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Unit-III ADMISSION. Presented by Mrs. Prashma Lecturer Dept. of Medical Surgical Nursing. Learning objectives. To define admission To explain the types of admission To list out the purposes of admission To discuss the principles of admission
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Unit-IIIADMISSION Presented by Mrs. Prashma Lecturer Dept. of Medical Surgical Nursing
Learning objectives • To define admission • To explain the types of admission • To list out the purposes of admission • To discuss the principles of admission • To demonstrate the procedure for admission in various settings • To discuss the role of nurse in admission procedure
Introduction • There may come a time when you or a loved one may need to be admitted to a hospital. In general, there are two major types of hospital admissions, emergent and routine.
Admission to the hospital Definition: • Admission of a patient means, allowing a patient to stay in the hospital for observation, investigation, diagnosis & treatment of the disease he is suffering from.
Types of admission • Emergency – clients are admitted in acute condition requiring immediate treatment. Example: patients with heart attack, accidents, acute appendicitis etc • Routine – which does not require immediate treatment & can wait. or patients are admitted for investigations & planned treatments & surgeries
Purposes of admission: • To welcome the client & family, thereby nurses & other members of healthcare establish therapeutic relationship with client • To collect primary & secondary data essential for diagnosis, treatment & rehabilitation • Clients suffering from minor ailments treated & others are admitted for further investigation & treatment
Patient preparation 1. Explanation 2. Change the to hospital gown 3. Provide bath /assist in bath & look for pediculi 4. Never leave the seriously ill patient alone in private room 5. Inform the doctors in charge of the unit about the newly admitted patient through proper channel 6. Prepare the patient for physical examination if necessary 7. While undressing the client , the clothing should be sent for washing 8. If client do not have relatives belongings should be numbered , labeled & kept in safe custody until relatives arrive .
Patient preparation(conti...) 9. Never through anything away that belongs to the client 10. Encourage the patient to send the jewellery, money & other valuables to home with responsible person. 11. On discharge/death/transfer of the patient the nurse should see that all the valuables are returned to the patient or his relatives.
Principles of admission • Sudden change or strangeness in the environment produces fear & anxiety • Entering the hospital is a threat to ones personal identity • People have diversity of habits & modes of behavior • Illness can be novel experience to the client & brings stress on mental & physical health
Principles of admission • Sudden change or strangeness in the environment produces fear & anxiety • Be friendly & courteous • First person to create impression are admission department • Non professional assistants need to be properly oriented in admission procedure • Adequate explanation before any procedure prevents uncertainty & fear • Never leave alone In the units & in dark rooms • Stigma, economic insecurity & lack of privacy produce fear & anxiety
Much of the anxiety connected with illness due to unknown fears • Nurses can allay fear & anxiety by talking, proper explanation, listening to them, explain the routine, introduce the newcomer, taking care of their valuables etc.
Principles of admission 2. Entering the hospital is a threat to ones personal identity • Every person is a unique in terms of personality, needs & illness • Address the client by proper name & title E.G Ms, Mrs., Mr. etc • Every patient expects the nurse greets him pleasantly & enquire about his welfare • The nurse should find out the likes & dislikes of the client & include the patient in plan
Principles of admission • 3. People have diversity of habits & modes of behavior • Understand the behavior pattern of patients according to the age, sex, race, caste& socio-economic factors. Assist them in developing good health habits & to retain their mode of behavior
Principles of admission • 4. Illness can be novel experience to the client & brings stress on mental & physical health • Health can be improved by formal & informal health education • Identify the clients needs & meet them without delay • Needs of the patient can be met according to maslow’s hierarchy of needs • Physiological needs • Stimulation needs • Protection needs • Love & belonging needs • Esteem needs • Spiritual needs
Principles of admission(conti...) • Much of the stress can be eliminated by proper explanation • Patients develop certain behavior pattern called mental mechanism during illness • Recognition of certain mental mechanism helps the nurse to understand the fears & anxieties of the people.
Preparation of articles • Consent form – pamphlet /brochure containing patients ‘Bill of Right’ , and brochure describing advance directives • A closed bed is converted to an open bed. • Prepare assigned room with necessary equipment & personal care items like bedpan & urinal, wash basin, bath towel & wash cloth, kidney & emesis basin, thermometer sphygmomanometer etc.
1. Outpatient department • Reception of the patient • Recording social & medical data. • Medical examination
2. Inpatient department • Transporting the client from OPD to IPD • Reception of the client by the ward in charge • Preliminary observation of the client • Helping the patient to occupy his bed • Care of the valuables and clothing
Admission to various health care facilities (possible admission procedure) • Hospital – introduction; orientation to room & equipment: complete nursing history, vital signs & other physical assessment • Emergency room – introduction: ABC (airway, breathing & circulation): vital signs, focused assessment of that problem; orientation to surroundings
Admission to various health care facilities (possible admission procedure) • 3. Clinic or physicians office – introduction; explore reason for seeking medical care & focused assessment of that problem: vital signs. • 4. Nursing Home - introduction; review of written or verbal report from transferring agency: nursing & assessment focusing on functional abilities: orientations to new surroundings.
Admission to various health care facilities (possible admission procedure) • 5.Hospice– Introduction; review of referral; nursing history & assessment focusing on pain control, functional abilities, coping, &support: wishes concerning terminal care & death (e.g. living will): orientation to procedure & care. • 6. Psychiatric facility – Introduction; mental health evaluation including history, mood state, suicide risk, use of drugs, support systems
Admission to various health care facilities (possible admission procedure) • 7. Home visit – introduction: review of referrals & clients medical & nursing problems; home environment, care giver & family support, community resources.
Children • Old age • Fractured/injuries • Bedridden/stroke • Operation
Roles & Responsibilities of the nurse • Maintain professional relationship with client; • Welcome & escort client & family to interviewing area Rationale – courteous welcome helps relieve anxiety of first encounter with agency personnel. Interviewing area provides privacy for client.
Roles & Responsibilities of the nurse • 2. Provide for clients safety • Acquire identify information including clients full legal name, age, birth date & address & nearest relative • Apply identification Band • 3. Provide for clients legal rights • Instruct the client /legal guardian to read general consent form for treatment • Provide information to make right decision for treatment /surgery • Provide brochures describing purpose of agency, organization & policies or rules that effect persons conduct as a client
Roles & Responsibilities of the nurse • 5. Assess the clients needs; • assign clients room according to the condition of the client • Send client to screening area for diagnostics • Provide continuity of care if the client is admitted through Emergency room
Roles & Responsibilities of the nurse • 6. Observation of the client • 7. Recording & reporting • record history & assessment findings • Notify physicians clients arrival to the ward • Begin to develop nursing care plan, confer with client as needed
Patient & family teaching • Hospitals no smoking policy • Clients admitted to the hospital on the day of surgery receive basic instructions regarding surgery, stay & post treatment care. • The nurse can provide information regarding physical assessment, diagnostics & hospital routines • The emergency situation instruct family members on the rationale for any procedure & routines to expect in the clients care.
Patient & family teaching • 5. Explain the time for meal servings • 6. Diet & meal passes should be given to the relatives & renewed periodically. • 7. Explain the timings of doctors visit, visiting time & other routines etc • 8.Clients on self diet needs to be instructed what type of diet is to be taken & timings of diet
Summary Today we discussed about types of hospital admission, procedure in various settings and role of a nurse.
Conclusion • Nurses play an important role in hospital admission procedure including patient and family teaching.
Evaluation 1. When a patient is suffering from a life threatening condition , which type of admission is done • A. Diagnostic • B. Emergency • C. Routine • D. Therapeutic 2. a. Define admission b. Explain the types and procedures of admission
References • Black J, Hawks J. Medical-surgical nursing. 8th ed. St. Louis, Mo.: Saunders/Elsevier; 2009. • Lewis, Heitkemper, Dirksen, O’ Brien, Bucher. Medical-Surgical Nursing Assessment and Management of Clinical Problems. 7th ed. India: Elsevier; 2009. • Suzanne C. Smeltzer, Brenda G. Bare, Janice L. Hinkle, Kerry H. Cheever. Brunner and Suddarth’s Text Book of Medical-Surgical Nursing. 11th ed. New Delhi: WoltersKluwer (India) Pvt, Ltd; 2009.
