Patient Hospital Admission

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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Becoming Leaders In Nursing Care

As nursing students we gain knowledge through informative lectures in all clinical aspects related to nursing. But our ultimate aim as future nurses should be to develop the ability to embed all gained knowledge into our daily nursing practice by providing patient-centered care. As good future nurses we need to keep up-to-date with innovative evidence-based nursing practices and be prepared to challenge the status quo whilst backing up our rationales with relevant literature. This is what we, as future nurses, need to do to become leaders in nursing care.

4 Primary Domains in Nursing

Retrieved from https://nurseslabs.com/nursing-theories/ on 22nd January 2022
Retrieved from https://nurseslabs.com/nursing-theories/ on 22nd January 2022

The Nursing Process

leaders in nursing care
Retrieved from https://nurseslabs.com/nursing-diagnosis/ on 7th November 2021
Retrieved from https://www.pinterest.ph/pin/611222980657579285/ on 7th November 2021
Retrieved from https://www.pinterest.com/pin/732679433111887637/ on 7th November 2021

Holistic Patient Care Considerations

leaders in nursing care
Retrieved from https://www.thepurpose.co/about on 7th November 2021

The Roper Logan Model of Activities of Daily Living

becoming leaders in nursing care activities of daily living
Retrieved from https://nursinganswers.net/reflective-guides/roper-logan-tierney.php on 12th October 2021

The Roper Logan model of activities of living, based on Nancy Roper’s 1976 work, was initially developed in 1980. The model, which is set on the 12 activities of living needed to live, acts as an assessment tool for nurses to assess a patient’s independence and/or potential for independence in relation to daily living activities. This model ranges from complete dependence to complete independence, and helps in pointing out required interventions and support to increase patient independence.

8 Dimensions of Patient-Centered Care

leaders in nursing care
Retrieved from https://www.researchgate.net/figure/Eight-dimensions-of-Pickers-Patient-centred-Care_fig1_322011083 on 12th October 2021

Elderly Care

When caring for the elderly, nurses should provide:

  • Proper nutrition and hydration
  • Incontinence prevention or management
  • Mobility maintenance – encourage mobility wherever possible
  • Medication management – assess needs and aim to reduce polypharmacy
  • Skin and foot care
  • Patient safety – prevent accidents/falls
  • Memory loss assessment

Becoming Leaders in Nursing Care through the 6Cs

leaders in nursing care
Retrieved from https://www.pinterest.co.uk/pin/462041243005083458/ on 13th October 2021

The 6Cs provide:

  • a foundation on which nursing care should be built on
  • guidance for nurses who aim to become leaders in nursing care by leading towards changes for the better within the profession
  • added value in the daily nursing practice that equals to better outcomes, better experiences and better use of resources

As leaders in nursing care, nurses should:

  • focus on promoting preventative measures, which improve the patient’s health, avoids unnecessary complications and lessens the burden of increased workload
  • promote patient-centered care whilst keeping up to date with innovative methods and technology use that increase quality and safety within the provided care
  • aim for efficiency to prevent resource shortage which hinders the quality and progress of the care given to the patient

This can only be achieved through:

Nursing Care:

Nurses should practice good communication skills with the patients, treating them as individuals rather than just a bed number;

Nurses should practice good communication skills within the multi-disciplinary team as this provides holistic care to the patient;

Nurses should focus on providing good, detailed documentation to ensure optimum patient care;

Nurses should not hold back from taking initiative and be part of the doctors’ ward rounds – patient observations are made by the nurse throughout the time spent with the patient, and so, the nurse plays an important role in individualised patient care;

Professional Development:

Nurses should aim to improve their nursing knowledge and work on skill development;

Nurses increase their knowledge through the experience they gain whilst working towards the wellbeing of their patients;

Nurses should be aware of different policies related to the different organisations;

Nurses should not be afraid to challenge current practices whilst backing up their theories with evidence;

Nurses should be active in nursing-related issues and act professionally – through their presence and actions, nurses are representing the nursing profession.


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