Dependency Outpatient Activity

This topic is for IBID

Dependency Outpatient Activity

The Daily Dependency record is the patents care record while under the care of the Burns team.

Creating a Dependency Record

A new Daily Dependency record can be created by

• clicking New Dependency Record shown next to Open Dependency Record,
• by clicking on the New Dependency Record on the Navigation tab or
• selecting New on the tool bar and selecting New Dependency Record.

See also: Entering Dependency Data

See also: Data Grids

Daily Dependency Dependency records should be created for each interaction with an out-patient.

Dependency Header

Linking with iBID Record

Please create the IBID record before creating Dependency 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 the user updates the Record Date/Time field, free type or choose from drop down calendar.

If there is no iBID record to link to either:

• Check that the dates are correct
• Manually select the correct iBID record by clicking the blue <None> link.

This will open a drop down list of the patients Ibid records, click to insert relevant record.

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

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.

• 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.

Daily Dependency

Dependency Scoring

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

• Basic Care and Support Needs - 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

• 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.

• 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.

• 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.

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

Dependency Notes

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 outpatient may have had a wound dressed, in this case a wound assessment load field will need to be completed.

Wound Assessment Load

Wound Assessment/Load Is designed to display the size of the wound dressed, types of wound treatments, grafts and skin substitutes used during the patients care episode.

Wound Assessment & Consumables

Wound Assessment

• Donor Site Load - Enter the size of the donor site

• SF/SD Load - Enter the Superficial or Superficial Mid-dermal surface load

• DD/FT Load - Enter the Deep Dermal or Full Thickness load

• Graft Failure Evident - Choose form drop down list the percentage of the graft failure evidence

• Large Skin Area Dressings Today - Enter the percentage of the dressing area applied the day of the dependency record

• 95% Healed - Tick box indicating the wound is 95% healed

• 100% Healed - Tick box when the wound is 100 healed

Treatments for:TODAY

Tick boxes for each treatment the patient has received for the relevant dependency record

• MR Bact Contamination

• MR Bact Septicaemia

• Non MR Bact Septicaemia

• Fungal Contamination

• Fungal Septicaemia

• Strep A Contamination

• Strep A Septicaemia

• Pseudomonas Contamination

• Pseudomonas Septicaemia

Skin Substitutes

To enter a new skin substitute Click the New Skin Substitute icon on the Skin Substitutes toolbar.

Multiple skin substitutes can be added for each Daily Dependency.

• Skin Substitute - Choose Skin Substitute from drop down list

• TBSA% - Enter percentage of Total Burn Surface Area

Click the save button and the skin substitute entered will be added to the Skin Substitute list, along with the date the information was entered and the users name. To add another Skin Substitute simply click the Skin Substitute button on the toolbar and the drop down list will appear once again.

To delete a skin substitute click the Delete button on the Skin Substitutes toolbar.

Outpatient Activity

• Patient Attendance - Choose the relevant option from the drop down list.

• Re Arranged - Tickbox if patient did not attend and appointment has been rearranged

Assessments

Tick Box if patient has been assessed by any of the following.

• Surgeon Assessment

• Nurse Assessment

• Therapy Assessment

• Psychology Assessment

• Pressure Gmt Assessment

• Other Assessment

Assessment Information

Once the relevant boxes have been ticked further information fields will appear

Enter grade of each speciality that has seen the patient and choose assessment time from drop down list.

Tick boxes for Follow up, Discharge or Listed

Referrals

Tick box if patient has been referred to any of the following specialities

• Referral to Dermatology

• Referral to Cosmetic Camouflage

• Referral to Psychiatrist

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.