In most cases, the patient's condition requires inpatient treatment. The patient is admitted to the hospital through one of the most important medical and diagnostic structural units of the health care facility - the admission department. The level of qualification and training of the medical staff working here is directly reflected on the health, and sometimes the life of the patient.
It is in the reception department that the service and first aid to the patient begin: registration of the patient, initial examination, anthropometry, sanitary treatment, emergency care in urgent conditions.
Informing applicants
Reception and registration of patients admitted to the hospital has a clear documented confirmation, which can be found in the building of the admission department. Scientific material for the work of medical staff and the awareness of relatives of patients is located in specially created information corners.
For patients and their relatives:
- a panel with a luminous inscription "Reception" above the entrance;
- information about the hours of receipt of elective patients;
- announcement of the time of visiting inpatients, the issuance of health certificates by specialists, the number and opening hours of the help desk;
- rules of the internal routine of healthcare facilities;
- list of products allowed for transfer;
- marking the premises of the reception department;
- copy of the document confirming the right of the institution to engage in medical activities;
- each admission to the hospital is given a memo, which summarizes the basic requirements and rules of the hospital.
Information for staff headquarters
For medical staff, the corner is filled with specialized documentation, orders and instructions used in daily work:
- instructions, the implementation of which is necessary when identifying a particularly dangerous infection;
- table of poisons and their antidotes;
- emergency care algorithms for various urgent conditions ;
- folder with laws and instructions for working in the front desk;
- schedule of doctors on duty at hospital departments;
- evacuation plan in case of fire or emergency.
Reception Room Functions
Admission of a patient to a hospital, record keeping is far from all the functions assigned to the medical staff. Among the main functions of the reception department, the following are distinguished:
- registration of patients admitted for treatment to the departments of health facilities;
- initial inspection by a specialist on duty;
- emergency care;
- determination of the diagnosis and department to which the patient enters;
- sanitization of patients;
- filling in the relevant documentation;
- transportation to the department or operating unit (if necessary);
- the provision of reference services.
How is the reception department
The arrangement of classrooms and rooms of the department depends on the profile of the medical institution. Reception of a patient in a hospital, the algorithm of which is quite voluminous, begins with the patient entering the waiting room. This is a room where there are waiting relatives of patients and the patients themselves who do not need bed rest.
The hall is equipped with a table and the necessary number of chairs to create comfort. The walls are equipped with information corners, including rules and instructions for patients and their relatives.
Reception and registration of a patient in a hospital requires a registry - a room in which necessary accompanying documentation is drawn up:
- a register of patients admitted to inpatient treatment;
- an alphabetical book used to provide reference services;
- a magazine for recording refusals from hospitalization;
- specialist consultation journal;
- pediculosis examination logbook;
- the journal of the movement of patients in a hospital.
Next is an examination room in which doctors conduct an initial examination of patients. The need for diagnostic and sanitary measures is being clarified. Then there is a sanitary inspection room with a bathroom and a changing room.
Admission of a patient to a hospital requires a diagnostic room for incoming people with an unknown diagnosis. Here the patient lies until a department for further treatment is determined. Such offices are located in large institutions. For proper diagnosis, specialists are assisted by a laboratory, an ECG, endoscopy, and X-ray room. These structural units should be located in or near the reception ward. An insulator is located here for patients with suspected infectious disease.
The duties of the medical staff of the diagnostic department include the provision of emergency care to persons who do not need further hospitalization. For this, a dressing room, a small operating room and a treatment room should be equipped with everything necessary.
The reception room also includes the office of the head physician of the health facility, the manager, the room where the clothes of the applicants and the toilet room are stored.
Ways of hospitalization
The patient is admitted to the hospital after direct transportation to the emergency room. There are four main ways of hospitalization:
- An ambulance can pick up a patient from home or on the street. This occurs in cases of trauma, acute illness or exacerbation of chronic diseases, poisoning, the onset of labor.
- In the absence of the effectiveness of outpatient therapy, the doctor writes out a referral for inpatient treatment. A similar document can be issued by a medical rehabilitation expert commission or a military registration and enlistment office.
- If necessary, specialized assistance or temporary closure of the hospital, the maternity hospital of the patient, in agreement with the administration, is transferred to another health care facility.
- In the event of a sharp deterioration in the condition, a person can independently go to the nearest hospital.
Depending on the condition of the patient and the timing of admission to the hospital, the patient’s admission to the hospital may be planned or emergency.
Sanitary treatment in the emergency room
Upon examination, the doctor determines the need for sanitization and its appearance, taking into account the general condition of the patient. The treatment is carried out by middle and junior medical personnel in the premises of the sanitary inspector. Inspect the head and pubic region to determine the pathogens of head lice. If lice or their nits are found, anti-pedicular treatment with special preparations is carried out. Accompanied by filling out documentation.
Distinguish between full and partial type of treatment of the patient. A full range of activities includes a bath or shower. The duration of the bath is about 20 minutes. A partial form is used for bedridden and seriously ill patients, rubbing and washing are used. If necessary, cut hair, nails, and shave.
Medical staff monitor the optimal conditions for the procedures, the absence of drafts, the observance of sanitary and epidemiological measures, including timely treatment of the bath and shower.
Anti-pediculosis treatment
Admission of a patient to a hospital, the algorithm of which includes treatment against lice, requires the registration of each case of head lice in the " Infectious Diseases Register ". An urgent written notice is given to the sanitary-epidemiological service and clinic at the place of residence.
Before treating an infected person, a medical officer puts on protective clothing: a scarf, an extra gown, an apron, and glasses. The patient is seated on a chair or couch and covers his shoulders with a diaper or towel. Next, a pediculicide is prepared (Nittifor, Medifox, Permethrin, Malathion), which is applied along the entire length of the hair.
The head is tied with a scarf and can withstand exposure time according to the instructions for use of the drug. After a while, the hair is washed using shampoo and rinsed with a solution of vinegar. Next, thoroughly combing dead insects and nits with a thick comb. All used tools and the room are disinfected.
Anthropometry
The algorithm for admitting a patient to a hospital includes anthropometric measurements:
- body weight
- growth;
- chest volume.
Growth measurement is carried out using a height meter. The patient becomes a back to the stance, touching her neck, shoulder blades, buttocks and heels. The bar lowers onto the head, fixing the number of centimeters. The indicators are recorded in the temperature sheet of the inpatient.
The determination of body weight is carried out using special medical scales equipped with weights to indicate indicators up to grams. A measurement procedure is being conducted to study the physical development of the applicant. Contraindication is the serious condition of the patient, the need for strict bed rest or severe overexcitation.
Transportation of patients to the ward or operating unit
The method of carrying or transferring the patient to the department where treatment will continue is determined by the doctor who conducted the initial examination. Patients who can move independently and do not have contraindications for this, rise to the department, accompanied by a nurse. Those who cannot move independently or have contraindications are transported in a lying position (on a stretcher, a lying gurney) or a sitting position (on a wheelchair).
The rules for admitting a patient to a hospital, if he is classified as “non-transportable,” include providing first aid in the emergency room, and then the patient is transferred to the intensive care unit.
Features of transportation in individual cases
The algorithm for admitting a patient to a hospital with a fracture of the skull bones includes its transportation in the following form: the patient is laid on his back, and the head end of the stretcher is lowered without using a pillow. A moderately deflated circle or a roll of clothes is placed around the head.
A fracture of the spine requires laying the victim on a hard bed on his back, while using a conventional stretcher - on his stomach with his head down.
A fracture or dislocation of the upper limb needs the body tilted to the healthy side. The hand in the tire is bandaged to the chest, while moving support. When a leg fracture occurs, the injured limb is placed on a raised platform from a pillow or folded blanket.
Fracture of the ribs - the patient is in a half-sitting position to facilitate the breathing process, and in case of fracture of the pelvic bones the patient is laid on his back, his legs are bent at the knees, under which they put rollers, a blanket, pillows.
A chest wound requires laying the patient on a wounded side or back in a half-sitting position. In case of injuries to the abdomen, the patient lies on his back with rollers placed under the knees in order to relax the muscles of the press.
In the presence of hemorrhage, the victim’s brain is laid on his back, and his head is turned to the side to avoid aspiration by vomit.
Reception of the patient in an infectious hospital
Hospitals with a narrow focus on infectious diseases differ from other health facilities. Their receiving departments have the structure of the 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 events are held:
- medical examination;
- nursing examination;
- sanitization;
- paperwork;
- diagnostic and laboratory examinations.
Then the patient is taken to the necessary department, controlling so that there are no contacts with other patients, and the used box must be disinfected.
Sanitary and epidemiological regime
The main provisions of the sanitary-epidemiological regime of the emergency room are an important part of the work of the entire medical institution and include the following points:
- compulsory sanitization of patients;
- issuing an emergency notice to the sanitary-epidemiological service about the detection of pediculosis, infectious disease, intestinal poisoning;
- previous, current and final disinfection of objects of use and premises of the reception department;
- strict adherence to instructions and orders for working with patients.
Conclusion
The article examined the reception and registration of patients in a hospital, the documentation of the admission department, especially the transportation, examination and sanitization of patients. The coordinated and timely work of the medical staff of the emergency room allows you to organize quick assistance and minimize the risk of death.