> ## Documentation Index
> Fetch the complete documentation index at: https://help.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Ward admissions

> Find a free bed, admit a patient onto the ward, and run their chart — observations, the drug round and inpatient orders.

export const AuditNote = ({action = 'This action'}) => <div className="ck-callout ck-callout--info" role="note">
    <p className="ck-callout__body">
      {action} is written to your workspace's audit log with your name, the
      record touched and the time — a HIPAA requirement, and one you can review
      yourself under <strong>Audit Log</strong>. See{' '}
      <a href="/platform/security/audit-log">Audit log</a>.
    </p>
  </div>;

export const StillStuck = ({topic}) => <div className="ck-callout ck-callout--note" role="note">
    <p className="ck-callout__body">
      <strong>Still stuck{topic ? ` with ${topic}` : ''}?</strong>{' '}
      Check <a href="/platform/help/troubleshooting">Troubleshooting</a> first —
      it covers the failures we see most often. If that does not resolve it,{' '}
      <a href="/platform/help/contact-support">contact support</a> and include
      your workspace name and the time the problem happened, so we can find the
      matching entry in your audit log.
    </p>
  </div>;

export const TaskHeader = ({before, time, after}) => <div className="ck-task">
    {before ? <div className="ck-task__cell">
        <div className="ck-task__title">Before you start</div>
        <p className="ck-task__body">{before}</p>
      </div> : null}

    {time ? <div className="ck-task__cell">
        <div className="ck-task__title">Takes about</div>
        <p className="ck-task__body">{time}</p>
      </div> : null}

    {after ? <div className="ck-task__cell">
        <div className="ck-task__title">When you're done</div>
        <p className="ck-task__body">{after}</p>
      </div> : null}
  </div>;

export const Path = ({steps = []}) => <span className="ck-path">
    {steps.map((s, i) => <span key={i} className="ck-path__step">
        {i > 0 ? <span className="ck-path__sep" aria-hidden="true">
            ›
          </span> : null}
        {s}
      </span>)}
  </span>;

export const Availability = ({editions = ['all'], plans, roles, note}) => {
  const list = editions.includes('all') ? ['clinic', 'pharmacy', 'lims'] : editions;
  return <div className="ck-avail" role="note" aria-label="Feature availability">
      <span className="ck-avail__label">Available in</span>

      {list.map(e => <span key={e} className={`ck-pill ck-pill--${e}`}>
          {EDITION_LABELS[e] || e}
        </span>)}

      {plans ? <span className="ck-avail__label">Plan</span> : null}
      {plans ? <span className="ck-pill ck-pill--plan">{plans}</span> : null}

      {roles ? <span className="ck-avail__label">Who</span> : null}
      {roles ? <span className="ck-pill ck-pill--role">{roles}</span> : null}

      {note ? <span className="ck-avail__note">{note}</span> : null}
    </div>;
};

<Availability editions={['clinic']} plans="Enterprise" roles="Doctors and nurses" note="Needs the In-patient care area" />

**Ward Admissions** is the bed map for your hospital: who is in which bed, and what is happening to them. From here you admit a patient, record their observations, run the drug round and place inpatient orders.

<Path steps={['Sidebar', 'Inpatient', 'Ward Admissions']} />

<TaskHeader before="Wards, sub-wards and beds created in Settings" time="About a minute to admit" after="A patient occupying a bed, with a live chart against their stay" />

## Before you start

The **In-patient care** area must be switched on in **Settings → Facility**, or the whole **Inpatient** group is absent from the sidebar — see [Care areas](/hospital/get-started/care-areas). At least one ward, sub-ward and bed must exist; create them under [Wards and beds](/hospital/get-started/wards-and-beds).

## What you're looking at

The page walks four states in order, and you cannot skip one.

| Step                 | What you see                                                  |
| -------------------- | ------------------------------------------------------------- |
| 1. Choose a ward     | The ward cards, under **Select a ward to view its sub-wards** |
| 2. Choose a sub-ward | Until you do, the panel reads **Select a ward first**         |
| 3. Ward statistics   | Occupancy for the sub-ward you picked                         |
| 4. The bed grid      | One card per bed, occupied or free                            |

A brand-new hospital sees **No wards available** with **Please contact your administrator** underneath. That is a settings job, not a ward job.

Selecting a bed card opens the **Bed \{number} Details** dialog, where the detail lives: **Admitted**, **Diagnosis**, **Attending Doctor**, **Notes** and **Last Updated**. The grid stays deliberately sparse so an empty bay is obvious from across the room.

## Admit a patient

Admission starts from the consultation that decided the patient needs a bed, not from this page.

<Steps>
  <Step title="Select Admit Patient on the consultation">
    Open the patient's [consultation](/hospital/outpatient/consultation) and select **Admit Patient**. A bed picker opens and walks the same ward → sub-ward → bed order as the admissions page.
  </Step>

  <Step title="Choose the bed">
    Select a free bed. Only beds in the sub-ward you picked are offered.
  </Step>

  <Step title="Fill in Admission Details">
    Enter the **Admission Summary**, the **Patient Diagnosis** and the **Patient Status**. This is what every colleague reads first on the bed grid, so write it for them rather than for the record.
  </Step>

  <Step title="Select Admit Patient">
    You get **Patient admitted successfully**, and the bed fills on the grid.
  </Step>
</Steps>

## Record observations

From an occupied bed, **Record Patient Vitals** opens a dialog in four sections — **Vital Signs**, **Measurements**, **Blood Sugar** and **Status**, which carries a **Triage Status** select. **Save Vitals** files them against the stay, and they appear on the chart's **Flowsheets** tab.

Only doctors and nurses may record observations. Anyone else is told **Only doctors and nurses can record vitals**.

## Read the ward chart

Opening an occupied bed opens the inpatient chart. Its tabs are:

**SnapShot · Flowsheets · MAR · Orders · Notes · Results · Care History · Problem List · Care Plan · Medications · History · Media**

<Note>
  Two pairs of names look alike and are not. **Care History** is the running record of *this* stay; **History** is the structured past history — conditions, surgeries, family history — that a provider entered. Likewise the **Problem List** belongs to the *patient* and follows them between admissions, while the **Care Plan** belongs to *this admission* and ends with it.
</Note>

A badge next to the patient's name states the stay in both directions — **Admitted**, **Discharged**, or **Admission date not recorded** — and the line under it reads ward · bed · **Day 3**.

The header carries four actions in a deliberate order: **Discharge** leftmost and never primary, then **Notes**, then **New order**, with **Record obs** in the primary slot. The frequent, safe action is where your thumb lands; the irreversible one is not.

<AuditNote action="Opening an inpatient chart" />

## Run the drug round

The **MAR** tab is the drug chart. For each due dose you can do one of three things:

| Action               | What happens                                                                                                                       |
| -------------------- | ---------------------------------------------------------------------------------------------------------------------------------- |
| Give it              | A confirm dialog asks **Record this dose as given?** and states that it is recorded against your name. Select **Record as given**. |
| **Hold this dose**   | Requires a reason before it will save                                                                                              |
| **Record a refusal** | Requires a reason before it will save                                                                                              |

<Warning>
  A hold or a refusal with no reason is a patient-safety gap: "A blank hold is indistinguishable from a missed dose." ClinikEHR will not accept either without one, and the entry carries your name permanently.
</Warning>

**Edit schedule** opens the schedule sheet for a drug. A **Needs scheduling** band above the grid catches active drugs that have no schedule at all — without it an unscheduled drug is invisible, and a blank grid reads as "nothing due".

Read the two empty messages carefully, because they mean different things:

* **No doses due in this window.** — the drug is active; nothing falls in this window.
* **No doses in this window — this drug is no longer generating any.** — the drug has been stopped.

### Claiming the round

**Claim this round** reserves that patient's outstanding doses for the device you are holding, so you can keep recording if the signal drops and so a second nurse cannot give the same dose elsewhere. **Hand back** releases it. A round claimed by someone else shows amber with no way to take it — give from the device that holds it, or ask an owner or manager to release it. As-needed (PRN) doses always need a connection, because their daily maximum is counted as each one is recorded.

## Order for an inpatient

**New order** opens a tabbed sheet. Where it cannot be used it disables itself and says why: **This stay has ended — nothing further can be ordered against it**, or **Ordering needs a connection**. Observations and notes carry on offline; ordering and discharge do not, and an amber banner explains that a bed is a shared resource. See [Working offline](/platform/apps/offline).

## Who can do this

Opening the ward at all is decided by your **role**, and by whether an owner has hidden the **Inpatient** group from that role under [Role navigation](/hospital/settings/role-navigation). What you may *do* once inside is decided by **permissions**, granted per person:

| Action                              | Who by default     | Permission                      |
| ----------------------------------- | ------------------ | ------------------------------- |
| Admit a patient from a consultation | Clinicians         | **Admit a patient to a ward**   |
| Record observations                 | Doctors and nurses | **Record observations**         |
| Give, hold or refuse a dose         | Doctors and nurses | **Give a medication**           |
| Change or stop a drug on the chart  | Prescribers        | **Change or stop a medication** |
| Amend the problem list              | Clinicians         | **Amend the problem list**      |
| Discharge a patient                 | Clinicians         | **Discharge a patient**         |

Enforcement is **opt-in per person** — anyone never saved in the permissions sheet is unrestricted, and the sheet warns **"Saving starts enforcing"**. A **denied action is recorded** in the audit log while an allowed one is not, so hiding the group from a role is a convenience, not a security boundary. See [Staff permissions](/platform/team/permissions).

## Check it worked

* The patient occupies the bed on the grid, with the diagnosis and attending clinician you entered.
* Saved observations appear on the chart's **Flowsheets** tab.
* A recorded dose shows as given on the **MAR** grid, against your name.

## Common issues

<AccordionGroup>
  <Accordion title="No beds appear">
    You have picked a ward but not a sub-ward — the panel says **Select a ward first**. The grid only builds after the second choice.
  </Accordion>

  <Accordion title="No wards available — Please contact your administrator">
    No wards exist yet. An owner creates them under **Settings → Ward Management**; see [Wards and beds](/hospital/get-started/wards-and-beds).
  </Accordion>

  <Accordion title="Only doctors and nurses can record vitals">
    Recording observations is restricted by role, and can also be granted per person. Ask an owner or manager.
  </Accordion>

  <Accordion title="The MAR grid is empty but the patient is on drugs">
    Look at the **Needs scheduling** band above the grid — an active drug with no schedule produces no doses at all. Select **Edit schedule** to give it one.
  </Accordion>

  <Accordion title="The round is claimed by someone else">
    Give from the device holding the round, or ask an owner or manager to release it. There is deliberately no way to take a live claim, because two nurses giving the same dose is exactly what claiming prevents.
  </Accordion>

  <Accordion title="New order is disabled">
    Hover it for the reason. Either the stay has already ended — **This stay has ended — nothing further can be ordered against it** — or you are offline, and **Ordering needs a connection**.
  </Accordion>
</AccordionGroup>

## FAQ

<AccordionGroup>
  <Accordion title="Can I admit a patient without a consultation?">
    No. Admission starts from the consultation that decided a bed was needed, so the reason for the stay is always attached to it. Open a consultation first.
  </Accordion>

  <Accordion title="Does the Problem List reset when the patient goes home?">
    No. It belongs to the patient and follows them into their next admission. The **Care Plan** is the one that ends with the stay.
  </Accordion>

  <Accordion title="What happens to a claimed round if I go home with it?">
    A claim covers the next few hours and expires on its own, so a flat trolley never blocks a ward overnight. An owner or manager can release one sooner.
  </Accordion>

  <Accordion title="Where do I review a stay after the patient leaves?">
    Under [Ward discharges](/hospital/inpatient/discharges), which keeps the whole stay — timeline, consultations, nursing notes, prescriptions, lab tests, services, radiology and vitals.
  </Accordion>
</AccordionGroup>

<StillStuck />