Patient Chart Records pg. 2-10 Flashcards
What are the 4 primary responsibilities of a NUA?
- Processing Physician’s Orders
- Admitting, Transferring, and Discharging Patients
- Answering and Making Telephone Calls
- Miscellaneous duties, example: Filing reports, maintaining charts
To be effective and efficient as NUA you will need to require:
- Good handwriting skills
- Good listening skills
- Excellent manner and professionalism
- The ability to communicate verbally with staff
- The ability to be organized
What are the 3 hospital types? 1 example hospital of each.
- Community Care Hospital - Salmon Arm
- Acute Care Hospital - Vernon
- Tertiary Care - Kelowna
Main purposes of the Admitting Department
- To register every patient
- To admit, discharge, and transfer all inpatients
- To record or update all Personal Information of Patient
- To print the Admission/Separation Record
- Patient Identification Wristband
- Patient Labels
What is an elective admission?
An elective admission is arranged by the physician with the hospital
NUA responsibilities for an Elective Admission
Notify their RN of the patient’s arrival.
It is not your responsibility to choose what room the patient will go in
You will receive 4 admission documents: Wristband, 4-5 labels, ADR, Admission/Separation Record
What is an Emergency Admission?
An emergency admission is when the patient comes into emergency by ambulance, wheelchair, or walking
What are the responsibilities of the NUA for an emergency admission?
- Will enter an order to let admitting know they need a bed
- Call hospital supervisor and let them know about the admission. (State patients name, age, diagnosis, doctors, and what floor)
- Print off BPMH/Pharmanet
NUA responsibilities for Admissions from other facilities
Will receive transfer forms , these forms will be filed in History or Miscellaneous of their chart. Follow same procedures as an elective admission. Nurse will call MRP. It is treated as an admission into the hospital.
NUA responsibilities with Food and Nutrition Services
For processing diet orders into the computer. Any changes need to be called in to the department. You need to give them Ward, Room Number, Bed Number, Patient’s Last name, Patient’s Diet or Diet Changes