Nursing Path, profile picture
Uploaded byNursing Path
PDF, PPTX14,648 views

Organization

The document discusses organization and organizing in management. It covers topics like the purpose of organization structure, formal vs informal organization, factors determining span of management, and principles of departmentation and delegation. It also discusses concepts like intrapreneurship, reengineering, and the relationship between organizing and other managerial functions. The document aims to explain the key learning objectives around organizing as a management function.

Embed presentation

Download as PDF, PPTX
1 / 111
2 / 111
Most read
3 / 111
Most read
4 / 111
5 / 111
6 / 111
7 / 111
8 / 111
9 / 111
10 / 111
11 / 111
12 / 111
Most read
13 / 111
14 / 111
15 / 111
16 / 111
17 / 111
18 / 111
19 / 111
20 / 111
21 / 111
22 / 111
23 / 111
24 / 111
25 / 111
26 / 111
27 / 111
28 / 111
29 / 111
30 / 111
31 / 111
32 / 111
33 / 111
34 / 111
35 / 111
36 / 111
37 / 111
38 / 111
39 / 111
40 / 111
41 / 111
42 / 111
43 / 111
44 / 111
45 / 111
46 / 111
47 / 111
48 / 111
49 / 111
50 / 111
51 / 111
52 / 111
53 / 111
54 / 111
55 / 111
56 / 111
57 / 111
58 / 111
59 / 111
60 / 111
61 / 111
62 / 111
63 / 111
64 / 111
65 / 111
66 / 111
67 / 111
68 / 111
69 / 111
70 / 111
71 / 111
72 / 111
73 / 111
74 / 111
75 / 111
76 / 111
77 / 111
78 / 111
79 / 111
80 / 111
81 / 111
82 / 111
83 / 111
84 / 111
85 / 111
86 / 111
87 / 111
88 / 111
89 / 111
90 / 111
91 / 111
92 / 111
93 / 111
94 / 111
95 / 111
96 / 111
97 / 111
98 / 111
99 / 111
100 / 111
101 / 111
102 / 111
103 / 111
104 / 111
105 / 111
106 / 111
107 / 111
108 / 111
109 / 111
110 / 111
111 / 111
ORGANIZATION Dr. Jayesh Patidar www.drjayeshpatidar.blogspot.com 04/10/2015 www.drjayeshpatidar.blogspot.com 1
1. The purpose of an organization structure 2. The meaning of "organizing" and "organization." 3. The distinction between formal and informal organization. 4. How organization structures and their levels are due to the limitations of the span of management. 5. The exact number of people a manager can effectively supervise depends on a number of underlying variables and situations. 6. The nature of entrepreneuring and intrapreneuring. 7. The key aspects and limitations of reengineering. 8. The logic of organizing and its relationship to other managerial functions. 9. That organizing requires taking situations into account. LEARNING OBJECTIVES 04/10/2015 www.drjayeshpatidar.blogspot.com 2
Organizing System of Roles What Part to Play How’s related to each other MaintainingDesigning ROLES Coordinating Efforts an understood area of discretion or clear idea of the major duties or activities involved verifiable objectives TOOLS Supply of Needed Information Performing in that roleto exist and be meaningful, it must incorporate 04/10/2015 www.drjayeshpatidar.blogspot.com 3
Organizing A basic process of combining / integrating Human / Physical / Financial resources in productive interrelationship for the achievement of enterprise objectives 04/10/2015 www.drjayeshpatidar.blogspot.com 4
Definition of Organization Organization implies a formalized intentional structure of roles or positions Effort Pooling towards designated objectives through definition / division of activities / responsibilities / authority04/10/2015 www.drjayeshpatidar.blogspot.com 5
identification and classification of required activities grouping of activities necessary to attain objectives Assigning responsibility with necessary authority To a manager for each grouping Coordination in organizational Structure Vertically, Horizontally Departmentation Manageable units Maximum possible specialization Delegation Aptitude / Attitude Job Requirement / Capabilities Organizing involves Synchronization Interrelationship between different positions must be clearly defined From whom ? To whom ? 04/10/2015 www.drjayeshpatidar.blogspot.com 6
Organizational Structure Design What Who Results Is to do Fitting various activities Give what Smoothly Efficiently Effectively04/10/2015 www.drjayeshpatidar.blogspot.com 7
Should not be flexible Channeled individual and group efforts intentional structure of roles in a formally organized enterprise Well defined jobs Definite authority / responsibility Formal organization 04/10/2015 www.drjayeshpatidar.blogspot.com 8
flexible Loosely organized Any joint personal activity without conscious joint effort even through contributing towards Joint Results ill defined Spontaneous Informal organization A network of personal / social relationships, not established, required by FORMAL organization but arising spontaneously Structure (membership), communication networks (“grapevine”), and relationships behaviors and norms) do not necessarily follow those of the formal organization. 04/10/2015 www.drjayeshpatidar.blogspot.com 9
What is a Department? The department designates a distinct area, division, or branch of an organization over which a manager has Authority for the performance of specified activities 04/10/2015 www.drjayeshpatidar.blogspot.com 10
Organization Level and Span of Management
Organization with Narrow SpanLevels = 4 Span of Control = 3 Total Employees = 40 Advantages •Close supervision •Close control •Fast communication between levels Disadvantages •Too much involvement in subordinate’s work •Many levels / higher cost •Excessive distance between top and lowest level Variety of non-recurrent problems, involving non- programmed strategic decisions 04/10/2015 www.drjayeshpatidar.blogspot.com 12
Organization with wide spanLevels = 3 Span of Control = 7 Total Employees = 57 Advantages •Superiors are forced to delegate •Clear policies are required •Subordinates must be carefully selected Disadvantages •Overloaded superior / decisional bottleneck •Superior’s loss of control •Requires exceptional quality managers For Recurrent, repetitive and routine problems 04/10/2015 www.drjayeshpatidar.blogspot.com 13
Principle of the Span of Management The principle of the span of management states that there is a limit to the number of subordinates a manager can effectively supervise, but the exact number will depend on the impact of underlying factors 04/10/2015 www.drjayeshpatidar.blogspot.com 15
Operational-management position: a situational approach Classical theory: No. of subordinates:3-8 Operational management theory: 1. What to supervise: complexity and variety of the subordinate’s work 2. Which tools are used 3. Quality of manager and subordinate 4. Degree of interaction No. depends of many underlying factors: 04/10/2015 www.drjayeshpatidar.blogspot.com 16
Difference Between an Intrapreneur and an Entrepreneur • An intrapreneur is a person who focuses on innovation and creativity and who transforms a dream or an idea into a profitable venture by operating within the organizational environment • The entrepreneur is a person who does similar things as the intrapreneur, but outside the organizational setting 04/10/2015 www.drjayeshpatidar.blogspot.com 17
Definition of Reengineering • "...the fundamental rethinking and radical redesign of business processes to achieve dramatic improvements in critical contemporary measures of performance, such as cost, quality, service, and speed.“ 04/10/2015 www.drjayeshpatidar.blogspot.com 18
Key Aspects of Reengineering Fundamental rethinking of what the organization is doing and why. Radical redesign of the business processes Reengineering calls for dramatic results The need for carefully analyzing and questioning business processes 04/10/2015 www.drjayeshpatidar.blogspot.com 19
Nurses form a very important group - the largest single technical group - of personnel engaged in patient care in hospitals next to doctors, consuming approximately one-third of hospital costs. because…. 04/10/2015 www.drjayeshpatidar.blogspot.com 20
• Nursing care is required for the prevention of disease and for promotion of health. • The nursing care of sick patients - a. in the interest of his or her mental and physical comfort. b. by reason of the disease from which he or she is suffering. 04/10/2015 www.drjayeshpatidar.blogspot.com 21
Functions of nursing services are: 1. Clinical 2. Technical 3. Caring relationship 4. Administrative 5. Educational 04/10/2015 www.drjayeshpatidar.blogspot.com 22
It is observed that 50% or more of her time will be spent on non-nursing functions like a. Clerical b. Answering telephones c. Supervise indent of drugs d. House keeping, etc 04/10/2015 www.drjayeshpatidar.blogspot.com 23
staffing The number of nurses required to man the nursing services in a hospital depends on many factors, • Number of beds in a hospital • The type of hospital and the prevailing medical practice, including kinds of treatment and medications given and tests and services required for the patients. • Pattern of assignment of nurses - based on functional method, case method or teach method. • The type and the number of emergency cases coming into the hospital. • Available labour - saving devices, automation, mechanization, centralization • Level of competence based on - qualification, experience, efficiency and sincerity. 04/10/2015 www.drjayeshpatidar.blogspot.com 24
Work allocation Patterns of assignment: the tasks of the nursing unit are carried out by 3 accepted patterns of assignment, depending on the training, experience and the rules of a particular institution. 1. Functional method: The tasks are divided among the staff. 2. Case method: Each nurse is assigned one or more cases. 3. Team method : Under this system the nursing staff is divided into teams each of which is guided by an experienced nurse. The team leader is responsible to the ward sister and she organizes the nursing care for her group of patients. 4. Group Assignment method: one nurse is assigned to a group of patient to provide total nursing care. 5. Primary nursing method: the primary nurse assumes 24-hour accountability for the care, planning and evaluation. When on duty on a shift, the primary nurse herself assumes responsibility for providing total care. Other functions of primary nurse is the coordination of nursing activities with physician and other health professionals. 04/10/2015 www.drjayeshpatidar.blogspot.com 25
Physical dependency of patients This is an important factor in assessing the workload. The patients can be classified under the following headings: a. Totally ambulant b. Partially bedfast c. Bedfast but not helpless d. Partially helpless e. Totally helpless 04/10/2015 www.drjayeshpatidar.blogspot.com 26
Indices of hospital nurses The nursing time provided per patient per day is the most useful and realistic index, since it takes into account Occupancy rates, working hours, and days absent from work. 04/10/2015 www.drjayeshpatidar.blogspot.com 27
To find out the average number of working days per year by a nurse: Earned leave 30 days Sick leave 10 days Casual leave 14 days Weekly off 85 days Non-working days 139 days Total working days in year 365 days Therefore total working days is 226 days 04/10/2015 www.drjayeshpatidar.blogspot.com 28
To find out the average number of hours worked per year by a nurse Average number of working days per year X Average number of working hours 226 x 8 = 1808 nursing hours 04/10/2015 www.drjayeshpatidar.blogspot.com 29
To find out the total number of nursing hours per day The hours worked per year by a nurse X total number of nurses For example Total bed capacity of hospital = 500 Required number of nurses = 217 nurses (as per INC norms 1808 x 217 = 361736 04/10/2015 www.drjayeshpatidar.blogspot.com 30
To find out the number of nursing hours per day Total number of nursing hours per year 365 361736 365 991.21 nursing hours per day To find out the number of nursing hours per Patient 991  500 = 1.98 nursing hours per patient per day approximately 04/10/2015 www.drjayeshpatidar.blogspot.com 31
Duties of different categories of nursing staff Director of nursing The nursing director has very little or no technical duty to perform. The work is mainly administrative and conceptual. 1. Supervision - working pattern 2. Maintaining discipline 3. Planning diff. services 4. Preparing policies to upgrade the routines. 5. Participating in recruitment of staff 6. Organizing for academic purposes. 7. Arrange (in-service) training programmes. 04/10/2015 www.drjayeshpatidar.blogspot.com 32
Sister-in-charge Sister-in-charge is the administrative head of the ward/section. Therefore the duties are based on responsible attitude and supervision. 1. Maintaining cleanliness and orderliness in the ward. 2. Supervising housekeeping activities. 3. Supervise staff nurse, nurse-aides, labour staff, patients. 4. Maintaining inventory. 5. Accompany senior clinician during their rounds/ discussion and actively participate in taking and implementing the decisions. 04/10/2015 www.drjayeshpatidar.blogspot.com 33
Staff Nurse This category is the most active. The duties they are expected to carry out are 1. General and routine care of patients as per clinicians instructions. She is an active bridge between treating clinician and patients. 2. To assist clinician. 3. Assist or independently perform certain procedure like a. collecting blood, b. catheterization of bladder, c. giving IV fluids, d. first aid. 4. Assist actively at ante natal clinic, post natal clinic, diabetes, asthma, etc. 5. Educational activity like health talk, counseling, etc. 6. Attend outdoor activities. 7. Admit and discharge patients. 04/10/2015 www.drjayeshpatidar.blogspot.com 34
Problems faced: 1. Shortage of nurses due to a. improper ratio of nurse : patient b. recruitment policy c. non availability d. migration to other hospitals e. increase in requirement. 2. Dissatisfaction 3. Absenteeism : particularly for night duty. 4. Unionization 5. Deterioration in standard of performance 04/10/2015 www.drjayeshpatidar.blogspot.com 35
Professional Hazards: 1. Risk of infection 2. Stress and burn out 3. Backache due to prolonged standing and walking on hard surface. 4. Fatigue due to shift duties. 5. Improper behavior of some patients, relatives, labour staff and even doctors. 6. Frustration. 04/10/2015 www.drjayeshpatidar.blogspot.com 36
1. Receiving and sorting the soiled material used in the hospital 2. Determining whether the items should be reused or discarded. 3. Carrying out the process of decontamination or disinfection prior to sterilizing. 4. Carrying out specialized cleaning of equipment and supplies. 5. Inspecting and testing instruments, equipment and linen. 6. Assembling treatment trays, instrument sets, linen packs, etc. 7. Packaging all materials for sterilizing. 8. Sterilizing. 9. Labelling and dating materials. 10.Storing and controlling inventory. 11.Issuing and distributing. Functions of CSSD 04/10/2015 www.drjayeshpatidar.blogspot.com 37
Functions of CSSD 1. To maintain an uninterrupted supply of bacteriologically safe supplies at all times. 2. To undertake studies for improvement of sterilization practices and 3. Processing methods to provide supplies economically. 4. To impart training to hospital personnel in safe hospital practices. 5. To participate in hospital infection control programme. 04/10/2015 www.drjayeshpatidar.blogspot.com 38
Receipt Accounting, Sorting Washing, Cleaning, Drying Packing Awaiting sterilization Sterilization Sterile storage Issue Gloves Instruments Needles & Syringes Autoclaves Dry ovens Gloves Gauze & Dressings Syringes & Needles Instruments Packs Torn/punctured Unserviceable Cracked/ broken Check for Sterility Shelf-life expired Sterility Not ok 04/10/2015 www.drjayeshpatidar.blogspot.com 39
The sequence of events is as follows: 1. Materials are received into the department from various users. 2. All used materials are cleaned - prelimary cleaning before sending the articles to CSSD. 3. Clean materials are inspected, assembled and packed, ready for sterilization. 4. After sterilization, they are either stored in a sterile storage area or distributed directly as required. 04/10/2015 www.drjayeshpatidar.blogspot.com 40
Location • The location of CSSD should be convenient to its principal consumers. • Preferably sited close to OT & wards. • Doors should have the following strong colours to signify the different zones to which they give access. Red - denotes contaminated zone Yellow - denotes clean zone Green - denotes sterile zone 04/10/2015 www.drjayeshpatidar.blogspot.com 41
Space A minimum of 7 sq ft on a per bed basis ( with 100 sq ft for the smallest hospital) is considered essential for planning a CSSD with scope for future expansion and growth. Up to 100 beds 10 sq ft per bed Up to 200 beds 9 - 10 sq ft per bed Up to 300 beds 8 - 9 sq ft per bed 300 and above 7 - 8 sq ft per bed 04/10/2015 www.drjayeshpatidar.blogspot.com 42
Room Nature of work Space in % Wash room in which everything is washed up Dirty 10 Work room in which all packaging is undertaken Clean 26 Syringe & instrument processing room Clean 9 Unsterile pack store Clean 4 Bulk store Clean 11 Sterile store Sterile 16 Miscellaneous rooms Clean 19 Autoclaves Clean 5 In planning a CSSD, following concept may be kept in mind 04/10/2015 www.drjayeshpatidar.blogspot.com 43
Staffing One qualified superintendent - In-charge of the dept. CSSD supervisor - senior nurse (traditionally). In-service trained CSSD attendants CSSD assistants - Semiskilled workers CSSD technicians Sweeper. A 500-bedded teaching hospital has the following staff. Technologists 5 Technical assistants 4 Nursing aides 4 CSSD attendants 4 04/10/2015 www.drjayeshpatidar.blogspot.com 44
Equipments • Autoclaves • Dry oven • Gauze cutter • Ultrasound washer • Needle flushing device • Ethylene oxide sterilizer • Soaking sinks • High pressure water jets. 04/10/2015 www.drjayeshpatidar.blogspot.com 45
Autoclaves • Saturated steam under pressure is the safest and dependable method of sterilization. • Minimum time for sterilization by autoclaving process is 121°C in 15 min. • sterilization checks for quality control. • Sterility indicators – Mechanical indicators – Chemical indicators – Biological indicators • Shelf life 04/10/2015 www.drjayeshpatidar.blogspot.com 46
Chemical sterilization Ethylene oxide (EO) - used for heat-sensitive and moisture-sensitive materials like rubber, plastics and fibre glass. Effective sterilization by EO depends upon the Following: Concentration of gas: 450mg/litre or higher Temperature exposure: 49 to 63°C and 30 to 37.8°C Packing: The type of wrapping used should be penetrable by ethylene oxide and water vapour. Polyethylene is commonly used for wrapping. Period of exposure: The time ranges from 110 to 260 min. up to 12 hours may be required. 04/10/2015 www.drjayeshpatidar.blogspot.com 47
Sterilization process After the sterilizer chamber is sealed and the controls set, sterilization process goes through the following phases: 1. Warming the chamber 2. Evacuating residual air to partial vacuum. 3. Introduction of moisture to ensure that it penetrates wrappings and material. 4. Introduction of EO. 5. Raising the temperature(if required) 6. Exposure for the required time. 7. Release of chamber pressure. 04/10/2015 www.drjayeshpatidar.blogspot.com 48
Ultra sonic cleaner • Ultrasonic cleaner cleans by bombarding the item with sound waves. • These tiny shock waves will knock debris off nooks and corners of instruments that are not easy to reach. 04/10/2015 www.drjayeshpatidar.blogspot.com 49
The list of items and special trays commonly processed in the CSSD are: Instruments Dressings Sponges OT linen Special packs Gauze and cotton materials Gloves Bowls and trays 04/10/2015 www.drjayeshpatidar.blogspot.com 50
Standardization of surgical packs The aim is to have a standard surgical pack containing all the items required for that procedure by the operating surgeon. Some of the Special trays and sets to be processed by CSSD are as follows: • Lumbar puncture set • Sternal puncture set • Catheterization set • Bladder wash set • Liver biopsy set • Fine-needle aspiration cytology set • Suturing set • Thoracic aspiration set • Incision and drainage set • Tracheostomy set. 04/10/2015 www.drjayeshpatidar.blogspot.com 51
04/10/2015 www.drjayeshpatidar.blogspot.com 52
Laundry Services • It is a centralized function coming under the housekeeping department taking care of all activities from purchase to linen management to laundry to condemnation • Linen Management will vary based on the climate, culture, systems and procedure of the individual organization 04/10/2015 www.drjayeshpatidar.blogspot.com 53
Hospital can go for • Inside laundry services - with adequate machineries • Inside laundry services – Manual wash by dhobi • Outside laundry services – On contract basis 04/10/2015 www.drjayeshpatidar.blogspot.com 54
Functions of laundry department • Collection or receiving soiled and infected linen • Processing soiled linen through laundry equipment. This includes sorting, sluicing and disinfecting, washing, extracting, drying, conditioning ironing, pressing and folding • Inspection and repair of damaged articles, their contamination and replacement • Distributing finished linen to the respective user departments • Maintenance and control of active and back-up inventions and processed linen • Maintaining all type of registers 04/10/2015 www.drjayeshpatidar.blogspot.com 55
Organizing laundry department • Manpower requirement • Duties and responsibilities of linen in - charge housekeepers • Recruitment and selection of dhobi • Management information system • Equipments – selection, care • Linen – selection, care, stain removal procedure • Work procedure • Stain removal procedure • Management issues 04/10/2015 www.drjayeshpatidar.blogspot.com 56
Tips • Stock the linen materials in 1:3 ratio • Each day the bed sheet is dusted and the side is changed when the bed is made. This way both sides of the sheet is used. On the third day the bed sheet is changed • Use all faded and damaged fabrics for dusting and cleaning windows, furniture etc 04/10/2015 www.drjayeshpatidar.blogspot.com 57
Diet service objective • To provide individualized nutritional care to the patients using normal diet or need based special type of diet. • Service needs to be organized for o Hospital staff o Outdoor patients o Visitors o Patient’s attendants i.e. relatives. 04/10/2015 www.drjayeshpatidar.blogspot.com 58
Different types of food services include following: 1.Patient food service. 2.Cafeteria or mess for the employees. 3.Cafeteria or mess for the students in teaching hospitals. 4.Coffee shop 5.Vending machines. 6.Special meals for meetings, guests and functions. 04/10/2015 www.drjayeshpatidar.blogspot.com 59
• Patient food service 1. Purchasing food items as per specification and in predetermined quantity. 2. Planning menu for different types of patients as per their a. Age b. Nutritional needs. c. Ability to consume eg. Unconscious patient, infants, etc d. Disease requiring restrictions. • Disease requiring special diet 04/10/2015 www.drjayeshpatidar.blogspot.com 60
• Different types of menu •  Full diet •  Light diet •  Soft diet •  Liquid diet •  Salt-free diet •  Chilly free diet/bland diet •  High protein diet •  High carbohydrate diet •  Diabetic diet •  Special diet (eliminating certain substance) Dietary habits of patients should be taken. 04/10/2015 www.drjayeshpatidar.blogspot.com 61
3. Ensuring hygienic method of cooking. 4. While cooking nutritive value and palatability do not get adversely affected. 5. Supervising food distribution. 6. Supervising consumption by patients on random basis. 7. Taking feedback from patients. 8. Avoiding wastage by not preparing excess food and preventing pilferage. 9. Avoiding shortage – particularly for new patients. 10. Counseling patients on special diets. 11. Training nurses, students and interns 04/10/2015 www.drjayeshpatidar.blogspot.com 62
• SITE, AREA & DESIGN It is necessary to have certain policies before deciding their details 1. Foods consumed outside a. Information is got at the time of admission. b. Wastage is avoided c. Attendants food pass can be issued 2. Vegetarian/ Non-Veg This policy decision will enable diet dept. in a. Purchase of raw material b. Organizing separate area for cooking veg & Non-veg meals. 04/10/2015 www.drjayeshpatidar.blogspot.com 63
• Ground floor is desirable 1.Receipt of raw materials a. Checking, b.Weighing c. Temporary storing before shifting 2.Storage area a. Godown or storeroom for non-perishable items like grains, oil, etc. b.Cold storage for perishable items milk, vegetables, etc. – refrigerator, cold room. 04/10/2015 www.drjayeshpatidar.blogspot.com 64
3. Preparation area a. Sorting out b. Washing vegetables c. Washing utensils d. Slicing, peeling, chopping, grinding e. Mixing 4. Cooking area a. Large size steam cooker. b. Cooking gas c. Special diet area 04/10/2015 www.drjayeshpatidar.blogspot.com 65
5. Serving and transportation of cooked food depends on a. Hospital policy b. Geographical area c. Vertical / horizontal /both. ｷMobile hot food carrier ｷContainers of adequate size ｷNurse in the ward will arrange to get food served. 6. Cleaning area a. Utensils cleaning b. Dish washer 04/10/2015 www.drjayeshpatidar.blogspot.com 66
• Staffing pattern • Manager – qualified dietitian • Dietitians – 2 or 3 • Clerical staff – paper work & inventory • Cooks – one/100 beds. Health check-up, food handlers. • Helpers 04/10/2015 www.drjayeshpatidar.blogspot.com 67
• Problems 1. Patient satisfaction 2. Wastage i. Cooking more than necessary ii. Less consumption due to a. Poor taste b. Becoming cold c. Poor appetite due to illness d. Home food/eatables 3. Shortage i. Diet sheet has not been submitted on time. ii. Sudden new admissions iii. Cooking less than necessary iv. Pilferage by staff. 4. Theft 5. Fraud in materials management. 04/10/2015 www.drjayeshpatidar.blogspot.com 68
• Outsourcing dietary • Cafeteria or mess for employees • Cafeteria for students • Coffee shop • Vending machines • Special meals for guests or for functions. • Diet committee – regular rounds, taste of food is checked. 04/10/2015 www.drjayeshpatidar.blogspot.com 69
The basic function of a laboratory service is: 1. To assist doctors in arriving at or confirm a diagnosis. 2. To assist in the treatment and follow-up of patients. 3. The laboratory not only generates prompt and reliable reports, but also to function as a storehouse of reports for future references. 4. To carry out urgent tests at any part of day or night and therefore provide serve 24 hours a day, 5. And in big hospitals, the laboratory also assists in teaching programs for doctors, nurses and laboratory technologists. 04/10/2015 www.drjayeshpatidar.blogspot.com 70
Types of laboratories1. Hematology Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases. The lab work that goes into the study of blood is performed by a Medical Technologist. 2. Microbiology Microbiology is the study of microorganisms, which are unicellular or cell-cluster microscopic organisms 3. Clinical chemistry Clinical biochemistry is the area of pathology that is generally concerned with analysis of bodily fluids. 04/10/2015 www.drjayeshpatidar.blogspot.com 71
4. Histopathology Histopathology (from the Greek histos (tissue) and pathos (suffering)) refers to the microscopic examination of tissue in order to study the manifestations of disease. 5. Routine urine and stool analysis 04/10/2015 www.drjayeshpatidar.blogspot.com 72
Functional planning 1. Determine approximate section wise workload. 2. Determining services to be provided. 3. Determining area and space requirement to accommodate equipment, furniture and personnel in technical, administrative and auxiliary functions. 4. Dividing the area into functional units, viz hematology, biochemistry, microbiology, histopathology, urinalysis, etc. 04/10/2015 www.drjayeshpatidar.blogspot.com 73
5.Determining the number of work stations in each functional unit/division and deciding the linear bench space allotted for each work station. 6. Determining the major equipment and appliances in each unit. This is generally classified into: i) Technical equipment peculiar to certain work stations. ii) Other equipment and appliances e.g. (refrigerators, hot air ovens, centrifuges) that can be jointly used by different work stations or units. 04/10/2015 www.drjayeshpatidar.blogspot.com 74
7. Determining the functional location of each section in relation to one another, from the point of view of flow of work, technical work considerations, auxiliary areas and administrative efficiency. 8. Identifying the units that are likely to expand, for locating them in such a manner which will permit smooth expansion. 9. Identifying the electrical and plumbing requirements for each area/work station. Independent electric circuits are required for electronic equipment items. Location of sinks and wash areas are vital for efficient performance of work stations. 04/10/2015 www.drjayeshpatidar.blogspot.com 75
10. Considering utilities, - lighting, ventilation (forced or normal exhaust, air-conditioning and air hygiene) and isolation of equipment or work stations. 11. Working out the most suitable laboratory space unit (LSU), which is a standard module for work areas. A standard module facilitates rearrangement of work units with least disruption and minimal structural changes. 04/10/2015 www.drjayeshpatidar.blogspot.com 76
Organization 1. Centralized • It avoids duplication of purchases of expensive equipment. • Avoids duplication of personnel. • Easy to monitor working and quality control • Automation will not be underutilized. • There can be delay in transporting samples and issue of reports. 04/10/2015 www.drjayeshpatidar.blogspot.com 77
2. Decentralized • Transportation • Dispatch • Can cater to the specific needs of certain areas e.g. ICCU, premature nursery • Results can be easily logged on to the ward • Duplication of equipments • Requires additional technical staff. • Lack of uniformity in procedures and conflicts. • Supervision difficulty • Quality control • Multiple lines of authority • Transfers to other area may disturb the services. 04/10/2015 www.drjayeshpatidar.blogspot.com 78
Workload • An admitted patient undergoes anywhere between 8 and 20 laboratory tests on an average during his or her hospitalization period. • In 1990, in a teaching hospital, laboratory tests averaged at 20 tests per patient in medical ward during an ALS of 10 days, giving a ratio of 2 tests per day, excluding radiographic investigations or other tests carried out in specialized laboratories. 04/10/2015 www.drjayeshpatidar.blogspot.com 79
• A 100-bedded hospital with a 10 days ALS will treat 365 ÷ 10 = 36.5 (37 pts)/bed in a yr, • 37 x 100 = 3700 total patient in a year which means that the hospital laboratory will have to carry out 3700 x 8 = 29,000 tests to 3700 x 20 = 74,000 tests during the year. 04/10/2015 www.drjayeshpatidar.blogspot.com 80
Location • Preferable on the ground floor and accessible to the wards. • Depends upon the size of the hospital and its outpatient set up, the laboratory can be situated. • Outpatient sample collection. – The design should include waiting room for patients, venepuncture room, and specimen toilets. – Provision should be made for containers with appropriate preservatives, for correct labeling of samples, and for keeping record of each patient. 04/10/2015 www.drjayeshpatidar.blogspot.com 81
• Primary space – The space utilized by technical staff for the primary task of carrying out professional work. – This space is expressed in terms of LSU. • Secondary space – The space utilized for all supportive activities. – Administrative space, viz. offices for the pathologist and other, rest and locker rooms, staff toilets, etc. should be considered separately from secondary space. • Circulation space – The space required for uncluttered movement of personnel and materials within the dept. between various technical work stations, rooms, stores and other auxiliary and admin. Areas. 04/10/2015 www.drjayeshpatidar.blogspot.com 82
Departments Primary space Space required Hematology  General hematology  Blood transfusion  Office desk/ admin 3.5 LSU 1.5 LSU 0.5 LSU 5.5 LSU 101.75sq m Clinical chemistry  Processing and preparation  Special and general tests  Office desk/ admin/ reagent stores 1.5 LSU 3.0 LSU 1.0 LSU 5.5 LSU 101.75 sq m Microbiology  General bacteriology  Media preparation  Office desk/ admin 3.5 LSU 1.0 LSU 0.5 LSU 5.0 LSU 92.50 sq m Histopathology  Specimen preparation  Section cutting and staining  Frozen section/ special techniques  Cytology  Office desk/ admin 1.0 LSU 0.5 LSU 0.5 LSU 1.0 LSU 0.5 LSU 3.5 LSU 64.75 sq m Urine and stool 0.5 LSU TOTAL 9.25 sq m 370.00 sq m Schedule of accommodation of hospital laboratory 04/10/2015 www.drjayeshpatidar.blogspot.com 83
Departments Secondary space Space required Patient area  Waiting area Consulting, examination, venepuncture, etc. Patient toilet (specimen toilet) 40 sq m 30 sq m 10 80 sq m Office and staff  pathologist office and laboratory General office: assembling, labeling, storing, distribution of reports Staff locker and rest room  staff toilet 30 60 40 10 140 sq m Supply and processing  chemical preparation Central glass washing Sterilization Distilled water still Store: general and glassware Store: chemical Disposal and cleaning 25 60 30 10 20 20 10 TOTAL 175 sq m 395 sq m Circulation space Approximately 30 % of the total of primary and secondary space 04/10/2015 www.drjayeshpatidar.blogspot.com 84
Layout • A simple, basic layout of spaces and equipment which can be supplemented or modified to suit different requirements is likely to be more efficient. • The structure, equipment and finishes should permit the original space allocation and the layout to be changed while the building is in use, with minimum disturbance. • Flexibility for use is needed so that areas can be converted from secondary to primary space and vice versa in the interest of rearrangement for expansion or change. 04/10/2015 www.drjayeshpatidar.blogspot.com 85
• A few large sinks which are capable of being moved without undue inconvenience are both more economical and more convenient than a larger number of small fixed sinks. • A fixed layout of services and equipment can be designed to be conveniently used in a number of alternative ways providing that working methods can be adapted or modified to fit the layout. • Open planning with a suitable arrangement of bays permits a higher ratio of usable bench length to floor area. 04/10/2015 www.drjayeshpatidar.blogspot.com 86
• Administrative and auxiliary areas • Waiting room • Venepuncture cubicle • Specimen toilet • Pathologists office • Glass washing and sterilizing unit • Staff locker room and toilet 04/10/2015 www.drjayeshpatidar.blogspot.com 87
Utility services • It include water, gas and compressed air system. • The need for uninterrupted functioning of these systems and the probability of future expansion, careful study is necessary in designing them for safety and efficiency. • Piping system – color, coding or labeling, non corrosive – to facilitate safety purposes and repairs. • Arrangement of laboratory benches – removable panels between the benches. 04/10/2015 www.drjayeshpatidar.blogspot.com 88
Internal design and fitments • Work benches • Lighting • Service spine • Storage • Partitions • Dust • Air-conditioning/exhaust • Working surface • Flooring 04/10/2015 www.drjayeshpatidar.blogspot.com 89
Staffing • The hospital laboratory service should be under the control and direction of a doctor with qualifications in pathology. – He becomes the overall in charge – quality control, standardization and administration. – Should be a part of the regular medical staff of the hospital. 04/10/2015 www.drjayeshpatidar.blogspot.com 90
• The number of medical laboratory technologists (MLT) and laboratory technicians will depend upon: – The number of samples per day – The range of tests to be performed under various sections, viz clinical chemistry, hematology, microbiology and histopathology. – Emergency service and – leave reserve. 04/10/2015 www.drjayeshpatidar.blogspot.com 91
• They perform all technical procedures in – Various section, – Prepare reports of completed investigations, – Check and maintain equipment and – Request for necessary supplies and materials. 04/10/2015 www.drjayeshpatidar.blogspot.com 92
Tests performed annually per medical technologist Laboratory unit Tests Hematology 13,400 Urinalysis 30,000 Serology 11,520 Biochemistry 9,600 Bacteriology 7,680 Histology 3,840 Parasitology 9,600 04/10/2015 www.drjayeshpatidar.blogspot.com 93
Equipment • The following is a list of the important items of equipments and instruments in a general hospital laboratory: – Robot cell counter – Centrifuge – Microhematocrit centrifuge – Refrigerators – Blood bank refrigerator – Water still – Pressure sterilizer – Pipette washer – Flame photometer – Spectrophotometer – Hot air oven – Incubator – Calorimeter – Analytical balance – Blood gas analyzer – Autoanalyzer. 04/10/2015 www.drjayeshpatidar.blogspot.com 94
Policies and procedures • Laboratory samples • Sample receiving • Request forms • Time of accepting specimens • Containers • Identification of specimens • Reports • Records • Blood bank service • Outpatient samples • HIV • Liaison with clinicians • Technician’s motivation • Cross-training of technicians • Laboratory waste disposal • Optimal utilization of laboratory service. 04/10/2015 www.drjayeshpatidar.blogspot.com 95
It is the area of service in the hospital, where quick and competent care can save lives and also reduce the severity and duration of illness. The casualty department provides the first impression which should be a positive one. The relationship of the casualty with other departments and wards should be close. Emergency service 04/10/2015 www.drjayeshpatidar.blogspot.com 96
Definition The casualty services provide immediate emergency, diagnostic and therapeutic care to patients with: • Injuries by accidents, suicidal, homicidal, etc. • Sudden attacks of illness or exacerbation of the disease. These patients require immediate attention and treatment. Emergency patients receive resuscitation and life-saving treatment. 04/10/2015 www.drjayeshpatidar.blogspot.com 97
Functions 1. Attend to all the patients brought to casualty & decide appropriate management which includes - Immediate resuscitation. - First aid - Emergency investigations - Hospitalization - Referral to specific specialty by calling down the concerned doctor. - Observation of patient to decide: whether the patient can go home and attend appropriate OPD - Reassurance and short counselling. 04/10/2015 www.drjayeshpatidar.blogspot.com 98
2. Carry out medico-legal formalities. 3. Maintaining up to date list of critically ill patients for the purpose of - issuing one visit pass to relatives. - replying telephone calls. - decide acceptance or rejection of transfer of patients from other hospitals. - assist intra hospital transfer. 04/10/2015 www.drjayeshpatidar.blogspot.com 99
• Following category of case can be labeled as medico legal : • 1. Cases of injuries and burns the circumstances of which suggest commission of an offence by some one. • 2. All Vehicular, factory or other unnatural accident cases specially when there is likelihood of patient’s death or grievous hurt. • 3. Cases of suspected or evident sexual assault. • 4. Cases of suspected or evident criminal abortion. • 5. Cases of unconsciousness where its cause is not natural or not clear. • 6. All cases of suspected or evident poisoning/intoxication. • 7. Cases referred from court or otherwise for age estimation etc. • 8. Cases brought dead with improper history creating suspicion of an offence. • 9. Any other case not falling under the above categories but has legal implication. 04/10/2015 www.drjayeshpatidar.blogspot.com 100
4. Carryout services of non emergency nature as per the policy of the organization. 5. Maintain list of doctors on emergency duty, their availability and alternative arrangements if they are busy. 6. Disaster preparedness for mass casualties. 04/10/2015 www.drjayeshpatidar.blogspot.com 101
Site, Area and Design • Ground floor • Proper sign board with illumination • Other human traffic restricted • Entrance pattern Compound gate OPD Casualty Inpatient Services 04/10/2015 www.drjayeshpatidar.blogspot.com 102
Important areas of casualty 1. Reception or Enquiry Counter • Sign boards with proper direction • Enquiry counter • Entrance to the casualty area should be broad enough to permit two ambulances • The entrance area should be covered. • ‘No parking’ board. 04/10/2015 www.drjayeshpatidar.blogspot.com 103
2. Waiting area for the relatives • Should be spacious with adequate light and ventilation. • Adequate sitting accommodation • All utility services should be provided • Public address system to call relative of patient to inform about patient’s condition. • Small statue of God/ Meditation hall. 04/10/2015 www.drjayeshpatidar.blogspot.com 104
3. Space for trolleys and wheel chairs • Immediate arrangement of wheel chair or trolley depending on the condition of the patient. • Based on work load, 4 - 6 trolleys/ wheel chairs are required. • Transferring of critical patients into other areas. • ‘Intensive care trolley’ should be there. • Trolley and wheel chair - parked in orderly fashion. • Soiled trolley should be kept clean always. 04/10/2015 www.drjayeshpatidar.blogspot.com 105
4. Space for security staff and police constable • Casualty is likely to get victims of assaults, riots, group rivalry, etc. so the security needs to be vigilant. • Entries should be restricted. • Cubicle with glass walls permitting visibility of hospital waiting area, compound & building entrance. • It is essential to have police constable counter either at the waiting hall or by the side of the entrance. 04/10/2015 www.drjayeshpatidar.blogspot.com 106
5. Space for administrator and night superintendent 6. Space for patient brought dead - procedural formalities - in the event of disaster - labeling is done - sent to mortuary - either to relatives or to police. 04/10/2015 www.drjayeshpatidar.blogspot.com 107
Facilities for management 1. Examination room - first aid 2. Treatment room - minor procedures 3. Observation area - depending upon the patient condition 4. Storage space - linen, consumable items, dressing material, I.V fluids, equipments 5. Fixtures: electrical connections, medical gas connection and vacuum connections. 6. Other support services: lab, radiology, blood bank, OT/table for infected and uninfected cases. 04/10/2015 www.drjayeshpatidar.blogspot.com 108
Staff required 1. Senior physician/surgeon/orthopedic surgeon who should be in-charge 2. Casualty officers - depending upon the size of the hospital. 3. Orientation given on emergency care and service. 4. Specialist doctors may be called as and when necessary. 5. Nursing staff - round the clock. 6. Labour staff - for cleaning, shifting, carry messages, samples, reports, etc. 04/10/2015 www.drjayeshpatidar.blogspot.com 109
Maintenance of record 1. Case register - all patients 2. Register for medico-legal cases 3. Police intimation register 4. Call book- to requisition services of doctors from different specialties 5. In/out register for resident doctors. Records/registers are required for: 1. Court case 2. Compensation to injured patients 3. Insurance 4. In the event of complaint 5. Medical audit.04/10/2015 www.drjayeshpatidar.blogspot.com 110
Problems faced 1. Poor upkeep of premises and poor level of cleanliness 2. Shortage of doctors on duty due to rapid turnover. 3. Waiting for specialist opinion. 4. Casualty officer unable to take decision. 5. Inadequate staff. 04/10/2015 www.drjayeshpatidar.blogspot.com 111
Continued.. 6. Waiting for investigation report 7. Sudden shortage of certain items during heavy attendance. 8. Pressure for hospitalization in public hospitals for non medical reasons. 9. Incomplete/ poor documentation in MLC 10. Conflicts due to poor public relations and stress due to nature of work. 04/10/2015 www.drjayeshpatidar.blogspot.com 112

More Related Content

PDF
Performance appraisal
byNursing Path
 
PPTX
DEVELOPMENT OF NURSING SERVICES IN HEALTH POLICY.pptx
byDishaThakur53
 
PPTX
Controlling ppt
byMaglinAnusha1
 
PDF
Nursing Management and Administration: Organizational Effectiveness And Organ...
byprakashRenu1
 
PPTX
Nurse manager
byElon Yunus
 
PPT
Dr. Maheswari Ganesan planning in Nursing Management
bymaheswarirajamanicka
 
PPTX
Concept of Management
byEric Pazziuagan
 
PPTX
Directing
byBincy.v. Kuruvilla
 
Performance appraisal
byNursing Path
 
DEVELOPMENT OF NURSING SERVICES IN HEALTH POLICY.pptx
byDishaThakur53
 
Controlling ppt
byMaglinAnusha1
 
Nursing Management and Administration: Organizational Effectiveness And Organ...
byprakashRenu1
 
Nurse manager
byElon Yunus
 
Dr. Maheswari Ganesan planning in Nursing Management
bymaheswarirajamanicka
 
Concept of Management
byEric Pazziuagan
 
Directing
byBincy.v. Kuruvilla
 

What's hot

PPSX
Staffing
byDr. Rahul B. Pandit
 
PPTX
Cost effectiveness
byRohit Dabas
 
PPTX
Management of school of nursing
byEko Priyanto
 
PPTX
ORGANIZATIONAL BEHAVIOR AND HUMAN RELATIONS
byDR .PALLAVI PATHANIA
 
PPTX
Factors affecting hospital expenditure and role of nurse.pptx
byNisha Yadav
 
PPTX
Quality assurance in nursing management
byAnshu Yadav
 
PPT
Planning process nursing
bySushil Kumar Maheshwari
 
PPTX
Methods of Patients assignment
byRahul Ranjan
 
PPTX
quality of nursing care and services
byDatta meghe institute of medical sciences
 
PPTX
Venture planning in nursing
byEko Priyanto
 
PPTX
Organizational behaviour and human relations
byvootanagaramesh
 
PPTX
Nursing Standards and Policies
byKULDEEP VYAS
 
PPTX
Clinical rotation plan
byDeblina Roy
 
PPTX
Current trends and issues in nursing administration
bypraveenPatel57
 
PPT
nursing Management
byshirish gawai
 
PPTX
Job description
bypraveenPatel57
 
PPTX
Power & politics
bySakuntalaGiri1
 
PPTX
Nursing rounds and reports ppt
byAmirDar14
 
PPTX
Rotation plan
byKALYANI SAUDAGAR
 
PPT
Clinical rotation plan in NURSING -chandiran
byV Chandiran Chetiyar
 
Staffing
byDr. Rahul B. Pandit
 
Cost effectiveness
byRohit Dabas
 
Management of school of nursing
byEko Priyanto
 
ORGANIZATIONAL BEHAVIOR AND HUMAN RELATIONS
byDR .PALLAVI PATHANIA
 
Factors affecting hospital expenditure and role of nurse.pptx
byNisha Yadav
 
Quality assurance in nursing management
byAnshu Yadav
 
Planning process nursing
bySushil Kumar Maheshwari
 
Methods of Patients assignment
byRahul Ranjan
 
quality of nursing care and services
byDatta meghe institute of medical sciences
 
Venture planning in nursing
byEko Priyanto
 
Organizational behaviour and human relations
byvootanagaramesh
 
Nursing Standards and Policies
byKULDEEP VYAS
 
Clinical rotation plan
byDeblina Roy
 
Current trends and issues in nursing administration
bypraveenPatel57
 
nursing Management
byshirish gawai
 
Job description
bypraveenPatel57
 
Power & politics
bySakuntalaGiri1
 
Nursing rounds and reports ppt
byAmirDar14
 
Rotation plan
byKALYANI SAUDAGAR
 
Clinical rotation plan in NURSING -chandiran
byV Chandiran Chetiyar
 

Viewers also liked

PPSX
Methods of acquiring knowledge in nursing
byNursing Path
 
PDF
Contemporary image of professional nursing
byNursing Path
 
PDF
Leadership roles and management functions associated with the planning hierar...
byNursing Path
 
PDF
Quality assurance in obstetrics
byNursing Path
 
PPT
Introduction to education
byNivedita Girish
 
PPTX
Educational objectives by bloom's taxonomy
byDani Paul
 
PDF
An outline of nursing
byNursing Path
 
PPTX
Disaster nursing
byJini Babu
 
PDF
Fats as a nutrient
byNursing Path
 
PDF
Amoebiasis Nursing Management
byNursing Path
 
PDF
Nursing research
byNursing Path
 
PDF
Lifting and moving patient from bed
byNursing Path
 
PDF
Loss and grief
byNursing Path
 
PDF
Acute peritonitis nursing care plan & management
byNursing Path
 
DOC
Modification of teachers behaviours
byUpendra Yadav
 
PPSX
The enterobacteriaceae basic properties.ppsx x
byNursing Path
 
PDF
Medication administration
byNursing Path
 
PDF
Medication calculation
byNursing Path
 
PDF
Abdominal Aortic Aneurysm Nursing Care Plan and Management
byNursing Path
 
PDF
Laboratory and diagnostic examination
byNursing Path
 
Methods of acquiring knowledge in nursing
byNursing Path
 
Contemporary image of professional nursing
byNursing Path
 
Leadership roles and management functions associated with the planning hierar...
byNursing Path
 
Quality assurance in obstetrics
byNursing Path
 
Introduction to education
byNivedita Girish
 
Educational objectives by bloom's taxonomy
byDani Paul
 
An outline of nursing
byNursing Path
 
Disaster nursing
byJini Babu
 
Fats as a nutrient
byNursing Path
 
Amoebiasis Nursing Management
byNursing Path
 
Nursing research
byNursing Path
 
Lifting and moving patient from bed
byNursing Path
 
Loss and grief
byNursing Path
 
Acute peritonitis nursing care plan & management
byNursing Path
 
Modification of teachers behaviours
byUpendra Yadav
 
The enterobacteriaceae basic properties.ppsx x
byNursing Path
 
Medication administration
byNursing Path
 
Medication calculation
byNursing Path
 
Abdominal Aortic Aneurysm Nursing Care Plan and Management
byNursing Path
 
Laboratory and diagnostic examination
byNursing Path
 

Similar to Organization

PPTX
Unit –IV Nursing Management oragnization M,Sc II year 2023.pptx
byanjalatchi
 
PPTX
Patient assignment method
byAnuAbraham37
 
PPTX
Organizing nursing services
byDeepthy Philip Thomas
 
PPTX
Role of Nurse as a Manager.pptx
byDR. RAMAR GURUSAMY
 
PPT
Organizing
byNhelia Santos Perez
 
PPT
nhelzki NCM 105 Organizing
byxtrm nurse
 
PPT
Organization patten
byMahesh Chand
 
PPT
Student
byxtrm nurse
 
PPTX
Chapter 04 Organizing(encrypted) (2).pptx
bysalianyashoda
 
PPT
MODULE 4.1 - NURSING ADMINISTRATION1 .ppt
byAartiSharma877628
 
PPTX
SEMINAR ON NORMS.pptx
bySANCHAYEETA2
 
PPTX
A brefly presentation on Staffing PPT.pptx
byRichaMishra186341
 
PPTX
leadership and management of nursing group 4.pptx
byFenembarMekonnen
 
PPTX
Organizing nursing services and patient care updated.pptx
bySwarpitaChatterjee
 
PPTX
Organizing Nursing Services.nnnnnnnnnnnnnn
bytedgau2022
 
PPTX
Lecture Three_6b497957-e587-4a8d-8126-4e83c1012b82.pptx
byashiningstar345
 
PPTX
Health professionals, Healthcare institutions and Healthcare systems ST საზ.ჯ...
byelijahp491
 
PDF
USING THE NOTES TO THE FINANCIAL STATEMENTS TO UNDERSTAND THE COMPOSITION OF...
bykhaldoonaied
 
DOCX
Chapter 3Organizing the Workplace[These slides .docx
bywalterl4
 
DOCX
The Organizing FunctionOrganizingDistributing or.docx
byssusera34210
 
Unit –IV Nursing Management oragnization M,Sc II year 2023.pptx
byanjalatchi
 
Patient assignment method
byAnuAbraham37
 
Organizing nursing services
byDeepthy Philip Thomas
 
Role of Nurse as a Manager.pptx
byDR. RAMAR GURUSAMY
 
Organizing
byNhelia Santos Perez
 
nhelzki NCM 105 Organizing
byxtrm nurse
 
Organization patten
byMahesh Chand
 
Student
byxtrm nurse
 
Chapter 04 Organizing(encrypted) (2).pptx
bysalianyashoda
 
MODULE 4.1 - NURSING ADMINISTRATION1 .ppt
byAartiSharma877628
 
SEMINAR ON NORMS.pptx
bySANCHAYEETA2
 
A brefly presentation on Staffing PPT.pptx
byRichaMishra186341
 
leadership and management of nursing group 4.pptx
byFenembarMekonnen
 
Organizing nursing services and patient care updated.pptx
bySwarpitaChatterjee
 
Organizing Nursing Services.nnnnnnnnnnnnnn
bytedgau2022
 
Lecture Three_6b497957-e587-4a8d-8126-4e83c1012b82.pptx
byashiningstar345
 
Health professionals, Healthcare institutions and Healthcare systems ST საზ.ჯ...
byelijahp491
 
USING THE NOTES TO THE FINANCIAL STATEMENTS TO UNDERSTAND THE COMPOSITION OF...
bykhaldoonaied
 
Chapter 3Organizing the Workplace[These slides .docx
bywalterl4
 
The Organizing FunctionOrganizingDistributing or.docx
byssusera34210
 

More from Nursing Path

PDF
Assessment
byNursing Path
 
PDF
Hospital Infection Control Programme
byNursing Path
 
PDF
Selection and organization of learning experience
byNursing Path
 
PDF
Universal Health Coverage
byNursing Path
 
PDF
Anxiety disorders
byNursing Path
 
PDF
Fundamentals of nursing practice exam
byNursing Path
 
PDF
Fluid and electrolyte balance
byNursing Path
 
PDF
Fundamentals of nursing practice exa1
byNursing Path
 
PDF
Outcome based education
byNursing Path
 
PPSX
Cardiopulmonary resuscitation
byNursing Path
 
PDF
Fundamentals of nursing practice exam
byNursing Path
 
PDF
Psychosocial care of coronavirus disease 2019
byNursing Path
 
PDF
Fundamental of nursing practice exam 4
byNursing Path
 
PPSX
Pneumonia
byNursing Path
 
PPSX
Abortion
byNursing Path
 
PPSX
Swine flu
byNursing Path
 
PPSX
Microbiology
byNursing Path
 
PDF
Isolation facility for covid-19
byNursing Path
 
PDF
Guidelines on clinical management of covid 19
byNursing Path
 
PPSX
Waterborne Pathogens in Historical and Social Contexts
byNursing Path
 
Assessment
byNursing Path
 
Hospital Infection Control Programme
byNursing Path
 
Selection and organization of learning experience
byNursing Path
 
Universal Health Coverage
byNursing Path
 
Anxiety disorders
byNursing Path
 
Fundamentals of nursing practice exam
byNursing Path
 
Fluid and electrolyte balance
byNursing Path
 
Fundamentals of nursing practice exa1
byNursing Path
 
Outcome based education
byNursing Path
 
Cardiopulmonary resuscitation
byNursing Path
 
Fundamentals of nursing practice exam
byNursing Path
 
Psychosocial care of coronavirus disease 2019
byNursing Path
 
Fundamental of nursing practice exam 4
byNursing Path
 
Pneumonia
byNursing Path
 
Abortion
byNursing Path
 
Swine flu
byNursing Path
 
Microbiology
byNursing Path
 
Isolation facility for covid-19
byNursing Path
 
Guidelines on clinical management of covid 19
byNursing Path
 
Waterborne Pathogens in Historical and Social Contexts
byNursing Path
 

Recently uploaded

PPTX
Foundations for the Future: Auditing Digital Collections for Long-Term Preser...
byCONUL Conference
 
PPTX
CHAPTER NO. 05 BIOLOGICAL SOURCE,CHEMICAL CONSTITUENTS AND THERAPEUTIC EFFICA...
byGanu Gavade
 
PPTX
Aligning Ireland’s Open Repository Network by Strengthening Shared Standards ...
byCONUL Conference
 
PDF
Result Analysis of the Pre Board 2025 .pdf
byDirectorate of Education Delhi
 
PDF
Road Safety Calendar-2026 Courtesy - IYSO Team India - Safer Indian Roads
byIndian Youth Secured Organisation
 
PPTX
Well on our way – Rolling out a wellbeing programme at the Radcliffe Science ...
byCONUL Conference
 
PDF
Old Historicism vs New Historicism Slides
byDr. Ilyas Babar Awan
 
PDF
Fever & Fragment Uncovering the Plague in The Waste Land
byNidhi Pandya
 
PDF
Digital_Empathy_Toolkit_Netiquette_and_Responsible_Communication
byNidhi Pandya
 
PPTX
YSPH VMOC Special Report - Measles - The Americas 12-28 2025 .pptx
byYale School of Public Health - The Virtual Medical Operations Center (VMOC)
 
PDF
Unit 4: Polynuclear Hydrocarbons | Pharma Organic Chemistry
bySandeshSul
 
PPTX
Empowering Equality: The Athena Swan Journey at Maynooth University Library. ...
byCONUL Conference
 
PDF
Cut off for Asst Professor Recruitment by HPSC i.e. Haryana Public Service Co...
byRajesh Verma
 
PPTX
All Things 2025 - A Year in Review Quiz!
byShashank Jogani
 
PPTX
Bookish Bats: a unique sustainable delivery service in the Russell Library. A...
byCONUL Conference
 
PPTX
AI Literacy at UCD Library. Dr Marta Bustillo & Sandra Dunkin, University Col...
byCONUL Conference
 
PPTX
Collecting and preserving: new imperatives and new challenges. Speaker: Richa...
byCONUL Conference
 
PPTX
Cultivation practice of Root vegetables.pptx
byUmeshTimilsina1
 
PPTX
Archival literacy and engagement through Brightspace: the new Special Collect...
byCONUL Conference
 
PPTX
Cultivation practice of Cucumber, Pumpkin and summer squash in Nepal.pptx
byUmeshTimilsina1
 
Foundations for the Future: Auditing Digital Collections for Long-Term Preser...
byCONUL Conference
 
CHAPTER NO. 05 BIOLOGICAL SOURCE,CHEMICAL CONSTITUENTS AND THERAPEUTIC EFFICA...
byGanu Gavade
 
Aligning Ireland’s Open Repository Network by Strengthening Shared Standards ...
byCONUL Conference
 
Result Analysis of the Pre Board 2025 .pdf
byDirectorate of Education Delhi
 
Road Safety Calendar-2026 Courtesy - IYSO Team India - Safer Indian Roads
byIndian Youth Secured Organisation
 
Well on our way – Rolling out a wellbeing programme at the Radcliffe Science ...
byCONUL Conference
 
Old Historicism vs New Historicism Slides
byDr. Ilyas Babar Awan
 
Fever & Fragment Uncovering the Plague in The Waste Land
byNidhi Pandya
 
Digital_Empathy_Toolkit_Netiquette_and_Responsible_Communication
byNidhi Pandya
 
YSPH VMOC Special Report - Measles - The Americas 12-28 2025 .pptx
byYale School of Public Health - The Virtual Medical Operations Center (VMOC)
 
Unit 4: Polynuclear Hydrocarbons | Pharma Organic Chemistry
bySandeshSul
 
Empowering Equality: The Athena Swan Journey at Maynooth University Library. ...
byCONUL Conference
 
Cut off for Asst Professor Recruitment by HPSC i.e. Haryana Public Service Co...
byRajesh Verma
 
All Things 2025 - A Year in Review Quiz!
byShashank Jogani
 
Bookish Bats: a unique sustainable delivery service in the Russell Library. A...
byCONUL Conference
 
AI Literacy at UCD Library. Dr Marta Bustillo & Sandra Dunkin, University Col...
byCONUL Conference
 
Collecting and preserving: new imperatives and new challenges. Speaker: Richa...
byCONUL Conference
 
Cultivation practice of Root vegetables.pptx
byUmeshTimilsina1
 
Archival literacy and engagement through Brightspace: the new Special Collect...
byCONUL Conference
 
Cultivation practice of Cucumber, Pumpkin and summer squash in Nepal.pptx
byUmeshTimilsina1
 

Organization

  • 1.
  • 2.
    1. The purposeof an organization structure 2. The meaning of "organizing" and "organization." 3. The distinction between formal and informal organization. 4. How organization structures and their levels are due to the limitations of the span of management. 5. The exact number of people a manager can effectively supervise depends on a number of underlying variables and situations. 6. The nature of entrepreneuring and intrapreneuring. 7. The key aspects and limitations of reengineering. 8. The logic of organizing and its relationship to other managerial functions. 9. That organizing requires taking situations into account. LEARNING OBJECTIVES 04/10/2015 www.drjayeshpatidar.blogspot.com 2
  • 3.
    Organizing System of Roles What Part to Play How’s relatedto each other MaintainingDesigning ROLES Coordinating Efforts an understood area of discretion or clear idea of the major duties or activities involved verifiable objectives TOOLS Supply of Needed Information Performing in that roleto exist and be meaningful, it must incorporate 04/10/2015 www.drjayeshpatidar.blogspot.com 3
  • 4.
    Organizing A basic processof combining / integrating Human / Physical / Financial resources in productive interrelationship for the achievement of enterprise objectives 04/10/2015 www.drjayeshpatidar.blogspot.com 4
  • 5.
    Definition of Organization Organizationimplies a formalized intentional structure of roles or positions Effort Pooling towards designated objectives through definition / division of activities / responsibilities / authority04/10/2015 www.drjayeshpatidar.blogspot.com 5
  • 6.
    identification and classification of requiredactivities grouping of activities necessary to attain objectives Assigning responsibility with necessary authority To a manager for each grouping Coordination in organizational Structure Vertically, Horizontally Departmentation Manageable units Maximum possible specialization Delegation Aptitude / Attitude Job Requirement / Capabilities Organizing involves Synchronization Interrelationship between different positions must be clearly defined From whom ? To whom ? 04/10/2015 www.drjayeshpatidar.blogspot.com 6
  • 7.
    Organizational Structure Design What Who Results Isto do Fitting various activities Give what Smoothly Efficiently Effectively04/10/2015 www.drjayeshpatidar.blogspot.com 7
  • 8.
    Should not be flexible Channeled individual and groupefforts intentional structure of roles in a formally organized enterprise Well defined jobs Definite authority / responsibility Formal organization 04/10/2015 www.drjayeshpatidar.blogspot.com 8
  • 9.
    flexible Loosely organized Any joint personalactivity without conscious joint effort even through contributing towards Joint Results ill defined Spontaneous Informal organization A network of personal / social relationships, not established, required by FORMAL organization but arising spontaneously Structure (membership), communication networks (“grapevine”), and relationships behaviors and norms) do not necessarily follow those of the formal organization. 04/10/2015 www.drjayeshpatidar.blogspot.com 9
  • 10.
    What is aDepartment? The department designates a distinct area, division, or branch of an organization over which a manager has Authority for the performance of specified activities 04/10/2015 www.drjayeshpatidar.blogspot.com 10
  • 11.
    Organization Level andSpan of Management
  • 12.
    Organization with NarrowSpanLevels = 4 Span of Control = 3 Total Employees = 40 Advantages •Close supervision •Close control •Fast communication between levels Disadvantages •Too much involvement in subordinate’s work •Many levels / higher cost •Excessive distance between top and lowest level Variety of non-recurrent problems, involving non- programmed strategic decisions 04/10/2015 www.drjayeshpatidar.blogspot.com 12
  • 13.
    Organization with widespanLevels = 3 Span of Control = 7 Total Employees = 57 Advantages •Superiors are forced to delegate •Clear policies are required •Subordinates must be carefully selected Disadvantages •Overloaded superior / decisional bottleneck •Superior’s loss of control •Requires exceptional quality managers For Recurrent, repetitive and routine problems 04/10/2015 www.drjayeshpatidar.blogspot.com 13
  • 14.
    Principle of theSpan of Management The principle of the span of management states that there is a limit to the number of subordinates a manager can effectively supervise, but the exact number will depend on the impact of underlying factors 04/10/2015 www.drjayeshpatidar.blogspot.com 15
  • 15.
    Operational-management position: asituational approach Classical theory: No. of subordinates:3-8 Operational management theory: 1. What to supervise: complexity and variety of the subordinate’s work 2. Which tools are used 3. Quality of manager and subordinate 4. Degree of interaction No. depends of many underlying factors: 04/10/2015 www.drjayeshpatidar.blogspot.com 16
  • 16.
    Difference Between anIntrapreneur and an Entrepreneur • An intrapreneur is a person who focuses on innovation and creativity and who transforms a dream or an idea into a profitable venture by operating within the organizational environment • The entrepreneur is a person who does similar things as the intrapreneur, but outside the organizational setting 04/10/2015 www.drjayeshpatidar.blogspot.com 17
  • 17.
    Definition of Reengineering •"...the fundamental rethinking and radical redesign of business processes to achieve dramatic improvements in critical contemporary measures of performance, such as cost, quality, service, and speed.“ 04/10/2015 www.drjayeshpatidar.blogspot.com 18
  • 18.
    Key Aspects ofReengineering Fundamental rethinking of what the organization is doing and why. Radical redesign of the business processes Reengineering calls for dramatic results The need for carefully analyzing and questioning business processes 04/10/2015 www.drjayeshpatidar.blogspot.com 19
  • 19.
    Nurses form avery important group - the largest single technical group - of personnel engaged in patient care in hospitals next to doctors, consuming approximately one-third of hospital costs. because…. 04/10/2015 www.drjayeshpatidar.blogspot.com 20
  • 20.
    • Nursing careis required for the prevention of disease and for promotion of health. • The nursing care of sick patients - a. in the interest of his or her mental and physical comfort. b. by reason of the disease from which he or she is suffering. 04/10/2015 www.drjayeshpatidar.blogspot.com 21
  • 21.
    Functions of nursingservices are: 1. Clinical 2. Technical 3. Caring relationship 4. Administrative 5. Educational 04/10/2015 www.drjayeshpatidar.blogspot.com 22
  • 22.
    It is observedthat 50% or more of her time will be spent on non-nursing functions like a. Clerical b. Answering telephones c. Supervise indent of drugs d. House keeping, etc 04/10/2015 www.drjayeshpatidar.blogspot.com 23
  • 23.
    staffing The number ofnurses required to man the nursing services in a hospital depends on many factors, • Number of beds in a hospital • The type of hospital and the prevailing medical practice, including kinds of treatment and medications given and tests and services required for the patients. • Pattern of assignment of nurses - based on functional method, case method or teach method. • The type and the number of emergency cases coming into the hospital. • Available labour - saving devices, automation, mechanization, centralization • Level of competence based on - qualification, experience, efficiency and sincerity. 04/10/2015 www.drjayeshpatidar.blogspot.com 24
  • 24.
    Work allocation Patterns ofassignment: the tasks of the nursing unit are carried out by 3 accepted patterns of assignment, depending on the training, experience and the rules of a particular institution. 1. Functional method: The tasks are divided among the staff. 2. Case method: Each nurse is assigned one or more cases. 3. Team method : Under this system the nursing staff is divided into teams each of which is guided by an experienced nurse. The team leader is responsible to the ward sister and she organizes the nursing care for her group of patients. 4. Group Assignment method: one nurse is assigned to a group of patient to provide total nursing care. 5. Primary nursing method: the primary nurse assumes 24-hour accountability for the care, planning and evaluation. When on duty on a shift, the primary nurse herself assumes responsibility for providing total care. Other functions of primary nurse is the coordination of nursing activities with physician and other health professionals. 04/10/2015 www.drjayeshpatidar.blogspot.com 25
  • 25.
    Physical dependency ofpatients This is an important factor in assessing the workload. The patients can be classified under the following headings: a. Totally ambulant b. Partially bedfast c. Bedfast but not helpless d. Partially helpless e. Totally helpless 04/10/2015 www.drjayeshpatidar.blogspot.com 26
  • 26.
    Indices of hospitalnurses The nursing time provided per patient per day is the most useful and realistic index, since it takes into account Occupancy rates, working hours, and days absent from work. 04/10/2015 www.drjayeshpatidar.blogspot.com 27
  • 27.
    To find outthe average number of working days per year by a nurse: Earned leave 30 days Sick leave 10 days Casual leave 14 days Weekly off 85 days Non-working days 139 days Total working days in year 365 days Therefore total working days is 226 days 04/10/2015 www.drjayeshpatidar.blogspot.com 28
  • 28.
    To find outthe average number of hours worked per year by a nurse Average number of working days per year X Average number of working hours 226 x 8 = 1808 nursing hours 04/10/2015 www.drjayeshpatidar.blogspot.com 29
  • 29.
    To find outthe total number of nursing hours per day The hours worked per year by a nurse X total number of nurses For example Total bed capacity of hospital = 500 Required number of nurses = 217 nurses (as per INC norms 1808 x 217 = 361736 04/10/2015 www.drjayeshpatidar.blogspot.com 30
  • 30.
    To find outthe number of nursing hours per day Total number of nursing hours per year 365 361736 365 991.21 nursing hours per day To find out the number of nursing hours per Patient 991  500 = 1.98 nursing hours per patient per day approximately 04/10/2015 www.drjayeshpatidar.blogspot.com 31
  • 31.
    Duties of differentcategories of nursing staff Director of nursing The nursing director has very little or no technical duty to perform. The work is mainly administrative and conceptual. 1. Supervision - working pattern 2. Maintaining discipline 3. Planning diff. services 4. Preparing policies to upgrade the routines. 5. Participating in recruitment of staff 6. Organizing for academic purposes. 7. Arrange (in-service) training programmes. 04/10/2015 www.drjayeshpatidar.blogspot.com 32
  • 32.
    Sister-in-charge Sister-in-charge is theadministrative head of the ward/section. Therefore the duties are based on responsible attitude and supervision. 1. Maintaining cleanliness and orderliness in the ward. 2. Supervising housekeeping activities. 3. Supervise staff nurse, nurse-aides, labour staff, patients. 4. Maintaining inventory. 5. Accompany senior clinician during their rounds/ discussion and actively participate in taking and implementing the decisions. 04/10/2015 www.drjayeshpatidar.blogspot.com 33
  • 33.
    Staff Nurse This categoryis the most active. The duties they are expected to carry out are 1. General and routine care of patients as per clinicians instructions. She is an active bridge between treating clinician and patients. 2. To assist clinician. 3. Assist or independently perform certain procedure like a. collecting blood, b. catheterization of bladder, c. giving IV fluids, d. first aid. 4. Assist actively at ante natal clinic, post natal clinic, diabetes, asthma, etc. 5. Educational activity like health talk, counseling, etc. 6. Attend outdoor activities. 7. Admit and discharge patients. 04/10/2015 www.drjayeshpatidar.blogspot.com 34
  • 34.
    Problems faced: 1. Shortageof nurses due to a. improper ratio of nurse : patient b. recruitment policy c. non availability d. migration to other hospitals e. increase in requirement. 2. Dissatisfaction 3. Absenteeism : particularly for night duty. 4. Unionization 5. Deterioration in standard of performance 04/10/2015 www.drjayeshpatidar.blogspot.com 35
  • 35.
    Professional Hazards: 1. Riskof infection 2. Stress and burn out 3. Backache due to prolonged standing and walking on hard surface. 4. Fatigue due to shift duties. 5. Improper behavior of some patients, relatives, labour staff and even doctors. 6. Frustration. 04/10/2015 www.drjayeshpatidar.blogspot.com 36
  • 36.
    1. Receiving andsorting the soiled material used in the hospital 2. Determining whether the items should be reused or discarded. 3. Carrying out the process of decontamination or disinfection prior to sterilizing. 4. Carrying out specialized cleaning of equipment and supplies. 5. Inspecting and testing instruments, equipment and linen. 6. Assembling treatment trays, instrument sets, linen packs, etc. 7. Packaging all materials for sterilizing. 8. Sterilizing. 9. Labelling and dating materials. 10.Storing and controlling inventory. 11.Issuing and distributing. Functions of CSSD 04/10/2015 www.drjayeshpatidar.blogspot.com 37
  • 37.
    Functions of CSSD 1.To maintain an uninterrupted supply of bacteriologically safe supplies at all times. 2. To undertake studies for improvement of sterilization practices and 3. Processing methods to provide supplies economically. 4. To impart training to hospital personnel in safe hospital practices. 5. To participate in hospital infection control programme. 04/10/2015 www.drjayeshpatidar.blogspot.com 38
  • 38.
    Receipt Accounting, Sorting Washing, Cleaning,Drying Packing Awaiting sterilization Sterilization Sterile storage Issue Gloves Instruments Needles & Syringes Autoclaves Dry ovens Gloves Gauze & Dressings Syringes & Needles Instruments Packs Torn/punctured Unserviceable Cracked/ broken Check for Sterility Shelf-life expired Sterility Not ok 04/10/2015 www.drjayeshpatidar.blogspot.com 39
  • 39.
    The sequence ofevents is as follows: 1. Materials are received into the department from various users. 2. All used materials are cleaned - prelimary cleaning before sending the articles to CSSD. 3. Clean materials are inspected, assembled and packed, ready for sterilization. 4. After sterilization, they are either stored in a sterile storage area or distributed directly as required. 04/10/2015 www.drjayeshpatidar.blogspot.com 40
  • 40.
    Location • The locationof CSSD should be convenient to its principal consumers. • Preferably sited close to OT & wards. • Doors should have the following strong colours to signify the different zones to which they give access. Red - denotes contaminated zone Yellow - denotes clean zone Green - denotes sterile zone 04/10/2015 www.drjayeshpatidar.blogspot.com 41
  • 41.
    Space A minimum of7 sq ft on a per bed basis ( with 100 sq ft for the smallest hospital) is considered essential for planning a CSSD with scope for future expansion and growth. Up to 100 beds 10 sq ft per bed Up to 200 beds 9 - 10 sq ft per bed Up to 300 beds 8 - 9 sq ft per bed 300 and above 7 - 8 sq ft per bed 04/10/2015 www.drjayeshpatidar.blogspot.com 42
  • 42.
    Room Nature of work Spacein % Wash room in which everything is washed up Dirty 10 Work room in which all packaging is undertaken Clean 26 Syringe & instrument processing room Clean 9 Unsterile pack store Clean 4 Bulk store Clean 11 Sterile store Sterile 16 Miscellaneous rooms Clean 19 Autoclaves Clean 5 In planning a CSSD, following concept may be kept in mind 04/10/2015 www.drjayeshpatidar.blogspot.com 43
  • 43.
    Staffing One qualified superintendent- In-charge of the dept. CSSD supervisor - senior nurse (traditionally). In-service trained CSSD attendants CSSD assistants - Semiskilled workers CSSD technicians Sweeper. A 500-bedded teaching hospital has the following staff. Technologists 5 Technical assistants 4 Nursing aides 4 CSSD attendants 4 04/10/2015 www.drjayeshpatidar.blogspot.com 44
  • 44.
    Equipments • Autoclaves • Dryoven • Gauze cutter • Ultrasound washer • Needle flushing device • Ethylene oxide sterilizer • Soaking sinks • High pressure water jets. 04/10/2015 www.drjayeshpatidar.blogspot.com 45
  • 45.
    Autoclaves • Saturated steamunder pressure is the safest and dependable method of sterilization. • Minimum time for sterilization by autoclaving process is 121°C in 15 min. • sterilization checks for quality control. • Sterility indicators – Mechanical indicators – Chemical indicators – Biological indicators • Shelf life 04/10/2015 www.drjayeshpatidar.blogspot.com 46
  • 46.
    Chemical sterilization Ethylene oxide(EO) - used for heat-sensitive and moisture-sensitive materials like rubber, plastics and fibre glass. Effective sterilization by EO depends upon the Following: Concentration of gas: 450mg/litre or higher Temperature exposure: 49 to 63°C and 30 to 37.8°C Packing: The type of wrapping used should be penetrable by ethylene oxide and water vapour. Polyethylene is commonly used for wrapping. Period of exposure: The time ranges from 110 to 260 min. up to 12 hours may be required. 04/10/2015 www.drjayeshpatidar.blogspot.com 47
  • 47.
    Sterilization process After thesterilizer chamber is sealed and the controls set, sterilization process goes through the following phases: 1. Warming the chamber 2. Evacuating residual air to partial vacuum. 3. Introduction of moisture to ensure that it penetrates wrappings and material. 4. Introduction of EO. 5. Raising the temperature(if required) 6. Exposure for the required time. 7. Release of chamber pressure. 04/10/2015 www.drjayeshpatidar.blogspot.com 48
  • 48.
    Ultra sonic cleaner •Ultrasonic cleaner cleans by bombarding the item with sound waves. • These tiny shock waves will knock debris off nooks and corners of instruments that are not easy to reach. 04/10/2015 www.drjayeshpatidar.blogspot.com 49
  • 49.
    The list ofitems and special trays commonly processed in the CSSD are: Instruments Dressings Sponges OT linen Special packs Gauze and cotton materials Gloves Bowls and trays 04/10/2015 www.drjayeshpatidar.blogspot.com 50
  • 50.
    Standardization of surgicalpacks The aim is to have a standard surgical pack containing all the items required for that procedure by the operating surgeon. Some of the Special trays and sets to be processed by CSSD are as follows: • Lumbar puncture set • Sternal puncture set • Catheterization set • Bladder wash set • Liver biopsy set • Fine-needle aspiration cytology set • Suturing set • Thoracic aspiration set • Incision and drainage set • Tracheostomy set. 04/10/2015 www.drjayeshpatidar.blogspot.com 51
  • 51.
  • 52.
    Laundry Services • Itis a centralized function coming under the housekeeping department taking care of all activities from purchase to linen management to laundry to condemnation • Linen Management will vary based on the climate, culture, systems and procedure of the individual organization 04/10/2015 www.drjayeshpatidar.blogspot.com 53
  • 53.
    Hospital can gofor • Inside laundry services - with adequate machineries • Inside laundry services – Manual wash by dhobi • Outside laundry services – On contract basis 04/10/2015 www.drjayeshpatidar.blogspot.com 54
  • 54.
    Functions of laundrydepartment • Collection or receiving soiled and infected linen • Processing soiled linen through laundry equipment. This includes sorting, sluicing and disinfecting, washing, extracting, drying, conditioning ironing, pressing and folding • Inspection and repair of damaged articles, their contamination and replacement • Distributing finished linen to the respective user departments • Maintenance and control of active and back-up inventions and processed linen • Maintaining all type of registers 04/10/2015 www.drjayeshpatidar.blogspot.com 55
  • 55.
    Organizing laundry department •Manpower requirement • Duties and responsibilities of linen in - charge housekeepers • Recruitment and selection of dhobi • Management information system • Equipments – selection, care • Linen – selection, care, stain removal procedure • Work procedure • Stain removal procedure • Management issues 04/10/2015 www.drjayeshpatidar.blogspot.com 56
  • 56.
    Tips • Stock thelinen materials in 1:3 ratio • Each day the bed sheet is dusted and the side is changed when the bed is made. This way both sides of the sheet is used. On the third day the bed sheet is changed • Use all faded and damaged fabrics for dusting and cleaning windows, furniture etc 04/10/2015 www.drjayeshpatidar.blogspot.com 57
  • 57.
    Diet service objective • Toprovide individualized nutritional care to the patients using normal diet or need based special type of diet. • Service needs to be organized for o Hospital staff o Outdoor patients o Visitors o Patient’s attendants i.e. relatives. 04/10/2015 www.drjayeshpatidar.blogspot.com 58
  • 58.
    Different types offood services include following: 1.Patient food service. 2.Cafeteria or mess for the employees. 3.Cafeteria or mess for the students in teaching hospitals. 4.Coffee shop 5.Vending machines. 6.Special meals for meetings, guests and functions. 04/10/2015 www.drjayeshpatidar.blogspot.com 59
  • 59.
    • Patient foodservice 1. Purchasing food items as per specification and in predetermined quantity. 2. Planning menu for different types of patients as per their a. Age b. Nutritional needs. c. Ability to consume eg. Unconscious patient, infants, etc d. Disease requiring restrictions. • Disease requiring special diet 04/10/2015 www.drjayeshpatidar.blogspot.com 60
  • 60.
    • Different typesof menu •  Full diet •  Light diet •  Soft diet •  Liquid diet •  Salt-free diet •  Chilly free diet/bland diet •  High protein diet •  High carbohydrate diet •  Diabetic diet •  Special diet (eliminating certain substance) Dietary habits of patients should be taken. 04/10/2015 www.drjayeshpatidar.blogspot.com 61
  • 61.
    3. Ensuring hygienicmethod of cooking. 4. While cooking nutritive value and palatability do not get adversely affected. 5. Supervising food distribution. 6. Supervising consumption by patients on random basis. 7. Taking feedback from patients. 8. Avoiding wastage by not preparing excess food and preventing pilferage. 9. Avoiding shortage – particularly for new patients. 10. Counseling patients on special diets. 11. Training nurses, students and interns 04/10/2015 www.drjayeshpatidar.blogspot.com 62
  • 62.
    • SITE, AREA& DESIGN It is necessary to have certain policies before deciding their details 1. Foods consumed outside a. Information is got at the time of admission. b. Wastage is avoided c. Attendants food pass can be issued 2. Vegetarian/ Non-Veg This policy decision will enable diet dept. in a. Purchase of raw material b. Organizing separate area for cooking veg & Non-veg meals. 04/10/2015 www.drjayeshpatidar.blogspot.com 63
  • 63.
    • Ground flooris desirable 1.Receipt of raw materials a. Checking, b.Weighing c. Temporary storing before shifting 2.Storage area a. Godown or storeroom for non-perishable items like grains, oil, etc. b.Cold storage for perishable items milk, vegetables, etc. – refrigerator, cold room. 04/10/2015 www.drjayeshpatidar.blogspot.com 64
  • 64.
    3. Preparation area a.Sorting out b. Washing vegetables c. Washing utensils d. Slicing, peeling, chopping, grinding e. Mixing 4. Cooking area a. Large size steam cooker. b. Cooking gas c. Special diet area 04/10/2015 www.drjayeshpatidar.blogspot.com 65
  • 65.
    5. Serving andtransportation of cooked food depends on a. Hospital policy b. Geographical area c. Vertical / horizontal /both. ｷMobile hot food carrier ｷContainers of adequate size ｷNurse in the ward will arrange to get food served. 6. Cleaning area a. Utensils cleaning b. Dish washer 04/10/2015 www.drjayeshpatidar.blogspot.com 66
  • 66.
    • Staffing pattern •Manager – qualified dietitian • Dietitians – 2 or 3 • Clerical staff – paper work & inventory • Cooks – one/100 beds. Health check-up, food handlers. • Helpers 04/10/2015 www.drjayeshpatidar.blogspot.com 67
  • 67.
    • Problems 1. Patientsatisfaction 2. Wastage i. Cooking more than necessary ii. Less consumption due to a. Poor taste b. Becoming cold c. Poor appetite due to illness d. Home food/eatables 3. Shortage i. Diet sheet has not been submitted on time. ii. Sudden new admissions iii. Cooking less than necessary iv. Pilferage by staff. 4. Theft 5. Fraud in materials management. 04/10/2015 www.drjayeshpatidar.blogspot.com 68
  • 68.
    • Outsourcing dietary •Cafeteria or mess for employees • Cafeteria for students • Coffee shop • Vending machines • Special meals for guests or for functions. • Diet committee – regular rounds, taste of food is checked. 04/10/2015 www.drjayeshpatidar.blogspot.com 69
  • 69.
    The basic functionof a laboratory service is: 1. To assist doctors in arriving at or confirm a diagnosis. 2. To assist in the treatment and follow-up of patients. 3. The laboratory not only generates prompt and reliable reports, but also to function as a storehouse of reports for future references. 4. To carry out urgent tests at any part of day or night and therefore provide serve 24 hours a day, 5. And in big hospitals, the laboratory also assists in teaching programs for doctors, nurses and laboratory technologists. 04/10/2015 www.drjayeshpatidar.blogspot.com 70
  • 70.
    Types of laboratories1.Hematology Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases. The lab work that goes into the study of blood is performed by a Medical Technologist. 2. Microbiology Microbiology is the study of microorganisms, which are unicellular or cell-cluster microscopic organisms 3. Clinical chemistry Clinical biochemistry is the area of pathology that is generally concerned with analysis of bodily fluids. 04/10/2015 www.drjayeshpatidar.blogspot.com 71
  • 71.
    4. Histopathology Histopathology (fromthe Greek histos (tissue) and pathos (suffering)) refers to the microscopic examination of tissue in order to study the manifestations of disease. 5. Routine urine and stool analysis 04/10/2015 www.drjayeshpatidar.blogspot.com 72
  • 72.
    Functional planning 1. Determineapproximate section wise workload. 2. Determining services to be provided. 3. Determining area and space requirement to accommodate equipment, furniture and personnel in technical, administrative and auxiliary functions. 4. Dividing the area into functional units, viz hematology, biochemistry, microbiology, histopathology, urinalysis, etc. 04/10/2015 www.drjayeshpatidar.blogspot.com 73
  • 73.
    5.Determining the numberof work stations in each functional unit/division and deciding the linear bench space allotted for each work station. 6. Determining the major equipment and appliances in each unit. This is generally classified into: i) Technical equipment peculiar to certain work stations. ii) Other equipment and appliances e.g. (refrigerators, hot air ovens, centrifuges) that can be jointly used by different work stations or units. 04/10/2015 www.drjayeshpatidar.blogspot.com 74
  • 74.
    7. Determining thefunctional location of each section in relation to one another, from the point of view of flow of work, technical work considerations, auxiliary areas and administrative efficiency. 8. Identifying the units that are likely to expand, for locating them in such a manner which will permit smooth expansion. 9. Identifying the electrical and plumbing requirements for each area/work station. Independent electric circuits are required for electronic equipment items. Location of sinks and wash areas are vital for efficient performance of work stations. 04/10/2015 www.drjayeshpatidar.blogspot.com 75
  • 75.
    10. Considering utilities,- lighting, ventilation (forced or normal exhaust, air-conditioning and air hygiene) and isolation of equipment or work stations. 11. Working out the most suitable laboratory space unit (LSU), which is a standard module for work areas. A standard module facilitates rearrangement of work units with least disruption and minimal structural changes. 04/10/2015 www.drjayeshpatidar.blogspot.com 76
  • 76.
    Organization 1. Centralized • Itavoids duplication of purchases of expensive equipment. • Avoids duplication of personnel. • Easy to monitor working and quality control • Automation will not be underutilized. • There can be delay in transporting samples and issue of reports. 04/10/2015 www.drjayeshpatidar.blogspot.com 77
  • 77.
    2. Decentralized • Transportation •Dispatch • Can cater to the specific needs of certain areas e.g. ICCU, premature nursery • Results can be easily logged on to the ward • Duplication of equipments • Requires additional technical staff. • Lack of uniformity in procedures and conflicts. • Supervision difficulty • Quality control • Multiple lines of authority • Transfers to other area may disturb the services. 04/10/2015 www.drjayeshpatidar.blogspot.com 78
  • 78.
    Workload • An admittedpatient undergoes anywhere between 8 and 20 laboratory tests on an average during his or her hospitalization period. • In 1990, in a teaching hospital, laboratory tests averaged at 20 tests per patient in medical ward during an ALS of 10 days, giving a ratio of 2 tests per day, excluding radiographic investigations or other tests carried out in specialized laboratories. 04/10/2015 www.drjayeshpatidar.blogspot.com 79
  • 79.
    • A 100-beddedhospital with a 10 days ALS will treat 365 ÷ 10 = 36.5 (37 pts)/bed in a yr, • 37 x 100 = 3700 total patient in a year which means that the hospital laboratory will have to carry out 3700 x 8 = 29,000 tests to 3700 x 20 = 74,000 tests during the year. 04/10/2015 www.drjayeshpatidar.blogspot.com 80
  • 80.
    Location • Preferable onthe ground floor and accessible to the wards. • Depends upon the size of the hospital and its outpatient set up, the laboratory can be situated. • Outpatient sample collection. – The design should include waiting room for patients, venepuncture room, and specimen toilets. – Provision should be made for containers with appropriate preservatives, for correct labeling of samples, and for keeping record of each patient. 04/10/2015 www.drjayeshpatidar.blogspot.com 81
  • 81.
    • Primary space –The space utilized by technical staff for the primary task of carrying out professional work. – This space is expressed in terms of LSU. • Secondary space – The space utilized for all supportive activities. – Administrative space, viz. offices for the pathologist and other, rest and locker rooms, staff toilets, etc. should be considered separately from secondary space. • Circulation space – The space required for uncluttered movement of personnel and materials within the dept. between various technical work stations, rooms, stores and other auxiliary and admin. Areas. 04/10/2015 www.drjayeshpatidar.blogspot.com 82
  • 82.
    Departments Primary space Space required Hematology General hematology  Blood transfusion  Office desk/ admin 3.5 LSU 1.5 LSU 0.5 LSU 5.5 LSU 101.75sq m Clinical chemistry  Processing and preparation  Special and general tests  Office desk/ admin/ reagent stores 1.5 LSU 3.0 LSU 1.0 LSU 5.5 LSU 101.75 sq m Microbiology  General bacteriology  Media preparation  Office desk/ admin 3.5 LSU 1.0 LSU 0.5 LSU 5.0 LSU 92.50 sq m Histopathology  Specimen preparation  Section cutting and staining  Frozen section/ special techniques  Cytology  Office desk/ admin 1.0 LSU 0.5 LSU 0.5 LSU 1.0 LSU 0.5 LSU 3.5 LSU 64.75 sq m Urine and stool 0.5 LSU TOTAL 9.25 sq m 370.00 sq m Schedule of accommodation of hospital laboratory 04/10/2015 www.drjayeshpatidar.blogspot.com 83
  • 83.
    Departments Secondary space Space required Patientarea  Waiting area Consulting, examination, venepuncture, etc. Patient toilet (specimen toilet) 40 sq m 30 sq m 10 80 sq m Office and staff  pathologist office and laboratory General office: assembling, labeling, storing, distribution of reports Staff locker and rest room  staff toilet 30 60 40 10 140 sq m Supply and processing  chemical preparation Central glass washing Sterilization Distilled water still Store: general and glassware Store: chemical Disposal and cleaning 25 60 30 10 20 20 10 TOTAL 175 sq m 395 sq m Circulation space Approximately 30 % of the total of primary and secondary space 04/10/2015 www.drjayeshpatidar.blogspot.com 84
  • 84.
    Layout • A simple,basic layout of spaces and equipment which can be supplemented or modified to suit different requirements is likely to be more efficient. • The structure, equipment and finishes should permit the original space allocation and the layout to be changed while the building is in use, with minimum disturbance. • Flexibility for use is needed so that areas can be converted from secondary to primary space and vice versa in the interest of rearrangement for expansion or change. 04/10/2015 www.drjayeshpatidar.blogspot.com 85
  • 85.
    • A fewlarge sinks which are capable of being moved without undue inconvenience are both more economical and more convenient than a larger number of small fixed sinks. • A fixed layout of services and equipment can be designed to be conveniently used in a number of alternative ways providing that working methods can be adapted or modified to fit the layout. • Open planning with a suitable arrangement of bays permits a higher ratio of usable bench length to floor area. 04/10/2015 www.drjayeshpatidar.blogspot.com 86
  • 86.
    • Administrative andauxiliary areas • Waiting room • Venepuncture cubicle • Specimen toilet • Pathologists office • Glass washing and sterilizing unit • Staff locker room and toilet 04/10/2015 www.drjayeshpatidar.blogspot.com 87
  • 87.
    Utility services • Itinclude water, gas and compressed air system. • The need for uninterrupted functioning of these systems and the probability of future expansion, careful study is necessary in designing them for safety and efficiency. • Piping system – color, coding or labeling, non corrosive – to facilitate safety purposes and repairs. • Arrangement of laboratory benches – removable panels between the benches. 04/10/2015 www.drjayeshpatidar.blogspot.com 88
  • 88.
    Internal design andfitments • Work benches • Lighting • Service spine • Storage • Partitions • Dust • Air-conditioning/exhaust • Working surface • Flooring 04/10/2015 www.drjayeshpatidar.blogspot.com 89
  • 89.
    Staffing • The hospitallaboratory service should be under the control and direction of a doctor with qualifications in pathology. – He becomes the overall in charge – quality control, standardization and administration. – Should be a part of the regular medical staff of the hospital. 04/10/2015 www.drjayeshpatidar.blogspot.com 90
  • 90.
    • The numberof medical laboratory technologists (MLT) and laboratory technicians will depend upon: – The number of samples per day – The range of tests to be performed under various sections, viz clinical chemistry, hematology, microbiology and histopathology. – Emergency service and – leave reserve. 04/10/2015 www.drjayeshpatidar.blogspot.com 91
  • 91.
    • They performall technical procedures in – Various section, – Prepare reports of completed investigations, – Check and maintain equipment and – Request for necessary supplies and materials. 04/10/2015 www.drjayeshpatidar.blogspot.com 92
  • 92.
    Tests performed annuallyper medical technologist Laboratory unit Tests Hematology 13,400 Urinalysis 30,000 Serology 11,520 Biochemistry 9,600 Bacteriology 7,680 Histology 3,840 Parasitology 9,600 04/10/2015 www.drjayeshpatidar.blogspot.com 93
  • 93.
    Equipment • The followingis a list of the important items of equipments and instruments in a general hospital laboratory: – Robot cell counter – Centrifuge – Microhematocrit centrifuge – Refrigerators – Blood bank refrigerator – Water still – Pressure sterilizer – Pipette washer – Flame photometer – Spectrophotometer – Hot air oven – Incubator – Calorimeter – Analytical balance – Blood gas analyzer – Autoanalyzer. 04/10/2015 www.drjayeshpatidar.blogspot.com 94
  • 94.
    Policies and procedures •Laboratory samples • Sample receiving • Request forms • Time of accepting specimens • Containers • Identification of specimens • Reports • Records • Blood bank service • Outpatient samples • HIV • Liaison with clinicians • Technician’s motivation • Cross-training of technicians • Laboratory waste disposal • Optimal utilization of laboratory service. 04/10/2015 www.drjayeshpatidar.blogspot.com 95
  • 95.
    It is thearea of service in the hospital, where quick and competent care can save lives and also reduce the severity and duration of illness. The casualty department provides the first impression which should be a positive one. The relationship of the casualty with other departments and wards should be close. Emergency service 04/10/2015 www.drjayeshpatidar.blogspot.com 96
  • 96.
    Definition The casualty servicesprovide immediate emergency, diagnostic and therapeutic care to patients with: • Injuries by accidents, suicidal, homicidal, etc. • Sudden attacks of illness or exacerbation of the disease. These patients require immediate attention and treatment. Emergency patients receive resuscitation and life-saving treatment. 04/10/2015 www.drjayeshpatidar.blogspot.com 97
  • 97.
    Functions 1. Attend toall the patients brought to casualty & decide appropriate management which includes - Immediate resuscitation. - First aid - Emergency investigations - Hospitalization - Referral to specific specialty by calling down the concerned doctor. - Observation of patient to decide: whether the patient can go home and attend appropriate OPD - Reassurance and short counselling. 04/10/2015 www.drjayeshpatidar.blogspot.com 98
  • 98.
    2. Carry outmedico-legal formalities. 3. Maintaining up to date list of critically ill patients for the purpose of - issuing one visit pass to relatives. - replying telephone calls. - decide acceptance or rejection of transfer of patients from other hospitals. - assist intra hospital transfer. 04/10/2015 www.drjayeshpatidar.blogspot.com 99
  • 99.
    • Following categoryof case can be labeled as medico legal : • 1. Cases of injuries and burns the circumstances of which suggest commission of an offence by some one. • 2. All Vehicular, factory or other unnatural accident cases specially when there is likelihood of patient’s death or grievous hurt. • 3. Cases of suspected or evident sexual assault. • 4. Cases of suspected or evident criminal abortion. • 5. Cases of unconsciousness where its cause is not natural or not clear. • 6. All cases of suspected or evident poisoning/intoxication. • 7. Cases referred from court or otherwise for age estimation etc. • 8. Cases brought dead with improper history creating suspicion of an offence. • 9. Any other case not falling under the above categories but has legal implication. 04/10/2015 www.drjayeshpatidar.blogspot.com 100
  • 100.
    4. Carryout servicesof non emergency nature as per the policy of the organization. 5. Maintain list of doctors on emergency duty, their availability and alternative arrangements if they are busy. 6. Disaster preparedness for mass casualties. 04/10/2015 www.drjayeshpatidar.blogspot.com 101
  • 101.
    Site, Area andDesign • Ground floor • Proper sign board with illumination • Other human traffic restricted • Entrance pattern Compound gate OPD Casualty Inpatient Services 04/10/2015 www.drjayeshpatidar.blogspot.com 102
  • 102.
    Important areas ofcasualty 1. Reception or Enquiry Counter • Sign boards with proper direction • Enquiry counter • Entrance to the casualty area should be broad enough to permit two ambulances • The entrance area should be covered. • ‘No parking’ board. 04/10/2015 www.drjayeshpatidar.blogspot.com 103
  • 103.
    2. Waiting areafor the relatives • Should be spacious with adequate light and ventilation. • Adequate sitting accommodation • All utility services should be provided • Public address system to call relative of patient to inform about patient’s condition. • Small statue of God/ Meditation hall. 04/10/2015 www.drjayeshpatidar.blogspot.com 104
  • 104.
    3. Space fortrolleys and wheel chairs • Immediate arrangement of wheel chair or trolley depending on the condition of the patient. • Based on work load, 4 - 6 trolleys/ wheel chairs are required. • Transferring of critical patients into other areas. • ‘Intensive care trolley’ should be there. • Trolley and wheel chair - parked in orderly fashion. • Soiled trolley should be kept clean always. 04/10/2015 www.drjayeshpatidar.blogspot.com 105
  • 105.
    4. Space forsecurity staff and police constable • Casualty is likely to get victims of assaults, riots, group rivalry, etc. so the security needs to be vigilant. • Entries should be restricted. • Cubicle with glass walls permitting visibility of hospital waiting area, compound & building entrance. • It is essential to have police constable counter either at the waiting hall or by the side of the entrance. 04/10/2015 www.drjayeshpatidar.blogspot.com 106
  • 106.
    5. Space foradministrator and night superintendent 6. Space for patient brought dead - procedural formalities - in the event of disaster - labeling is done - sent to mortuary - either to relatives or to police. 04/10/2015 www.drjayeshpatidar.blogspot.com 107
  • 107.
    Facilities for management 1.Examination room - first aid 2. Treatment room - minor procedures 3. Observation area - depending upon the patient condition 4. Storage space - linen, consumable items, dressing material, I.V fluids, equipments 5. Fixtures: electrical connections, medical gas connection and vacuum connections. 6. Other support services: lab, radiology, blood bank, OT/table for infected and uninfected cases. 04/10/2015 www.drjayeshpatidar.blogspot.com 108
  • 108.
    Staff required 1. Seniorphysician/surgeon/orthopedic surgeon who should be in-charge 2. Casualty officers - depending upon the size of the hospital. 3. Orientation given on emergency care and service. 4. Specialist doctors may be called as and when necessary. 5. Nursing staff - round the clock. 6. Labour staff - for cleaning, shifting, carry messages, samples, reports, etc. 04/10/2015 www.drjayeshpatidar.blogspot.com 109
  • 109.
    Maintenance of record 1.Case register - all patients 2. Register for medico-legal cases 3. Police intimation register 4. Call book- to requisition services of doctors from different specialties 5. In/out register for resident doctors. Records/registers are required for: 1. Court case 2. Compensation to injured patients 3. Insurance 4. In the event of complaint 5. Medical audit.04/10/2015 www.drjayeshpatidar.blogspot.com 110
  • 110.
    Problems faced 1. Poorupkeep of premises and poor level of cleanliness 2. Shortage of doctors on duty due to rapid turnover. 3. Waiting for specialist opinion. 4. Casualty officer unable to take decision. 5. Inadequate staff. 04/10/2015 www.drjayeshpatidar.blogspot.com 111
  • 111.
    Continued.. 6. Waiting forinvestigation report 7. Sudden shortage of certain items during heavy attendance. 8. Pressure for hospitalization in public hospitals for non medical reasons. 9. Incomplete/ poor documentation in MLC 10. Conflicts due to poor public relations and stress due to nature of work. 04/10/2015 www.drjayeshpatidar.blogspot.com 112