695830197-1622444731191-1622444688327-PROCESS-OF-HOSPITALIZATION.pdf

FON

1. PROCESS OF HOSPITALIZATION
By:Farzana Memon
Nursing Instructor
MCON liaquatabad
Unit XI:

2. OBECTIVES
At the end of this unit learners will be able to:
1. Define the term admission, transfer and discharge
2. Discuss the procedure for admission, transfer and discharge
3. Identify nursing responsibility during admission, transfer and
discharge
4. Discuss nurse role in preparing patients and family for discharge
5. Discuss the normal reaction of patient being hospitalized.

4. Admission the patient
 Admission refers to entry of a patient into health care
facility (hospital or other).
Entering a hospital for nursing care and medical or surgical
treatment


5. a.Anxiety and fear.
b.Decisional conflict.
c.Situational low self-esteem.
d.Powerlessness.
e. Social isolation.
f. Risk for ineffective therapeutic regimen management.
The nurse may help to reduce the severity of these common reaction to
hospitalization with warm , caring attitude and with courtesy and empathy.
Psychosocial Réponses on Admission:

6. Types of Admissions
6

7. Preparing the patient's room:
1. Before a patient is admitted, make sure the room is ready for his/her arrival.
a. Check necessary equipment, admission check list, Pen or pencil.
b. Gown or nightdress (if the patient is to be put to bed).
c. Portable scale, thermometer, sphygmomanometer, and stethoscope.
2. Make sure there is adequate light and proper ventilation.
3. Open the bed for patients by fan-folding the covers back, and attach the signal cord within easy reach.
4. Ensure patient supplies and equipment are present.
a. Wash basin, emesis basin, soap, towels, and lotion.
b. Bedpan and cover c. Urinal for male patients.
d. Other equipment may be brought to the unit to meet the needs of a particular patient. For example,
one patient may need an over bed trapeze, or an intravenous pole.
5. Make a final survey of the room to be sure it is clean, neat and orderly.

8. 1- Reviewing the physician`s order.
2- Meeting the persons immediate needs:
a. physical b. psychosocial.
3- Providing introduction and orientation
4- Performing a baseline assessment .
a. Interview and history taking
b. Observations and physical examination.
5- Caring for personal belongings
6- Documentation. (keeping record)
The nurses responsibilities on admission include
the following :

9. Check the physicians` s order for admission.
Welcome client to unit .
Check proper identification , attach to wrist.
Orient client to room and nursing unit ,describe items such as call bell system,
bath room and etc.
Provide privacy for client to change hospital gown.
Begin nursing assessment according to agency.
Perform any other action as directed by agency policy.
Complete admitting nursing assessment record .
Document Time and condition of the client on admission.
Nursing Intervention :

10. Transferring a patient
Transferring patient from unit to another or to other health care
institution according to the condition of the patient.
The changing condition of a patient, whether improved or more
critical, may require transfer either to another unit in the hospital or to
another health care institution, such as a nursing home or
rehabilitation hospital.

11. Reasons for patient transferred :
1. Sometimes the transfer is made at the patient's request:
a. Type of room (such as a private room).
b. Personal reasons, such as to find a more compatible roommate.
2. Transfer is made at the medical staff request:
a. The physician may request the patient be transferred from one level of nursing
care to another because of a change in the patient's condition that might require
more or less specialized care.
b. Sometimes the nursing staff will transfer a patient closer to the nursing station
where the patient's condition can be supervised more closely.

13. Cont….
1.Internal transfer:
To transfer the patient in a unit to provide a special care according the to the need of patient.
2.External transfer:
To transfer the hospital from one hospital to another hospital for the purpose of special care.

14. Steps involved in patient's transfer:
a. Informing client and family about the transfer.
b. Completing a transfer summary.
c. Speaking with a nurse on the transfer unit to coordinate the transfer.
d. Transporting the client and his or her belongings, medications,
nursing supplies, and chart to the other unit.
e. The nurse will post the transfer on the patient's chart include: (Time
of transfer, room numbers transferred from and to, reason for the
transfer, patient's attitude toward the move should also be charted).

15. PROCEDURE
 Transfer to another hospital/department
 Check the doctor’s order for transfer of patient
 Inform the patient and relatives
 Inform the ward sister where the patient needs to be transferred
 Check the chart for complete recording of vital sings, nursing care and treatment
given
 Collect patients x-ray medicine and other belongings

16. Cont….
 Cancel the hospital diet or transfer
 Make arrangement to settle the due bills if going to another hospital
 Record time, mode of transfer and general condition of the patient
 Assist in transferring patient to wheel chair/stretcher and accompany patient to
new area
 Hand over patient documents, belonging and report verbally to charge nurse/and
sister
 Collect the ward articles
 Inform the concern person/department regarding transfer of the patient
 Clean unit thoroughly and keep ready for next patient.

18. Discharging a patient
•Discharging a patient refers to releasing a patient from hospital to
home or to other health care facility.
•Patient is prepared for discharge when he is admitted in the hospital.
•He should be prepared physically mentally to leave the hospital or
ward.

19. REASON FOR DISCHARGE
 Cured
 Transfer to other hospital
 Discharged at request(DOR)
 Discharged against medical advice(LAMA)
 Death

20. PROCEDURE
 Check doctors written order for discharge
 Inform patient and relatives about discharge
 Document relevant discharge information
 Make sure all the fees are included such as special investigation, special
matters or devices, doctors or surgeons fees and narcotic drug used if any
 Obtain discharge prescription after retaining the medicines to be continued for
that day and after discharge

21. Cont…
 Send chart to billing section with relevant information
 Once bill is ready and chart is received back in ward, ensure that bill is
settled. check the cashier’s signature in the discharge bill
 Help the patient to obtain discharge summary, medical certificate and drugs
 Ensure that patient is instructed regarding medication follow up, out patient
visit, etc.
 Accompany the patient up to transport near exit gate

22. AFTER DISCHARGE
 Record time and date and condition of the patient at departure
 Sent chart to medical record department and inform to the concern
department
 After the patient has gone, the bed should be washed, blankets kept
in sunlight, mackintosh washed and dried
 The room and utensils should be cleaned and kept reedy for next
 Incase of infected cases, utensils should be disinfected and then
cleaned the linen should be disinfected and then send to laundry

23. Cont……
 When discharging the medico legal cases, the patient dead body should be
handed over to the police, before the concerning station should be informed about
the patient’s discharge/death
 Patient or dead body is hand over to the police and ask the police to sign with
the date and time

24. Thanks