to the next shift