Hospital admission and discharge

 Part 3

Points to remember___

Ensure that no dues certificate is taken before handing over the step to patient.

Inform relatives about  discharge in audience.

Change the dressing when the patient is ready for discharge.

 

Provide clear instruction regarding use of drugs, diet.

Keep the patients record in safe custody.

Discharge Procedure

* The physician should write the patient name who is being discharged on chart.

* Patient personal belongings should be returned.

* The articles in patient units should be checked and ensure that they are completed.

* Check the payment of hospital bills.

* Arrange wheelchair , if patient is not able to 

walk.

* Complete all records of the patients.

Nurses Responsibility In Discharging Patient

* Inform the patient and relatives a day before discharge.

* Get the discharge slip prepared after checking the vital signs.

* The nurses should be that the patient personal hygiene is maintained.

* Hand over patient belongings.

* Complete the admission unit and discharge register sheet.

* Hand over case sheet and other records to medical record department.

* Hand over the discharge sleep to the patient or relatives.

* Ensure that the patient receive old medicine as for discharge slip.

* Place the patient on wheelchair as per patients condition.

* Immediately after the patient leaves, reorganize the patient's.

Transferring the patients

It refers to the patient may require transfer either from the unit to another or to  other health Care institution according to condition of patient.

 Transferring procedure

* Check the order of transfer to another unit.

* Assess the unit where patient is to be shifted.

* Explain the procedure of transfer to patient.

* Review the checklist of patient belonging so that all things are transferred with patient.

* Transfer patient by using wheelchair.

Assess and gather equipment that will be transferred with patient

E.g. infusion pump

* Document time of transfer and patient condition medications.

Transfer to extended care facility

1. Make sure that physician has written the transfer order on patient chart and transfer form.

2. Complete the nursing summary.

3. Attach a copy of transfer form and nursing notes with patient chair.

Care of unit after discharge

1. After the patient is discharged and before admitting another patient,  the room is cleaned windows and doors are opened.

2. Disposable things are discarded and linens are send to laundry.

3. Hatters pellows, blanket are posed to sunlight .

4. In case of communicable disease fumigation of room and articles is done.

5. Sanititation of bed, cabinet and the general area of the patient care unit with germicidal agent after patient is discharged.

Purpose of cleaning

1. Prevention of spread from microorganism.

 

2. Removal of body waste from mattress .

3. Deodrizing the bed tray mattress and pillows.

Guideline for cleaning

1. Review ward policies.

2. Use only authorised detergent or solution for cleaning.

3. Check bedside cabinet is cleared from any valuable of patient.

 4. Check bed linens for personal cleams ( money, contact lense).

5. Replace torn mattress or pillow.

6. Allowed the mattress and pillow to dry thoroughly before making bed.

7. Prevent spread of microorganism by carefully removing linen from bed.

Medico legal case (MLC)

Medico legal case are the cases requiring medical statement , by the same time involve information to law enforcing authorities is called medico legal case.

Types of MLC_____

* All road traffic accident

 * Bomb blast

* Poisoning

* Sexual offence

* Domestic violence

* Criminal abortion

* Attempts suicide

* Bullet injuries