HOSPITALIZATION

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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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 Com position ofhospital
 Patient
 M edical Staff
 Various type of doctor
 Nursing Staff
 Nursing superintendents
 Head Nurses
 W ard sister
 LPNS
 Para M edical 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 M an
 Laundry M an
 Gardeners
 Part-time cleaner
 W ard Boys

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 Departm ent ofhospital
 Administrative Department
 M edical 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
 M ortuary Section
 Nursing school,Colleges & Pharmacy Lab
 Security Section,Spiritual care service
 Emergency Service section
 Various outpatient depart.
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 Function OfHospital
1. Investigation,Diagnosis & Treatment of the sick
or injured
2. Health supervision,Immunization & prevention
of diseases
3. M edical and Nursing Education
4. Training of paramedical staff
5. Research

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 Adm ission ofpatient

 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 ofAdm ission
They are two types of admission.
 Elective admission
 Emergency admission

Elective Admission
W ith 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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 Em ergency Adm ission
 W ith 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 ForAdm ission

 For diagnostic investigations to be

done

 For treatments which may be

medical or surgical.

 For observation
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 Purpose ofadm ission
 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 ofAdm ission
 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
hospitalization & write patient history including
past maj or illnesses.
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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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 Adm ission ofpatient

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 Role OfNurse In Adm ission 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 ofnurse 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 ofpatient
 “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
LAM A Discharge

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 Types ofdischarge

 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 ofdischarge

 Reduce hospital length of stay

 unplanned readmission to hospital
 Improve the coordination of
services

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 Procedure ofdischarge
 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 ofnurse on
discharge
 Check for medico legal history.
 Notify medical officer incharge.
 Abscond cases immediately contct medical
officer incharge.
 M aintain all documents in a proper M anner.
 Take in written handing over
 Taking of articles.
 Never dischrge patient without
 W ritten order by physician.
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 Transferofpatient
• 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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 TransferIn/Trans-in
 Patient is moved from one unit or ward of first
admission to a new unit or ward.
E.g.:M edical 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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 Transferofpatient

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 TransferOut/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 ofnurse in preparing patient &
fam ily fordischarge
 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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 Norm al Reaction OfPatient Being
Hospitalized

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 References:
 Fundamental of Nursing Kozier & Erbs.

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