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Behavioral Health Issues — EDECU Daily Care — Clinical Pathway: Emergency

Behavioral Health Issues Clinical Pathway — Emergency Department

EDECU Daily Care

RN Handoff Report (between shifts)

  • Name, MRN
  • Reason for admission
  • Medical history
  • Inpatient Psychiatric evaluation complete (Y/N)
  • 201/302 signed, location of document
  • Home medications
  • Agitation Plan
  • 1:1 assignment and breaks
  • Guardian information
  • Bed search updates

RN daily care

  • Bedside nurse will complete Behavioral Health Shift Assessment including safety observation every hour and psychosocial assessment every shift
  • Completes room and bathroom checklist for potential safety hazard before child’s arrival
  • Patient and room check each shift
  • Vital signs every 8 hours, when awake
  • Check I/Os
  • Check weight twice weekly

EDECU Team, Social Work, and Psychiatry Round Daily

During rounds:

  • EDECU attending: Signs “transport to inpatient psych facility form” during rounds
  • EDECU APP
    • Assures that daily medications have been reconciled and ordered
    • Notify PCP (and special immunology if they follow the child) of the child‘s status and need for meds

Patient Schedule, Rules and Expectations Reviewed with Child, Family, and 1:1

  • Child life implements a daily schedule for children
  • Activities in the daily schedule may include:
    • Team rounds
    • CLS group activities
    • Health education
    • Homework/learning time
    • Physical activity
    • Music therapy
    • Hospital bingo
  • Yoga/stretching
  • Home medications given
  • Psych tech role
    • Remains with the child at all times
    • Ensures “All About Me” card is filled out by child and family and is displayed on door
    • Facilitates activities and encourages the child to follow the schedule outlined by Child Life
    • Ensures room safety and checks items parents bring into the room

 

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