18. Was the mother transferred to this facility for maternal medical or fetal indications for delivery? Definitions Instructions Sources Key words/Abbreviations Transfers include: 1st Labor & Delivery Nursing If the mother was transferred Admission Triage Form hospital to hospital from another facility check under: birth facility to hospital “yes.” Reason for admission If enter the name of the “yes,” Comments Does not include home to facility the mother transferred hospital. from. 2nd Admission H&P If the name of the facility is not known, enter “unknown.” 3rd Labor & Delivery Delivery Check if the mother was – “no” Record: transferred from home. Maternal OB/labor summary Labor and delivery admission history Labor summary record
18. Was the mother transferred to this facility for maternal medical or fetal indications for delivery? Definitions Instructions Sources Key words/Abbreviations Transfers include: hospital to hospital birth facility to hospital Does not include home to hospital. If the mother was transferred from another facility check “yes.” If “yes,” enter the name of the facility the mother transferred from. If the name of the facility is not known, enter “unknown.” Check “no” if the mother was transferred from home. 1st Labor & Delivery Nursing Admission Triage Form under: Reason for admission Comments 2nd Admission H&P 3rd Labor & Delivery – Delivery Record: Maternal OB/labor summary Labor and delivery admission history Labor summary record
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx