“Advanced Cardiac Admission Program” (ACAP) was developed and implemented at St. Luke’s-Roosevelt Hospital Center, New York, NY, since 2004.
It is comprised of multiple evidence-based novel pathways developed in concordance with ACC/AHA published guidelines with one aim is to close the gap between guidelines and patients management.
All patients admitted to St. Luke's-Roosevelt hospital center with any cardiac diagnosis is covered by this program.
The form package consists of Five PAGES:
1. Admission Note which include FOUR PAGES; this form will be the RESIDENT ADMITTING NOTE.
§ Page 1: includes patient demographics (please make sure you note, the gender, race and admit to it is real important in data analysis), HPI, PMH, medication list, PE, Labs CBC, BMP, Coags, Lipids*, CRP*, BNP**, LFTs, CRX, EKG, then free lance A&P.
*/** Essential for any ACS or CHF Admissions
§ Page 2 : is split into two portions
a. Top: is for Chest pain pathway patients (P.A.I.N), please choose from the list the appropriate category and choose why? Then choose your plan.
b. Bottom: is the heart failure pathway, check whatever applicable
§ Page 3: is admission form for patients with A. Fib either as a sole admit for A. Fib or as part of Heart Failure or ACS admission.
§ Page 4: is admission form for patients with Syncope either as a sole admit or as part of Heart Failure or ACS admission.
2. The Discharge note: IT IS A MUST TO BE FILLED BY THE INTERN ON THE DAY OF DISCHARGE AND THE NURSE HAS TO CO-SIGN AS WELL AS THE PATIENT, IT INCLUDES THE PATIENT’S ALL DATA, MEDS & THE RESULTS OF ALL HIS DIAGNOSTIC TESTS.
3. All forms are duplicate, one copy stays in the chart and the other copy is placed on the special ACAP racks to be collected by our research associates. The discharge summery is triplicate; as Patient would take a copy for his record.
To download any of the forms, please follow one of these links:
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| ACAP General Admission Note | Chest Pain and Heart Failure Admission | Atrial Fibrillation Admission Note | Syncope Admission Note | Insulin Drip Form (ICU) | Insulin Drip Form (CCU) | Cardiac Discharge Summary |
It is crucial to complete all forms appropriately; Please refer to the following example of how to fill these forms.
ALL Admissions get the 1st page, Patients Demographics
1. Chest Pain or Heart failure admission.