 2.

Nursing Nursing encompasses autonomous and collaborative care of individuals of all

ages, families, groups and communities, sick or well and in all settings. It includes the
promotion of health, the prevention of illness, and the care of ill, disabled and dying people.
 3. Hospital  A hospital is a place where people who are ill are looked after by Nurses and
Doctors.  Hospital is an institution providing medical and surgical treatment and nursing
care for sick or injured people.
 4. Definition Admission is defined as allowing a patient to stay in hospital for observation,
investigation, treatment and care.
 5. Definition Admission is the entry of a patient into a hospital /ward for therapeutic
/diagnostic purposes.
 6. Purposes of admission  To undergo evaluation & treatment  To know what is really
happening in his/her body right oft it to be fixed  To provide emotional security to the
newly admitted patient and his family
 7. Types of admission 1. Emergency admission 2. Routine admission
 8. Emergency admission In this, patients are admitted in acute conditions requiring
immediate treatment. Examples. Patient with RTA, Poisoning, burns and cardiac or
respiratory emergency.
 9. Routine admission In this, patients are admitted for investigation, diagnostic and medical
or surgical treatment. Treatment is given according to patients problem. E.g. Patient with
hypertension, diabetes mellitus etc.
 10. Unit and it’s preparation It is a place where the patient is kept during hospital stay. The
admitting department notifies the unit prior to the patients arrival so that room /bed can be
prepared.
 11. Unit and it’s preparation  Prepare the treatment table  Ensure all the equipment are
completed  Check ventilation  Ensure patient privacy
 12. Special consideration  Admission cause undue stress (emotional factors as well as
financial capability must given utmost importance)  Be observant consider the individual
patient needs  Provide an individual admission procedure  Show may efficiency and
concerns
 13. Admission procedure  Meet and receive the patient  Verify the patient data, by
checking the record sheet, chart.  Introduce immediate personal  Assist patient to the
treatment area  Ask the patient to change clothes into hospital gown if necessary
 14. Perform examination and evaluation procedure  Perform examination and evaluation
procedure establish base line values like vital signs, do history taking, physical examination
etc.  Coordinate with the physician and carry out initial orders  Give the treatment and
instructions as need
 15. Orientation to the patient and relatives  The equipments /instruments  Use of call
system and telephone  Treatment schedule  Visitors timings  Other health care team
members  Policy and rules and regulations  Care of patients valuable etc.
 16. Record & Report  Admission Book  Preparation of Paper  Drug Book  Diet Book
 HMIS Entry  Cot List
 17. 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.
 18. Definition  MLC is defined as “any case of injury or ailment where, the attending
doctor after history taking and clinical examination, considers that investigations by law
enforcement agencies (and also superior military authorities) are warranted to ascertain
circumstances and fix responsibility regarding the said injury or ailment according to the
law”.
 19. Examples of MLCs.  Accidents like Road Traffic Accidents  Cases of trauma with
suspicion of foul play (d) Electrical injuries  Poisoning, Alcohol Intoxication  Burns and
Scalds  Sexual Offences  Attempted suicide
 20. Role and Responsibilities of Nurse in admission procedure  Nurse should deal every
effort to be friendly and courteous with the patient and family members  Make proper
observation of patients condition
 21. Role and Responsibilities of Nurse in admission procedure  Orient patient and relatives
regarding hospital polices  Deal with patient carefully who is suffering from communicable
disease or illness. Isolate if necessary  Patients valuables and clothes should be handed over
to relatives with proper recording.
 22. Discharge Procedure  The patient, the family, medical staff, nursing staff, social
worker, dietician all work together to coordinate the discharge.  The doctor plans the
discharge with the patient and leaves a written order on the patient’s chart.
 23. Introduction  The patient may have concerns regarding managing own care at home. 
Provisions such as home health care may be needed, as ordered.  Assessment needs to be
done as to what help the patient will need at home.  Discharge planning involves the entire
healthcare team.
 24. Definition “Discharge of patient from the hospital means, reliving a person from
hospital setting, who admitted as an inpatient in that hospital”.
 25. Types of Discharge 1. PLANNED DISCHARGE:- Patient completes the initial, actual
management in the hospital and now he or she need not to be under direct supervision of that
hospital.’ 2. DAMA/LAMA: Discharge/Leave Against Medical Advice 3. TRANSFER:
Transfer to other unit or hospital 4. ABSCOND: Abscond from Hospital 5. REFFERAL :
Referred for further management
 26. Consent for DAMA 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 and Nursing staffs will not be responsible for any ill effects happening after my
departure”. Name of the patient / relative :- Relation:- Signature:- Date :- Time:-
 27. Discharge planning 1. Nurses play an important role in discharge planning in the
hospital. 2. Continuity of care is important. 3. To achieve continuity of care, nurses use
critical thinking skills and apply the nursing process. 4. Discharge planning is a centralized,
coordinated, interdisciplinary process
 28. ESSENTIALS OF PLANNED DISCHARGE 1. Written order by doctor. 2. Discharge
card. 3. Informing other departments. 4. Check payment of the bills. 5. Hospital glossaries
taken back. 6. Returning of the personal belongings. 7. Arrangement for transport. 8.
Documentation.
 29. Steps involved in the Discharge Planning 1. Evaluation of the patient by qualified
personnel 2. Discussion with the patient or his relatives 3. Planning for homecoming or
transfer to other place 4. Determining if caregiver training or for other support 5. Referrals to
home care agency or appropriate support 6. Arranging for follow-up appointments or tests
 30. Nurses Responsibility in Discharge PREPARATION FOR DISCHARGE  Planning
in the beginning.  Plan for rehabilitation and follow-up need.  Teach nursing procedures to
be continued at home, get it’s practice done.  Arrangement for transport.
 31. Nurses Responsibility in Discharge DURING DISCHARGE PROCEDURE  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
 32. Nurses Responsibility in Discharge AFTER DISCHARGE  Documentation.  Care
of patient’s room and articles
 33. Nurses responsibility in MLC Discharge  Check for medico legal history.  Notify
medical officer in charge.  Abscond cases immediately contact medical officer in charge. 
Maintain all documents in a proper manner.  Take in written handing over and taking of
articles.  Never discharge patient without written order by physician.
 34. Checklist M E T H O D
 35. Checklist M = MEDICATION E = ENVIRONMENT T = TREATEMENT H =
HEALTH TEACHING O = OUT PATIENT REFFERAL D = DIET
 37. Summary  Admission is warranted for patient’s thorough evaluation and treatment 
Admitted patients should be comfortable and secured  Admission should be individualized
 38. Summary  Admission involves patient reception, history taking, patient orientation,
coordination, patient chart management and planning individualized treatment program.
 39. Question ????