Unit 11#process of Hospitalization

Process of Hospitalization
By : Ibne Amin
Institute of Nursing Sciences,
Khyber Medical University , Peshawar
Objectives
At the end of this unit learners will be able to:

1. Define the term admission, transfer and discharge
2. Discuss the procedure for admission, transfer and
discharge
3. Identify nursing responsibility during admission,
transfer and discharge
4. Discuss nurse role in preparing patients and family
for discharge
5. Discuss the normal reaction of patient being
hospitalized
Hospital
The word “ Hospital’’ has been derived from the Latin hospes,
signifying a stranger or foreiner, hence a guest.Another noun
derived hospitium came to signify hospitality, that is the
relation between guest and shelterer and hospitality
Types
Government Hospital
Semi Government hospitals
Private hospitals
Special hospital
Hierarchy in Pakistan
BHU-RHC-THQ-DHQ-TCH
Admission
Admission is a process of receiving a new patient to an

individual unit (ward) of the hospital. OR
It is the entry and acceptance of a patient to stay in a
health facilty.
Purpose of Admission
1.Observation
2.Diagnosis
3.Procedure/Surgery
4.Treatment
Types of admission
There are two major types of admission,

1. Elective / Planned
2. Emergency
Elective /Planned Admission
In this typ of admission the health care provider e.g.
medical officer plans a convenient date for
admission.Patient is informed well before the time so
as to make him prepare for Admission.Patient is taken
through the admission process from OPD
Types of admission
In Elective admission there is known medical

condition or complaint that requires further
workup,treatment or surgery
Types of admission
Emergency Admission
In this type of admission, the patient is being brought to
the hospital in a critical /serious condition which needs
prompt admission and immediate treatment so as to
prevent complication.
Admission Procedure
1. The admitting department

2. Arrival on Nursing unit
3. Hospital orientation
4. Preventing Dehumanization
Admission Procedure
1. The admitting department

• Fill out admission form
• Take Admission consent
• Provide identification Band
• Allocate Hospital’s bed
• Take care of personal belonging
Admission Procedure
2. Arrival on Nursing Unit

• Height & weight
• Vital signs
• Send samples for lab investigation
• Reporting The admission
• Admission Documentation
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, LAMA, MLC)
Admission Procedure
4. Dehumanization
• Anxiousness or Apprehension
• Fear of Unknown
• Fear of body image changes
• Financial concerns
• Embarressment
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.
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
Patient’s Discharge
Discharge planning Begin at admission

Assess
1. patient’s personal Hx & health Data
2. Pt’s ability to perform ADL
3. Any physical, cognitive, or other functional limitation
4. Care giver’s responses or ability
5. Financial resources
6. Community support
7. Need for home care assistant
Discharge Teaching
• Medication
• Activity (rest/ Exercise)
• Diet
• Appointment for next visit (Follow -up)
Day of Discharge
Discharge documentation
Hospital Discharge
Indication for discharge: After completion of

Required diagnosis,Observation,Procedure,treatment as
suggested by attending physicain or surgeon.
• Progress in the patient's condition
• No change in the patient's condition (Referral)
• After an Expiry
• Leaving Against Medical advice (LAMA)
• Stay against Medical advice (SAMA)
Reaction to Hospitalization
Illness Behaviour
• Pt not held responsible for their condition
• Excused from certain social role & tasks
• Obligate to try to get well ASAP
• Obliged to seek competent help
Reaction to Hospitalization conti…
Effect of illness
• Change in Behaviour
• Disruption of privacy & Autonomy
• Lifestyle,Roles and Finances
• Change in self concept, body image
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.
• 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
Discharge summaries usually include:
• Description of client’s condition at discharge

• Treatment (e.g. Wound care, Current medication)
• Diet
• Activity level
• Restrictions
References
Basic clinical Nursing Skill, 1st edition

(Abraham Alano, B.Sc.,M.P.H,HawassaUniversity)
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Process of Hospitalization

At the end of this unit learners will be able to:

Admission is a process of receiving a new patient to an

There are two major types of admission,

In Elective admission there is known medical

1. The admitting department

1. The admitting department

2. Arrival on Nursing Unit

Reason for Transfer

1. Check doctor’s order.

Discharge planning Begin at admission

Indication for discharge: After completion of

The Role of Nurse in discharge planning

• Ensure discharge is ordered by a medical officer

Discharge summaries usually include:

• Description of client’s condition at discharge

Basic clinical Nursing Skill, 1st edition

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