Registration and admission of a patient to a hospital
In most cases, the condition of the patient requires hospital treatment. Reception of the patient in a hospital is carried out through one of the most important medical-diagnostic structural divisions of medical establishments - an admission department. The level of qualification and training of medical personnel working here is directly reflected on the health, and sometimes the life of the patient.
It is in the reception department that the service begins and the first assistance is provided to the patient: patient registration, primary examination, anthropometry, sanitary treatment, emergency care in urgent conditions.
Informing entrants to the health facility
Reception and registration of patients entering the hospital has a clear documented confirmation, which can be viewed in the reception room. Scientific material for the work of medical staff and awareness of relatives of patients is located in specially created information corners.
For patients and their relatives:
- placard with a glowing inscription "Reception" above the entrance;
- information on the hours of admission of planned patients;
- announcement about the time of inpatient visits, the issue of health certificates by specialists, the number and hours of work of the reference service;
- internal health regulations;
- list of products allowed for transmission;
- marking of the reception rooms;
- a copy of the document confirming the right of the institution to engage in medical activities;
- , each person entering the hospital receives a memo, which summarizes the main requirements and rules of the hospital.
Information for employees' staff
For medical personnel, the corner is filled with specialized documentation, orders and instructions used in daily work:
- instruction, which is necessary when identifying a particularly dangerous infection;
- table of poisons and their antidotes;
- algorithms for providing emergency care for various urgent states;
- folder with laws and instructions for work in the reception area;
- schedule of doctors on duty at hospital departments;
- evacuation plan for fire or emergency situations.
Functions of the admission office
Admission to the hospital, documentation - not all functions assigned to the medical staff. Among the main functions of the admission department the following are distinguished:
- registration of patients entering treatment in the departments of health facilities;
- primary examination by the on-duty specialist;
- emergency care;
- definition of the diagnosis and separation to which the patient enters;
- sanitization of patients;
- filling in the relevant documentation;
- transportation to the office or operating unit( if necessary);
- rendering of reference services.
How the reception room of the
is arranged The arrangement of the offices and premises of the department depends on the profile of the medical institution. Reception of the patient in a hospital, the algorithm of which is sufficiently voluminous, begins with the fact that the patient enters the waiting room. This room, where there are waiting relatives of patients and patients themselves, who do not need bed rest.
The hall is equipped with a table and a necessary number of chairs to create comfort. The walls are equipped with information angles, including rules and instructions for patients and their relatives.
Reception and registration of a patient in a hospital requires the presence of a registry - a room where the necessary accompanying documentation is drawn up:
- register of patients entering hospital care;
- is an alphabetical book used for providing reference services;
- magazine for fixing refusals from hospitalization;
- Journal of Consulting Professionals;
- log of examination for pediculosis;
- Journal of patients' movement in a hospital.
Next is the viewing room, in which doctors conduct a primary examination of patients. The need for diagnostic and sanitary measures is being specified. Then there is a sanitary pass, which has a bathroom and a dressing room.
The admission of a patient to the hospital requires the presence of a diagnostic room for those who come in with an unidentified diagnosis. Here the patient lies until the department for further treatment is identified. Similar offices are located in large institutions. For proper diagnosis, specialists are provided with a laboratory, an ECG room, endoscopy, and an X-ray. These structural units should be located on or near the reception area. For patients with suspected infectious disease, an isolator is also located here.
The duties of the medical staff of the receiving and diagnostic unit include the provision of emergency care for people who do not need further hospitalization. To do this, all necessary must be equipped with dressing, a small operating room and a treatment room.
Also in the receiving dignity is the office of the chief doctor of the health facility, the head, the room where the clothes of the enrolled and the toilet room are stored.
The patient is admitted to the hospital after he is transported directly to the emergency room. There are four main methods of hospitalization:
- An ambulance can take a patient from home or on the street. This occurs in cases of traumatization, acute diseases or exacerbation of chronic diseases, poisoning, the onset of the onset of labor.
- In the absence of efficacy of outpatient therapy, the doctor prescribes referral to inpatient treatment. Such a document can be issued by a medical and rehabilitation expert commission or military registration and enlistment office.
- If it is necessary to provide specialized assistance or temporarily close the hospital, the patient's maternity hospital is transferred to another health facility by agreement with the administration.
- In case of severe deterioration, a person can independently turn to the nearest hospital.
Depending on the condition of the patient and the timing of admission to the health care facility, the patient's admission to the hospital can be planned or emergency.
Sanitary treatment in the reception room
Upon examination, the doctor determines the need for sanitization and its appearance, taking into account the general condition of the patient. The middle and junior medical staff are treated at the sanitary checkroom. Inspect the head and pubic area to determine the causative agents of pediculosis. When detecting lice or their nits, an anti-doping treatment with special preparations is performed. It is accompanied by the completion of the documentation.
There is a complete and partial treatment of the patient. The full scope of activities includes a bath or shower. The duration of the bath is about 20 minutes. Partial form is used for bedridden and seriously ill patients, wiping and washing are used. If necessary, hair, nails are cut, shaving is performed.
Medical personnel control the optimal conditions for conducting procedures, the absence of drafts, the observance of sanitary and epidemiological measures, including timely treatment of the bath and shower.
Patient admission to a hospital, whose algorithm includes treatment against lice, requires the registration of each case of lice in the Journal of Infectious Diseases. An emergency written notice is sent to the sanitary epidemiological service and a polyclinic at the place of residence.
Before the treatment of an infected person, the medical officer wears protective clothing: a kerchief, an extra gown, an apron, glasses. The patient is seated on a chair or a couch and cover his shoulders with a diaper or towel. Further, a pediculicide( "Nittifor", "Medifox", "Permethrin", "Malathion") is prepared, which is applied over the entire length of the hair.
The head is tied with a kerchief and the exposure time is maintained according to the instructions for use. At the end of the time, the hair is washed using a shampoo and rinsed with a solution of vinegar. Next, thorough combing of dead insects and nits with a thick crest. All used tools and premises are disinfected.
The algorithm for admission to hospital includes anthropometric measurements:
- body weight;
- of the chest.
Growth measurement is carried out with a rostomer. The patient becomes a back to the counter, touching it with the back of the head, shoulder blades, buttocks and heels. Plank falls on the head, fixing the number of centimeters. The parameters are recorded in the temperature sheet of a stationary patient.
Determination of body weight is carried out with the help of special medical scales equipped with weights to indicate the values up to grams. A measurement procedure is conducted to study the physical development of the patient entering treatment. Contraindication is a serious condition of the patient, the need for strict bed rest or strong overexcitation.
Transportation of patients to the department or operating unit
The method for carrying or transferring the patient to the department where the treatment will be continued is determined by the physician who conducted the initial examination. Patients who can move independently and do not have contraindications for this, go up to the department accompanied by a nurse. Those who can not move independently or have contraindications are transported in a reclining( on stretchers, a lying gurney) or sitting( on a wheelchair).
Rules for admission to hospital, if it is classified as "non-transportable", include the provision of first aid in the reception room, and then the patient is transferred to the intensive care unit.
Features of transportation in individual cases
The algorithm for admission of a patient to a hospital with a fracture of the bones of the skull includes its transportation in the following form: the patient is placed on his back and the head end of the stretcher is lowered without using a pillow. Around the head put a moderately deflated circle or a platen of clothes.
Fracture of the spine requires laying the victim on a hard bed on his back, using a normal stretcher - on the stomach with his head down.
Fracture or dislocation of the upper limb needs to tilt the body to the healthy side. The hand in the tire is bandaged to the chest, while supporting it. In case of a fracture of the leg, the injured limb is placed on a raised platform from a pillow or a folded blanket.
Fracture of the ribs - patient in a semi-sitting position, to facilitate the breathing process, and with a fracture of the pelvic bones the patient is placed on the back, legs bend at the knees, under which rollers, blanket, pillows are put.
A chest injury requires placing the patient on a wounded side or back in a semi-sitting position. When the stomach is injured, the patient lies on the back with the rollers placed under the knees to relax the muscles of the press.
In the presence of a hemorrhage in the brain, the victim is laid on his back, and his head is turned to the side to avoid aspirating the vomit.
Patient admission to the infectious hospital
Hospitals with a narrow focus on infectious diseases are different from other health facilities. Their reception rooms have the structure of boxes in which the patient is admitted to the hospital in accordance with strict sorting. The patient enters a separate box where all the necessary measures are taken:
- examination of the doctor;
- nursing examination;
- preparation of documentation;
- conducting diagnostic and laboratory examinations.
Then the patient is taken to the necessary department, making sure that there are no contacts with other patients, and the used box is to be disinfected.
The main provisions of the sanitary-epidemiological mode of admission are an important part of the work of the entire medical institution and include the following items:
- mandatory sanitary treatment of patients;
- registration of emergency notification to the Sanitary and Epidemiological Service for the detection of pediculosis, an infectious disease, intestinal poisoning;
- previous, current and final disinfection of objects of use and premises of the entrance department;
- strict adherence to instructions and orders for working with patients.
The article considered the reception and registration of patients in the hospital, the documentation of the admission department, the features of transportation, examination and sanitation of patients. The well-coordinated and timely work of the medical personnel of the receiving dormitory allows us to organize prompt assistance and minimize the risk of deaths.