admission & discharge

ADMISSION & DISCHARGERaymund Christopher R. dela Peña, RN, RM

Clinical FacultyUNP-College of Nursing

ADMISSION TO THE HOSPITAL

 Staff:

– prepares chart or records– gives identification band– checks his valuables in a

safety box deposit– notifies attending

physician or hospital physician about his admission to the hospital

Admission routines

– initial nursing assessment of the patient’s problems or needs

– orientation of patient and family to the physical set up and personnel in the unit or ward, ward routine, urine collection, visiting hours, visit of hospital chaplain

– maintain warmth, professional competence, and commitment to serve the patient

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Initial Nursing Assessment

– Nurses can gather data at the nursing station and identify health needs

– Patients data may be collected by observing and interviewing primary or secondary sources

Suggested action Rationale1. Greet the patient and relative2. take the patient to his room/bed, help

him put on hospital “camisa” or gown and put him to bed unless he is ambulatory

3. Take care of patient’s belongings

4. orient him to facilities and equipment inside room 5. take vital signs 6. give instructions on the proper collection of urine, stools and other specimens 7. orient relatives about hospital rules and policies 8. Record facts and observations on the patient’s charts

- Sign of welcome; reduces tension/stress

- Gives a feeling of security, privacy and belonging; initiation into role as a patient

- Prevents losses, and patient feels

assured that possessions are safe - Facilitates adjustment and comfort;

reduces apprehension- Provide baseline data on initial

condition of patient- Facilitate obtaining accurate specimens - reduces anxiety and prevents misunderstanding and keep lines of communication open - minimizes mistakes and provides basis for the formulation of an NCP

SUGGESTED GUIDE IN ADMISSION OF PATIENTS

DISCHARGE OF PATIENTS

• may mean sending him home or transferring him to another unit or service within the hospital or moving him to another hospital or the patient may have died

• when doctor discharges patient, he believes patient has fully recovered or illness might be irremediable and deems it best for him to die at home

• HAMA/HAA – Home against Medical Advice or Home against advice form - absolved of any liability should anything untoward happen to the patient outside the hospital

• Nurse foes thru formal discharge procedure when the doctor writes on the patient’s chart

1. Get a written discharge order from the physician2. Send patient’s chart to accounting section if pay px3. check patients belongings and collect hospital equipment4. collect all patient’s medicines and give written instructions on how to take these medicines. Review advice previously given him about home care, treatment and community resources5. write down a schedule of hospital visits6. help patient get dressed, and see him and his family off at the ward entrance7. record condition upon discharge

- prevent liabilities- all hospital bills settled before discharge - proper accounting to prevent misunderstanding- ensure regular intake and follow ups - ensure keeping of hospital appointments- still the responsibility of the nurse - give picture of patients condition on discharge