Program details, eating disorders inpatient handbook CHW

Information about what you and your child should expect from the program. This includes topics such as visiting, mealtimes, dress code and medical examinations.

Treatment decisions

  • Decisions are made by the treating doctors in consultation with the other members of the multidisciplinary ating disorder team.
  • Most decisions except for everyday medical decisions are made at the team meeting held twice weekly, usually on
    Monday and Friday.
  • Goals of the admission, criteria for discharge, anticipated length of stay and treatment following discharge will be discussed in these meetings and decisions are made in consultation with parents.

Morning rounds

  • Every weekday morning, the team will see inpatients for morning rounds starting at 7.30am.
  • This is a chance for inpatients to ask questions to the team. Writing down questions is encouraged.
  • Morning rounds normally include a paediatrician, psychiatrist, clinical nurse, allied health, and junior doctors called registrars or residents. 

Nursing staff are responsible for the wellbeing of patients on their ward. 

They should be aware of:

  • Location of patients  
  • Who their patients are with  
  • Expected time of return if leaving the ward
  • Depending on their progress level, patients may leave the ward with their parents, nursing staff or a responsible adult.  
  • Please tell nursing staff if leaving the ward with your child. When leaving on an external gate pass you need to fill out a leave form.   

What to bring

  • Appropriate clothes for each day and warm pyjamas.  
  • Toiletries including toothpaste, toothbrush, shampoo, soap and deodorant.  
  • Your child can bring their own pillow and blanket.
  • Schoolwork materials such as textbooks or homework.  
  • Optional: appropriate magazines and books, music players, laptops and craft activities. The hospital cannot guarantee the safe keeping of these items.  

Calls and visits

Calls:

  • Your child may receive incoming phone calls from you.  
  • These calls must not interfere with the therapeutic program.  
  • Calls can be made before 8.30am, after 4pm, outside meal and rest periods. This includes their mobiles as well.  

Visiting  

  • An important part of the treatment process is for you to temporarily leave the responsibility of managing the eating disorder to staff.  
  • To facilitate the development of therapeutic relationships between your child and staff, visiting is initially limited to immediate family (Parents/guardian, siblings and grandparents).
  • This creates an atmosphere of time and space in which you can reconnect and re-establish normal relationships without eating being a major focus.

Visiting for immediate family is available: 

  • 4pm-8pm Monday 鈥� Friday
  • 9:30am 鈥� 8pm Saturday and Sundays.  
  • Visits should not occur during meal and rest times 

Other family and friends should use gate passes for visiting out of the hospital. Please discuss with the treating team if you would like other family members to visit during your child鈥檚 stay.  

  • Young people still attending primary school may find staying in hospital away from family challenging. A parent can stay overnight with their child if preferred.  
  • Please discuss with the team if your child is finding it difficult to be away from family during the night.  
  • Parents may find restrictions on this program are different from others.  
  • For patients at Wade ward, a visitor鈥檚 log is available for parents to identify appropriate visitors. 

Bathroom and toilet use

  • We aim to prevent any attempts at interfering with weight gain while still respecting privacy.
  • Your child is not usually supervised in the bathroom however, time in the bathroom is limited to 10mins for a shower once a day and 2 toilet visits per shift.  
  • The bathroom is not to be used during school, group, meal or rest times where possible.  
  • If the bathroom is needed during these times a nurse will either supervise or provide a pan for use.  

Bed rest

  • Your child may have to be confined to bed for a variety of reasons such as medical instability, or minimisation of energy utilisation.  
  • Bed rest involves sitting or lying on the bed. It can be with or without independent access to the toilet.  
  • If able to use the toilet and bathroom your child will need to call for the nurse to accompany them to the bathroom.   

Dress code

  • All clothing on the ward must be appropriate to a hospital setting and weather.  
  • If your child鈥檚 clothing is considered inappropriate particularly for the temperature, they will be asked to change.  
  • Your child will need to be dressed and out of their pyjamas prior to breakfast.  
  • A washing machine and dryer are available on Wade ward for the use of patients of that ward.  

Medical examinations

  • Your child will have regular medical examinations and blood tests to monitor their medical stability and nutritional recovery during the program.  
  • Nursing staff will check your child鈥檚 heart rate, blood pressure and temperature at least once a shift and more regularly if medically unstable.  
  • If medically unstable it may be necessary for your child to be attached to a monitor so their heart rate can be monitored continuously.  
  • A Dual X-ray Absorpitometry (DXA) scan will also be done in the first few weeks of admission. This scan provides important information about the impact of weight loss on your child鈥檚 body. It also helps calculate the minimum healthy body weight for your child. 

Weigh-ins

  • Your child will be weighed on Monday and Friday mornings before breakfast wearing a hospital gown and underpants.  
  • Prior to being weighed, they are asked to pass urine into a bedpan so all urine can be measured and its concentration tested.  
  • A bladder scan will also be done to inform staff that the bladder has been emptied.  
  • Random weigh ins may be done at staff鈥檚 discretion and are usually done if there is extraordinary weight variation.  

Medication

  • Patients admitted with an eating disorder are placed on vitamins and nutrient supplements.
  • Other medication may be prescribed if there is evidence of depression, or anxiety.  
  • This medication will start after consultation with you and relevant team members. The decision will be part of the psychological medicine consultation and only with parental consent.   

Meals

To encourage positive behaviours, main meals and snacks are eaten in the dining room on Wade ward and at a table on other wards. Nursing staff remain in the dining room to encourage normal eating patterns and to supervise the meal.    

When your child reaches level 3, they are encouraged to have up to 2 meals outside the ward with their parents per week. Food for these meals can be from the ward, provided from home or bought from one of the shops in the hospital. Please let the nursing staff caring for your child know if the food served has been eaten to ensure adequate nutrition.  

Individual requirements will be decided by the treating team at weekly review meetings including:  

  • Amount and range of food eaten each week, with the aim of your child gaining 0.8 - 1.0 kg each week.  
  • In the early stages of admission, your child may need to receive supplementary feeds. Supplementary feeds are usually given through a naso-gastric tube using a feeding pump. Once the feeds are connected, your child will need to call for a nurse if they need to go to the toilet.  

Post meal support:

  • After each main meal your child will have 60 minutes of supervised rest.  
  • If parents are visiting during this time, they can spend the last 30 minutes in their child鈥檚 room.
  • If your child is not at Wade ward, parents can accompany their child for the full 60 mins.  
  • Use of the bathroom is not permitted for 60 minutes post meals and snacks. 

Hospital school

Inpatients attend the hospital school during their admission once medically well enough. This is a requirement of the Department of Education.

  • Education programs are developed in consultation with medical staff, therapists, hospital schoolteachers and your child's home school.
  • Shortly after admission, you will be asked to complete a school registration form.
  • The hospital school will be in touch with your child's home school.
  • We want to reduce any pressure on your child but if there are special school requirements such as year 12 exams, this can be considered.
  • The hospital school staff can assist with re-entry into the usual school.