Registration and admission of a patient to a hospital
In most cases, the condition of the patient requiresinpatient 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 room that theservice and first aid to the patient: patient registration, primary examination, anthropometry, sanitation, urgent care in urgent conditions.
Informing those entering the health facility
Reception and registration of patients entering thehospital, has a clear documented confirmation, you can see it in the body of the reception. 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:
- The scoreboard with the glowing inscription "Reception" above the entrance;
- information on the hours of admission of planned patients;
- announcement of the time of visiting inpatients, issuing certificates of health specialists, the number and opening hours of the reference service;
- internal regulations of the health facility;
- list of products that can be transferred;
- marking of the premises of the reception department;
- 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 staff of employees
For medical staff, the corner is filled with specialized documentation, orders and instructions used in daily work:
- instruction, the implementation of 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 department;
- a schedule of doctors on duty at the hospital;
- plan for evacuation in case of fire or emergency situations.
Admission office functions
Admission of patients to the hospital, documentation - not all functions assigned to the medical staff. Among the main functions of the admission department are the following:
- registration of patients entering treatment in the departments of health facilities;
- primary examination by the on-duty specialist;
- provision of emergency care;
- Determination of the diagnosis and separation into which the patient enters;
- sanitation treatment of patients;
- filling in the relevant documentation;
- transportation to the office or operating unit (if necessary);
- provision of reference services.
How is the reception room arranged?
Arrangement of offices and premises of the departmentdepends 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 in which the necessary accompanying documentation is drawn up:
- a register of patients entering hospital care;
- alphabetical book used for providing reference services;
- Journal for fixing refusals from hospitalization;
- Journal of specialist consultations;
- a log of examination for pediculosis;
- Journal of patients' movement in a hospital.
Next is the viewing room, in whichdoctors 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.
Admission of a patient to a hospital requiresa diagnostic room for incoming patients 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.
In the duties of medical staffreception and diagnostic department includes providing emergency care to 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, the reception room includes 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.
Ways of hospitalization
Implementation of the patient's admission to the hospital is carried out after his immediate transportation to the reception ward. There are four main methods of hospitalization:
- An ambulance can take a patient out ofat 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 effectiveness of outpatient therapy, the doctor prescribes a 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 to temporarily close the hospital, the patient's maternity hospital is transferred to another health facility by agreement with the administration.
- In the event of a sharp deterioration of the condition, a person can independently turn to the nearest hospital.
Depending on the condition of the patient and the timing of admission to the medical and preventive institution, the patient's admission to the hospital can be scheduled or emergency.
Sanitary treatment in the reception room
When examined, the doctor determines the need forsanitation 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.
Distinguish the complete and partial form of processingpatient. 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 monitor the optimalconditions of procedures, lack of drafts, compliance with sanitary and epidemiological measures, including timely treatment of the bath and shower.
Reception of the patient in a hospital, whose algorithmincludes 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 treatment of an infected medicalthe employee wears protective clothing: a kerchief, an additional robe, 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.
Head tied with a kerchief and withstood the timeExposure 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.
The growth is measured by means of 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 usingSpecial medical scales, equipped with weights for the designation of 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 a department or an operation unit
A method of carrying or transferring a patient to aThe department where the treatment will be continued is determined by the doctor who performed the primary 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).
The rules for admission to hospital, in the case ofif 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
Algorithm for admission of a patient to a hospital with a fracturethe skull bones include its transportation in the following form: the patient is laid on his back, and the head end of the stretcher is lowered, not 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 needstilt 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 - a patient in a semi-sitting position,to ease the process of breathing, and with a fracture of the pelvic bones, the patient is placed on his back, legs are bent at the knees, under which rollers, blanket, pillows are put.
Wounding of the chest requires layingpatient 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 placed on his back, and his head is turned to the side to avoid aspiration by vomit.
Admission of a patient to an infectious inpatient facility
Hospitals with a narrow focus ondiseases of an infectious nature, differ 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:
- medical examination;
- nursing survey;
- sanitary treatment;
- 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 and 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 an emergency notification to the sanitary and epidemiological service about the detection of pediculosis, an infectious disease, intestinal poisoning;
- previous, current and final disinfection of objects of use and premises of the admissions department;
- strict adherence to instructions and orders for working with patients.
The article considered reception and registrationpatients in the hospital, documentation of the admission department, 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.