/ Patient name
(Patient label)
Patient number
CDU Patient Admission Document / Date & time of Admission to CDU
Emergency Doctor Responsible
Referred To

Diagnosis and Co Morbidities

Acute Diagnosis / Co Morbidities

Reasons for Requiring CDU Admission– please indicate by ticking box

1 / Patient Flow (awaiting in patient bed orto free up space in main department)
2 / Awaiting investigations or results
3 / For observation if GCS 14-15 & haemodynamically stable (HIs, Minor ODs etc)
4 / For short course of treatment >4hrs but < 24hrs (cellulitis, simple infections etc.)
5 / AwaitRAIT Assessment
6 / Await psychiatric review
7 / Await transport / collection discharge lounge closed

Exclusion Criteria

If any exclusion criteria are met, the patient should be managed in the main department
or inpatient ward.

Yes No

< 18 yrs old (>16yrs should be discussed with the Consultant & require continued adult supervision)
Patients requiring cardiac monitoring
Ongoing chest pain suggestive of IHD
Haemodynamic instability
Patients not yet seen (inc direct admissions)
Thoseunsuitable for discharge within 24hrs (e.g. those unable to mobilise at time of assessment)

CDU Management Plan -MUST be completed prior to transfer to CDU and includethe

Investigations, test results & treatments outstanding

Investigations awaited
Results Awaited

ALL PATIENTSON CDU REQUIRE A VTE (THROMBO-EMBOLIC RISK) FORM

ALL OVERNIGHTSTAYS NEED A DRUG CHART COMPLETED (consider analgesia)

Admission Acceptance (can only be completed by a Consultant or Middle Grade Doctor)

I can confirm that this patient is suitable to be managed in CDUand all sections are completed

Name
Signature
Date & Time
Drug chart completed if overnight stay, analgesia or treatment required / YES / N/A
A VTE risk form has been completed / YES
If charts not yet done, name of doctor whose duty it is to complete

The patientremains the overallresponsibility of the clerking Drand theywill be responsible for reviewing the patient and results by the end of their shift and formally handing over to a colleague if the patient remains in CDU

To be completed for patients under a speciality team

Patient Suitable for CDU
Named Consultant - Sema needs to be updated
(so not under ED Consultant)
Name of team member contacted and bleep number
ED MG / Consultant signature to confirm happy
with plan

It is the responsibility of the admitting team to complete VTE forms and drug charts

Nursing Documentation

Admission Assessment / Name band Yes/No
Next of Kin aware of admission Yes/No / URINALYSIS? Yes / No
Sent: Yes / No
Risk of Fall: Yes / No
Action taken: Yes / No / For mental health review Yes / No
(If yes) ETOH level=
Referred to Alcohol liaison nurse (date & time): / Referred to (date & time)
Social worker:
Onecall review:
RAIT:
Orientated to time Yes / No
Orientated to place? Yes / No
History of confusion? Yes / No
GCS: / IV Access: Lt arm Rt arm
Infection status:
MRSA
C-Diff
Other………. / Waterlow score O/A
Action taken
Medications given in A&E Yes / No / Brought in own tablets? Yes / No
Use of dosette /blister pack required? Yes / No / Manage medicines independently at home? Yes / No
INITIALFALLS RISK SCREENING TOOL
For all patients: / Tick when complete
Review need for sedative or hypnotic medication
Appropriate well fitting footwear in use
Explanation in how to use call bell( left within reach)
HISTORY / CURRENT RISK OF FALLS / YES / NO
Recent history of falls?
Does the patient appear agitated / confused?
Does the patient try to walk but is unsteady on their feet or visually impaired?
Patient (or relatives) anxious about falling?
Needs toilet frequently/with urgency?
If yes to any of the above or if condition changes/ falls during admission:
Initiate falls risk assessment and care plan
Liaise with medical team if acute onset
Consider referral to physiotherapist / occupational therapist

SOCIAL CIRCUMSTANCES

LIVES / Alone / With Spouse
With Other (Please state): / Do they have carers: Yes / No Private or social services
Type of Package of care OD BD TDS QDS
Mobilises with: Sticks Frame
TYPE OF ACCOMMODATION – please circle
House / Flat / Bungalow / Warden Managed Flat / Other:
EMI Home / Nursing Home / Residential Home / No fixed abode
DISCHARGE RISK ASSESSMENT (ADULTS)
Next-of-kin or NH informed/? / Yes / No/ NA / TTOs required?
Medication returned to patient:
Property returned: / Yes / No
Yes / No/ NA
Yes / No/ NA
Transport required? / Yes / No
Booking reference: / IV Access removed? / Yes / No/ NA
Package of Care in place? / Yes / No / OneCall informed if appropriate / Yes / No/ NA
Own Keys: / Yes / No / Community folder returned to patient: / Yes / No/ NA
RN RESPONSIBLE: / Name / Signature
DATE: / TIME:

Discharge Section – To be completed by discharging Doctor

X-rays, Observations and blood results checked and within parameters / Yes / No
Medical notes completed and GP letter updated and sent via Sema / Yes / No
Signature of Doctor
Date & Time
Date/Time / Clinical Notes / Print Name and Signature
Date/Time / Clinical Notes / Print Name and Signature
Date/Time / Clinical Notes / Print Name and Signature
Date/Time / Clinical Notes / Print Name and Signature