Patient Hospital Admission

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Patient hospital admission refers to the admission and acceptance of a patient into a health facility with the aim of staying under observation, undergoing necessary diagnostic investigations, and receiving required medical or surgical treatment. Patient hospital admission can be either elective – where a procedure is planned beforehand, or an emergency.

Elective Admission

In an elective patient hospital admission, a healthcare professional agrees with the patient on a convenient date for admission. This enables the patient to prepare in advance for the procedure.

Emergency Admission

In an emergency patient hospital admission, the patient is usually brought in by relatives or friends in a critical condition. In such an admission, the patient is usually transported by a wheelchair or a stretcher to an adequate ward for immediate evaluation and treatment.

Elective Patient Hospital Admission Procedure

  1. Welcome the patient and any accompanying relatives to the ward and introduce yourself and any other present HCPs
  2. Gather all required documents such as admission papers and other important information or documentation from the accompanying nurse
  3. Confirm patient identity through given details
  4. Ensure that the patient and accompanying relatives feel welcomed and comfortable
  5. Gather any additional required information by the patient and/or the accompanying relatives
  6. Provide a hospital bed located at an ideal room for the patient in question, based on the patient’s health requirements and condition
  7. Provide assistance to the patient to change into pyjamas or hospital gown and ensure identification bracelet and any other required tags eg. allergy bracelet is provided
  8. Take baseline vital signs and document
  9. Collect any required specimens if needed
  10. Administer any urgent medications
  11. Ensure patient valuables are taken care of
  12. Ensure informed consent is obtained, signed by the patient
  13. Inform relatives about visiting hours and about anything that they may need to bring in for the patient on their next visit
  14. Following relatives’ departure from the ward, orient patient to the ward and to the surrounding environment
  15. Provide nursing care based on The Nursing Process
  16. Input the patient’s particulars in the admission and discharge book
  17. Document admission into the patient’s nursing documentation sheet
  18. Input ward state (bed availabilities), risk of pressure injuries and any required equipment based on the patient’s admission condition into the online system

Emergency Patient Hospital Admission Procedure

  1. Perform hand hygiene
  2. Gather emergency equipment– vital signs apparatus, resuscitation trolley, oxygen, venepuncture equipment, suction apparatus, and an adequate bed in a suitable location based on the patient’s condition
  3. Welcome the patient and accompanying relatives to the ward and introduce yourself and any other present HCPs
  4. Gather all required documents such as admission papers and other important information or documentation from the accompanying nurse
  5. Confirm patient identity through given details
  6. Assess patient’s overall condition efficiently
  7. Receive patient into a previously prepared bed, keeping the patient’s current condition in mind
  8. Provide assistance to the patient to change into pyjamas or hospital gown and ensure identification bracelet and any other required tags eg. allergy bracelet is provided
  9. Take baseline vital signs and observe further the patient’s overall appearance and reaction, level of consciousness, skin integrity, pain, breathing pattern, and any other complaints, and document
  10. Collect relevant history from the patient or accompanying relatives
  11. Ensure informed consent is obtained, signed by the patient (include detailed information about required emergency procedures is given to ensure informed consent)
  12. Ensure patient valuables are taken care of
  13. Inform relatives about visiting hours and about anything that they may need to bring in for the patient on their next visit
  14. Following relatives’ departure from the ward, orient patient to the ward and to the surrounding environment
  15. Collect any required specimens if needed
  16. Administer prescribed medications
  17. Input ward state (bed availabilities), risk of pressure injuries and any required equipment based on the patient’s admission condition into the online system
  18. Document admission into the patient’s nursing documentation sheet

The Nurse’s Role in the Admission Process

  • Ensure the patient’s physical and emotional needs are met
  • Ensure the patient is assigned to a bed adequate to his/her personal needs and condition
  • Ensure that the patient’s admission report is completed
  • Ensure the patient is assessed using The Nursing Process
  • Provide a holistic approach to patient care based on the Activities of Daily Living guide whilst considering the patient’s psychological, social, spiritual, and cultural needs
  • Ensure the patient’s comfort and aim to reduce anxiety in both the patient and accompanying relatives
Patient Hospital Admission
Retrieved from https://nurseslabs.com/nursing-diagnosis/ on 7th November 2021
Retrieved from https://nurseslabs.com/nursing-diagnosis/ on 7th November 2021

Transferring the Patient

During a hospital stay, the patient may require transferring from one ward to another within the same healthcare facility.

Transfer in

In a Transfer-In, a patient is moved from one unit to another, eg. from a medical to a surgical ward.

When a patient is being transferred in:

  1. ensure a suitable bed is available to receive the patient
  2. ensure all necessary equipment depending on the patient’s condition is readily available
  3. ensure the patient, accompanying nurse, and any accompanying relatives are received warmly
  4. ensure correct handover, transfer of notes, and any patient personal belongings are received from the accompanying nurse
  5. confirm patient identity with accompanying nurse
  6. clarify any queries pertaining to the patient’s condition
  7. introduce yourself and other present HCPs to the patient and accompanying relatives
  8. assess patient’s overall condition efficiently
  9. ensure the patient is assessed using The Nursing Process
  10. orient patient and relatives to the ward and to the surrounding environment
  11. input ward state (bed availabilities), risk of pressure injuries and any required equipment based on the patient’s admission condition into the online system, including time of admission
  12. document transfer into the patient’s nursing documentation sheet

Transfer Out

In a Transfer-Out, the patient can be transferred from one ward to another, or from one facility to another.

When transferring a patient out:

  1. confirm transfer with receiving unit
  2. assess the patient’s condition
  3. arrange for a nurse to accompany the patient
  4. plan for an appropriate transferring vehicle if required
  5. collect all patient data
  6. reduce the patient’s and accompanying relatives’ anxiety by explaining reason for transfer
  7. obtain informed written consent for transfer
  8. assist in the packing of the patient’s personal belongings
  9. ensure patient’s medication, diagnostic results, and transfer notes, are all compiled as required
  10. assist patient in dressing up adequately for the transfer
  11. assist patient into a wheelchair or stretcher, and into an ambulance, if required
  12. ensure patient’s notes and belongings are handed over to the accompanying nurse
  13. input ward state (bed availabilities), risk of pressure injuries and any required equipment based on the patient’s admission condition into the online system, including time of transfer
  14. document transfer into the patient’s nursing documentation sheet

Discharging the Patient from the Hospital

Discharge planning should start shortly after the patient is admitted, and is usually done at the discretion of the medical team, based on the patient’s overall health condition, or if the patient requests to be discharged. The patient and his/her relatives should always be informed about intended discharge plans.


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Claire

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Author: Claire

Claire Galea is a mum of three currently in her final year following a Degree in Nursing at the Faculty of Health Sciences, University of Malta, as a mature student. Claire is keen about public education on health-related subjects as well as holistic patient-centered care. She is also passionate about spreading awareness on the negative effects that domestic abuse leaves on its victims’ mental, emotional, social and physical wellbeing. Claire aspires to continue studying following completion of her Nursing Degree, because she truly believes in lifelong education.