High dependency ward

EMTs have systems in place for the safe management of patients admitted to their facility.

While inpatient capacity is only required for Type 2 and 3, Type 1 fixed need to be prepared to take care of patients for an extended period of time while referral is being arranged. Medical supervision must be available 24/7, either on the wards or through an on-call system. Staff must have relevant training and experience for their assigned function, such as paediatric nurses allocated to paediatric patients.

1. Type 1 fixed must ensure basic nursing care with capacity to observe/care for patients while arranging referral.
2. Process established for selecting patients for admission and regular
   follow up of their status including mechanisms to promptly detect deteriorating patients.
3. Systems in place for structured shift handover and multidisciplinary ward rounds.
4. Ensure information flow to patients and relatives including timely notification about readiness for discharge from facility.
5. Train patients, family members or caregivers in tasks they might need to take on.
6. Protocols for transfer and referral of patients that need a higher level of care, specialist or follow-up/long-term care. Provide documented discharge planning and follow-up care.
7. Hand out a discharge document/copy of patient record to the patient.
8. Assist with arranging transport, follow-up care if necessary, access to medication provided, rehabilitation, wheelchairs or crutches or other aids as needed.
9. Ensure visiting arrangements, if needed, with adapted agreements for paediatric or intensive care patients.

!  1. Minimum nurse–patient ratio of 1 : 8 in every shift
!  2. Minimum doctor–nurse ratio of 1 : 3
!  3. Type 1 Fixed: at least three doctors trained in emergency and primary care

!  This symbol refers to minimum requirements for international deployments in particular for teams seeking global classification status.