admission and discharge.pptx

admission and discharge.pptx

• 1.
  Hospital admission and discharge Preparedby daxa rathwa
• 2.
  Content •Definition •Types of admission •Purpose of admission •Preparing unit for admission •Admission procedure •Medico ligal case •Role and responsibility during admission procedure Admission
• 3.
  •Discharge Definition of discharge Typesof discharge Purpose of discharge Role and responsibility of nurse during discharge procedure Care of unit after discharge
• 4.
  Admission definition "Admission ofa client means, allowing a client to stay in the hospital for observation, investigations and treatment of the disease he/she is suffering from." • "Admission is the entry of a patient into a hospital /ward for therapeutic /diagnosis
• 6.
  EMERGENCY ADMISSION Clients areadmitted in acute conditions requiring •immediate treatment. E.g.: patient with heart attack, poisoning, breathing difficulty, RTA(Road traffic accident) etc •• Patient should be admitted in casualty or emergency department to save the life of
• 7.
  ROUTINE/ELECTIVE ADMISSION • Clients areadmitted for investigations and planned treatment and surgeries. E.g.: patient with appendicitis, jaundice, diabetes,hypertension,
• 8.
  Purpose of admission •• To receive the patient in ward for admission • according to his/her 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 the hospital environment
• 9.
  • • Toobtain information about patient such as address, • guardian, any information that serves as a basis of • care e.g. Allergy, diabetes. • • To establish Nurse-patient relationship
• 10.
  •EMOTIONA REACTION •Anxiety •• Fear ••Denial •Emotionally upset •Anger •• Sad
• 11.
  Preparing the unitfor admission • The admitting office notifies the unit prior to the patient's arrival, so that the room/bed can be prepared. • • Some of the activities carried out by the nurse before the • patient is to be admitted are: • Keeping the bed ready: open the bed, fold back the bedspread, top blanket, and top sheet. Cover the bed with full length mackintosh and two bath towels in order to protect from soiling
• 12.
  • • Positionthe bed: for ambulatory client, the bed should be in normal position. If client has to arrive on stretcher, the bed should be in lowest position. Make sure furniture in the room is arranged to ensure easy access to the bed • • Assemble the necessary equipment and supplies: hospital admission pack, which contains items such as drinking glass, papers, lotion etc should be ready at bedside. A hospital gown should be available, although the client may choose to wear own clothes
• 13.
  •• Assemble specialequipment and supplies: the client may require oxygen therapy, cardiac monitoring or suction equipment. The nurse should make sure that the equipment is functioning properly and is ready for patient use.
• 14.
  Gown Suction machinePulse Oxymetry Oxygen connection Towel
• 15.
  Class and plateCardiac monitor
• 16.
  Admission procedure
• 17.
  Perform examination and evaluationprocedure • examination and Perform 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
• 18.
  Orientation to thepatient and relatives 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.
• 19.
  Medico ligal case •A medico-legal case is one where besides the medical treatment; investigations by law enforcing agencies, are essential to fix the responsibility regarding the present state/ condition of the patient.
• 20.
  Medico ligal casesinclude •• Accidents like Road Traffic Accidents (RTA), Industrial accidents • Cases of trauma with suspicion of foul play •Electrical injuries •Poisoning •Chemical injuries • Burns •Sexual Offences •Attempted suicide • Domestic violence and child abuse
• 21.
  -Cases of asphyxiaas a result of hanging, drowning, •suffocation •Death in the operation theatre •Drug overdose •Drug abuse
• 22.
  Role during MLC •In emergencies, resuscitation and stabilization of the patient will be carried out first and medico legal formalities may be completed subsequently. The consent for treatment is implied in all emergencies • Hospitals will maintain a MLC register and the MLC will be initiated and documented in the register. • Medicolegal documents should be considered as • confidential records and should be stored under safe
• 23.
  ROLES & RESPONSIBILITIESOF NURSE DURING ADMISSION PROCEDURE At the time of admission, the registered nurse perform complete assessment of the patient. Enter patient name, date and time of admission, chief complains, medical diagnosis in the admission file or patient file. • Document if patient and family has valuables brought to the hospital. If yes, hand it over to the relatives with their signatures.
• 24.
  • family willbe given orientation regarding the unit, • visiting rooms, patients right and responsibilities. • • In medico-legal case, the police has to be informed and the nurse has to keep documents confidential & under safe At the time of arrival to the unit or ward patient and family will be given orientation regarding the unit, visiting rooms, patients right and responsibilities.
• 25.
  DISCHARGE DEFINITION • •"Discharge of patient from the hospital means, relieving a perso from hospital setting, who admitted as an inpatient in that hospital" • • "Discharge from the hospital is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home."
• 26.
  Types of discharge
• 27.
  • PLANNED DISCHARGE:Patient's treatment is over and the attending physician has discharged the patient • ABSCOND: Patient leaves the hospital without prior information • LAMA/DAMA (left against medical advise discharge against medical advise): In LAMA/DAMA, patient chooses to leave the hospital before the treating physician recommends discharge
• 28.
  • • TRANSFER:Patient is transferred to another health care facility or within the same hospital from one ward to another • • DEATH: after death of patient, the dead body is handed over to the relatives after completing the discharge procedure
• 29.
  PURPOSE OF DISCHARGE •To be certain that the patient has the information on his/her condition. • To inform about the follow-up visits or referral to other health agencies. • To teach the Nursing procedure or care he/she needs at home & to take re-demonstration • To provide for a safe, efficient return of all patient's clothing, valuables & to check that all hospital equipment & clothing in the hospital.
• 31.
  ROLES & RESPONSIBILITIESOF NURSE DURING DISCHARGE PROCEDURE • 1. See doctor's written order for discharge: no client should be discharged without doctor's written order • 2. Explanation of discharge procedure • 3. Hand over personal belongings: clothing, jewellery or other valuables that were entrusted with hospital at the time of admission should be returned to client.
• 32.
  • 4. Checkand receive any hospital property: any of the hospital property that was given to client for his/her use in hospital should be checked and received back before he/she leaves • 5. Teach nursing procedures to be continued at home, get it's practice done: Provide instructions regarding medication, follow-up visit
• 33.
  6. Confirm billpaid: Before client leaves, nurse should confirm that the client has paid the hospital bills. 7. Inform other departments regarding discharge. 8. Documentation: the nurse should check that the charts & files are completed 9. Arrange transport: if the client is not able to walk, then the nurse should see that he/she is transferred either on a wheel chair or stretcher
• 34.
  • 10. IfDAMA :-check consent, the form should state that the person is leaving against medical advise of doctor and that neither doctor nor the hospital can be held responsible for any ill effect happening after the departure • 11.Care of patient's room and articles after discharge
• 35.
  CARE OF UNITAFTER DISCHARGE • After a client is discharged & before admitting another patient, the room is cleaned & aired. • All articles used by client should be taken to utility room, washed, cleaned, sterilized if necessary or disinfected by chemicals. The articles are re-arranged and kept ready for next client • Used linen should be sent to laundry • Mattress, pillows, blankets etc should be exposed to sunlight and then the
• 36.
  •bed is madewith fresh linen •If the room was used for a client with communicable disease, it should befumigated