Admission Discharge Transition Unit
Description of Unit
The Admission Discharge Transition Unit (ADTU) is an 18 room medical/surgical patient throughput-transitory unit for the adult and pediatric patients (age 16 and above with parent or guardian). The unit consists of 18 private rooms. 13 rooms (with pull curtains) can accommodate a bed. 5 rooms (with doors) can accommodate standard hospital furniture for those admission/discharge patients that do not need to lie on a bed. However, the 5 rooms with doors can accommodate the hospital stretcher-bed. The unit does not have isolation rooms. Monitoring capabilities include bedside pulse oximetry (not centrally based) and remote cardiac telemetry monitoring from Unit 54. The unit does have wall-mounted oxygen and vacuum.
Description of Patient Populations
The ADTU admits and discharges patient populations from the Emergency Department and Admissions. The unit also serves all UF Health Clinics by admitting the unscheduled direct-admit patient once they have been triaged through the Transfer Center.
ADTU patients can present as ambulatory, non-ambulatory, infected, and immuno-compromised as well as those being transferred to a nursing home or rehabilitation facility. Patients can be admitted or discharged on hospital beds, stretchers and recliner chairs.
Ineligible patients include those who are:
- being ruled out for TB requiring a reverse isolation room
- verbally loud
- patients are under the Baker Act (except those deemed appropriate for the ADTU by the Nursing Coordinator)
- requiring vasoactive drips (except those coming in for admission or discharge on hospital or home managed pumps)
- without discharge orders (except those patients approved by the Physician Director)
- patients without an assigned bed in an accepting transfer facility
- patients requiring invasive monitoring.
The primary mission of the ADTU is to provide safe, effective and just-in-time nursing care to newly admitted and discharged inpatients while proactively facilitating the hospital’s patient throughput needs and goals. Therefore, the ADTU is one of the hospital’s primary “hubs” for the in-patient admission and discharge experience.
Nursing care in the ADTU regarding the admitted patient is primarily focused on completing the initial assessment which includes a focused assessment and initiating the physician orders when the patient is admitted.
Nursing activities consists of: pain management including patient controlled analgesia, wound management, respiratory management including pulse oximetry, nutritional management including TPN, NG-tube/J-tube feedings, assessment and management of abdominal/GI drainage systems including G-tubes, J-tubes, ostomies, NGs, GU drainage systems, medication management, safety precautions and patient/family education and support. The ADTU also responds to the UF Health Physician clinics (in-hospital with an outpatient clinic designation) that call to have their patients non-emergently transported to the South Tower Emergency Department.
Health Care Team
The ADTU’s management structure consists of a Nurse Manager who reports to an Associate Vice President of Nursing and a Unit Assistant. Off-shift support is provided by the Nursing Coordinators.
The ADTU’s admitted and discharged patients are under the care of their respective surgical/medical services consisting of Attending physicians, fellows/chief residents, residents/interns physician assistants, and ARNP’s. Case Managers serve as liaisons between the medical staff and multidisciplinary team to provide continuity of care for the ADTU patient population from admission through clinic follow-up. Available ancillary services for the ADTU patient include; Pharmacy, Respiratory Therapy, Physical Therapy, Occupational Therapy, Nutrition Services, Diabetic Education, Lift Team as well as Patient and Family Resources services.
Department of Nursing staff members are provided educational experiences to attain and maintain competencies as defined by the unit/role specific job descriptions and the departmental education plan. Registered Nurses, Licensed Practical Nurses and Patient Care Assistants provide nursing care. The Support Tech role provides ambulatory support for patients and work with both the RN and PCA. The Registered Nurse is responsible for overseeing care of the patient based upon an individualized plan of care. Patient care delivered by LPNs and PCAs is coordinated under the direction of the Registered Nurse.
Care One Clinic
On 11/6/2012, ADTU leadership began accepted nursing management responsibilities for overseeing the Care One Clinic endeavor under the physician leadership of Dr. Leverence. The mission of the Care One Clinic is to invite those patients that have had a significant number of visits to the Emergency Department within a determined monthly rolling calendar as determined by Dr. Leverence and his leadership.
On 12/12/12 ADTU leadership assumed leadership of the “new” 72TU (Transition Unit) which has been used to assist with patient throughput. 72TU is an 8 bed unit with 2 recliner chairs and therefore can accommodate a total of 10 discharged patients.