UT-Harris County Psychiatric Center
Nursing Procedures
Nursing
Harris County Psychiatric Center: Office Administration
Guidelines for the care of patients who expire and for preparation of the body with respect and dignity for transportation to the funeral home or morgue, and to support the family in their time of grief
death, post-mortem, LifeGift, medical examiner
The University of Texas Health Science Center at Houston
Date of
Last Review: 4/07
Guidelines for the care of patients who expire and for
preparation of the body with respect and dignity for transportation to the
funeral home or morgue, and to support the family in their time of grief.
Procedure:
Nursing staff notifies the Physician/Resident who examines the patient. After the patient is pronounced dead by the
physician, the nurse notifies the Director of Nursing/designee. The Head Nurse/Supervisor notifies the
Administrator/Administrator On-Call.
The Physician/Resident/designee contacts the family.
The Nursing
Supervisor/designee asks the family if they want to be contacted by LifeGift
Organ Donation Center.
·
If no, do not contact LifeGift.
· If yes,
the Nursing Supervisor/designee contacts LifeGift at 713-737-8111.
–
Provides LifeGift the patient’s name, age, sex, race, admit date, time of death, diagnosis,
and any other significant health history, next of kin’s name and phone number.
–
Fills out the LifeGift
Organ Donation Notification of Death form.
·
The LifeGift Coordinator obtains consent and sends a copy to
be placed in the chart.
The nurse gathers the following equipment and forms:
·
Postmortem checklist
· Policy and Procedure regarding postmortem care
· Authority for Release of Body Form
·
Shroud packs (adult or child)
Standard precautions will be used in postmortem care of
all patients.
Communication to
others outside UT-Harris County Psychiatric Center regarding special
precautions needed is required if patient was diagnosed
with one of the following
diseases:
·
AIDS
·
Anthrax
·
Brucellosis
·
HIV Infection
·
Plaque
·
Q Fever
·
Rabies
·
Rocky Mountain Spotted Fever
·
Syphilis
·
Tuberculosis
·
Tularemia
·
Viral Hemorrhagic Fever
·
Viral Hepatitis (types A, B, D, Non-A/Non-B)
Following the death of a
patient with a disease in the above category, personnel involved are to obtain
two tags available in the Shroud Kit (Adult or Child).
·
The name of the specific communicable disease is not
written on the tags.
· Two tags
from the Shroud Kit must be labeled:
–
COMMUNICABLE DISEASE
– STANDARD
PRECAUTIONS REQUIRED
·
The name of the patient is written on each tag.
One
labeled tag is attached to the foot of the deceased patient, (to the big toe
whenever possible) and the second tag secured to the shroud.
Personnel handling the deceased person shall follow
these precautions:
·
Wear gown, mask, double gloves, and protective eye-covering
when performing procedures involving contact with blood or body-fluids.
·
Contaminated disposable needles and syringes shall be
disposed of according to established policy.
·
Contaminated articles are to be double-bagged with red bag.
·
Spills of blood and body-fluids are decontaminated promptly
with a solution of Wexcide (sodium hypochlorite-household bleach) diluted 1:10
with water.
·
After pronouncement of death by a Physician/Resident, place
body in horizontal position with a pillow under the head and close the eyes and
mouth.
· Place
dentures, if any, in mouth. If unable
to do so, give dentures to family.
·
Remove any jewelry and personal belongings and give to the
family. If no family present, make a
list of articles and send to funeral home or morgue.
·
Allow family to be alone with the deceased, if desired.
·
Place body in the examination room until body is released to
Medical Examiner, funeral home, or LifeGift evaluation.
Medical Examiner's Case:
The Physician/Resident, Supervisor, Head Nurse or Charge
Nurse must notify the Harris County Medical Examiner's Office in any of the
following cases:
·
If death occurs within 24 hours after admission to the
hospital.
·
Patient involved in an accident leading to or contributing
to death.
·
Patient was suicide victim.
·
Patient was homicide victim.
·
Evidence or suspicion of foul play or child abuse exists.
·
Dead On Arrival (D.O.A.).
Have the following information available when calling
the Medical Examiner's office:
·
Patient's name, address, birthdate, age, diagnosis and
apparent cause of death.
·
History of illness and recent medical treatment.
·
Next of kin and telephone number.
·
Funeral home (if no funeral home is designated by the next
of kin, the Medical Examiner may elect to dispatch a car to pick up the
body). Indicate the name of the funeral
home to which the Medical Examiner dispatches the body on the Authority
for Release of Body form documenting that the funeral home is the Medical
Examiner's choice (i.e., Johnstone Funeral Home per Medical Examiner).
·
Advise that LifeGift has been called, if applicable.
The Release of Body Form shall indicate the following:
·
Name of the funeral home to which the body is to be
released.
·
Signature of next of kin and his/her relationship to the
deceased.
·
Two witnesses' signatures.
·
Designate whether the body is or is not to be transported to
the Medical Examiner's Office.
·
Funeral Director's receipt must be signed by representative
of the funeral home after proper identification of himself.
·
Body must not be released until proper signatures have been
obtained.
If the name of the funeral home has not been decided,
have the ARelease of Body@ form signed by the next of kin or responsible party
and write on the form that decision has been delayed.
UTHCPC
contacts the County Medical Examiner’s office and requests an autopsy in the
following cases:
·
Death occurs within 24 hours of admission
·
Unnatural death
·
Any unknown cause of death occurring during the patient’s
hospital stay
If an autopsy is to be performed:
·
Autopsies ordered by the Medical Examiner do not require
family signatures.
·
All postmortem examinations ordered by the Medical Examiner
are sent to the Harris County Morgue.
·
Authority for Release of Body Form must be signed according
to directions on the form and witnessed by two (2) persons.
Be sure patient's I.D. band is left on body.
Wrap body in shroud, tag body and shroud.
·
The name of the patient is written on each tag.
·
One labeled tag is attached to the foot of the deceased
patient (to the big toe whenever possible), and the second tag secured to the
shroud.
Complete Death/Postmortem
Care Checklist.
Document the following in the Progress Notes:
· Apparent
signs of death and time of occurrence.
· Time physician notified.
· Name of physician making pronouncement of death and time made.
· Note if family is present or has been notified.
· Time and route of disposition of body.
· Note if Medical Examiner was notified and if so, his/her name and to
whom the body was released.
· Note if belongings were sent to morgue, funeral home or with family.
Unclaimed
Body:
·
If unable to locate the next of kin or next of kin refuses
responsibility for the body, contact the Nursing Supervisor and Administrator
on-call.
· The
Medical Examiner, when notified, decides:
–
To arrange for transport of the body to the morgue
Or
–
Request that UTHCPC arrange for transport of the body to the
morgue.
·
The Administrator or designee notifies Harris County of
Potential County Burial Patients.
Call Harris County
Department of Social Services responsible for Harris County Burial Services
(8:00 a.m.-5:00 p.m. Monday through Friday phone 713-696-7900; after 5:00 p.m.,
weekends or holidays call the County operator for assistance at 713-755-5000.
The Nursing Director
or designee notifies appropriate hospital departments, such as Case
Management. Documentation of all
attempts to contact family members and deliberation as to disposition of case
should be indicated.
Related
Standards: