HOSPITALISATION –

EFFECTS OF
HOSPITALISATION ON
THE PATIENT AND FAMILY
Presented by –
SHABANA . N
M.Sc (N) Ist Year
Madras Medical College
Chennai – 600 003
 INTRODUCTION: -

Hospitalization is an important
resource in adult’s care and it is part
of the health care network,
Hospitalizations especially if repeated
and prolonged may produce negative
consequences to patient’s health, such
as decreased functional disability
lower quality of life it exacerbates
patients emotions and increases
feelings of depressions and anxiety.
DEFINITION: -
The hospital is an integral part of a social
and medical organization , the function of
which is to provide for the population
complete health care both curative and
preventive and whose outpatient service
reach out to the family in its home
environment ; the hospital is also a
centre for the training of health workers
and for bio social research.
HOSPITALIZATION
 Hospitalization means the admission into a
hospital as a patient for an overnight stay on
emergency treatment at a hospital to the
extent for a relevant disease.
PURPOSES: -

Patients are admitted to the
hospital for a variety of reasons
including
I. Scheduled tests,
II. Procedures or surgery
III. Emergency medical treatment
IV. Administration of medication
V. Stabilization or monitor an some
critical condition.
 TYPES OF HOSPITAL ADMISSIONS: -
 ELECTIVE HOSPITAL ADMISSIONS: -
 A Doctor will make a hospital bed reservation
for the patient on a specific day that can change as
needed.
Example: Advance for lab tests (blood) ECG’s other
pre screening tests.
DIRECT ADMISSION HOSPITALIZATION: -
It would occur after the patient has seen or
spoken to their doctor who feels they must admit
them to the hospital for immediate medical care.
Example: A doctor will reserve the bed soon,
anaemia.
 HOLDING ADMISSION HOSPITAL
STAYS: -
 Holding or observation admission often
takes place through the emergency
department.
 The Patient is admitted for diagnostic
testing and unless something stay up that
require another level of care. They will be
discharged within 24 to 48 hours.
 Example: Accidental fall without injury.
 EMERGENCY ADMISSION
HOSPITALIZATION: -
 A medical emergency is any serious injury
condition or symptom posing an immediate risk to
someone’s life or health.
Example: Myocardial infarct patient
 ADVANTAGES OF HOSPITAL: -
 Can get cure from disease
 Prevent Spreading of disease
 Promote Health
 Promote psychologically
 Promote Socialization
COMPONENTS OF A MEDICAL
HISTORY: -
 Identifying data
 Chief Complaint
 Personal History
 Post Health History
 History of Present illness
 Family History
 Review of Body Systems
 Conclusion
MEDICO – LEGAL ISSUES:-
 Medico – legal cases (MLC) are an
integral part of medical practice that is
frequently encountered by medical
officers.
 Proper handling and accurate
documentation of these cases is of
prime importance to avoid legal
complications and to ensure that the
next of kin (NOK) receive the entitled
benefits
 DEFINITION:- (MLC)
 It is defines as any case of injury or ailment
where the attending doctor of the history taking and
clinical examination, considers that investigations by
law enforcement agencies are warranted to ascertain
circumstances and fix responsibility regarding the
said injury or ailment according to the law.
 Examples of MLC’s: -
Accidents like road traffic accidents cases of
trauma with suspicion of electrical injuries
 Poisoning, Alcohol Intoxication
 Burns and Scales
 Sexual offences
 Attempted Suicide
DISCHARGE:-
 Discharge of patient from the hospital means
reliving a person from hospital setting with or without
cure.
TYPES OF DISCHARGE;
• PLANNED DISCHARGE
Patient completes the initial, actual
management in the hospital and he or she need
not to be under direct super vision of that
hospital
DAMA
Discharge against medical advice .
 TRANSFER; Transfer to other unit or hospital.
 AbSCOND; Absconds from hospital
 REFERRAL; Referred for further management
PREPARATION;
 Explain about what are all the procedures
during admission
 Ask about expectation during their hospital stay
 Encourage the family member should participate
in planning of care
 Encourage to ask question
 Give orientation to hospital
 Get a consent
 Inform about cost of treatment
IMPACT OF HOSPITALIZATION;
 84% Financial difficulties
 34% Home sickness
 20% Boredom
 18% Effect on house hold responsibility
 17% Effect on house hold member
education
 HOSPITALIZATION AND STRESS;
SOURCES;
 Psychosocial
 Physiologic
 Environmental
 Biologic
 Chemical
PSYCHOLOGICAL
 Separation from home
 Family members
 Fear and pain
 Anxiety
 ENVIRONMENTAL ;
 Unfamiliar noise
 Newly, unlike environment
 Lack of privacy
BIOLOGIC;
 Pathogenic organism
 Nosocomical infection
PHYSIOLOGIC:
 Loss of sleep, trauma, burns
 Surgery ,Immobilization
 Restaints
STRESS RESPONSE TO HOSPITALIZATION
BEHAVIOR AND EMOTIONAL CHANGES;
 Reaction to illness depends upon the nature of
illness
 Clients attitude towards it
 Depending on severity and duration of illness
 The family and client will react.

ADJUSTMENT TO CHANGE OF BODY IMAGES

 Same illness result in changes in physical
appearance
 Reaction depending upon type of changes
 Then client recognize the reality of the change
 CHANGE IN SELF CONCEPT: -
 Self concept changes because of illness
 Family expectations leading to tension and conflict
 LACK OF UNDERSTANDING OF THE HOSPITAL
LANGUAGE: -
 Health team members often speak in language that
the patient cannot understand
 Patient feels that he is entering a foreign country
 STRANGE SIGHTS AND SOUND:-
 The present of different equipments in the hospital
and in the patients room
 Unusual sounds of equipments and procedure
 Nurse should explain to the patient about every
procedure
 SEPARATION, ANXIETY: -
 Separation from family members may procedure
anxiety to the patient
 It is more prevalent in children
EFFECT OF HOSPITALIZATION ON FAMILIES:-
 Shocked
 Joyless
 Frightened
 Restlessness
 Depressed
 Family Dispute
 Noso comical infection
 Change in lifestyle
 Financial burden
FINANCIAL BURDEN ON PATIENT AND FAMILIES:

 The hospitalization costs and estimated the

financial burden on families .
 Patients with depression who had medical
insurance experienced on higher hospitalization
costs and longer stays.
 Without medical insurance patient will suffer
more specially in poverty.
 Low income families even with insurance
strained with family budgets.
 The different hospital cost structures for
drugs ,treatment ,bed fees ,nursing , doctor
charges are burden to the families.
 How ever more critical care patient ”s family
has spend more money for further
investigation.
 The low income group can face the problem
in hospital as well as the home after
admission of patient in hospital
 These problem can lead to depression to the
patient and family members.
HAZARDS OF HOSPITALIZATION
Hazards of hospitalization are
delirium ,malnutrition , urinary incontinence ,
pressure ulcers, depression, Falls, restraints us
in sick patient, adverse drug effects, Infection,
functional decline of the body mechanism and
death.
ROLE OF NURSE IN ADULT PATIENT CARE:-

 Patient is the good source of information about

illness so make the patient comfortable
 Make the patient should be co-operative with the
treatment
 Ask the patient and family about his care to make
choices or manage their conditions
 Decision can be done from stable patient for care
 Preparation to be done for care plan
 To be assist with all basic needs
 Provide companionship with the patient
 Properly check the housekeeping
 Properly monitor and care about the medications

 Prepare proper meal plan according to the disease
condition
 Explain them to chronic ill patient how to adopt and
co-operative with care
 Introduce and make interpreter to health team
members
 Nurse should clarity the misbelieves and doubts
regarding the treatment and procedures
 Encourage the patient to co-operate while assessment,
Planning implementation and evaluation of care
 Educate the patient and family members for active
participation of teaching programme
 Get the consent for surgeries and diagnostic procedures
 Encourage the patient and family members move the
health team members towards the goals of potential
well-being
 According to the patient and family members level
of knowledge make the patient can develop the
self management capacity, so that the patient
could be targeted towards the quality
improvement care
 Maintain safe environment to prevent injury,
Quality of communication to be given to meet the
patient & family in critical situation
 Encourage the patient to get ride of chronic illness
to attain optimal function health and adopt to an
altered life style

Pain &
Spiritual Family Bereavem
Symptom
Care Support -ent Care
Control
CONCULSION: -
 Illness and hospitalization are
stressful experiences for patients and
their families, Recent research has
identified a range of variables that can
influence the extent of negative reactions
of patients to hospitalization and medical
interventions.