1. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 31 Admitting, Transferring, and Discharging Residents

2. Slide 2 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  New residents and families may have concerns and fears.  Transfers to another nursing unit or to another agency cause similar concerns.  Discharge is usually a happy time.  OBRA has standards for transfers and discharges. The person’s rights must be protected. The person’s rights must be protected.

3. Slide 3 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Admitting, transferring, and discharging residents involve: Privacy and confidentiality Privacy and confidentiality Reporting and recording Reporting and recording Understanding and communicating with the person Understanding and communicating with the person Communicating with the health team Communicating with the health team Respecting the person and the person’s property Respecting the person and the person’s property Being kind, courteous, and respectful Being kind, courteous, and respectful

4. Slide 4 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  ADMISSIONS  During admission: Identifying information is obtained from the person or family. Identifying information is obtained from the person or family. The room assignment is made. The room assignment is made. A nurse or social worker explains the resident’s rights to the person and family. A nurse or social worker explains the resident’s rights to the person and family. The person or legal representative signs admitting papers and a general consent for treatment. The person or legal representative signs admitting papers and a general consent for treatment. The person’s photo is taken. The person’s photo is taken. The person receives an ID bracelet. The person receives an ID bracelet.  Residents arrive by ambulance, wheelchair van, or car.

6. Slide 6 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Admission is a hard time for the person and family.  Persons with dementia and their families may need extra help. Often confusion increases in a new setting. Often confusion increases in a new setting. Fear, agitation, and wanting to leave are common. Fear, agitation, and wanting to leave are common. The family also is fearful and may feel guilty. The family also is fearful and may feel guilty.  You prepare the room before the person arrives.  A nurse usually greets and escorts the person to the room.

7. Slide 7 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Admission is your first chance to make a good impression. Greet the person by name and title. Greet the person by name and title. Introduce yourself by name and title. Introduce yourself by name and title. Make roommate introductions. Make roommate introductions. Act in a professional manner. Act in a professional manner. Treat the person with dignity and respect. Treat the person with dignity and respect.  To help meet safety and security needs: Do not rush into admission procedures. Do not rush into admission procedures. Treat the person and family as guests in your home. Treat the person and family as guests in your home. Introduce the roommate and residents in nearby rooms. Introduce the roommate and residents in nearby rooms. Help make the room as home-like as possible. Help make the room as home-like as possible. Show caring and compassion. Show caring and compassion.

9. Slide 9 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  During the admission procedure you will: Collect some information for the admission form Collect some information for the admission form Measure the person’s weight and height Measure the person’s weight and height Measure the person’s vital signs Measure the person’s vital signs Complete a clothing and personal belongings list Complete a clothing and personal belongings list Orient the person to the room, the nursing unit, and the center Orient the person to the room, the nursing unit, and the center  Weight and height are measured on admission to the center. Then the person is weighed daily, weekly, or monthly. Then the person is weighed daily, weekly, or monthly. Standing, chair, bed, and lift scales are used. Standing, chair, bed, and lift scales are used.

10. Slide 10 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  When measuring weight and height: The person wears only a gown or pajamas. The person wears only a gown or pajamas. The person voids before being weighed. The person voids before being weighed. Weigh the person at the same time of day. Weigh the person at the same time of day. Use the same scale for daily, weekly, and monthly weights. Use the same scale for daily, weekly, and monthly weights. Balance the scale at zero (0) before weighing the person. Balance the scale at zero (0) before weighing the person.

14. Slide 14 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  TRANSFERS  Reasons for transfers include: The person’s condition changes. The person’s condition changes. The person requests a room change. The person requests a room change. Roommates do not get along. Roommates do not get along. The person’s care needs change. The person’s care needs change.  The doctor, nurse, or social worker explains the reasons for the transfer.  You assist with the transfer or perform the entire procedure. Support and reassure the person. Support and reassure the person. Use good communications skills. Use good communications skills.

15. Slide 15 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  DISCHARGES  Discharge is the official departure of the person from the center.  The health team: Plans the discharge Plans the discharge Teaches the person and family about diet, exercise, and drugs Teaches the person and family about diet, exercise, and drugs Teaches the person and family about procedures and treatments Teaches the person and family about procedures and treatments Arranges for home care, equipment, and therapies as needed Arranges for home care, equipment, and therapies as needed Makes a doctor’s appointment Makes a doctor’s appointment

16. Slide 16 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Use good communication skills when assisting with a discharge. Wish the person and family well as they leave the center. Wish the person and family well as they leave the center.  A person may want to leave the center without the doctor’s permission. Tell the nurse at once if the person expresses the wish or intent to leave. Tell the nurse at once if the person expresses the wish or intent to leave.

17. Slide 17 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  QUALITY OF LIFE  To help the person and family: Be courteous, caring, efficient, and competent. Be courteous, caring, efficient, and competent. Be sensitive to fears and concerns. Be sensitive to fears and concerns. Handle the person’s property and valuables carefully and with respect. Handle the person’s property and valuables carefully and with respect. Treat the person and family like you want your loved ones treated. Treat the person and family like you want your loved ones treated.  Visit new residents often.  Explain all procedures and what the various sounds mean.  Always protect the person’s rights and promote quality of life.