Skip to main content
UploadLanguage (EN)Support
BusinessMobileSocial MediaMarketingTechnologyArt & PhotosCareerDesignEducationPresentations & Public SpeakingGovernment & NonprofitHealthcareInternetLawLeadership & ManagementAutomotiveEngineeringSoftwareRecruiting & HRRetailSalesServicesScienceSmall Business & EntrepreneurshipFoodEnvironmentEconomy & FinanceData & AnalyticsInvestor RelationsSportsSpiritualNews & PoliticsTravelSelf ImprovementReal EstateEntertainment & HumorHealth & MedicineDevices & HardwareLifestyle
Dr. Rahul B. Pandit, profile picture
Uploaded byDr. Rahul B. Pandit
502,443 views

Admission and discharge

This document discusses admission and discharge procedures in a hospital setting. It defines admission as allowing a patient to stay in the hospital for treatment purposes. The admission process involves receiving the patient, collecting their history, orienting them and the family, and coordinating care. Discharge planning is an interdisciplinary process that ensures continuity of care after discharge and involves evaluating the patient's needs and arranging any follow up care. Nurses play an important role in both admission and discharge by properly caring for patients, educating them and families, and ensuring proper documentation and coordination of care.

Health & Medicine◦
Admission & Discharge Dr. Rahul B. Pandit Faculty of Nursing Sassoon General Hospital, Pune
Nursing Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people.
Hospital  A hospital is a place where people who are ill are looked after by Nurses and Doctors.  Hospital is an institution providing medical and surgical treatment and nursing care for sick or injured people.
Definition Admission is defined as allowing a patient to stay in hospital for observation, investigation, treatment and care.
Definition Admission is the entry of a patient into a hospital /ward for therapeutic /diagnostic purposes.
Purposes of admission  To undergo evaluation & treatment  To know what is really happening in his/her body right oft it to be fixed  To provide emotional security to the newly admitted patient and his family
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.
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.
Unit and it’s preparation It is a place where the patient is kept during hospital stay. The admitting department notifies the unit prior to the patients arrival so that room /bed can be prepared.
Unit and it’s preparation  Prepare the treatment table  Ensure all the equipment are completed  Check ventilation  Ensure patient privacy
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
Admission procedure  Meet and receive the patient  Verify the patient data, by checking the record sheet, chart.  Introduce immediate personal  Assist patient to the treatment area  Ask the patient to change clothes into hospital gown if necessary
Perform examination and evaluation procedure  Perform examination and evaluation procedure establish base line values like vital signs, do history taking, physical examination etc.  Coordinate with the physician and carry out initial orders  Give the treatment and instructions as need
Orientation to the patient and relatives  The equipments /instruments  Use of call system and telephone  Treatment schedule  Visitors timings  Other health care team members  Policy and rules and regulations  Care of patients valuable etc.
Record & Report  Admission Book  Preparation of Paper  Drug Book  Diet Book  HMIS Entry  Cot List
Medico – Legal issues  Medico-legal cases (MLC) are an integral part of medical practice that is frequently encountered by Medical Officers  Proper handling and accurate documentation of these cases is of prime importance to avoid legal complications and to ensure that the Next of Kin (NOK) receive the entitled benefits.
Definition  MLC is defined as “any case of injury or ailment where, the attending doctor after history taking and clinical examination, considers that investigations by law enforcement agencies (and also superior military authorities) are warranted to ascertain circumstances and fix responsibility regarding the said injury or ailment according to the law”.
Examples of MLCs.  Accidents like Road Traffic Accidents  Cases of trauma with suspicion of foul play (d) Electrical injuries  Poisoning, Alcohol Intoxication  Burns and Scalds  Sexual Offences  Attempted suicide
Role and Responsibilities of 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
Role and Responsibilities of Nurse in admission procedure  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.
Discharge Procedure  The patient, the family, medical staff, nursing staff, social worker, dietician all work together to coordinate the discharge.  The doctor plans the discharge with the patient and leaves a written order on the patient’s chart.
Introduction  The patient may have concerns regarding managing own care at home.  Provisions such as home health care may be needed, as ordered.  Assessment needs to be done as to what help the patient will need at home.  Discharge planning involves the entire healthcare team.
Definition “Discharge of patient from the hospital means, reliving a person from hospital setting, who admitted as an inpatient in that hospital”.
Types of Discharge 1. PLANNED DISCHARGE:- Patient completes the initial, actual management in the hospital and now he or she need not to be under direct supervision of that hospital.’ 2. DAMA/LAMA: Discharge/Leave Against Medical Advice 3. TRANSFER: Transfer to other unit or hospital 4. ABSCOND: Abscond from Hospital 5. REFFERAL : Referred for further management
Consent for DAMA 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 and Nursing staffs will not be responsible for any ill effects happening after my departure”. Name of the patient / relative :- Relation:- Signature:- Date :- Time:-
Discharge planning 1. Nurses play an important role in discharge planning in the hospital. 2. Continuity of care is important. 3. To achieve continuity of care, nurses use critical thinking skills and apply the nursing process. 4. Discharge planning is a centralized, coordinated, interdisciplinary process
ESSENTIALS OF PLANNED DISCHARGE 1. Written order by doctor. 2. Discharge card. 3. Informing other departments. 4. Check payment of the bills. 5. Hospital glossaries taken back. 6. Returning of the personal belongings. 7. Arrangement for transport. 8. Documentation.
Steps involved in the Discharge Planning 1. Evaluation of the patient by qualified personnel 2. Discussion with the patient or his relatives 3. Planning for homecoming or transfer to other place 4. Determining if caregiver training or for other support 5. Referrals to home care agency or appropriate support 6. Arranging for follow-up appointments or tests
Nurses Responsibility in Discharge PREPARATION FOR DISCHARGE  Planning in the beginning.  Plan for rehabilitation and follow-up need.  Teach nursing procedures to be continued at home, get it’s practice done.  Arrangement for transport.
Nurses Responsibility in Discharge DURING DISCHARGE PROCEDURE  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
Nurses Responsibility in Discharge AFTER DISCHARGE  Documentation.  Care of patient’s room and articles
Nurses responsibility in MLC Discharge  Check for medico legal history.  Notify medical officer in charge.  Abscond cases immediately contact medical officer in charge.  Maintain all documents in a proper manner.  Take in written handing over and taking of articles.  Never discharge patient without written order by physician.
Checklist M E T H O D
Checklist M = MEDICATION E = ENVIRONMENT T = TREATEMENT H = HEALTH TEACHING O = OUT PATIENT REFFERAL D = DIET
Summary  Admission is warranted for patient’s thorough evaluation and treatment  Admitted patients should be comfortable and secured  Admission should be individualized
Summary  Admission involves patient reception, history taking, patient orientation, coordination, patient chart management and planning individualized treatment program.
Question ????
Admission and discharge