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Admission and Discharge Criteria for IMC Status on the Heart and Vascular Progressive Care Unit (2.1.4)

Admission and Discharge Criteria for IMC Status on the Heart and Vascular Progressive Care Unit (2.1.4) - Policies, Clinical, UW Health Clinical, General Care and Procedures, Admission, Discharge, Transfer

2.1.4


UW HEALTH CLINICAL POLICY 1
Policy Title: Admission and Discharge Criteria for IMC Status on the Heart and
Vascular Progressive Care Unit
Policy Number: 2.1.4
Category: UW Health
Type: Inpatient
Effective Date: May 7, 2015

I. PURPOSE

To ensure the appropriate use of the Intermediate Care (IMC) beds located on the Heart and Vascular
Progressive Care Unit. To outline guidelines for the admission and discharge from the Intermediate Care
Unit located on the Heart and Vascular Progressive Care Unit.

II. POLICY ELEMENTS

IMC status on the Heart and Vascular Progressive Care Unit is designed to care for the adult patient w ho
fails to meet acuity criteria for admission to the Intensive Care Unit (ICU) or the General Care f loor. These
patients are hemodynamically stable, but require frequent monitoring for early recognition, and treatment of
potentially life threatening events. Priority for admission to IMC status is given to the Vascular Surgery and
Cardiovascular Medicine population. IMC bed availability may be limited by the total Vascular Surgery and
Cardiovascular Medicine population on the unit. It is the responsibility of the admitting service for patients
admitted to the unit.

III. PROCEDURE

A. Admission Criteria
i. Invasive monitoring to include arterial lines and central lines to measure Central Venous Pressure
(CVP).
ii. Unstable dysrhythmias requiring continuous monitoring of ECG and/or continuous antiarrhythmic
drug infusions as consistent w ith UWHC Guidelines for the Intravenous Administration of Formulary
Drugs in Adults. Within 24 hours of initiation of any antiarrhythmic, the primary service w ill
reevaluate the patient’s hemodynamic status and decide if the patient can be moved to general
care.
iii. Infusion of vasoactive medications as is consistent w ith UWHC Guidelines for the Intravenous
Administration of Formulary Drugs in Adults that are being administered per MD order.
iv. Decompensation of a general care patient’s condition requiring cardiac monitoring of vital signs,
cardiac status, urine output, respiratory status, or other systems on a frequency of greater than
every four hours. This could include new postoperative patients and/or decompensation of current
general care patients.
B. Admissions Process
i. Patients meeting criteria for IMC status w ill be admitted upon request if the attending physician or
designee by contacting the Nursing Coordinator. Bed availability must be determined prior to
admission. In the event that patient volume exceeds capacity, the Nursing Coordinator w ill w ork
w ith the Nurse Manager, or designee, and appropriate medical service to triage patients w ith a
status of IMC on the Heart and Vascular Progressive Care Unit.
ii. Patients being admitted for IMC status must be seen w ithin 2 hours by the admitting service
designee.
iii. As census permits, the Heart and Vascular Progressive Care Unit may accept patients on IMC
status for other services in the event that beds are not available in the IMC that w ould usually admit
those patients. In these cases, the admission and discharge policies in place for the IMC unit that
w ould usually manage these patients at the IMC level w ill apply.
C. Transfer Criteria to General Care Status
i. Resolution of issue requiring IMC status.
ii. Ability to safely monitor the patient under general care status.
D. Discharge
i. When discharge from Intermediate Care status on the Heart and Vascular Progressive Care Unit is
appropriate, it w ill be completed according to current UWHC policy #7.15, Discharge Planning
Process.

IV. CONFLICT RESOLUTION



UW HEALTH CLINICAL POLICY 2
Policy Title: Admission and Discharge Criteria for IMC Status on the Heart and Vascular Progressive Care Unit
Policy Number: 2.1.4


Conflicts w hich arise regarding the admission, transfer and/or discharge of patients and placement priorities
that cannot be adequately resolved by the parties involved should be promptly referred to the Nurse
Manager for resolution.

V. COORDINATION

Author(s): Nurse Manager, Heart and Vascular Progressive Care Unit; Director, Heart, Vascular, and
Thoracic Services
Senior Management Sponsor: SVP, Patient Care Services and Chief Nursing Officer
Review ers: Chair, Division of Vascular Surgery
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: March 16, 2015

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities.
This policy applies to facilities and programs operated by the University of Wisconsin Hospital and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.

VI. APPROVAL

Ronald Sliw inski
UWHC President and CEO

J. Scott McMurray, MD
Chair, UW Health Clinical Policy Committee

VII. REFERENCES

UWHC policy #7.15, Discharge Planning Process

VIII. REVIEW DETAILS
Version: Revision
Next Revision Due: May 7, 2018
Formerly Know n as: Hospital Administrative policy #7.07