Policy Number:

CLI.4110.PL.014 Death in Facility

Background

Updates to language throughout policy, section 13.1 Tissue Bank Manitoba Death, forms and supporting documents.

Key Message

Updated/new documents:

• CLI.4110.PL.014.FORM.01 Notification of Death
• CLI.4110.PL.014.FORM.02 Consent for Autopsy
• CLI.4110.PL.014.FORM.02.FR Consent for Autopsy
• CLI.4110.PL.014.FORM.03 Necropsy Clinical Data
• CLI.4110.PL.014.FORM.04 OCME Personal Care Home Death Report Form
• CLI.4110.PL.014.SD.01 Death Documentation Package Checklist of Forms
• CLI.4110.PL.014.SD.02 Tissue Bank Manitoba Sample Questions to Assess Donation Eligibility
• CLI.4110.PL.014.SD.03 Death in the Operating Room
• CLI.4110.PL.014.SD.04 Vital Statistics Manitoba Forms Requisition 2022
• CLI.4110.PL.014.SD.05 Spiritual, Religious and/or Cultural Considerations

Archived documents:

• CLI.4110.PL.014.FORM.03 – Shared-Health-Necropsy-Clinical-Data – Replaced SH-SS Document
• CLI.4110.PL.014.FORM.05 – Shared Health Authorization for Release Pathology Specimens – Replaced with Shared Health Link Shared Health, Authorization for Release Pathology Specimens F170-10-12
• CLI.4110.PL.014.FORM.06 – Shared Health Pathology Services Request for Placental Exam – Replaced with Shared Health, Pathology Services, Request for Placental Examination (R250-10-38-V02)
• CLI.4110.PL.014.FORM.07 – St. Boniface Pathology Services Laboratory Req – Replaced with Shared Health Link St. Boniface Pathology Services Laboratory Requisition R250-10-40 V01 (BRHC, HSAH)
• CLI.4110.PL.014.FORM.08 – Westman Pathology Services Laboratory Requisition – Replaced with Shared Health Link Westman Lab Pathology Services Laboratory Requisition R250-10-50 V01 (All other sites)
• CLI.4110.PL.014.SD.03 – Shared Health Pathology Specimens Policy – Replaced with Shared Health Link Shared Health, Authorization for Release Pathology Specimens F170-10-12

Recommendation(s)/Action Required

• All staff to review updated policy published on StaffNET.
• Print copies of policy and new revised forms and replace and destroy all past copies.

Timeline:

• Policy and documents to be actively used effective date published on StaffNET.

If you have any questions, please contact:

• Site Director or Manager

Submitted by: L Cassan, Regional Lead – Acute Care & Chief Nursing Officer