Hospitalization- NOTES
Definitions of the terms Used in the Process of
Hospitalization
1. Admission: is the process of officially receiving a patient into the hospital for care and
treatment. It includes completing necessary paperwork, assessing the patient’s
condition, and assigning them to a ward or unit.
2. Transfer : refers to the movement of a patient from one department, ward, unit, or
healthcare facility to another. Transfers may occur due to changes in the patient’s
condition, need for specialized care, or administrative reasons.
3. Discharge: is the process of officially releasing a patient from the hospital when the
doctor decides they no longer need inpatient care. It includes giving instructions,
medications, follow-up appointments, and education for home care.
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TYPES OF ADMISSION : Emergency
Emergency admission happens when a patient needs immediate medical
attention due to a sudden illness, accident, or life-threatening condition.
1. No prior appointment
2. Rapid assessment and quick care
3. Common examples: severe bleeding, fractures, asthma attack, heart
attack
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TYPES OF ADMISSION : Routine
Routine : Hospital Policy and procedure for non-emergency reasons.
1. Patient comes with an appointment
2. Pre-admission tests may already be done
3. Used for scheduled surgeries, planned investigations, or long-term
treatments
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Role and Responsibilities of the Nurse in Process of ADMISSION
1. Receive the patient courteously and ensure privacy.
2. Verify patient identity using hospital policy (ID band, file).
3. Complete admission documentation and nursing notes.
4. Perform initial assessment: vital signs, history taking, physical assessment.
5. Orientation for patient : Bed and ward, Call bell system, Visiting rules, Bathroom
location
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Role and Responsibilities of the Nurse in ADMISSION
[Link] safety: adjust bed, side rails, remove hazards.
[Link] and store patient belongings (label, document).
[Link] emotional support to reduce anxiety.
[Link] with the healthcare team regarding the patient’s arrival.
[Link] nursing routine assessment and documentation
[Link] to the next shift.
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Patient’s CoPing with hosPitalization
Types of reaction
When a person is admitted to the hospital, they may experience
1. Emotional,
2. Psychological, and
3. Behavioral reactions.
These reactions are normal and depend on the patient’s age, personality, past
experiences, and the severity of illness.
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Types of Reactions to Hospitalization
1. Anxiety : Fear of diagnosis, procedures, pain, or the hospital environment.,
Worry about family, work, or costs.
2. Denial : Patient may refuse to accept their illness., May say “I am fine, nothing
is wrong with me.”
3. Anger or Irritability : Anger toward staff, family, or situation., May express
frustration due to loss of control.
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Contd….tyPes of ReaCtions to
Hospitalization
1. Depression : Feelings of sadness, hopelessness, isolation, Loss of appetite
or interest in surroundings.
2. Dependency : Becomes overly reliant on nurses or family., Seeks constant
assurance.
3. Regression : Shows extreme behaviors (common in children but can occur
in adults), Excessive crying, clinginess.
4. Acceptance : Patient understands their illness and cooperates with
treatment., Shows a positive attitude toward recovery.
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Transfer of Patient
REASONS OF TRANSFER
1. Clinical Reasons : Condition deteriorates and needs higher-level care (ICU, HDU).,
Condition improves and patient can be shifted to a general ward., Need for specialized
treatment (cardiac unit, surgical ward, maternity unit).
2. Administrative Reasons : Bed unavailability in current department., For
isolation to prevent infection spread., For operational needs (renovation, cleaning,
staff shortage).
3. Patient-Related Reasons : Patient requests transfer (closer to family, private
room etc).
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Types Of Transfer
1. Intra-departmental Transfer : Patient is moved within the same department or ward.
Example: from one bed to another due to repair, infection control, or better monitoring.
2. Inter-departmental Transfer : Patient is moved from one department/ward to another
within the same hospital. Example: from General Ward to ICU, or from Emergency to
Surgical Ward.
3. Inter-hospital Transfer (External Transfer): Patient is transferred from one hospital to
another for specialized care, investigations, or when facilities are not available. Example:
transferring a critical patient to a tertiary care hospital.
4. Temporary Transfer: Patient is moved for a short duration for diagnostic or therapeutic
procedures. Example: transfer to Radiology Department, or Physiotherapy for treatment.
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Responsibilities of Nurse
Procedure of Transfer
1. Assess the Need for Transfer
2. Communicate With Patient and Family
3. Prepare the Patient
4. Prepare the Patient’s Records; Admission notes Latest vital signs, Progress notes,
Medication chart, Investigation reports, Transfer form - Ensure all documents
accompany the patient.
5. Handover to Receiving Unit
6. Document the Transfer
7. Record time of transfer, condition of patient, reason, and name of person receiving the
handover.
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Discharge of patient
Discharge occurs when the patient is fit to leave the hospital
Types of Discharge
1. Planned discharge – doctor-approved.
2. Absconded discharge – patient leaves without permission.
3. Discharge on request (DOR) – patient/family insists.
4. LAMA (Leave Against Medical Advice).
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Health Education & Discharge Plan
1. Medication /Theraphy Instructions : Names, doses, timings, side effects.
2. Diet Instructions to support health condition: What to eat, what to avoid.
3. Life style Activity Guidance : Rest, exercise limitations, wound care.
4. Danger/Warning Signs : Symptoms that require immediate medical attention.
5. Follow-up Care : Dates for check-ups, lab tests, or physiotherapy.
6. Home Care Advice: Wound care, Hygiene, Pain management
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Documentation & Follow-up
1. Discharge Summary : Diagnosis, Treatment provided, Condition at discharge.,
Medications and instructions.
2. Follow-up schedule.
3. Health education and home practice of self care and family role .
4. Community health worker reports and file and Follow-up
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Practical Practice :
Class Test and Demo with Presentation
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