educative

1. ADMISSION, TRANSFER AND
DISCHARGE OF PATIENTS
Ms. Nelly Nzingo

2. Admission of A Patient
It is the process of receiving and retaining a patient in the health facility overnight or
for an indeterminate time, usually several days or weeks (though some cases such as
coma patients, have been in hospitals for years).
Treatment provided in this fashion is called inpatient care.
Purpose
 To provide a safe environment
 Close monitoring
 Further investigations
 Therapeutic interventions of the client
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3. Indications: All patients
In critical conditions
In unstable psychological state that requires monitoring
Who require pre – operative care
Suffering from substance related disorders
Requiring detoxification
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4. ASSIGNMENT
Write notes on the procedure of patient admission from the procedure manual
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5. ADMISSION PROCESS
Assess the following: Physical and psychological state of the patient; Number of
patient’s companions; provisional diagnosis
Review admission requirements according to the hospital policy
Explain the procedure to the patient and companion
Requirements
Pen
Plain papers
Continuation sheets
Treatment trolley
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6. Trolley with equipment for physical examination
Consent forms
Daily Bed Return (DBR)
Admission record book
Nursing cardex
Assorted charts
Environment
A room that is well lit and ventilated
Resuscitative equipment within reach
Adequate comfortable seats
Examination coach
Hospital uniform
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7. Procedure
Welcome the patient and the companions and offer them seats
Identify the patient through the accompanying nurse/ companion
Receive patient from accompanying nurse
Check validity of admission documents and release the accompanying nurse
Ensure patient’s privacy
Take history from the patient or companion
Perform physical examination
Inspect all variations and identify items to be taken home by relatives. Label and list
items to be left in the ward
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8. Allocate a bed to the patient
Introduce patient to other staff and other inpatients
Ensure patient takes bath and changes to the hospital uniform
Give due treatment and inform the ward physician to review the patient
Develop a nursing care plan and document
Keep the patient’s file safe
Clear equipment
Record : History obtained, findings on physical examination, treatment given, findings of
evaluation, time the patient was reviewed by physician and their recommendations
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9. Transfer of Patients
This is the releasing of patient/client from the current ward/department/hospital to
another
Purpose:
To send a patient for some specialized or advanced care
Assess for:
 Reasons for transfer
Method of transferring the patient
Review on the knowledge concerning the transfer of patient
Explain to the patient and family the division and room to which the patient is intended
to be transferred to and the purpose of transfer
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10. ASSIGNMENT
Write note on the procedure of patient transfer/ discharge from the procedure manual
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11. Process
Gather the clients personal belongings
Gather re – usable equipment and supplies beside the patient’s bed e.g. bed pan,
urinals, basin.
Ensure all documentation is well done
Assist the patient onto a wheel chair or stretcher
Transport the patient, supplies, belongings and medical record to the receiving unit
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12. Announce the arrival of the patient at the center nursing station
Give the receiving unit a verbal report of the client, current condition, major therapies
being received and special nursing care needs and hand over
Transfer the patient to new room and assist him/her in to bed
Ensure other agency departments are notified of the transfer
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13. Discharge of Patients
This is the process of releasing of patient from the current inpatient care environment
Purpose
To provide effective integration of the patient with family, society
To promote and resume optimal functioning
Indications
Patients who have recovered
Patients ready to be rehabilitated in the environment of their choice (presumably home
environment)
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14. Process
Assess for:
Level of readiness of the patient
Level of the preparedness of the patient’s relatives/ guardians
Physical, psychological, spiritual and social needs of the patient
Mode of travel and available resources
Ensure resolution to therapy
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15. Review patient’s notes (charts, cardex etc.)
Review the discharge procedure and legal implications
Prepare information to share with the patient
Assign adequate time for the discharge process
Prepare patient’s belonging
Arrange for clearance of hospital bill
Ensure prescriptions if appropriate are done and drugs collected and instructions on
taking and storing them well explained
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16. Provide patient with a comfortable place to sit/lie
Carry out physical and mental assessment
Share information with the patient on his/her condition, including treatment, other
measure to promote health when at home and follow – up schedule
Allow the patient to leave
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17. Leaving Hospital Against Medical Advice
Patient may leave hospital against medical advice due to the following:
Increased hospital bill
Not satisfied with the services being offered
If this happens, the patient should sign a declaration form. This releases the doctors
and other staff from responsibility incase something bad happens
Note: Psychiatric patients should NEVER be allowed to leave hospital against medical
advise since they don’t have insight.
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