Admission

SESSION 2B: ADMISSION OF A PATIENT IN A HEALTH FACILITY

Learning Tasks

• At the end of this session each learner is expected to be able to:
• Define the term admission
• Identify types of admission
• outline the purpose of admitting patient to health facility
• Identify common worries of patient during admission

Admit patient in a health facility

ADMISSION OF A PATIENT IN A HEALTH FACILITY

Definition

Admission: Is a process of receiving patents with serious health problems to a health facility for diagnosis/investigations, care and treatment.

TYPES OF ADMISSION

• There two types of admission these are:-
• Planned admission: The patient is admitted from a waiting list or as a booked case

Emergency admission: The patient is admitted following an accident or acute illness

PURPOSE OF ADMITTING PATIENT TO HEALTH FACILITY

• To provide treatment and care to the patient
• To obtain baseline data on the patient’s condition which involves observation

Reduce patient anxiety related to his/her illness Draw initial patient’s need and problems that need immediate medical and nursing intervention For investigation and diagnostic procedures For advanced management e.g. surgery

Common Patients Worries

During admission the patient may have some worries which may predispose him to respond in a negative way. As a nurse you must be aware with the following worries and assist the patient accordingly About his/her family at home

• About his job or business or missing lessons at school
• About lack of privacy if she /he has to share room with many patients
• About unexpected diagnosis such as cancer or HIV infection
• About diagnostic or therapeutic procedures

About unknown reason

Admit Patient to Health Facility

• Assessment:
• Patient’s ability to adopt to the environment
• How much the patient understands about his illness and the imposed effects
• If patient is allergic to any drug
• Whether the patient is taking any medication

The patient’s ability to perform self-care Assess activity level of the patient if has any difficulties in walking or moving, has deformity Observe general condition of the patient if critically or moderately ill Assess his level of consciousness if alert, drowsy, semi conscious or unconscious

Admit Patient to Health Facility cont…

Assess his emotional state if depressed, irritable or anxious Observe his skin for any rashes, scars or birth mark, if soft, dry, smooth, clean or dirty Observe if has prosthesis or dentures Assess his ability to see, hear and speak Collect past and present medical history if condition allows Verify availability of equipment and supplies for admission Determine availability of suitable bed for the patient

Admit Patient to Health Facility cont…

• Preparation of the environment
• Identify suitable place for the patient
• Ensure safe and conducive room
• Preparation of the patient
• Discuss information regarding admission to the patient and relatives
• Preparation of the care giver
• Revisit the policy guideline for admission as per institution
• Check own competency on the procedure

Review literature on admission procedure, review the policy

Admit Patient to Health Facility cont…

Preparation of the necessary requirement:

Vital sign tray (with thermometer, sphygmomanometer, stethoscope, observation chart, cotton wool swabs, receiver for used swabs) Patient case note for reference and documentation Admission book for record keeping

• Intake and output chart for recording patients intake and output
• History taking forms for taking patients history

Physical examination guide/checklist

Admit Patient to Health Facility cont…

• Kitting book for recording patients property
• Weighing scale for determining patients weight
• Treatment chart for recording patient’s treatment
• Tray for specimen if any for obtaining patient’s specimen

Laboratory forms

Admit Patient to Health Facility cont…

• Interventions

Therapeutic aspect

Warmly welcome and greet patient and relatives in a friendly way and offer chairs, make them feel at easy.

• Introduce yourself and state your role

Wash hands and bring equipment nearby patient

Admit Patient to Health Facility cont…

• Fill the following information in admission book:
• Full name
• Age and date of birth
• Sex
• Marital status
• Address
• Religion
• Nationality
• Occupation
• Name and address of next of kin
• Name of the doctor
• Provisional diagnosis
• Date and time of admission

Hospital registration No.

Admit Patient to Health Facility cont…

• Check and record vital signs as required

Assist the patient to change into hospital garments Orient patient to health facility policy and regulations depending on his/her condition (visiting hours, doctors round, billing system any limit to number of visitors, , toilets and how to use them, meal time, where to get help in case of problem) Take the patient and show his/her bed and introduce his/her room or cubicle mates Maintain privacy and comfort when assisting patient Take care of his/her belongings or handle them to the relatives Perform general physical assessment as per guideline Remove decontaminates and cleans the used equipment

Admit Patient to Health Facility cont…

• Communicative aspect

Observe verbal and non verbal expression indicting pain, fear, and anxiety Record findings i.e. vital signs, weight, height, physical examination, interpret and communicate findings to the patient and other health profession Communicate rights of the patient, institution rules and regulations during admission Orient patient to the environment and show him his/her bed Initiate and implement nursing care plan Call relatives to see their patient when the patient is settled and tell them visiting hours and other relevant information regarding the patient. Allow the to say goodbye to the patient and escort them to the door

Admit Patient to Health Facility cont…

• Teaching aspect
• Discuss with relative information regarding admission of the patient
• Educate patient about his illness
• Evaluation
• Answer the following questions and document
• Was significant information about the patient obtained?
• Were patient concerned addressed?
• Was the patient comfortable and safe while in hospital?
• Did the doctor see the patient?

Were relative given adequate and relevant information?

If the answers for the above questions are all “yes”, you have admitted the patient successfully.

SUMMARY

Admission of patient to health facility is the process of receiving patient with serious health problem to a health facility for diagnosis/interventions, care and treatment A patient can be admitted as a cold/planned case or emergency case Admission process involves several activities including assessment, preparations, teaching, communication and therapeutic aspects

EVALUATION

• What are purposes for admitting a patient to the health facility?
• What assessment will you make to the patient during admission?

What teaching aspects will you give the patient on admission?

References:

Bunker Rosdahl, C. (1999). Basic nursing (7th ed.). New York: Lippincott Williams & Wilkins.

Kozier, B., Erb, G., Blais, K., & Wilkinson, J. M. (1995). Fundamental of nursing: Concepts, process and practice (5th ed.). Oakland, CA: Wesley KMTC-VVOB. (2009). Skills lab project: Nursing procedure manual. Kenya.

Lynn, P. (2011). Taylor’s clinical nursing skills: A nursing process approach (3rd ed.). New York: Lippincott Williams & Wilkins.MOHSW. (2008). Basic nursing procedures: A manual for nursing practice in Tanzania (3rd ed.). NCP: KIUTA.

Moshi, N., & Karungura, J. (2005). Basic nursing procedures. KCMC Nursing Profession.Paulinus, S. (2004). Basic nursing care (2nd ed.). Tanzania: Ndanda-Peramiho:Benedictine.Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). USA: Mosby.Rider Ellis, J. (1992). Basic nursing skills (5th ed.). New York: Lippincott Williams & Wilkins.Thomas, C. (1993). Taber’s cyclopedic medical dictionary. Philadelphia: F. A. Davis.

Barbara K. Timby, Nancy E. Smith-Introductory Medical-Surgical Nursing, 10th Edition (Lippincott's Practical Nursing) -Lippincott Williams & Wilkins (2009).pdf.