HOSPITAL ADMISSION AND DISCHARGE

Hafiz Ahmad Lubab Khattack

Institute of Nursing,KMU
Admission

Admission is defined as allowing a patient to stay in hospital

for observation ,investigation ,treatment, of the disease
he/she is suffering from.
Admission is the entry of a patient into a hospital ward for
therapeutic /diagnostic purposes.

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Purpose of Admission
 To provide immediate care, safety and comfort.
 To observe and report signs and symptoms of a disease
condition.
 To be ready for an emergency..
 To manage and improve the general condition of patient.
 To obtain information about the patient for better health
service.
 To reduce anxiety and fear of patient.
 To establish a nurse –patient relationship.
Types of admission
There are two major types of admission,
1. Emergency admission
2. Routine Admission
1.Emergency Admission.
The emergency admission means that the patient are
admitted in acute conditions requiring immediate
treatment.
e.g. patient with RTA,poisoning,shock,burns,and cardiac are
respiratory emergency.

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Types of admission
2.Routine Admission.
Routine admission means that the patients are admitted for
investigation, planned treatment,diagnotic, and medical or
surgical treatment.
Treatment is given according to the patients problem.
Example patients with hypertension, diabetes mellitus.

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Preparing the unit for Admission
 keeping the bed ready.
 Position the bed.
 Assemble special equipment and supplies.
 Assemble necessary equipment and supplies.
Preparing of Articles for Admitting the
patient
 Admission bed with articles.
 Thermometer tray,BP apparatus, stethoscope.
 Equipment used for physical examination such as
weighting machine, inch tape, or other necessary articles.
 Admission slips.
 Patient case sheet, doctors note, nurse note, progress note.
 Investigation form,blood,x-rays,urine,stool,report.
 Bath tray if needed.
 Kidney tray.
Admission Procedure
 Greet the patient and his/her relatives and introduce
yourself to them.
 Receive the patient cordially. Observe the clients vital
signs and symptoms and collect specimen for laboratory
tests if required.
 Introduce him to other person in the ward.
 Complete the admission record.
 Collect history and carry out simple physical examination
 Carry out the prescribed treatment and keep a record.
Conti
 Provide privacy. Give admission bath if needed. Change
to hospital clothes.
 Orient the patient to the ward
toilet,bathroom,drinking,water supply, nurse's station and
treatment room.
 Hand over the patient valuable to his relatives.
 Issue visitor pass. Answer queries of clients, and relatives
 Encourage patient to take hospital diet especially when
therapeutic diet is ordered.
 Complete necessary record, according to policy. Obtain
local address or mobile number.
Special Consideration
 Isolate the patient if suffering from communicable disease
 Make proper observation of the patient condition ,record
and report.
 Orient the patient and his relatives to hospital policy.
 Avoid physical and psychological trauma.
 Be cautious and kind to the patient and relatives.
 Collect necessary information about the patient from
relatives or patient himself.
 Never leave the patient alone in the casualty.
Admission Procedure in detail
1. The admitting department
2. Arrival on Nursing unit
3. Hospital orientation
4. Preventing Dehumanization

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Admission Procedure

1. The Admitting department

• Fill out admission form
• Take Admission consent
• Provide identification Band
• Allocate Hospital’s bed

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Admission Procedure

2. Arrival on Nursing Unit

• Height & weight
• Vital signs
• Send samples for lab investigation
• Reporting The admission
• Admission Documentation

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Admission Procedure

3. Hospital Orientation
• Ward routine
(doctor, Nurses round)
• Physical facilities in room
(Internet,TV, Bathroom,teleph etc.)
• Hospital services & timing
(meals ,medication, Med/surg.supply ,linen)
• Hospital Policies
(smoking policy,etc )
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Admission Procedure
4. Dehumanization

• Anxiousness or Apprehension
• Fear of Unknown
• Fear of body image changes
• Financial concerns
• Embarressment

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Role and responsibilities of the Nurse
 when the patient comes ,take the case sheet and receive
patient in the admission bed.
 If the patient is very ill, inform to the doctor incharge
immediately.
 Complete the admission register and other admission
record side by side.
 Make general observation from head to toe, check
hight,weight and vital signs.
 Give bath to the patient if required.
 Dress the patient in clean hospital clothes, comb the hair
and make him or her comfortable.
Conti
 Subsequently learn the patient habits ,interest,hobbies,and
health history.
 Hand over the patient belongings and valuables to the
relative or ward incharge nurse for safe custody.
 If the patient is admitted for operation or any treatment
requiring anesthesia, take the consent.
 If the patient is mentally upset due to worries of home,
disease or some other reasons ,give psychological support
to them.
 Nurse should deal every effort to be friendly and
courteous with the patient and family members.
Conti
 Make proper observation of patients condition.
 Orient patient and relatives regarding hospital polices.
 Deal with patient carefully who is suffering from
communicable disease or ill, isolate if necessary.
Transfer
 Transfer is defined as moving a patient from one flat
surface to another, such as from a bed to a stretcher.
Types of hospital transfer include bed to stretcher, bed to
wheelchair, and wheelchair to toilet, and vice versa.
Transfer to other Unit
Reason for Transfer

1. Temporary Assignment
2. Change in patient’condition
3. Quieter environment is required
4. Pt disturbing other patients
5. Patient needs special care or procedure etc.

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Guidelines for Pt’s Transfer
1. Check doctor’s order.
2. Explain to pt and family.
3. Provide detail for safety
4. Hand over to other unit staff
5. Inform other department about pt’s transfer
6. Assemble all personal belonging & medicines

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Discharge
 It is a systematic or plan process to way out patient from
the hospital after complete medical and medical
treatment.
 When you leave a hospital after treatment ,you go
through a process called hospital discharge .
 A hospital discharge you when you no longer need to
receive inpatient care and can go home. Or, a hospital will
discharge you to send to another type of facilities.
Types of discharge
1.Cured and discharge.
When the treatment of patient is completed from the
hospital. Gets discharge after doctors order.
2.LAMA(Leave against medical advice.
When the patient does not want to continue his treatment
and want to leave against doctor medical advices and patient
gone with LAMA.
3.Adconded.
When patient leave hospital with out any information to
hospital authorities. And patient leave the hospital without
clear dues.
Types of discharge
4.DOR(discharge on request).
When the patient is not want to take treatment from hospital
and his personal interest.
5.Transfer to other hospital.
The patient is refer to other hospital because better medical
service.
6.Relived.
From hospital treatment is over.
7.Death.
when the patient with critical heath problem admitted in
hospital and not recovered died in the hospital.
Patient’s Discharge
Discharge planning Begin at admission
Assess.
1. patient’s personal Hx & health Data
2. Pt’s ability to perform ADL.
3. Care giver’s responses or ability
4. Financial resources
5. Community support
6. Need for home care assistant

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Discharge Teaching
• Medication
• Activity (rest/ Exercise)
• Diet
• Appointment for next visit (Follow -up)

Day of Discharge
Discharge documentation

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Discharge of a Patient from the
Hospital
The Role of Nurse in discharge planning.
• Includes all caregivers involved in the care of the patient
i.e. Pysiotherapist (multidisciplinary).
• Adequate assessment of the patient during all stages of
care to identify discharge needs.
• Assess health teaching needs of clients and family and
provide family members with the knowledge and skill to
care for the client in the home setting e.g. wound care,
range of motion exercise etc.

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Discharge of a Patient from the
Hospital

• Ensure discharge is ordered by a medical officer

• Patient and relatives are informed about discharge
• They are educated on the need for continuing treatment
and follow up care
• Ensure patient’s hospital bills are worked out and
submitted to health insurance officer

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Discharge of a Patient from the
Hospital

Discharge summaries usually include:

• Description of client’s condition at discharge

• Treatment (e.g. Wound care, Current medication)
• Diet
• Activity level
• Restrictions

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