HOSPITALIZATION

Fundamentals of Nursing
CON GTH Shahdara
By Miss Nazia

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 Objectives
At the end of this presentation the students will be able to
▣ Define Hospitalization

▣ Discuss the Types of hospital

▣ Composition of hospital

▣ Enumerate the Departments in hospital

▣ Enlist the Function of hospital

▣ Define the Admission of patient

▪ Know about the types of admission

▪ Describe the Purpose of admission

▪ Explain the Procedure of admission

▣ Explain the Responsibility of nurse on admission

▣ Define Discharge of patient
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 Cont.…
▣ Enlist the Types of discharge
▣ Discuss the Purpose of discharge
▣ Explain the Procedure of discharge
▣ Enumerate the Responsibility of nurse on discharge
▣ Know about the transfer of patient
▣ Discuss the types of transfer
▣ Explain the procedure of transfer
▣ Describe the role of nurse in preparing patient & family for
discharge
▣ Illustrate the normal reaction of patient being hospitalized
▣ References

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 Hospitalization
▣ Hospitalization is the placing of a patient in a
hospital and it is a form of individual stressors.
▣ Types of Hospitalization
▣ General Hospital
▣ Special Hospital
▣ Government Hospital
▣ Non-Government Hospital

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 Composition of hospital
▣ Patient
▣ Medical Staff
▪ Various type of doctor
▣ Nursing Staff
▪ Nursing superintendents
▪ Head Nurses
▪ Ward sister
▪ LPNS
▣ Para Medical staff
▪ Pharmacist
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 Cont.…
▪ Technicians
▪ Physiotherapists
▪ Dietitian
▣ Administrative staff
▪ Leady secretary
▪ Record keepers
▪ Accountants
▪ Clerks
▪ Peons
▪ Other staff
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 Cont.…
▪ Cook
▪ Driver
▪ Ayahs
▪ Pantry Man
▪ Laundry Man
▪ Gardeners
▪ Part-time cleaner
▪ Ward Boys

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 Department of hospital
▣ Administrative Department
▣ Medical Depart.
▣ Surgical Depart.
▣ Pediatric Dept.
▣ Gynecology & obstetrical Depart.
▣ Neonatal & premature Birth Depart.
▣ Neurosurgical Department
▣ Operation Theater
▣ Casualty Depart.
▣ Eye & ENT Depart.
▣ Skin & VD Depart.
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 Cont.….
▣ Orthopedic Depart.
▣ Radiotherapy Department
▣ Nursing Department
▣ Laboratory Section
▣ Pharmacy Section
▣ House keeping & maintained Dept.
▣ Laundry
▣ Mortuary Section
▣ Nursing school, Colleges & Pharmacy Lab
▣ Security Section, Spiritual care service
▣ Emergency Service section
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 Function Of Hospital
1. Investigation, Diagnosis & Treatment of the sick or
injured
2. Health supervision, Immunization & prevention of
diseases
3. Medical and Nursing Education
4. Training of paramedical staff
5. Research

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 Admission of patient

▣ It is the entry and acceptance for the

purpose of a patient to stay in a health,
faculty for the purpose of observation,
investigation and treatment, client
coming for admission may walk
(ambulant) or not.

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 Types of Admission
They are two types of admission.
▣ Elective admission

▣ Emergency admission

Elective Admission
With this type of admission the medical officer or the health
care provider arranges with the patient on a convenient date
for admission. Patient is informed well a head of time to
enable him prepare for the admission.
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 Emergency Admission
❑ With this type of admission patient reports to the
hospital in a critical condition; he/her is usually
brought in by people( Relatives, friends or a good
Samaritan ).

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 Reasons For Admission

▣ For diagnostic investigations to be

done

▣ For treatments which may be medical

or surgical.

▣ For observation
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 Purpose of admission
▣ Identify interdisciplinary assessment parameters &
responsibilities to plan & deliver the appropriate
level of care to meet the patient’s needs, evaluate
the response of care, and support community care.
▣ To establish unified process of assessment and
reassessment of patients admitted to the units.
▣ Admission physical assessment shall be done with
in four hour in general unit.

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 Cont.….
▣ Admission physical assessment shall be done
within one hour in special care unit.
▣ All data collected are entered on the nursing
admission assessment sheet and available to all
those involved in the care of the patient.
▣ Data that is not obtainable with in four hours of
admission should be documented at the end of shift
by the assigned nurse.

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 Cont.….
▣ The RN assigned to the patient is responsible to
ensure that the form is completed within the time
frame specified.
▣ Documentation should be in permanent ink (blue or
black).
▣ The nurse should write her/his name, RN and
signature.

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 Procedure of Admission
▣ At the time of admission, the registered nurse
performs complete assessment of the patient.
▣ Enter patient’s name, medical record number and
age at the upper left corner of the form.
▣ Enter date & time of admission, medical diagnoses
& chief complaint in the appropriate space in the
form.
▣ Document the source of information(patient, family,
caregiver or health care person or significant
person)
▣ Check the document if patient has previous
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 Cont.…
▣ Indicate if patient was admitted from ER
(Emergency Registration), home, clinic, other and
accompanied by whom.
▣ Take patients vital signs (temperature, pulse,
respiration) height, weight.
▣ Assess & document the location and the severity of
the pain using the pain scale.
▣ Document if patient has history of allergy, if yes,
check whether it’s due to medication, food or others.

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 Cont.….
▣ Document patient brought medicine to the hospital. If
yes, check whether it was send to pharmacy.
▣ Document if patient & family has valuables brought
to hospital. If yes, check it was sent to admission
office.
▣ At the time of arrival to the room, patient and family
will be given orientation to the unit, an explanation to
the patients’ rights and responsibilities.
▣ Check the activities of daily living and need of
mobility aid.
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 Admission of patient

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 Role Of Nurse In Admission Of
Patient.
▣ Arrange patient’s unit.
▣ Greet the patient and orient to ward, other patients
patient’s room, and equipment.
▣ Tell rules and regulation to patient.
▣ Complete patient’s admission charts.
▣ Take temperature, blood pressure, respiration, pulse of
patient.
▣ Carry on required investigation.
▣ Follow the physician order, administer prescribed
medicine.
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 Role of nurse cont.…
▣ Enquire from patient, if he is allergic to any
medicines, apply allergy band & inform the
physician.
▣ Give instructions to patient to take care of belongings
& valuables.

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 Discharge of patient
▣ “Discharge of patient from the hospital means,
reliving a person from hospital setting, who
admitted as an inpatient in that hospital”
TYPES OF DISCHARGE
Planned Discharge
DAMA Discharge
LAMA Discharge

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 Types of discharge

▣ Planned Discharge
Patient completes the initial, actual
management in the hospital under direct
supervision of that hospital.’

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 Cont..
▣ DAMA Discharge
“I am leaving the hospital ward against medical
advice. Doctor explained me about my disease
condition and ill effects of discharge against
medical advice. Doctors, hospital and staffs will
not be responsible for any ill effects happening
after my departure”.

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 Purpose of discharge

❑ Reduce hospital length of stay

❑ unplanned readmission to hospital
❑ Improve the coordination of services

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 Procedure of discharge
▣ See doctor’s written order.
▣ Explanations.
▣ Hand over personal belongings.
▣ Check and receive any hospital property.
▣ Confirm bill paid.
▣ Inform other departments regarding discharge.
▣ Arrange transport.
▣ Dama :-check consent

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Responsibility of nurse on discharge
▣ Check for medico legal history.
▣ Notify medical officer incharge.
▣ Abscond cases immediately contct medical officer
incharge.
▣ Maintain all documents in a proper Manner.
▣ Take in written handing over
▣ Taking of articles.
▣ Never dischrge patient without
▣ Written order by physician.

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 Transfer of patient
• Transfer of patient within a healthcare
facility/hospital.
▪ It is the movement of a patient with in the
same health facility.
Types of Transfer of Patient
They are two types of transfer of patient.
1. Transfer in/Trans-In
2. Transfer out/Trans-out
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 Transfer In/Trans-in
▣ Patient is moved from one unit or ward of first admission
to a new unit or ward.
E.g.: Medical to surgical ward.
ROLE:
❖ Prepare a suitable bed to receive patient

❖ Assemble the necessary equipment depending on the

patients condition i.e. oxygen apparatus, suction machine,
vital signs tray
❖ Receive incoming patient, relatives and accompanying
nurse warmly.
❖ Take over the transfer notes and personal belonging of the
patient.
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 Role cont….
▣ Ask for clarification on vital issues pertaining to the
patient’s condition from the accompanying nurse.
▣ Introduce self and other nurses around to patient and
relatives
▣ Do a quick assessment of the patient’s condition and needs
and act accordingly
▣ Admit patient using the nursing process.
▣ Orientate patient and relatives to ward and its
environment, routine of the unit if necessary.
▣ Document time of patient’s arrival in the nurses note,
admission and discharge book and ward state.

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 Transfer of patient

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 Transfer Out/Trans-out
▣ It could be from unit to unit or facility to facility.
STEP
❖ Confirm with receiving unit.

❖ Assess patients condition

❖ Arrange for appropriate vehicle-where applicable.

❖ Arrange for accompanying nurse

❖ Collect all necessary data.

❖ Explain reason of transfer to patient and relatives and

reassure them to reduce anxiety.
❖ Obtain written consent for transfer

❖ Pack patient belonging

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 Role cont…
❖ Collect patient medication, investigation result and
transfer notes
❖ Assist patient to dress up
❖ Assist patient into wheel chair, stretcher, ambulance
where applicable
❖ Enter patient name in the A and D book, ward state and
nurse note
❖ Hand over patient’s notes and belonging to the
accompanying nusre.

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 Role of nurse in preparing patient &
family for discharge
▣ Educate the patient & family throughout the hospital stay
▣ Listen to the honor the patient & family goals,
preferences, observations, & concerns
▣ Provide resources to take home to back up information
given in hospital and advise follow up:
✔ Advise who contact & when if their condition deteriorates

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 Normal Reaction Of Patient Being Hospitalized

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 References:
▣ Fundamental of Nursing Kozier & Erbs.

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