ADMISSION ,TRANSFER AND
DISCHARGE PROCESS
Christinal Jeyapaul,Msc Nursing
LEARNINING OBJECTIVES
• Define admission
• Explain admission process
• State the nursing admission activities
• List the psychological responses of a admitting
patient
• Define transfer process
• Explain the steps involved in transfer
• Discuss the discharge process
INTRODUCTION
• Entering a health care agency for nursing care
and medical or surgical treatment. To meet
patients' healthcare needs during the
admission process, nurses provide holistic care
and establish the basis for how patients will
respond to and evaluate the remainder of
their stay.
Definition
This is a process of receiving ,registering and
retaining the patient in the health facility for
provision of skilled therapeutic interventions in
a safe environment
ADMISSION PROCESS
1. Authorization from a physician that the person
requires specialized care and treatment.
2. Collection of billing information by the admitting
department of the health care agency.
3. Completion of the agency’s admission data base
by nursing personnel.
4. Documentation of the client’s medical history
and findings from physical examination.
5. Development of an initial nursing care plan.
CONT,
6. Initial medical orders for treatment.
7. Medical authorization.
8. The admitting department.
a. Preliminary data collected.
b. Addressograph plate.
Nursing Admission Activities
1. Preparing the client’s room.
2. Welcoming the client.
3. Orienting the client.
4. Safeguarding valuables and clothing.
5. Helping the client undress
6. Compiling the nursing data base.
Psychosocial Responses on Admission
Anxiety and fear.
. Decisional conflict.
Situational low self-esteem
Powerlessness.
Social isolation.
Risk for ineffective therapeutic regimen
management
TYPES OF ADMISSION
1.In patient Length of stay generally more than 24 hours
Acute appendicitis, acute pneumonia.
a)Planned (non urgent) Is scheduled in advance Elective
surgery
b)Emergency admission Unplanned, stabilized in
emergency department and transferred to nursing care
unit ,Unrelieved abdominal or chest pain
c)Direct admission Unplanned, emergency department
bypassed. Acute condition as prolonged vomiting and
diarrhea
CONT,
2.Out patient length of stay less than 24 hours
Minor surgery " warts“
a)Observational Monitoring required, need for
inpatient admission determined within 23 hours
Head injury, RTA
The Transfer Process
Transfer: discharging a client from one unit or
agency; admitting him or her to another without
going home in the interim.
Transfers are used when there is a
need to:
1.Facilitate more specialized care in a
life-threatening situation.
2. Reduce health care costs.
3. Provide less intensive nursing care.
Steps Involved in Transfer
Informing client and family about the transfer
Completing a transfer summary.
Speaking with a nurse on the transfer unit to
coordinate the transfer.
Transporting the client and his or her
belongings, medications, nursing supplies, and
chart to the other unit
The Discharge Process
• Discharge is the termination of care from a
health care agency.. The key to successful
discharge planning is an exchange of
information among the patient, the
caregivers, and those responsible for care
while the patient is in the acute care setting
and after the patient returns home. This
coordination of care is usually the nurse's
responsibility.
Steps in the Discharge
1. Discharge planning
a. Assessing and identifying health care needs.
b. Setting goals with the patient.
c. Important teaching topics about self-care at
home must be covered before discharge
.d. Meeting eligibility requirements for home
health care
CONT,
2. Obtaining a written medical order.
3. Completing discharge instructions.
4. Notifying the business office.
5. Helping the client leave the agency.
6. Writing a summary of the client’s condition at
discharge.
7. Requesting that the room be cleaned.
Types of discharge:
1. Cured and discharged when the treatment of the pt is
over from the hospital
2. LAMA: Leave against medical advice,( due to any
personal reason of the pt)
3. DOR: Discharge on request
4. Absconded: Leaving hospital without any prior
information
5. Transferred to another hospital i.e refer the patient for
further treatment to another hospital
6. Death: Pt may expire during hospitalization
HOME CARE
• Home Health Care is provided in the home by
an employee of a home health agency
• Home care nursing services Help shorten time
spent recovering in hospital
• Prevent admissions to extended care facilities
• Reduce readmissions to acute care facilities
SUMMARY
• Standardization of admission and discharge
processes are largely in our control. There is a
significant opportunity to create important
benefits for increasing bed capacity and
hospital throughput
ASSIGNMENT
• Outline responsibilities of a nurse in admission
process
• Describe roles of a nurse in discharge process
• Describe the roles of a nurse in medico-legal
cases in discharge
REFERENCES
• https://conursing.uobaghdad.edu.iq/wp-
content/uploads/sites/20/uploads/others/d.al
i%20d/Admission,%20Discharge,%20Transfer%
20and%20Referrals.pdf
• https://medicopublication.com/index.php/ijf
mt/article/view/11448/10558
