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Entry of a patient into the hospital/health care facility
Admission
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Any agency that provides health care
Health Care Facility
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Some Common reactions expected upon admission to hospitalization
- Loss of Identity
- Fear of the unknown
- Disorientation
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Mental confusion characterized by inadequate or incorrect perception of place, time and identity.
Disorientation
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Fear of the unknown, which causes insecurity is perhaps the most common reaction. This relates to the need Maslow calls..
Safety
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Haitian-American Notes to Remember:
- More likely to feel they are receiving effective treatment when a nurse is seen.
- In Haiti a nurse is given more authority and status than a Physician
- Haitians believe that leaves have a special significance in healing. You will find leaves in the clothes and on various parts of the body.
- Some haitian Americans associate wheelchairs with being sick. Therefore, the patient who is allowed to walk out of the hospital at discharge is more likely to feel that care has been effective.
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Haitian American Notes II
It is possible that a poor patient and a wealthy patient with a Haitian background are similar but its known to be distasteful if put in the same room, according to customs
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Japanese Notes:
According to traditional belief, contact with blood, skin disease, and corpses causes illness, also believe improper care of the body, poor diet, and lack of sleep also cause illness
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Orthodox Jewish
Be aware that when caring, for these patients that the use of electronic equipment is avoided during the Sabbath which is from sundown Friday to sundown Saturday. Sometimes its necessary to find alternatives to the use of call lights and telephones for these patients
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Chinese-Americans:
The number 4 is VERY UNLUCKY, avoid placing a patient in this room because it sounds like the chinese word for death.
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Entities [people or elements] other than the giver or receiver of service responsible for payment e.g. medicare or insurance company
Third-Party Payor
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You should understand that the planning for discharge begins...
Immediately upon Admission/Right at Admission, or as soon as thereafter possible
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Systematic process of planning for patient care after discharge from the hospital
Discharge Planning
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Organization that provides health care in the home
Home Health Agency
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Patient Discharge
-Assessment
Make sure to note the following risk factors, if present:
- -Older adult age-group
- -Multisystem disease process
- -Major Surgical procedure
- -Chronic or terminal illness
- -Emotional or mental instability
Assess the patients and the families needs for health teaching and collaborate with the physicians and staff in other disciplines to assess any needs for referral.
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When the patient leaves a health care facility without a physicians order for discharge.
AMA Against Medical Advice
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Nclex Chapter 11:
I.) During the Registration process, the admission clerk is responsible for:
1.)informing the patient of the Patients bill of Rights.
2.) obtaining a list of patient allergies.
3.) informing the patient of current physicians orders.
4.) ensuring the patient has an allergy band.
ensuring the patient has an allergy band
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Nclex Chapter 11:
A 36 year old schoolteacher is admitted for observation and various diagnostic tests. The initial nursing action in her admission process is to:
1.) introduce self and roomates.
2.) measure vital signs.
3.) help her get undressed and into bed.
4.) notify the physician
Introduce self and roommates.
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Nclex Chapter 11:
A 90 year old great grandfather has been hospitalized with Pneumonia. it is ncessary to reorient him to his surrounded periodically. the Nursing assisting him with his morning care remembers that to call an older male patient "gramps" is:
1.) just find if he has grandchildren.
2.) acceptable if you cannot remember his name
3.) acceptable if you feel comfortable calling him gramps
4.) never acceptable
4.) never acceptable
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Nclex Chapter 11:
A patient has been transferred out of the ICU to a medical Unit. A nurse has been assigned to complete the transfer. This tye of transfer is called
1.) patient initiated transfer
2.) interagency transfer.
3.) business office transfer
4.) intraagency transfer
4.) Intra-Agency transfer.
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Nclex Chapter 11:
a 52 year old patient is being transferred from the recovery room following extensive surgey as a result of trauma from an automobile accident. the nurse assigned to complete his care remembers that when admitting, transferring or discharging a patient..
1.) the patient is a human being deserving dignity, courtesy, and respect.
2.) the patient is ill and unable to make decisions or give accurate information
3.) the nurse knows best and should tell the patient what to do
4.) families get in the way and should be encouraged not to get involved in the patients care.
1.) the patient is a human being deserving dignity, courtesy and respect.
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a 45 year old patient has been recently diagnosed and hospitalized for Type one diabetes mellitus. The mltidisciplinary health care team has been preparing her for dismissal, The purpose of the discharge planning is to
1.) make certain the patient takes her medication as prescribed.
2.) provide medical treatment
3.) provide ongoing patient education
4.) ensure continuity of care
4.) ensure continuity of care.
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An 84 year old patient has been hospitalized for 6 years with a diagnosis of a stroke. The nurse knows planning for the patients dismissal should begin with:
1.) when his condition has stabilized
2.) on his admission to the hospital
3.) when he begins to ask questions
4.) when his family asks for information.
2.) on his admission to the hospital
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A patient is determined to leave the hospital. his physician is not aware of his intent. Nor it is in his best interest to be discharged at this time. when a patient chooses to leave a healthcare facility without a physicians written order, the nurse should.
1.) call the family so they can expect the patient as home
2.) allow the patient to leave because no one can be held against his or her will
3.) call security because there must be a physicians order before a patient may leave.
4.) explain the risks of leaving and request that the patient sign a paper accepting responsibility for problems that may occur.
4.) explain the risks of leaving, and request that the patient sign a paper accepting responsibility for the problems that may occur.
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The nurse is admitting a patient to the nursing Unit. The nurses first action is to :
1.) greet the patient by name
2.) ask the patient his or her name.
3.) tell the patient everything will be all right.
4.) introduce the roommate
1.) greet the patient by name
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the patient is being discharged, the nurse should:
1.) tell the patient that everything will be alright.
2.) encourage the patient not to worry.
3.) wish the patient well.
4.) introduce the patient to the office staff.
3.) wish the patient well.
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a patient is being admitted to the hospital for stabilization of her heart condition. Before arriving on the nursing unit, the admissions department will:
1.) have the patient sign consent for treatment
2.) itemize the patients belongings
3.) measure the patients vital signs
4.) review the physicians orders.
1.) have the patient sign consent for treatment.
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When a patient arrives on the nursing unit, the lpn is probably responsible for:
1.) admission charting
2.) admission interview.
3.) formulating nursing diagnoses
4.) obtaining vital signs
4.) obtaining vital signs
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nursing documentation at discharge should include a:
1.) summary account of the hospital stay.
2.) account of all financial obligations
3.) method of discharge
4.) summary of personnel who cared for the patient
3.) method of discharge.
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services of a transition specialist for patient discharge often leads to an increase in:
1.) insurance reimbursement rates for facilities.
2.) continuity of care from hospital to home.
3.)completion of hospital documentation requirements.
4.) readmitting of patients to hospitals.
2.) continuity of care from hospital to home.
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PHI
Protected Health Information
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federal mandate that ensures the privacy of the patients protected health information PHI
HIPAA
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If the patient does not speak English and is not accompanied by a bilingual family member contact the appropriate resource:
Usually the social services department, to secure an interpreter.
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Have the patient give jewelry, money and medications to the family to take home. if no family member is present, see that valuables are put in the hospital safe. Carefully follow the hospital policy for patient valuables.
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Once the patient is established in her or his room, take the health history and do the initial nursing assessment (coordinated Care Box)
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