This document discusses hospital admission and discharge procedures. It defines admission as allowing a client to stay in the hospital for treatment and defines discharge as when a patient leaves the hospital. It describes the types of admission as emergency or routine. It outlines the roles and responsibilities of nurses in both admission and discharge procedures, including preparing the unit, obtaining patient information, and ensuring all paperwork and belongings are in order. It also discusses medico-legal cases and procedures for handling patient discharge against medical advice.

1. HOSITAL ADMISSION &
DISCHARGE
PRESENTED BY-
SRITAMA PATRA

2. OBECTIVES
 DEFINITION OF ADMISSION
 TYPES AND PRPOSE OF ADMISSION
 PREPARATION OF THE UNIT
 ADMISSION PROCEDURE
 ROLES AND RESPONSIBILITY OF NURSE IN ADMISSION
PROCEDURE
 MEDICOLEGAL CASES
 DEFINITION OF DISCHARGE
 TYPES OF DISCHARGE
 DISCHARGE PROCEDRE
 ROLES AND RESPONSIBILITY OF NURSE IN DISCHARGE
PROCEDURE
 UNIT AFTER DISCHARGE

3. Admission of a client means, allowing a client to stay in the hospital
for observation, investigations and treatment of the disease he/she
is suffering fro from.”
• “Admission is the entry of a patient into a hospital /ward for therapeutic
/diagnostic purposes.”

4. TYPES OF
ADMISSION
EMERGENCY ROUTINE

5. Clients are admitted 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 the patient.
Clients are admitted for investigations and planned treatment and surgeries.
E.g.: patient with diabetes, hypertension, appendicitis, jaundice etc.

7. • 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.
• To obtain 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.

8. ANXIETY
FEAR
DENIAL
EMOTIONAL UPSET
ANGER
SAD

9. • 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:
1. 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 .
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

10. hospital adission
pack,which contains items sch as drinking glass,papers,lotion,etc shold be
ready at bed side.hospital grown shold be available,although the client ay
choose to wear own clothes.
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.

13. 1.Reception of the client
2.Recording of social and medical data
3.Medical examination
1.Transporting client from O.P.D to I.P.D.
2.Reception of client by ward sister.
3.Preliminary observation of the client.
4.Helping to client to occpy his bed.
5.Care of valuables and clothing.

16. • 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 - the source of information (family, patient, care giver or health care person or
significant person).
• Check the document if patient has previous hospitalization and past major illness.
• Take patient vital signs (pulse, temperature, respiratory rate, height and weight).
• Document if patient and family has valuables brought to the hospital. If yes, hand it over to the
relatives with their signatures.
• 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.
• In medico-legal case, the police has to be informed and the nurse has to keep documents
confidential & under safe custody.

17. 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.

18. • 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.
• Cases of asphyxia as a result of hanging, drowning, suffocation etc
• Death in the operation theatre
• Death due to Snake Bite or Animal Bite
• Drug overdose
• Drug abuse

19. • 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.

20. • 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 - the source of information (family, patient, care giver or health care person or
significant person).
• Check the document if patient has previous hospitalization and past major illness.
• Take patient vital signs (pulse, temperature, respiratory rate, height and weight).
• Document if patient and family has valuables brought to the hospital. If yes, hand it over to
the relatives with their signatures.
• 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.
• In medico-legal case, the police has to be informed and the nurse has to keep documents
confidential & under safe custody.

21. “Discharge of patient from the hospital means,
relieving a person from hospital setting, who
admitted as an inpatient in that hospital”
“Discharge or dismissal from the hospital means
the departure of patient from the 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.”

23. : Patient’s treatment is over and the attending physician has
discharged the patient.
: Patient leaves the hospital without prior information.
(left against medical advise/ discharge against medical advise): In
LAMA/DAMA, patient chooses to leave the hospital before the treating physician
recommends discharge .
: Patient is transferred to another health care facility or within the sae hosppital
fro one ward to another.
After death of patient,the dead body is handed over to the relatives after
copleting the discharge procedure.

26. ROLES & RESPONSIBILITY OF NURSE IN
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.
• 4. Check and 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
• 6. Confirm bill paid: Before client leaves, nurse should confirm that the client has paid the hospital bill
• 7. Inform other departments regarding discharge.
• 8. Documentation: the nurse should check that the charts & files are completed 43 Monika Devi N R
• 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
• 10. If DAMA :-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 .

27. 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 bed is made with fresh linen
• If the room was used for a client with
communicable disease, it should be fumigated

28. THANKS
FORWATCHING