Health
Quest offers an outstanding health care, and wellness environment
in Christiansted, St. Croix (USVI). For individuals seeking
a welcoming and warm location for long term, intermediate or
shot term kidney care, please contact us for more information
at:
(340) 7RENAL7
(340) 773-6257
We will be happy to assist you with your stay in the U.S. Virgin
Islands!
THE TEMPORARY CARE OF DIALYSIS PATIENTS
(TRANSIENTS)
POLICY:
It is HealthQuest’s policy to accept dialysis patients
for temporary dialysis care, provided certain conditions are
met:
PROCEDURE:
1. Treatment arrangements are to be made only by the Facility
Administrator or Head Nurses working with the Social Worker.
2. A minimum of three
(3) weeks notice is required prior to the arrival of the patient.
3. A complete transient package will be sent to the patient’s
home facility for completion and returned to HealthQuest at
least two (2) weeks prior to the patient’s arrival for
treatment.
4. A local Nephrologist
with HealthQuest privileges agrees to accept responsibility
for the patient’s care.
5. The patient signs the local consent for treatment forms.
6. An admission summary
will be completed and a medical record number will be assigned
for the transient patient only if medical services are provided.
7. Current laboratory results and a copy of the most recent
treatment record must accompany the transient patient upon
his/her arrival for the first treatment.
Name:_________________________________________________________
Home Address:___________________________________________________
Home Phone: ____________________
Medicare number:_________________
Insurance Information:_____________________________________________
Local Address:____________________________________________________
Local Contact:__________________
Phone:___________________________
Dates treatments will
be required:___________________________________
ESRD Diagnosis:______________________________________________
Complicating Conditions:____________________________________________
Allergies:__________________________
Hepatitis status:________________
Activity level:________________________
Schedule:_____________________
Dry Weight:_________________
Heparin dose (loading
and subsequent):__________________________
Access Problems:_____________________________________________
Dialysate composition:_________________________________________
Dialysate flow rate:__________
Blood flow rate:___________________
Intra and post dialysis
medications and doses:__________________________________________________
__________________________________________________
Special Labs:_____________________________________________
TRANSIENT
PATIENT TRANSFER CHECKLIST |
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Name:____________________________________________________________
(PRINT)
Before being accepted
as a transient patient at HealthQuest, the following information
is needed:
______ Transient Dialysis
Information Summary Sheet
______ Medical History
and Physical Examination (within one year)
______ Short Term Care
Plan
______ Long Term Care
Plan
______ MEDICAL CONDITION:
STABLE
______ Copy of last
Clinic visit
______ INSURANCE CARDS
AND MEDICARE CARD (COPIES)
______ Nursing Assessment
______ Social Worker
Assessment – Social History
______ Dietician Assessment
– Diet History
______ Medication Summary
______ Labs –
cbc, chemistry profile summary
______ Hepatitis B
surface antigen (current)
______ EKG (current)
______ Chest xray (current)
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