GULF DIAGNOSTIC CENTER HOSPITAL

NURSING POLICY

Policy No: MED-NUR-P0044/12 Issue Date : November 2012 Revision No.: Original 01 Revision Date : Next Revision : November 2014 Page 1 of 4

TITLE: EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)
Department Section Distribution : Nursing : Nursing Care : Hospital Wide

EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)

APPROVAL SHEET Prepared by: Name Ms. Jennelyn Paderan Acting Charge Nurse, In-patient Ward Reviewed by: Name Ms. Nemesio Abuso Acting Head of Nursing Mr. Zuher Arawi Quality Manager Approved by: Name Dr Emad Yassin Al Rahmani Medical Director Mrs. Jamal Kaddoura Hospital Director and Co-Founder Signature Date Signature Date Signature Date

DOCUMENT AMENDMENT RECORD SHEET

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Appendix: Yes [ ]

No [ ]

GULF DIAGNOSTIC CENTER HOSPITAL

NURSING POLICY

Policy No: MED-NUR-P0044/12 Issue Date : November 2012 Revision No.: Original 01 Revision Date : Next Revision : November 2014 Page 2 of 4 Page Effected Revision Number

TITLE: EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)
Department Section Distribution Date : Nursing : Nursing Care : Hospital Wide Description of Change

1. PURPOSE 1.1 To ensure that all orders and critical values are communicated correctly.

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Appendix: Yes [ ]

No [ ]

GULF DIAGNOSTIC CENTER HOSPITAL

NURSING POLICY

Policy No: MED-NUR-P0044/12 Issue Date : November 2012 Revision No.: Original 01 Revision Date : Next Revision : November 2014 Page 3 of 4

TITLE: EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)
Department Section Distribution 2. DEFINITION : Nursing : Nursing Care : Hospital Wide

2.1 Pass is temporary absence for up to 24 hours of admitted patient from the unit upon explicit approval by the attending physician. 3. POLICY 3.1 Physicians written order or verified telephone order is required prior to issuance of pass. 3.2 When a patient or a legally authorize representative requests for patient to leave the hospital premises on a pass, an Out on pass consent is completed and signed after assessing the clinical status of the patient. However, no pass is issued to a minor patient (less than 18 years old) without explicit parental consent; and no pas is issued to patient scheduled for surgery after the pre-operative evaluation is completed. 3.3 Patients requiring equipment while on out on pass must make prior arrangements. The attending physician initiates arrangements with appropriate departments for equipment use. 4. SCOPE 4.1 Identifying a patient within in Gulf Diagnostic Center Hospital. 5. RESPONSIBILITY 5.1 All Hospital Staff 6. PROCEDURE 6.1 The attending physician writes an order for in-patient pass specifying the data and length of time the patient is allowed to be out of the In-patient Ward and any instructions related to the pass.
6.2 The nursing staff discusses the following with the patient: 6.2.1 The authorized time the patient can leave the nursing unit. 6.2.2 That the patient can come back to the nursing unit on or before the time authorized by his physician. 6.2.3 The number to contact if problem develops while out on pass. 6.3 In cases where medication(s) need(s) to be taken while out on pass, the nurse in charge provides the patient with accurate and appropriate education about the medications and prescription for the medication. 6.4 The self-pay patient settles all incurred hospital bill prior to leaving the hospital.
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Appendix: Yes [ ]

No [ ]

GULF DIAGNOSTIC CENTER HOSPITAL

NURSING POLICY

Policy No: MED-NUR-P0044/12 Issue Date : November 2012 Revision No.: Original 01 Revision Date : Next Revision : November 2014 Page 4 of 4

TITLE: EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)
Department Section Distribution : Nursing : Nursing Care : Hospital Wide

6.5 The nursing staff documents the following: 6.5.1 The time and date the patient left the nursing unit. 6.5.2 Any other pertinent patient education regarding pass instructions and/or restrictions. 6.5.3 Patient companion. 6.6 The patient signs out on the appropriate document, which indicates the date and time of departure from the nursing unit. 6.7 Upon patients return to the unit, the nursing staff assesses the clinical status of the patient and documents the information in the patients medical record. 6.8 If the patient does not return on the specified date and time or if unusual incidents were reported while on out on pass, the nursing staff notifies the attending physician. Also, the nursing staff notifies the Charge Nurse of In-patient Ward and the Nursing Director. 6.9 Patient who fails to return at the designated time may be discharged if appropriate of upon notification and approval of attending physician from the unit.

7. REFERENCES 7.1 JCIA Standard 8. RELATED DOCUMENTS 8.1 Out on Pass Consent Form

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Appendix: Yes [ ]

No [ ]

GULF DIAGNOSTIC CENTER HOSPITAL

NURSING POLICY

Policy No: MED-NUR-P0044/12 Issue Date : November 2012 Revision No.: Original 01 Revision Date : Next Revision : November 2014 Page 5 of 4

TITLE: EFFECTIVE COMMUNICATION POLICY READ BACK (VERBAL AND TELEPHONE ORDERS)
Department Section Distribution : Nursing : Nursing Care : Hospital Wide

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Appendix: Yes [ ]

No [ ]