ADMISSION OF PATIENTS

BY ADOM BOAKYE

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 Admission of patients
 Admission of patient is the entry and
acceptance of a patient to stay in a health
facility for the purpose of observation ,
investigation and treatment . Clients coming
in for admission may walk-in (ambulant ) or
not.

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TYPES OF ADMISSIONS

1. ELECTIVE/ PLANNED/ROUTINE

2. EMERGENCY

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 Procedure (emergency admission)

1. Welcome patient and relatives and escort them to the

nurses’ station or the admission bay (Triage area).

2. Collect necessary documents, admission notes and any

information from accompanying nurse.

3. Identify and confirm patient’s name and particulars and

reassure patient and relatives.

4. Make a quick assessment of patient’s general condition.

5. Put patient into prepared bed. 4

 Procedure
6. Change patient into bed clothing if possible.
7. Assess patient
8. Take relevant history from patient, if conscious, or
relatives and document.
9. Instruct patient or legal guardian to read consent
form for treatment or explain content to patient
and or relatives

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Procedure
10.Getpatient or legal guardian to sign
consent form.
11.Direct
relatives to pay cash deposit at
accounts department if not insured
12.Take care of patient’s valuables according
to institutions policy
13.Allow
relatives to see patient and say
goodbye
14.Inform relatives about visiting times and
other items to bring
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 Procedure
15.Collect specimen of urine, test and record
16.Make a care plan to implement nursing
interventions
17.Administer prescribed treatment
18.Enterpatient’s name into admission and
discharge book and onto the ward state

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Planned/Elective admission

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 Advance preparation

 Wash hands and assemble the following (may

depend on the condition of the patient)
 Temperature tray
 Resuscitation/emergency tray
 Oxygen apparatus
 Tray for venipuncture and I.V. line
 Suction apparatus
 Blood pressure apparatus
 Pad and pencil
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 Bed to suit patient’s condition

 Procedure(Planned)
1. Warmly welcome patient/relative to nurses’ station and make them
comfortable

2. Introduce yourself/any staff present to patient/relative

3. Collect necessary documents, admission notes and any information

from accompanying nurse

4. Identify and confirm patient patient’s name and particulars

5. Send patient to his bed and introduce him to other patients

6. Check vital signs and record and collect specimen if

ordered 10
7.
Administer urgent prescribed
medications if necessary
8. Assist patient to change into his
night dress/pyjamas
9. Take care of patient valuables
according to the institution’s policy
10.Get patient or legal guardian to
sign the consent form for treatment
if necessary

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8. Explain NHIS to patient/relatives
9. Inform relatives about visiting time and allow
them to see patient and say goodbye.
10.Orientate patient to ward and its annexes
11.Enter patient’s name into admission and
discharge book, and ward bed state
12.Document in nurses notes

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 ADMISSION OF CHILD (AMBULANT)
1. Welcome child and parent into nurses’ station
and make them comfortable. Identify child’s
name and introduce self and other staff
present to them and reassure them for their
support during admission.
2. Get patient’s record from accompanying nurse,
confirm patient’s name and diagnosis and apply
identification band.
3. Send child to the prepared cot and introduce
other patient near him when necessary.
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4. Orientate patient and parent to the unit eg.
Playroom, Tv room, baths and toilets as well as
snack room if available
5. Encourage parent to bring child’s favorite toys to
make child feel at home.
6. Inform parent to bring learning materials eg sch
books etc.

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7. Check vital signs, weight, height and record
and collect specimen if ordered.
8. Administer urgent prescribed drugs
9. Assist patient to change into pyjamas or
hospital wear.
10.Educate child on how to call the nurse and
emphasize the willingness to meet his needs
at all times.
11.Explain the hospital ward policies eg visiting
time, N.H.I.S etc 15
12.Letparent /legal guardian sign consent form for
treatment
13.Enterpatient’s name into the admission and
discharge book and onto daily ward state and
document on nurses notes.
14.Use the nursing process to plan care for the child

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 Admission of a seriously ill child
1. Welcomes child and parents and puts child into
cot and directs parents to wait in the day room
whiles taking care of child.
2. Collects child’s folder quickly, confirms name,
diagnosis and immediate treatment
3. Administers immediate treatment or performs
the necessary resuscitation
4. Checks vital signs, weight and records
5. Takes a brief history of patients condition from
parents
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6. Allows parent to see where child is lying and
orientates parents to the unit and its annexes
7. Explains ward and hospital policies, visiting
time, NHIS, meal time etc to them
8. Encourages parents to bring child’s favourites
toys etc and find out child’s likes and dislikes

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9. Guides parents to sign consent form for treatment
etc if necessary
10.Enters patient name into admission and discharge
book and daily ward state
11.Documents on nurses notes and use nursing
process to plan patient care

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Transfer of patient within a
healthcare facility/hospital
 Themovement of clients/patients
within the same hospital

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Types of Transfer

 Trans –in
 Trans-out

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Trans-in

Procedure
 prepare a suitable bed to receive
patient
 Assemble the necessary equipment
depending on the patients condition (eg.
oxygen apparatus, suction machine, vital
signs tray).
 Receive incoming patient, relatives and
accompanying nurse warmly. 22
TRANS IN (CONT…)
 Take over the transfer notes and personal belonging
of the patient from accompanying nurse.
 confirm patient’s identity with accompanying nurse
 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

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TRANS IN (CONT…)

 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. 24
Trans-out

Transfer out/ trans out: movement of

patient from unit to unit
Procedure
 Confirm with receiving unit
 Assess patients condition
 Arrange for accompanying nurse
 Arrangefor appropriate vehicle- where
applicable.
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 Transfer out/ trans out(CONT…)
 Collect all necessary data
 Explain reason of transfer to patient and
relatives and reassure them to reduce anxiety
 Obtain written consent for transfer
 Pack patients belonging
 Collect patients medications , investigations
results and transfer notes
 Assist patient to dress up
 Assist
patient into wheel chair, stretcher,
ambulance where applicable 26
Trans out(CONT…)
 handover patient’s notes and
belongings to the accompanying nurse.
 Enter
patient’s name in the A&D book,
ward state and nurse note.

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DISCHARGE OF A PATIENT

Discharge occurs when a patient leaves the

hospital after a period of treatment to his or
her home; it normally done at the discretion
of the medical team when patient is fit or his
condition is stable or upon patient's own
request.

It is important that patients and relative have

a prior knowledge of the intended discharge.
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DISCHARGE PLANNING
 Itis a process that facilitate the transition of
the client from the health care institution to
the most independent level of care, home or
another health facility.

 The goal of discharge planning is to ensure

adequate continuity of care.

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 DISCHARGE OF A PATIENT
The role of the nurse in discharge planning
 Include all caregivers involved in the care of the
patient i.e. physiotherapist ( multidisciplinary)
 Adequate assessment of patient during all the
stages of care to identify discharge needs.
 Assess health teaching needs of client and family
and provide family members with the knowledge
and skills to care for the client in the home setting
e.g. wound care, range of motion exercises.
 Assesshome situation i.e. bathroom facilities,
doorway, steps , home arrangement etc. 30
Procedure
 Ensure discharge is ordered by a medical
officer or signed letter from patient
 Patientand relatives are informed about
discharge
 Theyare educated on the need for
continuing treatment and follow up care

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DISCHARGE…

 Ensure patient’s hospital bills are worked out

and submitted to the health insurance
officer or paid at the revenue office by
patients who are not members of the
scheme.
 Receipt number is entered into the A&D book
and the receipt handed over to the patient.
 Relativesare directed to collect prescribed
drugs from the pharmacy if applicable.

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 DISCHARGE…
 Drug administration is well explained to
patient and relatives as well as education on
home and follow up care

 Patient is helped to pack belongings.

 Any patient valuable in the nurses custody is

handed over to patient and relatives, it is
recorded, witnessed and signed.

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DISCHARGE…

 Patientand relatives are once again

reminded of the review date and exactly
where to report on the said date.

 Bed linen is removed, bed and lockers are

decontaminated.

 Dischargeis documented in the nurses

note, A&D book and ward state.
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