Admission of patient..

1. ADMISSION OF PATIENT IN THE
HOSPITAL
Ms. RIWANKA.K
ASST. PROFESSOR
CON, NEMCARE FOUNDATION

2. ADMISSION OF PATIENT
Definition:
Admission is defined as allowing a patient to
stay in hospital for observation, investigation,
treatment and care.

3. PURPOSES OF ADMISSION
To welcome the patient
To provide comfort and safety to the patient
To provide immediate care
To be ready for any emergency
To establish nurse-patient relationship
To undergo evaluation & treatment

4. PURPOSES OF ADMISSION (CONT..)
To know what is really happening in his/her
body.
To obtain information about the patient.

5. TYPES OF ADMISSION:
1. Emergency admission
2. Routine admission
Emergency admission: In this, patients are admitted
in acute conditions requiring immediate treatment.
Examples. Patient with RTA, Poisoning, burns and
cardiac or respiratory emergency.

6. TYPES OF ADMISSION(CONT..)
Routine admission: In this, patients are
admitted for investigation, diagnostic and
medical or surgical treatment. Treatment is
given according to patients problem. E.g. Patient
with hypertension, diabetes mellitus etc.

7. PREPARING THE UNIT FOR ADMISSION
1. Keeping the bed ready
2. Position the bed
3. Assemble necessary equipment and supplies
4. Assemble special equipment and supplies

8. PREPARING THE UNIT FOR ADMISSION (CONT..)
Keeping the bed ready:
Open the bed, fold back the bedspread, top
blanket, and topsheet.
Cover the bed with a full bed-length
mackintosh and 2 bath blankets in order to
protect the bed from soiling.

9. PREPARING THE UNIT FOR ADMISSION (CONT..)
Position the bed:
Ambulatory clients, the bed should be in
normal position.
If the clients has to arrive on a stretcher, the
bed should be in lowest position.
Make sure that the furniture in the room has
been arrange to ensure easy access to the
bed.

10. PREPARING THE UNIT FOR ADMISSION (CONT..)
Assemble necessary equipment and supplies:
A hospital admission pack, which contains
items such as bath basins, drinking glass,
thermometer, paper and lotion should be
ready at bedside.
A hospital gown should be available, although
the clients may choose to wear personal
clothes

11. PREPARING THE UNIT FOR ADMISSION (CONT..)
Assemble special equipment and supplies:
Oxygen therapy, cardiac monitoring, or
suction equipment.
Make sure that the equipment is functioning
properly and is ready for the patient’s use on
arrival.

12. PREPARATION OF ARTICLES
Articles Rationale
 All articles for an open bed, bottom
sheet, draw mackintosh, draw-sheet,
top-sheet, blanket, counterpane.
 To keep the bed ready to receive the
patient in a calm manner.
 Full bed length mackintosh.  To protect the bed from soiling with
excreta/blood/dirt.
 Two bath blankets/bed sheets.  To cover the bed length mackintosh and
another to cover the patient.
 Hot water bags in cold weather.  To keep the bed warm before hand.
 Other articles required for daily care of
the patient e.g. temperature tray, sponge
bath tray, a set of hospitals clothes.
 To be ready to give care to the patient.
It can save time and energy for the
nurse.
 Any other special equipment such as
oxygen suction, monitoring equipment.
 To meet emergency in life-saving
situations.

13. RECEPTION OF THE PATIENT
In most hospitals, the admission of a client
begins in an admitting office, where basic
information is obtained
The client is assign an identification number,
which serves to identify his/her record during
hospitalization

14. RECEPTION OF THE PATIENT (CONT..)
Clients are directed to the unit. If a stretcher or
wheel chair is required, it is provided to the
patient.
Now-a-days due to the rising cost in private
hospitals many of the investigations are
completed before the person is admitted from
the outpatient department itself, so that the
hospitals stays can be shortened

15. STEPS OF THE PROCEDURE, SCIENTIFIC
PRINCIPLES & NURSING PRINCIPLES
Steps Rationale Scientific principles Nursing
principles
Prepare the room with
care and arrange all
items in place and
adjust height of the
bed.
To feel safe and
secure and for easy
transfer from stretcher
to bed
To relieve fear and
anxiety and
encourage
adjustment
(psychology)
Comfort &
safety
Check the client’s
identification and greet
him/her and relatives,
introduce yourself.
To help them to feel at
ease and provide
room for care of the
client.
To help the clients
to adjust to a new
environment
(psychology)
Comfort &
individuali
ty

16. STEPS OF THE PROCEDURE, SCIENTIFIC
PRINCIPLES & NURSING PRINCIPLES (CONT..)
Observe the client’s
vital signs and
symptoms and collect
speciment for
laboratory test, if
required.
To know the
condition of the
patient on admission.
To assist the
physician in the line
of treatment.
To detect any
variation from
normal.
(anatomy&
physiology)
Therapeutic
effectiveness
Provide privacy. Give
admission baths, if
need. Change to
hospital clothes.
To relax and make
the patient
comfortable. To make
important
observations.
To help in
relaxation of the
patient.
(psychology)
Comfort &
therapeutic
effectiveness

17. STEPS OF THE PROCEDURE, SCIENTIFIC
PRINCIPLES & NURSING PRINCIPLES (CONT..)
Explain use of
bathroom and other
equipment in the room
or ward.
Place a call bell and a
locker in easy reach of
the client.
Explain meal times and
visiting hours to the
client and relatives.
To help the client be
at ease and knowing
how to use equipment
to prevent accidents.
Helps in adjusting
to the new
environment.
Reduces anxiety
Helps in preventing
accidents.
(principle of
psychology and
sociology)
Comfort &
safety
Answer queries of
clients and relatives
Helps in decreasing
anxiety and fear
Helps to avoid
stress (psychology)
Comfort

18. STEPS OF THE PROCEDURE, SCIENTIFIC
PRINCIPLES & NURSING PRINCIPLES (CONT..)
Complete necessary
records according to
agency policy which
includes nursing history
and assessment.
The information
optained is an
important part of the
client’s permanent
record.
-- Individuality
and
Therapeutic
effectiveness

19. SPECIAL CONSIDERATION
 Admission cause undue stress (emotional factors as
well as financial capability must given utmost
importance)
 Be observant consider the individual patient needs
 Provide an individual admission procedure
 Show may efficiency and concerns

20. MEDICO – LEGAL CASES
 It can be defined as a case of injury or ailment, etc., in
which investigations by the law-enforcing agencies are
essential to fix the responsibility regarding the
causation of the said injury or ailment.
 In simple language it is a medical case with legal
implications for the attending doctor where the
attending doctor, after eliciting history and examining
the patient, thinks that some investigation by law
enforcement agencies is essential

21. CASES THAT ARE TO BE TREATED AS
MEDICO-LEGAL CASE
 Accidents like Road Traffic Accidents
 Cases of trauma with suspicion of foul play
 Electrical injuries
 Poisoning, Alcohol Intoxication
 Burns and Scalds
 Sexual Offences
 Attempted suicide
 Case referred from court

22. MEDICO –LEGAL ISSUES
 A medico legal case should be registered as soon as a
doctor suspects foul play and the same is applicable
on later stage of admission or even if it is brought
after several days of the incident.
 Issuance of the discharge certificate is the mandatory
duty of the treating doctor; failure to do so renders the
doctor liable for "negligence" and "deficiency of
service

23. PRECAUTIONS TO BE TAKEN
a) Consent
b) Confidentiality
c) Collection and preservation of samples

24. PROCEDURE OF REGISTERING A MLC
 MLC case rests solely with the attending medical
practitioner.
 In the casualty, while attending to an emergency, the
doctor should understand that his first priority is to
save the life of the patient.
 He should do everything possible to resuscitate the
patient and ensure that he is out of danger.
 All legal formalities to be suspended till the patient is
resuscitated.

25. REGISTRATION AND REPORTING
 The attending doctor is duty bound to inform the police
about the case
 Reports must be prepared in proper pro-forma giving all
necessary details
 Age, sex, father’s name, complete address, date and
time of reporting, time of incident, brought by whom
 Reports must be submitted to the authorities promptly

26. REGISTRATION AND REPORTING (CONT..)
 Avoid abbreviations, over writings. Correction if any,
should be initialed with date and time.
 Identification marks and finger impressions
 Medico-legal documents should be stored under safe
custody for 10 years
 All MLC to be informed to the police for taking legal
evidence

27. RESPONSIBILITIES OF A NURSE IN ADMISSION
PROCEDURE
 Nurse should deal every effort to be friendly and courteous
with the patient and family members
 Make proper observation of patients condition
 Orient patient and relatives regarding hospital polices
 Deal with patient carefully who is suffering from
communicable disease or illness. Isolate if necessary
 Patients valuables and clothes should be handed over to
relatives with proper recording.

28. LET US JOIN HANDS TOGETHER TO SAVE THE
WORLD AGAINST COVID-19
THANK YOU..