1. Copyright © 2008 Delmar Learning. All rights reserved. Unit 22 Admission, Transfer, and Discharge

2. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Spell and define terms. List the ways the nursing assistant can help in the processes of admission, transfer, and discharge. Describe family dynamics and emotions that occur when a loved one is admitted to the hospital.

3. Copyright © 2008 Delmar Learning. All rights reserved. Objectives List ways in which the nursing assistant can develop positive relationships with the patients’ family members.

4. Copyright © 2008 Delmar Learning. All rights reserved. Introduction The nurse is responsible for –Overseeing and carrying out all hospital procedures and physician’s orders regarding all admissions, transfers, and discharges.

5. Copyright © 2008 Delmar Learning. All rights reserved. Introduction You will usually help the nurse by carrying out the routine procedures associated with these activities.

6. Copyright © 2008 Delmar Learning. All rights reserved. Admission When a person enters a health care facility for the treatment of an illness or injury –Admission process often causes concern or stress to the patient, family, and friends –First impression is very important

7. Copyright © 2008 Delmar Learning. All rights reserved. The Power of First Impressions Admission to the hospital is often a difficult, stressful, frightening time for the patient –First impressions are usually lasting impressions –The patient’s perception may be affected by illness, pain, and fear

8. Copyright © 2008 Delmar Learning. All rights reserved. The Power of First Impressions Making a good first impression on the patient and family members is important. A negative first impression affects the patient’s impression of all health care workers, and the hospital.

9. Copyright © 2008 Delmar Learning. All rights reserved. The Power of First Impressions Think about this –Do your best to provide a positive, professional impression

10. Copyright © 2008 Delmar Learning. All rights reserved. Family Dynamics Family is an extension of the patient –They must often make adjustments when the patient is admitted to the hospital This can be a very emotional time

11. Copyright © 2008 Delmar Learning. All rights reserved. Family Dynamics Family emotions may include: –Guilt, fear, relief at getting help –Anger, uncertainty, sadness –Feeling helpless, worry about the patient and other matters, such as finances

12. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Get to know family members –Greet them warmly when they visit Wear a name badge –Introduce yourself by name and position –Build a positive and trusting relationship

13. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Be available to talk to the family –Tell them about the patient’s activities, as appropriate –Listen carefully to what they have to say and respond appropriately –Let family know you respect and support their role as their loved one’s caregiver

14. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Familiarize the family with facility routines and services Refer medical or personal questions to the nurse Listen to the family –Inform the nurse of complaints or concerns

15. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Listen closely to family caregivers’ advice about patient care –Inform the nurse Notify the nurse if a visit is stressful or tiring to a patient

16. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Avoid judging the family and decisions they make Stay out of family disagreements Avoid gossiping with families Do not discuss facility business with families

17. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Family Dynamics Allow the family to participate in the patient’s care –If the patient does not object Avoid making the family feel as if they must provide care for the patient

18. Copyright © 2008 Delmar Learning. All rights reserved. Transfer It may be necessary for a patient to be moved to another unit Preparations for the transfer will be handled by the nurse –You may be asked to assist

19. Copyright © 2008 Delmar Learning. All rights reserved. Discharge Cost of health care has increased Diagnosis related groups (DRGs) –Introduced to control hospital costs –Hospitals are paid an amount of money for the care of an individual with a particular condition or disease covered by a DRG

20. Copyright © 2008 Delmar Learning. All rights reserved. The Discharge Process Discharge or authorized release of a patient –Requires a written order from the physician –If a patient indicates an intention to leave without an order –Report it to your supervisor