IPHS for 51 to 100 bedded Sub-District/Sub-Divisional Hospitals
Item
- Title
- IPHS for 51 to 100 bedded Sub-District/Sub-Divisional Hospitals
- extracted text
-
Indian Public Health Standaids (IPH$)
for
51 to 100 bedded Sub-District/Sub-Divisional Hospitals
January
2007
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Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
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51 tt 100 beddc'1 SuMMM-DmiioI Hospitals
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Directorate General of Health Services
Ministry of Health & Family Welfare
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Government of India
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Foreword
The Government of India is strongly committed to strengthen the whole range of public
health infrastructure including Sub-district/Sub-divisional Hospitals for improving the availability
and accessibility of affordable quality services to the people. Most of the existing Sub-district/Subdivisional Hospitals require improvement of physical infrastructure as they are mostly located in old
buildings, in towns, where there is no scope for more physical expansion of the building. There is
shortfall of manpower, equipments, drugs and other logistics supply etc. too. Quality management
and quality assurance procedures are also needed to make their functioning more effective,
affordable and accountable.
A Sub-district/Sub-divisional Hospital has an important role to play as the First Referral Unit
in providing emergency obstetrics care and neo-natal care and help in bringing down the maternal
mortality and infant mortality. The National Rural Health Mission (NRHM) launched by the Hon’ble
Prime Minister of India aims to restructure the health delivery mechanism in the rural areas.
Formulation of Indian Public Health Standards (IPHS) is a step in the direction of achieving the
level of quality that these Hospitals are expected to meet or aspire to.
The Indian Public Health Standards (IPHS) for Sub-district/Sub-divisional Hospitals has
been worked out by constituting Expert Group comprising various stakeholders under the
Chairmanship of Director General Health Services, Ministry of Health & Family Welfare, Government
of India. These Standards have been prepared bed strength-wise for 31 -50 beds and 51-100 beds.
The Indian Public Health Standards (IPHS) for Sub-district/Sub-divisional Hospital has been
prepared, keeping in view the minimum resources available and mention functional level of the
Hospitals in terms of space, manpower, instruments, drugs and other basic health care services.
Constitution of Rogi Kalyan Samittee/Management Committee with involvement of PRIs, Citizen
Charter are expected to make imprbvement in the functioning and accountability of these Hospitals.
It is emphasized that setting Standards is a dynamic process and will require revision at
regular intervals. It is hoped that this document will be useful to all the stake holders. Any comment
for further improvement is most welcome.
I would like to acknowledge the efforts put in by the Director General of Health Services and
Infrastructure Division in preparing the Guidelines.
A
•
(Naresh Dayal)
Secretary (H&FW)
Ministry of Health & Family Welfare
Government of India
New Delhi
Dated : 16th May, 2007
iii
Preface
Sub-district/Sub-divisional Hospitals act as the First Referral Units for provision of specialist
services to the population from neighbouring Community Health Centres. They have an important
role to play in providing emergency obstetrics care and neo-natal care and help in bringing down
the maternal mortality and infant mortality. The Government of India through the National Rural. .
Health Mission (NRHM) is committed to strengthen these Hospitals to a level of Indian Public
Health Standards (IPHS).
Standards are a means of describing a level of quality that health care organizations are
expected to meet or aspire to. The performance of these Hospitals can then the assessed against
the set of Standards prescribed. Currently, the available Standards developed by the Bureau of
Indian Standards (BIS) are short of ensuring community involvement, accountability and rights of
citizens that are important for Public Hospitals. Therefore, for the first time under National Rural
Health Mission (NRHM), an effort has been made to prepare Indian Public Health Standards (IPHS)
for Sub-districts/Sub-divisional Hospitals in the country.
The Standards have been prepared in consultation with the Expert Group constituted for
this purpose and taking in to consideration the minimum functional level needed for providing a set
of assured services.
Setting Standards is a dynamic process and this document is not an end in itself. Further
revision of Standards will occur as and when these Hospitals achieve a minimum functional grade.
The contribution of the Expert Group members, and the efforts made by the Infrastructure Division
of the Ministry of Health & Family Welfare in bringing out the first document of IPHS for Sub-district/
Sub-divisional Hospitals is well appreciated. I hope that this document will be of immense help to
the State governments and other stakeholders in bringing up these Hospitals to the level of Indian
Public Health Standards.
(Dr. R.K. Srivastava)
Director General of Health Services
Ministry of Health & Family Welfare
Government of India
New Delhi
Dated: 16th May, 2007
iv
i
Acknowledgements
Indian Public Health Standards (IPHS) for the Sub-district/Sub-divisional Hospitals fulfill
the needs of secondary referral care which may be useful as a referral document for the delivery of
quality health care. The document is the result of efforts put in by both the government and non
government organizations. As the population and geographical size of the Sub-division varies
in different States and UTs, an attempt has been made to formulate IPHS for hospitals having
different bed strengths such as 31-50 and 51-100 bedded hospitals. This document contains the
Standards set for 51-100 bedded hospital at Sub-district/Sub-divisional level.
I gratefully acknowledge the valuable contribution made by all the members of the Expert
Group constituted to formulate Indian Public Health Standards (IPHS) for the Sub-district/Subdivisional Hospitals. I am thankful to them individually and collectively.
I also gratefully acknowledge the initiative, encouragement and guidance provided by Dr.
R.K. Srivastava, Director General of Health Services and Smt. S. Jalaja, Additional Secretary. The
help and encouragement provided by Shri Amarjeet Sinha, Joint Secretary(H&FW), M/o Health &
Family Welfare, Government of India is also gratefully acknowledged.
I would specifically like to thank Dr. R.N. Salhan, Addl D.G. and Medical Superintendent
(Safdarjang Hospital), Dr. Shivlal, Additional D.G. arid Director (NICD) and Shri S. Majumdar, Chief
Architect, Bureau of Design, Ministry of Health & Family Welfare for their valuable contribution and
guidance in formulating the IPHS for the Sub-district/Sub-divisional Hospitals.
The preparation of this document has been made possible by the assistance provided by
Smt. Sushma Rath, Under Secretary (ID/PNDT) and the secretarial and typing assistance provided
by Sh. Brij Mohan Singh Bhandari. The assistance provided by the staff of Rural Health Section of
the M/o Health & Family Welfare is duly acknowledged.
I
(Dr. S.K. Satpathy)
Member Secretary - Expert Group
Director
Central Health Education Bureau
Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
New Delhi
Dated: 16th May, 2007
V
Contents
1.
Introduction
1
2.
Objectives of IPHS for Sub-District Hospitals
2
3.
Definition of Sub-District Hospital
2
4.
Grading of Sub-District Hospital
2
5.
Functions
2
6.
Essential Services
3
7.
Physical Infrastructure
24
8.
Manpower
31
9.
Equipment
33
10.
Laboratory Services
47
11.
Recommended allocation of bed strength at various levels
49
12.
List of Drugs
50
13.
Capacity Building
66
14.
Quality Assurance in Services
66
15.
Rogi Kalyan Samities / Hospital Management Committee
66
16.
Citizen’s Charter
66
Annexure -1: Guidelines for Bio-Medical Waste Management
72
Annexure - II: Reference Laboratory Networks
75
List of Abbreviations
78 |
References
79 I
vii
IPHS for 51 to 100 Bedded Hospitals
1.
hospitals can be assessed against a set of
standards.
Introduction
Sub-district (Sub-divisional) hospitals are
below the district and above the block level (CHC)
hospitals and act as First Referral Units. Specialist
services are provided through these sub-district/
district hospitals. These hospitals should play an
important referral link between the Community
Health Centres, Primary Health Centres and sub
centres. They have an important role to play as First
Referral Units in providing emergency obstetrics
care and neonatal care and help in bringing down
the Maternal Mortality and Infant Mortality. It also
saves the travel time for the cases needing
emergency care and‘reduces the workload of the
district hospital. In some of the states, each district
is subdivided in to two or three sub divisions. A
subdivision hospital caters to about 5-6 lakhs
people. In bigger districts the sub-district hospitals
fills the gap between the block level hospitals and
the district hospitals. There are about 1200 such
hospitals in the country with a varying strength of
number of beds ranging from 50 to 100 beds or
more.
There has been effort to set standards for
30 and 100 bedded hospitals by the Bureau of Indian
Standards (BIS). However, these standards are
considered very resource intensive and lack the
process to ensure community involvement,
accountability and citizens charter issues that are
important for public hospitals.
The National Rural Health Mission(NRHM)
has given the opportunity to set Indian Public Health
Standards(IPHS) for various health institutions at
different levels right from Sub-centre to District
Hospital level including Sub-district/Sub-divisional
Hospitals.
The current effort is to prepare Indian Public
Health Standards for the Sub-district Hospitals.
Reference has been made to the BIS Standard for
100 bedded hospitals; Rationalisation of Service
Norms for Secondary Care Hospitals prepared by
Govt, of Tamil Nadu; District Health Facilities,
'Guidelines for Development and Operations, WHO,
1998 and Indian Public Health Standards (IPHS)
for Community Health Centres. Setting standards
is a dynamic process. This document contains the
standards to bring the Sub-district Hospitals to a
minimum acceptable functional grade with scope
for further improvement in it. These standards are
flexible as per the requirements and resources
available to the concerned State/UT Government.
The timeframe for implementation and achievement
of these Standards could be extended for five years
and to be done in phases.
The Government of India is strongly
committed to strengthen the health sector for
improving the availability, accessibility,of affordable
quality health services to the people. In order to
improve the quality and accountability of health
services a set of standards need to be there for all
health service institutions including sub-district
hospitals.
Standards are a means of describing the
level of quality that health care organizations
are expected to meet or aspire to. The key aim
of standard is to underpin the delivery of quality
services which are fair and responsive to
client’s needs, which should be provided
equitably and which deliver improvements in
health and well being of the population. Standards
are the main driver for continuous improvements
in quality. The performance of Sub-district
Most of the existing hospitals below district
level (51-100 Bed category) are located in older
buildings in urbanized areas / towns as compared
to most Primary Health Centres / Sub-centres. The
expansions already done have resulted in
construction touching the boundaries walls with no
scope of further expansions. As far as possible,
1
IPHS for 51 to 100 Bedded Hospitals
1,00,000 to 5,00,000. Based on the assumptions of
the annual rate of admission as 1 per 50 populations
and average length of stay in a hospital as 5 days,
the number of beds required for a sub district having
a population of 5 lakhs will be around 100-150 beds.
However, as the population of the sub district varies
a lot, it would be prudent to prescribe norms by
grading the size of the hospitals as per the number
of beds.
States should not dislocate the said hospitals to a
new location (in case of dislocating to a new location,
the original client group will not be able to have same
access to the desired health facilities)
2.
Objectives of Indian Public Health
Standards (IPHS) for Sub-District
Hospitals:
The overall objective of IPHS is to provide
health care that is quality oriented and sensitive to
the needs of the people of the district. The specific
objectives of IPHS for Sub District Hospitals are:
Grade I: Sub District hospitals norms for 100
beds or more
Grade II: Sub District hospitals norms for 50
beds not exceeding 100 beds
To provide comprehensive secondary health
care (specialist and referral services) to the
community through the Sub District Hospital.
ii.
To achieve and maintain an acceptable"
standard of quality of care.
iii.
To make the services more responsive and
sensitive to the needs of the people of the
district and act as the First Referral Unit
(FRU) for the hospitals/centers from which
the cases are referred to the Sub District
hospitals
3.
The minimum functional grade of the two
different grades of sub district hospitals requiring
the physical infrastructure, manpower, diagnostic
and investigation facilities, equipment norms, drugs
and other supportive services etc. have been given.
5.
A sub district hospital has the following
functions:
Def i nit io i of Sub District hospitals
1.
It provides effective, affordable healthcare
services (curative including specialist
services, preventive and promotive) for a
defined population, with their full participation
and in co-operation with agencies in the
district that have similar concern. It covers
both urban population (sub divisional
headquarter town) and the rural population
of the sub division.
2.
Function as a referral centre for the public
health institutions below the district level
such as Sub-divisional Hospitals,
Community Health Centres, Primary Health
Centres and Sub-centres.
The term Sub District / Sub Divisional
Hospital is used here to mean a hospital at the
secondary refer al level responsible for the Sub
District / Sub Division of a defined geographical area
containing a def ied population.
4.
Functions
Grading of Sub District hospitals
The size of a sub district hospital is a function
of the hospital bed requirement, which in turn s a
function of the size of the population it serves. In
India the population size of a sub district varies from
2
IPHS for 51 to 100 Bedded Hospitals
3.
Provide education and training for primary
health care staff.
♦
*
Ambulance services
Dietary services
Laundry services
6.
Essential Services (Minimum
Assured Services)
Security services
Services include OPD, indoor, emergency
services.
♦
Housekeeping and sanitation
♦
Waste management
Office Management (Provision should be
made for computerized medical records with
anti-virus facilities whereas alternate records
should also be maintained)
Secondary level health care services
regarding following specialties will be assured at
hospital:
Counseling services for domestic violence,
gender violence, adolescents, etc. Gender
and socially sensitive service delivery be
alssured.
Consultation services with following
specialists:
Inventory Management
General Medicine
General Surgery
* Subject to location and District Headquarter.
O&G
Paediatrics
Emergency/A&E
Financial powers of Head of the Institution
Medical Superintendent to be authorized to
- incure and expenditure up to Rs.15.00 lakhs for
repair/upgrading of impaired equipments/
instruments with the approval of executive
committee of RKS. Financial accounting and
ENT
auditing be carried out as per the rules along with
Dermatology and Venerology (Skin & VD) RTI/STI
timely submission of SOEs/UCs.
Orthopaedics
Critical care
Anaesthesia
Opthalmology
Dental care
AYUSH
No equipment/instruments should remain
non-functional for more than 30 days. It will amount
to suspension of status of IPHS of the concerned
institutions for absence period.
Diagnostic and other Para clinical services
regarding:
Outsourcing of services like laundry,
ambulance, dietary, housekeeping and sanitation,
waste disposal etc. to be arranged by hospital itself.
Manpower and outsourcing work could be done
through local tender mechanism.
Lab, X-ray, Ultrasound, ECG, Blood transfusion and
storage, and physiotherapy
Support services: Following ancillary services shall
be ensured:
♦
Following services mix of procedures in
medical and surgical specialties would be available:
Medico legal/postmortem*
3
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IPHS for 51 to 100 Bedded Hospitals
SERVICE MIX OF PROCEDURES IN MEDICAL AND SURGICAL SPECIALITIES
MEDICAL
1
Pleural Aspiration
2
Skin scraping for fungus / AFB
3
Skin Biopsies
4
Abdominal tapping
OPD Procedures (Including IPD)
1
Dressing (Small, Medium and Large)
2
Injection (l/M & l/V)
3
Catheterisation
4
Steam Inhalation
5
Cut down (Adult)
6
Enema
7
Stomach Wash
8
Douche
9
Sitz bath
10
Blood Transfusion
11
Hydrotherapy
12
Bowel Wash
Skin Procedures
1
Chemical Cautery
2
Electro Cautery
3
Intra Lesional Injection
4
Biopsy
Paediatric Procedures
1
Immunization (BCG, OPV, DPT, Measles, DT) / Children Ward / ORT corner
2
Services related to new borne care + all procedures as mentioned in IMNCI
2.1
- only cradle
________ . :
I
IPHS for 51 to 100 Bedded Hospitals
2.2
■‘Incubator
2.3
- Radiant Heat Warmer
2.4
- Phototherapy
2.5
- Gases (oxygen)
2.10
- Cut down
2.12
- Ventilator
Cardiology Procedures and Diagnostic Tests
1
. 2
3
ECG
Defibrilator Shock
Laproscopy (Diagnostic and Therapeutic)
Physiotherapy Services
1
With Electrical Equipments
1.1
- Short wave diathermy
•'■1.2
- Electrical Stimulator
1.3
- Ultra Sonic Therapy
1.4
- Infra Red Lamp (Therapy)
1.5
- Electric Vibrator
2
With Mechanical Gadgets/Exercises
2.1
- Mechanical Tractions (Lumber & Cervical)
•2.2
- Exercycle
2.3
- Shoulder Wheel
2.4
- Walking Bars
2.5
- Post Polio Exercise
Eye Specialist Services (Opthalmology)
1
1.1
OPD Procedures
Refraction (by using snellen’s chart)
Prescription for glasses using Trial frame.
1.2
- Syringing and Probing
IPHS for 51 to 100 Bedded Hospitals
1.3
- Foreign Body Removal (conjuctival)
1.4
- Foreign Body Removal (Corneal)
1.5
- Epilation
1.6
- Suture Removal
1.7
- Subconj Injection
1.8
- Retrobular Injection (Alcohol etc.)
1.9
- Tonometry
1.10
- Pterygium Excision
1.11
- Syringing & Probing
1.12
-1 & C of chalazion
1.13
- Wart Excision
1.14
-Stye
1.15
- Cauterization (Thermal)
1.16
- Conjuctival Resuturing
1.17
- Corneal Scarping
1.18
-1 & D Lid Abscess
1.19
- Uncomplicated Lid Tear
1.20
- Indirect Opthtalmoscopy
1.21
- Retinoscopy
2
IPD Procedures
2.1
- Cataract Extraction
2.2
- Glaucoma (Trabeculectomy)
2.3
- Small Lid Tumour Excision
2.4
- Conjuctival Cyst
ENT Services
1
OPD Procedures
1.1
- Foreign Body Removal (Ear and Nose)
6
IPHS for 51 to 100 Bedded Hospitals
1.2
- Syringing of Ear
1.3
- Chemical Cauterization (Nose & Ear)
1.4
- Eustachian Tube Function Test
1.5
- Vestibular Function Test/Caloric Test
2
Minor Procedures
' 2.1
- Therapeutic Removal of Granulations (Nasal, Aural, Oropharynx)
2.2
- Cautrization (Oral, Oropharynx, Aural & nasal)
3
Nose Surgery
3.1
- Packing (Anterior & Posterior Nasal)
3.2
- Antral Punchure (Unilateral & Bilateral)
3.3
-1 & D Septal Abscess (Unilateral & Bilateral)
3.4
■SMR
3.5
- Septoplasty
3.6
- Fracture Reduction Nose
3.7
- Fracture Reduction Nose with Septal Correction
4
Ear Surgery
4.1
- Ear Piercing
4.2
- Hearing Aid Analysis and Selection
5
Throat Surgery
5.1
- Adenoidectomy
5.2
- Tonsillectomy
5.3
Adenoidectomy + Tonsillectomy
5.4
- Tongue Tie excision
6
Endoscopic ENT Procedures
6.1
- Direct Laryngoscopy
6.2
- Hypopharyngoscopy
6.3
- Broncoscopic Diagnostic
_____
7
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IPHS for 51 to 100 Bedded Hospitals
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6.4
- Broncoscopic & F B Removal
7
General ENT Surgery
7.1
- Stiching of LCW (Nose & Ear)
7.2
- Preauricular Sinus Excision
7.3
- Tracheostomy
8
Audiometry
8.1
- Audiogram (Pure tone and Impedence)
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Obstetric & Gynecology Specialist Services
I
1
Episiotomy
2
Forceps delivery, VECC
3
Craniotomy-Dead Fetus/Hydrocephalus
4
Caeserean section
5
Female Sterilisation ( Mini Laparotomy & Laparoscopic)
6
D&C
7
MTP
8
Bartholin Cyst Excision
9
Suturing Perimeal Tears
10
Assisted Breech Delivery
11
Cervical Cautery
12
Nomal Delivery
13
Gasserian
14
EU A
15
Midtrimestor Abortion
16
Ectopic Pregnancy Ruptured
17
Retain Placenta
18
Suturing Cervical Tear
19
Assisted Twin Delivery
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SBRBSHaMW IPHS for 51 to 100 Bedded Hospitals
Dental Services
1
Dental Caries/Dental Abcess/Gingivitis
2
Periodontitis
v Cleaning
Surgery
3
Minor Surgeries, Impaction, Flap
4
Trauma including Vehicular Accidents
5
Sub Mucus Fibrosis (SMF)
6
Scaling and Polishing
7
Root Canal Treatment
8
Extractions
9
Light Cure
10
Amalgum Filling (Silver)
11
Sub Luxation and Arthritis of Temporomandibular Joints
12
Pre Cancerous Lesions and Leukoplakias
13
Intra oral X-ray
14
Complicated Extractions (including suturing of gums)
———---- 1
-------1
—
—;
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-4
SURGICAL
1
Abcess drainage including breast & perianal
----------------------------------------- ----------------------
2
Wound Debridement
3
Appendicectomy
4
Fissurotomy or fistulectomy
5
Hemorrohoidectomy
6
Circumcision
7
Hydrocele surgery
8
Herniorraphy
9
Suprapubic Cystostomy
10
Diagnostic Laparoscopy
11
Cysts and Benign Tumour of the Palate
12
Excision Submucous Cysts
-ii
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IPHS for 51 to 100 Bedded Hospitals fflHHHHHMHB
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Breast
Excision fibroadenoma - Lump
1
Hernia
1
Ingunial Hernia repair reinforcement
2
Ingunial Hernia repair with mesh
3
Femoral Hernia repair
4
Recurrent Ingunial Hernia repair
5
Strangulated Ventral or Incisional Hernia/lngunial
L
Abdomen
1
Exploratory Laparotomy
2
Gastrostomy or Jejuncstomy
3
Simple Closure of Perforated Ulcer
4
Burst Abdomen Repair
I ’
Appendix
1
Emergency Appendisectomy
2
Interval Appendisectomy
3
Appendicular Abscess Drainage
i
Small Intestine
1
Resection and Anastomosis
2
Multiple Resection and Anaestomosis
3
Intestinal Performation
I
_
Liver
7.
1
Open Drainage of liver abscess
2
Drainage of Subdia, Abscess/Perigastric Abscess
—
Biliary System
L
1
Cholecystostomy
2
Cholecystectomy
3
Cholecystectomy and Choledocholithotomy
t
10
IPHS for 51 to 100 Podded Hospitals
Colon, Rectum and Anus
J
1
Fistula in ane low level
2
Fistula in ane high level
3
Catheters
-I
4
IV Sets
-I
5
Colostomy Bags
6
Perianal Abscess
1
1
1
7
Ischiorectal Abscess
8
Ileostomy or colostomy alone
9
Haemorroidectomy
1
10
Anal Sphincter Repair after injury
I
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11
Resection anastomosis
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Penis, Testes, Scrotum
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1
Circumcision
2
Partial amputation of Penis
3
Total amputation of Penis
4
Orchidopexy (Unilateral & Bilateral)
5
Orchidectomy (Unilateral & Bilateral)
6
Hydrocele (Unilateral & Bilateral)
7
Excision of Multiple sebaceous cyst of scrotal skin
8
Reduction of Paraphimosis
Other Procedures
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-1
1
Suture of large laceration
2
Suturing of small wounds
3
Excision of sebaceous cyst
4
Small superficial tumour
5
Repair torn ear lobule each
6
Incision and drainage of abscess
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IPHS for 51 to 1110 Bedded Hospitals
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1
7
Injection Haemorrhoids/Ganglion/Keloids
i 8
Removal of foreign body (superficial)
k
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Removal of foreign body (deep)
k
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Excision Multiple Cysts
k
11
Tongue Tie
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12
Debridment of wounds
i 13
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Excision carbuncle
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Ingroving Toe Nail
Diabetic Foot Asnd carbuncle
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Urology
1
Pyelolithotomy
2
Nephrolithotomy
! 3
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Simple Nephrostomy
4
Uretrolithotomy
5
Open Prostectomy
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Cystokthotomy Superopubic
I 7
Dialatition of stricture urethra under GA
8
Dialation of stricture urethra without anaesthesia
9
Meatotomy
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Trocar Cystostomy
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Plastic Surgery
L2
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Burn Dressing Small, medium (10% to 30%), large 30% to 60%, extensive > 60%
Ear lobules repair one side (bilateral)
Simple wound
4
Complicated wound
5
Simple injury fingers
6
Multiple finger injury
Crush injury hand
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; IPHS for 51 to 100 Bedded Hospitals
8
Polio Surgery
•9
Surgery concerning disability with Laprosy
10
Surgery concerning with TB
Paediatric Surgery
1
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Minor Surgery, I & D, Prepuceal Dilatation, Meatotomy
Orthopaedic Surgery
1
Hip Surgery
2
Femoral Neck nailing with or without plating replacement prosthesis / Upper Femoral
Osteotomy; Innominate Osteotomy/Open Reduction of Hip disclocation; DHS/Richard Screw
Plate
3
Synovial or bone biopsy from HIP
4
Girdle stone Arthoplasty
5
Fractures
6
Open reductuin int, fixation or femur, tibia, B. Bone, Forarm Humerus inter-condylar fracture
of humerus and femur and open reduction and int. Fixation bimaleolar fracture and fracture
dialocation of ankle montaggia fracture dialocation
7
Medial condyle of humerus fracture lateral condyle of humerus Olecranen fracture, head of
radius lower end of radius, medial malleolus patella fracture and fracture of calcaneum talus
single forearm, bone fracture
8
Ext. fixation of hand & foot bones
9
Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula, lower and of Inia
10
Interlocking nailing of long bones
11
Debridement & Secondary closure
12
Percutaneous Fixation (small and long bones)
13
Closed Reduction
14
Hand, Foot bone and cervicle
15
Forearm or Arm, Leg, Thigh, Wrist, Aknle
16
Dislocation elbow, shoulder, Hip, Knee
17
Closed Fixation of hand / foot bone
18
Ingrowing toe-nail
_
,
.
"
----- ------------ j
1
-
---- 1
J
I
IPHS for 51 to 100 Bedded Hospitals ®
RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) FOR DIFFERENT ILLNESSES
[
CONCERNING DIFFERENT SPECIALITIES:
Obstetric & Gynecology
s J nAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
N°
(SUGGESTED ACTIONS)
1
Bleeding during first trimester
Treat
__________
2
Bleeding during second trimester
Treat___
_________
3
Bleeding during third trimester
Treat___
j4
Normal Delivery_______________
Abnormal lablour (Mai presentation,
Yes_______________________
Treat / Refer
5
I
r
t
L
h
prolonged labour, PROM,
6^
7
8
9
Obstructed labour)____________
PPM________________________
Puerperal Spesis______________
Ectopic Pregnancy____________
Hypertentive disorders
Treat and refer if necessary__________
r
Diagnose & refer if necessary_________
Conservative management and follow up servcies
10
11
I
Treat and refer if necessary__________
_______________
Septic abortion_____________________
Treat and refer if necessary__________
Medical disorders complicating
Diagnose and refer
r
k'
pregnancy ( heart disease, diabetes,
r
hepatitis)_________________________
Bronchial asthma___________________
Gynecology
______
12
RTI / STI_____________________
2
3
DUB
_______________________
Benign disorders (fibroid, prolapse,
Diagnose, tirst_aid_and delivery
L
Treat
Treat and refer if necessary
Diagnose and refer
H
ovarian masses)___________________
Initial investigation at PHC / Gr III level
4
Breast Tumors_____________________
5
Cancer Cervix screening_____________
Refer
_______ ___________
Collection of PAP SMEAR and biopsy
Initial investigation at PHC / Grade III level
6
Cancer cervix /ovarian Initial__________
investigation at PHC / Gr III level______ _
Diagnose and refer
7
8
9
Infertility__________________________
Prevention of MTCT_________________
Investigate and refer
MTP / MVA services
Treat
10 Tubectomy
r
Refer
r
k
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L
r
i
Yes
*
IPHS for 51 to 100 Bedded Hospitals
!
>
GENERAL MEDICINE
S. NAME OF THE ILLNESS
No
T~ Fever -a) Short duration (<1 week)
Fever -b) Long duration (>1 week)
2
3
4
5
6
7
8
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Basic investigation and Treatment
Investigation and treatment
Refer if necessary
c) Typhoid
d) Malaria / Filaria
e) Pulmonary Tuberculosis.
f) Viral Hepatitis______________
g) Leptospirosis / Menningitis and
Haemorrhagic fever ;
_______
h) Malignancy
COMMON RESP. ILLNESSES :
Bronchial Asthma / Pleuraleffusion /
Pneumonia/ Allergic
Bronchitis/COPD
COMMON CARDIAC PROBLEMS
a) Chest pain (IHD) __________
b) Giddiness (HT)
GI TRACT
a) G I Bleed / Portial hypertension /
Gallblader disorder___________ _
b) AGE / Dysentry / Diarrhoreas
NEUROLOGY'
Treat
a) Chronic Hpeadache_________ _
b) CVA/TIA/Hemiplegia/ Paraplegia
Ref. To Gr -1 sub district
Ref. To Gr -1 / G-ll district
HAEMATOLOGY
a) Anaemia
b) Bleeding disorder _________ _____
c) Malignancy___________ _________
Communicable Diseases__________ _
Cholera, Measles, Mumps, and Chickenpox
Psychological Disorders____________
Acute psychosis / Obsession /
Anxiety neurosis
Treat
Treat
Treat
Refer to Gr-I / G-ll District level
Refer to Gr-I / G-ll District
Diagnose and Treat
Treat and decide further management
Diagnose and treat ~
Emergencies - Ref. To Gr-ll / Gr-I District Hospital
Treat
Basic investigation and Treatment
Refer if necessary
Stabilise Ref. To tertiary
Ref. To Gr-I/G-ll district
Treat
Screening, emergency care and referral
J
r
^DiATRiCS
s.
3
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
investigate, Diagnose, Nebulizator
Treat & Refer if no improvement
Diagnose Treat (ORS, IVF), ORT Corner
Refer if no improvement
Diagnose, Treat, & Refer
5
Bleeding Disorders
Diseases of Bones and Joints
6
7
Childhood Malignancies
8 , Liver Disorders
9
Paediatric Surgical Emergencies
10 Poisoning, Sting, Bites
Investigate, diagnose, treat, refer if no
improvement
Treat
Treat
Early Diagnosis and Refer
Diagnose and Refer
Early Diagnosis and Refer
First Aid - Refer
NAME OF THE ILLNESS
No
1
ARI/ Bronchitis Asthmatic
2
Diarrohoeal Diseases
Protein Energy Malnutrition and
Vitamin Deficiencies
;...... -.................. .... --------------------------------4
Pyrexia of unknown origin improvement
S. NAME OF THE ILLNESS
No
FnEON-ATALOGY
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Attention at birth (to prevent illness)
2
Hypothermia
3 i Birth asphyxia
4 • Hypoglycemia
5
Meconium aspiration syndrome
6 | Convulsions (seizures)
7
Neonatal Sepsis
8
LBW
5 cleans warm chain
Warm chain
Resuscitation And Treatment
Treat
Treat
Treat and Refer
Treat
1800-1500 gms treat with kangaroo
care below that refer
Treat
Warm chain, feeding, kangaroo care
Examine and refer
Manage and Refer
Identify and manage
9
Neonatal Jaundice
10 Preterm
| i"l Fcongenital maiformations
12 R.D.S, ARI
13 Dangerously ill baby
■ 14 I Feeding Problems
15 Neonatal Diarrhoea
16 Birth injury
....................... ...............................
Identify and manage
Diagnosis and manage •
Minor -manage; major -refer
aioli
i
f
h
r
k
r
r
L
L
r
rx
I
I.
I
h
IPHS for 51 to 100 Bedded Hospitals
'l
J
J
j
J
3
17 Neonatal Meningitis
18 Renal problems/Congenital heart
19
20
21
22
23
24
25
26
27
ndisease/Surgical emergencies
HIV/AIDS
Hypocalcemia
Metabolic Disorders
Hyaline Membrane diseases
Neonatal Malaria
Blood disorders
Developmental Delays
UTIs
Failure to Thrive
Manage and Refer
Refer
Follow up and refer to ART Center
Manage
Identify & Refer
diagnose and refer
Manage
Manage
CBR
Manage Xrefer
Manage & Refer
DERMATOLOGY____ __
'a
4
J
J
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S. NAME OF THE ILLNESS
No
1
Infections
a) Viral - HIV Verrucca
Molluscum Contagiosa
Pityriasis Rosea, LGV, HIV
b) Bacteria
Pyoderma
Chancroid
Gonorrhea, Leprosy & Tuberculosis
c) Fungal
Sup.Mycosis
Subcut - Mycetoma
d) Parasitic Infestation
Scabies / Pediculosis/Larva
Migrans
____
e) Spirochaetes
Syphilis___________
____
Papulosquamous
2
Psoriasis (classical)uncomplicated/Lichen Planus
3 Pigmentary Disorder
Vitiligo_____________________
4 Keratinisation Disorder
Ichthyosis/Traumatic Fissures
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Treat
Treat
” T reat
Treat
Identify/Treat
and refer
Treat
Diagnosis and Treat
Treat
Treat / Refer
Refer/Treat
17M
-4
IPHS for 51 to 100 Bedded Hospitals
8.3.
Manpower- Administrative Staff
S. No.
Staff
51-100 bedded
Sub-District Hospital
1
Junior Administrative Officer
1
2
Accountant
2
3
Computer Operator
6
4
Driver
2
5
Peon
2
6
Security Staff*
2
Total
15
Note : Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be required if outsourced
* The number would vary as per requirement and to be outsourced.
8.4.
Man Power - Operation Theatre
S. No
8.5.
Staff
51-100 bedded
Sub-District Hospital
Emergency /
■ General OT
FW OT
4
1
1
Staff Nurse
2
OT Assistant
4
2
3
Satai Karamchari
2
1
Total
10
4
Man Power - Blood Storage
S. No.
Staff
Blood Storage
1
Staff Nurse
1
2
MNA/FNA
1
3
Blood Bank/Storage
Technician
5
4
Safai Karamchari
3
5
Attendant
2
IPHS for 51 to 100 Bedded Hospitals
I
9.
EQUIPMENT
I. Imaging Equipment
51-100 bedded
Sub-District Hospital
S.
No.
Name of the Equipment
1
500 M.A. X-ray machine*__________
2
300 M.A. X-ray machine___________
1
3
100 M.A. X-ray machine___________
1
4
60 M.A. X-ray machine (Mobile)_____
1
5 :
C arm with accessories *___________
6
Dental X-ray machine_____________
1
7
Ultra Sonogram (Obs & Gyne.
department should be having a separate
ultra-sound machine of its own)______
1 +1
8
C.T. Scan*________
9
Mammography Unit *
10
Echocardiogram*
* - These items will be provided depending upon the need and availability of skilled personnel
II. X-Ray Room Accessories
S.
No.
Name of the Equipment
51-100 bedded
Sub-District Hospital
1
X-ray developing tank
1
2
Safe light X-ray dark room
2
3
Cassettes X-ray______
10
4
X-ray lobby single
4
5
X-ray lobby Multiple
6
Lead Apron
1
7
Intensifying screen X-ray
1
33
IPHS for 51 to 100 Bedded Hospitals
S. No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
IE26
27
IE29
30
31
32
I
X. Surgical Equipment Sets
Name of the Equipment
P. S. Set__________________
MTP Set
_______ 1________
_______ 1________
Biopsy Cervical Set*__________
D & C Set_________________
I.U.C.D. Kit________________
LSCS set_________________
_______ 1________
_______ 1________
____ J_____
’ J________
2
MVA Kit__________
Vaginal Hysterectomy_________
Proctoscopy Set*____________
P.V. Tray*
Abdominal Hysterectomy set
Laparotomy Set_____________
1
j____ r
A.
Hernia, Hydrocele*
Varicosevein etc*____________
Gynaec Electric Cautery
Vaginal Examination set*
Suturing Set*
MTP suction apparatus
Thoracotomy set
Neuro Surgery Craniotomy Set
I M Nailing Kit
SP Nailing
j_____
j_______
1
Formaline dispenser______ Kick Bucket________________
General Surgical Instrument Set
Piles, Fistula, Fissure*
Knee hammer
51-100 bedded
Sub-District Hospital
2
6_______
,*>
1
2
1
4
3
1
1
Compression Plating Kit*_______
AM Prosthesis*
Dislocation Hip Screw Fixation*
Fixation Fracture Hip
Spinal Column Back Operation Set
Thomas Splint
5
IPHS for 51 to 100 Bedded Hospitals
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Paediatric Surgery Set
_________
Mini Surgery Set*_______________
Urology Kit____________________
Surgical Package for Cholecystectomy*
1
Surgical package for Thyroid_______
Gl Operation Set*_______________
Appendicectomy set *____________
L.P.Tray*____________________
Uretheral Dilator Set_____________
TURP resectoscope *____________
Haemodialysis Machine *__________
Amputation set_____ ___________
Universal Bone Drill______________
Crammer wire splints_____________
Heamo dialysis machine
2
2
3
2
1
8
* To be provided as per need.
XI. Physiotherapy Equipments
•»
S. No.
2
Skeleton traction set
2
3
Interferential therapy unit
Short Wave Diathermy.
S. No.
51-100 bedded
Sub-District Hospital
Name of the Equipment
1
_______ 1_______
1
____________ XII. Endoscopy Equipments
Name of the Equipment
5
Endoscope fibre Optic (OGD) *
Arthroscope ______________
Laparoscope operating major with
accessories *____________
Laparoscope diagnostic and for
sterilisation *_______________
Colonoscope and sigmoidoscope*
6
7
Hysteroscope *
Colposcope *
1
2
3
4
51-100 bedded
Sub-District Hospital
1
1
1
* - to be provided as per need
39
IPHS for 51 to 100 Bedded Hospitals
SI. No.
1
2
4
5
~6~
7
T"
9
11
Tr
is
ii15
16
___________ XIII. Anaesthesia Equipments
Name of the Equipment
51-100 bedded
Sub-District Hospital
2
Anaesthetic - laryngoscope magills
with four blades
Endo tracheal tubes sets
Magills forceps (two sizes)
Connector set of six for E.T.T
Tubes connecting for ETT
Air way female*
Air way male*
Mouth prop*
Tongue depressors*
A.
02 cylyinder for Boyles
N2O Cylinder for Boyles
CO2 cylinder for laparoscope,*
PFT machine
Boyles Apparatus with Fluotec and circle absorber
Exchange Transfusion Sets*
1
T
5
T
T
To
6
8
T
T
1
i
* - to be provided as per need
S. No.
1
2
3
4
~5
~Q
T
T
To
T7
12
13
14
________ XIV. Furniture & Hospital Accessories
Name of the Equipment
Doctor’s chair for OP Ward, Blood Bank, Lab etc.
Doctor’s Table
Duty Table for Nurses
Table for Sterilisation use (medium) '
Long Benches(6 1/2' x 1 1/2')
Stool Wooden
Stools Revolving .
Steel Cup-board
Wooden Cup Board
Racks -Steel - Wooden
Patients Waiting Chairs (Moulded) *
Attendants Cots *
Office Chairs
Office Table
51-100 bedded
Sub-District Hospital
6
■
—
5
Te
20
is7 '
is
, 6
—I
J ——
______
4
-u-
______
___
40
i-
IPHS for 51 to 100 Bedded Hospitals
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45"
46'
47"
48~
49
50
Foot Stools * ____________________
Filing Cabinets (for records) *_________
M.R.D.Requirements (record room use) *
Paediatric cots with railings___________
Cradle*
ZZZZ2Z2ZIZZIZ
Fowler’s cot_______________
Ortho Facture Table*________________
Hospital Cots (isT Model)____________
Hospital Cots Paediatric (ISI Model)
Wooden Blocks (Set)*
Back rest*
__________________
12
_f_
5
3
0
0
100 ’
10
2
4
Dressing Trolley (SS)________
Medicine Almairah
Bin racks (wooden or steel)*
Tccu Cols
Bed Side Screen (SS-Godrej Model)
Medicine Trolley'(SS)
Case Sheet Holders with clip(S.S.)*
Bed Side Lockers (SS)*
Examination Couch (SS)
Instrument trolley (SS)
~
5
4
4
”60“
0
2
T”
Instrument Trolley Mayos (SS)
'"“4
Surgical Bin Assorted
25
4
3 each
Wheel Chair (SS) >
Stretcher / Patience Trolley (SS)
instrument tray (SS) Assorted
Kidney Tray (SS) - Assorted
Basin Assorted (SS)
“so”
30 '
30
Basin Stand Assorted (SS)
(2 basin type)
4
(1 basin type)
Delivery table (SS Full)
T
T
Blood Donar Table*
02 Cylinder troliey(SS)
Saline Stand (SS)
Waste Bucket (SS)*
Dispensing Table Wooden
Bed Pan (SS)*.. ~
1
T
"15
25
__
20
IPHS for 51 to 100 Bedded Hospitals
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
Urinal Male and Female_________
Name Board for cubicals*________
Kitchen Utensils*______________
Containers for kitchen*__________
Plate, Tumblers*_______________
Waste Disposal - Bin / drums______
Waste Disposal - Trolley (SS)_____
Linen Almirah_________________
Stores Almirah________________
Arm Board Adult*______________
Arm Board Child*______________
SS Bucket with Lid_____________
Bucket Plastic*________________
Ambu bags__________________
02 Cylinder with spanner ward type
Diet trolley - stainless steel _____
Needle cutter and melter_________
Thermometer clinical *__________
Thermometer Rectal*___________
Torch light*__________________
Cheatles forceps assortted*_______
Stomach wash equipment*_______
Infra Red lamp*_______________
Wax bath*___________________
Emergency Resuscitation Kit-Adult*
Enema Set*__________________
Ceiling Fan$_________________
Bed Side Screen (SS-Godrej Model)A
* - to be provided as per need
$ - One fan per four beds in the ward.
A - At least one screen per five beds except female wards.
42
20
1
______ 8_
______ 1_
______ 3_
_______ 3_
______ 10
10
_______ 6_
_______ 8_
_______ 5_ . > W' ;
12
1
______ 15
20
______ 3_
10
_______ 8_
2
_______ 3_
.4;.
1
2
_ _____ 6_
As per requirement
As per requirement
IPHS for 51 to 100 Bedded Hospitals
S.
________________ XV. PM equipments
Name of the Equipment
No.
1
2
3
4
5
6
7
8
9
Mortuary table (Stainless steel) *
P.M.equipments (list)_________
Weighing machines (Organs)
Measuring glasses(liquids)
Aprons*___________________
PM gloves ( Pairs )*__________
Rubber sheets*_____________
Lens
________________
Spot lights
51-100 bedded
Sub-District Hospital
—— g
3
1
2
10
10
1
2
* - to be provided as per need
XVI. Linen
S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
I
Name of the Equipment
51-100 bedded Sub-District
Hospital
Bed sheets
Bedspreads
Blankets Red and blue
Patna towels
Table cloth
Draw sheet
Doctor’s overcoat
Hospital worker OT coat______
Patients house coat^for female)
Patients Pyjama (for male) Shirt
Over shoes pairs
Pillows
Pillows covers
Mattress (foam) Adult
Paediatric Mattress
Abdominal sheets for OT
Pereneal sheets for OT
Leggings
Curtain cloth windows and doors
Uniform / Apron
Mortuary sheet
Mats (Nylon)
Mackin tosh sheet (in meters)
Apron for cook
——~—400
600
30
150
50
75
30
200
300
200
60
150
300
100
16
50
50
80
43
30
50
150
I
IPHS for 51 to 100 Bedded Hospitals
S. No.
1__
2
3
4
5
6
7
8
9
_____________ XVII. Teaching Equipments
Name of the Equipment
51-100 bedded Sub-District Hospital
Slide Projector_______
_______________ 1________ __
O.H.P_____________
_______________ 1
Screen_____________
_____________ 1_____________
White / colour boards
_______________ 1________ ______
Television colour______
1_____________
________
Tape Recorder* (2 in 1 )
_______________ 1 .____________
VCD Player_________
_______________1_________ __
..........
" 1 ........
'
Radio_______
LCD Projectors
* • to be provided as per need
A.
S.
No.
1
2
3
4
5
6
7
8
9
10
_______________ XVIII. Administration
Name of the Equipment
51-100 bedded Sub-District
Hospital
Computer with Modem with UPS,
i
Printer with Internet Connection
Xerox Machine_____________
Typewriter (Electronic )*______
1
Intercom (15 lines)*
1
Intercom (40 lines)*_________
Fax Machine
1
Telephone
1
Paging System*____________
Public Address System*
.1
Library facility*
* ■ to be provided as per need
S. No.
1__
2
3
4
5
6
7
______________ XIX. Refrigeration & AC
Name of the Equipment
51-100 bedded Sub-District Hospital
Refrigerator 165 litres
3
;
Blood Bank Refrigerator
___________
1 .
' - ;>
ILR_______________
______________ 1_______ __
Deep Freezer
_ ___________ 1
Coolers*
As per requirement
4
"
Air conditioners
Central A/C for OT
* One cooler per 8 beds in the wards.
44 E
IPHS for 51 to 100 Bedded Hospitals
S. No.
1
2
3
4
5
6
7
8
______ XX. Hospital Plants
Name of the Equipment
51-100 bedded
Sub-District Hospital
Generator 40 / 50 KV_________
Generator 75 KV____________
Generator 125 KV____________
1
Portable 2.5 KV ____________
Solar Water heater *__________
Incinerator*
__________
1
Central supply of 02, N20, Vacuum *
Cold storage for mortuary *
* - to be provided as per need
XXi. Hospital Fittings & Necessities
S. No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Name of the Equipment
30
_______ 8_______
_______ 1_______
_______ 2_______
1
Ceiling Fans*^___
Exhaust Fan*
Pedestal Fan*
Wall Fan*
___
Hotwater geiser*
Fire extinguishers*
Sewing Machine*
Lawn Mover*__
Vaccum cleaner*
Aqua guard*
Solar water heater *________
1
2
1
Neon sign for hospital*______
Garden equipment*_____ '
Borewell motor OHT *______
Water dispenser / Water cooler*
Laundry (steam) *_________
Emergency lamp__________
Emergency trauma set*______
Tube lights*______________
Drinking Water Fountain*
* - to be provided as per need
I
51-100 bedded
Sub-District Hospital
KHHI 451
1
50
2
F
I
KUHBH
IPHS for 51 to 100 Bedded Hospitals BHHHHMIHHBI
XXII. Transport
S. No.
51-100 bedded
Sub-District Hospital
Name of the Equipment
1
Ambulance
2
Van (Family Welfare)
3
Pickup vehicles Maruti (Omni)
4
Mortuary Van
5
Administrative vehicle (Car)
6
Minidor 3 wheeler
7
Bicycle
8
Camp Bus
9
Progamme vehicle
10
Motorcycle
2
1
46
IPHS for 51 to 100 Bedded Hospitals
10.
Laboratory Services: Following services will be ensured, for advanced diagnostic
tests, a list of National Reference Laboratories has been provided as annexure:
S. No.
Speciality______
I.
Clinical Pathology
Diagnostic Services /Tests
Haemoglobin estimation___________
a. Haematology
Total Leucocyte count____________
Differential Leucocyte count
.
Absolute Eosinophil count_________
Reticulocyte count _____________
Total RBC count________________
E.S.R._______________________
Bleeding time
_____________
Clotting time______________
Prothrombin time________________
Peripheral Blood Smear___________
Malaria/Filaria Parasite___________
Platelet count__________________
-.. .
Packed Cell volume______________
Blood grouping_________________
Rh typing_____________________
b. Urine Analysis
Blood Cross matching____________
Urine for Albumin, Sugar,
Deposits,bile salts, bile pigments,
acetone, specific gravity, Reaction (pH)
c. Stool Analysis
Stool for Ovacyst (Eh)____________
Hanging drop for V.Cholera
Occultblood_______________
d. Semen Analysis
Morphology, count______________
e. CSF Analysis
Analysis, Cell count etc
f. Aspirated fluids
Cell count cytology
Pathology______
Sputum cytology
a. Sputum
47
I.
IPHS for 51 to 100 Bedded Hospitals ■»»»
S. No.
III.
Speciality
Diagnostic Services / Tests
Microbiology
Smear for AFB (Acid Fast Bacilli),
KLB (Diphtheria Bacilli)__ _ ___
Grams Stain for Meningococci
KOH study for fungus
r
I-------IV.
Serology
Grams Stain for Throat swab, sputum
etc._____
____
RPR Card Test for Syphillis
Pregnancy test (Urine gravindex)
WIDAL test
Rapid test for HIV, HBs Ag, HCV
Stocking of rapid H2S based test for
bacteriological examination of water
S. No.
V.
Speciality
Biochemistry
Diagnostic Services / Tests
Blood Sugar
Blood urea, blood cholesterol
Liver function tests
Kidney function tests
Stocking of OT test for residual
chlorine in water.
CSF for protein, sugar
r
L
I
L
Iodometry Titration
S. No.
Speciality________
Diagnostic Services / Tests
VI.
VII.
Cardiac Investigations
Ophthalmology
ECG
VIII.
IX.
ENL_
Radiology
__
Refraction by using Jnehen’s chart
Retinoscopy
______
Tonometry
____
Biometry
______________
Ophthalmoscopy
______
Audiometry
______
X-ray for Chest, Skull, Spine, Abdomen,
bones
Dental X-ray
Ultrasonography with colour doppler
$ IPHS for 51 to 100 Bedded Hospitals
S. No.
SpeciaHty
X
Endoscopy
Diagnostic Services / Tests
Laparoscopy (Diagnostic)
XI.
11.
Pulmonary function tests
Physiology
Recommended Allocation of Bed Strength at Various Levels
SI.
No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Item
Type
General Medicine____________
New born ward_
_________ _
Mothers room with dining and toilets
Paediatrics ward
___________
Critical care ward - IMCU________
Isolation Ward
______
Dialysis unit (as per specifications)
Thoracic medicine ward with room
for pulmonary function test__ _____
Blood bank
____________
General surgery ward (incl. Urology,
ENT)________________________
Post - Operative Ward__________
Accident ancT T rauma ward_____ _
Labour room___________
Labour room (Eclampsia)______
Septic Labour room ___________
Ante-natal ward
___________
Post-natal ward
Postpartum ward
___________
Post operative ward
______
Ophthalmology ward
_______
Burns Ward
________
Beds (M+F)
_ Beds
Beds_
Beds~
Beds__
Beds _
Beds
Beds (M+F)
Sub District Hospital
51-100 bedded
3
5
6
’
5
4
Yes
Beds (M+F)
8+8
Beds (M+F)
Beds
Boards _
Beds _
Boards _
Beds
Beds__
_Beds__
_ J3eds__
Beds _
Beds
1O‘+8
3
—
6
6
10
A
—
REQUiREMENTS FOR OPERATION THEATRE
S.
No
•1
2
3
4
item
Elective OT-Major
AE or
~Z.___
Emergency OT/FW OT
Ophthalmology /ENT OT*
* To be provided as per need.
Sub District Hospital
51-100 bedded
1
1
IPHS for 51 to 100 Bedded Hospitals
12.
List of Medicines / Instruments / Equipments /Lab Reagents / Other
Consumables and Disposables for District Hospitals
Name of the item
S. No.
Analgesics/Antipyretics/Anti Inflamatory
A)
1
Tab.Aspirin 300mg
2
Tab.Paracetamol 500mg
3
Inj.Diclofenac sodium
4
Tab.Diclofenac sod
5
Tab.Dolonex DT 20mg
6
Tab.lbuprofen
Chemotherapeutics
B)
7
Inj.Crystalline penicillin 5 lac unit
8
Inj.Fortified procaine pen 4 lac-
9
Inj.Ampicillin 500mg
10
Inj.Gentamycin 40mg/2ml vial
11
Inj.crystalline penicillin 10 lac unit
12
Cap.Ampicillin 250mg
13
Cap.Tetracycline 250mg
14
Tab.Trimethoprim+Sulphamethazol ss
15
Tab.Ciprofloxacin 250mg
16
Tab.Ciprofloxacin 500mg
17
Inj.Ciprofloxacin 100ml
18
Tab.Erythromycin 250mg
19
Tab.Erythromycin 500mg
20
Syrup Cotrimoxazole 50ml
21
Syrup Ampicillin 125mg/5ml 60ml
22
Inj.Cefoperazone 1Gm
23
Inj.cefotaxime 500mg
24
Tab. Norfloxacin 200mg
i.
■ IPHS for 51 to 100 Bedded Hospitals
25
Tab. Norfloxacin 400mg
26
Tab.Ofloxacin 200mg
27
I nj. Vionocef (Ceffixime)250mg
28
Inj.Amikacin sulphate 500mg
29
Inj.Amikacin sulphate 100mg
30
Cap.Cefodroxyl 250mg
31
Inj.Amoxycillin 500mg
Anti Diarrhoeal
C)
32
Tab.Metronidazole 200mg
33
Tab. Metronidazole 400mg
34
Syrup.Metronidazole
35
Tab.Furazolidone 100mg
36
Tab.Diolaxanide Fuzate
37
Tab.Tinidazole 300mg
Dressing Material/Antiseptic lotion
D)
38
Povidone Iodine solution 500ml
39
Phenyl 5litr jar(Black Phenyl)
40
41
Benzalkonium chloride 500ml bottle
-------------- Z----- ----------------------------------------------------
Rolled Bandage a) 6cm
b) 10cm
c) 15cm
42
Bandage cloth(100cmx20mm) in Than
43
Surgical Guaze(50cmx18m) in Than
44
Adhesive plaster 7.5cm x 5mtr
45
Absorbent cotton I.P 500gm Net
46
P.O.P Bandage a) 10cm
b) 15cm
47
Framycetin skin oint 100 G tube
48
Silver Sulphadiazene Oint 500gm jar
—w-
pw HrO\xoSS
AA
)-
(
7
IPHS for 51 to 100 Bedded Hospitals UBKB
Antiseptic lotion containing :
49
a) Dichlorometxylenol 100ml bot
I
50
Sterilium lotion
51
Bacillocid lotion
I__
L____
■
Infusion fluids
E)
—
b) Haffkinol 5litre jar
52
Inj.dextrose 5% 500ml
53
Inj.Dextrose 10% 500ml bottle
54
Inj.Dextrose in Normal saline 500ml bt
55
Inj.Normal saline (Sod chloride) 500ml
56
Inj.Ringer lactate 500ml
57
Inj.Mannitol 20% 300ml
58
Inj.Water for 5ml amp
59
Inj.Water for 10ml amp
60
Inj.Dextrose 25%100ml bot
61
I.V.Metronidazole 100ml
62
Inj.Plasma Substitute 500ml bot
63
Inj.Lomodex
>
Other Drugs & Material
F)
64
All Glass Syringes 2ml
5ml
L
10ml
20ml
65
Hypodermic Needle (Pkt of 10 needle)
7
a) No. 19
b) No.20
c) No.21
■
d) No.22
L
e)No.23
T
IPHS for 51 to 100 Bedded Hospitals
f) No.24
—I
g) No.25
—J
h) No.26
66
Scalp vein sets no a)19
b) .2O
c) 21
d) 22
e) 23
f) 24
g) 25
—
h) 26
b) 20
67
Geico all numbers
68
Tab.B.Complex NFI Therapeutic
69
Tab.Polyvitamin NFI Therapeutic
70
Inj.Dexamethasone 2mg/ml vial
71
Inj.Vitamin B Complex 10ml
72
lnj.B12 Folic acid
73
Surgical Gloves a)6 “
—
b) 6.1/2"
c) 7"
74
-------
d) 7.5"
—]
Catgut Chromic a)1 No.
____ j
b) 2 No.
I
c) 1-0 No
I
d) 2-0 NO
e) 8-0
75
Vicryl No.1
76
Sutupak 1,1/0,2,2/0
_J
53
IPHS for 51 to 100 Bedded Hospitals
77
Prolene
78
X Ray film 50 film packet(in Pkt) size
a)6.1/2x8.1/2"
b) 8"x10"
c) 10"x12'
d)12"x15"
79
Fixer
80
Developer
81
CT Scan film
82
Ultrasound scan film
83
Dental film
84
Oral Rehydration powder 27.5g
85
Ether Anaesthetic 500ml
86
Halothane
Eye Drops
G)
87
Sulphacetamide eye drops 10% 5ml
88
Framycetin with steroid eye drops 5ml
89
Framycetin eye drops 5ml
90
Ciprofloxacin eye drops
91
Gentamycin eye drops
Other Material
H)
92
Rubber Mackintosch Sheet in mtr
93
Sterile Infusion sets(Plastic)
94
Antisera I) A 5ml
II) B 5ml
III) D5ml
IV) AB 5ml
95
Inj.MethylErgometrine 0.2mg/amp
96
Inj.Streptokinase 7.5lac vial
54
h
IPHS for 51 to 100 Bedded Hospitals
. -'
97
Inj.Streptokinase 15lac vial
98
Inj.PAM
99
Tab.Antacid
100
ARS
101
Syp.Antacid
102
Inj.Rabipur
103 •
Inj.Ranitidine 2ML
104
Tab.Ranitidine
105
Tab.Omeprazole
106
Cough syrup Slitre Jar
107
Cough syrup with Noscapine 100ml
108
Coir Mattress
109
Inj.Lignocaine 1%
110
Inj.lignocaine 2%
111
Inj.Lignocaine 5%
112
Inj.Marcaine
113
Inj.Diazepam
114
lnj.Salbactum+Cefoperazone2Gm
115
Inj.Amoxycillin with clavutanite acid 600mg
116
Cap.Amoxycillin250+cloxacillin 250
117
Inj.Cefuroxime 250/750
118
Tab.Pefloxacin 400mg
119
Tab.Gattifloxacin 400mg
120
Tab.Valdecoxib 20mg
121
Tab.Atrovastatin 10mg
122
Sy.Himalt-X
123
Sy.Protein(Provita)
■
•
I)
_____ L
Antibiotics and Chemotherapeutics
Tab.Chloroquine phosphate 250mg
55
IPHS for 51 to 100 Bedded Hospitals KB
i
!-------
r—
2
Inj.Chloroquine phosphate
3
Inj.Quinine
4
Tab.Erythromycine Esteararte 250mg
5
Syp.Erythromycine
6
Tab.Phenoxymethyl Penicillinl25mg
7
Cap.Rifampicin
8
Tab.Isoniazid 100mg
9
Tab.Ethambutol 400mg
10
Tab.Isoniazid
11
Cap.Neomycin
12
Inj.Benzathine penicillin 121a
Antihistaminics/anti-allergic
J)
h
13
Inj.Pheniramine maleate
14
Tab.Diphenhydramine (eqv.Benadryl)
15
Tab.Cetrizine
16
Tab.Chlorpheniramine maleate 4mg
17
Tab.Diethylcarbamazin
■
1
Drugs acting on Digestive system
K)
I-
I
i
18
Tab.Cyclopam
19
Inj.Cyclopam
20
Tab.Bisacodyl
I
21
Tab.Perinorm
I
22
Inj.Perinorm
23
syrup.Furazolidone
24
Inj.Prochlorperazine(Stemetil)
25
Tab.Piperazine citrate
26
Tab.Mebendazole 100mg
27
Syp.Mebendazole
28
Sy.Piperazine Citrate
L
L
i IF
IPHS for 51 to 100 Bedded Hospitals
29
Sy. Pyrantel Pamoate
30
Tab.Belladona
Drugs related to Hoemopoetic system
L)
.
'A.
■■
31
Tab.Ferrous sulphate200mg
32
Inj.lron Dextran/lron sorbitol
Eye ointment
M)
33
Chloramphenicol eye ointment & applicaps
34
Chloramphenicol + Dexamethsone ointment
35
Gentamycin eye/ear drops
36
Dexamethasone eye drops
37
Drosyn eye drops
38
Atropine eye ointment
Drugs acting on Cardiac vascular system
N)
39
Inj.adrenaline
40
Inj.atropine sulphate
41
Inj.Digoxine
42
Tab.Digoxine
43
Inj.Mephentine
44
Tab. Atenolol
45
Tab.lsoxuprine
46
Inj.Duvadilan
47
Tab.Methyldopa
48
Tab.Isosorbide Dinitrate(Sorbitrate)
49
Tab.Propranolol
50
Tab.Verapamil(lsoptin)
j.
>'
■
_______
tab.Enalepril2.5/5mg
Drugs acting on Central/peripheral Nervous system
0)
52
Inj'.Pentazocine (Fortwin)
53
Inj.Pavlon 2ml amp
57
I
IPHS for 51 to 100 Bedded Hospitals
[
■
54
Inj.Chlorpromazine 25mg(like Largactil)
55
Inj.Promethazine Hcl Phenergan
56
inj.Pethidine
57
Inj.Diazepam 5mg
58
Tab.Haloperidol
59
Inj.Haloperidol
60
Tab.Diazepam 5mg
61
Tab.Phenobarbitone 30mg
62
Tab.Phenobarbitone 60mg
63
Tab.Largactil 25mg
64
Tab.Pacitane
I-
65
Tab.Surmontil
66
Syrup.Phenergan
67
Syrup Paracetamol
68
Ethyl chloride spray
> r
:I I
r
69.
Lignocaine oint
70
Gentamycin eye/ear drops
71
Betnesol-N/Efcorlin Nasal drops
1
I
L
■
•
■
•
'
1
•
I
I |
Drugs acting on Respiratory system
P)
72
Inj.Aminophylline
73
Tab.Aminophylline
74
Inj.Deriphylline
75
Tab.Deriphylline
76
Tab.Salbutamol 2mg
77
Syrup Tedral
h
78
Syrup.Salbutamol
r
r
Antiseptic Ointment
Q)
79
Furacin skin oint
80
Framycetin skin oint
L
L
k
F
IPHS for 51 to 100 Bedded Hospitals
Drugs acting on UroGenital system
R)
» *
81
Tab.Frusemide 40mg
82
Inj.KCL
83
Liquid KCL
84
Tab.Pyridicil
85
Inj.Frusemide
S)
Drugs acting on Uterus and Female Genital Tracts
ss
H
X- v?
‘
A?1
;
86
8T-
Inj.Prostodin
88
* Tab.Duvadilan
89
Tab.Methyl Ergometrine
90
Tab. Mesoprostol
91
Tab.Primolut-N
92
Haymycin vaginal tab
93
Inj Magnesium Sulphate.
94
Inj.Ethacredin lact(Emcredyl)
Inj.Pitocin
*4
Hormonal Preparation
T)
95
Inj.Insulin Rapid
96
Insulin lente Besal
......... V
.
'
97
.
.
■.
■
Inj.Cry Insulin
98
Inj.Mixtard
99
Inj.Testesterone plain 25mg
100
Testosterone Depot 50mg
101
Tab.Biguanide
....................
■
''
102
Tab.Chlorpropamide 100mg
...................................................... ■
103
Tab.Prednisolone 5mg
104
Tab.Tolbutamide 500mg
105
Tab.Glibenclamide
106
Tab.Betamethasone
59
IPHS for 51 to 100 Bedded Hospitals
Vitamins
U)
107
Inj.Vit “A”
108
Inj.Cholcalciferoll 6lac
109
Inj.Ascorbic acid
110
Inj.Pyridoxin 50mg
111
Inj.Vit K
112
Tab.Vit “A” & “D”
113
Tab.Ascorbic acid lOOmg
<
Other drugs
V)
114
Inj.Antirabies vaccine
115
Inj.Antisnake venom
116
Inj.AntiDiphtheria Serum
117
Inj.Cyclophosphamide
118
Inj.Sodabicarb
*
A
——
■
_____
; J?
■■
■;
119
Inj.Calcium Gluconate
120
Tab.Calcium lactate
121
Tr.lodine
122
Tr.Benzoin
123
Glcial acetic caid
124
Benedict solution
125
Caster oil
126
Liquid paraffin
127
Glycerine
128
Glycerine Suppositories
129
Turpentine oil
130
Potassium Permangnate
131
Formaldehyde
132
Dextrose Powder
—
<'v
—.—
.......
----------------------------
OH
7'
__
■
133
Methylated spirit
60
IPHS for 51 to 100 Bedded Hospitals
____
W'
>
_■
- .V—
5
134
Cotrimazole lotion
135
Cotrimazole cream
136
Tab.Theophylline
137
ECG Roll
138
Burnion Oint
139
Flemigel APC Ointment
140
Syp.Himobin
141
APDYL Cough &Noscopin
142
Tab. Septilin
143
Tab. Cystone
144
Tab. Gasex
145
Syp. Mental
146
Oint. Pilex
147
Rumalaya Gel
148
Pinku Pedratic Cough Syp.
Others
(W)
W'
1
Tab.Liv52
2
Syrup Liv52
3
Cap.Doxycycline lOOmg
4
Inj.Heparin sod.1000IU
5
Tab.Dipyridamol(Like Persentine)
6
Inj.Dopamine
7
Tab.Glyceryl Trinitrate
8
Tab.Amitryptilline
9
Tab.trifluoperazine(1 mg)
10
Tab.Nitrofurantine
11
Inj.Valethemide Bromide(Epidosyn)
12
Inj.lsolyte-M
13
Inj.lsolyte-P
61
IPHS for 51 to 100 Bedded Hospitals
14
lnj.lsolyte-G
15
Cap.Cephalexin 250mg
16
Tab.Taxim
17
Inj.Metaclopramide
18
Tab.Folic acid
19
Inj.Lignocaine Hcl 2%
20
Inj.Nor adrenaline
21
Betadine lotion
22
Tab.stilboesteral
23
Inj.Pyridoxine
24
Hydrogen peroxide
25
Inj.magnesium sulphate
26
Benzyl Benzoate
27
GammaBenzene Hexachloride
28
Inj.Tetglobe
29
Inj.Paracetamol
30
Pilocarpine eye drops 1%
31
Sy.Orciprenaline
32
Suturing needles (RB,Cutting)
33
Inj.Calcium pantothernate
34
Inj.Xylocaine 4% 30 ml
35
Halothane
36
Mixture Alkaline
37
Inj. Phenabarbitone 200mg
38
Inj. B12 (Cynacobalamine)
39
Neosporin, Nebasuef, Soframycin Pow
40
Magnasium Sulphate Powder
41
Furacin Cream
42
Xylocaine jelly
7
e
■
.
■
: ’ ; I If
62
BHHHB IPHS for 51 to 100 Bedded Hospitals
*
*
—
43
Formaldehyde Lotion
44
Cetrimide 100ml bott 3.5%, 1.5% 1
45
Bacitrium powder lOmg bolts
46
Bleaching Powder 5 Kg Pkts(ISI Mark)
47
Ether Solvent
48
Sodium Hypochloride Sod. 5 ltrs/1 ltrs
49
Inj. Diphthoria antition ADS)10000I.U
50
Inj. Gas gangrene Antitoxin(AGGS) 10000
51
Inj. Hydroxy Progesterone500mg/2ml
52
Inj. Methyl Prednisolon 500mg vial
53
Inj.Multivitamin I.V
54
Inj.Potassium chloride
55
Inj.Quinine Dihydrochloride
56
Tetanus Antitoxin 10000 I.U
57
Inj.Tetanus Toxoid 5ml vial
58
Inj.Theophylline Etophylline
59
Inj.Vitamin A
60
Tab.Ferrous sulphate200mg+Folic acid
61
Tab. ferrous sulphate 300mg
62
Tab.Griseofiilvin125mg
63
Tab.Phenobarbitone 30mg
64
Tab.Phenobarbitone 60mg
65
T^b.Pyridoxin lOmg
66
Tab.Thyroxine sod 0.1 mg
67
Warfarin sod 5mg
68
Tab.Alprazolam 0.25mg
69
Tab.Amlodipine 5mg
-------- .
—
—
Tab. Amlodipine 10mg
—
Tab.Nefidipine 20mg
63
IPHS for 51 to 100 Bedded Hospitals
-
72
Tab.Nefidipine 30mg
73
Tab.Riboflavin lOmg
74
Syp.Ferrous Gluconate 100ml bottle
75
Cream Fluconozole 15gm tube
76
Sus.Furazolidone
77
Oint.Hydrocortisone acetate
78
Syp.isoniazid 100mg/5ml 100ml bot
79
Liquid paraffin
79A
Linctus codein 500ml bot
80
Cream Miconozole 2% 15gm tube
81
Syp.Nalidixic acid
82
syp.Norfloxacin
83
Phenylepinephrine eye drops
84
Pilocarpine eye drops 2%
85
Syp.Pottassium chloride 400ml bot
86
Syp.Primaquine
87
Suspension Pyrantel pamoate
88
Sus Rifampicin
89
Syp.Salbutamol 100ml bot
90
Syp.Theophylline 100ml
91
Syp.Vitamin B.Complex
92
Vit D-3 Granules
93
Opthalmic & ear drops
94
Glycerine Mag sulphate ear drops
95
Pilocarpine eye drops 4%
96
Oint Acyclovir 3% 5gm tube
97
Benzyh Benzoate emulsion 50ml bot
98
Oint.Betamethasone
99
Cream Clotrimazole skin 1% 15gm
I.
r
1
■i IPHS for 51 to 100 Bedded Hospitals
100
Oint Dexamethasone 1%+ Framycetin
101
oint contain clotrimazole+Genta+Flucon
Oint Flucanazole 10 mg
‘ ’
103
Cream Framyctin 1% 20gm tube/IOOgm
104
Lot.Gamhbenzene hexachloride1% bt
105
Glycerine Suppository USP 3gm bott/10
106
Cream Nitrofurazone 0.2% jar of 500g
■
■
I
■■■'-
■
.....I... ................ .
107
Oint Silversulpadiazene 1% 25g
108
AIDS Protective kit
I
I
I
1
1
65
IPHS for 51 to 100 Bedded Hospitals
13.
Service / performance evaluation by
independent agencies
Capacity Building
At the time of entry into service, induction
training of at least six months duration must be made
mandatory for all categories of health care workers.
This must be a comprehensive training and must
have components of requisite skill enhancement,
management and knowledge about the drugs/
equipments and services offered at all levels of
health care.
District Monitoring Committees formed
under NRHM shall monitor the upgradation
of Hospitals to IPHS. Annual Jansamvad
may also be held as a mechanism of
monitoring.
Monitoring of laboratory
Secondly, at a duration of every two years,
on the job training must be provided to all categories
of health care personnel to upgrade their knowledge
and skills in technical and management fields.
Internal Quality Assessment Scheme
External Quality Assessment Scheme
Record Maintenance
14.
Computers have to be used for accurate
record maintenance and with connectivity to
the District Health Systems, State and
National Level.
Quality Assurance in Service
Delivery
Quality of service should be maintained at
all levels. Standard treatment protocols for locally
common diseases and diseases covered under all
national programmes should be made available at
all sub district hospitals. All the efforts that are being
made to improve hardware i.e. infrastructure and
software i.e. human resources are necessary but
not sufficient. These need to be guided by standard
treatment protocols and Quality Assurance in
Service Delivery
15.
Rogi Kalyan Samities (RKS) /
Hospital Management Committee
(HMC)
Each sub district hospital should have a Rogi
Kalyan Samiti / Hospital Management Committee
with involvement of PRIs and other stakeholders
as per the guidelines issued by the Government of
India. These RKS should be registered bodies with
an account for itself in the local bank. The RKS /
HMC will have authority to raise their own resources
by charging user fees and by any other means and
utilized the same for the improvement of service
rendered by the Sub District Hospital.
Quality Control
Internal Monitoring
Social audit through Rogi Kalyan Samities /
Panchayati Raj Institutions
Medical Audit, Technical Audit, Financial
Audit, Disaster Preparedness Audit,
Monitoring of Accessibility and equity issues,
information exchange.
16.
Citizen’s Charter
Each Sub District hospital should display a
citizen’s charter for the sub district hospital indicating
the services available, user fees charged, if any,
and a grievance redressal system. A modal citizen’s
charter is given as under.
External Monitoring
Monitoring by PRI / Rogi Kalyan Samities
66
IPHS for 51 to 100 Bedded Hospitals
I
I
1
I
General Information
Our motto - service with smile
Enquiry, Reception and Registration Services:
CITIZENS CHARTER
This counter is functioning round the clock.
This charter seeks to provide a framework
which enables our users to know:
Location guide maps have been put up at various
places in this hospital.
What services are available in this hospital;
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Telephone enquiries can be made over telephone
numbers:
The means through which complaints
regarding denial or poor quality of services
will be redressed.
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Colour coded guidelines and directional signboards
are fixed at strategic points for guidance.
The quality of services they are entitled to;
, &, Fax:
Standards of Service:
Casualty & Emergency Services:
This is a District, Sub-district/divisional
hospital;
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It provides medical care to all patients who
come to the hospital;
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Standards are influenced by patients load
and availability of resources;
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Yet we insist that all our users receive
courteous and prompt attention.
All Casualty Services are available round the clock.
Duty Doctor is available round the clock.
Specialist doctors are available on call from
resident doctors.
Locations:
It is located on
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Nurses:
staff).
Emergency Operations are done in-
floor of
(including supervisory
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Beds:
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Doctors wear white aprons and nurses are in
uniform.
Emergency Operation Theatre is functioned round
the clock.
In serious cases, treatment/management gets
priority over paper work like registration and medico
legal requirements. The decision rests with the
treating doctor.
All Staff member wear identity cards.
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Maternity OT
Orthopaedic Emergency OT
Burns and plastic OT
Main OT for Neurosurgery cases
(including residents
Doctors:
Emergency services are available for all
specialities as listed in the OPD Services.
OT located on
building.
road in front of
This hospital has-
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IPHS for 51 to 100 Bedded Hospitals
OPD Services:
Various outpatient services available in the hospital are detailed below (as available):
OPD
Time of Registration
Place
Time of OPD
General Medicine
Paediatrics
General Surgery
Obstetric & Gynec.
Eye
A
: — ;
ENT
A
Skin
Urology
Cardiology
Psychiatry
Radiotherapy
Neurology
■if
Orthopaedics
Burns & plastics
Dental OPD
ISM Services:
Homeopathic
Ayurvedic
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Any other
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IPHS for 51 to 100 Bedded Hospitals
There is a Central Collection Centre for receiving
and collecting various specimens for testing. The
timings for receiving specimens are 9:00 AM to
11:30 AM.
In OPDs specialists are available for
consultation.
OPD services are available on all working days
excluding Sundays and Gazetted Holidays.
Emergency: Emergency Laboratory Services are
available 24 hours for limited tests relating to clinical
pathology and bio-chemistry.
On Saturdays, the hospital functions from
................. AM to................. PM.
Medical Facilities Not Available:
Radio Diagnostic Services:
Organ Transplantation
Routine: These services include:
X-Rays
Ultrasound and
CAT Scan
Some specialities do not have indoor patients
services:
Routine X-Rays are done from 9:00 AM to 1:00 PM.
Registration is done from 9:00 AM to 11:30 AM.
Psychiatry
Ultrasound examination is done from 9:00 AM to
4:00 PM.
D-&ddiction
Dental
Genetic Counselling
Emergency: Emergency X-Ray services are also
available round the clock. CAT Scan services are
also available round the clock.
Endochronology
Indoor Patient Services:
Nuclear Medicine
Geriatrics
Wards providing free
Laboratory Services:
There are total of
indoor patient care.
Routine: Laboratory Services are provided in the
field of (as available):
Emergency ward A admits emergency cases for
medical problems.
Emergency ward B admits emergency cases for
surgical problems.
Bio-chemistry
Microbiology
There is a---------------- bedded Intensive Care Unit
for care of seriously ill patients.
Haematology
A------------------ bedded Intensive Coronary Care
Unit takes care of heart patients requiring intensive
treatment.
Cytology
Histopathology including FNAC
Clinical Pathology
In the Burns Department, there are
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IPHS for 51 to 100 Bedded Hospitals
bedded Intensive Care Unit to treat seriously injured
burns patients.
Wheel chairs and trolleys are available in the OPD
and casualty.
There are--------------------labour rooms for
conducting deliveries round the clock.
------------- Ambulances are available to pick up
patients from their places (on payment of nominal
charges) and also for discharged patients.
— ------------------nurseries provide necessary
care to the newborns - normal as well those born
with disease.
Mortuary Van is available on payment between 9:00
AM to 4:00 PM.
All indoor patients receive treatment under the
guidance and supervision during office hours i.e.
9:00 AM to 4:00 PM.
Public Telephone Booths are provided at various
locations.
Outside office hours, treatment is given by doctor
on duty and specialists are available on call.
Stand-by Electricity Generators have been provided.
Chemist Shops are available outside the hospital.
Canteen for patients and their attendants is
available.
Free diet is provided to all patients in the General
Wards.
Lifts are available for access to higher floors.
Every patient is given one attendant pass.
Visitors are allowed only between 5:00 PM to 7:00
PM.
Adequate toilet Facilities for use of patients and their
attendants are available.
Investigations like CAT Scan, Ultra Sound, Bariummeal, ECHO, TMT etc. are charged for as per
Government approved rates.
Complaints & Grievances:
There will be occasions when our services will not
be upto your expectations.
For poor patients, these charges can be waived
partially or fully on the recommendation of the
H.O.D. by the Additional Medical Superintendent.
In case of emergency CMO (on duty) may waive off
these charges.
Please do not hesitate to register your complaints.
It will only help us serve you better.
Every grievance will be duly acknowledged.
We aim to settle your genuine complaints within 10
working days of its receipt.
A Staff Nurse is on duty round the clock in the ward.
Admitted patients should contact the Staff Nurse for
any medical assistance they need.
Suggestions/Complaint boxes are also provided at
various locations in the hospital.
Other Facilities:
Other facilities available include:
If we cannot, we will explain the reasons and the
time we will take to resolve.
Cold Drinking Water
Name, designation and telephone number of the
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IPHS for 51 to 100 Bedded Hospitals
1 nodal officer concerned is duly displayed at the
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Please help us in keeping the hospital and its
surroundings neat and clean.
Reception.
Please use the facilities of this hospital with care.
Beware of Touts.
Dr.
Designation....
Tele‘(6)
(M)
(R)
Meeting Hours
The Hospital is a “No Smoking Zone” and smoking
is a Punishable Offence.
to
Please refrain from demanding undue favours from
the staff and officials as it encourages corruption.
Responsibilities of the Users:
Please provide useful feedback & constructed
suggestions. These may be addressed to the
Medical Superintendent of the Hospital.
The success of this charter depends on the support
we receive from our uses.
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Please try to appreciate the various constraints
under which the hospital is functioning.
♦
Don’t split here & there
On an average more than---------- lacs patients
attend the OPD annually and more than-------------- lacs patients are attended annually in the
casualty and emergency wards.
♦
Please do not inconvenience other patients.
♦
Use Dustbin
Keep Hospital Clean
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“No Smoking Please”
Give regards to Ladies and Senior Citizens
IPHS for 51 to 100 Bedded Hospitals
Annexure - /
Guidelines for the Project providing financial support to the selected
Government Hospitals for Hospital Waste Management.
institutions under Central/State Governments for:
The Ministry of Environment & Forests
notified the “Bio-Medical Waste (Management &
Handling) Rules, 1998” in July, 1998.
In accordance with the rules (Rule 4), it is
the duty of every “Occupier”, i.e. a person who has
the control over the institution and/or its premises,
to take all steps to ensure that the waste generated
is handled without any adverse effect to human
health and environment. The Rules further state that
every Occupier, where required, shall set up
requisite bio-medical waste treatment facilities like
incinerator, autoclave, microwave system for the
treatment of waste, or ensure requisite treatments
waste at a common treatment facility or any other
treatment facility. No untreated bio-medical waste
shall be kept stored beyond a period of 48 hours
(Rules 5 & 6).
1.
Purchase of equipments such as:
Incinerator
a)
Microwave
b)
Autoclave
c)
Shredder
d)
2.
Other equipments including colour coded
ba^s and puncture proof containers,
protective gears, etc.
3.
Civil and electrical works to house and
operate the waste treatment facilities.
4.
Training
5.
IEC activities.
Hospital Waste Management System must
be established in accordance with the Bio-Medical
Waste (Management & Handling) Rules, 1998
(Annexure).
The hospitals, nursing homes, clinic,
dispensary, animal house, pathological lab, etc. are,
therefore, required to set in place the biological
waste treatment facilities. It is, however, not
incumbent that every institution has to have its own
waste treatment facilities. The rules also envisage
that common facility or any other facilities can be
used for waste treatment. However, it is incumbent
on the occupier to ensure that the waste is treated
within a period of 48 hours. Schedule VI of the rules
also provides the time limits by which the waste
treatment facilities are required to be in place.
Segregation must be done at the source of
generation of waste. As 80-85% of waste generated
in hospitals is non-hazardous or general waste,
segregation will reduce the quantum of waste that
needs special treatment to only 15-20% of the total
waste. The categories for segregation of waste and
colour coding and type of container should be as in
Schedule 1 and 2 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.
The various options for treatment of waste
can be selected according to feasibility and type of
waste as given in the Schedule - I. The correct
colour bag should be used for the particular
treatment option.
In connection with the implementation of the
Rules, it has been decided to take up pilot projects
in selected Government hospitals - Central and
State.
AIM: The aim of the scheme is to implement
pilot projects to have a demonstration effect by
providing financial assistance to identified hospitals/
The various options are:
Incineration: The incinerator installed must
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5.
meet the specification and emission
standards as given in the Bio-Medical Waste
(Management & Handling) Rules, 1998 and
must meet the guidelines developed by
Central Pollution Control Board for design
and construction of bio-medical waste
incinerator (circulated to all States/UTs vide
letter no. Z.28015/50/2003-H, dated
18.11.2003) - a certificate may be taken
from the State Pollution Control Board.
Waste category, 1,2, 3, 5, & 6 as stated in
the Schedule - I of the bio-Medical Waste
(Management & Handling) Rules, 1998.
Wherever common facilities for treatment
and disposal of bio-medical waste are
available, installation of incinerators by
individual hospitals may not be encouraged
and such waste should be transported to the
common facility for proper treatment.
2.
3.
4.
The assistance will be given direct to the
hospital/institute for purchase of equipments for
waste treatment facilities/installation of equipment
and civil/electrical works to house the waste
treatment facilities, training, IEC activities including
preparation and publication of literature, posters,
pamphlets, etc. The financial assistance will be
limited to Rs.85 lakhs per hospital or Rs. 1.50 crore
per State/UT. The estimated costs are as under:-
Autoclaving/Microwavinq: Standards for
autoclaving and microwaving are provided
in the Bio-Medical Waste (Management &
Handling) Rules, 1998. The equipment for
autoclaving or microwaving waste should
conform to these standards. These options
can be selected for waste categories 3, 4,
6,7 of Schedule -1 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.
R s . 3 5.0 0
1.
Incinerator or Microwave =
lakhs
2.
Shredder (Approx. 100 kg to 360 kgJhour)
= Rs.10.00 lakhs
J.
Autoclave (Approx. Cap. Vol. 1015 litrs)
= Rs.30.00 lakhs
4.
Waste transportation: Onsite-wheel barrow/
wheeled
= Upto max. of
Shredder: Shredding will cause a reduction
in the volume of waste and will also
effectively prevent its re-use. It is required
for waste category 4 and 7 of the Schedule
- I of the Bio-Medical Waste (Management
& Handling) Rules, 1998. it should be
ensured that waste is disinfected by
chemicals/microwaving/autoclaving before
shredding.
container or similar carriage Rs.50,000.00
R s . 2 . 5 0
5.
Civil and Electrical works =
lakhs
6.
Literature/IEC/Training of Staff
= Rs.2.00 lakhs
7.
Needle and Syringe Destroyer: These
units can be used for needles and syringes
at the point of use. These will destroy the
used needles reducing it to ashes and cut
the syringe effectively preventing the re-use.
Procurement of equipments like needle
shredder puncture proof containers for
sharps, colour coded bags, trolleys,
protective gears for staff etc. for Disposal of
hospital wastes = Rs.5.00 lakhs
The following eligibility conditions have to be fulfilled
for availing of financial assistance:
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Transportation of Waste: Within the
hospital in dedicated wheeled containers,
trolleys or carts should be used to transport
the bins or plastic bags to the site of storage/
treatment. The wheeled container should be
designed so that waste can be easily loaded,
remain secure during transportation, does
not have sharp edges and is easy to clean
and disinfect.
IPHS for 51 to 100 Bedded Hospitals
The application for financial assistance
should be forwarded to this Ministry through
the State Government/UT Administration
concerned.
ii.
iii.
iv.
The State Government/UT Administration
should ensure that the existing facilities are
inspected by a responsible officer and
deficiencies pointed out. The proposal for
additionalities, if any, in the form of
equipment should be, as far as possible, by
way of complementary equipments
supported by estimates of concerned
authorities.
The cost of equipments to be purchased
should be indicated. The equipments will be
purchased as per prescribed procedure.
These will be entered into an Assets
Register to be maintained by the hospital.
The grant will be subject to the condition that
the State Government / UT Administration
will give an undertaking that adequate
arrangements for running the equipments
and their maintenance for disposal of
hospital waste shall be made.
v.
The grant will be subject to the condition that
the State Government/UT Administration/
Hospital will give an undertaking that they
will provide the required trained manpower
for running of the equipments and their
maintenance for proper treatment and
disposal for the bio-medical waste.
vi.
The funds sanctioned will be utilized for the
purpose for which it is sanctioned.
vii.
The accounts of the hospital about purchase
of equipment/maintenance of the
equipments/transportation of thw waste/
expenditure incurred on civil/electrical works
will be audited by the Accountant General
of the State Government / UT Administration
and its utilization certificate will be forwarded
to the Ministry of Health & Family Welfare
within a period of six months after the expiry
of the financial year during which the grants
is sanctioned.
The financial assistance will be limited to
Rs.85 lakhs per hospital or Rs.1.5 crore per State/
UT. The State/UTs will have the option to choose
any equipment (s) from the list above to cover as
many hospitals as possible. However, the financial
assistance per State will be provided upto a
maximum amount of Rs.1.5 crore.
Scrutiny, of Applications:
The applications received from the State
Government/UT Administrations for setting up of
facilities for disposal of hospital waste in the
hospitals under their administrative control will be
considered in the Ministry in a Committee headed .
by Additional Secretary and proposals cleared for
giving financial assistance. The proposals then will
be processed for sanction of financial assistance to
the Government Hospitals/institutes. In the case of
Central Government Hospitals/lnstitutions, the Head
of the Institutions may send their proposal through
Dte.GHS.
The Joint Secretary (Hospital), DDG level
officer in the Dte.GHS concerned with hospitals
matters will be the Nodal Officer for implementation
of the scheme. The proposals will be examined
through a Committee consisting of Additional
Secretary, Chairman, the Joint Secretary dealing
with hospital matters, Joint Secretary (FA) or his
representative, DDG level officer dealing with
hospitals in Dte.GHS and one representative of
Central Pollution Control Board/Ministry of
Environment & Forests as members. The Member
Secretary of the Committee will be Director/Deputy
Secretary dealing with hospital matters. The funds
for setting up facilities for disposal of hospital waste
will be sanctioned to the State Government/UT
Administration/Occupier and it will be implemented
by the concerned Government and to the concerned
Head of the Hospital in case of Central Government
Hospitals/lnstitutions.
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Annexure - II
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Referral Laboratory Networks
Referral Laboratory Network for Advanced diagnostic facilities
IDSP Level -4 Labs
South
Central
Zone
Zone
IDSP
Level ■ 5
Labs
NICED &
NICD
North
Zone
East
Zone
South
Zone
CMC
Vellore
PGIMER
Chandigarh
RMRC
Dibrugarh,
KEM
Mumbai,
Trivandrum
Medical
College
AllMS Delhi Cuttack
Medical
CRI Kasauli College
AFMC
Pune
BJ MC
CMC
Vellore
AFMC,
Pune
VP Chest
Institute,
Delhi
Surat
Medical
College
CMC Vellore
& PGIMER
Chandigarh
AFMC,
Pune
NICD, Delhi
Advance Diagnostic Facilities
Bacterial diagnosis
Enteric bacteria:
Vibrio choierae,
Shigella,
Salmonella
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Streptococcus
pyogenes and
S pneumoniae
Indore
Medical
College
St. John
Medical
College,
Bangalore
VP. Chest
University
of Delhi
C.diphtheriae
BHU
CMC,
Vellore
NICD,
Delhi
Neisseria
meningitidis and
N. gonorrheae
SN Medical
College,
Agra
State PH
Lab
Trivandrum
PGIMER
Chandigarh
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Staphylococcus
BHU
MGR
Medical
University
Maulana
Azad
Medical
College,
Delhi
STM,
Kolkata
Leptospirosis
DRDE
Virology
Institute,
Allepey
AllMS
IVRI
BJMC
RMRC,
Bubaneswar
&
Dibrugarh
Tamil Nadu
University,
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STM,
Kolkata
Chennai
VCRC,
Pondicherry
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RMRC
Port Blair
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Viral Diagnosis
Enteric viruses
DRDE
CMC,
Vellore
AllMS &
Villupuram
Chest
Institute
NICED
Kolkata
EVRC,
Mumbai,
NIV & NICD
Arboviruses
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
Chest
Institute
NICED
Kolkata
NIV
Myxoviruses
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
Chest
Institute
NICED
Kolkata
NIV, HSADL
Bhopal
Hepatitis viruses
DRDE
CMC,
Vellore
AllMS
ICGEB,
Delhi
NIQED
Kolkata
NIV
Neurotropic viruses
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
NIV
NIMHANS
HIV
DRDE
CMC,
Vellore
AllMS
NARI, NICD
& NACO
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ICGEB, Delhi
Parasitic Diagnosis
Malaria
All State Public Health Laboratories
MRC, Delhi
ICGEB, Delhi
Filaria
All State Public Health Laboratories
NVBDpP, Delhi VCRC
Pondicherry
Zoonoses
Dengue
JE
DRDE
DRDE
VCRC,
AllMS
Pondicherry
Institute of
Virology,
Aleppey
NICED
CRME,
Madurai &
NIMHANS
NICED
VCRC,
Pondicherry
AllMS
NIV
NIV
ICGEB,
Delhi
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NIV
NIV /NICD
IPHS for 51 to 100 Bedded Hospitals
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NICD,
Delhi
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DRDE
NICD
Bangalore
Rickettsial diseases
DRDE
CMC,
Vellore
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Anthrax
DRDE .
CMC,
Vellore
IGIB
Microbial water
quality monitoring
NEERI,
Nagpur
CMC
Vellore,
PGIMER
Chandigarh
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Trivandrum
Medical
College
NICED,
Calcutta
RMRC,
Dibrugarh,
Cuttack
AllMS, Delhi Medical
College
CRI Kasauli
NICD,
Delhi
AFMC
NICD
IVRI
BJMC
NICD
IVRI
KEM
Mumbai,
NICED &
NICD
HAFFKIN’s,
Mumbai
AFMC Pune
Unknown pathogens
Other laboratories to perform support functions
NIV, NICD, HSADL
Outbreak investigation
support
Medical Colleges and state public health
laboratories as L3/ L4
NICD, NIV, NICED,
VCRC
Laboratory data
management
Medical Colleges, state public health laboratories
and all the L4 & L5 laboratories (in their area of
expertise)
NIV, NICD
Capacity building
All the L4 & L5 laboratories (in their area of
expertise)
NIV, NICD
Quality assurance
All the L4 & L5 laboratories (in their area of
expertise)
CMC, TRC, NTI, AFMC,
NARI, RMRC, Port Blair
NIV, NICD
Quality control of
reagents & kits
evaluation
All the L4 & L5 laboratories (in their area of
expertise)
CMC, TRC, NARI,
RMRC,Port Blair NIV,
NICD, BJMC, NICED
DRDE, NIV, IVRI, NICED,
NICD, MRC, Delhi
Production & supply of
reagents/ kits/ biological/
standard reference
materials
Biosafety & bio
containment
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Haffikins
Institute
AFMC, Pune
NARI
TRC, Chennai
RMRC, Port Blair
Other laboratories to perform support function
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DRDE, NICD
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List of Abbreviations
BJMC
BJ Medical College
CHC
Community Health Centre
CME
Continuing Medical Education
CSSD
Central Sterile and Supply Department
CRI
Central Research Institute
CRME
Centre for Research in Medical Entomology
DRDE
Defense Research and Development Establishment
ICGEB
International Centre for Genetic Engineering and Bio-technology
EVRC
Enterovirus Research Centre
FRU
First Referral Unit
HSADL
High Security Animal Diseases Laboratory
IGIB
Institute of Genomics and Integrative Biology
IPHS
Indian Public Health Standards
IVRI
Indian Veterinary Research Institute
KEM
King Edmund Memorial Hospital
MRC
Malaria Research Centre
NARI
National AIDS Research Institute
NEERI
National Environmental Engineering Institute
NICED
National Institute of Cholera and Endemic Diseases
NIV
National Institute of Virology
NRHM
National Rural Health Mission
PRI
Panchayati Raj Institution
RKS/HMC
Rogi Kalyan Samiti / Hospital Management Committee
RMRC
Regional Medical Research Centre
STM
School of Tropical Medicines
VCRC
Vector Control Research Centre
/
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References
1.
Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100 Bedded Hospital, Bureau
of Indian Standards, New Delhi, January, 2001
2.
Rationalisation of Service Norms for Secondary Care Hospitals, Health & Family Welfare
Department, Govt, of Tamil Nadu. (Unpublished)
3.
District Health Facilities, Guidelines for Development and Operations; WHO; 1998.
4.
Indian Public Health Standards (IPHS) for Community Health Centres; Directorate General of Health
Services, Ministry of Health & Family Welfare, Govt, of India.
5.
Population Census of India, 2001; Office of the Registrar General, India.
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