3. introduction to gynaecology
• Gynaecology or gynecology (see spelling differences) is the medical
practice dealing with the health of the female reproductive systems
(vagina, uterus, and ovaries) and the breasts.
• Almost all modern gynaecologists are also obstetricians (see
obstetrics and gynaecology). In many areas, the specialities of
gynaecology and obstetrics overlap.
4. difference between obstetrics and
gynecology
• GYNECOLOGY deals with non pregnant women.
• OBSTETRICS deals with pregnant women and their unborn
• baby.
Obstetrical patients usually make monthly visits, which entail
weighing
• and a brief examination.
Gynecology patients require a more lengthy pelvic examination. This
• type of practice requires a large staff, as each physician needs one or
two
• nurses.
5. movement pattern in delivery
cases PATIENT COMES
IN LABOUR (to emergency)
RECEPTION
PREPARATION ROOM
HOLDING AREA
FIRST STAGE ROOM
DELIVERY ROOM
ASSISTED DELIVERY
RECOVERY ROOM
WARDS
CAESARIAN DELIVERY
SURGICAL SUITS
NORMAL DELIVERY
6. OB/GYN consists of the following
processes:
• Labour
• Delivery/ Birthing
• Recovery
• Postnatal (or Post-Partum)
• Separate from these 4 processes, the baby infant nurseries
7. Administrative
Processes
• Patient Registration, Admission & Discharge
Management
• Hospital Stores & Inventory Management
• Procurement & Outsourcing Management
• Hospital Transportation Management
• Hospital Security & Safety Management
• Hospital Finance & Accounting Management
• HospitalInfrastructure/EquipmentMaintenance
Management
• Hospital housekeeping & General Upkeep
Management
• Human Resource Development & Training
Management
• Dietary Management
• Laundry Management
• Hospital Waste Management
Clinical
Processes
• Outdoor Patient (OPD) Management
• In-Patient (IPD) Management (General/Critical/
Intensive Care)
• Hospital Emergency and Disaster Management
• Maternity and Child Health Management
• Operation Theatre and CSSD Managemen
• t Hospital Diagnostic Management
• Blood Bank/Storage Management
• Hospital Infection Control Management
• Data and Information Management
• Hospital Referral Management
• Pharmacy Management
• Management of Death
8. Functional Areas
• The Unit consists of the following functional areas:
• Reception and arrival area including provisions for visitors and administrative
• activities
• Inpatient areas for general mother care and for acute care (both antenatal and
• post natal)
• Neonatal Nursery area – General Care Nursery area.
• I. Feeding the baby
• II. Bathing, changing and weighing the baby
• III. Allowing the baby to sleep during the day.
9. Birthing/ preparation area
• Each designated birth/preparation room shall be for single occupancy and shall have minimum dimensions of 3900 x
4800mm.
• 3900mm is the dimension from the head of the bed to the wall opposite.
• This size equates to a room with no window, maximum use of wall space, and doors located in positions that have the least
impact on the activities within the room.
The main functions of the birth/preparation room(s) for which facilities shall be provided are:
• · patient preparation/relaxation during labour;
• · charting of medical records;
• · parking of dressings/treatment trolley;
• · bedhead services (electrical and mechanical);
• · access to assisted ensuite adjacent;
• · use of nurse call;
• · use of staff assistance call;
• · use of telephone;
• · use of intercom (optional);
• · area for delivery bed/etc.;
• · giving of analgesics;
• · task lighting (examination/minor theatre);
• · colour corrected lighting;
• · baby resuscitation (gases, power);
•soiled linen and waste disposal;
• timing of procedures (clocks);
•space for additional equipment as necessary (infant incubator, mobile
infant overhead heater etc.);
•clinical handwashing (hands off scrub up basin);
•· high level of acoustic privacy; and
•· space for spouse.
10. Assisted Ensuite
• Attention to the level of interior design is also important, with emphasis on the "homelike" environment.
• Colours shall be chosen which do not alter the observer's perception of skin colour.
Each birth/preparation room shall have direct access to an assisted ensuite for patient use with staff assistance.
A single suite may be shared between two birth/preparation rooms via a privacy lobby, although dedicated facilities are
recommended.
Staged Delivery Facilities.
there is a preference for a "staged" approach to the birthing procedure, then separate rooms may be provided. The separate
rooms are:
(a) Delivery Room - for the actual birth. The size and facility requirement is as for the Birth/Preparation Room.
b) Labour Room - for the labour phase. This room may be multiple bedded, with screened privacy afforded each patient.
Each screened cubicle size will be 2300mm wide by 3000mm long, minimum. Additional floor space as required for circulation,
trolley movement, emergency procedures, etc.
11. The main functions of the Labour
Room(s) for which facilities are provided
are:
• · patient preparation/relaxation during
labour;
• · charting of medical records;
• · parking of trolleys;
• · bedhead services (electrical and
• mechanical);
• · access to assisted ensuite(s) adjacent (1
• per 4 beds);
• · use of nurse call;
• · use of staff assistance call;
• · use of telephone;
• · use of intercom (optional);
• · area for bed;
• · giving of analgesics;
• · task lighting, including reading;
· colour corrected lighting;
· soiled linen and waste disposal;
· timing of procedures (clocks);
· space for emergency resuscitation
equipment;
· clinical handwashing (hands-off scrub up
basin); and
· space for spouse.
12. Service Areas/Functions
• The Birth Suite shall provide for the following
support service areas and functions.
• In some instances, alcoves or other open spaces
which do not interfere with traffic may be used.
• (a) Control/Nursing Station
• (b) Supervisor's Office or Station
• (c) Patient's and Father's Lounge
• (d) Sterile Supply
• (e) Drug Distribution Station
• (f) Clean Utility
• (g) Dirty Utility
• (h) Anaesthesia Storage
• (i) Anaesthesia Workroom (only in large Birth
• Suites)
• (j) Equipment Storage Area/Room
(k) Staff Change/Toilets/Showers
(l) Staff Lounge
(m) Conference/Handover Room
(n) Cleaner's Room
(o) Stretcher/Trolley/Equipment Park
(p) Nursery
(q) Formula Preparation Room
(r) Intensive Care (Obstetric)
13. OPERATING ROOM/S AND SUPPORT
FACILITIES
• If provided within the Obstetric Unit, Operating Room and support rooms shall
have: Operating Room to comply with Standard Components – Operating
Room, General; provision should be made for twin baby resuscitation areas
within the operating room
• Scrub-up/ Gowning Bay to comply with Standard Components Scrub-up/
Gowning, 6 m2
• Clean-up Room Two Patient Bed Bays for Recovery for each Operating Room,
to comply with Standard Components Patient Bay, Recovery Stage 1.
• The time taken to travel to the Operating Room from the Birthing area ideally
should not exceed three minutes. An assessment of the distance between the
Birthing area and the Operating Rooms should be done taking into
consideration the average speed of travel and whether lifts are involved
including any delays associated with lift travel.
14. Alternative Birthing Unit• Alternative birthing within the hospital environment is now a reality. It is a midwife based service which allows
the choice of an alternative birthing arrangement without the clinical environment, but with specialist medical
support close by.
• The unit shall be located within close proximity of the Birth Suite and the Operating Suite (caesarean facility).
This will facilitate safe transfer in an emergency situation.
• The following rooms/areas are considered to be the minimum level of provision.
• (a) Birthing/Lounge Room
• (b) Entry : A screened entry shall be provided, as a Lobby or similar, to ensure privacy.
• (c) Store : A separate area/room shall be provided for the storage of ancillary mobile equipment and stock that
would detract from the residential environment within the Birthing/Lounge Room. It should be directly
accessible from the Birthing/Lounge Room or Entry Lobby.
• (d) Ensuite/Bathroom : A room shall be provided for assisted toileting, showering, bathing, handwashing and
grooming.
• (e) Fitout/Finishes : Fitout shall be in a domestic style. Clinical items such as medical gases, equipment, etc are
concealed, but within easy reach.
• (f) Lighting : Lighting shall be domestic, although provision shall be made for a mobile examination light.
• (g) Emergency Egress
• (h) Air Conditioning : The room shall be air conditioned, with temperature control within the Birth/Lounge
Room.
15. EXAM ROOM
• • Exam rooms may have painted walls or vinyl wall covering, perhaps a
wood-look vinyl floor.
• • And a dressing area where patients may disrobe in privacy. This dressing
area can be a 3 × 3–foot corner of a room with a ceiling-mounted cubicle
drape and a chair or built-in bench.
• • The size of an OB-GYN exam room may be 8 × 12 feet but this width is
tight, especially if the casework has an area for a monitor and a place for
the patient and physician to sit side by side to view the monitor.
• • A room 10 × 12 feet is desirable and allows the physician to remain in the
room while the patient dresses behind a curtain in order to chart and write
a prescription.
16. • •LABOUR ROOM
• Labour rooms should preferably be in the form of cubicles; two labour
rooms for every 10 maternity beds. As birth follows labour, the labour
rooms should be placed adjacent to delivery rooms. The examination-
cum-preparation room and labour room may be combined into a single
room.
• •DELIVERY ROOMS
• Delivery rooms shall be of the following types: a) Clean delivery room for
normal deliveries. b) Operation theatre. One delivery bed shall be
provided for every 10 maternity beds.
• • STERILIZING ROOMS
• The facilities for sterilization of the equipment in the delivery suites
should be provided. This room should house a work counter, sink, small
high-speed pressure instruments sterilizer, etc.
17. • STERILE STORE ROOM
• Close to the sterilizing room, a room to store sterile material should be
provided. It should be provided.
• •SCRUBBING ROOMS
• Scrub-up facilities may be provided between two delivery rooms similar to
those provided in operation theatre department.
• •DIRTY UTILITY
• For collection and transferring of blood stained clothes to the laundry unit, a
sluice room shall be provided. It is desirable to install mechanical aid for
washing of bed pans, urinals, etc.
• •OTHER FACILITIES Other facilities for the unit should include change rooms
for doctors, nurses, technicians, anesthesia room, instrument and linen
storage, recovery room, etc. and these should be identical to operation
theatres department.
18. Patient Flow
• There should be three to four exam rooms per physician.
• The patient flow is from waiting room to weighing area, to toilet
(urine specimen), to exam room. A good space plan will channel
patients to each area by the most direct route with no backtracking or
unnecessary steps.
• If possible, the nurse station/sterilization/lab areas should be located
toward the front of the suite (centralized) so that the staff can cover for
each other.
20. PROVISIONS OF
VARIOUS FLOOR AREA
IN DELIVERY SUITE
UNIT
The following are the 5 categories :
Category A :25 to 50 beds
Category B :51 to 100 beds
Category C :101 to 300beds
Category D : 301 to 500 beds
Category E :501 to 750 beds
21. Provision of various floor areas of ward ancillaries in intensive care
unit :
No of rooms Area in SqM
1.Patient’s relatives waiting area 1 17.5
2.Nurse’s station with toilet 1 17.5
Doctor’s room with toilet 1 17.5
Intensive care laboratory 1 14
Equipment room 1 14
stores 2 14
pantry 1 10.5
Switch room 1 10.5
trolley bay 1 10.5
Sluice room 1 10.5
Janitors closet 1 3.5
22.
23. Environmental Considerations
• NATURAL LIGHT Essential to all patient rooms (mothers and babies).
• PRIVACY Privacy is essential for both the assessment and birthing rooms. Avoid direct
views into the room from the outside, both through the windows and through the door –
i.e. do not provide viewing panels and a privacy curtain should be allowed for.
Furthermore, the foot end of the bed should be facing away from the door or the access
point.
• ACOUSTICS Within the nursery, sound absorption and insulation techniques should be
applied to soften the noise created by crying babies and their support equipment. This
however should not impede the quality of observation or ease of access between
staff/support areas and the nursery.
• Similar techniques should be applied to the birthing rooms, allowing mothers to give birth
without disturbing other patients.
• The unit in general should be isolated from disturbing sounds of traffic and sirens of
ambulances, either through its strategic location or through applying sound absorption
and insulation techniques.
24. LABOUR ROOM
• Temp – 20-23
• RH – 30%-60%
• Pressure – Positive
• Air Changes – 3 fresh / 15 total
• Air Filtration – 5 μ
• Temp – 22-26
• RH – 30%-60%
• Pressure – Positive
• Air Changes – 3 fresh / 15 total
• Air Filtration – 5 μ
NURSERY ROOM
25. Construction Standards and Finishes
Corridors
• In areas where regular trolley
and stretcher movement is
expected, e.g., nursing units,
operating and birth suites,
intensive care units etc., the
minimum corridor width shall be
2100mm.
• The optimum corridor width is
2350mm.
Materials Generally
• All building material used in the
construction of a Private
Hospital
• shall be new and of a type
suitable for use in the particular
element of construction.
Installation shall be to the
manufacturers'
recommendations, or as dictated
by codes etc.
26. • Ceiling Heights
• The minimum ceiling height in
occupied areas shall be
2400mm, but consideration
should be given to the size
(aesthetic consideration) and
use of the room.
• Windows
• All rooms occupied by patients
or staff on a regular basis shall
have glazed windows or doors to
achieve external views and/or
make use of direct or borrowed
natural light, where practical.
• Doors
• The minimum dimensions of clear
door openings to inpatient
bedrooms in new areas shall be
1200mm wide and 2030mm high,
to ensure clearance for the
movement of beds.
• Screens and Grilles
• Generally, openable external
windows, vents and doors shall
be fitted with flyscreens.
Doorways that are used on a
regular basis (e.g. service or main
entries) need not be flyscreened
but shall be fitted with a self-
closing device.
31. Introduction to Nephrology
• Nephrology (from Greek nephros "kidney", combined with the suffix -logy,
"the study of") is a specialty of medicine and pediatrics that concerns itself
with the kidneys.
• The study of normal kidney function and kidney problems, the preservation
of kidney health, and the treatment of kidney problems, from diet and
medication to renal replacement therapy (dialysis and kidney transplantation).
• Systemic conditions that affect the kidneys (such as diabetes and autoimmune
disease) and systemic problems that occur as a result of kidney problems
(such as renal osteodystrophy and hypertension) are also studied in
nephrology.
• A physician who has undertaken additional training to become an expert in
nephrology may call themselves a nephrologist or renal physician.
33. •The Nephrology Unit provides care to
patients with chronic, acute, end-stage
renal disease and general medicine
related diagnoses.
• minimum Number of Beds
• 23
• Nurse/Patient Ratio
• 1:4-5
Skill Mix
Registered Nurse - 66%
Patient Care Technician - 34%
Nursing Unit Orientation
New graduate - 8 weeks
Experienced - 6-8 weeks
34. REQUIREMENTS
• waiting area
• reception area
• administrative area
• patient exam treatment
• staff toilets and lockers
• house keeping area
• patient toilets and lockers
• clean / laundry
• opration theater
• nurse stations
• dialysis stations
• water treatment area
• equipment processing area
• equipment storage area
• equipment repair area
• dialysis preparation area
• medication preparation area
• labs
• pharamcy
42. • Neurology is a branch of medicine dealing
with disorders of the nervous system.
• Neurology deals with the diagnosis and
treatment of all categories of conditions and
disease involving the central and peripharal
nervous system
43. • NEURO CRITICAL CARE
• NEURO SURGERY DEPARTMENT
• NEURO REHABITATION DEPARTMENT
• NEURO IMAGING AND INTERVENTION DEPARTMENT
• DEPARTMENT OF NEUROLOGY
44. • consultent rooms
• physical examination room
• treatment room
• motor senses checkup room
• neuro intensive care unit
• neuro operation theater
• special neuro inpatient facility
• ECG,EPG,MRI imaging
45. • This department has to deal with both inpatients and
outpatients
• The department works on patient examination or
checkup and surgical services
• The patients to this department are mostly referred
by other doctors
• Neurology department depends on other vastly such
as radiology department and surgical department
46. •Access to neurology department should be easy
and do be placed in the shortest path beacuse
this department deals with the patients who can
be physically handicapped or motor in capable.
•Barier free access should be provided
47. • their are 3 types of NICU
• NICU FOR CIRITICAL CONDITIONS
• STEP DOWN MEDICAL NICU
• STEP DOWN SURGICAL NICU
• step down nicu are used for patients whose condition is
stable after medical care or surgery
48. FUNCTIONAL RELATION BETWEEN NEURO AND RADIOLOGY
DEPARTMENT
• their is a seperate department called
neuroradilogy which deals with neuroimaging
for better understanding if neuro problems
• neuro department vastly depends of imaging by
radiology department
• they get better understanding of neuro cases
through MRI , CT scans etc
