Unit # 11

Hospitalization
 Process of Hospitalization
1. Define the term admission, transfer and
discharge.
2. Discuss the procedure for admission, transfer
and discharge.
3. Identify nursing responsibility during admission,
transfer and discharge.
4. Discuss nurse role in preparing patient and family
for discharge.
5. Discuss the normal reaction of patient being
hospitalized.
 1:Define the term admission, transfer
and discharge
Admission:
• The process of accepting patients .the concept
includes patients accepted for medical and
nursing care in a hospital or other health care
institution.
 1:Define the term admission, transfer
and discharge
Transfer:
• The act of moving a person with limited function
from one location to another. This may be
accomplished by the patient or with assistive
device.
• Transfer are defined as moving a patient from
one flat surface to another ,such as from a bed to
a stretcher. Types of hospital transfers include bed
to stretcher ,bed to wheelchair , wheelchair to
chair, and wheelchair to toilet , and vice versa.
 1:Define the term admission, transfer
and discharge
Discharge:
• When you leave a hospital after treatment
,you go through a process called hospital
discharge. A hospital will discharge you when
you no longer need to receive inpatient care
and can go home. Or a hospital will discharge
you to send you to another type of facility.
2: Discuss the procedure for admission

• Admission to the hospital

• Unit and its preparation, admission bed
• Admission procedure
• Special consideration
• Medico legal issues
• Role and responsibilities of the nurse
 Types of Admission
Emergency admission:
• In this patients are admitted in acute conditions
requiring immediate treatment . For example:
patient with poisoning , burns and cardiac or
respiratory emergency.
Routine admission:
• In this ,patients are admitted for investigation,
diagnostic and medical or surgical treatment.
Treatment is given according to patients problem.
For example: patient with hypertension, diabetes
mellitus etc.
 Role and responsibility of nurse in admission
procedure
1. Meet and receive the patient- verify the patient data ,by checking the record
sheet, chart-introduce immediate personal-assist patient to the treatment area
-ask the patient to change cloths into hospital gown if necessary.
2. Perform examination and evaluation procedure.
3. Perform examination and evaluation procedure establish base line values like
vital signs ,do history taking, physical examination etc.
4. Coordinate with physician and carry out initial orders.
5. Give the treatment and instructions as needed.
6. The equipment's / instruments
7. Use of call system or telephone
8. Treatment schedule
9. Visitors timings
10. Other health care team members
11. Policy and rules and regulations
12. Care of patients valuable etc.
 Role and responsibility of nurse in
admission procedure
1. Complete all kind of data entry according to the
policy of health care facility.
2. Nurse should deal every effort to be friendly and
courteous with the patient and family members.
3. Make proper observation of patients condition.
4. Orient patient and relatives regarding hospital
polices.
5. Deal with patient care fully who is suffering from
communicable diseases or illness.
6. Isolate if necessary
7. Patient valuables and clothes should be handed over
to relatives with proper recording.
 Transfer of patient
1. Written order by physician .
2. Inform patient and family.
3. Inform ward in charge of another unit/ ward.
4. Complete patient’s documents and discharge
summary.
5. Arrangement of transport.
6. Inform other departments.
7. Transportation of the patient.
8. Receiving of the patient in new ward.
 Types of transfer
• Transfer of a patient from one unit to another
in same hospital.
• Transfer of a patient from one hospital to
another.
 Procedure of transfer of patient
1. Steps of transfer from one unit to another in same
hospital.
2. Written order by physician.
3. Inform patient and family.
4. Inform ward incharge of another unit/ ward.
5. Complete patients documents and discharge summary.
6. Arrangement of transport.
7. Inform other departments.
8. Transportations of the patient.
9. Receiving of the patient in new ward.
10. Handing over and taking over of the personal belongings.
11. Documentations.
 Nurses responsibility in patient transfer
1. Be sure that patient and family informed of the need
transfer .
2. Communication promotes co-operation.
3. Decision should be always made by person who are
going to be affected.
4. Communicate with the agency or unit where the
patient will be transferred.
5. Make photocopy of the medical records.
6. Other personal needs time to prepare for patient’s
arrival.
7. Copy of the records aids in continuity of care and
avoids duplication of services.
 Nurses responsibility in patient transfer
8.Provide written transfer summery .Person at the
new facility may not have time to read the
documents thoroughly before assuming
responsibility of patient’s care.
9.Collect all the patient’s belongings carelessness
can lead to the loss of the patient’s valuable
belongings and cause inconvenience in returning.
10. Help in transportations of the patient.
11.Give transfer personnel a copy of the medical
records in a folder .
 Discharge of a patient
1. The patient, the family, medical staff, nursing staff social
worker, dietician all work together to coordinate the
discharge.
2. The doctors plans the discharge with the patient and
leaves a written order on the patient’s chart.
3. The patient may have concerns regarding managing own
care at home.
4. Provision such as home health care may be needed ,as
ordered.
5. Assessment needs to be done as to what help the patient
will need at home.
6. Discharge planning involves the entire health care team.
 Nurses responsibility in patient
discharge
1. Nurse is responsible for ensuring that the patient is to be
discharged.
2. Discharge from the hospital should never come
unexpectedly to patients and his/her family members.
3. His/her discharge should be planned from the time of his
admission and he should be informed sufficiently early of
the day he or she can leave the hospital.
4. Any discharge instructions reviewed with the patient
must also be put in a written form for the patient to take
home.
5. They need to be specific ,written in terms the patient can
understand, through ,and legible.
6. Make sure family members are notified of pending
 Discuss Nurse role in preparing patient
and family for discharge.
• Nurse’s will have responsible and major role in patients
teaching.
Topics included for pre-discharge teaching
1. Medications and drugs ,diet
2. Wound care
3. Using equipment
4. Taking medication
5. Exercise programs
6. Physical therapy
7. Changing dressing/ bandages
8. Injections or respiratory treatment
9. Any home health care
10. When to follow up with doctors.
 Documentation of discharge
1. Chart the date and time of discharge.
2. How patient left the facility.
3. Any special instructions given to the patient.
4. Make a notation that the patient’s personal
belongings were sent with the patient.
Discuss the normal reaction of patient
being hospitalized.
• THE EIGHT COPING TASKS OF ILL ADULTS ARE:
1. Change in body image
2. Reality of their own mortality
3. Coping with altered relationship with others
4. Dealing with an altered level of dependency
5. Adjusting to physiological changes
6. Grieving for their loss (self or life style)
7. Fear of recurrent problems
8. Illness occurs with other stressors.
Discuss the normal reaction of patient
being hospitalized
• There are many reactions that ill adults may have
to illness. Three major categories of reaction are
frequently seen in hospitalized individuals.
1. The angry individual: Anger is often a reaction to
perceived powerlessness. When a patient feels
powerless, they may relate in an angry manner
with staff in an unconscious attempt to
externalized their uncomfortable inner
experience.
Discuss the normal reaction of patient
being hospitalized
2. The agitated ,hyper vigilant individual:
This response presents its own set of challenges
to the caregiver. The anxiety underlying the
agitation is often a response to the individuals
feeling of helpless or decreased control due to
their illness. These uncomfortable perceptions
cause anxiety and the anxiety , in turn , increase
the uncomfortable feelings.
Discuss the normal reaction of patient
being hospitalized
3.The withdrawn individual:
This type of reaction is serous for a number of
reason .A withdrawn patient can become “lost in the
crack”. He /she may not receive the assessment and
intervention this behavior requires and can be
ignored emotionally and even physically in a busy
practice setting. Some patients are naturally
isolative and have only a minimal support system
because of their personality style.