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Hospital Transfer Checklist

The document provides a checklist for transferring a patient from one hospital to another. It includes sections on preparing the patient, organizing necessary documentation and equipment, and ensuring safety during departure. The checklist covers monitoring the patient, securing lines and equipment, notifying relatives, preparing case notes and test results, advising the receiving facility, and properly equipping the ambulance.

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CHANDAK HOSPITAL
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215 views1 page

Hospital Transfer Checklist

The document provides a checklist for transferring a patient from one hospital to another. It includes sections on preparing the patient, organizing necessary documentation and equipment, and ensuring safety during departure. The checklist covers monitoring the patient, securing lines and equipment, notifying relatives, preparing case notes and test results, advising the receiving facility, and properly equipping the ambulance.

Uploaded by

CHANDAK HOSPITAL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Chandak hospital.

Katni
CHECKLIST TO TRANSFER PATIENT FROM HOSPITAL TO
OUTSIDE FACILITIES (INTER HOSPITAL)
Patients Name………………………………Age…….…Sex: ………Unique Id……………………I P No……...........

Blood Group…....…….Ward……………… Bed no …….....…Date of Admission……......................…

1 Patient Yes No Any remarks


1.a Appropriately monitored for transfer
1.b All infusions running and lines adequately
secured
1.c Adequately secured to trolley
1.d Adequately covered to prevent heat
1.e Staff adequately trained and experienced
1.f Relatives informed

2 Organization
2.a Case notes (photocopy if necessary)
2.b X-rays, results, blood collected
2.c Transfer documentation prepared
2.d Receiving unit advised of departure
2.e Telephone No of referring /receiving units
available for transfer

3 Equipment
3.a Appropriately equipped ambulance
3.b Appropriate equipment and drugs
3.c Sufficient oxygen supplies
3.d Ventilator transferred to ambulance
oxygen supply

4 Departure
4.a Patient trolley secured
4.b Batteries checked (spares available)
4.c Electrical equipment plugged into
ambulance power supply
4.d All equipment safely mounted or stowed

Nurse Concerned Doctor

Name
Sign

Date

Time

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