ADMISSION OF PATIENTS TO THE HOSPITAL.
Feb 15, 2016
ADMISSION OF PATIENTS TO THE HOSPITAL.
ADMISSION OF PATIENTS TO THE HOSPITAL.
ADMISSION: it is the entry and acceptance of a patient to stay in a health facility for the purpose of observation , investigation and treatment . Clients coming in for admission may walk-in (ambulant ) or not.
TYPES OF ADMISSIONS1. ELECTIVE/ PLANNED/ROUTINE 2. EMERGENCY
Elective /Planned Admission: with this type of admission the medical officer or the health care provider arranges with the patient on a convenient date for admission. Patient is informed well ahead of time to enable him prepare for the admission.
Patient is taken through the admission process from the OPD.
ADMISSION OF PATIENTS TO THE HOSPITALEmergency Admission- with this type
of admission patient reports to the hospital in a critical condition; he/her is usually brought in by people (relatives, friends or a good Samaritan).
The patient is transported to the ward in a wheel chair or stretcher. This type of patients needs immediate treatment.
REASONS FOR ADMISSION
For diagnostic investigations to be done
For treatments which may be medical or surgical
For observation
ADMISSION PROCEDURE (PLANNED/AMBULANT PATIENT)
1. Welcomed Patient/ relatives to the ward/unit and introduce yourself and any other nurse present to the patients
2. Collect the necessary documents i.e. admission papers and other information from the accompanying nurse
ADMISSION OF PATIENTS CONT’D1. Identify and confirm patient by name
particulars2. Provided seats for patient and the relatives
to make them comfortable3. Gather information from patient and if
necessary the relatives to fill the admission papers.
4. Depending on the condition provide an admission bed.
5. Assist patient to change into pyjamas or hospital gown and give identification bracelets if applicable
ADMISSION OF PATIENTS CONT’D6. Provide privacy and do baseline assessment
of patient and document (observation, vitals etc.), collect specimen if ordered.
7. Serve prescribed urgent medication if applicable.
8. Take care of patient’s valuables if necessary.
9. Ensure patients sign consent form for treatment.
ADMISSION OF PATIENTS CONT’D10. National health insurance scheme is
explained to the patient and relatives.11. Patients relatives are informed about
the visiting hours, thing the patient needed on admission. Patient is allowed to see relatives and bid them goodbye.
12. Patient is oriented to ward and its environment.
13. The nursing process is used to nurse the patient
ADMISSION OF PATIENTS CONT’D
14. Patient’s name and particulars are entered into the admission and discharge book as well as the ward state. Admission is documented in the nurses note.
ADMISSION PROCEDURE (EMERGENCY; PATIENT IN A WHEEL CHAIR OR
STRETCHER)Advance PreparingWash hands and assemble the following depending on the condition Temperature tray Resuscitation/emergency tray Oxygen apparatus
Patient is received into an already prepared bed- type of bed may depend on the condition of the patient i.e cardiac bed for for respiratory distress
ADMISSION OF PATIENTS CONT’D Tray for venipuncture Suction apparatus Blood pressure apparatus Bed to suit patient’s condition.
ADMISSION PROCEDURE…
1. Welcome patient/ relatives to the ward/unit and introduce your self and any other nurse present to the patients
2. Collect the necessary documents i.e. admission papers and other information from the accompanying nurse
3. Identify and confirm patient by name , particulars
ADMISSION PROCEDURE…
4. Quickly assess the patient’s general condition
5. Receive patient into an already prepared bed – depending on the condition.
6. Patient is changed into bed clothing if possible
ADMISSION PROCEDURE...7. privacy provided and patient is
assessed i.e. checking of vital signs, observation and examination- general appearance, skin for abnormalities, pain, breathing pattern, complaints, general reaction of the patient, level of consciousness, etc.
8. Relevant history is taken from patient or relatives
ADMISSION PROCEDURE...9. Ensure consent form is signed.10. Patients valuables are taken care of if
necessary11. National health insurance scheme is explained
to the patient and relatives.12. Patients relatives are informed about the
visiting hours, thing the patient needed on admission. Patient is allowed see relatives and bid them goodbye.
ADMISSION PROCESS…13. Depending on the condition specimen
collected and tested.
14. Nurse patient using the nursing process.
15. Administer prescribed medications
16. Patient’s name and particulars are entered into the admission and discharge book as well as the ward state. Admission is documented in the nurses note
ADMISSION PROCESS...The Role of the Nurse in the Admission Process meeting the immediate needs of the
patient- physical and emotional Thorough assessment of the patient-
nursing process Ensure patient is assigned to the
appropriate room. Write admission report- day and night
report Ensuring comfort and reducing anxiety of
patients and relatives
TRANSFER OF PATIENTSTransfer of patient within a healthcare facility/hospitalIt is the movement of a patient within the same health facility
Types Transfer in/Trans –in: when patient is moved
from one unit or ward of first admission to a new unit or ward. E.g. Medical to Surgical Ward, Emergency Ward to the Medical or Surgical Ward for update treatment. The receiving ward must be informed about trans in before it is done.
ROLES…Steps prepare a suitable bed to receive
patientAssemble the necessary equipment
depending on the patients condition i.e. oxygen apparatus, suction machine, vital signs tray.
Receive incoming patient, relatives and accompanying nurse warmly.
ROLES…
TRANS IN (CONT…) Take over the transfer notes and personal
belonging of the patient from accompanying nurse.
confirm patient’s identity with accompanying nurse
Ask for clarification on vital issues pertaining to the patient’s condition from the accompanying nurse.
Introduce self and other nurses around to patient and relatives
TRANS IN (CONT…)
Do a quick assessment of the patient’s condition and needs and act accordingly
Admit patient using the nursing process Orientate patient and relatives to ward and its
environment, routine of the unit if necessary Document time of patient’s arrival in the
nurses note, admission and discharge book and ward state.
TRANSFER OF PATIENTS
TRANSFER OUT/ TRANS OUT(CONT…)Transfer out/ trans out: it could be from unit to unit or facility to facility
StepsConfirm with receiving unitAssess patients conditionArrange for accompanying nurse Arrange for appropriate vehicle-
where applicable.
TRANSFER OUT/ TRANS OUT(CONT…)
Collect all necessary data Explain reason of transfer to patient and
relatives and reassure them to reduce anxiety
Obtain written consent for transfer Pack patients belonging Collect patients medications ,
investigations results and transfer notes Assist patient to dress up Assist patient into wheel chair, stretcher,
ambulance where applicable
TRANSFER OUT/ TRANS OUT(CONT…)hand over patient’s notes and
belongings to the accompanying nurse.
Enter patient’s name in the A&D book, ward state and nurse note.
DISCHARGE OF A PATIENT FROM THE HOSPITALDischarge occurs when a patient leaves the hospital after a period of treatment to his or her home; it normally done at the discretion of the medical team when patient is fit or his condition is stable or upon patient's own request.
It is important that patients and relative have a prior knowledge of the intended discharge.
DISCHARGE PLANNINGIt is a process that facilitate the
transition of the client from the health care institution to the most independent level of care, home or another health facility.
The over all goal of discharge planning is to provide the most appropriate level and quality of care throughout all stages of the client illness. To ensure adequate continuity of care.
DISCHARGE OF A PATIENT FROM THE HOSPITAL
The role of the nurse in discharge planning Include all caregivers involved in the care of the
patient i.e. physiotherapist ( multidisciplinary) Adequate assessment of patient during all the
stages of care to identify discharge needs. Assess health teaching needs of client and
family and provide family members with the knowledge and skills to care for the client in the home setting e.g. wound care, range of motion exercises.
Assess home situation i.e. bathroom facilities, doorway, steps , home arrangement etc.
DISCHARGE OF A PATIENT FROM THE HOSPITAL...
STEPSEnsure discharge is ordered by a
medical officer or signed letter from patient
Patient and relatives are informed about discharge
They are educated on the need for continuing treatment and follow up care
DISCHARGE… Ensure patient’s hospital bills are
worked out and submitted to the health insurance officer or paid at the revenue office by patients who are not members of the scheme.
Receipt number is entered into the A&D book and the receipt handed over to the patient.
Relatives are directed to collect prescribed drugs from the pharmacy if applicable.
DISCHARGE… Drug administration is well explained to
patient and relatives as well as education on home and follow up care
Patient is helped to pack belongings.
Any patient valuable in the nurses custody is handed over to patient and relatives, it is recorded, witnessed and signed.
DISCHARGE… Patient and relatives are once again
reminded of the review date and exactly where to report on the said date.
Bed linen is removed, bed and lockers are decontaminated.
Discharge is documented in the nurses note, A&D book and ward state.