Transfer of Patient in Healthcare

Study Notes

The transfer of a patient can be between departments within the same hospital or between hospitals.
The purpose of transfer is to:
- Obtain necessary diagnosis tests and procedures
- Provide treatment and nursing care
- Provide specialized care
- Ensure the most appropriate utilization of personnel and services
- Match the intensity of nursing care based on the patient's level of needs and problems

Internal transfer: transferring the patient to a unit that provides special care or care suited to their needs (e.g., from general wards to ICU)
External transfer: transferring the patient from one hospital to another hospital for special care (e.g., from a general hospital to a specialized hospital or cancer center)

The sister in charge should inform the sister in charge of the new ward
Check and hand over the patient's belongings to the new sister
Assess the method of transport and inform the receiving nurse
Maintain the patient's physical wellbeing during transport
Provide a verbal report about the patient's condition to the receiving unit nurse
Ensure all documentation, including the care plan, is complete
Assist the patient's arrival to the new unit and transport to the new room
Hand over to the receiving nurse

Inform the patient and relatives about the transfer
Complete information about the patient should be written down and handed over to the physician
If the patient is in a risk condition, the nurse should accompany them

Vital signs reflect the body's physiologic status and provide information critical to evaluating homeostatic balance
Includes:
- Temperature
- Pulse rate
- Respiratory rate
- Blood pressure

Normal body temperature is 37°C (98.6°F) with a range of 36-38°C (96.8-100°F)
Body temperature may be abnormal due to fever (high temperature) or hypothermia (low temperature)
Factors that can influence body temperature:
- Age
- Diurnal variations (circadian rhythm)
- Exercise
- Hormones
- Stress
- Environment

Oral temperature: obtained by putting the thermometer under the tongue, leaving it for 3-5 minutes, and measuring 0.65°C less than rectal temperature
Rectal temperature: obtained by inserting the thermometer into the rectum or anus, holding it for 3-5 minutes, and measuring 0.65°C higher than oral temperature
Axillary temperature: obtained by placing the thermometer in the armpit, holding it for 3-5 minutes, and measuring 0.65°C lower than oral temperature
Tympanic temperature: obtained by inserting the thermometer into the ear canal

Respiratory rate (RR) is the number of breaths per minute
Factors that can influence RR:
- Age
- Medications
- Stress
- Exercise
- Gender
Normal RR is 15-20 breaths per minute
RR can be measured by:
- Watching the movement of the chest or abdomen
- Counting the number of breaths per minute

Blood pressure is the force exerted by the blood against the walls of the arteries
Blood pressure is expressed in terms of millimeters of mercury (mmHg)
Factors that can influence blood pressure:
- Fever
- Stress
- Arteriosclerosis
- Exposure to cold
- Obesity
- Hemorrhage
- External heat
Normal blood pressure is 120/80 mmHg
Blood pressure can be measured at various sites, including:
- Upper arm (using brachial artery)
- Thigh (using popliteal artery)
- Forearm (using radial artery)
- Leg (using posterior tibial or dorsal pedis artery)

Use a blood pressure cuff (sphygmomanometer) and stethoscope
Position the patient in a lying, sitting, or standing position, with the arm supported and the palm facing upwards
Apply the cuff snugly around the arm, 2.5 cm above the antecubital space
Palpate the radial pulse and inflate the cuff until the radial pulse can no longer be felt
Inflate the cuff 30 mmHg higher than the estimated systolic pressure
Palpate the brachial artery and place the bell of the stethoscope over the site
Deflate the cuff 2-4 mmHg per second, and record the systolic and diastolic pressure
Compare the present reading with previous readings and report or treat any changes