> ## Documentation Index
> Fetch the complete documentation index at: https://docs.bizaxl.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Inpatient Management
> How to admit a patient, assign a bed, manage daily nursing care and medication orders, and process discharge at a general clinic.
Some patients seen at a general clinic need to stay overnight or for several days - following a minor procedure, an acute illness, or while awaiting specialist referral. The inpatient module tracks everything from the moment a patient is admitted to the moment they leave: which bed they are in, what medications they are taking, what nursing care they are receiving, and what needs to be billed at discharge.
***
## Before You Start
* **Healthcare Service Units** (rooms and beds) must be set up for your clinic.
* The patient must be registered and have had a consultation where admission was ordered.
* You need the **Healthcare Practitioner** role to create and manage inpatient records.
* Nurses (with the **Nursing User** role) handle nursing tasks and medication administration.
***
## Admitting a Patient
### Step 1: Order Admission During a Consultation
When the doctor decides a patient needs to stay in, they record this in the Patient Encounter:
1. In the consultation, set the **Inpatient Status** to "Admission Scheduled"
2. Submit the encounter
This signals the admin or nursing team to prepare a bed.
### Step 2: Create the Inpatient Record
1. Go to Healthcare workspace → Inpatient card → **Inpatient Record** → New
2. Fill in the admission details:
| Field | What to Enter |
| ----------------------- | ------------------------------------------- |
| Patient | The patient being admitted |
| Medical Department | Which department is responsible |
| Primary Practitioner | The main doctor caring for the patient |
| Secondary Practitioner | A covering or co-treating doctor (optional) |
| Admission Ordered For | Date when admission was decided |
| Expected Length of Stay | Estimated number of days |
| Expected Discharge | Estimated discharge date |
| Chief Complaint | The main reason for admission |
| Admission Instruction | Any special care instructions on arrival |
### Step 3: Assign a Bed
1. In the **Service Unit** section, click the bed assignment button
2. The Healthcare Service Unit tree opens - green = Vacant, red = Occupied
3. Select an available bed or room
4. The patient is assigned and the bed status changes to Occupied
The **Vacant Service Units** count on the workspace shortcut updates immediately.
### Step 4: Save
Click Save. The patient's status on their Patient record changes to **Admitted**, and the **Total Patients Admitted** number card increases by one.
***
## Daily Nursing Care
### Nursing Tasks
Nursing tasks are the standard care actions nurses complete for each inpatient: vital signs monitoring, medication rounds, wound care, repositioning for immobile patients, and discharge preparation.
**To see nursing tasks:**
1. Go to Healthcare workspace → Nursing card → **Nursing Task**
2. Filter by patient or date
**To complete a nursing task:**
1. Open the task record
2. Review the task description
3. Carry out the care
4. Record the actual start and end time
5. Add any notes (what was observed while completing the task)
6. Change status to **Completed** and save
***
## Inpatient Medication Orders
When the doctor prescribes medications for an admitted patient:
**For the Doctor:**
1. Open the Inpatient Record
2. Add medications in the **Drug Prescription** section
3. The medications are visible to the nursing team as Inpatient Medication Orders
**For the Nurse:**
1. Go to Healthcare workspace → Reports card → **Inpatient Medication Orders**
2. Filter for today's pending orders for your ward
3. Open each order and mark the dose as given with the time administered
4. If a dose is missed (patient refused, patient was away), record the reason in the notes
***
## Transferring a Patient Between Rooms
If a patient needs to move to a different room or ward:
1. Open the Inpatient Record
2. Click the **Transfer** button
3. Select the new Healthcare Service Unit
4. The previous bed's occupancy record closes and a new one opens for the new location
5. Save
The full movement history (all rooms and dates) is preserved in the **Inpatient Occupancies** table.
***
## Discharging a Patient
When the patient is ready to leave:
### Step 1: Final Consultation
The doctor conducts a final Patient Encounter with:
* Progress summary
* Final diagnosis
* Discharge instructions (home care, diet, medications to continue)
* Follow-up appointment date
### Step 2: Update the Inpatient Record
1. Open the Inpatient Record
2. Fill in the discharge section:
| Field | What to Enter |
| ---------------------- | ------------------------------------- |
| Discharge Practitioner | Doctor authorising the discharge |
| Discharge Encounter | Link to the final consultation |
| Discharge Ordered Date | Date the discharge was ordered |
| Discharge DateTime | Actual date and time the patient left |
| Discharge Note | Summary of the patient's stay |
| Discharge Instructions | What the patient should do at home |
| Followup Date | Date of the next outpatient visit |
3. Submit the Inpatient Record
After submission:
* Patient status changes from Admitted to blank on the Patient record
* **Total Patients Admitted** count decreases
* The bed becomes Vacant and available for the next patient
***
## Field Guide: Inpatient Record
| Field | What It Contains |
| ----------------------- | ---------------------------------------------------- |
| Patient | The admitted patient |
| Medical Department | Department managing the patient |
| Primary Practitioner | Main responsible doctor |
| Secondary Practitioner | Covering doctor |
| Status | Active (admitted), Completed (discharged), Cancelled |
| Admitted DateTime | When the patient arrived |
| Expected Length of Stay | Planned days in clinic |
| Expected Discharge | Planned discharge date |
| Chief Complaint | Main reason for admission |
| Inpatient Occupancies | Table of all bed assignments during stay |
| Drug Prescription | Medication orders for the inpatient stay |
| Discharge DateTime | When the patient actually left |
| Discharge Note | Summary note at discharge |
| Followup Date | Next outpatient appointment |
***
## Troubleshooting
**No beds are available when I try to admit a patient**
All beds in the requested unit are occupied. Check the Healthcare Service Unit tree. If truly full, contact the clinic manager. Do not double-assign a bed.
**The patient's status still shows "Admitted" after discharge**
Check that the Inpatient Record was submitted (not just saved). Submitting the discharge updates the patient's inpatient status.
**A nursing task shows as Pending but the nurse says it was done**
The nurse completed the task physically but did not update the system. Ask the nurse to open the task record and mark it as Completed.
**I cannot discharge the patient because of unbilled services**
The setting "Allow Discharge Despite Unbilled Healthcare Services" is off. The billing team must create and submit invoices for all pending services before the system allows discharge.
***
## Best Practices
* Assign a bed immediately when the patient is admitted - a patient with an Inpatient Record but no bed assignment creates confusion in nursing assignments
* Update medication orders same-day when they change - administering yesterday's outdated order is a patient safety risk
* Review inpatient billing every 2-3 days during a long stay rather than leaving it all to discharge day
* Set the follow-up date at discharge - patients who leave without a follow-up appointment often do not return, leading to incomplete care
* Use the Pre-op and Post-op nursing checklist templates if your clinic performs procedures on admitted patients
***
## Related Features
* [Consultations](/health-wellness/general-clinic/consultations): The Patient Encounter where admission is ordered
* [Laboratory](/health-wellness/general-clinic/laboratory): Lab tests continue during inpatient stay
* [Clinical Procedures](/health-wellness/general-clinic/clinical-procedures): Procedures can be ordered for admitted patients
* [Billing and Finance](/health-wellness/general-clinic/billing-finance): Inpatient billing at discharge