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The below guidelines can decrease length of stay and facilitate discharge to acute rehab facilities sooner. Place Physical Medicine and Rehabilitation (PM&R) consult early on these diagnoses: spinal cord injury, stroke, amputations, brain injury.

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In addition to a patients medical clearance, it is important that the following are in place: 

• Patient has the potential to tolerate and participate in three hours of daily therapy 
• Accepting facility can manage patient¡¯s medical needs 
• Follow up appointments and upcoming diagnostic testing should be scheduled after discharge from rehabilitation (unless approved by accepting facility).

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• Work-up completed and treatment plan agreed upon by primary and consulting services
• Agreement of discharge readiness among consulting services
• No active psychiatric issues that would prevent participation in rehabilitation program.
• Sitter / 1:1 should be discontinued prior to transfer
• Dialysis cannot be provided for patients under age 18

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• LVAD may be admitted after all equipment and batteries issued
• Documented Weight Bearing Status, orthopedic or spinal precautions
• Blood product transfusions no more than three times per week
• No telemetry monitoring
• Stable labs values, requiring lab draws no more than two times per week

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• Suctioning needed at a maximum frequency of every four hours
• Respiratory treatments maximum frequency of every six hours
• O2 per nasal cannula 4 LPM or less
• O2 per trach collar FiO2 40% or less
• Two caregivers should be identified for vented patients

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• No PIV medications, except IV antibiotics with PICC line
• No IV chemo medications; oncology plan to be established prior to discharge. No radiation therapy
• Established anticoagulation/DVT ppx, if age appropriate
• IVIG after initial dose must be approved 48 hours prior to transfer

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• Oral diet or able to tolerate tube feeding to provide caloric and fluid requirements
• Gastrostomy tubes recommended. NG/NJ tubes accepted on a case by case basis
• TPN patients need to be on a stable solution for discharge to home on TPN

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• No active TB
• No airborne/droplet precautions
• Isolation protocols vary by diagnosis at Shirley Ryan ³Ô¹ÏÌìÌÃ91, secondary to rehabilitation outside patient rooms

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These are guidelines. For more information, please speak with your Shirley Ryan ³Ô¹ÏÌìÌÃ91 liaison or consulting physician.