Labor and Delivery Unit- Admission and Transfer 

1. 
   TITLE:

Labor and Delivery Unit- Admission and Transfer 

2. PURPOSE:

1. To evaluate the condition of the laboring patient on admission.

2. To provide safe guidelines for the transfer out of delivered mothers from labor and delivery unit. 

3. CONDITION/ APPLICABILITY:

This policy applies to all Medical staff, Nurses/Midwives in Obstertric and gynecology department.

4. DEFINITION:

Admission of patients : The hospitalization of patients whose medical condition requires inpatient evaluation or treatment by appropriately privileged clinicians.

5. POLICY:

1. Admission

1. Physician’s order is required for admission of patient from clinic

2. If patient is booked or un booked and in labor then admission is through by the Ob/ Gyn Specialist or consultant on call

2. Criteria

1. All patients in labor with high risk pregnancy for Induction Of Labor admission after    Consultant order.

2. Pregnant patient requiring close and continuous maternal or fetal Monitoring admission after consultant order.

3. All pregnant mothers require HIV & hepatitis investigation for current  pregnancy Prior to admission. 

3. Transfer /Discharge

1. Maternal

   1. Transfer to be done within one hour post delivery or as per Physician’s order .

   2. All patient post NVD should have DVT risk assessment before discharege from labor room and post caeasarean section before discharge from word to home . 

   3.  All post delivery discharges from OB/Gyne Ward after 24 hours,  in  case of bed crisis after 12 hours of NVD.No discharge from L&D except in bed crisis situation .

2. Neonatal

   1. Transfer baby to nursery as soon as possible after bonding and Breast feeding . High risk baby should be transferred to NICU As per pediatrician's order with newborn identification.

6. PROCEDURE:

1. Admission - Nurse /Midwife (ER)

1. Prepare patients file 

2. Upon arrival in L&D the patient will be transferred to the allocated bed accompanied by the assigned nurse or midwife. Patient belogings and valubles not allowed.

3. The nurse /Midwife will assess patient general condition

4. The patient will be changed to clean hospital gown.

5. Check and record vital signs, urine analysis report to physician if any deviation from normal.

6. Obtain brief medical and obstetric history and course of delivery 

7. Do obstetric abdominal examination. Inform and reassure the patient.

8. Record the fetal heart rate and contractions with a CTG 

9. If labor status permits and there are no contractions, give enema and commence intravenous infusion extract routine blood works for laboratory test as per physician.

10. After reviewing the patients’ medical file OB doctor perform vaginal examination if not contraindicated.

11. Any abnormalities inform to resident on call ,senior registrar or consultant. 

2. Transfer/ Discharge from ER, L&D, Ward

1. Telephone receiving ward to inform them the transfer and confirm that  the bed is ready. Patients are not transferred during endorsement time, unless if there is an urgent need.

2. Transfer patient on wheel chair or stretcher according to patient  Condition.

3. Upon arrival in the unit , transfer patient to her allocated bed, ensuring That she knows how to use the nurse call bell.

4. Give concise report of the patient the labor delivery condition to the  Unit nurse.

5. The nurse/Midwife will ensure all the patient’s belongings are sent With her and handed over to the unit nurse except to L&D.

7. RESPONSIBILITY:

1. Chair man OB/GYNE Department

2. Physician OB/GYNE

3. Nurse /Midwife

8. FORMS/ EQUIPMENT:

1. Admission face sheet

2. Informed  surgical/medical consent

3. ID Band.

9.0 REFERENCE:

Maternal and Child Care by Lippincott.

10.0 REVISION

11.0 APPROVALS: