Criteria Led Discharge ( CLD ) for Elective Surgical Patient on J81 SJUH

Publication: 17/05/2017  --
Last review: 01/01/1900  
Next review: 01/05/2020  
Standard Operating Procedure
CURRENT 
ID: 5034 
Approved By: ACC Clinical Governance 
Copyright© Leeds Teaching Hospitals NHS Trust 2017  

 

This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Criteria Led Discharge (CLD) for Elective Surgical Patient on J81 SJUH


Summary

Background and indications for standard operating procedure/protocol

Applicable to
Patient who have :

  • routine elective surgery
  • Uncomplicated post-operative course
  • Can be discharged by nursing staff J81, without parent team review

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Procedure method (step by step)

Exclusions :

  • Deteriorating patient
  • Use of vasopressors/inotropes high flow oxygen
  • Unstable co-morbidities eg angina
  • Any concern- parent team to liaise with J81 critical care consultant
  • Non elective surgery eg acute surgery/ medical patients
  • Post –operative patients with management of unstable medical comorbidities
  • High flow oxygen/ fluid resuscitation/ inotropes/vasopressors/ new agitation

Applicable to

  • Major Liver resections (eg hemihepatectomy, trisectionectomy)
    1 night
  • Major Pancreas resections (eg Whipples, total pancreatectomy
    1 night
  • Stomach resections (eg partial/total gastrectomy
    1 night
  • Oesophagectomy
    3 nights
  • Bladder resections (Cystectomy, cystoprostatectomy)
    1 night
  • Colorectal resections
    1 night
  • Gynaecological procedures
    1 night
  • Lung resection
    1 night

How

  • Identify patient 0600- undergone elective procedure as listed above, uncomplicated stay for target time (see above), co-morbidities stable
  • Assess suitability- No need for vasopressors/inotropes, fluid resuscitation, high flow oxygen
  • Apply NEWS score- NEWS score ≤ 4… Suitable for discharge
  • Email potential discharge CLD list to Bed Manager, site matron and j81 senior team
  • Email out all potential step-downs. “Borderline” patients can be reviewed by j81 consultant 0800.
  • Contact the surgical team (SHO or above)- to inform them patient meets CLD and will be discharge to ward
  • If the surgical team requests a longer stay on HDU, this must be discussed directly with a critical care consultant
  • Patients who do not strictly meet Criteria Led Discharge can also potentially be discharged at the discretion of parent team/ critical care consultant

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Provenance

Record: 5034
Objective:

To standardise and Optimise patient flow through Surgical High Dependency J81

Clinical condition:
Target patient group: Patients on J81
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Adapted from:

Evidence base

Not supplied

Approved By

ACC Clinical Governance

Document history

LHP version 1.0

Related information

Not supplied

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