Patient Admission, Transfer

and Discharge

1
 Caring for a patient during
admission
Admission is the entry of a patient in to a hospital
ward for therapeutic or diagnostic purpose.
Hospitalized individuals have many needs and
concerns that must be identified then prioritized and
for which action must be taken.

2
 Purpose
 To help a new patient to adjust to hospital
environment and routines.
 To provide immediate care, safety and comfort.
 To observe sign and symptoms, and general
conditions of the patient.
 To enable the patient to use facilities, resource &
personal of the hospital.
 To alleviate fear, worry & loneliness about the
hospital.

3
 Types of admission
A. Emergency admission: means of the patients
are admitted in acute conditions requiring
immediate treatment, e.g. patient with
accidents, poisoning, burns and heart attack
B. Routine admission: the patients are admitted
for investigation and medical or surgical
treatment is given accordingly, e.g. patient with
hypertension, diabetics and bronchitis

4
 General Instruction
1.Nurse should make every effort to be friendlily and
courteous with the patient
2. Make proper observations or the patient’s condition.
3. Orient the patient and his relatives to hospital and
ward policies
4. Observe policies in dealing with medico-legal cases

5
5. Deal with the patients belonging very carefully
communicable diseases
6. Isolate the patient if suffering from communicable
disease
7. The nurse should be recognized the various needs
of the patient and meet them without delay
8. The needs to understand the fears and anxiety of
patient and help to overcome
9. The nurse should find out the likes and dislikes of
the patient and include the patient in his plan of
care
6
10. The nurse should be address the patient by
their name and proper title
11. Patient’s valuables and clothes should
handover to the relatives with proper recording

7
 Transfer
o Transfer is defined of the patient
as preparing patient, completing
necessary records and shifting patient to another
department within the hospital or to another
hospital/home
o Transfer/referral is the preparation of a patient and
the referral records to shift the patient to another
department within the hospital or to another hospital

8
 Purpose
1. To obtain necessary diagnostic tests and procedure
2. To provide treatment and nursing care
3. To provide specialized care
4. To place most appropriate utilization or available
personnel and services
5. To match intensity of nursing care, based on
patients level of needs and problems

9
 Types
1. Internal of transfer
transfer: of the
to transfer thepatient
patientin a unit
that provide special care or care suited to his need,
e.g. from general ward to ICU
2. External transfer: to transfer the patient from one
hospital to another hospital for the purpose of
special care, e.g. from general hospital to
specialized hospital- cancer center

10
A. Assess thePreliminary Assessment
method for transport, inform receiving
nurse
B. Maintain patient’s physical wellbeing during
transport to new nursing unit
C. Provide verbal report about patient’ s condition to
the receiving unit nurse
D. Be sure all documentation including care plan is
completed

11
E. Assist’s patients arrival to the new unit
F. Announce patients arrival to the new unit
G. Transport patient to the new room and assist
in transfer to bed
H. Hand over to receiving nurse

12
 Caring
Patient for aispatient
discharge on hospitalized
sending the discharge
patient to home or to referral after successful
discharge planning process.
Patient discharge planning is systematic process
for preparing the patient to leave the hospital &
for continuity of care at home.

13
Purpose
o To continue self care at home
o To adjust the patients setting out of the hospital
o To ensure adequate home health care support
o To minimize the patient’s anxiety at discharge

14
Indications for discharge
o Progress in the patient's condition (cured)
o No change in the patient's condition (Referral)
o Against medical advice
o Death

15
 Procedure
1. Check for the doctor’s written order that pt. to be
discharged.
2. Inform patient and relative about discharge
3. Document relevant discharge information
4. Make sure all the fees are included
5. Send admission card to registration office

16
6. Plan for continuing care of the patient
o Give information for a person involved in the
patient care.
o Contact family or significant others, if needed.
o Facilitate transportation with responsible unit
7. Assist patient to dress up

17
8. Teaching the patient about
o What to expect about disease outcome
o Medications (Treatments)
o Activity and Diet
o Need for Follow up and others as needed
9. Do final assessment of physical and emotional
status of the patient and the ability to continue own
care.

18
10. Check and return all patients’ personal property
(bath items in patient unit and those kept in safe
area).
11. Help the patient or family to deal with business
office for customary financial matters and in
obtaining supplies.
12. Accompany patient to the gate, if possible

19
13. Write Discharge summaries note which usually
include:
o Time and date of discharge
o Description of client’s condition at discharge
o Treatment (e.g. Wound care, Current medication)
o Diet
o Activity level
o Restrictions

20
N.B: If a patient insist upon going home against
medical advice he should be requested to sign a
statement indicating that he is responsible for his
action.

21
 Discharging a patient against medical
When the patientadvice
want to(AMA)
leave an agency without
the permission of the physician –unauthorized
discharge the following activities are indicated:
1. Ascertain why the person wants to leave the
agency
2. Notify the physician of the client’s decision
3. Offer the patient the appropriate form to complete
4. If the client refuses to sign the form, document the
fact on the form and have another health
professional witness this
22
5. Provide the patient with the original of the signed
form and place a copy in the record
6. When the patient leaves the agency, notify the
physician, nurse in charge, and agency
administration as appropriate
7. Assist the patient to leave as if this were a usual
discharge from the agency (the agency is still
responsible while the patient is on premises)

23