Infirmary 23 hour observation

[military spouse]

Just curious how each of your facilities handles a 23 hour observation? Less paperwork? Orders? Thanks in advance!!

[DawnJ]

Not sure what you mean by 23 hour observation. If they are in our infirmary, they are observed hourly or more. Some have 15 minute checks and some have a CO sitting outside their cell every minute.

Paperwork is the same, orders are dependant upon the condition of the patient.

[SinMiedo]

Basically, our 23 hour obs is nurse-initiated rather than requiring an MD order. The paperwork is different, but equally as voluminous (as is the paperwork for everything we do :/). That's really the only difference.

[military spouse]

Thanks for the reply. Do you get orders for things such as VS frequency?

[SinMiedo]

We do V/S q shift automatically any time someone is in TCU. In an admission, the provider will sometimes specify that he/she wants them done q 6/8 or at intervals after giving meds. Our admission sheet has areas for all sorts of superfluous orders (e.g. T/P, fall risk assmts q DAY, et al.) which we rarely use, thank God!

[Orca, ADN, ASN, RN]

In our system, 23-hour observation allows an RN to put an inmate in the infirmary for temporary evaluation without a physician order. The nurse can handle acute situations without the formality of calling a physician. Usually this is done after hours for situations that are not medical emergencies, but they merit close observation until a provider can see them.

[military spouse]

Thanks everyone for your replies!