ADMISSION &

DISCHARGE

Prepared By:
CHEZEL B. AGUILAR, RN, MN
RIZA MAE T. ABELLANOSA, RN MSN
• State the processes involved in admission and discharge of
patients
• Identify the purpose of following the proper procedure of
admitting and discharging patients
• Elaborate on the underlying principles of admission and
discharge
• Enumerate the materials/equipment used in admission of
patients
• Demonstrate competence in performing admission and
discharge procedure
• Care which a patient receives when he enters the hospital; allowing a patient
to stay in hospital for observation, investigation, treatment and care
• A process that takes place when a person enters a health care agency for more
than 24 hours of care and treatment.
• The process involves the following:
* obtaining medical authorization
* compiling billing information
* completing nursing admission
* fulfilling mandated medical responsibilities
PURPOSE
• To establish guidelines regarding admission of patients
• To make the patient feel welcome, comfortable and at
ease
• To acquire vital information regarding the patient
• To assess the patient from which the nursing care plan
can be initiated and implemented
NURSING OBJECTIVES

1. Make the patient and his family feels welcome and facilitate
their adjustment to the hospital environment
2. Ensure safety and comfort of patient
3. Institute primary diagnostic measure
4. Preserve person's individuality
5. Prepares patients both physically and emotionally for
examination, treatment and other experiences
UNDERLYING PRINCIPLES

1. Entering a health care facility is a main crisis in the lives of most persons
• Illness can be novel experience for the patient and bring stress on his physical
and mental health
• Sudden change or strangeness on the environment produces fear and anxiety
2. The best approach in reducing fear of the unknown is adequate explanation
3. Some people value beauty and cleanliness very highly
4. Each health care facility needs to maintain certain routine procedures and needs
specific information about incoming patients to facilitate the performance of each
functions
UNDERLYING PRINCIPLES

5. Every society maintains attitude and beliefs related to illness and

death, which serve as guidelines in the behavior of its members
6. Inconsistencies in verbal and non-verbal communication may
result to problems because hospitalized patient is sensitive to
some verbal and non-verbal communication
7. Family centered approach in patient care enhances the
therapeutic atmosphere and facilities patient's acceptance of his
current experiences
TYPES OF ADMISSION

• Emergency Admission. Means the patient are admitted in acute

conditions requiring immediate treatment, e.g. patient with
accidents poisoning, burns and heart attacks

• Routine Admission. The patients are admitted for investigation

and medical or surgical treatment is given accordingly, e.g.
patients with hypertension, diabetes and bronchitis
EQUIPMENT

• Open Bed
• Admission Pack with the following contents: face towel, toilet soap, calibrated drinking glass,
toilet paper,poon, fork, teaspoon, bath soap, thermometer and mineral water
• Tray
• Kidney or emesis basin, bed pan or urinal PRN
• Face mask PRN
• Hospital gown
• Sphygmomanometer and stethoscope
• Documentation forms: patient's chart with admission pack slip
ASSESSMENT

1. Assess patient for signs and symptoms of physical or emotional

distress
2. Assess patient's ability to ambulate and/or move in room free of
obstacles; and ability to safely and efficiently use equipment in
the room such as bedside table, call lights, etc.
3. Assess patient's knowledge and reason for admission
ASSESSMENT
PLANNING/EXPECTED OUTCOME

1. The patient will be comfortable in the health care facility

2. The patient and family will be oriented to hospital environment
3. Provide safety to patient
4. The patient and family will adjust to hospital/facility nurse
5. Answer the patient's and family's questions
6. Complete nursing paperwork according to agency policy
EVALUATION

1. Patient is comfortable
2. Patient understands hospital policies and procedures
3. Safety measures are implemented
4. Patient verbalizes understanding of the need for
hospitalization
RECORDING and REPORTING

1. Record or chart the following:

a. Date and time of admission
b. Manner of arrival and general condition
c. Chief complaints: subjective and objective data
d. Assessment result such as: appetite, sleep, urination, bowel movement, etc. (if normal, do not make
any remarks)
e. Vital Signs: TPR, BP
f. Height and Weight
g. All procedures and treatments done
h. Any specimen sent to laboratory
i. Visits of the physician and other members of the health team
RECORDING and REPORTING

2. Report any unusual assessment findings

3. Notify physician of patient's admission
 DISCHARGE
• It is a process that occurs when a patient leaves a health
agency
• It consists of:

• The best discharge planning starts on admission

 DISCHARGE
PURPOSE

• To ensure continuity of care to patient after discharge

• To assist patient to complete hospital formalities before
returning home
• To assist patient to return to a state of optimal
independent living
• To assist the patient in discharge process
• To acknowledge patient's right in deciding to leave hospital
 DISCHARGE
REASONS for DISCHARGE

• Cured
• Transfer to Other Hospital
• Discharged at Request
• Discharged Against Medical Advice
• Death
 DISCHARGE
NURSING OBJECTIVES

1. To allay fear and anxiety of the patient and his family

2. To ensure continuity of care at home through health
teachings and instructions given to the family for
effective implementation of the medical regimen
3. To have a better understanding of the psycho-social
component of re-adjustment after hospitalization
 DISCHARGE
UNDERLYING PRINCIPLES

1. Planning for the patient's discharge should start upon

admission, not on the day of discharge
2. A written order of the physician is pre-requisite to
dismissal of the patient from a health care facility
3. Continuity of care is an integral aspect of the discharge
procedure and should be given careful attention
 DISCHARGE
UNDERLYING PRINCIPLES

4. Before the departure of the patient from the unit, a final

assessment should be done (physical, emotional, and his
ability to continue or participate in his own care)
5. Need learning is difficult to assimilate if given at the last
minute, so health teachings should be planned ahead of
the time of discharge
 DISCHARGE
EQUIPMENT
• Wheelchair, as necessary
• Patient's Chart
• Patient's Istruction Sheet
• Discharge Summary Sheet

ASSESSMENT
1. Assess patient's feelings about being discharged
2. Assess the patient's and family's knowledge of care at home
3. Assess the patient's understanding of the psychosocial component of readjustment after
hospitalization
DISCHARGE
DISCHARGE
DISCHARGE
 DISCHARGE
EVALUATION

1. Ask client or family member to decribe nature of

illness, treatment regimen and physical signs or
symptoms to be reported to physician
2. Have patient and family member perform any
treatment to be continued at home
 DISCHARGE
RECORDING and REPORTING

1. Recording: Complete documentation in nurse's notes. Chart the following:

a. Date and time of discharge
b. Company during discharge
c. Mode of departure
d. Patient's condition or status of health problem at time of discharge
e. Discharge instructions given
2. Reporting: Endorse to next shift the patient's discharge
REFERENCES