Patient Admission – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Patient Admission
Hospital admission may be defined as “Receiving a patient to stay in the hospital for observation, investigation diagnosis, treatment and care”.
Or,
Admission of patient means, allowing a patient to stay in the hospital for observation, investigation and treatment of the disease he is suffering from.
Or,
Hospital admission is the act or process of accepting someone into a hospital, clinic, or other treatment facility as an inpatient
Purposes of Hospital admission:
1. To welcome the patient and establish a positive relationship with patient and close relatives.
2. To offer immediate management and care in acute conditions.
3. To orient patient to immediate environment and services available.
4. To acquire baseline data of a patient through history and physical examination.
5. To collaborate with patient in planning and providing comprehensive care.
Articles which is needed for admission of a patient in hospital:
1. Prepared bed.
2. Thermometer tray.
3. B.P. apparatus.
4. Weighing machine (scale)
5. Admission advisory form (from admitting department).
6. Complete form of admission forms (in the file or chart).
7. Documents such as-
- Doctors order sheet
- TPR sheet
- Nursing assessment sheet
- Nursing record
- Progress recorded
- Lab master sheet
8. Articles for physical examination according to the patient’s illness.
9. Kidney tray or emesis basin.
10. Tissue paper.
11. Bedpan and urinal.
12. Bath towels and wash cloth.
Procedure of Admission of Patient in a Hospital:
1. Prepare admission bed/ room before the patient entering in the ward/room/bed.
2. Introduce yourself to the patient. Greet / welcome the patient’s warmly.
3. Orient the patient (helping a patient become familiar with a new environment) to the unit and the entire ward.
- The location of nursing station, toilet, shower or bathing area and lounge available to the patient and visitors.
- Where clothing and personal items can be stored.
- How to call for nursing assistance from bed and bath room.
- How to adjust the hospital bed.
- How to regulate the room’s light and fan.
- How to use the telephone and any policy about diverting incoming calls to the nursing station during the night.
- How to operate the television.
- The daily routine such as meal time.
- When the doctor usually visit.
- When surgery is scheduled (if needed).
- When laboratory or diagnostic test are performed
4. Explain roles of the personnel who will be caring for the individual introduce him to all staff and other patient.
5. Explain the daily routine of the ward including meal time, medication and visiting hours.
6. Explain to the patient what his rights are observing policies in dealing with medico legal cases.
7. Obtain and record vital signs high and weight.
8. Collect specimen as needed.
9. Take nursing history and health history to established a database for the patient and complete the admission record..
10. Encourage the patient to ask questions and clarify doubts.
11. Review and explain the purposes of consent. Take consent from the patient or relatives after proper explanation.
12. Record the collected data of the patient in the records file so that every one concerned will be familiar with the patient.
13. The doctor of the patient should be introducing to him and patient should feel free to talk about his problems to the doctors.
14. Start the individual nursing care plane and carry out the admission orders of the doctors.
15. Take care of the patient’s valuables and clotting.
16. Helping the patient during undress-
- Providing privacy.
- Have the patient sit on the edge of the bed
- Encourage patient to remove his/her shoes.
- If the patient is helpless, weak or tired help him her to remove dress
Definition of Patient Transfer:
Transfers are defined as moving a patient from one flat surface to another, such as from a bed to a stretcher (Perry et al., 2014). Types of hospital transfers include bed to stretcher, bed to wheelchair, wheelchair to chair, and wheelchair to toilet, and vice versa.
Transfer the Patient from Bed to Stretcher:
Always predetermine the number of staff required to safely transfer a patient horizontally.
➤ Explain what will happen and how the patient can help (tuck chin in, keep hands on chest).
➤ Collect supplies.
➤ Raise bed to safe working height. Lower head of bed and side rails.
➤ Position the patient closest to the side of the bed where the stretcher will be placed.
➤ Roll patient over and place slider board halfway under the patient, forming a bridge between the bed and the stretcher.
➤ Place sheet on top of the slider board. The sheet is used to slide patient over to the stretcher.
➤ The patient is returned to the supine position.
➤ Patient’s feet are positioned on the slider board. Position stretcher beside the bed on the side closest to the patient, with stretcher slightly lower. Apply brakes.
➤ Two health care providers climb onto the stretcher and grasp the sheet. The lead person is at the head of the bed and will grasp the pillow and sheet. The other health care provider is positioned on the far side of the bed, between the chest and hips of the patient, and will grasp the sheet with palms facing up.
➤The two caregivers on the stretcher grasp the draw sheet using a palms up technique, sitting up tall, and keeping their elbows close to their body and backs straight.
➤ The caregiver on the other side of the bed places his or her hands under the patient’s hip and shoulder area with forearms resting on bed.
➤ The caregiver on the other side of the bed places his or her hands under the patient’s hip and shoulder area with forearms resting on bed.
➤ The designated leader will count 1, 2, 3, and start the move.
➤The person on the far side of the bed will push patient just to arm’s length using a back- to-front weight shift.
➤ At the same time, the two caregivers on the stretcher will move from a sitting-up-tall. position to sitting on their heels, shifting their weight from the front leg to the back, bringing the patient with them using the sheet.
➤ The two caregivers will climb off the stretcher and stand at the side and grasp the sheet, keeping elbows tucked in.
➤ One of the two caregivers should be in line with the patient’s shoulders and the other should be at the hip area.
➤ On the count of three, with back straight and knees bent, the two caregivers use a front- to-back weight shift and slide the patient into the middle of the bed.
➤ At the same time, the caregiver on the other side slides the slider board out from under the patient.
➤ Replace pillow under head, ensure patient is comfortable, and cover the patient with sheets.
➤ Lower bed and lock brakes, raise side rails as required, and ensure call bell is within reach.
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