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HOSITAL ADMISSION.pptx,Nursing Foundation.
- 1. HOSITAL ADMISSION & DISCHARGE PRESENTEDBY- SRITAMA PATRA
- 2. OBECTIVES DEFINITION OFADMISSION TYPES AND PRPOSE OF ADMISSION PREPARATION OF THE UNIT ADMISSION PROCEDURE ROLES AND RESPONSIBILITY OF NURSE IN ADMISSION PROCEDURE MEDICOLEGAL CASES DEFINITION OF DISCHARGE TYPES OF DISCHARGE DISCHARGE PROCEDRE ROLES AND RESPONSIBILITY OF NURSE IN DISCHARGE PROCEDURE UNIT AFTER DISCHARGE
- 3. Admission of aclient means, allowing a client to stay in the hospital for observation, investigations and treatment of the disease he/she is suffering fro from.” • “Admission is the entry of a patient into a hospital /ward for therapeutic /diagnostic purposes.”
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- 5. Clients are admittedin acute conditions requiring immediate treatment. E.g.: patient with heart attack, poisoning, breathing difficulty, RTA( Road traffic accident) etc . Patient should be admitted in casualty or emergency department to save the life of the patient. Clients are admitted for investigations and planned treatment and surgeries. E.g.: patient with diabetes, hypertension, appendicitis, jaundice etc.
- 7. • To receivethe patient in ward for admission according to his/her condition . • To welcome the patient . • To provide comfort and safety to the patient. • To provide immediate care. • To be ready for any emergency. • To assist the patient in adjusting to the hospital environment. • To obtain information about patient such as address, guardian, any information that serves as a basis of care e.g. Allergy, diabetes. • To establish Nurse-patient relationship.
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- 9. • The admittingoffice notifies the unit prior to the patient’s arrival, so that the room/bed can be prepared. • Some of the activities carried out by the nurse before the patient is to be admitted are: 1. open the bed, fold back the bedspread, top blanket, and top sheet. Cover the bed with full length mackintosh and two bath towels in order to protect from soiling . for ambulatory client, the bed should be in normal position. If client has to arrive on stretcher, the bed should be in lowest position. Make sure furniture in the room is arranged to ensure easy access to the bed
- 10. hospital adission pack,which containsitems sch as drinking glass,papers,lotion,etc shold be ready at bed side.hospital grown shold be available,although the client ay choose to wear own clothes. the client may require oxygen therapy, cardiac monitoring or suction equipment. The nurse should make sure that the equipment is functioning properly and is ready for patient use.
- 13. 1.Reception of theclient 2.Recording of social and medical data 3.Medical examination 1.Transporting client from O.P.D to I.P.D. 2.Reception of client by ward sister. 3.Preliminary observation of the client. 4.Helping to client to occpy his bed. 5.Care of valuables and clothing.
- 16. • At thetime of admission, the registered nurse perform complete assessment of the patient. • Enter patient name, date and time of admission, chief complains, medical diagnosis in the admission file or patient file. • Document - the source of information (family, patient, care giver or health care person or significant person). • Check the document if patient has previous hospitalization and past major illness. • Take patient vital signs (pulse, temperature, respiratory rate, height and weight). • Document if patient and family has valuables brought to the hospital. If yes, hand it over to the relatives with their signatures. • At the time of arrival to the unit or ward patient and family will be given orientation regarding the unit, visiting rooms, patients right and responsibilities. • In medico-legal case, the police has to be informed and the nurse has to keep documents confidential & under safe custody.
- 17. A medico-legal caseis one where besides the medical treatment; investigations by law enforcing agencies, are essential to fix the responsibility regarding the present state / condition of the patient.
- 18. • Accidents likeRoad Traffic Accidents (RTA), Industrial accidents • Cases of trauma with suspicion of foul play • Electrical injuries • Poisoning • Chemical injuries • Burns • Sexual Offences • Attempted suicide • Domestic violence and child abuse. • Cases of asphyxia as a result of hanging, drowning, suffocation etc • Death in the operation theatre • Death due to Snake Bite or Animal Bite • Drug overdose • Drug abuse
- 19. • In emergencies,resuscitation and stabilization of the patient will be carried out first and medico legal formalities may be completed subsequently. The consent for treatment is implied in all emergencies. • Hospitals will maintain a MLC register and the MLC will be initiated and documented in the register. • Medicolegal documents should be considered as confidential records and should be stored under safe.
- 20. • At thetime of admission, the registered nurse perform complete assessment of the patient. • Enter patient name, date and time of admission, chief complains, medical diagnosis in the admission file or patient file. • Document - the source of information (family, patient, care giver or health care person or significant person). • Check the document if patient has previous hospitalization and past major illness. • Take patient vital signs (pulse, temperature, respiratory rate, height and weight). • Document if patient and family has valuables brought to the hospital. If yes, hand it over to the relatives with their signatures. • At the time of arrival to the unit or ward patient and family will be given orientation regarding the unit, visiting rooms, patients right and responsibilities. • In medico-legal case, the police has to be informed and the nurse has to keep documents confidential & under safe custody.
- 21. “Discharge of patientfrom the hospital means, relieving a person from hospital setting, who admitted as an inpatient in that hospital” “Discharge or dismissal from the hospital means the departure of patient from the hospital” “Discharge from the hospital is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home.”
- 23. : Patient’s treatmentis over and the attending physician has discharged the patient. : Patient leaves the hospital without prior information. (left against medical advise/ discharge against medical advise): In LAMA/DAMA, patient chooses to leave the hospital before the treating physician recommends discharge . : Patient is transferred to another health care facility or within the sae hosppital fro one ward to another. After death of patient,the dead body is handed over to the relatives after copleting the discharge procedure.
- 26. ROLES & RESPONSIBILITYOF NURSE IN DISCHARGE PROCEDURE • 1. See doctor’s written order for discharge: no client should be discharged without doctor’s written order • 2. Explanation of discharge procedure • 3. Hand over personal belongings: clothing, jewellery or other valuables that were entrusted with hospital at the time of admission should be returned to client. • 4. Check and receive any hospital property: any of the hospital property that was given to client for his/her use in hospital should be checked and received back before he/she leaves • 5. Teach nursing procedures to be continued at home, get it’s practice done: Provide instructions regarding medication, follow-up visit • 6. Confirm bill paid: Before client leaves, nurse should confirm that the client has paid the hospital bill • 7. Inform other departments regarding discharge. • 8. Documentation: the nurse should check that the charts & files are completed 43 Monika Devi N R • 9.Arrange transport: if the client is not able to walk, then the nurse should see that he/she is transferred either on a wheel chair or stretcher • 10. If DAMA :-check consent, the form should state that the person is leaving against medical advise of doctor and that neither doctor nor the hospital can be held responsible for any ill effect happening after the departure • 11.Care of patient’s room and articles after discharge .
- 27. After a clientis discharged & before admitting another patient, the room is cleaned & aired. • All articles used by client should be taken to utility room, washed, cleaned, sterilized if necessary or disinfected by chemicals. The articles are re- arranged and kept ready for next client • Used linen should be sent to laundry • Mattress, pillows, blankets etc should be exposed to sunlight and then the bed is made with fresh linen • If the room was used for a client with communicable disease, it should be fumigated
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