Ch. 11: Admission, Transfer, and Discharge Flashcards Preview

Fundamentals of Nursing > Ch. 11: Admission, Transfer, and Discharge > Flashcards

Flashcards in Ch. 11: Admission, Transfer, and Discharge Deck (49)
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1
Q

Admission to a hospital or other health care facilities

A

Is an anxious time for patients

2
Q

The nurse’s responsibility is to

A

Assist the patient in maintaining dignity and a sense of control and in becoming comfortable in the new environment

3
Q

Upon admission, some patients may experience

A

Disorientation, fear of the unknown, loss of identity, or separation anxiety

4
Q

What can help alleviate a patient’s fear and anxiety?

A

Orienting the patient to the new environment

5
Q

Only address a patient’s first name

A

At the patient’s request

6
Q

Empathy

A

Ability to recognize and to some extent share the emotions and significance of that person’s behavior

7
Q

If the patient does not speak English, and is not accompanied by a bilingual family member on admission

A

contact the social services department to secure an interpreter

8
Q

Medicare and Medicaid reimbursements are required to present information on

A

patient’s right to refuse or accept medical treatment and information regarding advance directives

9
Q

Some hospitals have telephone admitting

A

the day before a planned admission, a representative from the admitting office calls the patient at home and gathers all the information needed to begin the records

10
Q

Patient room orientation

A

Explanation of policies applicable to the patient, how to adjust the bed and the lights, how to call the nurse form the bed and the bathroom, how to operate the telephone and the radio, how to operate the television, how to use the intercom system if one is present, the location of lounge areas, the locations of shower and bathroom facilities, the relationship of the room to the nurses’ station

11
Q

To introduce yourself

A

give your name and title, a person who is warmly welcomed is more at ease in a new enviorment

12
Q

What expedites the admission process in the admitting department and on the nursing unit?

A

The EHR

13
Q

The admitting procedure on the patient care unit is much more extensive than that in the

A

admitting department

14
Q

The nurse must verify information

A

found in the EHR

15
Q

Assess immediate needs

A

such as pain, shortness of breath, or severe anxiety

16
Q

Steps associated with patient admission

A
  1. Perform hand hygiene
  2. Prepare the room before the patient arrives
  3. Courteously greet the patient and family
  4. Check the ID band and verify its accuracy
  5. Assess immediate needs
  6. Orient the patient to the unit, the lounge and the nurse’s station
  7. Orient the patient to the room. Explain the use of equipment, call system, bed, telephone, and television
  8. Explain facility routines, such as visiting hours and meal times
  9. Provide privacy if the patient desires or if abuse is suspected
  10. Follow facility policy for care of valuables, clothing and medications
  11. Obtain the patient’s health history and perform the initial nursing assessment.
  12. Provide for safety
  13. Begin care as ordered by the health care provider
  14. Invite family back into the room if they left earlier
  15. Perform hand hygiene
  16. Record the information on the patient’s health care record according to agency policy
  17. Allow patient and family time alone together, if desired
  18. Perform patient teaching
17
Q

TJC requires each hospitalized patient to have an admission assessment prepared by a registered RN within

A

24 hours of admission

18
Q

The initial assessment includes

A

level of consciousness, vital signs, height, weight, and a review of body systems

19
Q

When is a hospitalist assigned to the patient’s care?

A

If the primary health care provider chooses not to follow patient care in the hospital setting

20
Q

The role of the LPN/LVN in the nursing process

A

participate in planning care for patients based on patient needs, review patient’s plan of care for patients based on patient needs, review and follow defined prioritization for patient care, use clinical pathways, care maps, or care plans to guide and review patient care

21
Q

Assessment of the patient begins at

A

admission

22
Q

Subjective and objective data are collected

A

during the assessment

23
Q

The patient being admitted to most health care facilities is required to have a nursing care plan initiated by the RN within

A

the first 24 hours of admission

24
Q

Common patient problems for a newly admitted patient include

A

anxiousness and potential for injury, insufficient knowledge regarding admission process/illness, and fearfulness, related to admission to health care facility

25
Q

Examples of patient-centered goals

A

Patient will voice understanding of care planned while in facility
Patient will not suffer accidental injury while in facility

26
Q

Examples of nursing intervention/implementation

A

orient or acquaint the patient to the facility to ease the patient’s anxiety, establish nurse-patient rapport directed at fostering a therapeutic nurse-patient relationship, identify risk behaviors or limitations to assist the staff in making the environment safe, confirm though discussion and questions that the patient understands the diagnostic tests and procedures, monitor the patient’s ability to ambulate alone, monitor the patient’s ability to operate the hospital bed, the call light, and the emergency button

27
Q

Determine whether the patient has met the previously established goals

A

Patient demonstrates understanding of procedure, Patient has remained injury free

28
Q

The changing condition of a patient, whether improving or becoming more critical, frequently necessitates

A

transfer

29
Q

Documentation of the patient’s condition before and during transfer and adequate communication among nursing staff ensures

A

continuity of care

30
Q

Transfer combines

A

admission and discharge

31
Q

Assessment for transfer

A

the patient’s condition must be assessed before transfer to determine the necessary method of transfer

32
Q

Patient problems that the patient had before the transfer

A

may still be current after the transfer, the nurse’s assessment helps in determining whether revisions to the care plan are necessary

33
Q

Examples of patient-centered goals with transferring

A

Patient will voice an understanding of the reason for and the process involved with the transfer
Patient will incur no injury during or after transfer

34
Q

Implementation for transfer

A

explain to patient and family the reason for the transfer, when it is to occur, and what procedures are planned
encourage questions
confirm the patient understands the transfer and procedures through discussion and questions
inspect the patient’s positioning in or on transport vehicle
during final assessment, compare present data with previous findings

35
Q

Evaluation for transfer

A

Patient state the reasons for the transfer

Patient is secured into wheelchair or gurney and remains injury free

36
Q

Discharge planning

A

is defined as the systematic process of planning for patient care after discharge from a hospital or health care facility

37
Q

Effective discharge requires

A

careful planning and continued assessment of the patient’s needs during the stay in the facility

38
Q

The Joint Commission suggest the following instructions be given to patients upon discharge from a health care facility

A

reason for the admission, safe and effective use of medications and medical equipment, instruction on nutrition and modified diets, rehabilitation techniques to support adaptation to or functional independence in the environment, access to available community resources as needed, when and how to obtain further treatment, the patient’s and family’s responsibilities in the patient’s ongoing health care needs, maintenance of good standards for personal hygiene and grooming

39
Q

The social worker is often in charge of

A

discharge planning for the long-term care resident

40
Q

Another approach to discharge planning is to perform

A

transitional care with transition specialists

41
Q

A discharge summary is part of the

A

discharge plan

42
Q

A discharge summary includes

A

the patient’s learning needs, how well they have been met, the patient teaching completed, short-term and long-term goals of care, referrals made, and coordinated care plan to be implemented after discharge

43
Q

Referrals should be made

A

as soon as possible after the patient’s need is identified

44
Q

The nurse is responsible to ascertain

A

whether the patient or family is able to provide any care still needed

45
Q

AMA

A

when a patient leave a health care facility without a health care provider’s order for discharge

46
Q

If the health care provider fails to convince the patient to remain in the facility

A

the provider asks the patient to sign an AMA form

47
Q

Patient problem on discharge example

A

Compromised Maintenance of Health and Inability to Bathe Self.

48
Q

Patient planning at discharge examples

A

Patient or family member will be able to care for individual needs
Health care resources regarding bathing and hygiene will be available at home

49
Q

Evaluation at discharge examples

A

Home health agency has been notified of a patient’s needs on arrival at home
Home health agency’s initial visit is completed before discharge or soon thereafter