CHAPTER 11: ADMITTING, TRANSFERRING, AND DISCHARGING

LEARNING OBJECTIVES Describe how residents may feel when entering a facility Explain the nursing assistant’s role in the admission process Explain the nursing assistant’s role during an in-house transfer of a resident Explain the nursing assistant’s role in the discharge of a resident Describe the nursing assistant’s role in physical exams

HOW RESIDENTS MAY FEEL WHEN ENTERING A FACILITY Many emotions

THE NURSING ASSISTANT’S ROLE IN THE ADMISSION PROCESS Guideline’s for admission

ADMITTING A RESIDENT 1. Identify yourself by name. Identify the resident by name. 2. Wash your hands. 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with curtain, screen, or door. If the family is present, ask them to step outside until the admission process is over. Show them where they can wait and let them know approximately how long the process will take. 5. If part of facility policy, do these things: Measures the resident’s height and weight (see procedures below). Measures the resident’s baseline vital signs (see Chapter 14). Baseline signs are initial values that can then be compared to future measurements. Obtain a urine specimen if required (see Chapter 16). Complete the paperwork. Take an inventory of all the personal items. Help the resident put personal items away. Provide fresh water. 6. Show the resident the room and bathroom. Explain how to work the bed controls and the call light. Show the resident the telephone, lights, and the television controls. 7. Introduce the resident to his roommate, if there is one. Introduce other residents and staff. 8. Make sure resident is comfortable. Remove privacy measures. Bring the family back inside if they were outside. 9. Place call light within resident’s reach. 10. Wash your hands. 11. Document procedure using facility guidelines.

MEASURING AND RECORDING WEIGHT OF AN AMBULATORY RESIDENT 1. Identify yourself by name. Identify the resident by name. 2. Wash your hands. 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for resident’s privacy with curtain, screen, or door. 5. If using a bathroom scale, set the scale on a hard surface in a place the resident can get to easily. 6. Make sure resident is wearing non-skid shoes that are securely fastened before walking to scale. 7. Start with scale balanced at zero before weighing the resident. 8. Help resident to step onto the center of the scale as needed. Be sure she is not holding, touching, or leaning against anything. This interferes with weight measurement. Do not force someone to let go. If you are unable to obtain a weight, notify the nurse. 9. Determine the resident’s weight. Using a standing scale: Balance the scale by making the balance bar level. Move the small and large weight indicators until the bar balances. Read the two numbers shown (on the small and large weight indicators) when the bar is balanced. Add these two numbers together. This is the resident’s weight. 10. Help resident to safely step off scale before recording weight. 11. Record the resident’s weight. 12. Remove privacy measures. 13. Place call light within resident’s reach. 14. Wash your hands. 15. Report any changes in resident’s weight (when weighing resident after admission) to the nurse. 16. Document procedure using facility guidelines.

MEASURING AND RECORDING HEIGHT OF AN AMBULATORY RESIDENT Equipment: standing scale, pen and paper 1. Identify yourself by name. Identify the resident by name. 2. Wash your hands. 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for resident’s privacy with curtain, screen, or door. 5. Make sure resident is wearing non-skid shoes that are securely fastened before walking to scale. 6. Help resident to step onto scale, facing away from the scale. 7. Ask resident to stand straight if possible. Help as needed. 8. Pull up measuring rod from back of the scale and gently lower the rod until it rests flat on the resident’s head 9. Determine the resident’s height. 10. Assist the resident in stepping off scale before recording height. Make sure that the measuring rod does not hit the resident in the head while trying to help the resident off of the scale. 11. Record height. 12. Remove privacy measures. 13. Place call light within resident’s reach. 14. Wash your hands. 15. Document procedure using facility guidelines.

THE NURSING ASSISTANT’S ROLE DURING AN IN- HOUSE TRANSFER OF A RESIDENT 1. Identify yourself by name. Identify the resident by name. 2. Wash your hands. 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Collect the items to be moved onto the cart. Take them to the new location. If the resident is going into the hospital, they may be placed in temporary storage. 5. Help the resident into the wheelchair (stretcher may be used). Take him or her to proper area. 6. Introduce new residents and staff. 7. Help the resident to put personal items away. 8. Make sure that the resident is comfortable. 9. Place call light within resident’s reach. 10. Wash your hands. 11. Report any changes in resident to the nurse. 12. Document procedure using facility guidelines

NURSING ASSISTANT’S ROLE IN THE DISCHARGE OF A RESIDENT 1. Identify yourself by name. Identify the resident by name. 2. Wash your hands. 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for resident’s privacy with curtain, screen, or door. 5. Compare the inventory checklist to the items there. If all items are there, ask the resident to sign. 6. Put the personal items to be taken onto the cart and take them to pick-up area. 7. Help the resident dress and then into the wheelchair or onto stretcher if used. 8. Help the resident to say his goodbyes to the staff and residents. 9. Take resident to the pick-up area. Help him into vehicle. You are responsible for the resident until he is safely in the car and the door is closed. 10. Wash your hands. 11. Document procedure using facility guidelines. Include the following: Time of discharge Method of transport Who was with the resident The vital signs at discharge What items the resident took with him (inventory checklist)

NURSING ASSISTANT’S ROLE IN PHYSICAL EXAMS Supplies the NA may gather Positions for exams NA guidelines for physical exams

REVIEW Describe how residents may feel when entering a facility Explain the nursing assistant’s role in the admit of a resident Explain the nursing assistant’s role in the transfer of a resident Explain the nursing assistant’s role in the discharge of a resident Explain the nursing assistant’s role in physical exams