Teaching

on
REFERRAL SERVICES

Mr.mahendra singh
lecture , Jcn
 MEANING OF REFERRAL

The practice of sending a patient to another

program or practitioner for services or advice
which the referring source is not prepared to
provide.
 DEFINITION
 The system in which the patient is
send from the health Centre having
fewer amenities to the health
institution or treatment Centre, which
has more resources ,facilities and
amenities, is called referral system.
 REFERRAL PROCESS

The referral process is a systematic problem

solving approach involving series of action that
help clients use resources for the purpose of
resolving needs.
 IMPORTANCE OF REFERRAL SYSTEM
 Providing diagnostics service to patient and community

 Providing specialty services to the patient

 Providing the purposes of referral system among health

worker

 Teaching the nursing personnel for reviewing of patients

sent for referral

 Preventing further complication and for appropriate

treatment
 PRINCIPLES OF REFERRAL SERVICES

 It should meet the needs and objectives of the client

and should be necessary and appropriate. There
should be merit in referral.
 The client should use of referral services in effectively
and efficient manner.
 It should be practice.
 It should be individualized to the client.
 It should be timely.
 PRINCIPLES OF REFERRAL SERVICES

 It should be coordinated with other agencies.

 The referral should incorporate the client and

family into planning and implementation.

 To referral services should have the right to refuse

the referral.
 SELECTION OF THE PATIENT FOR
REFERRAL
Which patient should be sent for referral or what should

be the basis of patient by referral system . This depends

upon the resources available in the health Centre and the

condition of the patient .such patients can be divided into

three Categories.
CONT.….

1. First group or fatal patient

2. Second group or serious patient

3. Third group or general patient

CONT.
 FIRST GROUP Or FATAL PATIENT :-
such patients can not survive despite the best
treatment made available to them. So, to send them
for treatment is the waste of time and money hence
it is better to give them appropriate treatment at the
health Centre itself with available resources.
CONT.
SECOND GROUP OR SERIOUS
PATIENT:-
Condition of such patients is considered serious but

immediate treatment can save their lives , so before

sending them for referral ,attempts should be made

to reduce the seriousness of condition and only after

that they should be sent for referral.

CONT.….
THIRD GROUP OR GENERAL
PATIENT
Though the disease may be serious in such
patients still the condition of the patient is
found to be normal delayed treatment may not
threaten his life .such patients can be
immediately sent for referral. Similarly after the
surgery or in case diagnosis is not possible
 DIFFERENT LEVEL OF REFERRAL SERVICES

1. Primary level (first contact level) with a health

centre (smaller health centers may be called
dispensaries, health stations, health posts)
serving a defined community or area – normally
several villages (at a single village level, at best
there might be some community or auxiliary
health workers).
 DIFFERENT LEVEL OF REFERRAL SERVICES

2. First referral level – Normally a district hospital

that is a recognized referral facility providing a 24-
hour intramural medical care which represents a
higher level of competence than the source of
referral, e.g. health centre. It may be very small
with just few beds.
 DIFFERENT LEVEL OF REFERRAL SERVICES

3. Secondary referral level – A more sophisticated

hospital (may be a provincial hospital) providing
multi-specialist intra- and extramural care, and
serving as a backstop for the first referral
hospitals in the hierarchy of technical
competence.
 DIFFERENT LEVEL OF REFERRAL SERVICES

4. Last referral level – A most sophisticated hospital

located in a national or provincial capital or other
big city, typically a University Teaching Hospital,
providing the highest level of medical care
available in the country or a region.
 FAMILY REFERRAL SERVICE

Family Referral Services assist children and young

people who do not meet the statutory (legal)
threshold for child protection intervention but
would benefit from accessing support to address
current problems and prevent its growth.
 ROLE OF NURSE
The Nurse should aware about….
 Address and telephone number of the client.

 Client age, sex and marital status.

 Name, and birth date of the family member and significant.

 Source of medical and health history.

 Financial status and records.

 Research with whom client presently works.

 Reason for seeking reform.

 ROLE OF NURSE

Steps
1. Establish a working relationship with the client.
2. Established the needs of referral.
3. Set the objectives of referral.
4. Explore resource availability.
5. Client decides to use or not use referral services.
6. Make referral to resources.
7. Facilitate a referral.
8. Evaluate and follow up.
 BARRIER OF REFERRAL SERVICES

1. Resource barrier

 Attitude of health care professional.

 Physical accessibility of resources.

 Cost of resources services.

 BARRIER OF REFERRAL SERVICES
2. Client barrier
• Priorities.
• Motivation.
• Previous experience with resources.
• Lack of knowledge about available resources.
• Lack of understanding about need of the referral.
• Client self image.
• Cultural factor.
• Finance.
• Accessibility.
 Summary
and
Conclusion
 ASSIGNMENT

What are the requirement for developing

PHC in first referral unit?
 Any
Question