Hospitalization

Hospital

1. Hospitalization 5/8/2020 1

2. Objectives At the end of this presentation the students will be able to Define Hospitalization Discuss the Types of hospital Composition of hospital Enumerate the Departments in hospital Enlist the Function of hospital Define the Admission of patient Know about the types of admission Describe the Purpose of admission Explain the Procedure of admission Explain the Responsibility of nurse on admission Define Discharge of patient 2 5/8/2020

3. Cont.… Enlist the Types of discharge Discuss the Purpose of discharge Explain the Procedure of discharge Enumerate the Responsibility of nurse on discharge Know about the transfer of patient Discuss the types of transfer Explain the procedure of transfer Describe the role of nurse in preparing patient & family for discharge Illustrate the normal reaction of patient being hospitalized References 3 5/8/2020

4. Hospitalization Hospitalization is the placing of a patient in a hospital and it is a form of individual stressors. Types of Hospitalization General Hospital Special Hospital Government Hospital Non-Government Hospital 4 5/8/2020

5. Composition of hospital Patient Medical Staff Various type of doctor Nursing Staff Nursing superintendents Head Nurses Ward sister LPNS Para Medical staff Pharmacist 5 5/8/2020

6. Cont.… Technicians Physiotherapists Dietitian Administrative staff Leady secretary Record keepers Accountants Clerks Peons Other staff 6 5/8/2020

7. Cont.… Cook Driver Ayahs Pantry Man Laundry Man Gardeners Part-time cleaner Ward Boys 7 5/8/2020

8. Department of hospital Administrative Department Medical Depart. Surgical Depart. Pediatric Dept. Gynecology & obstetrical Depart. Neonatal & premature Birth Depart. Neurosurgical Department Operation Theater Casualty Depart. Eye & ENT Depart. Skin & VD Depart. 8 5/8/2020

9. Cont.…. Orthopedic Depart. Radiotherapy Department Nursing Department Laboratory Section Pharmacy Section House keeping & maintained Dept. Laundry Mortuary Section Nursing school, Colleges & Pharmacy Lab Security Section, Spiritual care service Emergency Service section Various outpatient depart. 9 5/8/2020

10. Function Of Hospital Investigation, Diagnosis & Treatment of the sick or injured Health supervision, Immunization & prevention of diseases Medical and Nursing Education Training of paramedical staff Research 10 5/8/2020

11. Admission of patient It is the entry and acceptance for the purpose of a patient to stay in a health, faculty for the purpose of observation, investigation and treatment, client coming for admission may walk (ambulant) or not. 11 5/8/2020

12. Types of Admission They are two types of admission. Elective admission Emergency admission Elective 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 a head of time to enable him prepare for the admission. 12 5/8/2020

13. 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 ). 13 5/8/2020

14. Reasons For Admission For diagnostic investigations to be done For treatments which may be medical or surgical. For observation 14 5/8/2020

15. Purpose of admission Identify interdisciplinary assessment parameters & responsibilities to plan & deliver the appropriate level of care to meet the patient’s needs, evaluate the response of care, and support community care. To establish unified process of assessment and reassessment of patients admitted to the units. Admission physical assessment shall be done with in four hour in general unit . 15 5/8/2020

16. Cont.…. Admission physical assessment shall be done within one hour in special care unit . All data collected are entered on the nursing admission assessment sheet and available to all those involved in the care of the patient. Data that is not obtainable with in four hours of admission should be documented at the end of shift by the assigned nurse. 16 5/8/2020

17. Cont.…. The RN assigned to the patient is responsible to ensure that the form is completed within the time frame specified. Documentation should be in permanent ink (blue or black). The nurse should write her/his name, RN and signature . 17 5/8/2020

18. Procedure of Admission At the time of admission, the registered nurse performs complete assessment of the patient. Enter patient’s name, medical record number and age at the upper left corner of the form. Enter date & time of admission, medical diagnoses & chief complaint in the appropriate space in the form. Document the source of information(patient, family, caregiver or health care person or significant person) Check the document if patient has previous hospitalization & write patient history including past major illnesses. 18 5/8/2020

19. Cont.… Indicate if patient was admitted from ER (Emergency Registration), home, clinic, other and accompanied by whom. Take patients vital signs (temperature, pulse, respiration) height, weight. Assess & document the location and the severity of the pain using the pain scale. Document if patient has history of allergy, if yes, check whether it’s due to medication, food or others. 19 5/8/2020

20. Cont.…. Document patient brought medicine to the hospital. If yes, check whether it was send to pharmacy. Document if patient & family has valuables brought to hospital. If yes, check it was sent to admission office. At the time of arrival to the room, patient and family will be given orientation to the unit, an explanation to the patients’ rights and responsibilities. Check the activities of daily living and need of mobility aid . 20 5/8/2020

21. Admission of patient 21 5/8/2020

22. Role Of Nurse In Admission Of Patient. Arrange patient’s unit. Greet the patient and orient to ward, other patients patient’s room, and equipment. Tell rules and regulation to patient. Complete patient’s admission charts. Take temperature, blood pressure, respiration, pulse of patient . Carry on required investigation. Follow the physician order, administer prescribed medicine . 22 5/8/2020

23. Role of nurse cont.… Enquire from patient, if he is allergic to any medicines, apply allergy band & inform the physician . Give instructions to patient to take care of belongings & valuables . 23 5/8/2020

24. Discharge of patient “Discharge of patient from the hospital means, reliving a person from hospital setting, who admitted as an inpatient in that hospital ” TYPES OF DISCHARGE Planned Discharge DAMA Discharge LAMA Discharge 24 5/8/2020

25. Types of discharge Planned Discharge Patient completes the initial, actual management in the hospital under direct supervision of that hospital.’ 25 5/8/2020

26. Cont.. DAMA Discharge “I am leaving the hospital ward against medical advice. Doctor explained me about my disease condition and ill effects of discharge against medical advice. Doctors, hospital and staffs will not be responsible for any ill effects happening after my departure”. 26 5/8/2020

27. Purpose of discharge R educe hospital length of stay unplanned readmission to hospital I mprove the coordination of services 27 5/8/2020

28. Procedure of discharge See doctor’s written order. Explanations . Hand over personal belongings. Check and receive any hospital property. Confirm bill paid. Inform other departments regarding discharge. Arrange transport. Dama :-check consent 28 5/8/2020

29. Responsibility of nurse on discharge Check for medico legal history. Notify medical officer incharge. Abscond cases immediately contct medical officer incharge. Maintain all documents in a proper Manner. Take in written handing over Taking of articles. Never dischrge patient without Written order by physician. 29 5/8/2020

30. Transfer of patient Transfer of patient within a healthcare facility/hospital. It is the movement of a patient with in the same health facility. Types of Transfer of Patient They are two types of transfer of patient. Transfer in/Trans-In Transfer out/Trans-out 30 5/8/2020

31. Transfer In/Trans-in Patient is moved from one unit or ward of first admission to a new unit or ward. E.g.: Medical to surgical ward. ROLE: 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 . Take over the transfer notes and personal belonging of the patient. 31 5/8/2020

32. Role cont…. 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 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 . 32 5/8/2020

33. Transfer of patient 33 5/8/2020

34. Transfer Out/Trans-out It could be from unit to unit or facility to facility. STEP Confirm with receiving unit. Assess patients condition Arrange for appropriate vehicle-where applicable. Arrange for accompanying nurse Collect all necessary data. Explain reason of transfer to patient and relatives and reassure them to reduce anxiety. Obtain written consent for transfer Pack patient belonging 34 5/8/2020

35. Role cont… Collect patient medication, investigation result and transfer notes Assist patient to dress up Assist patient into wheel chair, stretcher, ambulance where applicable Enter patient name in the A and D book, ward state and nurse note Hand over patient’s notes and belonging to the accompanying nusre. 35 5/8/2020

36. Role of nurse in preparing patient & family for discharge Educate the patient & family throughout the hospital stay Listen to the honor the patient & family goals, preferences, observations, & concerns Provide resources to take home to back up information given in hospital and advise follow up: Advise who contact & when if their condition deteriorates 36 5/8/2020

37. Normal Reaction Of Patient Being Hospitalized 37 5/8/2020

38. References: Fundamental of Nursing Kozier & Erbs . 38 5/8/2020

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