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Admission and Discharge Criteria for the Pediatric Universal Care Unit (2.1.5)

Admission and Discharge Criteria for the Pediatric Universal Care Unit (2.1.5) - Policies, Clinical, UW Health Clinical, General Care and Procedures, Admission, Discharge, Transfer

2.1.5


UW HEALTH CLINICAL POLICY 1
Policy Title: Admission and Discharge Criteria for Pediatric Universal Care Unit
Policy Number: 2.1.5
Category: UW Health
Type: Inpatient
Effective Date: May 22, 2015

I. PURPOSE

To ensure the use of a uniform policy w hen patients are admitted to and discharged from Intermediate Care
(IMC) status w hile in the Pediatric Universal Care Unit.

II. POLICY ELEMENTS

The Pediatric Universal Care Unit provides inpatient care for patients age new born to age 18. The level of
care provided on the Pediatric Universal Care Unit includes both general care and intermediate care.
Pediatric IMC status is designed to care for the pediatric patient w ho fails to meet criteria for admission to
Intensive Care Unit (ICU) status or General Care Status. These patients are hemodynamically stable, but
require a level of nursing care and monitoring that cannot be provided on the general pediatric care unit.

III. CRITERIA FOR IMC LEVEL OF CARE

A. Patients admitted to the Pediatric Universal Care Unit w ill be medically managed by the admitting physician
team. The follow ing are criteria for IMC level of care w ithin the Universal Care Unit:
i. Any patient requiring monitoring of vital signs, urine output, respiratory status or other systems
more frequently than every four hours for a sustained period of time.
ii. Patients that require a level of nursing or respiratory care that is not available on the general
pediatric unit.
iii. Patients that are dependent on technology such as those w ith tracheostomies that are ventilator
dependent or on non-invasive positive pressure (CPAP or BiPAP continuous or intermittent greater
than every 4 hours) at home.
iv. Patients w ho require frequent vital signs or aggressive pulmonary physiotherapy such as suctioning
greater than every 2 hours.
v. Patients w ith progressive pulmonary disease of moderate severity w ith risk of progression to
respiratory failure or w ith obstruction potential.

IV. ADMISSION, TRANSFER, AND DISCHARGE PROCESS
A. Admission Process
i. Patients w ho meet admission criteria for IMC status w ill be admitted upon the request of the
attending physician or designee by contacting the Nursing Coordinator. Bed availability must be
determined prior to admission. In the event that the patient volume exceeds capacity, the Nursing
Coordinator w ill w ork w ith the Nurse Manager or designee, and appropriate medical service
regarding w hich patients w ill be admitted and discharged f rom IMC status. Patients being admitted
for IMC status must be seen w ithin 2 hours by the admitting service designee.
B. Transfer Process
i. Patients w ill be transferred out of IMC status w hen physiologic status has stabilized, intensive
monitoring and treatments are no longer needed, or the condition w hich required IMC care has
been resolved.
ii. Patients w ill be transferred to intensive care status w hen physiologic status has deteriorated and
intensive life support is required or highly likely.
C. Discharge
i. When discharge is appropriate, it w ill be completed according to current UWHC policy #7.15
(Discharge Planning Process).

V. COORDINATION

Author(s): Nurse Manager, Pediatric Universal Care Unit
Senior Management Sponsor: VP, AFCH Clinical Operations
Review ers: Director, Pediatric Nursing
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: April 20, 2015



UW HEALTH CLINICAL POLICY 2
Policy Title: Admission and Discharge Criteria for Pediatric Universal Care Unit
Policy Number: 2.1.5


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
UWHC Policy #7.18: Admission and Discharge Criteria for Pediatric Intensive Care
UWHC Policy #7.44: American Family Children’s Hospital Admissions
Jaimovich, D.G. (2004). Admission and Discharge Guidelines for Pediatric Patient Requiring Intermediate
Care. Pediatrics, 113(5), 1430-1433.

VIII. REVIEW DETAILS
Version: Original
Next Revision Due: May 22, 2018