REFERRAL SYSTEM

INTRODUCTION
Referral system is an essential component of
health care system. From rural level to
metropolises, and from health sub enters to
specialist hospitals, all kind of health facilities
can be provided to community through this
system.
IMPORTANCE OF REFERRAL
SYSTEM
 Providing diagnostic services to patient and
community.
 Providing specialist’s services to the patient.
 Propagating the purposes of referral system
among health workers.
 Teaching the nursing personal for reviewing
of patients, sent for referral.
 Preventing further complication and
providing appropriate treatment.
 Sending or transporting the patient
comfortably to the referral institute.
SELECTION OF THE PATIENT
FOR REFERRAL
 Which patient should be sent for referral,
this depends upon the resources available in
the health centre and the condition of the
patient. Such patients can be divided into
three categories.
FIRST GROUP OR FATAL
PATIENTS
 Such patients cannot survive despite the best
treatment made available to them.
 It is better to give them appropriate
treatment at the health centre itself with
available resources.
 It is essential for the relatives of the patient
to understand that owing to his fatal
condition it will not be beneficial to send the
patient for referral.
SECOND GROUP OR SERIOUS
PATIENTS
 Condition of such patients is considered
serious but immediate treatment can save
their lives, so before sending them for
referral, attempts should be made to reduce
the seriousness of condition and only after
that they should be send for referral.
THIRD GROUP OR GENERAL
PATIENTS
 Through the disease may be serious in such
patient still the condition of the patient is
found to be normal.
 Delayed treatment may not threaten his life.
Such patients Can be immediately sent for
referral.Similary, after the surgery or in case
diagnosis is not possible or for use of some
special technique patient can be sent to a
big or specialist hospital for consultation.
 Thus, on the basis of patient’s condition,
type of disease, objectives of treatment or
the need of diagnosis, the case of the patient
can be prepared for the referral system.
 Inter-Disciplinary
Referral System
INTER DISCIPLINARY REFERRAL
SYSTEM
 When a patient cannot be treated, neither
properly diagnosed nor satisfied with a
particular pathy,then he can be referred to
another type of therapy for needful. This
type of referral is called as inter-disciplinary
referral system.
 It is very common in our country, where
patient shifts oftenly from allopathy to
AYUSH
NEED FOR URGENT REFERRAL
 Hyperpyrexia (high fever not responding the
treatment or has lasted more than 4-5 days).
 Severe pain in any part of the body that is
continuous for more than 3 days.
 Stiff neck, stiff jaw with arched
back(Tetanus)?
 Convulsions: More than one attack with
fever or serious illness or convulsions without
any specific cause.
 Hematemesis/ haemoptysis.
 Pain abdomen, frequent vomiting, absence
of bowel sounds.
 Black coloured stools.
 Complicated deliveries.
 Coma (due to any cause).
 Severe diarrhoea.
 Severe cyanosis.
 Chest pain in heart patient.
 Retention of urine for more than 18 hours 24
hours.
 Multiple trauma (including fractures)/ severe
haemorrhage.
 Poisonous condition.
RESPONSIBILITY OF NURSE IN
REFERRAL SYSTEM
 Nurse should have the knowledge of referral
system.
 She should have the knowledge about
carefully selected for the referral system.
 She should be aware of their limitation and
responsibility in the referral system.
 In case of emergency, attempt should be
made to save the life of the patient, and
then only he should be sent for referral.
 Entries in the referral form or/ticket should be
clear and correct, related records should also
be enclosed with it.
 While sending serious patient, life saving
equipment/medicine should be arranged with
him.
 If facilities are available then consultation for
the patient can be procured through telephone,
television network, medical transcription or
internet (telemedicine) etc.
 As far as possible, nurse should accompany the
patient while sending him for referral.
SUMMARY
 During the session we have discussed about
meaning of Referral system, important of
referral system, Selection of the patient for
referral system, and levels of referral
system, need for urgent referral system, and
Responsibility of Nurse in Referral system.
THANK YOU