IPHS For 31 To 50 Bedded With Comments of Sub Group PDF
IPHS For 31 To 50 Bedded With Comments of Sub Group PDF
IPHS For 31 To 50 Bedded With Comments of Sub Group PDF
GUIDELINES
(January 2007)
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Contents
1. Introduction 3
2. Objectives of IPHS for Sub-District Hospitals 4
3. Definition of Sub-District Hospital 4
4. Categorizing of Sub-District Hospital 4
5. Functions 5
6. Essential Services 5
7. Physical Infrastructure 25
8. Manpower 35
9. Equipment 38
10. Laboratory Services 48
11. Recommended allocation of bed strength at various levels 51
12. List of Drugs 52
13. Capacity Building 64
14. Quality Assurance in Services 64
15. Rogi Kalyan Samities / Hospital Management Committee 65
16. Citizen’s Charter 65
List of Abbreviations 83
References 84
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1. Introduction
Sub-district (Sub-divisional) hospitals are below the district and above the block level
(CHC) hospitals and act as First Referral Units for the Tehsil /Taluk /block population in
which they are geographically located. Specialist services are provided through these sub-
district hospitals and they receive referred in cases from neighboring CHCs. These
hospitals should play an important referral link between the Community Health Centres,
Primary Health Centres and sub-centres. They have an important role to play as First
Referral Units in providing emergency obstetrics care and neonatal care and help in
bringing down the Maternal Mortality and Infant Mortality. It also saves the travel time
for the cases needing emergency care and reduces the workload of the district hospital. In
some of the states, each district is subdivided in to two or three sub divisions. A
subdivision hospital caters to about 5-6 lakhs people. In bigger districts the sub-district
hospitals fills the gap between the block level hospitals and the district hospitals. There
are about 1200 such hospitals in the country with a varying strength of number of beds
ranging from 50 to 100 beds or more.
The Government of India is strongly committed to strengthen the health sector for
improving the availability, accessibility of affordable quality health services to the
people. In order to improve the quality and accountability of health services a set of
standards need to be there for all health service institutions including sub-district
hospitals.
Standards are a means of describing the level of quality that health care organizations are
expected to meet or aspire to. The key aim of standard is to underpin the delivery of
quality services which are fair and responsive to client’s needs, which should be provided
equitably and which deliver improvements in health and well being of the population.
Standards are the main driver for continuous improvements in quality. The performance
of Sub-district hospitals can be assessed against a set of standards.
There has been effort to set standards for 30 and 100 bedded hospitals by the Bureau of
Indian Standards (BIS). However, these standards are considered very resource intensive
and lack the process to ensure community involvement, accountability and citizens
charter issues that are important for public hospitals.
Under the National Rural Health Mission (NRHM), the concept of Indian Public Health
Standards (IPHS) for the Health Centres/ Hospitals functioning in the country. IPHS for
CHC, PHC and Sub-centres have been finalized available on the ministry’s website
www.mohfw.nic.in.
The current effort is to prepare Indian Public Health Standards for the Sub-district
Hospitals. Reference has been made to the BIS Standard for 100 bedded hospitals;
Rationalisation of Service Norms for Secondary Care Hospitals prepared by Govt. of
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Tamil Nadu; District Health Facilities, Guidelines for Development and Operations,
WHO, 1998 and Indian Public Health Standards (IPHS) for Community Health Centres.
Setting standards is a dynamic process. This document contains the standards to bring the
Sub-district Hospitals to a minimum acceptable functional grade with scope for further
improvement in it. These standards are flexible as per the requirements and resources
available to the concerned State/UT Government. The timeframe for implementation and
achievement of these Standards could be extended for five years and to be done in
phases.
Most of the existing hospitals below district level (31-50 Bed category) are located in
older buildings in urbanized areas / towns as compared to most Primary Health Centres /
Sub-centres. The expansions already done have resulted in construction touching the
boundaries walls with no scope of further expansions. As far as possible, States should
not dislocate the said hospitals to a new location (in case of dislocating to a new location,
the original client group will not be able to have same access to the desired health
facilities)
The overall objective of IPHS is to provide health care that is quality oriented and
sensitive to the needs of the people of the district. The specific objectives of IPHS for
Sub District Hospitals are:
The term Sub District / Sub Divisional Hospital is used here to mean a hospital at the
secondary referral level responsible for the Sub District / Sub Division of a defined
geographical area containing a defined population.
The size of a sub district hospital is a function of the hospital bed requirement, which in
turn is a function of the size of the population it serves. In India the population size of a
sub district varies from 1,00,000 to 5,00,000. Based on the assumptions of the annual rate
of admission as 1 per 50 populations and average length of stay in a hospital as 5 days,
the number of beds required for a sub district having a population of 5 lakhs will be
around 100-150 beds. However, as the population of the sub district varies a lot, it would
be prudent to prescribe norms by categorizing the size of the hospitals as per the number
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of beds. For the purpose of classification, we have arbitrately leveled Sub-district
Hospitals as Category-I (31-50) and Category II (51-100). We presume that above 100
beds strength, health care facility will constitute District Hospital Group.
The minimum functional requirement of sub district hospitals (31-50 bedded) is given as
under.
5. Functions
2. Function as a referral centre for the public health institutions below the tehseel /
taluka level such as Community Health Centres, Primary Health Centres and Sub-
centres.
Secondary level health care services regarding following specialties will be assured at
hospital:
General Medicine
General Surgery
Obstetric & Gynecology
Pediatrics
Anesthesia
Orthopedics
ENT
Radiologist and Ultrasonologist
Ophthalmology
Community Health
Dermatology and Venerology (Skin & VD) RTI/STI
Dental care
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AYUSH
♦ Finance*
♦ Medico legal/postmortem
♦ Ambulance services
♦ Dietary services
♦ Laundry services
♦ Security services
♦ Housekeeping and Sanitation
♦ Inventory Management
♦ Waste management
♦ Office Management (Provision should be made for computerized medical records
with anti-virus facilities whereas alternate records should also be maintained)
♦ Counseling services for domestic violence, gender violence, adolescents, etc.
Gender and socially sensitive service delivery be assured.
* Financial accounting and auditing be carried out as per the rules along with timely
submission of SOEs/UCs.
MEDICAL
1 Pleural Aspiration
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2 Lumbar Puncture
3 Skin scraping for fungus / AFB
4 Skin Biopsies
5 Abdominal tapping
OPD Procedures (Including IPD)
1 Dressing (Small, Medium and Large)
2 Injection (I/M & I/V)
3 Catheterisation
4 Steam Inhalation
5 Cut down (Adult)
6 Enema
7 Stomach Wash
8 Douche
9 Sitz bath
10 Blood Transfusion
11 Hydrotherapy
12 Bowel Wash
Skin Procedures
1 Chemical Cautery
2 Electro Cautery
3 Intra Lesional Injection
4 Biopsy
Paediatric Procedures
1 Immunization (BCG, OPV, DPT, Measles, DT) / CH/ORT corner
Services related to new borne care + All procedures as mentioned in
2
Medical
2.1 - only cradle
2.2 - Incubator Nebulization equipment
2.3 - Radiant Heat Warmer
2.4 - Phototherapy
2.5 - Gases (oxygen)
2.6 - Cut down
Cardiology Procedures and Diagnostic Tests
1 ECG
2 Defibrillator Shock
Physiotherapy Services
1 With Electrical Equipments
1.1 - Short wave diathermy
1.2 - Ultra Sonic Therapy
1.3 - Infra Red Lamp (Therapy)
1.4 - Electric Vibrator
Eye Specialist Services (Opthalmology)
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1 OPD Procedures
Refraction (by using snellen’s chart)
1.1
Prescription for glasses using Trial frame.
1.2 - Syringing and Probing
1.3 - Foreign Body Removal (conjunctival)
1.4 - Foreign Body Removal (Corneal)
1.5 - Epilation
1.6 - Suture Removal
1.7 - Subconj Injection
1.8 - Retrobular Injection (Alcohol etc.)
1.9 - Tonometry
1.10 - Pterygium Excision
1.11 - Syringing & Probing
1.12 - I & C of chalazion
1.13 - Stye
1.14 - Conjuctival Resuturing
1.15 - Corneal Scraping
1.16 - I & D Lid Abscess
1.17 - Uncomplicated Lid Tear
1.18 - Indirect Opthalmoscopy
1.19 - Retinoscopy
Obstetric & Gynecology Specialist Services
1 Episiotomy
2 Forceps delivery
3 Craniotomy-Dead Fetus/Hydrocephalus
4 Caesarean section
5 Female Sterilization ( Mini Laparotomy & Laparoscopic)
6 D&C
7 MTP
8 Bartholin Cyst Excision
9 Suturing Perineal Tears
10 Assisted Breech Delivery
11 Cervical Cautery
12 Normal Delivery
13 E U A
14 Retained Placenta & MRP
15 Suturing Cervical Tear
16 Assisted Twin Delivery
Dental Services
1 Dental Caries/Dental Abcess/Gingivitis
2 Minor Surgeries, Impaction, Flap
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3 Trauma including Vehicular Accidents
4 Sub Mucus Fibrosis (SMF)
5 Scaling and Polishing
6 Root Canal Treatment
7 Extractions
8 Amalgum Filling (Silver)
9 Intra oral X-ray
10 Complicated Extractions (including suturing of gums)
SURGICAL
1 Abcess drainage including breast & perianal
2 Wound Debridement
3 Appendicectomy
4 Fissurotomy or fistulectomy
5 Hemorrohoidectomy
6 Circumcision
7 Hydrocele surgery
8 Herniorraphy
9 Suprapubic Cystostomy
10 Vasectomy
11 Cysts and Benign Tumour of the Palate
12 Excision Submucous Cysts
Breast
1 Excision fibroadenoma – Lump
Hernia
1 Ingunial Hernia repair reinforcement
2 Femoral Hernia repair
3 Strangulated Ventral or Incisional Hernia/Ingunial
Abdomen
1 Exploratory Laparotomy
2 Gastrostomy or Jejuncstomy
3 Simple Closure of Perforated Ulcer
Pancreas
1 Drainage of Pseudopancreatic Cyst
2 Retroperitoneal Drainage of Abscess
Appendix
1 Emergency Appendisectomy
2 Interval Appendisectomy
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3 Appendicular Abscess Drainage
Small Intestine
1 Resection and Anastomosis
2 Multiple Resection and Anaestomosis
3 Intestinal Performation
Liver
1 Open Drainage of liver abscess
2 Drainage of Subdia, Abscess/Perigastric Abscess
Biliary System
1 Cholecystostomy
2 Cholecystectomy
3 Cholecystectomy and Choledocholithotomy
Colon, Rectum and Anus
1 Fistula in anus low level
2 Catheters
3 IV Sets
4 Colostomy Bags
5 Fistula in ano high level
6 Perianal Abscess
7 Ischiorectal Abscess
8 Ileostomy or colostomy alone
9 Haemorroidectomy
10 Anal Sphincter Repair after injury
Penis, Testes, Scrotum
1 Circumcision
2 Partial amputation of Penis
3 Total amputation of Penis
4 Orchidopexy (Unilateral & Bilateral)
5 Orchidectomy (Unilateral & Bilateral)
6 Hydrocele (Unilateral & Bilateral)
7 Excision of Multiple sebaceous cyst of scrotal skin
8 Reduction of Paraphimosis
Other Procedures
1 Suture of large laceration
2 Suturing of small wounds
3 Excision of sebaceous cyst
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4 Small superficial tumour
5 Repair torn ear lobule
6 Incision and drainage of abscess
7 Injection Haemorrhoids/Ganglion/Keloids
8 Removal of foreign body (superficial)
9 Removal of foreign body (deep)
10 Excision Multiple Cysts
11 Tongue Tie
12 Debridment of wounds
13 Excision carbuncle
14 Ingroving Toe Nail
15 Diabetic Foot And carbuncle
Urology
1 Pyelolithotomy
2 Nephrolithotomy
3 Uretrolithotomy
4 Open Prostectomy
5 Cystolithotomy Superopubic
6 Dialatition of stricture urethra under GA
7 Dialation of stricture urethra without anaesthesia
8 Meatotomy
9 Trocar Cystostomy
Plastic Surgery
Burn Dressing Small, medium (10% to 30%), large 30% to 60%, extensive >
1
60%
2 Ear lobules repair one side
3 Simple wound
4 Complicated wound
5 Simple injury fingers
6 Crush injury hand
7 Polio Surgery
8 Surgery concerning disability with Leprosy
9 Surgery concerning with TB
Orthopaedic Surgery
1 Fractures
Open reduction int, fixation of femur, tibia, B. Bone, Forearm Humerus
1.1
inter-condylar fracture of humerus and femur and open reduction and int.
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Fixation bimaleolar fracture and fracture dislocation of ankle montaggia
fracture dislocation
Medial condyle of humerus fracture lateral condyle of humerus Olecranen
1.2 fracture, head of radius lower end of radius, medial malleolus patella fracture
and fracture of calcaneum talus single forearm, bone fracture
1.3 Ext. fixation of hand & foot bones
Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula,
1.4
lower and of Inia
1.5 Interlocking nailing of long bones
1.6 Debridement & Secondary closure
1.7 Percutaneous Fixation (small and long bones)
2 Closed Reduction
2.1 Hand, Foot bone and cervicle
2.2 Forearm or Arm, Leg, Thigh, Wrist, Aknle
2.3 Dislocation elbow, shoulder, Hip, Knee
2.4 Closed Fixation of hand / foot bone
3 Open Reduction
3.1 Shoulder dislocation, knee dislocation
3.2 Acromiocalvicular or stemoclavicular Jt. Clavicle
3.3 Wrist dislocation on intercarpal joints
3.4 MP & IP Joints
3.5 Debridement of hand/foot
3.6 Fibula Radius Ulna (Clavicle) and Wrist, Ankle, Hand foot
3.7 Amputation (Thigh or arm, leg or forearm, feet or hand, digits)
POP Aplication (Hip Spica, Shoulde spica POP Jacket; A-K/A-E POP; B-
3.8
K/B-E POP)
3.9 Patellectomy
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3 Bleeding during third trimester Diagnose ,Treat & refer
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12 PPTCT Counseling Yes
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GENERAL MEDICINE
Chronic Vertigo/
b) Ref. To Gr - I / G-II district
CVA/TIA/Hemiplegia/Paraplegia
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6 HAEMATOLOGY
Basic investigation and Treatment
a) Anaemia
Refer if necessary
Emergencies - Ref. to Gr-II- SDH
b) Bleeding disorder
otherwise - Ref. To Tertiary
c) Malignancy Ref. To Gr - I / G-II district
7 COMMUNICABLE DISEASES
Cholera, Measles, Mumps, and Chickenpox Treat
8 PSYCHOLOGICAL DISORDERS
Acute psychosis / Obsession / Anxiety Screening, emergency care and
neurosis referral
PAEDIATRICS
S. RECOMMENDED SERVICE
NAME OF THE ILLNESS
No MIX (SUGGESTED ACTIONS)
Diagnose, Treat & Refer if no
1 ARI/Asthmatic Bronchitis
improvement
Diagnose, Treat & Refer if no
2 Diarrohoeal Diseases
improvement
Protein Energy Malnutrition and Vitamin
3 Diagnose, Treat, & Refer
Deficiencies
Investigate, diagnose, treat & refer if
4 Pyrexia of unknown origin
no improvement
5 Bleeding Disorders Early Diagnosis and Refer
6 Diseases of Bones and Joints Early Diagnosis and Refer
NEONATOLOGY
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7 Neonatal Sepsis Treat and refer in necessary
1800-1500 gms treat with kangaroo care below
8 LBW
that refer
9 Neonatal Jaundice Treat and refer if necessary
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DERMATOLOGY
Autoimmune
5 Treat / Refer
Collagen Vascular DLE, Morphea
Skin Tumors, Seb.Keratosis, Soft Fibroma,
6 Benign Surface,Tumors / Cysts, Appendageal Refer
Tumors
Miscellaneous
7 a.) Acne Vulgaris, Miliaria, Alopecia, Nail Treat
disorder,Toxin induced
b) Leprosy - Resistant/
Complications / reaction
Treat /
Allergy - EMF / SJS / TENP
Refer
soriasis/Collagen Vascular/Auto immune
Disorders
c) Deep Mycosis, STD Complications Treat / Refer
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CHEST DISEASES
PSYCHIATRY
DIABETOLOGY
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4 Nephropathy/Retinopathy Diagnose and Refer
Emergency :-
i) Hypoglycemia
6 Diagnose first and refer
ii)Ketosis
iii)Coma
NEPHROLOGY
7 Acute renal Failure/ Chronic Renal Failure Suspect / Refer to District level
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GENERAL SURGERY
RECOMMENDED
S. NAME OF THE SURGICAL SERVICE MIX
No PROCEDURE/ILLNESSES (SUGGESTED
ACTIONS)
a. Minor Cases
under LA Abcess I&D/Suturing, Excision of
Treat
Lipoma / Ganglion / Lymph Node, Seb-Cyst /
Basic
1 Dermoid / Ear Lobe Repair / Circumcision
Techniques
b. Breast Lumps, Lymph nodes Swelling Diagnosis and Refer
Benign/
Breast/Oral/GI tract/Genitourinary (Penis,
4 Malignant Diagnose & refer
Prostate, Testis)
Diseases
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OPTHALMOLOGY
RECOMMENDED
S. No. NAME OF THE ILLNESS SERVICE MIX
(SUGGESTED ACTIONS)
1 Superficial Infection Treatment with drugs
2 Deep Infections First aid and refer
3 Refractive Error Treat
4 Glaucoma Diagnosis and refer
5 Eye problems following systemic disorders Refer
6 Cataract Screening and refer
7 Foreign Body and Injuries First aid and refer
Squint and Amblyopia/Corneal
8 Refer
Blindness(INF,INJ, Leucoma)/ Oculoplasty
9 Malignancy/Retina Disease Refer
10 Paediatric Opthalmology Refer
EAR
RECOMMENDED SERVICE MIX
S. No. NAME OF THE ILLNESS
(SUGGESTED ACTIONS)
1 ASOM/SOM/CSOM Treat
2 Otitis External / Wax Ears Treat
3 Polyps Diagnose and Refer
Treatment
4 Mastoiditis
(Medical)
5 Unsafe Ear Diagnose and Refer
THROAT
1 Tonsillitis/Pharyngitis/Laryngitis Treat
2 Quinsy Diagnose and Refer
3 Malignancy Larynx Diagnose and Refer
4 Foreign Body Esophagus Diagnose and Refer
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NOSE
1 Epistaxis First aid & Refer
2 Foreign Body Treat(Removal)And refer if needed
3 Polyps Refer
4 Sinusitis Treat (Medical)
5 Septal Deviation Treat (Symptomatic)
ORTHOPADICS
UROLOGY
CHILDREN
RECOMMENDED SERVICE
S. No NAME OF THE ILLNESS
MIX (SUGGESTED ACTIONS)
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ADULT
All above and
1 Stricture Urethra Diagnose and refer
2 Stone Diseases Diagnose and refer
3 Cancer - Urinary and Genital Tract Diagnose and refer
DENTAL SURGERY
8 Neoplasms Refer
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HEALTH PROMOTION & COUNSELLING
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7. Physical Infrastructure
7.1. Size of the hospital: the size of a district hospital is a function of the hospital bed
requirement which in turn is a function of the size of the population serve. In India the
population size of a district varies from 50,000 to 15,00,000. For the purpose of
convenience the average size of the district is taken in this document as one million
populations. Based on the assumptions of the annual rate of admission as 1 per 50
populations. And average length of stay in a hospital as 5 days. The number of beds
required for a district having a population of 10 lakhs will be as follows:
7.2. Area of the hospital: An area of 65-85 m2 per bed has been considered to be
reasonable. The area will include the service areas such as waiting space, entrance hall,
registration counter, etc. In case of specific requirement of a hospital, flexibility in
altering the area be kept.
7.3. Site information: Physical description of the area which should include bearings,
boundaries, topography, surface area, land used in adjoining areas, limitation of the site
that would affect planning, maps of vicinity and landmarks or centers, existing utilities,
nearest city, port, airport, railway station, major bus stand, rain fall and data on weather
and climate. Hospital Management Policy should emphasize on quake proof, fire proof
and flood proof buildings. Infrastructure should be eco-friendly and disabled (physically
and visually handicapped) friendly. Provision should be made for water harvesting,
generating back-up, solar energy / power back-up, and horticulture services including
herbal garden. Local agency Guidelines and By-laws should strictly be followed. A room
for horticulture to store garden implements, seeds etc will be made available.
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7.5. Site selection criteria
A rational, step-by-step process of site selection occurs only in ideal
circumstances. In some cases, the availability of a site outweighs other rational
reasons for its selection, and planners arid architects are confronted with the job
of assessing whether apiece of land is suitable for building a hospital. In the case
of either site selection or evaluation of adaptability, the following items must be,
considered: size, topography, drainage, soil conditions, utilities available, natural
features and limitations.
Administrative Block:
Circulation Areas
Circulation areas like corridors, toilets, lifts, ramps, staircase and other
common spaces etc. in the hospital should not be more than 55% of the
total floor area of the building.
Floor Height
The room height should not be less than approximately 3.6 m measured at
any point from floor to floor height.
Entrance Area
Physical Facilities
Waiting Spaces
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Registration, assistance and enquiry counter facility be made
available in all the clinics.
Clinics
Nursing Services
Diagnostic Services
Imaging
Clinical Laboratory
28
For quick diagnosis of blood, urine, etc., a small sample collection
room facility shall be provided.
Separate Reporting Room for doctors should be there.
Blood Bank
General
Location
Ward Unit
29
station caters to above 40-45 beds, out of which half will be for
acute patients and chronic patients.
Pharmacy (Dispensary)
General
In this unit, critically ill patients requiring highly skilled life saving
medical aid and nursing care are concentrated. These should
include major surgical and medical cases, head injuries, severe
haemorrhage, acute coronary occlusion, kidney and respiratory
catastrophe, poisoning etc. It should be the ultimate medicare the
hospital can provide with highly specialized staff and equipment.
The number of patients requiring intensive care may be about 2 to
5 percent total medical and surgical patients in a hospital. The unit
shall not have less than 4 beds not more than 12 beds. Number of
beds will be restricted to 5% of the total bed strength. Out of these,
they can be equally divided among ICU and High Dependency
Wards. For example, in a 500-bedded hospital, total of 25 beds will
be for Critical Care. Out of these, 13 may be ICU beds and 12 will
be allocated for High Dependency Wards. Changing room should
be provided for.
Location
30
ventilation, central air conditioning and efficient life services. A
good natural light and pleasant environment would also be of great
help to the patients and staff as well.
ICU and High Dependency Wards: Number of beds for both the
units will be restricted to 5% of the total bed strength. Out of these,
they can be equally divided among ICU and High Dependency
Wards. For example, in a 500 bedded hospital, total of 25 beds will
be for critical care. Out of these 13 may be ICU beds and 12 will
be allocated for high dependency wards.
Facilities
Nurses Station
Clean Utility Area
Equipment Room
Therapeutic Services
Operation Theatre
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a Scrub-up room where operating team washes and scrub-up their hands
and arms, put on their sterile gown, gloves and other covers before
entering the operation theatre. The theatre should have sink / photo sensors
for water facility. Laminar flow of air be maintained in operation theatre.
It should have a central air conditioning facility. It should have a single
leaf door with self closing device and viewing window to communicate
with the operation theatre. A pair of surgeon’s sinks and elbow or knee
operated taps are essential. Operation Theatre should also have a Sub-
Sterilizing unit attached to the operation theatre limiting its role to
operating instruments on an emergency basis only.
Theatre refuse, such as, dirty linen, used instruments and other disposable
/ non disposable items should be removed to a room after each operation.
Non-disposable instruments after initial wash are given back to instrument
sterilization and rest of the disposable items are disposed off and
destroyed. Dirty linen is sent to laundry through a separate exit. The room
should be provided with sink, slop sink, work bench and draining boards.
Physiotherapy
32
Hospital Services
Hospital Laundry
Mortuary
Engineering Services
Electric Engineering
Illumination
33
The illumination and lightning in the hospital should be done as
per the prescribed standards.
Emergency Lighting
Call Bells
Call bells with switches for all beds should be provided in all types
of wards with indicator lights and location indicator situated in the
nurses duty room of the wards.
Ventilation
Mechanical Engineering
Water Supply
34
shall be in accordance with the prescribed standards. Prescribed
standards and local guidelines shall be followed.
Trauma Centre
Guidelines to be followed
Fire Protection
Medical Gas
35
8. MANPOWER REQUIREMENT
36
8.2. Man Power – Para Medical
37
8.3. Manpower- Administrative Staff
Note: Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be
required if outsourced
S.
Staff Blood Storage
No
1 Staff Nurse 1
2 MNA / FNA 1
Blood Bank
3 1
Technician
4 Sweeper 1
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9. EQUIPMENT
I Imaging Equipment
31 -50 bedded
S. Sub District
No. Name of the Equipment Hospital
1 100 M.A. X-ray machine 1
2 Dental X ray machine 1
Ultra Sonogram (Obs & Gyne.
department should be having a separate
3 ultra-sound machine of its own) 1+1
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4 Radiant Warmer 1
5 Room Warmer 2
6 Foetal Doppler 1
7 Delivery Kit 2
8 Episiotomy kit 1
9 Forceps Delivery Kit 1
10 Vacuum extractor metal 1
11 Silastic vacuum extractor 1
12 Pulse Oximeter baby & adult 1
13 Cardiac monitor baby 1
14 Nebulizer baby 1
15 Weighing machine adult 2
16 Weighing machine infant 2
17 CTG Machine
18 Arc
V Eye Equipments
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
1 Opthalmoscope - Direct 1
2 Slit Lamp 1
3 Retino scope 1
4 Perimeter 1
5 IOL Operation set 1
VI Dental Equipments
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
1 Air Rotor 1
2 Dental Unit with motor for dental OP 1
3 Dental Chair 1
4 Dental Kit 1
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VII Operation Theatre Equipment
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
5 Autoclave vertical single bin 1
6 Shadowless lamp ceiling type major* 1
7 Shadowless lamp ceiling type minor* 1
8 Shadowless Lamp stand model 1
9 Focus lamp Ordinary 1
10 Sterilizer big (Instrument) 1
11 Sterilizer Medium (Instrument) 2
12 Steriliser Small (Instruments) 2
13 Bowl Steriliser – big* 1
14 Bowl steriliser – Medium* 1
15 Diathermy Machine (Electric Cautery) 1
16 Suction Apparatus - Electrical 2
17 Suction Apparatus - Foot operated 1
18 Ultra violet lamp philips model 4 feet 2
41
VIII Laboratory Equipments
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
25 Test tube rack* 3
26 Test tube holders* 3
27 Spirit lamp* 4
34 Timer stop watch 1
35 Alarm clock 1
36 Refrigerator 1
37 Laboratory Auto Claves 2
Automatic Processing Unit for
38 Radiology
39 Tonometer for Ophthalmology
42
IX Surgical Equipment Sets
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
25 L.P.Tray* 1
26 Uretheral Dilator Set 1
27 Amputation set 1
28 Crammer wire splints 6
XI Endoscopy Equipments
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
Laparoscope diagnostic and for
1 sterilisation * 1
* To be provided as per need.
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XIII Furniture & Hospital Accessories
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
Doctor' s chair for OP Ward, Blood Bank,
1 Lab etc. 12
2 Doctor' s Table 3
3 Duty Table for Nurses 4
4 Table for Sterilisation use (medium) 4
5 Long Benches(6 1/2'x 1 1/2' ) 10
6 Stool Wooden 8
7 Stools Revolving 6
8 Steel Cup-board 8
9 Wooden Cup Board 4
10 Racks -Steel – Wooden 5
11 Patients Waiting Chairs (Moulded)* 10
12 Office Chairs 4
13 Office Table 3
14 Foot Stools * 8
15 Filing Cabinets (for records) * 4
16 M.R.D.Requirements (record room use) * 1
17 Paediatric cots with railings 3
18 Cradle* 2
19 Hospital Cots (ISI Model ) 50
20 Hospital Cots Paediatric (ISI Model ) 5
21 Wooden Blocks (Set)* 1
22 Back rest* 2
23 Dressing Trolley (SS) 2
24 Medicine Almairah 1
25 Bin racks (wooden or steel)* 3
26 ICCU Cots 2
27 Bed Side Screen (SS-Godrej Model)^ As per requirement
28 Medicine Trolley(SS) 2
29 Case Sheet Holders with clip(S.S.)* 40
30 Examination Couch (SS) 2
31 Instrument Trolley (SS) 4
32 Instrument Trolley Mayos (SS) 2
33 Surgical Bin Assorted 15
34 Wheel Chair (SS) 3
35 Stretcher / Patience Trolley (SS) 2 each.
36 Instrument Tray (SS) Assorted 20
37 Kidney Tray (SS) - Assorted 20
38 Basin Assorted (SS) 20
39 Basin Stand Assorted (SS)
44
XIII Furniture & Hospital Accessories
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
(2 basin type ) 3
( 1 basin type) 5
40 Delivery Table (SS Full) 4
41 O2 Cylinder Trolley(SS) 3
42 Saline Stand (SS) 10
43 Waste Bucket (SS) 20
44 Dispensing Table Wooden 1
45 Bed Pan (SS) 10
46 Urinal Male and Female 10
47 Name Board for cubicals 1
48 Waste Disposal - Bin / drums 5
49 Waste Disposal - Trolley (SS) 1
50 Linen Almirah 2
51 Stores Almirah 2
52 Arm Board Adult 6
53 Arm Board Child 6
54 SS Bucket with Lid 4
55 Bucket Plastic 6
56 Ambu bags 3
57 O2 Cylinder with spanner ward type 6
58 Diet trolley - stainless steel 1
59 Needle cutter and melter 10
60 Thermometer clinical 10
61 Thermometer Rectal 3
62 Torch light 6
63 Cheatles forceps assorted 5
64 Stomach wash equipment 2
65 Infra Red lamp 3
66 Wax bath 1
67 Emergency Resuscitation Kit-Adult 2
68 Enema Set 2
69 Ceiling Fans$ As per requirement
* To be provided as per need.
^ At least one screen per five beds except female wards.
$ One fan per four beds in the ward.
XIV PM Equipments
S. 31-50 bedded Sub
No. Name of the Equipment District Hospital
1 Mortuary table (Stainless steel)* 2
2 P.M. equipments (list) 3
45
3 Weighing machines (Organs) 1
4 Measuring glasses(liquids) 2
5 Aprons* 10
6 PM gloves ( Pairs )* 10
7 Rubber sheets* 4
8 Lens 1
9 Spot lights 1
* To be provided as per need.
XV Linen
31-50 Bedded Sub
S. No. Name of the Equipment District Hospital
1 Bedsheets 200
2 Bedspreads 300
3 Blankets Red and blue 20
4 Patna towels 100
5 Table cloth 30
6 Draw sheet 30
7 Doctor's overcoat 20
8 Hospital worker OT coat 25
9 Patients house coat (for female) 150
10 Patients Pyjama (for male) Shirt 100
11 Over shoes pairs 40
12 Pillows 60
13 Pillows covers 150
14 Mattress (foam) Adult 50
15 Paediatric Mattress 6
16 Abdominal sheets for OT 30
17 Pereneal sheets for OT 30
18 Leggings 40
19 Curtain cloth windows and doors As per requirement
20 Uniform / Apron As per requirement
21 Mortuary sheet 10
22 Mats (Nylon) 30
23 Mackin tosh sheet (in meters) 100
24 Apron for cook As per requirement
46
4 White / colour boards 1
5 Television colour 1
6 Tape Recorder ( 2 in 1 )* 1
7 VCD Player 1
8 Radio 1
* To be provided as per need.
XVII Administration
S. 31-50 Bedded Sub
No. Name of the Equipment District Hospital
Computer with Modem with UPS,
1 Printer with Internet Connection 2
2 Xerox Machine 1
3 Intercom (15 lines)* 1
4 Fax Machine 1
5 Telephone 1
6 Public Address System* 1
47
3 Pedestal Fan* 1
4 Wall Fan* 1
5 Hotwater geiser* 1
6 Fire extinguishers* 1
7 Sewing Machine* 1
8 Lawn Mover* 1
9 Aqua guard* 4
10 Emergency trauma set* 1
11 Tube lights* 30
12 Drinking Water Fountain* 1
XXI Transport
S. 31-50 Bedded Sub District
No. Name of the Equipment Hospital
1 Ambulance 1
2 Pickup vehicles Maruti (Omni) 1
48
10. Laboratory Services: Following services will be ensured, for advanced
diagnostic tests, a list of National Reference Laboratories has been provided as
annexure:
I. CLINICAL PATHOLOGY
a. Haematology Haemoglobin estimation
Total Leucocyte count
Differential Leucocyte count
Absolute Eosinophil count
Reticulocyte count
Total RBC count
E.S.R.
Bleeding time
Clotting time
Peripheral Blood Smear
Malaria/Filaria Parasite
Platelet count
Packed Cell volume
Blood grouping
Rh typing
Blood Cross matching
49
S. No. Speciality Diagnostic Services / Tests
III. MICROBIOLOGY
Smear for AFB, KLB (Diphtheria)
Grams Stain for Throat swab, sputum
etc.
KOH study for fungus
IV. SEROLOGY RPR Card test for syphillis
Pregnancy test (Urine gravindex)
WIDAL test
Rapid Test for HIV, HBs Ag, HCV
Syringing
Tension
50
a) Xray for Chest, Skull, Spine,
IX. RADIOLOGY
Abdomen, bones
e) Dental Xray
f) Ultrasonography*
51
11. ALLOCATION OF BED STRENGTH AT VARIOUS
LEVELS:
52
12. LIST OF MEDICINES / INSTRUMENTS / EQUIPMENTS /LAB
REAGENTS / OTHER CONSUMABLES AND DISPOSABLES FOR DISTRICT
HOSPITALS.
53
34 Tab.Metronidazole 200mg
35 Tab. Metronidazole 400mg
36 Syrup. Metronidazole
37 Tab. Furazolidone 100mg
38 Tab. Diolaxanide Fuzate
39 Tab. Tinidazole 300mg
D) Dressing Material/Antiseptic lotion
40 Povidone Iodine solution 500ml
41 Phenyl 5litr jar(Black Phenyl)
42 Benzalkonium chloride 500ml bottle
43 Rolled Bandage a)6cm
b)10cm
c)15cm
44 Bandage cloth(100cmx20mm) in Than
45 Surgical Guaze (50cmx18m) in Than
46 Adhesive plaster 7.5cm x 5mtr
47 Absorbent cotton I.P 500gm Net
48 P.O.P Bandage a) 10cm
b)15cm
49 Framycetin skin oint 100 G tube
50 Silver Sulphadiazene Oint 500gm jar
51 Antiseptic lotion containing :
a) Dichlorometxylenol 100ml bot
b) Haffkinol 5litre jar
52 Sterilium lotion
53 Bacillocid lotion
52 Infusion fluids
54 Inj. Dextrose 5% 500ml
55 Inj. Dextrose 10% 500ml bottle
56 Inj. Dextrose in Normal saline 500ml bt
57 Inj. Normal saline (Sod chloride) 500ml
58 Inj.Ringer lactate 500ml
58 Inj.Mannitol 20% 300ml
60 Inj.Water for 5ml amp
61 Inj.Water for 10ml amp
62 Inj.Dextrose 25%100ml bot
63 I.V.Metronidazole 100ml
64 Inj.Plasma Substitute 500ml bot
65 Inj.Lomodex
F) Other Drugs & Material
66 All Glass Syringes 2ml
54
5ml
10ml
20ml
67 Hypodermic Needle (Pkt of 10 needle)
a)No.19
b)No.20
c)No.21
d)No.22
e)No.23
f)No.24
g)No.25
h)No.26
68 Scalp vein sets no a)19
b)20
c)21
d)22
e)23
f)24
g)25
h)26
69 Gelco all numbers
70 Tab.B.Complex NFI Therapeutic
71 Tab.Polyvitamin NFI Therapeutic
72 Inj.Dexamethasone 2mg/ml vial
73 Inj.Vitamin B Complex 10ml
74 Inj.B12 Folic acid
75 Surgical Gloves a)6 "
b)6.1/2"
c)7"
d)7.5"
76 Catgut Chromic a)1 No.
b)2 No.
c)1-0 No
d)2-0 N0
e)8-0
77 Vicryl No.1
78 Sutupak 1,1/0,2,2/0
79 Prolene
80 X Ray film 50 film packet(in Pkt) size
a)6.1/2x8.1/2"
b)8"x10"
55
c)10"x12'
d)12"x15"
81 Fixer
82 Developer
83 CT Scan film
84 Ultrasound scan film
85 Dental film
86 Oral Rehydration powder 27.5g
87 Ether Anaesthetic 500ml
88 Halothane
G) Eye Drops
89 Sulphacetamide eye drops 10% 5ml
90 Framycetin with steroid eye drops 5ml
91 Framycetin eye drops 5ml
92 Ciprofloxacin eye drops
93 Gentamycin eye drops
H) Other Material
94 Rubber Mackintosch Sheet in mtr
95 Sterile Infusion sets(Plastic)
96 Antisera I) A 5ml
II)B 5ml
III)D 5ml
IV)AB 5ml
97 Inj.MethylErgometrine 0.2mg/amp
98 Inj.Streptokinase 7.5lac vial
99 Inj.Streptokinase 15lac vial
100 Inj.PAM
101 Tab.Antacid
102 ARS
103 Syp.Antacid
104 Inj.Rabipur
105 Inj.Ranitidine 2ML
106 Tab.Ranitidine
107 Tab.Omeprazole
108 Cough syrup 5litre Jar
109 Cough syrup with Noscapine 100ml
110 Coir Mattress
111 Inj.Lignocaine 1%
112 Inj.lignocaine 2%
113 Inj.Lignocaine 5%
114 Inj.Marcaine
56
115 Inj. Diazepam
116 Inj. Salbactum+Cefoperazone2Gm
117 Inj. Amoxycillin with clavutanite acid 600mg
118 Cap.Amoxycillin250+cloxacillin 250
119 Inj. Cefuroxime 250/750
120 Tab. Pefloxacin 400mg
121 Tab. Gattifloxacin 400mg
122 Tab. Valdecoxib 20mg
123 Tab. Atrovastatin 10mg
124 Sy. Himalt-X
125 Sy. Protein (Provita)
57
26 Syp.Mebendazole
27 Sy.Piperazine Citrate
28 Sy.Pyrantel Pamoate
29 Tab.Belladona
L) Drugs related to Hoemopoetic system
30 Tab.Ferrous sulphate200mg
31 Inj.Iron Dextran/Iron sorbitol
M) Eye oint
32 Chloramphenicol eye oint & applicaps
33 Chloramphenicol + Dexamethsone oint
34 Gentamycin eye/ear drops
35 Dexamethasone eye drops
36 Drosyn eye drops
37 Atropine eye oint
N) Drugs acting on Cardiac vascular system
38 Inj.adrenaline
39 Inj.atropine sulphate
40 Inj.Digoxine
41 Tab.Digoxine
42 Inj.Mephentine
43 Tab.Atenolol
44 Tab.Isoxuprine
45 Inj.Duvadilan
46 Tab.Methyldopa
47 Tab.Isosorbide Dinitrate(Sorbitrate)
48 Tab.Propranolol
49 Tab.Verapamil(Isoptin)
50 tab.Enalepril2.5/5mg
58
61 Tab.Phenobarbitone 60mg
62 Tab.Largactil 25mg
63 Tab.Pacitane
64 Tab.Surmontil
65 Syrup.Phenergan
66 Syrup Paracetamol
67 Ethyl chloride spray
68 Lignocaine oint
69 Gentamycin eye/ear drops
70 Betnesol-N/Efcorlin Nasal drops
P) Drugs acting on Respiratory system
71 Inj.Aminophylline
72 Tab.Aminophylline
73 Inj.Deriphylline
74 Tab.Deriphylline
75 Tab.Salbutamol 2mg
76 Syrup Tedral
77 Syrup.Salbutamol
Q) Antiseptic Ointment
78 Furacin skin oint
79 Framycetin skin oint
R) Drugs acting on UroGenital system
80 Tab.Frusemide 40mg
81 Inj.KCL
82 Liquid KCL
83 Tab.Pyridicil
84 Inj.Frusemide
59
96 Insulin lente Besal
97 Inj. Cry Insulin
98 Inj. Mixtard
99 Inj. Testesterone plain 25mg
100 Testesterone Depot 50mg
101 Tab. Biguanide
102 Tab. Chlorpropamide 100mg
103 Tab. Prednisolone 5mg
104 Tab. Tolbutamide 500mg
105 Tab. Glibenclamide
106 Tab. Betamethasone
U) Vitamins
107 Inj.Vit "A"
108 Inj.Cholcalciferol16lac
109 Inj.Ascorbic acid
110 Inj.Pyridoxin 50mg
111 Inj.Vit K
112 Tab.Vit "A" & "D"
113 Tab.Ascorbic acid 100mg
V) Other drugs
114 Inj.Antirabies vaccine
115 Inj.Antisnake venom
116 Inj.AntiDiphtheria Serum
117 Inj.Cyclophosphamide
118 Inj.Sodabicarb
119 Inj.Calcium Gluconate
120 Tab.Calcium lactate
121 Tr.Iodine
122 Tr.Benzoin
123 Glcial acetic caid
124 Benedict solution
125 Caster oil
126 Liquid paraffin
127 Glycerine
128 Glycerine Suppositories
129 Turpentine oil
130 Potassium Permangnate
131 Formaldehyde
132 Dextrose Powder
133 Methylated spirit
134 Cotrimazole lotion
60
135 Cotrimazole cream
136 Tab.Theophylline
137 ECG Roll
138 Burnion Oint
139 Flemigel APC Ointment
140 Syp.Himobin
141 APDYL Cough & Noscopin
142 Tab. Septilin
143 Tab. Cystone
144 Tab. Gasex
145 Syp. Mentat
146 Oint. Pilex
147 Rumalaya Gel
148 Pinku Pedratic Cough Syp.
(W) Others
1 Tab.Liv52
2 Syrup Liv52
3 Cap. Doxycycline 100mg
4 Inj. Heparin sod.1000IU
5 Tab. Dipyridamol (Like Persentine)
6 Inj. Dopamine
7 Tab. Glyceryl Trinitrate
8 Tab.Amitryptilline
9 Tab.trifluoperazine(1mg)
10 Tab.Nitrofurantine
11 Inj.Valethemide Bromide(Epidosyn)
12 Inj.Isolyte-M
13 Inj.Isolyte-P
14 Inj.Isolyte-G
15 Cap.Cephalexin 250mg
16 Tab.Taxim
17 Inj.Metaclopramide
18 Tab.Folic acid
19 Inj.Lignocaine Hcl 2%
20 Inj.Nor adrenaline
21 Betadine lotion
22 Tab.stilboesteral
23 Inj.Pyridoxine
24 Hydrogen peroxide
25 Inj.magnesium sulphate
61
26 Benzyl Benzoate
27 GammaBenzene Hexachloride
28 Inj.Tetglobe
29 Inj.Paracetamol
30 Pilocarpine eye drops 1%
31 Sy.Orciprenaline
32 Suturing needles (RB,Cutting)
33 Inj.Calcium pantothernate
34 Inj.Xylocaine 4% 30 ml
35 Halothane
36 Mixture Alkaline
37 Inj. Phenabarbitone 200mg
38 Inj. B12 (Cynacobalamine)
39 Neosporin, Nebasuef , Soframycin Pow
40 Magnasium Sulphate Powder
41 Furacin Cream
42 Xylocaine jelly
43 Formaldehyde Lotion
44 Cetrimide 100ml bott 3.5%, 1.5% 1
45 Bacitrium powder 10mg botts
46 Bleaching Powder 5 Kg Pkts(ISI Mark)
47 Ether Solvent
48 Sodium Hypochloride Sod. 5 ltrs/1 ltrs
49 Inj. Diphthoria antition ADS)10000I.U
50 Inj. Gas gangrene Antitoxin(AGGS)10000
51 Inj. Hydroxy Progesterone500mg/2ml
52 Inj. Methyl Prednisolon 500mg vial
53 Inj. Multivitamin I.V
54 Inj. Potassium chloride
55 Inj. Quinine Dihydrochloride
56 Tetanus Antitoxin 10000 I.U
57 Inj. Tetanus Toxoid 5ml vial
58 Inj. Theophylline Etophylline
59 Inj. Vitamin A
60 Tab. Ferrous sulphate200mg+Folic acid
61 Tab. Ferrous sulphate 300mg
62 Tab. Griseofulvin125mg
63 Tab. Phenobarbitone 30mg
64 Tab. Phenobarbitone 60mg
65 Tab. Pyridoxin 10mg
66 Tab. Thyroxine sod 0.1mg
62
67 Warfarin sod 5mg
68 Tab. Alprazolam 0.25mg
69 Tab. Amlodipine 5mg
70 Tab. Amlodipine 10mg
71 Tab. Nefidipine 20mg
72 Tab. Nefidipine 30mg
73 Tab. Riboflavin 10mg
74 Syp. Ferrous Gluconate 100ml bottle
75 Cream Fluconozole 15gm tube
76 Sus. Furazolidone
77 Oint. Hydrocortisone acetate
78 Syp. Isoniazid 100mg/5ml 100ml bot
79 Liquid paraffin
79A Linctus codein 500ml bot
80 Cream Miconozole 2% 15gm tube
81 Syp.Nalidixic acid
82 syp.Norfloxacin
83 Phenylepinephrine eye drops
84 Pilocarpine eye drops 2%
85 Syp.Pottassium chloride 400ml bot
86 Syp.Primaquine
87 Suspension Pyrantel pamoate
88 Sus Rifampicin
89 Syp.Salbutamol 100ml bot
90 Syp.Theophylline 100ml
90 Syp.Vitamin B.Complex
92 Vit D-3 Granules
93 Opthalmic & ear drops
94 Glycerine Mag sulphate ear drops
95 Pilocarpine eye drops 4%
96 Oint Acyclovir 3% 5gm tube
97 Benzyl Benzoate emulsion 50ml bot
98 Oint.Betamethasone
99 Cream Clotrimazole skin 1% 15gm
100 Oint Dexamethasone 1%+ Framycetin
101 oint contain clotrimazole+Genta+Flucon
102 Oint Flucanazole 10 mg
103 Cream Framyctin 1% 20gm tube/100gm
104 Lot.Gamabenzene hexachloride1% bt
105 Glycerine Suppository USP 3gm bott/10
106 Cream Nitrofurazone 0.2% jar of 500g
63
107 Oint Silversulpadiazene 1% 25g
108 AIDS Protective kit
109 EAR DROP
110 Wax Solvent Eardrops
111 Antifungal 2 Anti biotic Ear Drops (Clohoaimazole PMB)
112 Stewcd & AB Ear Drops
64
13. Capacity Building
Training of all cadres of workers at periodic intervals is an essential component
of the IPHS for sub district hospitals. Both medical and paramedical staff should
undergo continuing medical education (CME) at intervals.
Sub District hospitals also should provide the opportunity for the training of
medical and paramedical staff working in the institutions below sub district level such as
skill birth attendant training and other skill development / management training.
Quality Control
Internal Monitoring
External Monitoring
Monitoring of laboratory
Record Maintenance
65
Computers have to be used for accurate record maintenance and with
connectivity to the District Health Systems, State and National Level.
CITIZENS CHARTER
This charter seeks to provide a framework which enables our users to know:
Standards of Service:
Locations:
66
Nurses: …………………. (including supervisory staff).
Beds: …………………….
General Information
Maternity OT
Orthopaedic Emergency OT
Burns and plastic OT
Main OT for Neurosurgery cases
In serious cases, treatment/management gets priority over paper work like registration
and medico-legal requirements. The decision rests with the treating doctor.
OPD Services:
Various outpatient services available in the hospital are detailed below (as available):
67
General Medicine
Paediatrics
General Surgery
Paediatric Surgery
Neuro Surgery
Cardiac Surgery
Eye
ENT
Skin
Urology
Cardiology
Psychiatry
Radiotherapy
Neurology
Orthopaedics
Dental OPD
ISM Services:
Homeopathic
Ayurvedic
Any other
68
OPD services are available on all working days excluding Sundays and Gazetted
Holidays.
Organ Transplantation
………………………..
………………………..
………………………
Psychiatry
D-addiction
Dental
Nuclear Medicine
Genetic Counselling
Endochronology
Geriatrics
Laboratory Services:
• Bio-chemistry
• Microbiology
• Haematology
• Cytology
• Histopathology including FNAC
• Clinical Pathology
There is a Central Collection Centre for receiving and collecting various specimens for
testing. The timings for receiving specimens are 9:00 AM to 11:30 AM.
69
Emergency: Emergency Laboratory Services are available 24 hours for limited tests
relating to clinical pathology and bio-chemistry.
X-Rays
Ultrasound and
CAT Scan
Routine X-Rays are done from 9:00 AM to 1:00 PM. Registration is done from 9:00 AM
to 11:30 AM.
Emergency: Emergency X-Ray services are also available round the clock. CAT Scan
services are also available round the clock.
There are total of ………. Wards providing free indoor patient care.
There is a ------------- bedded Intensive Care Unit for care of seriously ill patients.
A --------------- bedded Intensive Coronary Care Unit takes care of heart patients
requiring intensive treatment.
In the Burns Department, there are ----------- bedded Intensive Care Unit to treat seriously
injured burns patients.
There are --------------- labour rooms for conducting deliveries round the clock.
------------------ nurseries provide necessary care to the newborns – normal as well those
born with disease.
All indoor patients receive treatment under the guidance and supervision during office
hours i.e. 9:00 AM to 4:00 PM.
70
Outside office hours, treatment is given by doctor on duty and specialists are available on
call.
Investigations like CAT Scan, Ultra Sound, Barium-meal, ECHO, TMT etc. are charged
for as per Government approved rates.
For poor patients, these charges can be waived partially or fully on the recommendation
of the H.O.D. by the Additional Medical Superintendent. In case of emergency CMO (on
duty) may waive off these charges.
Admitted patients should contact the Staff Nurse for any medical assistance they need.
Other Facilities:
Wheel chairs and trolleys are available in the OPD and casualty.
----------- Ambulances are available to pick up patients from their places (on payment of
nominal charges) and also for discharged patients.
Stand-by Electricity Generators have been provided. Chemist Shops are available outside
the hospital. Canteen for patients and their attendants is available.
Adequate toilet Facilities for use of patients and their attendants are available.
There will be occasions when our services will not be upto your expectations.
71
Please do not hesitate to register your complaints. It will only help us serve you better.
We aim to settle your genuine complaints within 10 working days of its receipt.
If we cannot, we will explain the reasons and the time we will take to resolve.
Name, designation and telephone number of the nodal officer concerned is duly displayed
at the Reception.
Dr. …………………….
Designation…………….
Tele (O)……………… (R)………………….. (M)…………………..
Meeting Hours…………… to ……………………
The success of this charter depends on the support we receive from our uses.
Please try to appreciate the various constraints under which the hospital is functioning.
On an average more than --------- lacs patients attend the OPD annually and more than ---
---------- lacs patients are attended annually in the casualty and emergency wards.
Please help us in keeping the hospital and its surroundings neat and clean.
Please use the facilities of this hospital with care. Beware of Touts.
Please refrain from demanding undue favours from the staff and officials as it encourages
corruption.
Please provide useful feedback & constructed suggestions. These may be addressed to the
Medical Superintendent of the Hospital.
♦ Use Dustbin
72
♦ Keep Hospital Clean
73
Annexure – I
Guidelines for the Project providing financial support to the selected Government
Hospitals for Hospital Waste Management.
The Ministry of Environment & Forests notified the “Bio-Medical Waste (Management
& Handling) Rules, 1998” in July, 1998.
In accordance with the rules (Rule 4), it is the duty of every “Occupier”, i.e. a person who
has the control over the institution and/or its premises, to take all steps to ensure that the
waste generated is handled without any adverse effect to human health and environment.
The Rules further state that every Occupier, where required, shall set up requisite bio-
medical waste treatment facilities like incinerator, autoclave, microwave system for the
treatment of waste, or ensure requisite treatment of waste at a common treatment facility
or any other treatment facility. No untreated bio-medical waste shall be kept stored
beyond a period of 48 hours (Rules 5 & 6).
The hospitals, nursing homes, clinic, dispensary, animal house, pathological lab, etc. are,
therefore, required to set in place the biological waste treatment facilities. It is, however,
not incumbent that every institution has to have its own waste treatment facilities. The
rules also envisage that common facility or any other facilities can be used for waste
treatment. However, it is incumbent on the occupier to ensure that the waste is treated
within a period of 48 hours. Schedule VI of the rules also provides the time limits by
which the waste treatment facilities are required to be in place.
In connection with the implementation of the Rules, it has been decided to take up pilot
projects in selected Government hospitals – Central and State.
AIM: The aim of the scheme is to implement pilot projects to have a demonstration effect
by providing financial assistance to identified hospitals/institutions under Central/State
Governments for:
Hospital Waste Management System must be established in accordance with the Bio-
Medical Waste (Management & Handling) Rules, 1998 (Annexure).
74
Segregation must be done at the source of generation of waste. As 80-85% of waste
generated in hospitals is non-hazardous or general waste, segregation will reduce the
quantum of waste that needs special treatment to only 15-20% of the total waste. The
categories for segregation of waste and colour coding and type of container should be
as in Schedule 1 and 2 of the Bio-Medical Waste (Management & Handling) Rules,
1998.
The various options for treatment of waste can be selected according to feasibility and
type of waste as given in the Schedule – I. The correct colour bag should be used for
the particular treatment option.
1. Incineration: The incinerator installed must meet the specification and emission
standards as given in the Bio-Medical Waste (Management & Handling) Rules,
1998 and must meet the guidelines developed by Central Pollution Control Board
for design and construction of bio-medical waste incinerator (circulated to all
States/UTs vide letter no. Z.28015/50/2003-H, dated 18.11.2003) – a certificate
may be taken from the State Pollution Control Board. Waste category, 1, 2, 3, 5,
& 6 as stated in the Schedule – I of the bio-Medical Waste (Management &
Handling) Rules, 1998. Wherever common facilities for treatment and disposal of
bio-medical waste are available, installation of incinerators by individual hospitals
may not be encouraged and such waste should be transported to the common
facility for proper treatment.
2. Autoclaving/Microwaving: Standards for autoclaving and microwaving are
provided in the Bio-Medical Waste (Management & Handling) Rules, 1998. The
equipment for autoclaving or microwaving waste should conform to these
standards. These options can be selected for waste categories 3, 4, 6, 7 of
Schedule – I of the Bio-Medical Waste (Management & Handling) Rules, 1998.
3. Shredder: Shredding will cause a reduction in the volume of waste and will also
effectively prevent its re-use. It is required for waste category 4 and 7 of the
Schedule – I of the Bio-Medical Waste (Management & Handling) Rules, 1998. it
should be ensured that waste is disinfected by
chemicals/microwaving/autoclaving before shredding.
4. Needle and Syringe Destroyer: These units can be used for needles and syringes
at the point of use. These will destroy the used needles reducing it to ashes and
cut the syringe effectively preventing the re-use.
5. Transportation of Waste: Within the hospital in dedicated wheeled containers,
trolleys or carts should be used to transport the bins or plastic bags to the site of
storage/treatment. The wheeled container should be designed so that waste can be
easily loaded, remain secure during transportation, does not have sharp edges and
is easy to clean and disinfect.
The assistance will be given direct to the hospital/institute for purchase of equipments
for waste treatment facilities/installation of equipment and civil/electrical works to
house the waste treatment facilities, training, IEC activities including preparation and
75
publication of literature, posters, pamphlets, etc. The financial assistance will be
limited to Rs.85 lakhs per hospital or Rs.1.50 crore per State/UT. The estimated costs
are as under:-
76
vii. The accounts of the hospital about purchase of equipment/maintenance of the
equipments/transportation of thw waste/expenditure incurred on
civil/electrical works will be audited by the Accountant General of the State
Government / UT Administration and its utilization certificate will be
forwarded to the Ministry of Health & Family Welfare within a period of six
months after the expiry of the financial year during which the grants is
sanctioned.
The financial assistance will be limited to Rs.85 lakhs per hospital or Rs.1.5 crore per
State/UT. The State/UTs will have the option to choose any equipment (s) from the
list above to cover as many hospitals as possible. However, the financial assistance
per State will be provided upto a maximum amount of Rs.1.5 crore.
Scrutiny of Applications:
The applications received from the State Government/UT Administrations for setting
up of facilities for disposal of hospital waste in the hospitals under their
administrative control will be considered in the Ministry in a Committee headed by
Additional Secretary and proposals cleared for giving financial assistance. The
proposals then will be processed for sanction of financial assistance to the
Government Hospitals/institutes. In the case of Central Government
Hospitals/Institutions, the Head of the Institutions may send their proposal through
Dte.GHS.
The Joint Secretary (Hospital), DDG level officer in the Dte.GHS concerned with
hospitals matters will be the Nodal Officer for implementation of the scheme. The
proposals will be examined through a Committee consisting of Additional Secretary,
Chairman, the Joint Secretary dealing with hospital matters, Joint Secretary (FA) or
his representative, DDG level officer dealing with hospitals in Dte.GHS and one
representative of Central Pollution Control Board/Ministry of Environment & Forests
as members. The Member Secretary of the Committee will be Director/Deputy
Secretary dealing with hospital matters. The funds for setting up facilities for disposal
of hospital waste will be sanctioned to the State Government/UT
Administration/Occupier and it will be implemented by the concerned Government
and to the concerned Head of the Hospital in case of Central Government
Hospitals/Institutions.
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Annexure - II
REFERRAL LABORATORY NETWORKS
Bacterial diagnosis
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Tuberculosis State TB Demonstration & Training Centre (for all NTI, TRC
zones) ICGEB, Delhi
Viral Diagnosis
Parasitic Diagnosis
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Malaria All State Public Health Laboratories MRC, Delhi
ICGEB, Delhi
Zoonoses
80
Unknown pathogens Other laboratories to perform support NIV, NICD,
functions HSADL
Capacity building All the L4 & L5 laboratories (in their NIV, NICD
area of expertise)
Quality assurance All the L4 & L5 laboratories (in their CMC, TRC,
area of expertise) NTI, AFMC,
NARI,
RMRC,Port
Blair NIV,
NICD
Quality control of All the L4 & L5 laboratories (in their CMC, TRC,
reagents & kits area of expertise) NARI,
evaluation RMRC,Port
Blair NIV,
NICD, BJMC,
NICED
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Production & supply of - DRDE, NIV,
reagents/ kits/ biological/ IVRI, NICED,
standard reference NICD,MRC,Delhi
materials
AFMC, Pune
NARI
TRC, Chennai
RMRC, Port Blair
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LIST OF ABBREVIATIONS
83
References
1. Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100
Bedded Hospital, Bureau of Indian Standards, New Delhi, January, 2001
2. Rationalisation of Service Norms for Secondary Care Hospitals, Health & Family
Welfare Department, Govt. of Tamil Nadu. (Unpublished)
84