Table 1.

Ship hospital pre-hospitalization assessment sheet.

Pre-Hospitalization Assessment Sheet for the Ship Hospital, Port of Genoa
Name
Surname
Date and place of birth
Hospital
Ward
YES	NO	Patient with current COVID-19 infection diagnosis
		Colonized patient/patient infected with multidrug resistant organisms (MDRO)
		Colonized patient/infected with Clostridium difficile (CD)
		Dementia
		Drug dependence
		Psychiatric disorder
		Claustrophobia
		Oxygen therapy   Litres/min:
		Has the patient’s clinical and diagnostic assessment been completed?
		Are the patient’s clinical conditions stable?
		Does further hospitalization require low intensity care?
		Is the patient able to walk autonomously and are they self-sufficient in daily functions?
		Is the patient awake, oriented, and cooperative?
		Is hospital pharmacological therapy and clinical monitoring still required?
		Has a treatment cycle been prepared for the patient for the presumed duration of the disease?
		Has necessary clinical documentation been prepared for the patient, including a detailed treatment program?
		Does healthcare documentation contain the phone numbers of relatives or family members authorized by the patient?
First positive swab date:		Second swab date (if any):	Third swab date (if any):
Specify any comorbidities and/or essential anamnestic data: Signature and stamp of the Discharging Physician  Physician’s Mobile Phone: