Hospital admission and discharge

  Part 1

        Unit 3

HOSPITAL ADMISSION AND DISCHARGE

Admission to the hospital

The entrance of the patient into the health care agency such as hospital eastern as admission.

Admission

It means allowing a client to stay in the hospital for observation investigation and treatment of disease he is suffering from.

Indication

A patient admitted to hospital with following reason such as diagnostic procedure , surgical  intervention ,condition requiring expert care,  therapeutic  aspect for treatment , etc.,

Types of admission_____

Emergency admission

Client are admitted in acute conditions requiring immediate care .

e.g Client with heart attack

Routine admission

Client admitted for investigation and plant treatment and surgeries.

e.g. Patient with hypertension or pregnant lady 

Purpose of admission

1. To provide immediate care safety and comfort.

 2. To observe and report sign and symptoms of disease condition.

3. To improve general condition of patient.

 4. To reduce fear and anxiety .

Unit and its preparation

It is a place where the patient is kept during hospital stay.

The admission department notify the unit prior to the patient arrival . So that room /bed can be prepared.

Preparations

1. Prepare the treatment table

2. Ensure all the equipments are completed.

3. Check  ventilation properly.

4. Ensure patient airway.

Admitting the patient

The procedure for admitting a client to a health Care facility is very important.

Data required for admission of patient includes____

# Name of patients 

# Age 

# Gender / sex 

# Marital status

 # Occupation 

# Income

# Mobile number

Articles

Admission bed

 Temperature

 Weighing machine

 Kidney tray

 Documentation sheet

 Articles for physical examination

 BP apparatus

Admission Procedure

* Meet and receive the patient 

* Verify the patient data , by checking records sheet.

 

* Introduce personal 

* Assist to treatment care.

 

* Ask the patient to change clothes into hospital gown if necessary .

* Perform examination and evaluation procedure established baseline values like vital signs.

For Routine Admission

OPD ------ Doctor office ----- Admission office --- Ward

For Emergency Admission

In this patient is directly admitted emergency.

 

Bed and emergency equipment should be ready.

 When patient is out of danger , then he is shifted to other wards

Observation of Patient

Nurses should check all vital sign of the patient. 

Patients general facial expression will denote not only his emotions but also presence of pain.   

Any discolouration of skin like jaundice, cyanosis.

Special Consideration

1. Isolate the patient is suffering from communicable diseases.

 

2. Make proper observation of the patients condition record and report.

 

3. Orient the patient and his relatives to hospitals.

 

4. Be kind to patient and family members .

5. Collect information about patient from relatives.

 

6. Never leave the patient alone in  casualty.

बैठ जाती हूं मिट्टी पर अक्सर

 बैठ  जाती हूं मिट्टी पर अक्सर

बैठ जाती हूं मिट्टी पर अक्सर.....

क्योंकि मुझे अपनी औकात अच्छी लगती है...

मैंने समंदर से सीखा है जीने का सलीका...

चुपचाप से बहना और अपनी मौज में रहना...

ऐसा नहीं है कि मुझमें कोई ऐब नहीं है पर सच कहती हूं

मूझमे  कोई फरेब नहीं है।

जल जाता हैं मेरे अंदाज से मेरे दुश्मन

क्योंकि एक जमाने से मैंने

न मोहब्बत बदली और ना ही दोस्त बदले।।

एक घड़ी खरीद कर हाथ में क्या बांध ली....

वक्त तो मेरे पीछे ही पड़ गया।।

सोचा था घर बना कर बैठूंगी सुकून से....

पर घर की जरूरतों ने मुसाफिर बना डाला...

सुकून की बात मत कर ऐ गालिब....

वह बचपन वाला इतवार अब नहीं आता..

शौक तो मां - बाप के पैसों से पुरी होती हैं

अपने पैसों से तो बस जरूरत ही पूरी हो पाती हैं....

एक सवेरा था जब हंस कर उठा करती थी, और

आज  कई बार

 बिना मुस्कुराए ही शाम हो जाती है।।

कितने दूर निकल गए हैं हम,

 रिश्तो को निभाते - निभाते...

खूद को खो दिया हैं हमने ,

अपनों को पाते-पाते...

लोग कहते हैं हम मुस्कुराते बहुत हैं ,

और मै थक गई हूं दर्द छुपाते - छुपाते ....

खुश हूं और सबको खुश रखती हूं,

 लापरवाह हूं फिर भी सबकी परवाह करती हूं....

मालूम है कोई मोल नहीं है मेरी,

 फिर भी कुछ अनमोल लोगों से रिश्ता रखती हूं....

यूं ही मैं दिल को साफ रखने की बात करती हूं ....

पिता नहीं था कीमत तो चेहरों की हुआ करती है

जिंदगी का इतना तजुर्बा तो नहीं ....पर सुना है 

सादगी में लोग जीने नहीं देते ।

कीसी की गलतियों का हिसाब ना कर

खुदा बैठा है तू तो हिसाब ना कर

 ईश्वर बैठा है तू हिसाब करना।।

Documentation and reporting

 Part 3

              Methods of recording

Records and report must be accurate, factual complete , current and confidential . There are many method used for recording such as______

1. Narrative charting

This is traditional method of recording nursing care is a story format that describe that client status.

2. Problem oriented charting 

This is a method of the human documentation that places emphasis on clients problems.

3. Sources oriented charting 

This is a descriptive recording done by each member of healthcare team or separate records.

4. PIE charting

SOP format is developed on medical models PIE(problem , intervention , evolution) chatting has a nursing origin.

5. Focus charting 

Focus charting is a method of identifying and organising the narrator documentation of clients concerns.

6. Charting by exception (CBE)

Patient is charting method that requires nurse to record only deviations from pre - established norms.

Flow sheets

Highlight important findings and define assessment parameters and findings.

Reference documentation:- Is related to standard of nursing practice.

Bed side accessibility :-Is related to documentation forms.

Patient have four components of problem oriented charting

Database

It contains information recording assessment. E.g. history , physical examination , nurses assessment , laboratory findings.

Problem list

Best of on the database list of problem planning (physiological , social , spiritual , cultural, environmental, etc)

Initial plan

Based upon the identified problems , care is developed with clients active participation is setting goals , outcomes and interventions.

Progress notes

Health team members will evaluate and record the progress of  client's problems information can be expressed in various formats such as SOAPIE or SOAP.

Computerized documentation

Nurse use computer to store the client database , add new data , created and revise care plans and documents client progress.

Advantages

1. Legibility of information 

2. Increased time efficiency , consistency and accuracy in records keeping .

3. Provide database for research.

4. Patient link various sources.

5. Client information , request and result are sent and received quickly.

6. Standard terminology improve communication.

Disadvantages

1. Clients may not have privacy is security measures are not used.

2. System failure can cause an availability of information.

3. System is expensive.

4. Extended training may be required whenever an updated system is installed.

Documentation and reporting

 Part 2

          Types of records___

1. Patient clinical records 

2. Medical /Nursing records

 3. Ward records

 4. Administrative records

Patient  clinical record

It is the knowledge of involved in the patients illness progress in his recovery and the type of care provided by the hospital personnel. All records basically contain the following information ______

1. Client's identification and demography data.

2. The present complaints 

3. Informed content for treatment and procedures 

4. Admission nursing history

 5. Family history

6. Physical examination findings

 7.Nursing diagnosis and problems

 8. Nursing care plan 

9. Medical history 

10. Tentative diagnosis 

11. Medical diagnosis

 12. Therapeutic orders

13. Treatment given

 14. Reports of diagnostic studies

 15. Final diagnosis

 16. Client education

 17. Summary of operative procedures

 18. Discharge plan and summary 

19. Any specific special instruction

Medical records

Medical record is a legal document providing information of a patient medical history and data by physician , nurse practitioner and other members of the health care.

 Some  information contained in the medical records____

Identification information of the patient .

Patient health is information on a patient tell the health care providers about their past and present health status.

Medical examination findings.

Nursing records

Progress notes :- it should be written at least once every 24 hours and for each of the following events.

a) Admission 

b) Transfer

c) Discharge

d) Treatment or procedure 

e) Charge in patients condition.

 f) Patient incident note.

 g) Patient or parent /caregiver education.

Worksheet and kardexes :- nurse use worksheet to organise the care they provide and to manage their time and multiply priorities. Kardexes are used to communicate current orders , upcoming test or surgery is special clients for the use of aids  for independent.

Flow sheets :-  A new flow sheet  is to be initiated for each 24 hours period , by signing and initiating the flow sheets  the RN indicate.

A safety check has been performed the presence of correct ID band 

The presence of an accurate allergy band.

The documentation of the monitor control number and assessment of appropriate alarm limits.

Intake/output section

Hourly IV site/ rate check.

Cumulative IV volume infused hourly. 

Complete description of all IV solutions.

 All medication given.

Vital signs section

Document vital signs in the space provided. Graph by the vital sign using the graph legend symbol and assessment legend.

Client care plan

Care plan outlines of the care for individual clients and make a part of the permanent health records.

Care plan written in ink ,  up-to-date and clearly identify the needs and wishes of the client

E - Health records

There is no doubt that the computerization of the health care records has  many benefits .  The same principle apply whether documentation is completed in the paper health care records or electronically.

Wards records

Ward records include ;-

Admission and discharge record

Line in record

Record of production or increasing beds.

Index books

Round book , attendance book and record book 

Treatment records

Administration records

It includes record of______

Treatment

Admission

Equipment losses and replacement .

Personal performance

Organiszational records

Some great people

                    SOME GREAT PEOPLE

1. Father of zoology   = Aristotle

2. Father of botany   = Theophrastus

3. Father of telephone. = Alexand (Graham Bell)

 4. Father of chemistry = Robert Boyle

 5. Father of medicine = Hippocrates

 6. Father of genetics = Gregor Mendel

7. Father of Immunology = Edward Mendel

8. Father of modern chemistry = Antoine Lavosier

 9. Father of psychology = Sigmund Freud

 10. Father of atom bomb = Robert Oppenheimen

 11. Father of geometry = Euclid

 12. Father of nuclear physics = Ernest Rutherford

13. Father of history  = Herodotus

14. Father of Homeopathy = S. Mahneman

15. Father of computer = Charles Babbage

16. Father of economics = Adam Smith

17. Father of Indian chemistry = P.C. Roy

18. Father of green revolution in India = M.S. Swaminathan

 19. Father of white revolution in India  = V. Kurien

20. Father of atom  = John Dalton

 21. Father of electron = J.J. Thomson

22. Father of proton = Rutherford

 23. Father of neutron = James Chadwick

Psychology unit 3

 Part 6

                 Transfer of Learning

Definition

Transfer refers to the transfer of knowledge ; training and habits acquired in one situation to the other.

                Sorenson -1948

The carry over of the habits of thinking , feeling or working of knowledge or of Skills from one learning area to another is usually referred to as the transfer of training.

             Crow and Crow - 1973

Types of transfer

There are three types of transfer of learning

Positive transfer 

It is said to be positive when something previously learned benefits performance or learning in any situation.

Negative transfer

When something previously  learnt hinders performance or learning in a new situation , we call it negative transfer.

Zero transfer

In case , the previous learning makes no difference at all to the performance or learning in a normal situation , there is said to be zero transfer from the previous situation to the new one.

Essential implication of transfer of learning

The following suggestion can help the learner to achieve maximum previous transfer______

1. While engaging in learning the learner should try to integration of the theoretical studies with the practical experiences.

2. Learning should be properly correlated with the life experience , environmental surroundings and other area of study and knowledge.

3. Rote learning should be avoided.

4. Learning should never hesitate to utilise the learning of one field in the learning of the other fields.

5. Learning should try to learn the proper knowledge and insight in the making the difference between the positive and negative transfer of his learning.

6. Learners should have positive attitude during learning.

Study habits

A student must follow the point for her learning to be effective________

1. Being self prepared :- sound physical and mental health are needed for good study.

2. Planning and organization:- the student nurse should have what time table for whole day with a definite period for study.

3. Clarity of purpose:- the nurse should be clear about , what she is learning , how the piece of learning will help her in the carrier.

4. The student nurse should always look for the basic facts of the study and give the importance to those principles.

5. Notes taking :- while studying notes should be written . Notes should be brief and concentrated on the important ideas.

6. Review and over learn:- the rate of forgetting is far in excess of what is retained , therefore, constant review is required to retain the essential of any subject.

7. Paying more attention to the important words charts tables and formulas.

8. Proper physical surrounding for the study.

9. Interrelationship and correlation between the topics and subjects will help the study more effectively.

Theories of learning

There are five theories of learning____

1. Trial and error theory of learning

2.  Theory of classical conditioning

 3. Theory of operant conditioning

 4. Theory of insightful learning 

5. Observational learning.

To be continued in next part.......😊

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अंतराष्ट्रीय योग दिवस

                 अंतराष्ट्रीय योग दिवस

जैसे कि आप सभी जानते हैं कि 21 जून को पूरे विश्व में योग दिवस मनाया जाता है । वैसे तो हमारे देश में योग की शुरुआत कई हजार साल पहले ही हो चुका था । पहली बार योग को ऋग्वेद में दर्शाया गया था।

योग शब्द की उत्पत्ति संस्कृत के यूज (yuj) शब्द से हुआ जिसका अर्थ जुड़ना (to unite or to join or to yoke) होता है। योग करने से हमारा शरीर स्वस्थ और रोगों से मुक्त हो जाता है । योग से आत्मा का परमात्मा से मिलन होता है । योग  हमारे जीवन में सकारात्मक शक्ति का प्रवाह होता है।

नए पीढ़ी में योग दिवस का आरंभ_____

योग दिवस की पहल भारत के प्रधानमंत्री नरेंद्र मोदी ने की। 27 सितंबर 2014 को संयुक्त राष्ट्र महासभा में मोदी जी ने अपने भाषण में कहा था कि____

योग भारत का  प्राचीन परंपरा का अमूल्य उपहार है । यह दिमाग और शरीर के एकता का प्रतीक है।  यह मनुष्य जीवन में संयम , सामंजस्य  और विचार की पूर्ति करता हैं । तो  आइए हम सभी एक साथ मिलकर अंतरराष्ट्रीय योग दिवस की पहल करते हैं।

जिसके बाद 21 जून को अंतरराष्ट्रीय योग दिवस घोषित किया गया । 21 जून को साल का सबसे बड़ा दिन होता है और योग दीर्घ जीवन प्रदान करता है यही कारण है कि योग दिवस 21 जून को मनाया गया।

योग जो सभी को करना चाहिए______

लोम विलोम प्राणायाम

इस प्राणायाम में एक नाक से सास को लिया जाता है फिर दूसरे नाक से उसे छोड़ दिया जाता है। इसे कम से कम 5 मिनट तक करना चाहिए।

अनुलोम विलोम के लाभ

अनुलोम विलोम करने से शारीरिक और मस्तिष्क रोगों से निजात मिलता है।

यह तनाव , घबराहट को दूर करता है और एकाग्रता बनाए रखता है।

पूरे शरीर में शुद्ध ऑक्सीजन की आपूर्ति करता है।

दिमाग , फेफड़े और हृदय को शक्तिशाली बनाता है।

एहतियात

शुरुआत में ज्यादा  समय तक नहीं करना चाहिए। रात को ज्यादा वक्त तक नहीं रुके रहना चाहिए। धीरे-धीरे समय को बढ़ाना चाहिए।

शितकारी प्राणायाम

यह तन और मन को शीतल बनाता है।

शीतकारी प्राणायाम शरीर की मांसपेशियों को आराम पहुंचाता है।

 यह प्राणायाम मस्तिष्क के उन केंद्रों को प्रभावित करता है जो शारीरिक तापमान को केंद्रित करते हैं।

एहतियात

जिस क सर्दी खांसी अस्थमा हो वह इस प्राणायाम को करने से बचें।

सूर्य नमस्कार

सूर्य नमस्कार करने से हमारे शरीर में सकारात्मक शक्ति का प्रभाव होता है।

हमारे शरीर को शुद्ध और स्वस्थ बनाता है।

हमारे शरीर के सभी अंग स्वस्थ रहते हैं।

दिमाग को शांत और सक्रिय बनाता है।

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