Part Two
- Policy of evaluation and identification of patient categories
Patient evaluation policy for abuse or neglect
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Policy: the hospital is committed to preventing harm or neglect of patients while they are in the hospital and dealing with those cases as soon as they occur to remove harm from patients or neglect while dealing with them.
The purpose: is to develop methods of dealing with patients in case of abuse or neglect .
Ill-treatment: the patient while in the hospital, which leads to his exposure to physical, psychological or both harm/ injury, and there are types
Different types of mishandling can be divided into :
Mental abuse :
By influencing the mental state .
Manifestations of mental abuse:
* Verbal abuse .
* A threat .
* Intimidation .
* Isolation .
* Insult ·
* Humiliation .
* Deprivation .
Physical abuse :
By affecting the physical condition of the patient by exposing the patient to the ( beating - slapping - kicking ) .
Manifestations of physical abuse:
* The fall of the patient .
· The appearance of bedsores in the patient .
* The presence of wounds that are not well cared for .
* The presence of unexplained wounds .
* Physical pain when touched .
* The presence of marks as a result of biting, scratching, abrasions or bruises .
* The presence of signs of dehydration, unjustified malnutrition, patients, sunken eyes or the presence of eye injuries .
· The presence of blood stains in underwear .
Sexual abuse; :
The patient has been subjected to any form of sexual assault / harassment .
Physical abuse:
Manifestations of physical abuse :
* Theft .
* Misuse of money and property .
* Blackmail .
* Fraud .
* The presence of abnormal actions of the patient's bank account.
* Indifference in the disbursement of financial amounts .
Negligence :
It is any negligence [negligent treatment] harming a patient in need without an acceptable medical reason by a responsible person while the patient is in the hospital .
People in need :
A person who needs the help of another person due to (intellectual disability, lack of age, brain atrophy / dysfunction) which hinders the person's ability to protect himself or provide his own care.
Types of possible neglect to which the patient was exposed :-
* Negligence in medical and nursing care .
* Neglect of administration of treatment doses.
* Neglect of social and psychological needs .
* Lack of food/ water .
* Placing the patient in an unsafe or unattended place .
Actions : -
1. The doctor and the nurse assess the patient's condition and determine his treatment needs.
2. The doctor and the nurse introduce the patient to the treatment plan and how to implement it.
3. Nursing teaches the patient how to call her when needed
4. The social worker visits patients daily in the internal departments to monitor patient complaints to report them to the administration and those responsible for resolving their complaint
5. If a case of neglect or ill-treatment is detected, the patient's attending physician is informed:
- The Doctor assesses the patient's condition, identifies manifestations of abuse or neglect, a report is written with adherence to physical and psychological treatment of cases .
- The doctor asks the patient to write his complaint (for the damage caused to him ) if he wants it with an appendix with or without a signature.
- The head of the medical authority shall assign whoever he deems appropriate to investigate and follow up the complaint and then the results will be presented to him for necessary action.
Responsible : - doctor – nursing-social worker.
Forms: - the patient's rights and duties form-the form of confirmation of the existence of secretariats
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Policy: the hospital is obliged to specify the minimum requirements for medical examination of the patient upon admission.
Purpose: to determine the minimum medical examination and medical history necessary to evaluate the patient upon admission to the hospital.
Working procedures:-
1. The department doctor takes the patient's medical history and examines the patient upon admission according to the medical history and examination form, which includes :
* Personal history of the patient and explains (name, gender, age, profession, marital status, national ID card, special habits such as smoking and drinking alcohol).
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2. The doctor conducts a clinical examination of the patient and includes :-
* Measurement of vital signs (pressure – pulse – temperature ).
* Comprehensive examination of all parts of the patient's body .
* Local examination of the place of the patient's complaint by various manual examination methods.
* The doctor records the result of the examination, the results from the date of admission and clinical examination in the patient's file (preliminary diagnosis) .
* The doctor records the initial treatment plan
3. Based on what he has arrived at and according to the patient's need, the doctor will write the order in writing in the doctor's orders form to do the necessary tests and radiographs for the patient and specify the vital signs notes to be taken and the dates of registration by the nursing staff of the Department .
4. The doctor accurately writes out the drug therapy in the form of prescribing and carrying out treatment .
5. The doctor selects the appropriate type of nutrition for the patient in the doctor's order form.
6. The nurse records the patient's data in the food form to bring meals to the patient .
7. The Attending Physician informs the patient and his relatives about the initial diagnosis, the treatment plan or surgery, the possible results, the expected complications and the nutrition system .
Responsible: specialist doctor
Forms: medical history and medical examination form – food form-doctor's orders form.
References: Egyptian accreditation standards
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Politics:
Patients with critical conditions most at risk should be identified and followed up and then the medical team will start the evaluation process and the plan will be coordinated and applied with the patient and the family .
Purpose:
* Identify the most vulnerable patients such as children, individuals with special needs, the elderly and psychiatric patients in the hospital and the necessary special assessment for each of them.
* Patients who require special services regarding hospital care :
◾ Age 75 years or older .
◾ Alteration of the state of consciousness or related disorders (States of mental disorders).
◾ Injuries, multiple fractures, fractures of major joints.
◾ Malnutrition, dehydration, microbial poisoning.
◾ Patients with delayed cases.
◾ Children.
◾ Victims of violation, negligence or injuries.
◾ Patients of the dialysis department.
◾ Intensive care patients.
◾ Patients with chronic diseases.
◾ Patients prone to falls.
◾ Patients prone to bedsores.
* Patients taking sedative drugs and diuretics.
Actions:
* The medical team matches the high-risk cases for each patient within 24 hours of admission to the hospital and if the patient's condition matches one of the following conditions, the expected signs of severity for the patient are determined.
* Doctors and nursing staff record current and expected problems, Major and alternative solutions in care plans.
* Doctors and nurses follow up the cases and re-evaluate them according to the requirements of each case.
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