📘 Essential for GNM/BSc Nursing, NHM, NORCET, AIIMS, GPSC & Community Health Nursing Exams
Referral services are the systematic process of directing a patient from one level of healthcare to a higher level for specialized diagnosis, treatment, or care which cannot be provided at the existing level.
👉 It ensures continuity of care and better outcomes for patients needing advanced services.
✔️ Provide patients with specialized or advanced care
✔️ Ensure timely treatment of complicated conditions
✔️ Reduce morbidity and mortality
✔️ Promote optimum use of health system resources
✔️ Enhance coordination between health centers and hospitals
| 📚 Type | 🔎 Description |
|---|---|
| Primary to Secondary | From Sub-center or PHC to CHC or District Hospital |
| Secondary to Tertiary | From CHC/District Hospital to Medical College or Super-specialty Hospital |
| Lateral Referral | From one specialist to another (e.g., gynecologist to pediatrician) |
| Reverse Referral | From higher center back to lower center for follow-up and rehabilitation |
🔹 High-risk pregnancy
🔹 Complicated labor or cesarean need
🔹 Severe dehydration or pneumonia
🔹 TB, HIV, or cancer cases needing specialized treatment
🔹 Congenital anomalies in children
🔹 Mental health disorders
🔹 Major injuries or fractures
👩⚕️ Identify cases needing referral
👩⚕️ Stabilize the patient before referral
👩⚕️ Document referral details (referral slip, forms)
👩⚕️ Coordinate with ambulance or transport services
👩⚕️ Inform and educate the family
👩⚕️ Follow-up after referral for continuity of care
👩⚕️ Maintain records for future review
📝 Patient’s name and age
📝 Diagnosis or suspected condition
📝 Reason for referral
📝 Treatment given
📝 Date and time of referral
📝 Signature and name of referring nurse or doctor
✅ Prevents complications by ensuring timely intervention
✅ Saves lives in emergency conditions
✅ Improves efficiency and quality of care
✅ Links primary, secondary, and tertiary levels
✅ Avoids overcrowding at tertiary hospitals
🟨 Referral is shifting of patient from lower to higher health center
🟨 High-risk pregnancies must be referred to FRU or tertiary center
🟨 Reverse referral promotes follow-up care at community level
🟨 Referral must be documented using a referral slip or form
🟨 Timely referral reduces maternal and infant mortality
Q1. What is the main purpose of referral services?
🅰️ Home care
🅱️ Nutrition education
✅ 🅲️ Provide higher-level care
🅳️ Disease notification
Q2. From where is a primary to secondary level referral done?
🅰️ Medical college to PHC
✅ 🅱️ PHC to CHC
🅲️ CHC to Subcenter
🅳️ District to village
Q3. Which document is essential during referral?
🅰️ Ration card
🅱️ Aadhar card
✅ 🅲️ Referral slip
🅳️ Immunization card
Q4. What is reverse referral?
🅰️ From lower to higher center
🅱️ From PHC to CHC
✅ 🅲️ From higher to lower center for follow-up
🅳️ Referral to private hospital
Q5. Who is responsible for identifying cases for referral?
🅰️ Anganwadi worker
🅱️ Pharmacist
✅ 🅲️ Community health nurse
🅳️ Clerk
📘 Vital for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC, and Community Health Nursing Exams
📋 Records and Reports are essential tools in community health nursing for maintaining accurate health information, ensuring continuity of care, and supporting planning, evaluation, and policy-making.
👉 They are maintained by ANMs, ASHAs, CHOs, and PHC staff at various levels of healthcare delivery.
✔️ Document health services and care provided
✔️ Monitor individual and community health status
✔️ Evaluate progress of national health programmes
✔️ Ensure legal documentation and accountability
✔️ Facilitate follow-up and referral
✔️ Assist in planning, budgeting, and supervision
| 📑 Record Type | 📝 Purpose |
|---|---|
| Family Folder | Complete record of family profile and health history |
| Eligible Couple Register (ECR) | Tracks reproductive health and contraception use |
| Child Health Card | Immunization, growth, nutrition tracking |
| MCP Card (Mother and Child Protection) | Records antenatal, postnatal, and child care |
| Immunization Register | Documents all vaccine doses given |
| Birth and Death Register | Vital statistics for planning and reporting |
| Home Visit Register | Details of services provided during home visits |
| Nutrition Surveillance Register | Identifies malnutrition and monitors interventions |
| School Health Register | Tracks screening, treatment, and health education of school children |
| Communicable Disease Register | Records of notifiable diseases (TB, malaria, leprosy) |
| NCD Register | Records for diabetes, hypertension, cancer, etc. |
| Referral Register | Details of referred cases and follow-ups |
| TB/Leprosy Register | Case detection, treatment initiation, and follow-up |
| Daily Diary/Register | Routine work done by health workers |
| Sterilization and IUD Register | Tracks family planning procedures |
| 📊 Report Type | 📝 Purpose |
|---|---|
| Monthly Report | Summary of activities (immunization, FP, ANC) |
| Weekly Epidemic Report | Early reporting of outbreaks (e.g., IDSP) |
| Disease Surveillance Report | Tracks communicable diseases (NVBDCP, NTEP) |
| Maternal and Child Health Report | Progress on antenatal, delivery, PNC, child health |
| ASHA Report | Daily/monthly activities by ASHA worker |
| ANM/CHO Reports | Routine field reports to PHC or Block office |
| Birth and Death Report | Vital statistics submitted to higher authorities |
| Referral and Follow-up Report | Details on referred patients and treatment status |
👩⚕️ Maintain complete and accurate records
👩⚕️ Ensure timely reporting to PHC/CHC
👩⚕️ Use standard formats and codes
👩⚕️ Keep records safe and confidential
👩⚕️ Utilize data for community planning and follow-up
✅ Ensure continuity of care
✅ Help in monitoring health programmes
✅ Aid in early detection of epidemics
✅ Serve as legal documents
✅ Support data-driven decisions
🟨 MCP Card tracks mother and child care services
🟨 ECR is vital for family planning services
🟨 Home Visit Register documents services provided at doorstep
🟨 Weekly IDSP report is used for epidemic alerts
🟨 Records must be confidential, accurate, and timely
Q1. Which record is used to track contraceptive use?
🅰️ MCP card
✅ 🅱️ Eligible Couple Register
🅲️ Child Health Card
🅳️ Immunization Register
Q2. Who maintains the Home Visit Register?
🅰️ ASHA
🅱️ PHC Doctor
✅ 🅲️ ANM/CHO
🅳️ Block Health Officer
Q3. What is the purpose of the Nutrition Surveillance Register?
🅰️ Monitor elderly health
🅱️ Register for NCDs
✅ 🅲️ Identify and track malnutrition
🅳️ School dropout list
Q4. Which report is used to detect early outbreaks?
🅰️ Monthly health report
✅ 🅱️ Weekly IDSP report
🅲️ Annual budget report
🅳️ Quarterly progress report
Q5. Which of the following is a vital statistics register?
🅰️ Child Health Card
✅ 🅱️ Birth and Death Register
🅲️ Family Folder
🅳️ Sterilization Register