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Being Admitted to the Hospital
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Topics in Hospital Care
  • Being Admitted to the Hospital
  • Problems Due to Hospitalization
  • Being Discharged From the Hospital
     
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    Being Admitted to the Hospital

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    People are admitted to a hospital when they have a serious or life-threatening problem (such as a heart attack). They also may be admitted for less serious disorders that cannot be adequately treated in another place (such as at home or in an outpatient surgery center). A doctor—the primary care doctor, a specialist, or an emergency department doctor—determines whether people have a medical problem serious enough to warrant admission to the hospital. The main goal of hospitalization is to restore or improve health so that people can return home. Thus, hospital stays are intended to be relatively short and to enable people to be safely discharged to home or to another health care setting where treatment can be completed.

    For many people, hospital admission begins with a visit to the emergency department. When and how to go to an emergency department are important (see Making the Most of Health Care: Visits to the Emergency Department). When people do go to the emergency department, they should bring their medical information. Of particular importance is a list of all drugs being taken, including over-the-counter drugs, prescription drugs, and dietary supplements (such as vitamins, minerals, and medicinal herbs). A copy of their most recent medical summary and records of recent hospital stays are also helpful, although many people do not have these records. In such cases, the emergency department staff typically obtains the information from the primary care doctor, the hospital records department, or both.

    The first step in admission is registration. Sometimes registration can be done before arriving at the hospital. Registration involves filling out forms that provide the following:

    What to Bring to the Hospital

    People should bring a list of the drugs and doses they are taking and any written instructions from the doctor. Hospitals recommend that people also bring advance directives (see Legal and Ethical Issues: Advance Directives). All of this information should be given to the nurse responsible for getting them settled into a hospital room. People should also bring the following:

    • Toiletries
    • A robe
    • Sleepwear
    • Slippers
    • Eyeglasses, hearing aids, and dentures (if they are used at home)
    • A few personal items, such as photographs of loved ones, to make them feel more comfortable

    If a child is being hospitalized, parents should bring a comforting object, such as a favorite blanket or stuffed toy. All personal items should be marked or labeled.

    Prescription drugs and any valuables (such as a wedding ring or other jewelry, credit cards, or large sums of money) should be left at home.

    • Basic information (such as name and address)
    • Health insurance information
    • Telephone numbers of family members or friends to contact in case of an emergency
    • Consent to be treated
    • Consent to release information to insurance companies
    • Agreement to pay the charges

    People are given an identification bracelet to be worn on the wrist. They should check to make sure the information on it is correct and should wear it at all times. That way, when tests or procedures are done, staff members can make sure that they have the right person.

    After admission, people may be taken for blood tests or x-rays or go immediately to a hospital room. Hospital rooms may be private (one bed) or shared (more than one bed). Even in a private room, privacy is limited. Staff members frequently go in and out of the room, and although they usually knock, they may enter before people can respond.

    Various tests, such as blood or urine tests, may be done to check for other problems. Staff members may ask questions to determine whether people are likely to develop problems in the hospital or to need extra help after discharge from the hospital. People may be asked about eating habits, mood, vaccinations, and drugs taken. They may be asked a standard series of questions to evaluate mental function (see Symptoms and Diagnosis of Brain, Spinal Cord, and Nerve Disorders: Mental Status TestingTables).

    During the hospital stay, people are examined by a doctor at least once a day. Nurses and other staff members usually come in several times a day and provide most of the care. Physical therapists may come in regularly to help with exercise. If people need extra help, such as help with eating or getting to the toilet, family members may provide this care. Family members can also talk with a social worker at the hospital about making arrangements for extra help. Children may require a parent or other caregiver to stay at the hospital most of the time.

    Special Care Units: When People Need Special Care

    People who need specific types of care may be put in special care units.

    Intensive care units (ICUs) are for people who are seriously ill. These people include those who have had a sudden, general malfunction (failure) of an organ, such as the liver, lungs (requiring assistance with breathing), or kidneys (requiring dialysis). People who are in shock, who have a severe infection, or who have had major surgery are likely to be placed in an ICU. Large hospitals may have a special pediatric intensive care unit (PICU) for children.

    Some hospitals also have a type of intensive care unit for people who are too sick to go to a regular hospital bed but are more stable than people in the ICU. These units may be called step-down units or intermediate care units.

    Coronary care units are for people who are having or have had a heart attack. People who are likely to have a heart attack (such as people with angina or an abnormal heart rhythm) and people with heart failure may be admitted to a coronary care unit or, if it is unavailable, to an ICU.

    Intensive care and coronary care units have equipment to support and constantly monitor vital functions:

    • A machine to monitor heart rate (electrocardiography, or ECG), blood pressure, and breathing rate is connected to people by various lines or wires.
    • A flexible catheter inserted into a vein (an intravenous line) is used to give people drugs, fluids, and sometimes nutrients.
    • Ventilators to help people with breathing and defibrillators to restore heart rhythm to normal are available.

    Visiting hours and rules are more restrictive in these units.

    Isolation is used to prevent a person from infecting others. Isolation may be complete (when a disorder can be transmitted through the air). Or it may be incomplete (when a disorder is transmitted only by contact with the skin, blood, or stool). Incomplete isolation requires fewer precautions.

    Reverse isolation is used to prevent a person from being infected by others. Reverse isolation is needed when a person's immune system is not functioning well—for example, after bone marrow transplantation.

    Either type of isolation may involve the following:

    • The person is placed in a single room.
    • Anyone who goes into the room must wear a mask, gown, cap, and gloves, which are sterilized or burned after use.
    • All items that come in contact with the person are also sterilized.
    • The air in the room may be filtered.
    • Visitors are usually limited to the immediate family.

    Last full review/revision February 2009 by Robert M. Palmer, MD, MPH

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    angina

    dialysis

    electrocardiography

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