Entering Dependency Data

This topic is for IBID

Daily Dependency

Daily Dependency data should be entered once per day for patients who are admitted & under the care of the burns team. Dependency records should also be created for each interaction with an out-patient.

Creating a dependency record will generate validation messages for each required field. Only one dependency record per day shopuld be created, any attempt to create a daily dependency for a duplicate date will result in a critical level validation message.

If an Ibid record type is dated before 2014 and there is no linked daily dependency record, a "Manage Historics" data set will be added to the resuscitation fields to enable a user with "Manage Historics" Permissions to fill in missing data. For further information please follow link Historical ICU Admission Data

Linking with iBID Record

Dependency records cannot be created before creating IBID records

It is vital from an information analysis perspective that the Dependency record is correctly linked with the associated iBID record, this is done automatically. When creating a dependency record an Ibid Selection Dialog Box is generated for patients with more than one IBID record.

For Patients with only one IBID record the Dependency record will automatically be linked to the existing iBID Record.

Different fields will be displayed for iBID record types seen as tabs across the top of the Dependency record, for Outpatients, screens relating to Out Patient care will be displayed.

An In Patient, Acute major Injury admission (resus &/or significant inhalation) for instance, will display all available In Patient care fields.

Dependency Header

Once the Dependency Record has been created, details of the linked iBID record will be displayed in the Linked iBID Details box at the bottom of the Dependency Header. The Dependency Header will be displayed throughout the dependency record regardless of the dependency tab open.

Status - Choose from drop down list the patients status at the time of the dependency record treatment, I.e In Patient, Ward Attender etc.

Location - Choose from drop down list the location of the patient whilst treatment is received, i.e Hospital Ward, Residence etc.

Bed Number - Choose bed number, ward or other Location for patient whilst treatment is received.

Shift - Choose from drop down list the shift the procedure was carried out.

Off Ward - Choose from drop down list the location the patient received treatment.

Ward Attender for (hrs) - Box to enter the hours the patient has been on the ward.

Linked Ibid Records

Trauma Network ID - Automatically Displays the linked Ibid Record Trauma Network ID once the Ibid Record is selected in the dependency header.

Date of Injury - Displays the date of injury as entered in the selected Ibid Record.

Admission Date - Displays the admission date as entered in the selected Ibid Record.

Dep Days Post Injury - Displays the number of dependency days post injury, calculated from the Admission Date in the Ibid record


The dependency record can be edited up to 24 hours after the record has been created, after that time the Dependency record will be opened in Un-editable mode, click the "Edit" button on the Dependency Tool bar to make an changes after this point.

Dependency Scoring

Please note, the Dependency Scoring and Rehabilitation Scoring fields will not be present for Ibid Outpatient record types

Made up of KPI Required fields the dependency scoring builds a score of patient dependency for analysis purposes.

Monitoring Requirements - Choose from the drop down list the patient's level of monitoring dependency required.

Procedure Complexity - Choose from the drop down list, the complexity level of procedures undertaken for the patient on this date. Ranging from small dressing or procedure to major op.

Psychosocial Support - Choose from the drop down list the level of Psychosocial Support the patient and NOK requires.

ADL Achievement - Choose from the drop down list the level of support the patient received provided by burn care staff to fulfil the activities of daily living on this date.

Mobility Limitation - Choose from the drop down list the menu item that best describes the level of input provided to the patient.

No Physical Therapy - Tickbox that hides the physical therapy fields 'Therapy Support' and 'Treatment Complexity' when no physical therapy was given.

Therapy Support - Choose from the drop down list the menu item that best describes the level of input provided to the patient.

Treatment Complexity - Choose from the drop down list the degree of complexity of care provided to the patient by the physical therapy staff.

Rehabilitation Complexity Score

Nursing staff to complete this section

Basic Care and Support Needs - (including washing, dressing, hygiene, toileting, feeding and nutrition, maintaining safety etc) **Ensure info correlates to the ADL Section** Choose from the drop down list the menu item that best describes the level of basic care and support requirements to the patient. This forms part of the rehabilitation complexity score for analysis purposes.

Definitions as follows :-

C0 Largely independent - patient maintains their own safety and manages basic self-care tasks largely by themselves. May have incidental help just to set up or to complete eg, application of orthoses, tying laces etc

C1 Needs Help from 1 person for most basic care needs - for washing, dressing toileting etc. May have incidental from a 2nd person eg just for one task such as bathing

C2 Requires help from 2 people for most basic care needs -for washing, dressing toileting etc.

C3 Requires help from 2 people for basic care needs - OR requires constant 1:1 supervision eg to manage confusion and maintain their safety

Skilled Nursing Needs - Choose from the drop down list the menu item that best describes the level of The specialist nurse care requirements of the patient. This forms part of the rehabilitation complexity score for analysis purposes.

N0 No need for skilled nursing – needs can be met by care assistants only

For Ward Patient

N1 Requires intervention from a SRN - (eg medication, wound/stoma care, nursing obs, enteral feeding, IV infusion etc)

N2 Requires intervention from trained rehabilitation nursing staff - This level is for neuro rehab patients HDU or ICU

N3 Requires highly specialised nursing care - For very complex needs such as:-Patients management of tracheostomy or ventilation

Management of challenging behaviour/psychosis/complex psychological needs

Highly complex postural, cognitive or communication needs

Vegetative or minimally responsive states, locked-in syndromes

Therapists to complete this section

Therapy Intervention (describes the approximate level of input that is given from therapy disciplines. Includes individual or group based sessions. Run by therapists)

Therapy Intervention - Choose from the drop down list the menu item that best describes the level of physical therapy requirements of the patient on this date. This forms part of the rehabilitation complexity score.

T0 No therapy intervention (eg awaiting discharge)

T1 Total therapy intervention less than 4 hours per week (or less than 1 hr / day)

T2 total therapy intervention 4 – 9 hours per week (or approximately 1-2 hours / day)

T3 Total therapy intervention 10 – 15 hours per week (or approximately 2-3 hours / day)

T4 Total therapy intervention 16 – 20 hours per week (or approximately 3-4 hours / day)

T5 Total therapy intervention 21 – 25 hours per week (or approximately 4-5 hours / day)

T6 Total therapy intervention more than 25 hours per week (or More than 5 hrs / day)

Nursing staff to complete this section

Medical Intervention (describes the approximate level of medical care environment for medical/surgical management)

Medical Intervention - Choose from the drop down list the degree of medical support and intervention required by the patient on this date. This forms part of the rehabilitation complexity score.

M0 No active medical intervention - For patients being managed by GP

M1 Basic investigation/monitoring/treatment- For patients in non-specialised hospital setting or community eg intermediate care, normal ward)

All/most pts

M2 Specialist medical intervention - Requiring in-patient hospital care in specialised hospital setting ie; in-patient in burns service

Unwell ICU pts

M3 Acutely sick or potentially unstable medical condition -Requiring 24 hour on-site acute medical cover ie; requires Acute Medical/Surgical Care or potentially unstable requiring out-of-hours intervention – eg, for uncontrolled seizures, immune-compromised

Worst Mews Score - Box to enter the highest medical early warnings score recorded on this date.

Pain Scoring

Pain Overall

Lowest Pain Score in 24 Hours Highest Pain Score <24 Hours

Score lowest and highest pain experienced to a value of 1 to 10 as follows:- PainOverall
0 = No Pain
2 = Mild, annoying pain
4 = Nagging uncomfortable pain
6 = Distressing, Miserable Pain
8 = Intense, dreadful Pain
10= Unbearable Pain

Pain Neuropathic

Mark the Neuropathic pain in the boxes below using the LANSS Pain Scale, marks from 0 -24

LANSS (0-24) For Patients assessed by Medical Staff

Self LANSS (0-24) For Patients Self Assessment

Dependency Notes

Present for all record types 

Enter in free text boxes as much information as possible regarding the patients care.

Current Status

Treatment Plan



Other events

Once the Daily Dependency fields are completed the patient may have been admitted to Intensive care, in this case an 'Intensive Care/Critical Care Dataset' will need to be completed. For further information on 'Intensive Care/Critical Care Dataset' please follow link to Intensive Care

Editor Types

Date Editor

Can free type date or select from drop down calender. Enter "Today" or press "Clear to exit without entering data.

Time Editor

Can free type time or use scroll bars at the right of data field.

Date & Time Editor

Free type date dd/mm/yyy and time 00.00, or drop down list. Choose "today" button if event was day of inputting data or "Clear to exit field without data entered.

Drop Down / Lookup List

The Lookup List is a collection of common names, places, catagorys, or other types of information that can help you choose a required field. Click on the down arrow to the right of the data field, highlight the relevant information to enter.

Staff Drop Down / Lookup List

Populated by staff names entered as "Users" in Administration.

'Yes/No/(Don't Know Drop Down

A special kind of drop down list to allow a clearer selection of yes, no & don't know when compared to the tick box. Used predominantly in the iBID editors, but due to roll out to all data-entry fields. Input via keyboard can be acheived by pressing Y or N on the keyboard.

Tickbox

Checked - Positive with a known value = 1.

Unchecked - Negative with a known value = 0.

Gray - Don't know with a value = null.

Please note: Check boxes are grey (Unknown) by default.

Postcode Editor (2 part)

Free type 1st part of postcode letters and numbers.

Free type 2nd part of postcode numbers and letters.

Text Field

A free type field to enter as much detail as possible.

(Note: Max 255 characters)

Memo Field

A free type field to enter as much detail as possible (Unlimited chars)

Automatically Filled in Fields

Sometimes shaded, Aquila will fill in these fields automatically from the data entered in previous fields.