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Hospitalization-1.pptx process of hospitalization

process of hospitalization

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 HOSPITALIZATION Hospitalization is the placing of a patient in a hospital and it is a form of individual stressors.
 HOSPITAL  Hospital has been derived from the Latin word HOSPES signifying a stranger or foreigner , hence a guest. Definition  Hospital is an institution providing medical and surgical treatment and nursing care for sick or injured people.
 Types of the hospital Government Hospital Semi government Hospital Private Hospital Special Hospital [ Children, Mental, Surgical, Cardiac hospital ] Hierarchy in Pakistan [ BHU-RHU-THQ-DHQ- TCH ]
 FUNCTION Of HOSPITAL Patient care. Diagnosis and treatment of the sick or injured person. Immunization ,prevention of diseases and promotion of health. Medical education and training. Training of paramedical staff. Medical and nursing Research
 Admission Definition Admission is a process of receiving a new patient to an individual unit of the hospital. OR It is the entry and acceptance of a patient to stay in a health faculty for care, observation and treatment.  Types of admission  Elective Admission  Emergency Admission
 Elective / Planned Admission  In this type of admission the health care provider or medical officer plans a convenient date for admission.  Patient is informed well before the time so as to make him prepare for admission.
Continue…  Patient is taken through the admission process from OPD. [ out door patient department]  Elective admission there is known medical condition or complaint that requires further workup , treatment or surgery. Example  Surgery  Dialysis  chemotherapy
 Emergency Admission  In this type of admission, the patient is being brought to the hospital in a critical / serious condition which needs prompt admission and immediate treatment so as to prevent complication.  Example  Road accident  Heart attack  Chest pain
 Purpose of admission  Identify intradisciplinary assessment [Inspection, palpation , percussion , Auscultation] parameters in order to plan or deliver the appropriate level of care to meet the patient need.  To establish unified process of assessment and reassessment of patient admitted to the unit.  Admission physical assessment shall be done within four hours in general unit.  Admission physical assessment shall be done within one hour in special care unit.
Continue…  Data that is not obtained within four hours of admission should be documented at the end of shift by assigned nurse.  Documentation should be in permanent ink  ( Blue or Black ).  The nurse should write her / his Name or signature.
 Discharge of Patient Definition Shifting or departure of patient from hospital to home or another hospital.
 TYPES Of DISCHARGE Formal discharge [ when patient treatment over doctor discharge the patient ] LAMA / DAMA [ Leave / Discharge against medical advice ] Discharge at request. Abscond [ leave without any information ] Transferred to other hospital. Relieved from hospital. Temporary relieved from hospital.
 Purpose of discharge  For providing continuously care at home.  When patient have no longer need to receive care.  Provide critical information for patient to manage their own care.  To provide for a safe return of the patient clothing and valuables.
 Role of NURSE in preparing Pt. for DISCHARGE  Prepared patient for discharge.  Nurse should provide support to the patient and patient relative.  Identify patient strength and weakness.  Physician’s discharge orders have been written.  Notify all hospital department.  Ensure that all Lab work , X-Ray, treatment and procedure are completed.
Continue…  Help patient with hygiene , dressing and packing.  Remember that each individual handle termination letter in his/ her own.  If patient is unable to walk , Provide stretcher or wheel chair.
 Role of Nurse after Discharging patient  After patient has gone the bed should be cleaned , Blanket should be kept in sunlight , room should be cleaned.  Kept ready for next use.  Responsibility of hospital staff to protect the record of patient.
 Discharge Teaching  Educate patient about medication , diet , physical activities.  Educate patient family to continue Care.  Educate patient about his / her own health.  Explain the patient to follow up.  Tell patient to bring all documents during follow up.
Continue.. 5. Ask for clarification on vital issues pertaining to the patient's condition from the accompanying nurse. 6. Introduce self and other nurses around to patient and relatives. 7. Do a quick assessment of the patient's condition and needs and act accordingly. 8. Admit patient using the nursing process. 9. Orientate patient and relatives to ward and its environment, routine of the unit if necessary. 10. Document time of patient's arrival in the nurses note , admission and discharge book and ward state.
TRANSFER DEFINITION Discharging a patient from one unit or agency and admitting them to another unit.  Inform patient / family.  Speaks with nurse on transfer unit. Types of Transfer There are two types of transfer.  Transfer - in  Transfer- out
 Transfer – in Definition Patient is moved from one unit or ward of first admission to a new unit or ward . E.G : Medical to surgical ward. ROLE 1. Prepare a suitable bed to receive patient. 2. Assemble the necessary equipment depending on the patients condition . i.e. oxygen apparatus, suction machine, vital signs tray. 3. Receive incoming patient, relatives and accompanying nurse warmly. 4. Take over the transfer notes and personal belonging of the patient.
 TRANSFER - OUT Definition It could be from unit to unit or facility to facility Role 1. Confirm with receiving unit. 2. Assess patients condition. 3. Arrange for appropriate vehicle-where applicable. 4. Arrange for accompanying nurse. 5. Collect all necessary data. 6. Explain reason of transfer to patient and relatives and reassure them to reduce anxiety.
CONTINUE.. 7. Obtain written consent for transfer. 8. Pack patient belonging.9. Collect patient medication , Investigation result and transfer notes. 10. Assist patient to dress up. 11. Assist patient into wheel chair, stretcher, ambulance where applicable. 12. Enter patient name in the A and D book, ward state and nurse note. 13. Hand over patient's notes and belonging to the accompanying nurse.
 Responsibility of Nurse during Admission  Arrange patients unit  Greet the patient and orient to ward , other patients , patient room and Equipment .  Tells rules and regulation to patient.  Complete patients admission charts.  Takes Temperature ,blood pressure , respiration and pulse of patient.  Carry on required investigation.  Follow the physician order , administer prescribed medicine.  Enquire from patients ,if he is allergic to any medicine , apply allergy band and inform the physician.  Give instruction to patient to take care of belonging and valuable
 Responsibility of nurse during Discharge  Check for medico legal history.  Notify medical officer incharge .  Abscond cases immediately contact medical officer incharge .  Maintain all documents in a proper Manner.  Take in written handing over.  Taking of articles.  Never discharge patient without Written order by physician.
 Admission Procedure Admitting Department  Fill out admission form.  Take admission consent.  Provide identification Band.  Allocate hospitals bed.  Take care of personal belonging. Arrival on nursing unit  Height and weight.  Vital signs.  Send sample for lab investigation  Reporting the admission.  Admission documentation.
Continue.. Hospital Orientation  Ward Routine.( Doctor and Nurses round) Physical facilities in room  Internet, TV, Bathroom , Telephone etc. Hospital services and timing  Meals , Medication, Medicine / surgery supply linen. Hospital policies Smoking policy, lama( leave against medical advice, ML
CONTINUE… Dehumanization  Anxiousness or apprehension.  Fear of unknown.  Fear of body image changes.  Financial concerns.  Embarrassment.
 Transfer procedure  Check the doctor’s order for transfer.  Inform the patient and relatives.  Inform the ward sister where the patient need to be transferred.  Check the chart for complete recording of vital signs ,nursing care and treatment given .  Collect patients X-Ray ,medicine and other belongings.  Cancel the hospital diet or transfer.  Assist the relative to collect other belongings.
Continue…  Make arrangement to settle the due bills if going to other hospital .  Record time made of transfer and general condition of the patient .  Assist in transferring sick patient to wheelchair/stretcher and accompany patient to new area.  Handover patient documents ,belonging and report verbally to the incharge nurse/ sister.  Collect the word articles.
 Discharge procedure  Instructions regarding further care ,medications follow up should be clearly written.  Client personal belonging such as money ,clothing other valuable things which were taken by hospital personal at the time of admission should be checked and written return to him. The nurse should get a receipt from to the client at the time of delivery.  The articles in the client’s unit should be checked and so that they are complete including bed and linen.  Before the client leave the hospital the nurse should confirm whether he has paid all the hospitals bills.
CONTINUE…  See that the client is ready to go home, recently bathed , hair combed and dressed in clean cloths.  The diet department should be inform the client discharge.  If any client leave the hospital against a medical order , she/ he should be asked to sign the release form.  The nurse should see the charts are complete and sent to record section.