ADMISSION and Discharge PROCEDURE

Binita Basnet
M.sc.1st year
2023 Batch
 General objective:

• At the end of the session, participants will

be able to explain about Admission and
discharge Procedure.
 Specific objectives:

At the end of the session, participants will be

able to:
• define of Admission
• state Indication of Admission
• list purposes of Admission Procedures
• describe Types of Admission
• explain method of Admission
• describe steps of Admission Procedures
 Specific objectives cont…

• define of discharge
• list purposes of discharge Procedures
• describe Types of discharge
• describe Procedures of discharge
 Definition

Admission of a patient means allowing and

facilitating a patient to stay in the hospital
unit or ward for observation, investigation,
treatment of the diseases and for the care
of the patient suffering from different
disease.
 Indications

• Therapeutic aspect for treatment of any

acute or chronic disease
• For observation of the status of client
• For diagnostic need
• For surgical interventions
• On an emergency basis
• For conditions requiring expert care
Purpose 1/2
• To welcome the patient
• To provide immediate care
• To provide comfort and safety to the
patient
• To receive the patient in ward for
admission according to his condition
• To be ready for any emergency
 Purpose 2/2
• To assist the patient in adjusting to the
hospital environment
• To obtain information about the client so
as to establish therapeutic nurse patient
relationship
• To involve patient and family in care
• To assist in proper discharge planning of
care
 Types of Admission

Depending on Planning
• Routine admission: These are planned for
clients suffering from clinical disorders and
who need to undergo any treatment
modality or diagnostic procedure.
 Types of Admission

Depending on Planning
• Emergency admission: These are done for
clients suffering from acute conditions or
life-threatening conditions like cardiac
arrest, stroke, poisoning, accidents, etc.
 Types of Admission
Depending on Time Spent in Hospital
• Long-term admission: Long-term admission
is required for clients suffering from
pathological conditions having a long-term
recovery period.

• Short-term admission: Short-term

admission is required if clients need less
time in health care system
 Types of Admission
Depending on Purposes of Admission
• Diagnostic admission: Diagnostic admission is
usually a short-term admission meant to
undergo some investigation,

• Therapeutic admission: In therapeutic

admission, patients suffering from any medical
condition requiring continuous medical care are
admitted to hospital for better management.
 Method of Admission

• Routine Admission

OPD Doctor's Office Admission

Office Ward
 Method of Admission

• Emergency Admission
Emergency Department OT, ICU, CCU,
Burns Unit or Ward
 Articles

Complete set of admission form

Vital Sign Tray

Equipment for physical examination

Bathroom tray including hospital dress

 Articles

Specimen container

Prepared bed

Bedpan ,Urinal
 Procedure
• Wash hands
• Prepare all required equipments
• Check the bed is ready to keep the patient
• Assemble the special equipment such as suction equipment,
oxygen supplies, I.V stand, etc and make sure they are working
condition.
• Greet the patient and his relatives in a pleasant manner and
introduce yourself, staff members and another patients and
visitors to them.
• Receive the patient and family to assign bed. Make
comfortable and assist according to needs.
 Procedure
• Observe the general condition of patient, if patient is
very ill, place on the examination table or bed and inform
to the doctor immediately, perform immediate care.
• Check for admission consent whether it is duly signed by
patient and relatives.
• Check vital signs and report to the ward sister or on duty
doctor for any abnormality
• Assess immediate need, see the chart and the immediate
order
• Obtain Initial patient history and perform physical
examination.
 Procedure
• Orient patient to the physical set up of the ward such
as treatment room, nurses station, toilet, bathroom,
drinking water supply, kitchen, patients cupboard
• Explain about the facilities available such as canteen,
telephone, pharmacy, safety rules
• Explain the hospital policies regarding visiting hours,
gate pass, attendants staying with patient, and
restrictions in the ward.
• Explain the daily routine of the ward including meal
time, medication time and morning wake up and
doctors round
 Procedure

• Help the patient to change his/her clothing and

maintain personal hygiene such as nail car, hair
care, bath etc.
• Complete the admission chart
• Obtain detail nursing history and physical
examination.
• Ask the patient and relative to bring daily use
equipment, eg, towel, oil, comb, soap, toothpaste,
and brush
 Procedure

• Report/inform to unit in charge and duty

doctors about admission of patient
• Handover the patient's valuable things to
the family
• Write a complete admission report in the
patient's chart including date, time of
arrival to the ward, patient's condition, vital
sign, any abnormalities and interventions.
 Discharge
Definition
• Discharge of the patient from the hospital
means, relieving a person from the hospital
setting , who admitted as an inpatient in the
hospital.
 Purposes
To reduce the days of stay at the hospital.
• To ensure continuity of care to the patient
after discharge

To make the patient comfortable in a healthy

atmosphere
• To coordinate referrals to appropriate hospital
or rehabilitation centre.
 Types OF DISCHARGE

PLANNED DISCHARGE
ABSCOND
LAMA
Transfer
Death
 Nurses responsibilities in discharge

• Planning for continuity of care

• Patient Teaching
• Discharge teaching should be given in the
following topics
• Disease
• Nature of disease process
• Prognosis of disease
 Nurses responsibilities in discharge

Signs and Symptom of complication and its

management
• Diet
• Drugs Activity Level
• Precaution to be taken
• Follow up visit
• Recording
 Articles

Patient’s all records.

Discharge letter (paper)

Register

Wheel chair or stretcher

 Procedure

• Inform the patient’s relatives in time

• Check written order for discharge
• Prepare and check the patient’s entire
document
• Collect the discharge ticket from the
doctor
• Send chart with the discharge ticket to
billing section with relevant information
 Procedure

• After clearance of the bill, give instruction

about diet, rest, sleep and exercise,
medication including dose, time, duration,
complication of diseases, home care, follow up
visits, wound care.
• Gather equipment and supplies that the
patient has taken.
• Handover the patient’s belonging and any
valuable which have been kept safely to the
patient’s relatives under proper receipt.
 Procedure

• Assist the patient in dressing and packing items

to go home.
• If the patient is ambulatory, instruct relatives to
assist him.
• Obtain wheel chair for patient who is unable to
ambulate.
• Complete documentation of patient discharge in
nurse’s note.
• After the patient has gone, the bed should be
made clean and tidy and keep ready for next use.
 Refrences

• Potter PA, Perry AG. Fundamental of

Nursing.3rd edition. RELX India Pvt. Ltd
• Lillis T, Lynn L. Fundamental of Nursing. The art
and science of Nursing care. 7th edition.
Lippincott Williams and Wilkins, Philadelphia.
• Berman A, Synder . Fundamental of Nursing of
Concept, Process and Practice. 9th edition. Julie
Levin Alexander
• Giri.M,Sharma.P Essential fundamental of
Nursing. 1st edition. Medhavi Publication