Professional Documents
Culture Documents
Inpatient DPT PDF
Inpatient DPT PDF
Inpatient wards are for those patient who need treatment under healthcare
personal supervision. Patients are admitted in Inpatient ward for short or long
term depending on severity of their disease.
INPATIENT DEPARTMENT CONSIST
• Nursing station
• ICU, CCU, HDU, OT, Post-operative care & Burns unit
• Pharmacy
• Radiology, Laboratory service
• Beds
• Sanitary Area
• Sluice Room
• Pantry
• Unit store
• Treatment room
• Dinning & Daycare/Recreation
FUNCTIONS OF INPATIENT DEPARTMENT
The IPD forms 33%-50% of the structure of hospital construction and most of the
equipment and staff are in this department with maximum amount of patient care,
training, medical teaching and research concentrated in the department.
FORMS OF INPATIENT WARDS
Nightingale
Rig’s pattern
Modified Rig’s pattern
Racing track ward
‘T’ and ‘Y’ shaped ward
Single straight corridor ward
‘L’ shaped plan
Cruciform plan
‘H’ shaped plan
‘E’ shaped plan
Box plan
Central corridor multiple rib pattern
NIGHTINGALE WARD
It may have side room if isolation room required for privacy and improve condition
Noise pollution
Fatigue of nurses
Less noisy
More nurses required, Costly and difficult to maintain than open ward
COMPONENTS OF WARD UNIT
Nursing station
Ward kitchen/ pantry
Treatment room
Clean and utility area
Doctors duty room
Seminar room
Attendant’s room
Side room laboratory
Locker room
Wheelchair room/ Trolley bay
Physical Facilities related requirement
Sufficient space for carrying out patient care activities with adequate circulation space
Facility should be non-slippery floor, safe electrical fittings, no accidental spot etc to avoid injury
chances
Inter bed distance should be around 6feet
Hand washing area easily accessible to healthcare staff
Accessibility of fire fighting equipment
Crash cart should be kept from where it is easily accessible to healthcare staff.
Patient washroom should have anti skid mats, emergency call button, grab bars, door opening from
outside
Adequate privacy arrangement especially in multi-bed ward
Availability of all necessary patient care equipment
Biomedical waste bins as per BMW rules
Segregated storage area for clean and dirty supplies
Emergency exit route should be displayed
Staffing related requirement
Categories of nurses required to be identified (depending upon the type of ward)
Nurse: Patient ratio to be defined for the ward in each shift
Duty roster to serve as an evidence of nurse patient ratio
Doctor should be available round the clock
Other support staff as required
Ward management related requirement
Linen on patient bed to be changed daily
Periodic cleaning of mattresses pillow and other bed items
Temperature of the refrigerator in which medicine should be checked at-least once in each shift
Crash cart should have life- saving drug and equipment it should be replenished if used
All emergency medicine should be available as per defined quantity
Mechanism for replenishing emergency medicine to be followed
High risk medicine to be identified and stored separately
If the narcotic drugs and psychotropic substance act are temporarily stored it should be under lock and
key. NDPS regulation should be followed.
Reporting adverse patient
List of hazardous material in the ward to be identified material safety data sheet(MSDS).
Bio- medical waste should be segregated as per regulation
Area of ward washroom should be kept neat and clean
Clean supplies and dirty used items should be stored separately
Medical records should be stored as per hospital policy
Security and confidentiality of medical records to be maintained as per hospital’s policy
Maintenance of admission discharge, stock, laundry, adverse incident register is necessary.
Staff awareness related requirements.
Components and time- frame for initial assessment of admitted patients.
Uniform care policy and patient care processes that fall under it
Patient’s rights
Dealing with HIV+ve patients and manufacturing confidentiality
Provision of basic cardiac support
Code blue policy and procedure
Other emergency code(pink code, yellow code, red code etc.)
Identification and care of vulnerable patients
Care of surgical patient/ paediatric patients/ obstetric patient
Proper identification of patient
Safe medication practices(things to check before administration monitoring, verbal orders
administering high risk medicine etc.)
Safe blood transfusion practices
Policy and procedure of patient’s restraint
Pain management policy and protocol
Standard precaution for infection control (hand hygiene, use PPE etc.)
Safe injection practices
Patient safety incidents, its types and reporting(such as near miss, sentinel, adverse drug reaction
etc.)
Emergency evacuation plan
Their role during any disastrous situation
Basic fire safety measures
Quality indicators of wards
Average time for initial assessment of admitted patient and percentage outliner
Incidence of medical errors
Percentage of admission with adverse drug reaction
Percentage of patients receiving high risk medicine and developing adverse drug reaction
Percentage of transfusion reaction
Incidence of bed sore after admissions
Incidence of patient right violation
Incidence of needle stick injuries
Incidence of missing medical records
Percentage of non-compliance observed related to infection control practice
Patient satisfaction rate of the ward
Time taken for discharge
Average Patient : Nurse ratio in each shift
Percentage of current medical record that are incomplete as per hospital policy.
OPERATION THEATRE
Operation theatre is a facility within the hospital in which surgical procedures are carried out in aseptic
environment.
Operating rooms are spacious, easy to clean, and well-lit, typically with overhead surgical lights, and may
have viewing screens and monitors. Operating rooms are generally windowless and feature controlled
temperature and humidity. Special air handlers filter the air and maintain a slightly elevated pressure.
Electricity support has backup systems in case of a black-out. Rooms are supplied with wall suction,
oxygen, and possibly other anesthetic gases. Key equipment consists of the operating table and
the anesthesia cart. In addition, there are tables to set up instruments. There is storage space for common
surgical supplies. There are containers for disposables. Outside the operating room is a dedicated
scrubbing area that is used by surgeons, anesthetists, operating department practitioners, and nurses prior
to surgery. An operating room has a map to enable the terminal cleaning staff to realign the operating table
FUNCTIONS ERGOMETRIC or
WORK FLOW
LOCATION
SIZE Space free movement of staff,
NO. OF OTS
patients, supplies
GROUPING OF OTS
ZONING
EQUIPMENT
INSTALLATION
PLANNING
FFFFpLFFFFp
CRITEREA
TECHNICHAL ENVIRONMENT
• OT Staff • Lighting
• Functional Area • Air conditioning
• Preparation of • Ventilation
Patient • Water supply
• Sterilization unit • Fire safety
• Scrub station • Plumbing
• Designing & • Clothing
finishing
NUMBER OF OTS
No. of OTs= One OT unit for 50 surgical beds
No. of Operation/day= No. of Surgical bed
Average length of stay surgical patient
No. of operations/day= No. of surgical beds x % bed occupancy x 365
ALS x 100 x No. of working OT day
The number of operation per suit should not exceed 06 per day or 8 to 10hr
per day
Zoning of OTs
Protective
zone Clean zone
Zoning
Disposal Aseptic
zone zone
ZONING OF OPERATION THEATRE
CLEAN ZONE
• Preparation of patient
• Recovery room
• Theatre work room
• X-ray plaster room
• Sister room
PROTECTIVE ZONE • Anesthetist room
• Patient waiting area &
reception STERILE ZONE
• Trolley bay • Operating suit
• Lift ZONING of OT • Scrub room
• Stairs • Anesthesia room
• Switch • Instrument trolley
• Pre anesthesia room area
• Changing room
• Store room DISPOSAL ZONE
• Dirty room
• Disposal room
• Janitor corridor
PROTECTIVE ZONE
Reception, patient identification & case sheet check
Waiting area for relatives
Changing room for OT staff & surgeon
Pre-anesthesia room
Store room, trolley boy
Autoclaves
Record & controller room
OT in charge, electricity control
Seminar & meeting room
Entrance to observation gallery
CLEAN ZONE
Patient preparation room
Recovery room
Plaster room, blood storage, frozen section
Work room for doctors, sisters
Nurses duty room
Anesthesia room
Equipment room, drugs, linins, X-ray board
Clean closet, telephone & fire fighting equipment
STERILIZATION OF OPERATION THEATRE
Immediate pre- operative checkup before wheeling in patient in operation room from pre-
operative ward.
Narcotic to be stored as per regulation (under lock and key, record maintenance etc.)
Look alike, sound alike medicine to be stored separately as per hospital policy
Multi- use open vials to have a label of date of opening and expiry
All high risk materials should be identified listed and material safety data sheet(MSDS) for
Reception of Supportive
Administrative
patient services
PHYSICAL FACILITIES
Each operation room should be monitored for humidity and temperature on daily basis
All area in OT should be kept clean from dust all the time
Regular environmental surveillance for microbes to be done in each OT and other area to
identify forming of any colonies of bacteria.
Segregation of route of biomedical waste movement if this is not possible time of BMW
should be different from time of staff and clean supplied movement.
Awareness of OT Staff
Prevent needle injuries
Patient rights
Dealing with HIV+ve patient
Isolation requirement of patient
Various emergency coloures codes followed in hospital
Safe injection practices
Patient safety incidents its types and reporting (such as near miss, sentinel, adverse drug
reaction)
Emergency evacuation plan
Their role during any disastrous situation
Quality indicators of OT
Quality Indicators for OT and Surgeries
Compliance percentage to environmental norms( temperature, humidity)
Percentage compliance to WHO surgical safety checklist
Percentage of unplanned returns to OT
Percentage of re-scheduling of surgeries
Percentage of re- exploration of surgical site
Percentage of unplanned ventilation following anaesthesia
Percentage of modification of anaesthesia plan
Percentage of adverse anaesthesia events
Anaesthesia related mortality rate
OT ADMINISTRATION
Operation theatre committee
Each unit must have from 4-7 OT staff
i. Chief Surgeon
ii. OT. Assistant
iii. Chief Anesthetist
iv. Anesthesia assistant
v. Scrub nurse
vi. Anesthesia nurse
vii. Circulating nurse
viii. OT Nurse for assisting
ix. Attendant, House keeping, OT technicians
STAFF
Theatre superintendent
Maintain cleanliness
Asepsis
Equipment in working order
Adequate stock of consumables & instruments
Finalize operation schedules
Trained nurses
Two nurses per table
Special training for pediatric, cardiac, neuro surgery
Recovery room nurse patient ratio 1:1
Theatre assistant
Preparation of trolley
Packing instruments, gloves, gowns
Coordinating supply of sterilized item from CSSD
Arrange for transportation of patient from ward to theatre & back
Labour staff
Cleaning segregation
Taking blood/biopsy sample to laboratory
ADMINISTRATION OF OT
Monitoring of OT asepsis
Once a week maintenance