Admissions criteria - Nottingham University Hospitals NHS Trust

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Referrals to the unit need to be made via NOTIS using the on-line referral form.
Order item code for referral is “LLNRU”.
Admission Criteria
Linden Lodge Rehabilitation Unit is a 25-bedded unit which accepts patients who
require complex specialist in-patient rehabilitation. New referrals will be discussed within
the multi-disciplinary team and will usually also receive a pre-admission assessment
visit.
Patients will not be admitted if they meet any of the exclusion criteria outlined
in Sections 1 – 6 below.
Criteria
Inclusion
Exclusion
1. Condition
New neurological condition (for
oncology - see below) affecting
the brain, spinal cord or
peripheral nerves such as
traumatic brain injury, hypoxic
brain injury, spinal cord injury or
disease, encephalitis, meningitis,
Guillain-Barre syndrome
Stroke - refer to the stroke wards
(see below for more detail)
All subarachnoid haemorrhage
whether managed surgically or
not
Dementia
Parkinson's disease - refer to
specialist Parkinson's disease
service eg:
a) in-patients to Health Care of
Older Person wards at NUH
b) out-patients to NUH Rehab, City
Campus, Nottingham University
Hospitals NHS Trust or to Lings Bar
Hospital
Spontaneous intracranial
haemorrhage following head
trauma or cranial surgery
Spontaneous intracranial
haemorrhage in the absence of
head trauma or cranial surgery –
refer to stroke wards. This includes
those patients who require
craniotomy.
Existing neurological conditions
requiring intensive in-patient
rehabilitation eg following relapse
of multiple sclerosis or for
complex spasticity management
Patients who do not need in-patient
rehabilitation. Consider referral to
out-patient services.
Neuro-oncology patients who
have a definite oncology plan
documented & sent with referral
No documented oncology plan
Neuro-oncology patients with a
favourable prognosis as
established by referring oncology
team
Non-neurological conditions
Prognosis is not favourable
Patients requiring chemotherapy or
radiotherapy during proposed inpatient rehabilitation period
Patients who have limited exercise
tolerance or limited potential to
benefit from rehabilitation
Patients who do not need in-patient
Referrals to the unit need to be made via NOTIS using the on-line referral form.
Order item code for referral is “LLNRU”.
requiring complex in-patient
rehabilitation such as multiple
fractures or complex amputees
2. Age
rehabilitation
16 years and above whose needs Below 16 years
can be met by adult services
Patients aged 16-17 years who:
a) may be better served in
neuro-paediatric services
b) require access to education
(access to education is not
available at LLIP)
3. Need for
complex
specialist inpatient
rehabilitation
Needs complex specialist inpatient rehabilitation
Non-complex rehabilitation required
Does not require in-patient
rehabilitation
Appropriate for out-patient or
community services
Appropriate for Lings Bar Hospital
(ie people usually over 60 years
who required slow-stream
rehabilitation for less complex
conditions or those who require nonweight bearing beds after lower limb
fractures).
3. Suitability
for
rehabilitation
Willing to cooperate with staff and Minimal potential for improvement
to participate in a programme of
No realistic rehabilitation goals
rehabilitation.
identified
Pre-admission assessment
Needs would be served better
identifies potential to improve &
elsewhere eg specialist spinal
benefit from a rehabilitation
centre, behavioural management
programme.
unit
Clear & realistic goals of
admission
Significant co-morbidities that would
compromise ability to participate
actively in rehabilitation eg severe
cardiac failure, COPD, or multiple
co-morbidities.
Very limited functional
independence pre-morbidly
4. Medical
management
Medically stable
Medically unstable
Unpredictable medical conditions.
Requires medical support which is
not available on unit eg ventilation,
piped oxygen
Referrals to the unit need to be made via NOTIS using the on-line referral form.
Order item code for referral is “LLNRU”.
Stable tracheostomy, medically
stable, does not require oxygen.
Maximum of 2 patients with
tracheostomy at any time.
Unstable tracheostomy; requires
frequent suction
Need for ongoing oxygen therapy
2 patients with tracheostomy
already at Linden Lodge NRU
5. Behavioural
management
Patients with occasional
outbursts of aggression or some
level of disinhibition who can be
managed safely with supervision
of 1 person
Patients whose behaviour cannot be
safely managed with supervision of
1 person
Patients whose behaviour poses
risk of harm to self or others & who
require specialist behaviour
management
Patients whose behaviour is
abusive, insulting or threatening
towards staff & needs specialist
management
Patients whose behavioural
problems are not primarily resulting
from neurological injury
Patients who currently misuse drugs
or alcohol
5.
Psychological
/ psychiatric
management
Psychological disturbance
secondary to a neurological
condition (see 1.)
6. Patient / GP
address
Patients with a Nottingham/shire
GP
A person whose primary needs
arise from a psychiatric condition.
Patients who need access to
specialist neuropsychological
assessment and therapy.
Patients from out of area may be
considered if the patient is an inpatient in Nottingham University
Hospital, if they are suitable for
rehabilitation, if patient & family
agree & if a bed is available
Note - patients resident in
Nottingham/shire with
Nottingham/shire GP will be given
priority over patients from out of
area.
Patients from outside
Nottingham/shire who require
complex discharge planning &
whose needs would be better
served by services local to their
residence
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