Planning of hospital equipment and requirements

1. GOVERNMENT COLLEGE OF NURSING
RAJNANDGAON (C.G.)
SUBJECT- NURSING MANAGEMENT
SEMINAR ON
Planning equipments and supplies for nursing care unit and
hospital, inventory control and condemnation

2. Planning equipments and supplies for nursing care unit
and hospital
Introduction: The term "equipment" means all items necessary for
functioning of all services of the hospital including accounting and
records maintenance of buildings laundry nursing units its extra both
movable and fined equipments are required for the hospital Supplies
are those items that are used up or consumed hat the term consumable
is also used for supplies. The supplies in hospital includes drugs
surgical goods (disposables and glass wares) chemicals, antiseptics,
food materials stationeries the linen supply etc.

3. Equipment Planning:- A good equipment planning includesCareful
attention to fined and movable equipment that will be needed in
operations. The lack of planning will result, wastage of millions of
rupees. Reduced operational efficiency lower standard of patient care.
Equipment planning involve medical staff needed equipments a series
of meeting of HODs and other staffs to discuss the needed
equipments.
Materials used in hospitals-
Hospital material medical side
Perfusion material
Surgical disposables

4. Instruments
Drugs, medicine, Oxygen linen
Biomedical equipment
Disinfecting items
Computers, telephone and fax
 food and beverage materials
Anesthetic equipment
Electro medical equipment
Glassware, dental machines.
Surgical dressing utensils
Artificial limbs, bandages
Engineering items and others.

5. Hospital material management side
Computer, fax, telephone stationery items
Public address items
Overhead projector
Audio-visual systems.
Purchase of supplies and equipment
The purchase of equipments and supplies in a hospital is carried out
through-
1. General store
2. Dietary department and
3. Pharmacy department

6. When planning for the purchase of articles, budgeting is done not only for the
actual price of articles but also for the additional costs that are involved such
as-
Transport charges (local delivery reduce the transport Change)
Incidental costs
Cost of chemicals and other consumable to be used with the equipment (eg-
ECG paper for an ECG machine)
Operating costs ( hiring a technician).
 Cost of maintenance service, 10-20% of hospital equipment may remain
ideal of serving is not done periodically.
Cost of technology obsolesces when a better quality appears in market there
is tendency to discard the old model.
 Replacement cost of equipment.

7. Selection of article - while buying articles it has to meet the standards-
•Indian standards Institution is the national agency set up to bring
standardization of articles in India.
•Articles that meet the criteria specified by the Indian standandard institution
will be marked by ISI markings.
•The article bought should safety to the patient and personnel faulty
instruments and equipments cause not on inconvenience in the patient care,
but also it may cause the loss of life.
Purchasing article-
•The material used for any equipment should be durable non- use corroding
non- tonic and safe for
• Should have standard shapes and dimensions to fit into various situations.

8. •Reparability and spare part availability of the article
• Interchangeability of the article.
• All surgical instruments used in a hospital should be sterilizable and they
should stand the tests for leakage, hydraulic pressure tests for bursting etc.
•Should have accuracy in measurements.
The Central supply service
Most hospital have a central department where equipments and supplies are
stored and from which they are distributed to the units.
The type of materials that is kept in the central supply room varies from
hospital to hospital.
In some hospital the central supply room deals only the sterile supplies and
ward trays

9.  In other hospitals all types of equipment such as oxygen, suction
ward trays, catheters, syringes etc are stored here.
Linen supply -Methods of handling supply includes-
 Departmentalized system-Here the supply of the linen for each
department of the hospitals marked for that department The head of the
department is responsible for making a linen standard for his own
department.
Centralized linen supply- Under the centralized System, linen is
issued on exchange basis that is clean linen is exchange for soiled linen.

10. General utility services in the hospital-
 Electric supply and installations
. water supply
 Disposal of waste-liquids and solids
Refrigeration, air conditioning, ventilation and Environment control
Transport
 Supply of medical gases, compressed air, hot water vacuum suction and
gas plants.
 Laundry
fire-hazard
Communication
Repairs .

11. Essential equipments for a 50 bedded district hospital
(WHO)-
1. Scope of services-
a. Essential clinical services - medicine, surgery, Pediatrics, obstetrics and
Gynecology and acute psychiatry (when necessary)
b. Optional clinical services - Oral surgery, orthopedic surgery,
otolaryngology, neurology and psychiatry
c. Essential clinical support - anesthesia radiology and clinical laboratory
d. Optional clinical support services - pathology and rehabilitation including
physiotherapy.

12. 2. Essential medical equipment –
a. Diagnostic imaging equipment - It includes x-ray and ultrasound
equipment. X-ray equipment can be stationery in one room or mobile.
b. Laboratory equipment –
 Microscope
 Blood counters
 Analytical balance
 Calorimeter
 Centrifuge
 Water bath
 Incubator / oven
c. Refrigerator.
d. Instillation and purification apparatus.

13. 3. Electrical medical equipment-
a. Portable electrocardiograph
b. Defibrillator (external)
c. Portable anesthetic unit
d. Respirator - it should be applicable for prolonged administration during post
operative care.
e. Dental chair unit - a complete unit should be available to carry out standard
dental operations.
f. Suction pump - one portable and one other suction pump are required.
g. Operating theatre lamp-one main lamp with at least 8 shadows lamp and an
auxiliary of 4 lamp units.
h. Delivery table-it should be standard and mainly operated.
i. Diathermy unit - a standard coagulating unit which is operated by hand or
foot switch.

14. 4. Other equipment-
a. Autoclave - for general sterilization
b. Small sterilizers - for specific services.eg- Stabbiliser
c. Cold chain and other preventive medical equipment
d. Ambulance.
5. Small, inexpensive equipment and instruments-
Equipment and instruments such as BP apparatus, oxygen manifolds,
stethoscope. Diagnostic sets and spotlights.

21. FUNCTIONS OF INVENTORY CONTROL
•To carry adequate stock to avoid stock-outs
• To order sufficient quantity per order to reduce order cost
• To stock just sufficient quantity to minimize inventory carrying cost.
• To make judicial selection of limiting the quantity of perishable items
and costly materials
•To take advantage of seasonal cyclic variation on availability of
materials to order the right quantity at the right time.
• To provide safety stock to take care of fluctuation in demand/
consumption during lead time.
• To ensure optimum level of inventory holding to minimize the total
inventory cost.

22. STEPS IN INVENTORY CONTROL
1. fining minimum quantities or points of ordering. and maximum
quantities on all materials.
2. Arranging a Orders that are method for allocation of material and
in process-
a. Raw material inventories This consists of my material and semi
finished goods supplied by another firm.
b. Finished goods inventory - finished goods inventor idling in the
stockroom waiting for dispatch.
c. In-process inventory goods undergoing These are semi finished
the manufacturing process.

23. 3. Creating stores accounts that will control the store room. Selective
control in material management-
a. ABC analysis- ABC analysis is the process of classifying items by
using values as measures. ABC analysis helps us from one in
segregating the items another and gives us the value of the items and
to what intent controlling the materials in the best interest is to frame
policy guidelines regarding control of items‘
b. VEd analysis -Vital items are stocked in abundance, under proper
safety measures and very strict control. most essential items are
controlled moderately based on firm requirements under strict
supervision. Desirable items are under ordinary control, safety
measures are high and purchase is based on usage estimate.

24. c.HML analysis- Materials are classified according to their unit value as
high, medium and low.
d.XYZ analysis- X items are the supplies that have very high rate,
whereas z items are categorized as low in rate. The rate of y category
items falls in between that of the x and y Categories.
e.FSN analysis- This kind of categorization is based on the movement of
item consumption. F indicates the items that move faster, whereas the
items. under S are found to be slow moving and the N represents the
nonmoving items.

25. f. SDE analysis- Classification methods are based on the source of
supply. SDE classification is a system where in materials are sorted
out as scarce to obtain difficult to obtain and easy to obtain.
g. GOLF analysis - In the GOLF system classification is based on the
availability and nature of supplies. government, ordinary suppliers,
local suppliers and foreign suppliers.
h. SOS analysis- Raw material can be classified into seasonal or off-
season items.

26. CONCEPTS RELEVANT IN CONTROLLING INVENTORY
COSTS
1. Periodic /cyclic system- Periodic / fixed interval placement of orders
depending on the stock on hand and rate of consumption. The ordering
interval is thus fixed but the quantity to be ordered varies each time.
2.Two bin system - It is a system where the stock of each item is held in
two bins one large bin containing sufficient stock to meet the demands
during interval between arrivals of an order quantity and placing of next
order and the other bin containing stocks large enough to satisfy probable
demands during the period of replenishment is placed, and the stock in
the second bin is utilized until the ordered material is received.

27. 3.Minimum / Safety / butter stock -This is the amount of stock that
should be kept in reserve to avoid a stock-out in case consumption
increases unexpectedly or in case the lead time turns out to be longer
than normal. It is also the level at which fresh supply should normally
arrive, faili which action should be taken on an emergency basis to
expendite supply and replenish the stock.
4.Lead time- This is the period required to obtain the supply once the
need is determined. It is therefore the average number of days
between Placing and indent and receiving the material. lead time is
composed of two elements -

28. Administrative or buyer's lead time (i.e.Time required for
raising purchase requisitions, obtaining quotations raising
purchase order, order to reach supplier etc) and.
Delivery or supplier's leading time (i.e. Time required for
manufacture packing and forwarding shipment, delays in transit).
5. Safety Stock - Maximum daily consumption - average daily
consumption x total lead time.

29. 6. Maximum order level -This is the maximum quantity of the
materials to be stocked, beyond which the item must not be in the
inventory. If the inventory is maintained beyond this point, there
would be loss to the hospital by way of expiry of life items beyond
the shelf life of items / loss incurred on the capital locked up in the
inventory, unnecessary use of items just to exhaust the inventory.
7.Re-order level- This is the value which is very important from the
point of view of the inventory control. This is the point at which we
have to place an order for procurement for replenishing the stock. It
is derived by the formula (minimum order level + buffer stock).

30. Advantages of inventory control
1. Delivery in time
2. Possibility of discount for bulk purchase.
3. Un foreseen circumstances can be handled to Some entent.
4. Workers and machinery needn't idle.
Disadvantages
1. working capacity is tied up.
2. more space required.
3. Increase insurance chargers.
4. Increased overhead expenses.
5. Changes of damage.
6. Increase charge for obsolescence.

31. Nurses role in inventory control
1. keeping an adequate amount of equipment and supplies in the
ward.
2. Make sure that equipments and supplies are in good
conditions.
3. Put in a requisition for necessary equipment for repair and
maintenance when needed.
4. Make sure that equipments and supplies are Conveniently
located.
5. To be observant of waste and misuse.
6. To delegate someone the responsibility for handling supplies
and equipment.
7. Set a standard for the quantity of each item. to be maintained
in the ward all the time.

32. Responsibilities of the ward sister
1. Sufficient supply of materials.
2. Materials should be in good conditions.
3. Checking for misuse and how to minimize it.
4. Educating the ward staffs and other healthcare workers in
the economical use of material.

33. CONDEMNATION
The materials which could not be used within its shelf life, deteriorated
and declared unfit for use, became obsolete or banned due to legal
provisions are considered for condemnation or disposal.
Criteria for condemnation:
• The equipment has become:
• Non-functional & beyond economical repair
• Non-functional & obsolete
• Functional, but obsolete
• Functional, but hazardous
• Functional, but no longer required

34. PROCEDURE FOR CONDEMNATION
A condemnation committee comprising of three or more members is constituted by
the competent authority.
 The committee members go into details through inventory records right from the
point of demand estimation to the distribution level of materials, and will find out
reasons for being an item surplus and remained unused.
The committee will declare the items condemned and make recommendation for
further disposal of items.
The condemned items are to be destroyed, so it is to be taken out from the
inventory registers, a write off sanction of the competent authority is obtained before
final disposal.
The items particularly medicines which are toxic and cannot be disposed of by
burial or as per the relevant laid down rules under the subject of waste disposal.

35. ROLE OF NURSE
1.POPULATION/PROBLEM- inventory system under continuous
review with two demand classes.
2. INTERVANTION -Two bin policy for inventory system.
3.COMPARASION- Higher demand class and lower demand
class.
4.OUTCOME -The proposed policy is able to provide a much
higher service level for the lower priority class demand without
increasing the total cost too much and without affecting the
service level for the higher priority class.

36. THANK YOU