ADMISSION OF CLIENT TO HOSPITALNAVREET KAUR

SAINI

OBJECTIVES•Admission- types•Admission procedure•Preparation of unit•Transfer procedure•Role of nurse

ADMISSION : It means allowing a client to stay in the hospital for observation, investigations and treatment of disease he is suffering from.

TYPES OF ADMISSION 1. Emergency Admission : Clients are admitted in acute conditions requiring immediate treatment. Ex: Client with heart attack, accidents, poisoning etc

2. Routine Admission : Clients are admitted for investigations and planned treatments and surgeries. Ex: Client with hypertension, diabetes, bronchitis etc 3. Transfer from one ward to another

ADMISSION PROCEDURE a) O.P.D (Out patient department) 1. Receiving the client : The personnel in admitting department should greet and make patient feel comfortable.• In emergency condition no time should be waste to initiate the treatment.• The manner in which doctor or nurse receive the client is most important aspect of reception.

2. Recording of Social and Medical data: Clerk in record section records data essential for identification of client.Social data: name, age, sex, education, address, occupation, religion, income, marital status, telephone no. etc.Medical data: Diagnosis, provisional diagnosis, duration of illness, name of doctor etc.

3. Medical Examination : A detailed social and medical history of the client is taken by physician and recorded. Patient’s temperature, BP, Pulse, respiration etc are recorded. • The necessary investigations such as x-ray, lab test are done to diagnose the disease and prescribe treatment.

b) I.P.D (Inpatient department):The clients who are suffering from mild ailments are sent home with necessary treatment. Others are admitted to hospital for further investigations and treatment. 1) Transporting the client from O.PD to I.P.D•Clients who are not very ill and are allowed to walk are escorted to ward by a nurse or attendant.•Wheel chairs should be available for those who are too sick, weak , not able to walk.•Clients who are bought to hospital on ambulance should be carried to their respective wards on stretchers.

2. Reception of the client by ward sister •The ward sister or the nurse admitting the client should introduce herself and greet the client and his relatives with friendliness. Her behavior should be such that she gains the confidence and cooperation of the client.•If the client is very sick she should put him on bed immediately.•The client who is not very ill is allowed to move about and can be taken to a round in the ward.

• Introduce the other clients to him and vice versa and also with nursing personnel in the ward.•Orient the client to whole ward, duty room, toilet rooms and unit prepared for the client.•Explain hospital policies, procedures, routines to the client and relatives.•Explain to client the time for meal servings, doctor’s visit, visiting time, prayer hours.•Make arrangements for paying hospital bills.•Issue diet pass or stay pass to the relatives.

•3. Preliminary Observation of client: The first few moments with client , facial expressions will denote his emotional reactions and presence of pain, fatigue.•Any discoloration of skin such as jaundice, cyanosis, facial paralysis should be noted. Further observations can be made while giving care to the client.4. Helping the client to occupy his bed: A closed bed is converted to open bed on admission of client.

• His temperature, pulse and respirations are recorded at the time of admission and later on at regular intervals.•Check the doctor’s orders that are to be carried out immediately.•Record in the inpatient chart, date and time of admission, condition of patient and observations made on the client.•Give time to patient to change his dress with hospital dress. Give assistance if client is not able to.

•If the client have to bath on admission , bathroom should be given.•Bed bath should be given to a client not fit for bathroom bath.•Bed bath gives opportunity to the nurse to examine client carefully.•Never leave a seriously ill client alone in the private room without any help.•If any tests are ordered by doctor, the nurse must make arrangements to carry out.•Carry out other procedures prescribed by doctor, if any.

5. Care of valuables and clothing :• If patient is wearing hospital dress, patient’s clothing should be handed over to relatives.•In case of absence of relatives, clothing is numbered, labelled and kept in store until such time it is handed over to relatives.•Encourage the client to send jewellery, money and other valuables such as watch to home with relatives. Make him understand if he keeps something with himself, it is on his own risk.

PREPARATION OF UNIT Preparation of Equipment:• Patient Bed• Linen, Sheets• Patient Locker• Patient Chart• Adequate light, clock, ventilation.• Wheelchair/Stretcher

Chartsdoctors ordersgeneral history sheetnurses recordTPR chart (temperature, pulse, respiration chart)progress recordintake output recordInvestigation record operation recordDischarge sheet

TRANSFER OF PATIENT FROM ONE WARD TO ANOTHER•The doctor in-charge will write the transfer order in the client’s chart•The sister in charge should inform the sister in-charge of the new ward•Clients chart should be completed and made up to date•The clients record with x’rays , ECG, lab reports and the medicine cards should be sent with the patient•The belongings of the patient should be checked and handed over to the sister

TRANSFER OF PATIENT FROM ONE WARD TO ANOTHER•The client and his relatives should be told about the purpose of the transfer to prevent anxiety •The client should be introduced to the sister in -charge of the new ward and vice versa•Arrangement for the diet should be made with the dietician•The procedure in the new ward will be similar to the admission procedure

ROLE OF NURSE IN ADMISSION

oArrange patient’s unit.oGreet the patient and orient to ward, other patients, patient’s room, equipments.oTell rules and regulations to patient.oComplete patient’s admission charts.oTake temperature, blood pressure, respiration, pulse of the patient.

ROLE OF NURSE IN ADMISSIONoCarry on required investigations.oFollow physician orders, administer prescribed medicine.oEnquire from patient if he is allergic to any medicines, apply allergy band and inform to physicianoGive instructions to patient to take care of belongings and valuables.

SUMMARY•Admission- types•Admission procedure•Preparation of unit•Transfer procedure•Role of nurse