Pathway for the Evaluation/Treatment of Newborn with Single Ventricle

ISVMP Discharge Checklist

Clinical

Equipment

  • Scale
  • Pulse ox
  • Care binder
  • Feeding supplies

Medications

  • Prescriptions
  • Supplies
  • Compounded medications
  • Medications picked up from pharmacy
  • Discharge medications match prescribed medications

Education

  • Standard cardiac center discharge education
  • Medication chart/schedule
  • Meet with ISVMP – red flags, plan for follow up
  • Nutrition plan (cal/oz, minimum ml/day documented in discharge summary)
  • Daily weight measurement (training in use of home scale, calculating difference, red flags) – including agreed-upon plan for communication with family and NP
  • Immunizations (current status documented, plan for future) – Syangis for patient and flu/TDaP for family members)
  • Guidelines for exposure to outside risk
  • 24 hours of care

Follow up

  • Cardiology – appointment made, discharge team communicates, ISVMP team communicates
  • Pediatrician – appointment made, discharge team communicates, ISVMP team communicates
  • Nutrition – appointment made (if possible), plan for who titrates feeds

Therapies (initiate in CICU)

  • Speech evaluation done
  • PT/OT

Discharge planning

  • Social work (insurance, WIC)
  • Case management (supplies, home nursing)

Routine newborn discharge

  • Hep B vaccination
  • Hearing screen

Other

  • Completed CCU emergency info card
  • NPC-QIC consent as appropriate

Other ideas to consider

  • Patient information card (ie, for presentation to ER)
  • Pre-discharge conference via phone (cardiology, PCP, CCU or ISVMP rep, parent)