Transcript ADMISSION OF PATIENTS TO THE HOSPITAL.

ADMISSION OF PATIENTS TO THE HOSPITAL.
ADMISSION OF PATIENTS TO THE
HOSPITAL.
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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 ADMISSIONS
ELECTIVE/ PLANNED/ROUTINE
EMERGENCY
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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 HOSPITAL
Emergency 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
1.
Collect the necessary documents i.e.
admission papers and other information from
the accompanying nurse
ADMISSION OF PATIENTS CONT’D
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Identify and confirm patient by name
particulars
Provided seats for patient and the relatives
to make them comfortable
Gather information from patient and if
necessary the relatives to fill the admission
papers.
Depending on the condition provide an
admission bed.
Assist patient to change into pyjamas or
hospital gown and give identification
bracelets if applicable
ADMISSION OF PATIENTS CONT’D
6.
Provide privacy and do baseline assessment
of patient and document (observation, vitals
etc.), collect specimen if ordered.
7.
Serve prescribed
applicable.
8.
Take care of patient’s valuables if necessary.
9.
Ensure patients sign consent form for
treatment.
urgent
medication
if
ADMISSION OF PATIENTS CONT’D
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13.
National health insurance scheme is
explained to the patient and relatives.
Patients relatives are informed about the
visiting hours, thing the patient needed on
admission. Patient is allowed to see
relatives and bid them goodbye.
Patient is oriented to ward and its
environment.
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 Preparing
Wash hands and assemble the following
depending on the condition
 Temperature tray
 Resuscitation/emergency tray
 Oxygen apparatus
ADMISSION OF PATIENTS CONT’D
 Tray
for venipuncture
 Suction
 Blood
 Bed
apparatus
pressure apparatus
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
necessary
11.
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 patientphysical 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 PATIENTS
Transfer of patient within a healthcare
facility/hospital
It 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 patient
 Assemble 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
Steps
 Confirm with receiving unit
 Assess patients condition
 Arrange 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
HOSPITAL
Discharge 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 PLANNING
 It
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...
STEPS
 Ensure
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
 Any
is helped to pack belongings.
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.