BANGALORE BAPTIST HOSPITAL Page: 1 of 12

DEPARTMENT OPERATING MANUAL Version No: 03

Effective Date :
PM/DOM-03/DERM DERMATOLOGY
01/06/18

TABLE OF CONTENT

Sl No Topic Page No
1 Scope of Department 2

2 Registration process 5

3 Protocol for OPD procedures 6

4 Protocol for inpatient consultations 7

5 Protocol for inpatient admissions 8

6 Maintenance of equipment 9

7 Other activities 10

8 List of associated records 11

Annexure

Role of
Annexure No.I a. HOD
b. Registrar
c. Nursing Aid
Annexure No. II OPD Nursing service manual

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
PM/DOM-03/DERM DERMATOLOGY
01/06/18

1. SCOPE OF THE DEPARTMENT

1.1. Purpose
1.1.1. To provide high quality basic and advanced dermatology care.
1.1.2. To improve diagnosis, treatment and prevention of skin disease.
1.1.3. To increase the number of procedures being performed in the department.
1.1.4. To set up a cosmetic dermatology clinic with the latest treatment facilities.
1.2. Scope
The functions of the department are:
1.2.1. Diagnosis and treatment of all skin, hair and nail diseases, leprosy and sexually
transmitted infections.
1.2.2. To admit patients with serious skin disease and manage then as inpatients.
1.2.3. Treatment of patients with cosmetologic related skin problems.
1.2.4. Performing minor dermatosurgical and cosmetic dermatology procedures.
1.2.5. To participate in National Leprosy Eradication program through early detection and
free treatment of leprosy cases, maintaining their follow up.
1.2.6. To provide Dermatology training to medicine, family medicine and paediatric
residents.
1.3. Facilities and equipments:
1.3.1. The following facilities are available:
a. Phototherapy – UVA / UVB
b. Cryotherapy
c. Electrosurgery
d. Radiofrequency surgery
e. Chemical peeling
f. Microdermabrasion
g. Patch testing for allergy
h. Chemical cautery
i. Skin biopsy
j. Cosmetic procedures – mole removal/ skin tag excision / DPN (dermatoses
papulosa nigra) removal
k. Intralesional injection
l. Fungal scrapings

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
PM/DOM-03/DERM DERMATOLOGY
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m. Hand foot phototherapy

n. Laser Hair Removal
o. Treatment of acne scars with dermaroller
p. Wood’s lamp examination for diagnosis
q. Comedone extraction.
r. Mesotherapy for acne scars and hair loss using PRP.
s. Vitiligo surgery
t. Tricology services
u. Treatment of nail diseases
v. Fractional CO2 laser treatment
w. Special clinics for leprosy & STI
1.3.2. Equipments:
a. Phototherapy chamber – PUVA / UVB
b. Cryogun, Cryocan
c. Microdermabrader
d. High frequency radiosurgery unit.
e. Wood’s lamp
f. Skin biopsy punches
g. Patch testing kit – Indian standard series
h. Computer
i. Hand foot phototherapy chamber
j. Facilities for chemical peeling
k. Facilities for chemical cautery
l. Fractional CO2 laser
1.4. Responsibility
Head of the Department
1.5. Quality Objectives
1.5.1. Complete and continuous care of all patients towards their functional well being.
1.5.2. Accurate diagnosis by performing relevant investigations and accurate treatment
according to latest treatment guidelines.
1.5.3. Constant training for staff to provide up to date and timely patient care.

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
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1.6. Organogram
Director

Deputy Director

HOD Charge Nurse

Team leader
Registrar Jr. Consultant
Staff Nurse

Nursing Aide

House keeping

Note* -For all the general nursing procedures refer OP- nursing department operating manual.

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
PM/DOM-03/DERM DERMATOLOGY
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2. REGISTRATION PROCESS
2.1. The patient registers their charts at MRD Counter either as general or By choice or at PC
Counter.
2.2. The patient is asked to wait outside the skin OPD
2.3. The chart is sent to the skin OPD
2.4. On receiving the chart, the nursing aid puts the department seal on the chart and enters the
time of receival.
2.5. The nursing aid calls the patient according to order of registration
2.6. General patients may be seen by either dermatologist. By choice and PC patients are seen
by the respective consultant.
2.7. Priority is given to private patients, Bychoice, referrals, senior citizens and babies over
other general patients.
2.8. General patients are seen within 2 hours of registration. Bychoice and PC patients within 1
hour of registration.
2.9. The patient is seen by the doctor who takes history, performs clinical examination and
prescribes treatment. Details are entered in the patient’s chart.
2.10. If a procedure is required, it is done on the same day or the patient is given an
appointment at a later date.
2.11. If a patient needs to be seen by another department, he is given a referral slip and asked
to go to the MRD counter and register himself.
2.12. The chart is sent to the respective department by the nursing aid.
2.13. Similarly, if any patient is referred to Dermatology, the receipt is checked by the
nursing aid and the patient is seen.
2.14. The nursing aid enters the patients’ name, age, hospital number, diagnosis, name of the
referring department of the department referred to, in the OPD register
2.15. If a patient is to be admitted, he/she is advised to get the admissions done and the
patient is admitted to the respective ward.
2.16. Then the patient is managed as an inpatient.
2.17. At the time of discharge, a discharge summary is given to the patient by the
Dermatologist.

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DEPARTMENT OPERATING MANUAL Version No: 03
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3. PROTOCOL FOR OPD PROCEDURES:

3.1. If a procedure is to be done, the procedure is entered on the outpatient prescription slip and
the patient is sent to the billing counter to pay the bill.
3.2. The nursing aid enters the receipt number in the respective register.
3.2.1. PUVA Therapy / UVB – PUVA register
3.2.2. Cryotherapy, Procedure register
3.2.3. Skin biopsy – biopsy register
3.2.4. Other procedures – Procedure register
3.2.5. Informed consent is taken by the doctor before all the procedures.
3.2.6. PUVA/UVB therapy is administered by the nursing aid under supervision of the
dermatologist.

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DEPARTMENT OPERATING MANUAL Version No: 03
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4. PROTOCOL FOR INPATIENT CONSULTATIONS:

4.1. The consultation sheet is received by the nursing aid.
4.2. The nursing aid enters the patient name, date, hospital number and ward in the inpatient
consultation register.
4.3. If the patient is mobile, then the patient is made to come to the skin OPD for the required
consultation.
4.4. If the patient is very ill and immobile, then the patient is seen in the ward.
4.5. Non emergency ward consultants to be seen on the same day or within 24 hrs.

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DEPARTMENT OPERATING MANUAL Version No: 03
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5. PROTOCOL FOR INPATIENT ADMISSIONS:

5.1. The doctor decides that the patient requires admission.
5.2. The admission discharge time sheet is entered and the doctors orders sheet is filled by the
doctor. The doctor enters the treatment and investigations, if any.
5.3. The nursing aid hands over the sheet to the medicine OPD nurse to complete the admission
formalities.
5.4. The patient is then sent to the social service department.
5.5. In the ward, the patient is seen by the dermatologist daily and progress notes, doctors
orders are entered. The patient is seen asper hospital policy on assessment and
reassessment of patients.
5.6. At the time of discharge, a detailed discharge summary is given to the patient.

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
PM/DOM-03/DERM DERMATOLOGY
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6. MAINTENANCE OF EQUIPMENT
6.1. If any equipment in the department requires repair or replacement, the details are entered
in the maintenance register. The equipment is taken to the maintenance department by the
nursing aid or the maintenance department is contacted regarding the defect.
6.2. All equipments are checked by the maintenance department every 6 months to ensure that
they are in working condition. Details are entered in preventive maintenance register.

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DEPARTMENT OPERATING MANUAL Version No: 03
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7. OTHER ACTIVITIES:
7.1. The nursing aide keep track of the need for dressing materials, spirit, betadine etc and
replenishes the stock from the stores as and when needed.
7.2. Books, registers, prescription pads, stationary, etc are replenished from the general stores
from time to time.
7.3. Dressing trays, skin biopsy trays, suture removal sets, electrocautery sets are brought from
the central sterile supply department and used sets returned to CSSD by the nursing aid.
Details are entered by the aid in CSSD register.
7.4. For any patient who deserves and requests concession, the prescription and chart are sent
to social worker through the nursing aid. After categorization by the social worker, the
category is written on the prescription and countersigned by the doctor and the prescription
given to the patient to buy medicines from the hospital pharmacy.
7.5. Leprosy cases are given antileprosy drugs free of cost, in the department. Details of stocks
of drugs are maintained in the anti leprosy drug stock register.
7.6. Staff training criteria
New staffs are oriented to the functioning of the department at the time of joining the
department.
7.7. Patient education
Patients are counseled regarding their disease condition and its management and this is
entered in the charts.

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
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8. LIST OF ASSOCIATED RECORDS

8.1. Phototherapy register R/DERM/01
8.2. Procedure register R/DERM/02
8.3. Anti Leprosy drug stock register R/DERM/06
8.4. IP consultation register R/DERM/09
8.5. Inventory Register R/DERM/10
8.6. Leprosy Register R/DERM/11
8.7. Medical School & Clinical register R/DERM/12
8.8. Sexually Transmitted Infections Register R/DERM/14
8.9. CSSD register R/NS/OPD/10
8.10. OPD register R/NS/OPD/16
8.11. Laser Register R/DERM/04
8.12. Lab Register R/NS/DERM/14
8.13. Triage Register R/NS/DERM/15
Forms
8.14. Skin smear form F/DERM/01
8.15. Patch Test Report F/DERM/02
8.16. Leprosy Body Chart F/DERM/03
8.17. Leprosy Comprehensive Assessment Record F/DERM/04
8.18. Phototherapy card F/DERM/05

Signature: Signature:

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DEPARTMENT OPERATING MANUAL Version No: 03
Effective Date :
PM/DOM-03/DERM DERMATOLOGY
01/06/18

Annexure I
1. Role of Head of the department:
a. Responsible to Chief of Medical Staff
b. Responsible for all functions and personnel in dermatology department.
c. Management of daily outpatient clinics
d. Admitting in patients and working up their treatment regimens.
e. Performing procedures on an outpatient basis.
f. Leprosy drug dispensation and examination, maintaining their follow up
g. Managing OPD and ward consultations from all other specialties.
h. Maintenance of all day to day records in the department
i. Impart training in Dermatology to residents, medical students.
j. Keeps track of requirement for new equipments, maintenance of existing equipment and
staffing and communicates the same to the management.
k. Planning capital budget requirement in line with department objective.
l. Submitting department reports and statistics to the Chief of medical staff when required.
m. Conducting and submitting performance appraisals for department staff
n. Participating in meeting as required.
o. Responsible for keeping a check on income-expenditure for the department.
p. Any other duties as assigned by the management.
2. Registrar:
Assists the Head of Department in carrying out department activities
3. Nursing aid:
a. Ensure prompt and timely consultation of patients according to order of registration.
b. Accurate maintenance of department registers.
c. Checking and entry of all patient receipts
d. Responsible for department cleanliness and neatness
e. Maintenance of adequate stocks of dressing materials, antiseptic, stationery and other
general store items and raising timely indents.
f. Ensures prompt sterilization of instruments.
g. Assists the doctor in performing procedures and administering phototherapy
h. Communicates maintenance requirements to the HOD

Reviewed & issued by: Division Head Approved by: Director(CEO)