1 Admission 1 Discharge to hospital, 2024.pptx

administration

1. بسم الله الرحمن الرحيم

2. Admission, Discharge, Transfer, and Referrals

3. Learning Objectives On completion of this chapter, you will List four major steps involved in the admission process . Identify 4 common psychosocial responses when clients are admitted to health agency. List steps involved in the discharge process . Give three examples of use of transfers in client care. Explain difference between transferring clients and referring clients.

4. The admission process

5. Admission process Admission means entering health care agency for nursing care and medical or surgical treatment . `

6. Admission الدخول Authorization from physician ( care & treatment ) تصريح من الطبيب (عناية او معالجة ) Collect billing information ( admission department) اجمع معلومات كشف الحساب ( قسم الدخول ) Complete agency’s admission procedure by nursing personnel اكمل العمليات الخاصة بالدخول

7. Document client’s medical history & physical examination Develop of an initial nursing care plan Initial medical orders for treatment

8. Types of Admissions

9. TYPE EXPLANATION EXAMPLE Inpatient Length of stay 24 hours Acute pneumonia Planned ( non-urgent ) Scheduled in advance Elective/ required major surgery Emergency admission Unplanned; stabilized in ER & transferred to nursing care unit Unrelieved chest pain , major trauma

10. TYPE EXPLANATION EXAMPLE Direct admission Unplanned; emergency department bypassed Acute condition such prolonged vomiting/ diarrhea Outpatient Less than 24 hours ; for continued care or treatment Minor surgery , cancer therapy , physical therapy Observat-ional Monitoring required ; need for inpatient admission determined within 23 hours Head injury , unstable vital signs , premature or early labor

11. Medical Authorization الطبي التفويض A physician determines that client's condition requires special tests , technical care or treatment Physician advise ينصح both client & nursing staff to proceed with admission process

12. Admitting Department قسم الدخول Patient file ملف المريض Information from client or family member Information include: Client’s address عنوان الزبون Place of employment مكان التوضيف Insurance company شركة التامين ⇨

13. Medical care information معلومات رعاية طبية Personal data البيانات الشخصية Notify nursing unit and escort client to unit بلغ قسم التمريض ورافق التمريض الي الوحدة Identification bracelet ( name & ID ) سوار التعريف

14. Nursing Admission Activities Preparing Client’s Room استعداد غرفة الزبون Welcoming Client الترحيب بالزبون Orienting Client التوجية بالزبون Safeguarding Valuables & Clothing Helping Client Undress Compiling Nursing Data Base

15. Preparing Client’s Room Ensure room cleanliness & stocked with basic equipment for initial care. Provide personal care ( soap , skin lotion , toothbrush , toothpaste & ... Place oxygen equipment or anything required for initial treatment .

16. Welcoming Client يرحب بالزبون Admitting nurse wears name tag , introduces self & also introduces clients who share the room. Make اجعل the client feel welcome . Greets the client warmly with smile and handshake .

17. Orienting Client توجية الزبون Person become familiar with new environment Facilitates comfort & adaptation تسهل الراحة التكيف When orienting client, nurse describes: Nursing station location , toilet , shower area Where to store clothing & personal items How to call for nursing assistance

18. How to adjust hospital bed and regulate room lights How to use telephone How to operate TV , daily routine as meal times When doctor visits & surgery scheduled When laboratory or diagnostic tests routine

19. Safeguarding Valuables & Clothing Give valuable jewelry & money to family members . Place clients’ valuables in hospital’s safe temporarily. Makes notation in record identifying valuables

20. Have second nurse or security person present when safeguarding valuables Make inventory signed by both nurse & client Identify client-owned equipment as wheelchair

21. Compiling Nursing Data Base On admission , begins assessing client and collect information for databas لقاعدة البيانات Registered nurse is responsible for admission physical assessment . Additions or modifications depend on client’s condition & agency policies. على شرط الزبون وسياسات الوكالة

22. Medical Admission Responsibilities Notifies physician when admission is completed ملاحظات الطبيب عندما يكون الدخول مكتمل Physician orders medications , treatments , lab & diagnostic tests , diet & activity . Obtains history يحصل على التاريخ Performs physical examination يودى الفحص الطبيعى

23. Helping Client Undress Provides privacy تزود بالخصوصية Helps client lie down if weak or tired . Rolls client from side to side to remove clothes that fasten up front or back .

24. Covers client with bath blanket after removing outer clothing or puts hospital gown , explaining that hospital gowns fasten in back

25. Common response to admission

26. Common Responses to Admission Some common reactions include: Anxiety ( قلق, خوف ) Loneliness ( الوحدة ) Decreased privacy ( نقص الخصوصية ) Loss of identity ( فقد الذاتية )

27. Anxiety القلق Fear الخوف Powerlessness انعدام القوة Decisional Conflict نزاع الحكم Social Isolation العزلة الاجتماعية Situational Low Self-esteem

28. It is an uncomfortable feeling caused by insecurity . هو شعور غير مريح سببه عدم الامان Vague , uneasy feeling شعور مبهم من المضايقة o f discomfort or dread caused by autonomic response ; feeling of apprehension شعور من الفزع مصحوب برد مستقل وشعور بالتخوف Anxiety

29. It warns of impending danger and enables the individual to take measures to deal with threat .” يحذر من الخطر ويمكن للفرد لاتخاذ اجرات للتعامل مع التهديد

30. Loneliness الوحدة Loneliness occurs when client cannot interact with family and friends . Nurses act as temporary surrogates & make frequent contact with client. To combat loneliness , many hospitals have adopted liberal visiting hours .

31. Decreased Privacy نقص الخصوصية Most clients have few feet considered their personal space . Clients often share rooms with strangers To ensure privacy , closes room doors unless require nursing observation . Protect each client’s right to privacy .

32. Protect clients from the view of others when giving personal care. Close door or pull curtains Knocks & asks permission to enter room

33. Loss of Identity فقد الهوية - Admission to hospital may temporarily deprive person of his/her identity - Learn & use client’s name . - Encourage clients to display family pictures or other small personal objects

34. The Method Discharge Planning Guide

35. TOPIC NURSING ACTIVITY EXAMPLE M-Medications Instruct client about drugs that will be self-administered. Insulin, anti-hypertension E-Environment Explore how home environment can be modified to ensure client’s safety . Remove scatter rugs T-Treatments Demonstrate how to perform skills involved in self-care & provide opportunities for re-demonstration . Dressing changes H-Health teaching Identify information that is necessary for maintaining or improving health Signs & symptoms O-Outpatient referral Explain what community services are available that may ease client’s transition to independent living. Physical therapy D-Diet Arrange for dietitian to provide verbal written instructions on modifying or restricting certain foods or suggestion for altering methods of preparation. Low-fat diet

36. Notifying Business Office Before client leaves agency , nurse notifies business office to verify that all insurance information is complete & that client has signed consent form authorizing release of medical information to insurance carrier .

37. Discharging Client When all preliminary business is complete , the nurse helps the client to : Gathering Belongings الممتلكات الخاصة Arranging Transportation ترتيب النقل Escorting the Client مرافقة الزبون

38. Gathering Belonging الممتلكات الخاصة Nurse helps client to repack personal items تساعد الممرضة لاعادة المواد الشخصية Use inventory of valuables to ensure that nothing has been lost or forgotten . A wheeled cart is helpful to transport client’s belongings.

39. Arranging Transportation ترتيب النقل Inform clients about agency’s “checkout time”. اخبر العملاء عن وقت الخروج Contacts client's family member or friend for assistance with transportation . If no transportation is available , client may use public transportation.

40. Terminal Cleaning Housekeeping personnel prepare client’s room for next admission . The bed is stripped of linen & cleaned with disinfectant , bedside cabinet is restocked with basic equipment.

41. Escorting Client مرافقة العميل Nurse takes client to door in wheelchair or allows client to walk there with assistance . Generally nurse remains with client until he/she is safely inside vehicle or waiting in lobby for ride .

42. CLIENT TRANSFER نقل العميل

43. CLIENT TRANSFER A transfer is discharging client from one unit or agency & admitting him/her to another without going home in interim . It may facilitate more specialized care , or it may reduce health care costs .

44. Transfer Activities نشاطات النقل Informs client & family about transfer . Completes transfer summary briefly describing client’s current condition & reason for transfer . Speaks with nurse on transfer unit to coordinate transfer.

45. Many hospitals are creating step-down units or progressive care units, for clients who were once in critical condition but have recovered sufficiently to require less intensive nursing care .

46. Transports client & his/her belongings , medications , nursing supplies , chart to other unit. When transferring client to nursing home or other facility , nurse conducts process similarly to discharge , client is discharged from hospital

47. CLIENT REFERRAL احالة العميل

48. Referral is process of sending someone to another person/ agency for special services A nurse , or discharge planner may help to refer clients for home care .

49. Because planning, coordinating , and communicating take time & initiate referrals as soon as possible once need is identified. Early planning helps to ensure continuity of care

50. Transferring Client Be sure to inform client & family of need for transfer as early as possible. Communicate with agency or unit where client will be transferred . Make photocopy of medical record.

51. Should include reason for hospitalization Significant findings الهامة النتائج Treatment rendered المعالجة المعادة Current condition & الشرط الحالى Instructions to client & family (JCAHO) التعليمات للزبون والعائلة (5) Check that client has been notified دقق بان الزبون اشعر

52. Place written information in large envelope or send them via facsimile (fax) machine with cover sheet. Accompany emergency medical staff or paramedics to client’s room . Help transfer client onto stretcher.