The document discusses the admission, transfer, and discharge processes in a healthcare setting. It describes the key steps in each process, including obtaining physician authorization and billing information for admission, explaining the transfer to the client and preparing their belongings, and ensuring discharge orders are complete before a client leaves. The admission process involves assessing the client, developing a care plan, collecting medical history, and orienting the client to their new environment and care routines. Transfers may occur to change units or when a client's condition requires a higher level of care. Referrals connect clients to outside services like hospice care.

1. Prepared by: Zuhair Rushdi Mustafa
Lecturer
College of Nursing

2. The Admission Process
 Admission: means entering a health care agency for
nursing care and medical or surgical treatment.
 The admission process involves the following:
1. Authorization from a physician verifying that the person
required specialized care and treatment.
2. Collection of billing information by the admitting
department of the health care agency.

3. 3. Documentation of the client’s medical history and findings
from physical examination.
4. Development of an initial nursing care plan.
5. Initial medical orders for treatment.

4.  Types of admission
Type Explanation Example
Inpatient Length of stay more than 24
hours
Acute pneumonia, head injury,
acute myocardial infarction.
Outpatient Length of stay less than 24
hours; possible return on a
regular basis for continued care
or treatment
Minor surgery, cancer therapy or
Hemodialysis therapy.

5. Nursing admission activities
1) Preparing the clients room
2) Welcoming the client
3) Orienting the client
4) Safeguarding valuables and clothing
5) Helping the client undress

6. Admitting a client
Assessment process involve:
 Obtain the name, admitting diagnosis, and condition of the
client and the room to which he or she has been assigned.
 Check the appearance of the room and presence of basic
room supplies:
1. Wash basin
2. Soap dish
3. Emesis basin
4. Bedpan
5. urinal

7. Planning include the Following:
1. Assemble needed equipment: admission assessment form,
thermometer, blood pressure cuff, stethoscope, scale, urine
specimen container.
2. Obtain special equipment such as
IV pole, oxygen.
3. Arrange the height of the bed
to coordinate with the expected
mode of arrival.

8. 4. Fold the top linen of the bed if the client will be immediately
confined to bed.

9.  Implementation include:
1. Greet the client by name
and demonstrate
a friendly smile, extend
a hand as a symbol
of welcome.

10. 2. Introduce yourself to the client and those who have a
companied the client.
3. Observe the client for sings
of acute distress.
4. Attend to urgent needs for
comfort and breathing.
5. Introduce the client to his or her roommate
6. Offer the client a chair unless the client requires immediate
bed rest.

11. 7. Check the client identification bracelet.
8. Orient the client to the
physical environment
of the room and the
nursing unite.

12. 9. Demonstrate how to use equipment in the room such as
adjustments for the bed, how to use signal for a nurse, use of
the telephone and TV.
10. Explain the general routine and schedules that are followed
for visiting hours, meals, and care.

13. 11. Explain the need to examine the client and ask personal
health questions.
12. Ask if the client would like family members to leave or
remains.
13. Request the client undress and don a hospital or
examination gown. Assist as necessary.
14. Ask the client about the need to
urinate at the present time,
and obtain a urine specimen if ordered.
15. Weigh the client before helping him or her into bed.

14. 17. Assist the client to a comfortable position in bed.
18. Take care of client’s clothing and valuables according to
agency policy.
19. Ask the client to identify allergies to food, drugs, or other
substances and to describe the type of symptoms that
accompany a typical allergic reaction.
20. Apply a second bracelet that is color coded to the client’s
arm that identifies client’s allergy.

15. 21. Wash hands or perform hand antisepsis with an alcohol rub
before any nursing care.
22. Obtain the client’s temperature, pulse,
respiratory rate, and blood pressure.
24. Make sure the bed is in low position, and follow agency
policy about raising the side rails on the bed.
25. Wash hands or perform
hand antisepsis with an
alcohol rub when you
finishing nursing care.

16. Discharging a client include:
1. Determine that medical order has been written.
2. Note that any medical orders must be carried out before the
client’s discharge.
3. Determine the client’s mode of transportation.
4. Cancel any meals that the client’s will miss after discharge.

17. 5. Notify the pharmacy of the approximate time of discharge.
6. Help the client dress clothing appropriate for leaving
hospital.
7. Have the client sing the discharge instruction sheet.
8. Assist the client in to a
wheelchair when
transportation is available.

18. Transfer the client
The client may be transferred to another unit for several
reasons:
1. Assignment to a certain unit is temporary.
2. The client’s condition becomes serious enough to require
transfer to an intensive care unit (ICU).
3. The client is becoming agitated by a very busy unit and
requires a quieter environment.

19. 4. The client is disturbing others, for example by snoring loudly,
and needs a private room.
5. The client has had surgery and is being moved to postsurgical
care.
6. The client is exhibiting behavior that is dangerous to himself or
herself or to others and requires transfer to a psychiatric or
other secure unit.

20. TRANSFER TO ANOTHER UNIT
Preparation for the Transfer
1. Explain the transfer to the client and family.
2. Assemble all the client’s personal belongings, as well as all
documents.
3. Determine how the client will be moved.
4. Provide for client safety. Take measures to hold IV bottles,
drains, and catheters.

21. 5. Collect all the client’s medications, IV bags, and tube feedings,
and take these to the new unit.
6. Record the transfer in a transfer note.
7. Make sure the receiving unit is ready. Usually a short verbal report
is given to the receiving nurse.
Client referral
A referral is the process of sending someone to another person
or agency for special services. For example, client referral to
hospice.