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NURSING ADMISSION POLICY

Policy statement

The admission policy is aimed at providing a clear, efficient and speedy process whereby orthopaedic patients are accepted for treatment/rehabilitation in line with the expertise/facilities available within the hospital.

Procedure

Patients are admitted under the care of the orthopaedic surgeon (in the referring hospital) provided they can benefit from the services of the hospital and are deemed to be sufficiently medically fit to be cared for at the hospital. If patients are living alone the level of care/family support available for them needs to be established to ensure that they can be discharged following treatment at the hospital.

Patients who are confused and who are unable to accept the treatment offered by the hospital are not considered suitable for admission. It is also important that the referring hospitals obtain a speedy response to their request for a bed and that the screening is carried out in such a way that encourages referrals while at the same time offers an opportunity for the nursing staff to prevent inappropriate admissions. Patient admission requests are processed on a first come first served basis.

To facilitate a smooth working arrangement between the referring hospital and the IOH, it must be accepted that, if during the rehabilitation period a patient’s condition deteriorates or if they are found to be unsuitable, the referring hospital will be expected to re-admit the patient.

NURSING ADMISSION PROCEDURE

Procedure statement

All patients admitted to the Incorporated Orthopaedic Hospital are planned admissions and must receive equitable treatment with information to enable them to be safely orientated and made to feel secure in their environment. On admission, the nursing staff looking after the patient must record all information required to ensure the needs of the patient are fully met during their hospital stay and ensure that appropriate provisions are made for their discharge.

Procedure: standard introduction

  • Each patient on admission must be greeted by a member of the nursing staff who introduces themselves by giving their name and title. An outline of the admission process must be described and details of all routine procedures explained.
  • The patient must be orientated to the local environment including toilets, washing facilities, nurse call system and fire exits.
  • Relatives or friends accompanying patients can be given information regarding the admission, estimated length of stay, hospital visiting times and any other information that may be required.

Admission to ward

  • The patient is allocated a suitable bed on the ward and if appropriate, introduced to other patients in the bay.
  • The ward routine is explained and a hospital booklet is made available to the patient in addition to providing local relevant ward information for example, meal times, ward rounds.
  • Visiting times must be explained clearly highlighting the reasons for any restrictions in operation at the time of admission and accompanying persons should also be informed.

Individual needs: admission procedure

  • Patients are initially interviewed on admission, facilitating the identification and assessment of their needs and expectations in order that they may be adequately addressed during their admission to the hospital. The Roper, Logan and Tierney model of nursing incorporating the Activities of Daily Living is the nursing model to be used within the hospital, thus providing a framework to the process of assessment, enabling appropriate interventions and achievement of outcomes.
  • Once the patient’s needs are identified they must be recorded in the appropriate nursing documents and any referrals to other members of the multidisciplinary team must be made at this time. i.e. medical social worker, catering supervisor, occupational therapist.
  • Patients and their relatives must be made aware of the approximate length of stay or their exact discharge date when available. For interim care patients and respite patients the exact discharge date must be written on their bed sign. For orthopaedic patients an approximate length of stay must be given. The discharge date will be documented in the in-patients notes to assist the multidisciplinary team plan and co-ordinate a safe and timely discharge.
  • Each patient must be involved in their plan of care and kept informed of their progress.

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