Nursing foundation- admission procedure of the patient in a hospital And sample documents of AIIMS

1. ARUNDHATI
FINAL YEAR
BSC
NURSING
Admission procedure

2. OBJECTIVE
 After studying the unit, students will be able to
 Describe the admission procedure of a patient
 Prepare the patient relatives and unit for his/her
admission

3. INTRODUCTION
 Admission to the hospital can be a traumatic
experience with anxiety and fear for anyone. The
patient no longer enjoys any of the special privileges
enjoyed at home. Most people are not used to a
hospital atmosphere and its regimen. The person
loses his identity, independence and control of daily
activities. The nurse is one of the most important
persons the client meet in a hospital. The manner in
which the client is admitted to the hospital helps to
diminish some of the anxiety and fear.

4. DEFINITION
 Admission of patient means allowing and facilitating
a patient to stay in the hospital unit or ward for
observation, investigations and treatment of the
diseases he or she is suffering from.

5. INDICATIONS
 A person can be admitted to a health care facility
with several reasons including
 Therapeutic aspect for treatment of any acute or
chronic disease
 For observation of the status of client
 For diagnostic need
 For surgical interventions
 On an emergency basis
 For condition requiring expert care.

6. PURPOSES
 To receive the patient in the ward for admission
according to his 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 hospital
environment
 To establish a nurse patient relationship

7. TYPES OF ADMISSION
 Depending on planning
Routine admission
Emergency admission
 Depending on time spent in hospital
Long term
Short term
 Depending on purpose of admission
diagnostic
therapeutic

8. Emotional response to hospitalisation
 Female clients may be worried about their children,
lack of caretakers, decreased pain thresholds,
disruption of family routines and disruption of
marital relationship.
 Males may be worried about the treatment financial
burden, pain discomfort due to pathological
conditions.
 Children develop feeling mistrust, fear of pain and
strange environment

9. NURSES RESPONSE
• The nurses attitude to the newly admitted
client should be friendly and unhurried
• Make the patient feel at ease
• The patient should be received like a
guest in courteous manner
• Thus much of the clients fear can be
alleviated by skilled admission
• Confidence and competence from nurses
have a positive influence on the patients

10. METHOD OF ADMISSION
ROUTINE ADMISSION
In routine admission client reaches the OPD first. The
clerical staff gathers information to start patients
record and is escorted to doctors office where doctor
makes a decision for admission.
In the admission office detailed information is
gathered regarding identification data, insurance
coverage, possible allergies etc. the client is issued an
identification number. From admission office the
client is taken to nursing unit by an auxiliary person

11.  EMERGENCY ADMISSION
In emergency admission safety and immediate care
of the client is essential to save life. From emergency
department client is admitted directly to special care
units such as ICU, CCU, burns unit, emergency OT. In
these situations relative go to the admission office to
provide necessary information.

12. OPD
Doctor’s Office
admission office
ward
Emergency department
OT CCU ICU Burns unit
or a ward
Routine admission Emergency admission

13. PREPARATION OF THE UNIT
Keeping the bed ready
Open the bed, fold back the bed spread, top blanket
with a full length Macintosh and two bath blankets in
order to protect the bed from soiling
Position the bed
For the ambulatory client, the bed should be in normal
position. If the client has to arrive on a stretcher, the
bed should be in lowest position. Make sure that the
furniture in the in the rom has been arranged to
ensure easy access to bed.

14. Assemble necessary equipment and supplies
Including hospital admission pack (basin, water
pitcher, tissues, glass, soap, etc) hospital dress, vital
signs tray, weighing machine, specimen bottle and so
on. Also assemble special equipment-oxygen cylinder,
suction apparatus, etc
Adjust physical environment: proper lighting
ventilation

15. ARTICLES RATIONALE
 All articles for open
bed (bottom sheet
draw sheet top sheet
blanket, etc)
 Macintosh full length
 Two bath blankets
 Hot water bags in cold
weather
 To receive patient
 To protect the bed from
soiling
 To cover the bed length
 To keep bed warm
ARTICLES

16. ARTICLES RATIONALE
 Other articles for daily
care of the patient e.g
vital tray sponge tray,
a set of hospital clothes
 Any other special
equipment such as
oxygen suction,
monitoring euipment
 To be ready to give care
to patient.
 To meet emergency life
situations

17. HELPING THE PATIENT TO OCCUPY BED
A Nurse should observe the following while helping the
patient to occupy the bed
 Receive the ambulatory patient in the admission bed
and greet him with name and introduce yourself
 Adjust the height of the bed depending on patients
condition
 Accompany the patient to his bed.
 Arrange for the assistance, if patient arrives in trolley
for shifting
 Maintain privacy

18. Remove extra furniture in the room for
smooth transportation
Check the doctors order for stat medication

19. Orientation of patient to ward
 Introduce the patient to the hospital staff and other
patients
 Show him bathroom facilities
 Arrange personal belongings
 Valuables are listed and handed over to relatives
after taking consent
 Show communication system
 Inform meal timing visiting timing doctors round
and ward routine

20. STEPS OF ADMISSION PROCEDURE
 Prepare the room with care & arrange all items in
place &adjust height of the bed.
 Check the clients identity & greet his relatives.
Introduce yourself.
 Observe the clients vital signs & symptoms & collect
specimens for lab test, if required.
 Provide privacy, give admission bath if needed.
change to hospital clothes.
 Explain use of bathroom & other equipment in ward.
Place a call bell and a locker in easy reach of the
client. Explain meal times & visiting hours.

21.  Answer queries of patient and family
 Complete necessary records as per agency policy that
includes nursing history and assessment.

22. FEW SAMPLES OF
RECORDS USED IN
OUR HOSPITAL

27. SPECIAL CONSIDERATIONS DURING
ADMISSION
 When the patient is admitted in critical collect only the
most pertinent information
 In case of unknown client keep their clothing and
valuables safety and label them. Inform police
department
 Never leave patient alone in causality. A female client
should never be left alone with male attendant
 All jewellery should be removed at the time of admission
(white & yellow metals) with label and keep it under
custody or returned to family
 Medico legal cases should have the MLC stamp and
notified MLC no. in case sheet

28. MEDICOLEGAL ISSUES
Nurses must keep the following medico legal issues
under consideration to safeguard themselves and the
institution.
 Physician must be informed immediately on arrival
of patient to OPD.
 Patient’s OPD records must be kept under lock and
key
 Patients record must be kept confidential
 Patient’s belongings should be kept under custody

29. • A complete record of description of the patients
body fluid must be maintained
• It must be ensured that no evidence related to
patient must be destroyed/lost
• A written consent must be taken from the patient
before any invasive procedure
• It is compulsory for the nurse to provide
information to the police officer. In case of any
difficulty immediate higher authority may be
informed

30. TRANSFER IN OF A
PATIENT

31. DEFINITION
 Transfer of a patient is defined as shifting a patient
from one department to another department in the
same hospital or between hospitals

32. PURPOSE
 To receive different forms of therapy and the
management
 To have care continued closer to home
 To have care continued when financial resources
prohibit receiving care in current facility.
 To provide more skilled care and close observation in
specialised units

33. ARTICLES
1. Wheelchair or stretcher
2. Oxygen tank and tubing
3. IV stand
4. Cardiac monitor
5. Requisition forms
6. Records

34. PROCEDURE

35. SUMMARY
 It is very essential for the nurse to introduce herself
to patient as he/she may be experiencing
fear/anxiety etc. Relative need to be treated wit
kindness. The patient needs to be informed about
his/her immediate n environment. The nursing
procedure required for admission of a patient inlude
recording vitals signs, collection of specimens
admission bath, care of clothing and valuables,
maintaining the patient’s records.

36. REFERENCE
 FUNDAMENTALS OF NURSING 2005
A PROCEDURE MANAUL (TNAI)
Page: 129-131
 POTTER AND PERRY’S
FUNDAMENTALS OF NURSING
page 320-322
 PRACTICAL MANUAL OF NURSING
Jacob
page 58-68