34. Admissions, transfers, and discharges


Admissions, transfers, and discharges


Objectives



Key terms


admission  Official entry of a person into a nursing center


discharge  Official departure of a person from a nursing center


transfer  Moving the person to another health care setting; moving the person to a new room within the center


KEY ABBREVIATIONS











CMS Centers for Medicare & Medicaid Services
OBRA Omnibus Budget Reconciliation Act of 1987

Admission is the official entry of a person into a nursing center. It causes anxiety and fear in residents and families. They are in a new, strange setting. They may have concerns and fears about:



Moving to another room may cause similar concerns. So may transfer to another health care setting—hospital or nursing center. Discharge to a home setting is usually a happy time. However, the person may need home care. Discharge and transfer are defined as follows:



Admission, transfer, and discharge are critical events. So is moving the person to a new room. Sometimes the new room is on another nursing unit. These events involve:



See Teamwork and Time Management: Admissions, Transfers, and Discharges.



TEAMWORK AND TIME MANAGEMENT


Admissions, Transfers, and Discharges


Transfers and discharges are easier if a co-worker helps you. So is moving the person to a new room. When asking for help, politely tell your co-worker:



Remember to thank the person for helping you.


See Delegation Guidelines: Admissions, Transfers, and Discharges.



See Promoting Safety and Comfort: Admissions, Transfers, and Discharges.



Admissions


An admission coordinator starts the process. The goal is to make it simple and easy. Often the process starts 2 or 3 days before the person enters the center.


The person’s identifying information is obtained. This includes the person’s:



A nurse or social worker explains the resident’s rights to the person and family. They also receive the rights in writing.



Admitting papers and a consent for treatment are signed. The person signs them or the person’s legal representative does so. The nurse or admission coordinator obtains needed signatures.


The person’s photo is taken. Then the person may receive an ID (identification) bracelet. The photo or ID bracelet are used to identify the person (Chapter 12).


Admission is often a hard time for the person and family. They do not part until ready to do so. Remember, the center is now the person’s home.


See Residents With Dementia: Admissions.



RESIDENTS WITH DEMENTIA


Admissions


Persons with dementia and their families may need extra help during the admission process. Often confusion increases in a new setting. Fear, agitation, and wanting to leave are common. The family also is fearful. Many feel guilty about the need for nursing center care. The health team helps the person and family feel safe and welcome.


See Focus on Rehabilitation: Admissions.



FOCUS ON REHABILITATION


Admissions


Patients are admitted to rehabilitation units from hospitals. Often they arrive with special equipment and supplies.


A nurse usually greets the person and starts the admission process. Assist as needed. The nurse may ask you to complete parts of the admission process if:



imagePreparing the room


You prepare the room before the person arrives. Figure 34-1 shows a room ready for a new resident.



Admitting the person


The room assignment is made before the person arrives. Some residents arrive by ambulance or wheelchair van. Attendants take them to their rooms. Some arrive by car. A nurse usually greets and escorts the person to the room. The nurse may ask you to do so if the person has no discomfort or distress.


Admission is your first chance to make a good impression. You must:




Safety and security


Physical and mental comfort are important. So is feeling safe and secure. Do not rush the admission procedures. Rather, treat the person and family as guests in your home. Offer them a beverage. Visit with them. Tell them some of the good things about the center.


Introduce residents in nearby rooms. This way the person knows other residents. They can provide comfort and support. They understand, better than anyone else, what a nursing center is like.


The center is the person’s home. Help make the room as home-like as possible. Also help the person unpack. Perhaps the person needs help putting clothes away. The person may want to hang pictures or display photos. Show care and compassion. Help the person feel safe, comfortable, and secure.


imageThe admission procedure


During the admission procedure the nurse may ask you to:



• Collect some information for the admission form.


• Measure the person’s weight and height.


• Measure the person’s vital signs.


• Complete a clothing and personal belongings list.


• Orient the person to the room, the nursing unit, and the center.



Nov 5, 2016 | Posted by in MEDICAL ASSISSTANT | Comments Off on 34. Admissions, transfers, and discharges

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