Mini project on MEDICINE DEPARTMENT

4,085 views

Published on

Published in: Education, Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,085
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
0
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Mini project on MEDICINE DEPARTMENT

  1. 1. MINI PROJECT ON DEPARTMENT OF MEDICINE ATACHARYA VINOBA BHAVE RURAL HOSPITAL DEPARTMENT OF MHA & M, DMIMS, SAWANGI WARDHA PREPARED BY DR MANJIT RAMESH BARSAGADE MHA & M 1ST YEAR
  2. 2. ACKNOWLEDGEMENT I WOULD LIKE TO EXPRESS MY GRATITUDE TO ALL THOSE WHO GAVE ME THE POSSIBILITY TO COMPLETE MY STUDY SUCCESFULLY. I WOULD LIKE TO THANKS DR GODE MADAM (DIRECTOR, MHA & M, DMIMS) FOR GIVING ME PERMISSION TO COMMENCE MY STUDY IN AVBRH HOSPITAL. IN ADDITION, I WOULD LIKE TO THANK ADMINISTRATOR OFFICER MRS PARIHAR MADAM (AO) AT AVBRH FOR PROVIDING ME BASIC SUPPORT FOR INTERACTIVE SESSION WITH CONCERNED STAFF & FOR CO-OPERATION DURING WHOLE STUDY. I WOULD LIKE TO THANKS DR AMOL AMLE FOR PROVIDING ME VALUABLE INPUTS & GUIDELINE. ESPECIALLY I AM DEEPLY INDEBTED TO DR SANTOSH TIWARI (FACULTY) WHO IS HELP; STIMULATING SUGGESTIONS & ENCOURAGEMENT HELPED ME IN ALL THE TIME OF STUDY & ACEDEMIC SESSION. LASTLY MY DEEP HEARTED REGARDS TO MY PARENTS & FAMILY WHO ALWAYS STOOD NEXT TO US IN ANY CIRCUMSTANCES.
  3. 3. DECLARATION I DECLARE THAT I DR. MANJIT RAMESH BARSAGADE STUDENT OF MASTER IN HOSPITAL ADMINISTRATION AND MANAGEMENT 1ST YEAR , DATTA MEGHE INSTITUTE OF MEDICAL SCIENCES , SAWANGI , WARDHA HAS COMPLETED ONE WEEK TRANING ON MINI PROJECT TITLE “ DEPARTMENT OF MEDICINE ” AT ACHARYA VINOBA BHAVE RURAL HOSPITAL , SAWANGI , WARDHA . I ASSURE YOU THAT IT IS MY ORIGINAL WORK YOUR’S SINCERELY, MANJIT RAMESH BARSAGADE MHA & M 1ST YEAR DMIMS, SAWANGI WARDHA
  4. 4. TABLE OF CONTENTSR NO PARTICULARS PAGE NO 1 INFORMATION ABOUT AVBRH 2 INTRODUCTION TO MEDICINE DEPARTMENT 3 AIMS & OBJECTIVES 4 METHODOLOGY 5 MEDICINE OPD 6 MEDICINE WARD 7 MEDICINE ICU 8 OBSERVATION 9 RECOMMENDATION 10 BIBLIOGRAPHY
  5. 5. INFORMATION ABOUT AVBRH SAWANGI WARDHA INTRODUCTION ACHARYA VINOBA BHAVE RURAL HOSPITAL WAS ESTABLISHED IN 1991 BY HONOURABLE DATTAMEGHE WITH ADVANCE MEDICAL SERVICES AND FACILITES. IT IS LOCATED 4 KM FROM WARDHA CITY & WELL CONNECTED WITH ALL MODES OF TRANSPORT.AVBRH IS 1138 BEDDED FULLY EQUIPPED TEACHING HOSPITAL. ITS MOTTO IS “CURE WITH CARE”. IT OFFER SUPER SPECIALITY TREATMENT IN THE FORM OF ADVANCED SURGERIES SUCH AS RENALTRANSPLANT, JOINT REPLACEMENT, CORNEAL TRANSPLANT, ENDOSCOPIES AND LAPAROSCOPICSURGERIES, NEURO AND SPINAL SURGERIES, MAXILLOFACIAL AND PLASTIC SURGERIES AS WELL ASONCOSURGERY TO NAME A FEW. IT IS BACKED BY THE LATEST MEDICAL, IMAGING AND DIAGNOSTIC EQUIPMENT SUCH AS COLOURDOPPLER, CT SCAN, HIGH PRECISION MONITORS, WHICH ARE UPGRADED PERIODICALLY TO KEEP PACEWITH THE LATEST ADVANCEMENTS IN THE FIELD OF MEDICINE. IT IS ALSO EQUIPPED WITH AN ULTRA MODERN OPERATION THEATRE COMPLEX WITH ATTACHED ICU,ICCU, SURGICAL ICU, PEDIATRIC ICU AND NEONATAL ICUS HAVING ALL THE NECESSARY EQUIPMENTSSUCH AS MULTIPARA MONITORS, CENTRAL MONITORING SYSTEM, VENTILATORS FOR PROVIDING THEBEST POSSIBLE TREATMENT TO THE PATIENT. 24 HRS TRAUMA & EMERGENCY SERVICES IS AVAILABLE.
  6. 6. INFORMATION ABOUT AVBRH SAWANGI WARDHA INTRODUCTION HOSPITAL IS HAVING DAILY OPD 1000 – 1200 PATIENTS. FREE BUS FACILITIES IN VILLAGES IS AVAILABLE. THIS COMPREHENSIVE TERTIARY LEVEL HOSPITAL IS FAST DEVELOPINGINTO A REFERRAL CENTRE OF CENTRAL INDIA. ANOTHER FEATHER HAS BEEN ADDED TO ITS CAP WITH THE INAUGURATIONOF THE ‘CARDIAC CENTRE’ ON THE 5TH OF APRIL 2010 WHICH WILL OFFERALL SURGERIES RELATED TO THE HEART INCLUDING ANGIOPLASTY, OPENHEART SURGERY, BY- PASS SURGERY ETC. THIS IS THE FIRST OF ITS KIND INWARDHA AND WILL BENEFIT THOUSANDS OF PATIENTS OF WARDHA ANDNEIGHBOURING DISTRICTS. AVBRH IS A TEACHING HOSPITAL HAVING A WELL KNOWN INSTITUTIONJAWAHARLAL NEHRU MEDICAL COLLEGE. DATTA MEGHE INSTITUTE OFMEDICAL COLLEGE IS A PUBLIC TRUST REGISTERED UNDER BOMBAY PUBLICTRUST IN 1950 IT WAS PREVIOUSLY KNOWN AS SMT. RADHIKABAI MEGHEMEMORIAL MEDICAL TRUST.
  7. 7. VISION “TO EMERGE AS THE GLOBAL CENTER OF EXCELLENCE IN THE BEST EVIDENCE BASED HIGHER EDUCATION ENCOMPASSING A QUALITY CENTRIC, INNOVATIVE AND INTERDISCIPLINARY APPROACH, GENERATING REFUTATIVE RESEARCH AND OFFERING EFFECTIVE AND AFFORDABLE HEALTH CARE FOR THE BENEFIT OF THE MANKIND”.
  8. 8. MISSION DMIMS SHALL DEVLOP COMPETENT, CONFIDENT, CONCERNED, COMPASSIONATE AND GLOBALLY RELEVANT PROFESSIONALS BY QUALITY, LEARNER, COMMUNITY AND EVIDENCE CENTRIC ‘COMPETENCY BASED MODEL’ OF HIGHER EDUCATION WITH VALUE ORIENTATION, THROUGH ALL ITS CONSTITUENT UNIT. IT SHALL FOSTER A CONDUCIVE MILIEU FOR INTERDISCIPLINARY RESEARCH PRACTICES GENERATING CONSEQUENTIAL AND MEANINGFUL OUTCOMES FOR THE NATION IN GENERAL AND THE REGION IN PARTICULAR. IT SHALL DELIVER COMPREHENSIVE QUALITY HEALTH CARE SERVICES TO THE RURAL, NEEDY, MARGINALIZED AND UNDERPRIVILEGED POPULACE. THIS SHALL BE ACHIEVED THROUGH APPROPRIATE COLLABORATIVE LINKAGE AND A PROACTIVE TRANSPARENT AND ACCOUNTABLE DECENTRALIZED GOVERNANCE SYSTEM.
  9. 9. LOCATION ACHARYA VINOBA BHAVE RURAL HOSPITAL IS ATTACHED TO JAWAHARLAL NEHRU MEDICAL COLLEGE RUNS BY SMT. RADHIKABAI MEGHE MEMORIAL MEDICAL TRUST, NAGPUR AS A TEACHING HOSPITAL. THIS 1138 BEDDED HOSPITAL STARTED IN THE YEAR 1990 HAS DEVELOPED RAPIDLY DURING THESE YEARS. THE BASIC IDEA OF THE TRUST WHILE STARTING THIS HOSPITAL WAS TO CATER TO THE RURAL POPULATION OF WARDHA DISTRICT AND CENTRAL INDIA AND PROVIDE ADVANCED MEDICAL CARE FACILITIES TO THE DOWNTRODDEN. IT IS 70KM FROM NAGPUR BY BUS/CAR. 2 KM FROM WARDHA RAILWAY STATION, 7 KM FROM SEWAGRAM RAILWAY STATION.
  10. 10. HOSPITAL RECOGNITION MAHARASHTRA STATE GOVERNMENT EMPLOYEES. M.S.R. TRANSPORT CORPORATION. BSNL (BHARAT SANCHAR NIGAM LTD). CENTER AMMUNITION DEPARTMENT PULGAON. TTK HEALTH SERVICES. MD INDIA HEALTH PLAN LTD. LLOYDS STEEL. MAHARASHTRA RAJYA POLICE MUKHALAYA. DEDICATED HEALTH CARE SERVICES. GOODS HEALTH PLAN LTD.
  11. 11. HOSPITAL SERVICES MEDICAL SERVICES  DERMATOLOGY.  PSYCHIATRY.  ENDOCRINOLOGY.  PULMONOLOGY.  CARDIOLOGY.  NEPHROLOGY.
  12. 12. HOSPITAL SERVICES SURGICAL SERVICES LAPROENDOSCOPY & GENERAL SURGERY. TRAUMA CENTER & ORTHOPEDICS. OPHTALMOLOGY. GYNECOLOGY & OBSTETRICS. NEUROSURGERY.
  13. 13. HOSPITAL SERVICES CLINICAL SERVICES INTERVENTIONAL RADIOLOGY (ANGIOGRAPHY) ETC. CT SCAN, MRI, ULTRASOUND & XRAY ETC. LAB SERVICES:-BIOCHEMISTRY, MICROBIOLOGY, CLINICAL PATHOLOGY, HISTOPATHOLOGY, CYTOLOGY, HEMATOLOGY, SEROLOGY, IMMUNOLOGY ETC. 2D ECHO, COLOUR DOPPLER, TMT, DIALYSIS, ECG, EEG ETC. VIDEO ENDOSCOPY, COLONOSCOPY, SIGMOIDOSCOPY ETC.
  14. 14. PUBLIC HEALTH SCHEME IMPLIMENTED AT AVBRH HOSPITAL DATTATRAYA AYROGYA DATTAK YOJNA (DADY) VANDE MATRAM SCHEME FOR ALL PATIENTS FAMILY CARD HOLDER SANJIWANI SCHEME KAWACH KUNDAL YOJNA BAL SANJIWANI SCHEME FREE TRANSPORTATION SCHEME JANANI SURAKSHA YOJANA (GOVT. FUNDED SCHEMES) JEEVAN DAI YOJNA (GOVT. FUNDED SCHEMS SMILE TRAIN SARVA SHIKSHAN ABHIYAN (GOVERNMENT OF INDIA’S SCHEME) RSBY SCHEME (RASHTRIYA SWASTH BEEMA YOJNA)
  15. 15. INTRODUCTION TO MEDICINE DEPARTMENT MEDICINE DEPARTMENT CONSIST OF MEDICINE OPD. MALE MEDICINE WARDS. FEMALE MEDICINE WARDS. MEDICINE ICU (MICU). ECG ROOM. INJECTION ROOM. IT IS MOST IMPORTANT AND BUSY DEPARTMENT AT AVBRH BECAUSE MOST OF THE PATIENTS COMES TO MEDICINE OPD AND MOST OF THE PATIENTS ARE ADMITTED IN MEDICINE WARD AND MICU. MEDICINE DEPARTMENT IS TOTAL 210 BEDDED MEDICINE DEPARTMENT HAS 13-BEDDED ICU. MEDICINE WARDS ARE DISTRIBUTED INTO 7 WARDS THEY ARE AS FOLLOWS 27 & 28 FEMALE MEDICINE WARD. 16, 17,18,33,MALE MEDICINES WARD.
  16. 16. AIM TO STUDY THE PLANNING, ORGANISATIONAL STRUCTURE, MANAGEMENT, EVALUATION AND GIVE RECOMMENDATIONS IF ANY OF MEDICINE DEPARTMENT AT AVBRH HOSPITAL SAWANGI WARDHA.
  17. 17. OBJECTIVES TO STUDY ORGANISATION AND WORKING OF MEDICINE OPD. TO STUDY ORGANISATION AND WORKING OF MEDICINE WARDS. TO STUDY ORGANISATION AND WORKING OF MEDICINE ICU (MICU). TO SEE THE FACILITY AND SERVICES PROVIDED TO PATIENTS. TO FIND OUT ANY NEED TO IMPROVE BASIC SERVICES PROVIDED TO PATIENTS.
  18. 18. METHODOLOGY AN OBSERVATIONAL STUDY WAS CARRIED OUT IN MEDICINE OPD, MEDICINE WARDS, MEDICINE ICU, WHICH COMES UNDER MEDICINE DEPARTMENT OF AVBRH HOSPITAL SAWANGI FROM 19/03/2012 TO 25/03/2012. THE DATA HAS BEEN COLLETED THROUGH OBSERVATIONAL AND INFORMAL DISCUSSION WITH DOCTORS, NURSES, PATIENTS & OTHER STAFFS. FOR THIS STUDY DATA COLLECTED INCLUDED- TOTAL NO. OF OPD PATIENTS. TOTAL NO. OF ADMISSION TOTAL NO. OF DISCHARGE AVERAGE LENGTH OF STAY OF PATIENTS
  19. 19. HIEARCHY STRUCTURE OF MEDICINE DEPARTMENT HEAD OF DEPARTMENT (HOD) – 1 PROFESSOR – 10 INCLUDING (HOD) ASSOCIATE PROFESSOR – 4 ASSISTANT PROFESSOR – 7 •DR S.N.MAHAJAN PROFESSOR & HOD •DR S.R.TANKHIWALE PROFESSOR •DR S.K.DIWAN PROFESSOR •DR ANIL.H.INAMDAR PROFESSOR •DR A.K.WANJARI PROFESSOR •DR M.V.DHAKATE PROFESSOR •DR RAJESH SARODE PROFESSOR •DR T.K.KAMBLE PROFESSOR •DR M.M.PATIL PROFESSOR •DR SOURYA ACHARYA PROFESSOR
  20. 20. HIEARCHY STRUCTURE OF MEDICINE DEPARTMENT•DR S.K.GUPTA ASSOCIATE PROFESSOR•DR SUNIL KUMAR ASSOCIATE PROFESSOR•DR R.T.REWEKAR ASSOCIATE PROFESSOR•DR BHARTI GANVIR ASSOCIATE PROFESSOR•DR SHILPA BAWANKULE ASSISTANT PROFESSOR•DR SAMMIR CHAUDHARI ASSISTANT PROFESSOR•DR AMOL SAMARTH ASSISTANT PROFESSOR•DR SIDDHART SUBHEDAR ASSISTANT PROFESSOR•DR R.N.KALMEGH ASSISTANT PROFESSOR•DR PARIMAL TAYDE ASSISTANT PROFESSOR•DR N.S.KOTHARI ASSISTANT PROFESSOR
  21. 21. MEDICINE OPD LOCATION OF OPD MEDICINE OPD IS SITUATED IN A WING AT GROUND FLOOR. NO OF MEDICINE OPD IS 11. MEDICINE OPD TIMINGS  MONDAY TO FRIDAY- 8.30AM TO 3.30PM.  SATURDAY – 8.30AM TO 1:00PM.  SUNDAY – CLOSED. STAFF ATTENDENT – 1. SISTER – 1. INSTRUMENTS USED IN OPD BP APPRATUS. TORCH. STETOSCOPE. HAMMER – 4. SUCTION MACHINE – 1. O2 CYLINDER – 1. INSPECTION TABLE – 4. INSPECTING STOOLS – 4.
  22. 22. MEDICINE OPDMEDICINE OPD CONSIST OFWAITING AREA.RECEPTION.CONSULTATION ROOM – 4.TEACHING AREA. WAITING AREA WAITING AREA OF OPD IS SITUATED OUTSIDE OF OPD. WAITING AREA CONSIST OF FACILITY FOR SITTING FOR PATIENTS. RECEPTION IT IS SITUATED IN FRONT OF THE ENTRY OF OPD. RECEPTION IS COMPUTERISED WITH HIS SYSTEM. SISTER HANDELS THIS RECEPTION COUNTER. CONSULTATION ROOM MEDICINE OPD CONSIST OF 4 CONSULTATION ROOM. EACH ROOM CONSISTS OF INSEPECTION STOOL, INSEPECTION TABLE, DOCTORS CHAIR, AND TABLE. TEACHING AREA MEDICINE OPD HAS CLINICAL DEMO ROOM. AS AVBRH IS A TEACHING HOSPITAL SO THERE IS A CLINICAL DEMO ROOM TO CARRY OUT LECTURES FOR STUDENTS. IT CONSISTS OF BOARD, EXAMINATION TABLE AND CHAIRS.
  23. 23. MEDICINE OPD  DAILY OPDDAY UNIT DOCTORS DOCTORSMONDAY 1 DR SATISH DR ANIL WANJARI MAHAJANTUESDAY 2 DR T.K.KAMBLE DR ANIL INAMDARWENESDAY 3 DR SANJAY DIWAN DR M.M.PATILTHURSDAY 4 DR ANIL INAMDAR. DR T K.KAMBLEFRIDAY 5 DR ANIL WANJARI DR SATISH MAHAJANSATURDAY 6 DR M.M.PATIL DR SANJAY DIWANSUNDAY CLOSED
  24. 24. MEDICINE OPD  SPECIALITY CLINIC OPDDAY SPECIALITY CLINIC TIME DOCTOR NAMEMONDAY DIABETES 12PM TO 2PM •DR S.N.MAHAJAN •DR SOURYA ACHARYA •DR NIRMESH KOTHARITUESDAY NEUROLOGY 12PM TO 2PM •DR S.R.TANKHLWALA •DR T.K.KAMBLE •DR ROHAN KALMEGHWEDNESDAY NEPHROLOGY 12PM TO 2PM •DR S K DIWAN •DR SUNIL KUMAR •DR SHEETAL KRIPLANIWEDNESDAY HEMATOLOGY 12PM TO 2PM •DR S B KANE •DR S K DIWAN •DR SHEETAL KRIPLANITHURSDAY GASTRO+ 12PM TO 2PM •DR AMOL SAMARTH HEPATOBILIARYFRIDAY CARDIOLOGY 12PM TO 2PM •DR A K WANJARI •DR M V DHAKATE •DR PARIMAL TAYDEFRIDAY ENDOCRINOLOGY 12PM TO 2PM •DR SOURYA ACHARYA •DR NIRMESH KOTHARI
  25. 25. EVALUATION- DATA ANALYSIS  TOTAL NO. OF OPD PATIENTS DATE NO OF PATIENT 19/03/2012 381 20/03/2012 376 21/03/2012 355 22/03/2012 370 23/03/2012 0 24/03/2012 345 25/03/2012 0 TOTAL 1827AVERAGE TIME TAKEN FOR CHECKUP IN MEDICINE OPD WAS 10 TO 15MINUTES.
  26. 26. MEDICINE WARDS  MEDICINE WARDS ARE SITUATED IN DIFFERENT WINGS OF HOSPITAL.  WARDS ARE DIFFERENTIATED ON BASIS OF SEX OF PATIENTS.  EACH WARD IS FURTHER SUBDIVIDED ON THE BASIS OF VARIOUS UNITS DEPENDING UPON THE DAY OF ADMISSION MALE MEDICINE WARD NO 33 UNIT UNIT INCHARGE CALL DAY 5 DR WANJARI FRIDAY 6 DR PATIL SATURDAY 7 DR TANKIWALE TUESDAYMALE MEDICINE WARD NO 27 UNIT UNIT INCHARGE CALL DAY 1 DR MAHAJAN MONDAY 2 DR DIWAN TUESDAY 3 DR KAMBLE WENESDAY
  27. 27. MEDICINE WARDS MALE MEDICINE WARD NO 17 & 18 UNIT UNIT INCHARGE CALL DAY 3 DR KAMBLE TUESDAY 4 DR INAMDER THURSDAY MALE MEDICINE WARD NO 16 UNIT UNIT INCHARGE CALL DAY 1 DR S N MAHAJAN MONDAY 2 DR S K DIWAN WENESDAY FEMALE MEDICINE WARD NO 28 UNIT UNIT INCHARGE CALL DAY 4 DR INAMDAR THURSDAY 5 DR WANJARI FRIDAY 6 DR PATIL SATURDAY 7 DR TANKHIWALE TUESDAY
  28. 28. LOCATION OF WARDS MALE MEDICINE WARD NO 33 – SITUATED IN E BLOCK OPPOSITE TO ENT OPD MALE MEDICINE WARD NO 16 – SITUATED IN A BLOCK AT SECOND FLOOR. FEMALE MEDICINE WARD NO 27 – SITUATED IN A BLOCK AT THIRD FLOOR. FEMALE MEDICINE WARD NO 28 – SITUATED IN A BLOCK AT THIRD FLOOR. MALE MEDICINE WARD NO 17 & 18 – SITUATED IN A BLOCK AT SECOND FLOOR.
  29. 29. DESIGN OF WARDS THIS ALL MEDICINE WARDS ARE DESIGNED IN SUCH A WAY THAT THEY ARE EASILY ASSESABLE WITH STAIR CASES AND LIFT. ALL MEDICAL WARDS ARE BIG IN SIZE AND AMPLE SPACE TO ACCOMODATE LARGE NO OF PATIENTS. WARDS ARE OF NIGHTINGALE TYPE. (NIGHTINGALE WARDS IS A TYPE OF HOSPITAL WARDS WHICH CONTAIN A LARGE ROOM WITHOUT SUBDIVISON FOR PATIENTS OCCUPANCY.)
  30. 30. FUNCTIONAL AREA OF MEDICINE WARDS NURSING STATION EXAMINATION & TREATMENT ROOM CLINICAL DEMO ROOM STORE ROOM DOCTORS DUTY ROOM SR RESIDENT ROOM PANTRY TOILET
  31. 31. ORGANOGRAM ORGANISATIONAL CHART FOR MEDICAL STAFF HOD UNIT INCHARG E ASSOCIAT E PROFESSO R LECTURE R JR 1, 2, 3 INTER N
  32. 32. ORGANISATIONAL CHART FOR NURSING STAFFCHIEF NURSINGSUPRITENDANT MATRON WARD INCHARGE HEAD NURSE STAFF NURSE ATTENDANT SWEEPAR
  33. 33. TIMING FOR WARD STAFF SHIFTS DUTY DOCTORS – 9AM TO 9PM (24HRS) INCHARGE SISTER – 7:30AM TO 3:00PM SISTER & ATTENDANT – MORNING - 7AM TO 2PM EVENING – 2PM TO 8PM NIGHT – 8PM TO 7AM DOCTORS VISITING TIMES MORNING – 10:00AM ONWARDS BY HOD, LECTURER, PG STUDENT EVENING – 5:00PM ONWARDS BY LECTURER, PG STUDENTS
  34. 34. MANAGEMENT FLOW CHART SHOWING WORKING OF MEDICINE WARDSPATIENT TO BE ADMITTED COMES FROM CASULTY, OPD, ADMISSION COUNTER, AND ICU. ↓ NECESSARY FORMALITIES ARE CARRIED OUT AT ADMISSION COUNTER ↓ PATIENT GETS ADMITTED IN WARD ↓PATIENT GETS FULL NURSING CARE, MEDICINES, FOOD, AND INVESTIGATIONS ARE DONE ↓ PATIENT GETS CURE AFTER GEETING ALL HOSPITAL SERVICES ↓ CONSULTANT ADVICE DISCHARGE TO PATIENT ↓ NURSES PREPARE RECORD TO ATTACH IN DISCHARGE FILE ↓ AFTER DISCHARGE FILE IS COMPLETE NURSES PREPARE THE BILL OF THE PATIENT ↓ FAMILY MEMBERS ARE INTIMATED FOR CLERANCE OF BILL ↓ AFTER CLERANCE OF BILL NURSES HAND OVER ALL DOCUMENT TO PATIENT AND THE PATIENT IS DISCHARGE
  35. 35. HOW ON CALL DOCTORS ARE CALLED IN CASE OF EMERGENCY IN WARD SISTER CALL IN MICU.AS TOLD BY SISTERS DOCTORS ARE PRESENT IN MICU IF DOCTORS ARE PRESENT IN MICU THEY COMES IN 5 TO 10 MINUTES AT WARD IF THEY ARE NOT PRESENT IN MICU SISTER CALL THEM ON THERE PERSONAL MOBILE NUMBER
  36. 36. LIST OF REGISTAR MAINTAINED IN WARDS MEDICINE TABLET BOOK INJECTION BOOK LINEN BOOK STATIONARY BOOK CONSUMABLE BOOK INSTRUMENT BOOK FURNITURE + EQUIPMENT BOOK DAILY INVENTORY BOOK ASSIST + STUDENT BOOK INTERN BOOK HFC BOOK DIET BOOK DAILY ACCOUNT BOOK DAILY PATIENT ACCOUNT BOOK AUTO CLAVE SENDING BOOK PATIENT CALL BOOK TOILET CLEANING BOOK MRD BOOK INVESTIGATION BOOK DAILY INSTRUMENT HAND OVER BOOK LEAVE UNFIT REGISTER MEDICAL FITNESS PHONE BOOK MOVEMENT BOOK ADMISSION REGISTAR DISCHARGE REGISTAR BLOOD TRANFUSION BOOK DEATH BOOK MLC BOOK ATTENDANT BOOK DUTY BOOK BREAK DOWN EQUIPMENT BOOK REQUISITION BOOK
  37. 37. LISTS OF FILES MAINTAINED IN WARDS CIRCULAR FILE MRD FILE DISCHARGE REPORT FILE COMPLAINT FILE STUDENT CIRCULAR FILE
  38. 38. INSTRUMENTS USED IN MEDICINE WARDS O2 CYLINDER SUCTION MACHINE BP APPRATUS THERMOMETER NEBULIZER MACHINE HUMIDIFIER O2 FLOW METER INJECTION TRAY STEEL KIDNEY TRAY LARINGOSCOPE SET AMBUBAG NEEDLE CUTTER SUCTION BOTTLES CHITTLE FORCEPS PLAIN THUMB FORCEPS (BIG & SMALL) BIG PLAIN CURVE FORCEPS MOSQUITE PLAIN FORCEPS (ARTERY) SUTURE PLAIN SCISSOR SUTURE PLAIN CURVE SCISSOR SPONGE HOLDING FORCEPS O2 KEY TOUNGE DEPRESSURE CURVE ARTERY FORCEPS ECG MACHINE VENISECTION TRAY VASOFIX
  39. 39. EMERGENCY TROLLEY IN MEDICINE WARD CONSIST OF INJ ADRENALIN INJ DOPAMIN INJ DIAZIPAM INJ ATROPIN INJ POTASSIUM INJ CALCIUM GLUCONATE IINJ KESOL INJ SODA BICARB IV RL IV D5% IV D25% DNS IV METRO IV CIPRO 2ML SYRINGE 5ML SYRINGE 10ML SYRINGE 20ML SYRINGE ISOPROPYL RUBBING BP APPRATUS CHITALS FORCEP ECG MACHINE RYLES TUBE LARYNGOSCOPE AMBUBAG GLOVES STERILIUM SAFTEY EQUIPMENT FIRE EXTINGUISHER
  40. 40. NURSING STAFFWARD NO NURSING INCHARGE PRESENT ATTENDANT STATION SISTER STAFF STAFF33 MMW 1 1 5 428 FMW 1 1 9 5 FOR27 FMW 1 1 9 BOTH 27 &2817 & 18 1 1 10 4 MMW16 MMW 1 1 5 3
  41. 41. BED DISTRIBUTION IN EACH WARD WARD NO NO OF BEDS MALE MEDICINE WARD 33 30FEMALE MEDICINE WARD 28 45FEMALE MEDICINE WARD 27 45MALE MEDICINE WARD 17&18 60 MALE MEDICINE WARD 16 30 TOTAL 210
  42. 42. WHEEL CHAIRS AND STRETCHERSWARD NO WHEEL CHAIR STRETCHER BEDS33 MMW 2 2 3028 FMW 1 1 4527 FMW 1 1 4517 & 18 MMW 2 2 6016 MMW 2 1 30
  43. 43. BED ARRANGMENT IN WARD THE ARRANGEMENT IN THIS WARD IS OF NIGHTINGALE TYPE. DISTANCE BETWEEN TWO BEDS IS AROUND 3 FEETS. THERE ARE ABOUT 4 TO 5 SEMI FLOWER BEDS IN EACH WARD. BESIDE EACH BED BEDSIDE TROLLEYS ARE KEPT .
  44. 44. NURSING STATIONS EACH WARD HAS ONE NURSING STATION. IT IS SITUATED IN SUCH A WAY THAT EVERY PATIENT CAN BE OBSERVED FOR THERE. EACH NURSING STATION IS INSTALLED WITH COMPUTER HAVING HOSPITAL INFORMATION SYSTEM (HIS). IT HAS TELEPHONE WITH INTERCOM NUMBERS. IT HAS CABINET FOR FILE STORAGE.
  45. 45. DOOR AND WINDOWS OF WARDS DOORS ARE BIG TO FACILITATE EASY PASSAGE OF STRETCHER, WHEEL CHAIR, EQUIPMENTS, AND BEDS. ALL WARD HAVE ABOUT 12 TO 15 GLASS WINDOWS SO THAT THERE IS SUFFICIENT NATURAL LIGHT IN WARDS. WINDOWS ARE PROVIDED WITH CURTAIN AND NETS.
  46. 46. LIGHT AND COOLING SYSTEM IN WARDS THERE ARE 12 TO 15 LIGHTS IN EACH WARD FOR ADEQUATE LIGHT IN WARD. GENERATOR BACKUP IS THERE IN CASE OF EMERGENCY. DUCTING FACILITY IS AVAILABLE IN EACH WARD FOR COOLING. BESIDES DUCTING 15 TO 18, FANS ARE AVAILABLE IN EACH WARD FOR COOLING.
  47. 47. TREATMENT & EXAMINATION ROOM EACH WARD CONSISTS OF TREATMENT AND EXAMINATION ROOM. TREATMENT & EXAMINATION ROOM IS USED FOR DRESSING & OTHER MINOR PROCEDURE. TREATMENT & EXAMINATION ROOM CONSISTS OF  SAVLON SOAP  HYDROGEN PEROXIDE  POVIDONE IODINE  CARDIAC GEL  LIQUID PARAFFIN  INJ LIGNOCANE  INJ XYLOCAIN 4%  CHITAL FORCEP  SURGICAL TRAY  MERCURY CHROM SOLUTION  CATHERATER TRAY  DRESSING TRAY
  48. 48. DOCTORS DUTY ROOM  EACH WARD CONSISTS OF DOCTORS DUTY ROOM FOR RESIDENT DOCTOR ON DUTY.  THIS ROOM CONSISTS OF BED AND CHAIRS. STORE ROOMEACH WARD CONSISTS OF STORE ROOMIN THIS ROOM CLEAN LINEN, STATIONARY, MEDICINE, OFFICIAL REGISTARSETC ARE KEPT. CLINICAL DEMO ROOMEACH WARD HAS CLINICAL DEMO ROOM.AS AVBRH IS A TEACHING HOSPITAL SO THERE IS A CLINICAL DEMO ROOMTO CARRY OUT LECTURES FOR STUDENTS.IT CONSISTS OF BOARD, EXAMINATION TABLE AND CHAIRS.
  49. 49. PANTRY  EACH WARD CONSISTS OF PANTRY ROOM.  PANTRY CONSISTS OF GAS & CYLINDER. HOUSKEEPINGIN EACH WARD HOUSKEEPING IS DONE BY ATTENDANT.CLEANING OF WARDS IS DONE THRICE A DAY IN MORNING, EVENING AND NIGHT.TOILET IS ALO CLEANED THRICE A DAY BY ATTENDANT.LINEN IS CHANGED EVERY DAY AND DIRTY LINEN IS KEPT IN A DRUM.DIRTY LINEN IS TAKEN TO LAUNDARY BY ATTENDANT IN MORNING AT 10AM TO 11AMAND CLEAN LINEN IS BROUGHT AT 4PM.
  50. 50. BIO MEDICAL WASTE MANAGEMANT EACH WARD CONSISTS OF FOLLOWING COLOUR CODING BUCKETS FOR COLLECTION OF WASTES.  RED - INFECTIOUS PLASTIC WASTE, DISPOSABLE TUBING, CATHRETER, GLOVES, PLASTIC GOWNS AND SYRINGES.  BLACK – PAPERS, EXPIRED MEDICINE, GENERAL WASTE.  YELLOW – INFECTOUS WASTE, HUMAN TISSUE, ORGANS, PATHOLOGICAL WASTE, PLACENTA, SOLID COTTON, BANDAGE, PLASTER ETC.  CARD BOARD BOX – GLASS WASTE, AMPOULES, BROKEN GLASS, TUBING, PLASTIC WASTE ETC. BIO MEDICAL WASTE IS COLLECTED DAILY IN MORNING AT 8:30 AM.
  51. 51. SOME OF THE SCHEMES RUNNING IN HOSPITAL THAT IS COMMAN FOR MEDICINE WARDS SANJEEVANI YOJNA – IN THIS YOJNA MEDICINES ARE GIVEN FREE TO PATIENTS. RASHTRIYA SWASTH BEEMA YOJNA (RSBY) – OPD & IPD SERVICES, AND INVESTIGATIONS ARE FREE. ADHAR YOJNA – FREE TREATMENT, INVESTIGATIONS, MEDICATION, BREAK FAST.
  52. 52. HIGH DEPANDANCY UNIT (HDU) IT IS ALSO CALLED AS STEP DOWN ICU PATIENT WHO REQUIRES LESS CARE ARE SHIFTED TO HDU IT IS SITUATED IN WARD NO 16. PORTABLE PARTITION IS USED FOR PRIVACY OF PATIENTS. IT CONSIST OF TOTAL 6 BED EACH BED HAS FOLLOWING ARRANGEMENT  CRADEL BED  CENTRAL O2  CENTRAL SUCTION  PULSE OXIMETER  MONITOR  ELETRIC SOCKET  STOOL. NURSING STAFF FOR HDU - 5
  53. 53. EVALUATION- DATA ANALYSIS  NUMBERS OF ADMISSIONS DISCHARGES OF MEDICINE WARD DATE ADMISSION DISCHARGE 19/03/2012 64 49 20/03/2012 51 47 21/03/2012 43 31 22/03/2012 44 41 23/03/2012 10 32 24/03/2012 38 52 25/03/2012 08 06 TOTAL 258 258AVERAGE LENGTH OF STAY OF PATIENT-Data was collected regarding the admission & discharge of 20 patients in medical ward and it was seenthat the average length of stay of patient was about 7-10 days.
  54. 54. MEDICINE INTENSIVE CARE UNIT (MICU) IT IS SITUATED IN A WING ON SECOND FLOOR NEAR GENERAL MEDICINE WARD NO 16. MICU IS 13 BEDDED. NURSING STAFF – 22 INCLUDING INCHARGE SISTER. ATTENDANT – 3 MICU IS FULLY EQUIPPED WITH AIR CONDITIONER. 8 VENTILATORS THERE IS PARTITION OF CURTAIN FOR EVERY BED FOR PRIVACY OF PATIENT. NURSING STAFF & ATTENDANT STAFF SHIFT NURSING STAFF ATTENDANT STAFF MORNING 4 TO 5 1 EVENING 4 1 NIGHT 4 1 DOCTORS DUTY SHIFT DOCTOR AVAILABLE MORNING 1 JUNIOR RESIDENT EVENING 1 JUNIOR RESIDENT NIGHT 1 JUNIOR RESIDENT
  55. 55. MANAGEMENTPATIENT TO BE ADMITTED COMES FROM CASULTY, OPD, ADMISSION COUNTER, AND WARDS. ↓ NECESSARY FORMALITIES ARE CARRIED OUT AT ADMISSION COUNTER ↓ PATIENT GETS ADMITTED IN MICU ↓PATIENT GETS FULL NURSING CARE, MEDICINES, FOOD, AND INVESTIGATIONS ARE DONE ↓ PATIENT GETS CURE AFTER GEETING ALL HOSPITAL SERVICES ↓ CONSULTANT ADVICE DISCHARGE TO PATIENT ↓ NURSES PREPARE RECORD TO ATTACH IN DISCHARGE FILE ↓AFTER DISCHARGE FILE IS COMPLETE NURSES PREPARE THE BILL OF THE PATIENT ↓ FAMILY MEMBERS ARE INTIMATED FOR CLERANCE OF BILL ↓ AFTER CLERANCE OF BILL NURSES HAND OVER ALL DOCUMENT TO PATIENT AND THE PATIENT IS DISCHARGE.
  56. 56. LIST OF FACILITIES AVAILABLE IN MEDICINE ICU ARTERIAL BLOOD GAS ANALYSER CENTRAL CARDIAC MONITORS VENTILATORS – INVASIVE NON – INVASIVE MULTIPARA MONITORS, CARDIAC MONITOR CUM DEFIBRILLATORS PULSE OXYMETERS PORTABLE X-RAY MACHINE E.C.G. MACHINE NEBULIZERS CENTRAL 02 CENTRAL SUCTION NON INVASIVE B. P. APPARATUS SYRINGE INFUSION PUMPS EXTERNAL CARDIAC PACEMAKER INTERNAL CARDIAC PACEMAKER OPHTHALMOSCOPES CENTRALIZED COMPRESSED AIR HEMODIALYSIS MACHINE 2-D ECHO- CARDIOGRAPHY COMPUTERIZED T.M.T. COLOUR DOPPLERS PORTABLE X-RAY MACHINE P.F.T. MACHINE HOLTERMONITOR
  57. 57. SOME PICTURES FROM MICU FUNCTIONAL AREA OF MICUNURSING STATIONSTORE ROOMDOCTORS DUTY ROOMTOILETDIALYSIS ROOM
  58. 58. NURSING STATION MICU HAS ONE NURSING STATION. IT IS SITUATED IN SUCH A WAY THAT EVERY PATIENT CAN BE OBSERVED FOR THERE. EACH NURSING STATION IS INSTALLED WITH COMPUTER HAVING HOSPITAL INFORMATION SYSTEM (HIS). IT HAS TELEPHONE WITH INTERCOM NUMBERS. IT HAS CABINET FOR FILE STORAGE
  59. 59. DIALYSIS ROOM  IT IS SITUATED IN BETWEEN THE BARRIERS OF ENTRY OF ICU.  THERE ARE 3 DIALYSIS MACHINE AND 3 BED IN DIALYSIS ROOM.  ONE DIALYSIS MACHINE IS NOT WORKING AND IT IS KEPT IN DIALYSIS STORE ROOM.  THERE IS ONE STORE ROOM INSIDE DIALYSIS ROOM.  DIALYSIS ROOM IS VERY SMALL.  THERE ARE 2 ASSISTANTS IN DIALYSIS ROOM WHO CARRY OUT THE DIALYSIS PROCEDURE. DOCTORS ROOMSITUATED IN FRONT OF DIALYSIS ROOM.DOCTORS ROOM CONSISTS OF CHAIR AND BED. STORE ROOM IN STORE ROOM MEDICINE, CLEAN LINEN, AND OFFICIAL REGISTARS AREKEPT.
  60. 60. BED ARRANGEMENT ARRANGMENT OF BED IN ICU IS OF NIGHTINGALE TYPE THERE IS PARTITION OF CURTAIN FOR EACH BED FOR PRIVACY OF PATIENT. CEILING HANGING IV STAND IS USED FOR EVERY BED. THERE IS STOOL AND DUSTBIN BUCKET FOR EACH BED. WALL MOUNTED FANS ARE THERE FOR EVERY BED. BESIDE EVER BED, THERE IS BED SIDE TROLLEY. CENTRAL O2 AND SUCTION IS PROVIDED TO EACH BED. DOORS AND WINDOWSTO ENTER IN ICU WE HAVE TO COME THROUGH 2 DOORS.DOORS ARE BIG TO FACILITATE EASY ENTRY OF STRETCHER AND WHEELCHAIR.WINDOWS ARE PACKED WITH GLASS TO PREVENT OUTSIDE SOUND ANDPREVENTS FROM INSECTS.
  61. 61. LIGHT  THERE ARE 12 TO 15 LIGHTS IN MICU.IT SEEMED TO BE ADEQUATE FOR PROPER ILLUMINATION.  GENERATOR BACKUP IS ALSO THERE IN CASE OF EMERGENCY. HOUSKEEPINGATTENDANT DOES MICU HOUSKEEPING.CLEANING OF MICU IS DONE THRICE A DAY IN MORNING, EVENING AND NIGHT.TOILET IS ALO CLEANED THRICE A DAY BY ATTENDANT.LINEN IS CHANGED EVERY DAY AND DIRTY LINEN IS KEPT IN A DRUM.ATTENDANT TAKES DIRTY LINEN TO LAUNDARY IN MORNING AT 10AM TO 11AM AND CLEAN LINENIS BROUGHT AT 4PM. BIO MEDICAL WASTE MANAGEMANT MICU CONSISTS OF FOLLOWING COLOUR CODING BUCKETS FOR COLLECTION OF WASTES. RED - INFECTIOUS PLASTIC WASTE, DISPOSABLE TUBING, CATHRETER, GLOVES, PLASTIC GOWNS AND SYRINGES. BLACK – PAPERS, EXPIRED MEDICINE, GENERAL WASTE. YELLOW – INFECTOUS WASTE, HUMAN TISSUE, ORGANS, PATHOLOGICAL WASTE, PLACENTA, SOLID COTTON, BANDAGE, PLASTER ETC. CARD BOARD BOX – GLASS WASTE, AMPOULES, BROKEN GLASS, TUBING, PLASTIC WASTE ETC. BIO MEDICAL WASTE IS COLLECTED DAILY IN MORNING AT 8:30 AM.
  62. 62. OBSERVATION AVBRH IS FULLY EQUIPPED HOSPITAL.AS IT COVERS ALL WARDHA DISTRICT IT PROVIDES A QUALITY SERVICES TO THE RURAL POPULATION RESIDING NEAR BY AT A VERY RESONABLE & AFFORDABLE COST.ALSO VARIOUS TYPE OF CONCESSIONS ARE PROVIDED IN FORM OF SCHEMES SUCH AS DADY, ADHAR ETC RUNNING IN HOSPITAL. HIGHLY QUALIFIED AND BEST DOCTORS IN MEDICINE OPD TREAT THE PATIENTS. MEDICINE OPD IS SITUATED AT GROUND FLOOR, AS IT IS VERY EASILY ACCESSIBLE TO PATIENTS. SPECIALITY CLINICS ARE ALSO RUNNED IN MEDICINE OPD AT THERE RESPECTIVE DAYS. MEDICINE OPD IS ONE OF THE BUSIEST OPD IN HOSPITAL. AS AVERAGE OPD OF EACH DAY IS, MORE THAN 100, IT IS MANAGED BY ONE ATTENDENT & ONE SISTER.IT IS DIFFICULT FOR THEM TO MANAGE MORE THAN 100 PATIENTS AS WELL AS DOCTORS ORDERS. MEDICINE WARDS IS 210 BEDDED.THEY ARE SPACIOUS AND WELL DESIGNED.THEY ARE EASILY ACCESSIBLE BY LIFT AND STAIRCASE.THERE IS PROPER VENTILATION, LIGHT,COOLING FACILITY IN WARD.
  63. 63. OBSERVATION CLEANESS IN WARDS WAS MAINTAINED AS IT IS CLEANED THRICE A DAY AS TOLD BY SISTER IN SOME WARD & IN SOME WARD IT WAS TOLD THAT IT IS CLEANED ONCE A DAY.HYGIENE IS MAINTAINED IN WARDS.TOILETS ARE NOT CLEANED PROPERLY. ONLY ONE RELATIVE SHOULD BE ALLOWED IN WARD.I SAW TOO MUCH NO OF RELATIVES IN WARD BECAUSE OF WHICH OTHER PATIENTS GET DISTURBED. IN WARD SISTERS FIRST PRIORITY IS PATIENTS CARE.THEY ALSO HAVE TO OBEY THE ORDERS GIVEN BY DOCTORS.BILLING IS ALSO DONE BY SISTER AS IT IS NOT THERE WORK BECAUSE OF WHICH PATIENT CARE IS BEING NEGLECTED BY THEM. EVERY WARD HAS A NURSING STATION SITUATED IN SUCH A WAY THAT IT COMMANDS A CLEAR, UNOBSTRUCTED VIEW OF COMPLETELY PATIENT AREA. IT ALSO HAS TELEPHONE SERVICE& ADEQUATE SPACE FOR SECRETARIAL WORK. IN SOME WARDS, THERE WAS A BOWL FILLED WITH SAVLON SOLUTION FOR HAND WASHING, BUT MANY WARDS DO NO HAVE IT. IN EACH WARD, I OBSERVED THAT THERE IS NO FACILITY OF DRINKING WATER FOR PATIENTS. IN SOME, WARD FIRE EXTINGUISHER IS INSTALLED AND IN SOME WARD, IT IS NOT INSTALLED.
  64. 64. OBSERVATION IT IS DIFFICULT FOR PATIENTS TO GO BY STAIR CASE IN SOME WARDS THAT ARE SITUATED ON THIRD FLOOR.PATIENTS LIFT IS ONLY TILL 2ND FLOOR. IN WARD NO 28 & 27 THERE ARE 5 ATTENDENT OF WHICH 2 ATTENDANT ARE IN MORNING, 1 ATTENDANT IN EVENING, AND 1 ATTENDANT IN NIGHT.THIS 5 ATTENDANT CANT HANDEL TWO WARD AT A TIME.SO THERE IS DEMAND FOR INCREASE ATTENDANT STAFF IN WARD NO 28 & 27. NO REFRIGARATOR IN EACH WARD FOR STORAGE OF DRUGS. HOWEVER, NONE OF THE WARD I OBSERVED WAS HAVING A DIRTY UTILITY ROOM & THEY WERE KEPT NEARBY PATIENT AREAS.THE DIRTY LINEN WAS COLLECTED IN A BIG CONTAINAR AND THAT IS KEPT IN CORNER OF A WARD.IN ADDITION, THE BROOMS, BUCKETS BRUSHES WERE KEPT IN OPEN SPACE. THIS IS NOT JUST A REASON TO SPREAD INFECTION BUT IS ALSO A THREAT FOR HOSPITAL’S REPUTATION. MEDICINE ICU IS 13 BEDDED THEY ARE SPACIOUS, WELL DESIGNED.THEY ARE EASILY ACCESSIBLE BY LIFT, AND STAIRCASE.THERE IS PROPER VENTILATION, LIGHT, COOLING FACILITY IN ICU. IN FRONT OF MICU THERE WERE TOO MANY RELATIVES OF THE PATIENTS AND THEY WERE ENTERING MICU IN BULK BY WEARING THERE FOOTWARES.AS THERE WAS NOBODY TO STOP THEM. DIALYSIS ROOM IS TOO SMALL.
  65. 65. RECOMMENDATIONS ONE MORE ATTENDANT AND SISTER MUST BE PROVIDED IN MEDICINE OPD. STRICT CONTROL OVER VISITOR TIMING SHOULD BE FOLLOWED TO MAINTAIN QUIETNESS IN WARD SECURITY GUARD SHOULD BE PROVIDED IN BUSY AREA OF EACH FLOOR TO CONTROL THE CROWD & RELATIVES & FOR THE SAFTEY OF STAFF. BILLING DEPARTMENT SHOULD BE REMOVED FROM SISTERS AS THERE FIRST PREFERENCE IS PATIENTS CARE.AS THEY ALSO HAVE OTHER DOCUMENTATION WORK OF FILLING SUMMARY,DISCHARGE FILES ETC ALSO THEY HAVE TO OBEY THE ORDERS GIVEN BY DOCTORS. BOWLS FILLED WITH SAVLON SOLUTION FOR HAND WASHING SHOULD BE MADE COMPULSARY IN EVERY WARD. IN EVERY WARD, FILTERED HOT AND COLD WATER FOR DRINKING SHOULD BE PROVIDED FOR PATIENTS.
  66. 66. RECOMMENDATIONS FOR SAFTEY PURPOSE OF WARDS AS WELL AS HOSPITAL IT SHOULD BE MADE COMPULSARY TO INSTALL, A FIRE EXTINGUISHER IN EACH WARDS.IF POSSIBLE SMOKE DETACTORS SHOULD ALSO BE INSTALLED IN WARDS & ICU. IT SHOULD BE TRIED THAT PATIENTS LIFT SHOULD BE EXTENDED TILL 3RD FLOOR FOR PATIENTS CONVINENCE. STAFF OF ATTENDANTS SHOULD BE INCREASED IN WARDS ESPECIALLY IN WARD NO 28 & 27. TOILETS& BATHROOMS NEEDS MORE FREQUENT CLEANING. DIRTY UTILITY ROOM SHOULD BE PROVIDED IN EVERY WARD. SECURITY GUARD MUST BE MADE COMPULSARY IN FRONT OF MICU. DIALYSIS ROOM SHOULD BE MADE LARGE.
  67. 67. BIBLIOGRAPHY HOSPITAL: PLANNING & DESIGNING & MANAGEMENT: G.D.KUNDER. MODERN TRENDS IN PLANNING & DESIGNING OF HOSPITAL: SHAKTI KUMAR, GUPTA SUNIL KANT. PRINCIPLES OF HOSPITAL ADMINISTRATION & PLANNING B.M.SAKHARKAR. ACHARYA VINOBA BHAVE RURAL HOSPITAL. DMIMS WEBSITE.
  68. 68. THANK YOU

×