ADMISSION OF THE CLIENT

     DEFINITION--

 Admission of a client means, receiving a client to stay in the hospital for observation, investigations, treatment and care.

    PURPOSE--

1. To welcome the patient and establish a positive relationship with patient and close relatives.
2.  To offer immediate management and care of acute conditions.
3. To orient patient to immediate environment and services available.
4. To acquire baseline data of a patient through history and physical examination.
5.  To collaborate with patient in planning and providing comprehensive care.

PRINCIPLES OF ADMISSION TO HOSPITAL

1. Sudden change or strangeness in the environment produces fear and anxiety.
2. Entering the hospital is a threat to one’s personal identity.
3. People have diversity of habits and modes of behaviour.
4. Illness can be novel experience for the client and bring stress on his physical and mental health.

PRINCIPLES

1. SUDDEN CHANGE OR STRANGENESS IN THE ENVIRONMENT PRODUCES FEAR AND ANXIETY 

• For many, admission may be the first time in the hospital.
• It is a new and sometimes a frightening experience. The nurses should be friendly and courteous and make him feel that he will receive sympathetic as well as efficient care.
•  Remember ‘” the first impression is the best and lasting impression”
• The first persons to meet the client and his family members are greeted and treated are most important.
•  treat all clients with interest and respect and establish healthy personnel relationship to gain the confidence and cooperation of the clients and his family
• Submitting to examination, taking ill tasting medications and injections with no explanations, putting restrictions over his freedom of movement, eating habits etc can cause emotions of anger, fear and anxiety in the clients.
• Fear and anxiety can be produced in the clients who are left alone in their units or in darkness, when the clients hear the loud cries of other clients and face the unpleasant sight such as death of a clients.
• social humiliations (social stigma of certain diseases),economic insecurity and lack of privacy produce fear and anxiety in the clients.
• UNKNOWN FEARS:IT MAY BE DUE TO:

 Lack of knowledge about illness.

 Being in a strange place with strange articles around.

 Being alone and away from the family members.

being housed with strangers and cared for by the strangers.

 fare of treatment and fear of failure of treatment.

 fear of pain and fear of loss of body parts.

 fear of being experimented on.

 fear of being neglected.

 fear of exposure.

 having nothing to be to pass time with minimum activity.

 The nurse can do much to allay this fear and anxiety. 

 Talking with the clients and clarifying their doubts, listening to their problems,

 introducing the hospital department,

 the hospital personnel and other clients to the newcomer, explaining the hospital routine,

 taking care of the clients valuables,

 giving explanations foe treatments ,

 allowing the family members and friends to spend some time with the clients

 Establishing an effective nurse-client relationship can reduce fear and anxiety to a greater extent.

 Remember ‘’uncertainty builds up anxiety and knowledge dispels fear 

 

2.ENTERING A HOSPITAL IS A THREAT TO ONE'S PERSONAL IDENTITY 

 Every client admitted to the hospital should be considered as a unique person in terms of personality, needs and extent of illness.

 e.g. All fever cases are not the same in their needs even though they appear to be the same in the eyes of the nurses.

 Never to identify the clients either by the number or by the diseases that they suffer from.

 The nurses should address them by their name and proper title .

 greet the client pleasantly and enquire about his welfare every day .

 allow the client to use his own articles as far the hospital policy permits.

 Make the client feel that he is considered and cared for .

 the nurse should find out the likes and dislikes of the clients and include the clients in their plan of care.

 The hospital routines should not be too rigid but applicable to everyone.

3.PEOPLE HAVE DIVERSITY OF HABITS AND MODES OF BEHAVIOUR

 Every nurse should understand the behavioural patterns of clients according to age, sex, race, caste and socioeconomic factors.

 Their needs should be met in an appropriate manner.

 Assist them to develop good health habits and to retain their behaviour as far as they do not any harm to their health.

4.ILLNESS CAN BE NOVEL EXPERIENCE FOR THE CLIENT AND BRING STRESS ON HIS PHYSICAL AND MENTAL HEALTH 

 The nurse can do much to improve the physical and mental health by formal and informal health teachings.

 To give satisfaction to the clients, the nurse should recognize the various needs of the clients and meet them without delay 

 The needs of the clients according to Maslow are:

 physiological needs: the for oxygen, water, food, elimination, rest and sleep, exercise and temperature regulation .

 stimulation needs: need for activity, exploration novelty and change.

 Protection needs: The safety and security of the client .

 Love and belonging needs: the need for love and affection, need for intimacy and the need to belong.

 Esteem needs: Need for recognition and self esteem.

 Spiritual needs: Freedom to practice one’s own religious practices .

 Much of the stress due to illness can be eliminated by proper explanations about the disease, its prognosis and its complications in the language the client can understand.

 The clients develop certain behaviour patterns called mental defence mechanisms during illness.

 Recognition of these mental mechanisms and their associated behaviour patterns will help the nurse to understand the fears and anxiety of people and do her best to help them.

ADMISSION PROCEDURE

 The admission of a client to a hospital can be either emergency and routine. 

 THE Emergency admission means that the clients are admitted in acute conditions requiring immediate treatment, e.g. clients with heart attack, accidents, acute appendicitis, poisonings, labour pains, diarrhoea dysentery, hyperpyrexia, haematemesis, dyspnoea, shock etc.

 In emergency admission, every moment is precious. Therefore, the clients should be admitted to the casualty department or emergency ward and the immediate treatment is initiated to save the life of the client.

 Routine admission means that the clients are admitted for investigations and planned treatments and surgeries, e.g., the clients with hypertension, diabetes, chronic appendicitis, jaundice, chronic renal failure nephritis, bronchitis etc.

 Outpatient department (O.P.D.)

 Reception of the client

 The personnel in the admitting department should greet him and make him at ease.

  In emergency conditions, no time should be lost to initiate the treatment.

 The manner in which the nurse and the physician receive and treat the client is the important aspect of his reception and admission.

 RECORDING OF SOCIAL AND MEDICAL DATA

 The recordes section is responsible for recording data essential for identification of the client.

 He questions the client or his family members to get the name, address, age, sex, religion, occupation, income, marital status, the business address and the telephone number.

 The name and address of the nearest relative, if any.

 He records it in the outpatient record.

 Clients very sick should be admitted immediately and the necessary data is supplied by the family or friends .

 The client is given the OPD number which is essential for the future reference.

 Give necessary direction on how to proceed further.

 A detailed social and medical history of the client is taken by the physician and is recorded.

 The client’s temperature, pulse, respiration and blood pressure etc. are recorded.

 A thorough examination of the body from head to foot will reveal any deviations from the normal structure & functions which will help the physician to diagnose the disease and to prescribe the treatment..

INPATIENT DEPARTMENT (I.P.D)

 The clients who are suffering from mild ailments are sent home with necessary treatment. Others are admitted to the hospital for further investigations and treatment.

TRANSPORTING A CLIENT FROM O.P.D. TO I.P.D .

 Clients who are not very ill and are allowed to walk are taken to the clinical division by a nurse or an attender. Wheel chairs & stretchers should be available for those who are too sick, weak or lame to walk. A seriously ill client should never be left in the hands of an untrained personnel. A female client should never be left with a male attender.

ARTICLES REQUIRED

 1. Prepared bed

 2. Thermometer tray 🔲📨

 3. Bp apparatus 4. Weighing machine

 5. Admission advisory form( from admitting department)

 6. Documents such as:

                                     Doctor’s order sheet, TPR sheet, nursing assessment form, nurse’s record, progress record, laboratory master sheet, additional sheets as indicated like: diabetic urine chart, intake & output chart and specific flow sheets, admission consent form.

 7. Kidney tray and emesis basin

 8. Tissue paper

 9. Bedpan and /or urinal

 10.Bath towels and wash cloth 

PROCEDURE