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Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
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Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
I
Foreword
District Hospital is an integral part of the District Health System (DHS), which is, the point of
origin for implementing various health policies and delivery of health care. It fulfills the need of
secondary level of health care acting as a centre for curative, preventive, and promotive health
care services as well as interface with institutions controlled by non-government and private voluntary
health organizations. The current functioning of most of the District Hospitals is below the level of
expectations due to non-uniformity in staff/bed strength, equipments and service availability and
population coverage.
The National Rural Health Mission (NRHM) launched by the Hon’ble Prime Minister of India
on 12,h April, 2005 aims to restructure the delivery mechanism for health towards providing universal
access to equitable, affordable and quality health care that is accountable and responsive to the
peoples needs, reducing child and maternal deaths as well as stabilizing population and ensuring
gender and democratic balance. As envisaged under NRHM, Sub-districts/Sub-divisional Hospitals
would be upgraded from its present level to a level of set of Standards called 'Indian Public Health
Standards (IPHS)’.
The Indian Public Health Standards (IPHS) for District Hospitals has been worked out by
• constituting an Expert Group comprising of 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 101-200 beds, 201-300 beds and 301-500 beds. The
Indian Public Health Standards (IPHS) for District 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
.Spmittee /Management Committee with involvement of PRIs, Citizen Charter are expected to make
improvement in the functioning and accountability of these Hospitals.
Of course, setting Standards is a dynamic process and this document provides at this
stage the standards for a minimum functional grade for a District Hospital. I hope 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
District Hospitals function as a secondary level of health care which provides curative,
preventive and promotive healthcare services to the people in the district. It is also the fundamental
platform for implementing various health policies and delivery of healthcare and management of
health services for defined geographical areas. 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. For the first time under National Rural Health Mission (NRHM), an
effort has been made to prepare Indian Public Health Standards (IPHS) for District 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 District
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
*
Acknowledgements
Indian Public Health Standards (IPHS) for the District Hospitals fulfill the needs of secondary
level of healthcare providing curative, preventive and promotive healthcare services to the people
In'the district. The document is the result of efforts put in by both the government and non-government
organizations. As the population and geographical area of a district varies in different States and
UTs, an attempt has been made to formulate IPHS for District Hospitals having different bed strengths
such as 101-200, 201-300 and 301-500 bedded hospitals. This document contains the Standards
set for 301-500 bedded hospital at district 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 District 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. and Director(NICD) and Shri S. Majumdar, Chief
Architect, Bureau of Design, Ministry of Health & Family Welfare for their valuable contribution and
guidelines in formulating the IPHS for the District 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.
(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: 16,h May, 2007
V
Contents
Introduction
I,
.
1
.........
2
Objectives of IPHS for District Hospitals
3
3.
Definition of District Hospital
3
4.
Grading of District Hospital
3
5,
Functions
4
6.
Essential Services
4
7.
Physical Infrastructure
33
Manpower
39
9.
Equipment
42
10.
Laboratory Services
60
11.
Recommended allocation of bed strength atyarious levels
63
12'
List of Drugs
64
13.
Capacity Building
78
8.
______________________________________________________
.
~~~~~~
14. Quality Assurance in Services
78
________
15.
t
Rogi Kalyan Samities / Hospital Management Committee
'
'
16.
78
—~———
Citizen’s Charter
78
Annexure -1: Guidelines for Bio-Medical Waste Management
84
Annexure - II: Reference Laboratory Networks
87
List of Abbreviations
90
_________
.
——
References
91
vii
IPHS for 301 to 500 Bedded District Hospitals
1.
able to build interface with the institutions external
to it including those controlled by non-government
and private voluntary health organization. In the first
changing scenario, the objectives of a district
hospital need to unify scientific thought with practical
operations which aim to integrate management
techniques, interpersonal behaviour and decision
making models to serve the system and improve its
efficiency and effectiveness.
Introduction
India’s Public Health System has been
developed over the years as a 3-tier system, namely
primary, secondary and tertiary level of health care.
District Health System is the fundamental basis for
implementing various health policies and delivery
of healthcare, management of health services for
define geographic areas. District hospitals is an
essential component of the district health system
and functions as a secondary level of health care
which provides curative, preventive and promotive
healthcare services to the people in the district.
The current functioning of the most of the
district hospitals in the public sector are not up to
the expectation especially in relation to availability,
accessibility and quality. The staff strength, beds
strength, equipment supply and service availability
and population coverage are not uniform among all
the district hospitals.
Every district is expected to have a district
hospital linked with the public hospitals/health
centres down below the district such as Sub-district/
Sub-divisional hospitals, Community Health
As per Census 2001, the population of a
Centres, Primary Health Centers and Sub-centres.
district varies from as low as 32,000 (Yanam in
As per the information available, 609 districts in the
Pondicherry, Lahul & Spiti in Himachal Pradesh) to
country at present are having about 615 district
hospitals. However, some of the medical college as high as 30 lakhs (Ludhiana, Amritsar districts).
hospitals or a sub-divisional hospital is found to The bed strength also varies from 75 to 500 beds
depending on the size, terrain and population of the
serve as a district hospital where a district hospital
district. As per the second phase of the facility survey
as such (particularly the newly created district) has
not been established. Few districts have also more 'undertaken by the Ministry of Health & Family
Welfare, Government of India, covering 370 district
than one district hospital.
hospitals from 26 states have revealed that 59% of
The Government of India is strongly
the surveyed district hospitals have tap water facility.
committed to strengthen the health sector for
The electricity facility is available in 97% of the
improving the health status of the population. A
districts with a stand by generator facility in 92% of
number of steps have been taken to that effect in
the cases. Almost all the DHs in India have one
the post independence era. One such step is
operation theatre and 48% of them have an OT
strengthening of referral services and provision of
specifically for gynecological purpose. About 73%
speciality services at district and sub-district
of the surveyed district hospitals have laboratories.
hospitals. Various specialists like surgeon,
A separate aseptic labor room is found in only 45%
physicians, obstetricians and gynecologists,
of the surveyed district hospitals. Only half of the
pediatrics, orthopedic surgeon, ophthalmologists,
total number of district hospitals have OPD facility
anesthetists, ENT specialists and dentists have
for RTI/STI. As regards manpower 10% of the district
been placed in the district headquarter hospitals.
hospitals do not have O&G specialists and
The district hospitals caters to the people
pediatricians. 80% of the DHs have at least one
living in urban (district headquarters town and
pathologist and 83% of the total DHs have at least
adjoining areas) and the rural people in the district.
one anesthetist. The position of general duty
District hospital system is required to work not only
officers, staff nurses, female health workers and
as a curative centre but at the same time should be
laboratory technicians are available in almost all
1
IPHS for 301 to 500 Bedded District Hospitals
with quality assurance in district hospitals services
to ensure efficiency and effectiveness of the services
rendered.
district hospitals. Only 68% of the district hospitals
have linkage with the district blood banks.
Most of the district hospitals suffer from large
number of constraints such as
♦
Buildings are either very old and in
dilapidated conditions or are not maintained
properly.
♦
The facilities at district hospitals require
continued upgradtion to keep pace with the
advances in medical knowledge, diagnostic
procedures, storage and retrieval of
information. It has been observed that
development of hospitals is not keeping
pace with the scientific development.
♦
A typical district hospital lacks modern
diagnostics and therapeutic equipments,
proper emergency services, intensive caje
units, essential pharmaceuticals and
supplies, referral support and resources.
♦
There is a lack of trained and qualified staff
for hospitals management and for the
management of other ancillary and
supportive services viz. medical records,
central sterilization department, laundry,
house keeping, dietary and management of
nursing services.
♦
There is lack of community participation and
ownership, management and accountability
of district hospitals through hospital
management committees.
Standards are a means of describing the
level of quality that health care organization are
expected to meet or aspire to. The key aim of the
standard is to underpin the delivery of quality
services which are fair and responsive to clients'
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 district hospitals can be assessed
against a set of standards.
The National Rural Health Mission (NRHM)
has provided the opportunity to set Indian Public
Health Standards (IPHS) for various health
institutions at various levels starting from Sub
centres, Primary Health Centres, Community Health
Centres and so on up to the district level hospitals.
The present draft guidelines are an effort to
prepare Indian Public Health Standards for the
District Hospitals. This is not to say that standards
for various hospitals do not exist in the country. The
Bureau of Indian standards(BIS) have developed
standards for hospitals services for 30 bedded and
100 bedded hospitals and standards for 250
bedded, 500 bedded teaching and non teaching and
750 bedded teaching and non teaching will be
published by BIS later. However, these standards
are considered very resource intensive and lack the
processes to ensure community involvement,
accountability, the hospital management, and
citizens’ charter etc peculiar to the public hospitals.
In this context a set of standards are being
recommended for district hospitals to be called as
Indian Public Health Standards (IPHS) for
District Hospitals. Setting standards is a dynamic
process. The current effort is only to workout
standards for a minimum functional grade level
district hospital. Reference has been made to the
BIS Standard for 100 beded hospitals;
Rationalisation of Service Norms for Secondary
District Hospitals have come under
constantly increasing pressure due to increased
utilization as a result of rapid growth in population,
increase awareness among common consumers,
biomedical advancement, resulting in the use of
sophisticated and advanced technology in diagnosis
and therapies, and constantly rising expectation
level of the use of the services. The need for
evaluating the care being rendered through district
hospitals has gained strength of late. There is an
urgent need to provide guidance to those concerned
2
T
IPHS for 301 to 500 Bedded District Hospitals
sensitive to the needs of the people of the
district and the hospitals/centers from which
the cases are referred to the district hospitals
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. This
document contains the standards to bring the District
Hospitals to a minimum acceptable functional grade
with scope for further improvement in it.
3.
Definition
The term District Hospital is used here to
mean a hospital at the secondary referral level
responsible for a district of a defined geographical
area containing a defined population.
Most of the existing hospitals below district
level (31-50 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,
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).
4.
Grading of District Hospitals:
The size of a district hospital is a function of
the hospital bed requirement, which in turn is a
function of the size of the population it serves. In
India the population size of a district varies from
35,000 to 30,00,000 (Census 2001). 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 district having a population of 10 lakhs will be
around 300 beds. However, as the population of
the district varies a lot, it would be prudent to
prescribe norms by grading the size of the hospitals
as per the number of beds.
Setting standards is a dynamic process. This
document contains the standards to bring the 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.
Grade I: District Hospitals norms for 500 beds
Objectives of Indian Public Health
Standards (IPHS) for District
Hospitals:
Grade IV: District Hospital norms for 100 beds.
2.
Grade II: District Hospitals norms for 300 beds
Grade III: District Hospitals norms for 200 beds
The disease prevalence in a district varies
widely in type and complexities. It is not possible to
treat all of them at district hospitals. Some may
require the intervention of highly specialist services
and use of sophisticated expensive medical
equipments. Patients with such diseases can be
transferred to tertiary and other specialized
hospitals. A district hospital should however be able
to serve 85-95% of the medical needs in the districts.
It is expected that the hospital bed occupancy rate
should be atleast 80%.
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 DHs are:
To provide comprehensive secondary health
care (specialist and referral services) to the
community through the District Hospital.
n.
iii.
To achieve and maintain an acceptable
standard of quality of care.
The minimum functional grade of the
different grades of district hospitals requiring the
To make the services more responsive and
3
IPHS for 301 to 500 Bedded District Hospitals
Ophthalmology
physical infrastructure, manpower, diagnostic and
investigation facilities, equipment norms, drugs and
other supportive services etc. has been given.
5.
1.
2.
3.
Functions
ENT
Dermatology and Venerology (Skin & VD)
RTI/STI
A district hospital has the following functions:
Orthopaedics
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 (district headquarter
town) and the rural population in the district.
Radiology including ultrasonologist
Radiotherapy
Dental care
Public Health Management
Psychiatry
Plastic Surgery
Allergy
Function as a secondary level referral centre
for the public health institutions
below the district level such as Subdivisional Hospitals, Community Health
Centres, Primary Health Centres and Sub
centres.
Super Specialties
Cardiology
Cardio-thoracic Vascular Surgery
Gastro-enterology
Surgical Gastro-enterology
To provide wide ranging technical and
administrative support and education and
training for primary health care.
Nephrology
Urology
Essential Services (Minimum
Assured Services)
Neurology
Services include OPD, indoor, emergency
services.
Oncology
6.
Neurosurgery
Endocrinology/Metabolism
Secondary level health care services
regarding following specialties will be assured at
hospital:
6.1
6.2
Diagnostic and other Para clinical services
regarding:
Laboratory services
Consultation services with following
specialists:
Imaging services
CT Scan services
General Medicine
Sonography
General Surgery
ECG
O&G services
Paediatrics including Neonatalogy
EEG
Emergency (Accident & other emergency)
Echocardiogram
Critical care
Endoscopy
Anaesthesia
Angiography
4
L
IPHS for 301 to 500 Bedded District Hospitals
Echocardiography
6.4
Administrative services
Pathology
(i)
Medical records (Provision should be made
for computerized medical records with anti
virus facilities whereas alternate records
should also be maintained)
(ii)
Procurement
(iii)
Personnel
(iv)
Housekeeping and Sanitation
Medico-legal/postmortem*
(v)
Education and training
Ambulance services
(vi)
Inventory Management
Dietary services
Financial powers of Head of the Institution
Laundry services
Medical Superintendent to be authorized to
incure and expenditure up to Rs.25.00 lakhs for
repair/upgrading of impaired equipments/
instruments with the approval of executive
committee of RKS. Financial accounting and
auditing be carried out as per the rules along with
timely submission of SOEs/UCs.
Blood Bank
Physiotherapy
Dental Technology (Dental Hygiene)
Drugs and Pharmacy
6.3
Ancillary and support services: Following
ancillary services shall be ensured:
Security services
Waste management
Counseling services for domestic violence,
gender violence, adolescents, etc. Gender
and socially sensitive service delivery be
assured.
Ware housing/central store
Maintenance and repair
Electric Supply (power generation and
stabilization)
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.
Transport
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.
Communication
6.5
Services under various National Health
and Family Welfare Programmes
6.6
Epidemic Control
Preparedness
6.7
SERVICE MIX OF PROCEDURES IN
MEDICAL
AND
SURGICAL
SPECIALITIES
Water supply (plumbing)
Heating, ventilation and air-conditioning
Medical Social Work
Nursing Services
Sterilization and Disinfection
Horticulture (Landscaping)
Lift and vertical transport
Refrigeration
and
Disaster
Following services mix of procedures in
medical and surgical specialties would be available:
* Subject to location at District Headquarter
5
IPHS for 301 to 500 Bedded District Hospitals
Name of the Procedure
SI. No
MEDICAL
1
Pleural Aspiration
2
Pleural Biopsy
3
Bronchoscopy
4
Lumbar Puncture
5
Pericardial tapping________
6
Skin scraping for fungus / APB
7
Skin Biopsies___________
8
Abdominal tapping
9
Liver Biopsy______
10
Liver Aspiration
11
Fibroptic Endoscopy
12
Peritoneal dialysis
13
Hemodialysis_____
14
Bone Marrow Biopsy
BOO
OPD Procedures (Including IPD)
1
Dressing (Small, Medium and Large)
2
Injection (1/M & 1/V)
3
Catheterisation
4
Steam Inhalation
5
Cut down (Adult)
6
Enema
7
Stomach Wash
8
Douche
9
Sitz bath
10
CVP Line
11
Blood Transfusion
12
Hydrotherapy
13
Bowel Wash
6
J
IPHS for 301 to 500 Bedded District Hospitals
Skin Procedures
1
Chemical Cautery
Electro Cautery
3
Intra Lesional Injection
4
Biopsy
Paediatric Procedures
<!
1__
Immunization (BCG, OPV, DPT, Measles, DT) / Children Ward / ORT centre
2
Services related to new borne care + All procedures as mentioned in IMNCI
2.1
- only cradle_____________ ______________________________
2.2
- Incubator_____________________________________________
2.3
- Radiant Heat Warmer______________________________
24
- Phototherapy_____________________ _____________________
2.5
- Gases (oxygen)_________________________________________
2.6
- Pulse Oxementer____________________________________
2.7
- Lum bar Puncture________________________________________
2.8
- Bone Marrow___________________________________________
2.9
- Exchange Transfusion
2.10
- Cut down
2.11
- Plural/Acite Tap
2.12
- Ventilator
2.13
- Live Biopsy u/s guided
"
v
Cardiology Procedures and Diagnostic Tests
1
ECG
2
TMT___________
HI
Holter
4
Thrombolytic Therapy
5
C VP Line
6
Defibrilator Shock
7
NTG/Xylocard Infusion
8
ECHO Cardiography
7
I
IPHS for 301 to 500 Bedded District Hospitals
Endoscopic Specialised Procedures and Diagnostic
Gastroscopy (Oesophagus, stomach, deudenum) (Diagnostic and Therapeutic)
1
2
Sigmoidoscopy and Colonoscopy
3
Bronchoscopy and Foreign Body Removal
1
4
Arthros copy (Diagnostic and Therapeutic)
L
5
Laproscopy (Diagnostic and Therapeutic)
6
Colposcopy________________________
7
Hysteroscopy
_
r
_____________ ________
Psychiatry Services
I
1
Modified ECT______________________
2
Narcoanalysis
_
Physiotherapy Services
k
A..
_
L
h
________ _
1
With Electrical Equipments_______
1.1
- Computerised Tractions (Lumbar & Cervical)
1.2
- Short wave diathermy________________
1.3
• Electrical Stimulator with TENS
1.4
- Electrical Stimulator________
1.5
- Ultra Sonic Therapy_________________
1.6
- Paraffin Wax Bath__________________
1.7
- Infra Red Lamp (Therapy)_____________
1.8
- U V (Therapeutic)
1.9
- Electric Vibrator_________
1.10
- Vibrator Belt Massage_______________
2
With Mechanical Gadgets/Exercises
2.1
- Mechanical Tractions (Lumber & Cervical)
2.2
- Exercycle
2.3
- Shoulder Wheel
_
2.4
- Shoulder Pulley
_
_
J
L
k
__
L
;
L
____
____
■
2.5
- Supinator Pronator Bar
2.6
- Gripper
2.7
- Visco Weight Cuffs
_
_ ________ _
_
_
8
___________
IPHS for 301 to 500 Bedded District Hospitals
2.8
- Walking Bars_____________ ______
2.9
- Post Polio Exercise___________
2-10
- Obesity Exercises________________
2.11
- Cerebral Palsy - Massage______
2.12
- Breathing Exercises & Postural Drainage
Eye Specialist Services (Opthalmology)
J
I'
OPD Procedures
1.1
- Refraction (by using snellen’s chart)
1.2
- Refraction (by auto refrectro meter)
1.3
- Syringing and Probing
1.4
- Foreign Body Removal (conjuctival)
1.5
- Foreign Body Removal (Corneal)
1.6
- Epilation_________________
1.7
- Suture Removal______________
..1.8
' •
- Subconj Injection_____________
1.9
- Retrobular Injection (Alcohol etc.)
1 1.10
- Tonometry
1.11
- Biometry / Keratometry
I
1-12
- Automated Perimetry
r
1.13
■ Pterygium Excision
A14
- Syringing & Probing
1.15
-1 & C of chalazion
1.16
- Wart Excision_______
1.17
- Stye
1.18
- Cauterization (Thermal)
1.19
- Conjuctival Resuturing
1.20
- Corneal Scarping
1.21
-1 & D Lid Abscess
1.22
- Uncomplicated Lid Tear
1.23
- Indirect Opthalmoscopy
1.24
- Retinoscopy
1
I
E
si
p
■
!
4
9
f
IPHS tor 301 to 500 Bedded District Hospitals
r
2
IPD Procedures
2.1
- Examination under GA
2.2
- Canthotomy
2.3
- Paracentesis
2.4
- Air Injection & Resuturing__________
2.5
- Enucleation with Implant
I
_____
__
k
2.6
■ Enucleaion without Implant
2.7
- Perforating Coneo Scleral Injury Repair
r
2.8
- Cataract Extraction______________
2.9
- Glaucoma (Trabeculectomy)
2.10
- Cutting of Iris Prolapse___________
2.11
- Small Lid Tumour Excision
2.12
- Conjuctival Cyst__________
2.13
- Capsulotomy
2.14
- Ant. Chamber Wash
2.15
- Evisceration
ENT Services
k
r
____
_
r
_____
1
OPP Procedures____________
1.1
- Foreign Body Removal (Ear and Nose)
1.2
- Stitching of CLW’s______________
1.3
1.4
- Dressings____________________
- Syringing of Ear
1.5
- Chemical Cauterization (Nose & Ear)
1.6
- Eustachian Tube Function Test
1.7
- Vestibular Function Test/Caloric Test
2
2.1
Minor Procedures
. Therapeutic Removal of Granulations (Nasal, Aural, Oropharynx)
2.2
- Punch Biopsy (Oral Cavity & Oropharynx)
2.3
- Cautrization (Oral, Oropharynx, Aural & nasal)
3
Nose Surgery
3.1
- Nasal Endoscopy & Endoscopic Sinus Surgery
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IPHS for 301 to 500 Bedded District Hospitals
3,2
- Packing (Anterior & Posterior Nasal)____________________________
3.3
- Antral Punchure (Unilateral & Bilateral)___________________________
3.4
- Inter Nasal Antrostomy (nilateral & Bilateral)_______________________
3.5
-1 & D Septal Abscess (Unilateral & Bilateral)_______________________
3.6
-SMR
»3?7
- Septoplasty______________________________________________
3.8
- Fracture Reduction Nose________________________ ____________
3.9
- Fracture Reduction Nose with Septal Correction____________________
3.10
- Transantral Procedures (Biopsy, Excision of cyst and Angiofibroma Excision)
3.11
- -Transantral Biopsy
3.12
- Rhinoplasty____________
3.13
- Septoplasty with reduction of terbinate (SMD)______________________
4
Ear Surgery______________ ,
4.1
- Mastoid Abscess I & D
4.2
- Mastoidectomy___________________________________________
4.3
- Stapedotomy
4.4
■ Examination under Microscope
4.5
- Myringoplasty
4.6
-Tympanoplasty
4.7
- Myringotomy
4.8
- Ear Piercing
4.9
- Hearing Aid Analysis and Selection
5
Throat Surgery_______________
5.1
- Adenoidectomy
5.2
- Tonsillectomy
5.3
- Adenoidectomy + Tonsillectomy
5.4
- Tongue Tie excision
6i
Endoscopic ENT Procedures
6.1
- Direct Laryngoscopy
6.2
- Hypopharyngoscopy
6.3
■ Direct Laryngoscopy & Biopsy
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___ ______________________________
________________________
11
IPHS for 301 to 500 Bedded District Hospitals
6.4
- Broncoscopic Diagnostic
6.5
- 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)
Obstetric & Gynecology Specialist Services
1
Episiotomy
2
Forcepsdelivery_________________
3
Craniotomy-Dead Fetus/Hydrocephalus
4
Caeserean section
5
Female Sterilisation ( Mini Laparotomy & Laparoscopic)
6
D&C
7
MTP
8
Hysterectomy
9
Bartholin Cyst Excision_________
10
Suturing Perimeal Tears
11
Ovarian Cystectomy / Oophrectomy
12
Vaginal Hysterectomy
13
Haematocolpes Drainage Colpotomy
14
Gasserian Hystrectomy
15
Assisted Breech Delivery
16
Cervical Biopsy
17
Cervical Cautery
18
Nomal Delivery
19
Gasserian
20
EU A
21
Midtrimestor Abortion
22
Ectopic Pregnancy Ruptured
_____________ _____
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IPHS for 301 to 500 Bedded District Hospitals
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Retain Placenta
24
Suturing Cervical Tear
|251., Assisted Twin Delivery
II
Dental Services
Dental Caries/Dental Abcess/Gingivitis
1
.Cleaning
Periodontitis
2
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Minor Surgeries, Impaction, Flap
4
Malocclusion
Prosthodontia (Prosthetic Treatment)
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Maxillo Facial Surgeries______________________
9
Sub Mucus Fibrosis (SMF)
Neoplasms_______________________________
Scaling and Polishing
1
11
Root Canal Treatment________________________
p
12
Extractions________________ _______________
13
Light Cure ____________ ■ /
14
Amalgum Filling (Silver)
15
Sub Luxation and Arthritis of Temporomandibular Joints
16
Pre Cancerous Lesions and Leukoplakias__________
17
Intra oral X-ray_____________________________
18
Fracture wiring_____________________________
19
Apiscectomy______________________________
20
Gingivectomy______________________________
21
Removal of Cyst
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22
. .. ............................... ... ■
—----------------------------------------------------------------------------------
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I -SURGICAL
i —1 Abcess drainage including breast & perianal
I 2 Wound Debridement
I
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IPHS for 301 to 500 Bedded District Hospitals
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Appendicectomy
4
Fissurotomy or fistulectomy
5
Hemorrohoidectomy
6
Circumcision
7
8
Hydrocele surgery
Herniorraphy
9
Suprapubic Cystostomy
10
Urethral Dilatation
11
Cystoscopy
_
12
Endoscopy
____
13
Esophagoscopy
14
Diagnostic Laparoscopy
i
15
Colonoscopy_______
i
16
Sigmoidoscopy
17
Colposcopy
18
Hysteroscopy_______
19
Arthroscopy______
20
Tonsillectomy_____
21
Mastoidectomy
22
Stapedotomy
23
Craniotomy (Neurosurgical)
24
Episiotomy
25
Forceps delivery
26
Craniotomy-Dead Fetus/Hydrocephalus
27
Caesereansection
28
Female Sterilisation ( Mini Laparotomy & Laparoscopic)
29
Vasectomy
30
D&C
31
MTP
32
Hysterectomy
33
FNAC
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IPHS for 301 to 500 Bedded District Hospitals
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Intra-oral removal of submandibular duct Calculous
36
Excision Branchial Cyst or Fistula/sinus
37
Lingual Throid
38
Thyroid Adenoma Resection / Enucleation
39
Hemithyroidectomy (Sub total Thyroidectomy/Lobectomy)
40
Cysts and Benign Tumour of the Palate
41
Excision Submucous Cysts
1
Excision fibroadenoma - Lump
2
Simple Mastectomy
3
Halstead’s Radical, Mastectomy/Patey’s Operation
4
Sectoral Mastectomy/Microdochectomy/Lumpectomy
5
Wadge Biopsy
6
Excision Mammary Fistula
Hernia
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Breast
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Ingunial Hernia repair reinforcement
2
Ingunial Hernia repair with mesh
3
Femoral Hernia repair
4
Epigastric/Ventral Hernia repair
5
Recurrent Ingunial Hernia repair
•
6
Ventral Hernia repair with mesh
7
Strangulated Ventral or Incisional Hernia/lngunial
8
Recurrent Incisional Hernia
9
Diaphargmatic Hernia
Abdomen
1
Exploratory Laparotomy
2
Gastrostomy or Jejuncstomy
3___ Simple Closure of Perforated Ulcer
Reamstedt’s Operation
4
J
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Gastro-Jejunostomy
15
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IPHS for 301 to 500 Bedded District Hospitals
6
Vagotomy & Drainage Procedure
7
Adhesonolysis or division of bands
8
Mesenteric Cyst
9
Retroperitoneal Tumour Excision
10
Intussuception (Simple Reduction)
11
Burst Abdomen Repair__________
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Spleen and Portal Hypertension
1
Splenectomy
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Pancreas____________________
1
Drainage of Pseudopancreatic Cyst
2
Retroperitoneal Drainage of Abscess
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1
Emergency Appendisectomy
2
Interval Appendisectomy
3
Appendicular Abscess Drainage
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1
Resection and Anastomosis
2
Intussusception
3
Intestinal Fistula
4
Multiple Resection and Anaestomosis
5
Intestinal Performation
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1
Open Drainage of liver abscess______ _____ _
2
Drainage of Subdia, Abscess/Perigastric Abscess
B i I iary System
i
Cholecystostomy
2
Cholecystectomy
3
Cholecystectomy and Choledocholithotomy
■
Colon, Rectum and Anus
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Fistula in ane high level
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Catheters___________________
IV Sets__________
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Colostomy Bags______________
7
Ischiorectal Abscess___________
8
Ileostomy or colostomy alone_____
9
Perianal Abscess_____________
■
Sigmoid Myotomy,.
10
Right Hemicolectomy
11
Sigmoid & Descending Colectomy
12
13
14
15
Haemorroidectomy
Sphincterotomy of Fissurectomy
Tube Caecostomy____________ •
Closure of loop colostomy_______
16
Rectal Prolapse Repair
17
Anal Sphincter Repair after injury
18
Thiersch’s operation___________
19
Volvulus of colon
20
Resection anastomosis
21
Imperforate anus with low opening
22
Pilonidal Sinus*
Penis, Testes, Scrotum_______________________
1
2
Circumcision_______ ,
Partial amputation of Penis
________
3
Total amputation of Penis
_______
'4'
Orchidopexy (Unilateral & Bilateral)__________
_____ ____
Orchidectomy (Unilateral & Bilateral) ________
6
Hydrocele (Unilateral & Bilateral)
7
Excision of Multiple sebaceous cyst of scrotal skin
8
Reduction of Paraphimosis________________
________
■
Other Procedures
Suture of large laceration
I
17
II
IPHS for 301 to 500 Bedded District Hospitals
2
Suturing of small wounds
3
Excisionofsebaceouscyst____________
4
Small superficial tumour___________ _
5
Large superficial tumour___________
6
Repair torn ear lobule each___________
7
Incision and drainage of abscess
8
Lymph node biopsy___________ __
9
Excision Biopsy of superficial lumps
10
Excision Bipsy of large lumps_______ _
11
Injection Haemorrhoids/Ganglion/Keloids
12
Removal of foreign body (superficial)
13
Removal of foreign body (deep)
14
Excision Bipsy of Ulcer______________
15
Excision Multiple Cysts_____________ _
16
Muscle Biopsy___________________ _
17
Tongue Tie____________
18
Debridment of wounds___________ ___
19
Excisioncarbuncle________________
20
Ingroving Toe Nail__________________
21
Excision Soft Tissue Tumour Muscle Group
22
Diabetic Foot Asnd carbuncle
_
4
U rology
1
Pyelolithotomy____________
2
Nephrolithotomy__________
3
Simple Nephrostomy
4
Implantation of ureters Bilateral
5
Vesico-vaginal fistula
6
Nephrectomy____________
7
Uretrolithotomy
8
Open Prostectomy
9
Closure of Uretheral Fistula
I
18
IPHS for 301 to 500 Bedded District Hospitals
10
Cystolithotomy Superopubic
11
Difiilatition of stricture urethra under GA
12
Dialation of stricture urethra without anaesthesia
13
Meatotomy________________ __________
-I
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Testicular Biopsy______________________
J
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Trocar Cystostomy
J
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Burn Dressing Small, medium (10% to 30%), large 30% to 60%, extensive > 60%
2
Ear lobules repair one side (bilateral)_______________________________
3
Simple wound
4
Complicated wound___________________________________________
5
Face Scar - Simple___________________________________________
6
Cleft Lip - One side___________________________ ________________
7
Small wound skin graft_________________________________________
8
Simple injury fingers___________________________________________
9
Finger injury with skin graft _____ _______________________________
10
Multiple finger injury________________
11
Crush injury hand_____________________________________________
12
Full thickness graft
13
Congenitial Deformity (Extra digit, Syndactly, Constriction brings)___________
____________________________________________
_________________________________________
jZ Reconstruction of Hand (Tendon)
______________________________
15
Polio Surgery__________ ______
16
Surgery concerning disability with Laprosy___________________________
Surgery concerning with TB
Paediatric Surgery
1
Minor Surgery, I & D, Prepuceal Dilatation, Meatotomy_____________
2
Gland Bipsy, Reduction Paraphimosis, small soft Tissue tumour (Benign)
J
3
Rectal Polyp removal, deep abscess_________________________
8
4
Big soft tissue tumour_________ ___________________________
5
Branchial cyst/fistula/sinus_________________________________
6
Ingunial Herniotomy (Unilateral & Bilateral)
-1
19
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IPHS for 301 to 500 Bedded District Hospitals
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7
Orchidopexy 9Unilateral & Bilateral)
8
Pyoric Stenosis Ramsteadt operation
9
Exploratory Laprotomy ____________
10
Neonatal Intestinal Obstruction / Resection / Atresia
L
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Gastrostomy, colostomy__________ _ ________ _
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Umbilical Hernia / Epigastric Hernia
F
13
Sacrocaccygeal Teratoma____________________ _
14
Torsion of Testis______________
15
Hypospadius single stage (first stage)___________
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Orthopaedic Surgery________________ _________ '
1
Hip Surgery_________________ _____________ <
B
2
Femoral Neck nailing with or without plating replacement prosthesis / Upper Femoral
Osteotomy; Innominate Osteotomy/Open Reduction of Hip disclocation; DHS/Richard Screw
Plate________________
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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
Medical concyle 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
External Fixation Appleication Pelvis femur, tibia humerus forearm
9
Ext. fixation of hand & foot bones
10
Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula, lower and of Inia.
11
Drainage of fracture ______________ _____________ __ _____________________
12
Interlocking nailing of long bones
13
-------------------
14
Percutaneous Fixation (small and long bones)
15
Closed Reduction______________
16
Hand, Foot bone and cervicle_________
17
Forearm or Arm, Leg, Thigh, Wrist, Aknle
'
_____ _____________________________ _
Debridement & Secondary closure_____________ ______ ______________________
—
20
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Dislocation elbow, shoulder, Hip, Knee
19
Closed Fixation of hand / foot bone_______________
20
Open Reduction
21
Shoulder dislocation, knee dislocation
22
Acromiocalvicular or sternoclavicular Jt. Clavicle
23
Ankle Bimalleolar Open reduction, Ankle Trimalleolar open reduction
24
Wrist dislocation on intercarpal joints
25
MP & IP Joints
26
Knee Synovectomy / Menisectomy_______________
27
Fasciotomy leg/forearm_______________________
28
High Tibial Osteotomy____________________________________________
29
Arthodesis (Shoulder/Knee Ankle, Triple/elbow, Wrist/Hip)______________________
30
Arthodesis - MP & IP Joints
31
Excision Exostosis long bones, single / two____________________
32
Currentage Bone Grafting of Bone Tumour of fumur/tibia Humerus & forearm______
33
Surgery tumours of small bone hand and foot____________
_______________________________
34
‘ 35
Debridement primary closure of compounds fracture of tibia, femur forearm without fixation
36 ;
Debridement primary closure of compound fractures of tibia, femur forearm with fixation
37
Tendon surgery soft tissue release in club foot
Debridement of hand/foot
_________________________
<138
Internal fixation of small bone (Single, Two , More than two)
.39
Tendon Surgery (Repair and Lengthening)
40
Surgery of chronic''Osteomlitis (Saucerization,Sequentrectomy of femur, Humerus, Tibia)
41
Fibula Radius Ulna (Clavicle) and Wrist, Ankle, Hand foot________________________
42
Amputation (Thigh or arm, leg or forearm, feet or hand, digits)
i<43..
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Disarticulation of hip or shoulder (Disarticulation of knee elbow/wrist/ankle; Fore-quarter or
hind-quarter)
44
PPOP Application (Hip Spica, Shoulde’ spica POP Jacket; A-K/A-E POP; B-K/B-E POP)
45
Corrective Osteotomy of long bones_______________________________________
46
Excision Arthoplasty of elbow & other major joints; Excision Arthoplasty of small joints
47
Operation of hallus valgus
!
21
IPHS for 301 to 500 Bedded District Hospitals
48
Bone Surgery (Needle biopsy, Axial Skelton, Non-Axial)
49
Removal K Nail AO Plates
50
Removal Forearm Nail, Screw, Wires_____________
51
Skeltal Traction Femur, Tibia, Calcanlum, Elbow
52
Bone Grafting (small grafting and long bone)
53
------------------ -
54
Soft tissue Biopsy_____________
55
Skin Graft (small, medium and large)
56
Patellectomy
57
Olacranon fixation______________
58
Open Ligament repair of elbow, Ankle & Wrist
59
Arthrotomy of hip/shoulder/elbow
60
Carpal Tunnel Release______________
61
Dupuytrens contracture_____________
62
Synovectomy of major joint shoulder/hip/ Elbow
63
Repair of ligaments of knee
64
——------- ---- -------------------------------------—-———-------------------
65
External fixator readjustment dynamisation removal of external fixation/removal of implant
66
Excision of soft tissue tumour muscle group
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Closed Nailing of long bones
_
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IPHS for 301 to 500 Bedded District Hospitals
I
RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) FOR DIFFERENT
ILLNESSES CONCERNING DIFFERENT SPECIALITIES:
OBSTETRIC & GYNEACOLOGY
s.
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NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Treat
Treat
Treat
Yes
No
1
Bleeding during first trimester
•2Bleeding during second trimester
~3”
Bleeding during third trimester
4
Normal Delivery
5
Abnormal lablour (Mai presentation,
prolonged labour, PROM, Obstructed
labour)
6
PPH
7
Puerperal Spesis
8
Ectopic Pregnancy
9
Hypertentive disorders
Septic abortion
Medical disorders complicating
pregnancy (heart disease, diabetes,
hepatitis)____________________
Bronchial asthma
12
Gynaecology
RTI/STI
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2
Benign disorders (fibroid, prolapse,
3
ovarian masses) Initial investigation
at PHC/Grill level
________
4
Breast Tumors
Cnacer Cervix screening Initial
5
investigation at PHC / Grade III level
Cancer cervix /ovarian Initial
6
investigation at PHC / Gr III level
7
Infertility
Prevention of MTCT
8
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Treat
Treat
Treat
Treat
Treat
To
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10
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Treat
Treat
Treat
Treat
Investigate,treat and refer if necessary
Collection of PAP SMEAR and biopsy
Repairing Cytology & Hispothalogy
Treat________________________
Treat
Pretest andpost test andcounselling and
treatment
Treat
Yes
ia
MTP / MVA services
Tubectomy
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IPHS for 301 to 500 Bedded District Hospitals
GENERAL MEDICINE
S.
No
7“
NAME OF THE ILLNESS
Fever -a) Short duration (<1 week)
Fever -b) Long duration (>1 week)
c) Typhoid
______
_
d) Malaria / Filaria______________
e) Pulmonary Tuberculosis._________
f) Viral Hepatitis
_
g) Leptospirosis / Menningitis and
Haemorrhagic fever
_____
h) Malignancy______________
COMMON RESPIRATORY ILNESSES
2
Bronchial Asthma / Pleuraleffusion /
RECOMMENDED service mix
(SUGGESTED ACTIONS)
Basic investigation and Treatment
Investigation and treatment
r
Treat
Treat
i
Treat
Treat If HBs, Ag +ve refer to tertiary care
I
Confirm by MAT / CSF Analysis and
treat
_____________
'Confirm diagnosis refer to tertiary care
I
Diagnose and Treat
Pneumonia / Allergic Bronchitis/COPD
[
COMMON CARDIAC PROBLEMS
3
a) Chest pain (I HD)_____________
b) Giddiness (HT)______________
4
a)
5
a)
b)
a)
Anaemia
___
Bleeding disorder
Malignancy _____________
'
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8
Investigate and treat
Gallblader disorder____________
AGE / Dysentry / Diarrhoreas
NEUROLOGY_________
Chronic Hpeadache____________
Chronic Vertigo/CVA/TIA/Hemiplegia/
Paraplegia
_________ _
HAEMATOLOGY
b)
c)
7
Diagnose and treat_____
G 1 TRACT________ __________
G I Bleed / Portial hypertension /
6
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Treat
Investigate, treat & decide further
I '
Treat
Basic investigation and Treatment
Stabilise Ref; To tertiary
Treat & decide further
__
£
Treat
Cholera
Measles
Mumps
Chickenpox
_
Psychological Disorders
Acute psychosis / Obsession /
Anxiety neurosis
t
Treat
24
I
IPHS for 301 to 500 Bedded District Hospitals
I
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PAEDIATRICS_____________
S.
No
NAME OF THE ILLNESS
Bl
ARI/ Bronchitis Asthmatic
2
Diarrohoeal Diseases
3
Protein Energy Malnutrition and
Vitamin Deficiencies
4
Pyrexia of unknown origin
5
Bleeding Disorders
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Investigate
Diagnose
Nebulizator Oxygen___________________
I
Diagnose
Treat
ORT Center________________________
Investigate, then refer & then supportive
treatment in liaison with the specialized centre.
Diagnose
Treat with help of Dietician______________
Diagnose
Treat_____________________________
Investigate
1
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Treat____________________________
6
Investigate
Treat_____________________________
Investigate, then refer & then supportive
treatment in liaison with the specialized centre.
manage___________________________
Investigate
Manage___________________________
Investigate
Manage_________________________
Treat
Diseases of Bones and Joints
Childhood Malignancies
-I
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Liver Disorders
9
Paediatric Surgical Emergencies
10
Poisoning, Sting, Bites
11
Step down & follow up care for patients being managed from tertiary care hospital in liaison
with them for further management.
NEONATOLOGY
s.
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Attention at birth (to prevent illness)
5 cleans warm chain
3
Hypothermia
Birth asphyxia
Warm chain
Resuscitation And Treatment
Hypoglycemia
Investigate & Treat
Meconium aspiration syndrome
Treat
Convulsions (seizures)
Investigate & Treat
Neonatal Sepsis
Investigate & Treat
No
d
1
4
~5~
25
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8
9
10
11
12
13
14
15
16
17
18
LBW
______________
Neonatal Jaundice
Preterm ___________
Congenital malformations_____
Investigate & Treat__________
Treat_____ ________________ :_____
Warm chain, feeding, kangaroo care, Treat
Manage_________________ ________
Dangerously ill baby_________
Manage, CPAP
_____ _______
Identify and manage & refer appropriately
Feeding Problems
Identify and manage
Neonatal diarrhoea__________
Diagnosis and manage’
R.D.S, ARI_______________
Birth injury
_________
Manage
______
Manage________ ___________ ______
Neonatal Meningitis_________
Renal problems/Congenital heart
ndisease/Surgical emergencies
Refer
________ ________ _____________
19
20
21
22
HIV/AIDS___________
Exclusive breast feeding &manage
Hypocalcemia_____________
Manage
____________
Metabolic Disorders_________
manage
_______
Hyaline Membrane diseases
Diagnose & treat with CPAP
23
Neonatal Malaria__________
24
25
26
27
Blood disorders___________
Manage _____________
Manage________ ________ _
UTIs________________
CBR_______ _____________ _
Manage & refer
_______ __
Failure to Thrive
Manage & Refer__
Developmental Delays
I
DERMATOLOGY________
S.
No
1
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
NAME OF THE ILLNESS
Infections
a) Viral - HIV - Verrucca
Molluscum Contagiosa
Pityriasis Rosea
LGV
HIV_______________
b) Bacteria
Pyoderma
Chancroid________
Gonorrhea
Leprosy
Tuberculosis
Treat
_______________
I
Treat
k
Treat
k
L
hl
Treat
26
o
IPHS for 301 to 500 Bedded District Hospitals
-I
J
■ N'T
2
3
-I
-I:
T
-I
-1
4
5
6
TN"
_____
7
;_____
Tf
T
-I
' 1
2
N
3
4
6
£
Treat
Treat
Diagnosis and Treat
Treat
Treat
Treat
Treat/Refer
Treat
Treat
Treat
Treat
Treat
CHEST DISEASES
S.
No
-I
I
T
c) Fungal
Sup. Mycosis
Subcut - Mycetoma
d) Parasitic Infestation
Scabies / Pediculosis/Larva Migrans
e) Spirochaetes
Syphilis
Papulosquamous
Psoriasis (classical)-uncomplicated/
Lichen Planus
Pigmentary Disorder
Vitiligo____________________ ___
Keratinisation Disorder
Ichthyosis/Traumatic Fissures
Autoimmune
Collagen Vascular DLE, Morphea
Skin Tumors, Seb.Keratosis, Soft
Fibroma, Benign Surface,Tumors /
Cysts, Appendageal Tumors
Miscellaneous
a) Acne Vulgaris, Miliaria, Alopecia,
Nail disorder, Toxin induced
b) Leprosy - Resistant/Complications/
reaction Allergy - EMF / SJS /
TENPsoriasis/Collagen Vascular/
Auto immune Disorders >
c) Deep Mycosis, STD Complications
d) Genetically Determined Disorders
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Investigation and Treatment
Treatment CT Scan if necessary
NAME OF THE ILLNESS
Fever___________________
Cough with Expectoration / Blood
Stained__________________
Hemoptysis1_____________
Chest Pain_______________
Wheezing________________
Breathlessness
CT scan Bronchoscopy Treatment
Investigation and Treatment
Treatment, PFT_____________
Investigation and Treatment Chest
Physiotherapy
27
IPHS for 301 to 500 Bedded District Hospitals
PSYCHIATRY______________
NAME OF THE ILLNESS
S.
No
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Schizophrenia_________
Treatment and Follow up IP Management
2
Depression
Treatment and Follow up IP Management
3
Mania
Treatment and Follow up IP Management
4
Anxiety Disorders______
Treatment and Follow up IP Management
5
6
Mental Retardation
Treatment and Follow up IP Management
Other Childhood Disorders
Treatment and Follow up IP Management
7
Alcohol and Drug Abuse
Treatment and Follow up IP Management
8
Dementia
Treatment and Follow up IP Management
DIABETOLOGY____________
S.
NAME OF THE ILLNESS
No
I
I
F
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Screening for Diabetes
Diagnose and Treat
2
Gestational Diabetes/DM with Pregnancy
Diagnose and Treat_________
3
DM with HT_____________________
Diagnose and Treat____________ _
4
Nephropathy/Retinopathy___________
Diagnose and Treat________ '
5
Neuropathy with Foot Care__________
Diagnose and Treat
6
Emergency
i) Hypoglycemia
ii) Ketosis
iii) Coma
Diagnose and Treat
NEPHROLOGY
s.
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Uncomplicated UTI________________
Treat
2
Nephrotic Syndrome - Children/ Acute
Nephritis
Treat
3
4
Nephrotic Syndrome - Adults
HT, DM________________________
Refer to Tertiary follow up care
Treat_____________________
5
Asymptomatic Urinary Abnormalities
Treat_____________________
6
Nephrolithiasis
Treat_____________________
7
8
Acute renal Failure/ Chronic Renal Failure
Tumors
Treat___________________ __
No
28
Refer to Tertiary
h
r
I
I
IPHS for 301 to 500 Bedded District Hospitals
NEURO MEDICINE AND NEURO SURGERY
s.
-I
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Investigate and Treat
Investigate and Treat
Investigate and Treat
Investigate and Treat
Investigate and Treat
Investigate and Treat
• No
Epilepsy
2
C.V.A. ______________
3__ Infections
4
Trauma______________________
~5~~ Chronic headache
6 •
Chronic Progressive Neurological
disorder
,•
“i
hl
-1
GENERAL SURGERY
I
s7
NAME OF THE ILLNESS
No
1
Basic
Techniques
I !
■
Elective
Surgeries
I ?
•.h.
-
■
_ ■ ' '
Emergency
surgeries
I
I
4
3s-:
5
6
J
•J
Benign/
Malignant
Diseases
Others
Burns
T~ Medico legal
a. Minor Cases
under LA Abcess l&D/Suturing.Biopsy
' / Excision of Lipoma / Ganglion / Lymph
Node, Seb-Cyst / Dermoid / Ear Lobe
Repair / Circumcision____________
b. FNAC Thyroid, Breast Lumps,
Lymphnodes, Swelling____________
a. Genitourinary tract
Hydrocele,Hernia,Circumcision, Supra
pubic cysostomy,________________
b. Gastrointestinal disorder
Appendicitis/Anorectal
abcesses/Recfelprolapse/Liver
abscess/Haemorrhoids/Fistula
Assault injuries/Bowel injuries/Head
injuries/Stab injuries/Multiple injuries/
Perforation/lntestinal obstruction______
Breast/Oral/GItract/Genitourinary (Penis,
Prostate,Testis)
Thyroid, Varicose veins
Burns
<15%
>15%________ ______
a) Assualt/ RTA
b) Poisonings
c) Rape____________
d Postmortem
Treat
Investigate / Diagnosis /
Treatment
Treat
Treat
Treat
Treat
Treat
Treat
Treat
AR Entry/Treat
AR Entry/Treat
AR Entry/Treat
Done
29
!■
RECOMMENDED SERVICE
MIX(SUGGESTED ACTIONS)
IPHS for 301 to 500 Bedded District Hospitals
r
OPTHALMOLOGY__________
NAME OF THE ILLNESS
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
1
Superficial Infection
Treatment with drugs
2
Deep Infections
Treat
3
Refractive Error
Treat
4
Glaucoma_______________________
Treat
5
Eye problems following systemic disorders
Treat
6
Cataract ______________
Treat
7
Foreign Body and Injuries___________
Treat
8
Squint and Amblyopia/Corneal
Blindness(INF,INJ,Leucoma)/ Oculoplasty
Treat
r
u
_
9
Malignancy/Retina Disease
Treat
h
10
Paediatric Opthalmology
Treat
r
s.
No
__
-
______________
L
EAR, NOSE, THROAT
S.
No
k
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
NAME OF THE ILLNESS
L_
EAR
1
ASOM/SOM/CSOM
Treat/Surgical if needed
2
Otitis External / Wax Ears
Treat________
3
Polyps
Surgical Treatment
4
Mastoiditis
T reatment
Surgery if needed
5
Unsafe Ear
Surgery
r
II-
THROAT
1
Tonsillitis/Pharyngitis/Laryngitis
Treat
2
Quinsy ______________ __
Surgery________
3
Malignancy Larynx________
Biopsy/Treat
L
4
Foreign Body Esophagus
Treat (removal)
h
5
Foreign Body Bronchus_____
Treat
r
_____
30
1
r
IPHS for 301 to 500 Bedded District Hospitals
NOSE
I
1
Epistaxis
Treat
2
Foreign Body
Treat
3
Polyps
Treat
(Removal)
4
. a '
5
Sinusitis
Treat
(surgery if needed)
Septal Deviation
Treat
(surgery if needed)
ORTHOPADICS
S.
No
1
■
2
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)_______
Osteomyelitis_____________
Surgery
Rickets /Nutritional Defeciencies
Manage
with Physiotherapy
3
Poliomyelitis with residual
Deformities/JRA/RA
Joint Replacement / Rehab for Polio
4
RTA/Polytrauma
Manage
UROLOGY
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
NAME OF THE ILLNESS
S.
No
CHILDREN
~T
“|
. 1
Diagnose and refer
Hydronephrosis
2
! Urinary Tract Injuries______
Diagnose and refer
3
PUV/ Posterior Urethral Valve
Diagnose and refer
Cystic Kidney___________
Diagnose and refer
5
Urinary Obstruction
Urethrral Catheter Insertion SPC and
Referral
6
Undesended Testis
Diagnose and refer
7
Hypospadias and Epispadias
Diagnose and refer
8
Mega Ureter___________
Diagnose and refer
9
10
Extrophy______________
Diagnose and refer
Tumours - Urinary Tact
Diagnose and refer
V
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31
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I
IPHS for 301 to 500 Bedded District Hospitals
i
ADULT
All above and
Stricture Urethra
Treatment
2
Stone Diseases
Treatment/ Referral
3
Cancer - Urinary and Genital Tract
Treatment/ Referral
4
Trauma Urinary Tact
Treatment/ Referral
5
GUTB
Treatment/Referral/ Follow up
1
OLD AGE
I
tl
II
t(
J
a
a
« «
1
Prostate Enlargement and Urinary Retention
Treatment / Referral
2
Stricture Urethra
Treatment
3
Stone
Treatment/Referral
4
Cancer
(Kidney, Bladder, Prostate,Testis,Penis
and Urethra)
Treatment/Referral
Trauma Urinary Tract
Treatment/Referral
I
r
A
5
c
DENTAL SURGERY
I
SI.
No
Name of the Illness
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Dental Caries/Dental Abcess/Gingivitis
Treat
c
j
h
Cleaning
2
ii
Treat
Periodontitis
Surgery
7
3
Minor Surgeries, Impaction, Flap
Treat
4
Malocclusion
Treat with appliances
5
Prosthodontia (Prosthetic Treatment)
Treat with appliances
6
Trauma
Treat (wiring and plating)
7
Maxillo Facial Surgeries
Treat and refer
ci
8
Neoplasms
Treat and Refer if necessary
IV
si
p
(I
q
I
32
4
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IPHS for 301 to 500 Bedded District Hospitals
I
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7.
PHYSICAL INFRASTRUCTURE
7.1.
Size of the hospital
and horticulture services including herbal garden.
Local agency Guidelines and By-laws should strictly
be followed. A room for horticulture to store garden
‘
implements, seeds etc will be made available.
7.4.
Factors to be considered in locating a
district hospital
The size of a district hospital is a function of
the hospital bed requirement which in turn is a
function of the size of the population serve. In India
the population size of a district varies from 50,000
to 15,00,000. For the purpose of convenience the
average size of the district is taken in this document
as one million populations. 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 district having a population of 10 lakhs will be
as follows:
The total number of admissions per year =
10,00,000x 1/50 = 20,000
Bed days per year = 20,000 x 5 = 100,000
Total number of beds required when
occupancy is 100% = 100000/365 = 275
Total number of beds required when
occupancy is 80% = 100000/365 x 80/100
Area of the hospital
An area of 65-85 m2 per bed has been
considered to bejeasonable. The area will include
the service areas such as waiting space, entrance
hall, registration counter, etc. In case of specific
requirement of a hospital, flexibility in altering the
area be kept.
Site information
7.3.
Physical description of the area which
should include bearings, boundaries, topography,
surface area, land used in adjoining areas, limitation
of the site that would affect planning, maps of vicinity
and landmarks orcenters, existing utilities, nearest
city, port, airport, railway station, major bus stand,
rain fall and data on weather and climate. Hospital
Management Policy should emphasize on quake
proof, fire proof and flood proof buildings.
Infrastructure should be eco-friendly and disabled
(physically and visually handicapped) friendly.
Provision should be made for water harvesting,
generating back-up, solar energy / power back-up,
The location may be near the residential
area.
7.2.
-
Too old building may be demolished and
new construction done in its place.
It should be free from dangers of flooding; it
must not, therefore, be sited at the lowest
point of the district.
It should be in an area free of pollution of
any kind, including air, noise, water and land
pollution.
It must be serviced by public utilities: water,
sewage and storm-water disposal,
electricity, gas and telephone. In areas
where such utilities are not available,
substitutes must be found, such as a deep
well for water, generators for electricity and
radio communication for telephone.
Necessary environmental clearance will be
taken.
Disability Act will be followed.
Site selection criteria
7.5.
A rational, step-by-step process of site
selection occurs only in ideal circumstances. In
some cases, the availability of a site outweighs other
rational reasons for its selection, and planners arid
architects are confronted with the job of assessing
whether apiece of land is suitable for building a
hospital. In the case of either site selection or
evaluation of adaptability, the following items must
be, considered: size, topography, drainage, soil
conditions, utilities available, natural features and
limitations.
7.6
In the already existing structures of a
district hospital
It should be examined whether they fit into
33
IPHS for 301 to 500 Bedded District Hospitals
and venereology, psychiatry, neonatology,
orthopaedic and social service department.
The clinics for infectious and communicable
diseases should be located in isolation,
preferably, in remote corner, provided with
independent access. For National Health
Programme, adequate space be made
available.
the design of the recommended structure
and if the existing parts can be converted
into functional spaces to fit in to the
recommended standards.
If the existing structures are too old to
become part of the new hospital, could they
be converted to a motor pool, laundry, store
or workshop or for any other use of the
district hospital.
Nursing Services
Various cfinics under Ambulatory Care Area
require nursing facilities in common which
include dressing room, side laboratory,
injection room, social service and treatment
rooms, etc.
If they are too old and dilapidated then they
must be demolished. And new construction
should be put in place.
7.7.
Building and Space Requirements
Administrative Block:
!
Nursing Station
Administrative block attached to main
hospital along with provision of MS Office and other
staff will be provided.
On an average, one nursing station per ward
will be provided. However, it should be
ensured that nursing station caters to about
40-45 beds. Out of these half will be for acute
and chronic patients.
Circulation Areas
Circulation areas like corridors, toilets, lifts,
ramps, staircase and other common spaces etc. in
the hospital should not be more than 55% of the
total floor area of the building.
Diagnostic Services
Imaging
Floor Height
Role of imaging department should be radio
diagnosis and ultrasound along with hire
facilities depending on the bed strength. The
department should be located at a place
which is accessible to both OPD and wards
and also to operation theatre department.
The size of the room should depend on the
type of instrument installed. The room should '
have a sub-waiting area with toilet facility
and a change room facility, if required. Film
developing and processing (dark room) shall
j
be provided in the department for loading,
unloading, developing and processing of Xray films. Separate Reporting Room for
doctors should be there.
The room height should not be less than
approximately 3.6 m measured at any point from
floor to floor height.
Entrance Area
Physical Facilities
Ambulatory Care Area (OPD)
Waiting Spaces
Registration, assistance and enquiry counter
facility be made available in all the clinics.
Main entrance, general waiting and
subsidiary waiting spaces are required
adjacent to each consultation and treatment
room in all the clinics.
Clinics
Clinical Laboratory
The clinics should include general, medical,
surgical, ophthalmic, ENT, dental, obsetetric
and gynaecology, paediatrics, dermatology
For quick diagnosis of blood, urine, etc., a
small sample collection room facility shall be
provided.
34
IPHS for 301 to 500 Bedded District Hospitals
room, treatment room, nursing store along
with wards and toilets as per the norms. On
an average one nursing station per ward will
be provided. It should be ensure that nursing
station caters to above 40-45 beds, out of
which half will be for acute and chronic
patients.
Separate Reporting Room for doctors
should be there.
Blood Bank
1
3
a
1
t
i
Blood bank shall be in close proximity to
pathology department and at an accessible
distance to operation theatre department,
intensive care units and emergency and
accident department.
Private ward: Depending upon the
requirement of the hospital and catchment
area appropriate beds may be allocated for
private facilities. However, 10% of the total
bed strength is recommended as private
wards beds.
Blood Bank should follow all existing
guidelines and fulfill all requirements as per
the various Acts, pertaining to setting up of
the Blood Bank.
Separate Reporting Room for doctors
should be there.
Pharmacy (Dispensary)
The pharmacy should be located in an area
conveniently accessible from all clinics. The
size should be adequate to contain 5 percent
of the total clinical visits to the OPD in one
session.
Intermediate Care Area (Inpatient
Nursing Units)
General
Nursing care should fall under following
categories:
Pharmacy should have component of
medical store facility for indoor patients and
separate pharmacy with accessibility for
OPD patients.
General Wards - Male / Female
Private Wards:
Wards for Specialities
I
j
Intensive Care Unit and High Dependency Wards
Depending upon the requirement of the
hospital and catchment area, appropriate
beds may be allowed for private facility. 10%
of the total bed strength is recommended
as private wards beds.
General
In this unit, critically ill patients requiring
highly skilled life saving medical aid and
nursing care are concentrated. These
should include major surgical and medical
cases, head injuries, severe haemorrhage,
acute coronary occlusion, kidney and
respiratory catastrophe, poisoning etc. It
should be the ultimate medicare the hospital
can provide with highly specialized staff and
equipment. The number of patients requiring
intensive care may be about 2 to 5 percent
total medical and surgical patients in a
hospital. The unit shall not have less than 4
beds nor more than 12 beds. Number of
beds will be restricted to 5% of the total bed
strength. Out of these, they can be equally
divided among ICU and High Dependency
Location
I
i
I
I
Location of the ward should be such to
ensure quietness and to'control number of
visitors.
Ward Unit
The basic aim in planning a ward unit should
be to minimize the work of the nursing staff
and provide basic amenities to the patients
within the unit. The distances to be traveled
by a nurse from bed areas to treatment
room, pantry etc. should be kept to the
minimum. Ward unit will include nursing
station, doctors' duty room, pantry, isolation
35
I
IPHS for 301 to 500 Bedded District Hospitals
Therapeutic Services
Wards. For example, in a 500-bedded
hospital, total of 25 beds will be for Critical
Care. Out of these, 13 may be ICU beds
and 12 will be allocated for High
Dependency Wards. Changing room should
be provided for.
Operation Theatre
Location
This unit should be located close to
operation theatre department and other
essential departments, such as, X-ray and
pathology so that the staff and ancillaries
could be shared. Easy and convenient
access from emergency and accident
department is also essential. This unit will
also need all the specialized services, such
as, piped suction and medical gases,
uninterrupted electric supply, heating,
ventilation, central air conditioning and
efficient life services. A good natural light"
and pleasant environment would also be of
great help to the patients and staff as well.
Number of beds for both the units will be
restricted to 5% of the total bed strength.
Out of these, they can be equally divided
among ICU and High Dependency Wards.
For example, in a 500 bedded hospital, total
of 25 beds will be for critical care. Out of
these 13 may be ICU beds and 12 will be
allocated for high dependency wards.
Facilities
Nurses Station
Clean Utility Area
Equipment Room
Critical Care Area (Emergency Services)
It should preferably have a distinct entry
independent of OPD main entry so that a
very minimum time is lost in giving
immediate treatment to casualities arriving
in the hospital. There should be an easy
ambulance approach with adequate space
for free passage of vehicles and covered
area for alighting patients.
36
Operation theatre usually have a team of
surgeons anesthetists, nurses and
sometime pathologist and radiologist
operate upon or care for the patients. The
location of Operation theatre should be in a
quite environment, free from noise and other
disturbances, free from contamination and
possible cross infection, maximum
protection from solar radiation and
convenient relationship with surgical ward,
intensive care unit, radiology, pathology,
blood bank and CSSD. This unit also need
constant specialized services, such as,
piped suction and medical gases, electric
supply, heating, air-conditioning, ventilation
and efficient life service, if the theatres are
located on upper floors. Zoning should be
done to keep the theatres free from micro
organisms. There may be four well defined
zones of varying degree of cleanliness
namely, Protective Zone, Clean Zone,
Aseptic or Sterile Zone and Disposal or Dirty
Zone. Normally there are three types of
traffic flow, namely, patients, staff and
supplies. All these should be properly
channelized. An Operation Theatre should
also have Preparation Room, Pre-operative
Room and Post Operative Resting Room.
Operating room should be made dust-proof
and moisture proof. There should also be a
Scrub-up room where operating team
washes and scrub-up their hands and arms,
put on their sterile gown, gloves and other
covers before entering the operation theatre.
The theatre should have sink / photo sensors
for water facility. Laminar flow of air be
maintained in operation theatre. It should
have a central air conditioning facility. It
should have a single leaf door with self
closing device and viewing window to
communicate with the operation theatre. A
IPHS for 301 to 500 Bedded District Hospitals
pair of surgeon’s sinks and elbow or knee
operated taps are essential. Operation
Theatre should also have a Sub-Sterilizing
unit attached to the operation theatre limiting
its role to operating instruments on an
emergency basis only.
f
t
toilets separate for male and female.
Normative standards will be followed.
Hospital Services
Hospital Kitchen (Dietary Service)
The dietary service of a hospital is an
important therapeutic tool. It should easily
be accessible from outside along with
vehicular accessibility and separate room for
dietician and special diet. It should be
located such that the noise and cooking
odours emanating from the department do
not cause any inconvenience to the other
departments. At the same time location
should involve the shortest possible time in
delivering food to the wards.
Theatre refuse, such as, dirty linen, used
instruments and other disposable / non
disposable items should be removed to a
room after each operation. Non-disposable
instruments after initial wash are given back
to instrument sterilization and rest of the
disposable items are disposed off and
destroyed. Dirty linen is sent to laundry
through a separate exit. The room should
be provided with sink, slop sink, work bench
and draining boards.
r
Central Sterile and Supply Department
(CSSD)
Delivery Suite Unit
As the operation theatre department is the
major consumer of this service, it is
recommended to locate the department at
a position of easy access to operation
theatre department. It should have a
provision of hot water supply.
The delivery suit unit be located near to
operation theatre.
The delivery Suit Unit should include the
facilities of accommodation for various
facilities as given below:
Reception and admission
Examination and Preparation Room
Labour Room (clean and a septic room)
Delivery Room
Neo-natal Room
Sterilizing Rooms
Sterile Store Room
Scrubbing Room
Dirty Utility
Physiotherapy
i.
The physiotherapy department provides
treatment facilities to patients suffering from
crippling diseases and disabilities. The
department is more frequently visited by out
patients but should be located at a place
which may be at convenient access to both
outdoor and indoor patients with privacy. It
should also have a physical and electro
therapy rooms, gymnasium, office, store and
Hospital Laundry
It should be provided with necessary
facilities for drying, pressing and storage of
soiled and cleaned linens.
Medical and General Stores
There are of medical and general store
should have vehicular accessibility and
ventilation, security and fire fighting
arrangements.
Mortuary
It provides facilities for keeping of dead
bodies and conducting autopsy. It should be
so located that the dead bodies can be
transported unnoticed by the general public
and patients.
Engineering Services
Electric Engineering
Sub Station and Generation
37I
IPHS for 301 to 500 Bedded District Hospitals
Electric sub station and standby generator
room should be provided.
Separate provision for fire fighting and water
softening plants be made available.
Illumination
Drainage and Sanitation
The illumination and lightning in the hospital
should be done as per the prescribed
standards.
The construction and maintenance of
drainage and sanitation system for waste
water, surface water, sub-soil water and
sewerage shall be in accordance with the
prescribed standards. Prescribed standards
and local guidelines shall be followed.
Emergency Lighting
Shadow less light in operation theatre and
delivery rooms should be provided.
Emergency portable light units should be
provided in the wards and departments.
Waste Disposal System
National Guidelines on Bio-Medical Waste
Management and a Notification of
Environment and Forests are at Annexure I
Call Bells
Call bells with switches for all beds should
be provided in all types of wards with
indicator lights and location indicator
situated in the nurses duty room of the
wards.
Fire Protection
Ventilation
Telephone and Intercom
The ventilation in the hospital may be
achieved by either natural supply or by
mechanical exhaust of air.
Medical Gas
Cooking Gas: Liquefied petroleum gas
(LPG)
Laboratory Gas: Liquefied petroleum gas
(LPG) and other specified
gases.
Trauma Centre
Guidelines to be followed
Mechanical Engineering
Air-conditioning and Room Heating in
operation theatre and neo-natal units should
be provided. Air coolers or hot air
convectors may be provided for the comfort
of patients and staff depending on the local
needs.
Building Maintenance: Provision for
building maintenance staff.and an office-cum store
will be provided to handle day to day maintenance
work
Parking: Sufficient parking place as per the
norms will.be provided
Administrative Services: Two sections (i)
General section to deal with overall upkeep of the
hospital and welfare of its staff and patients (ii)
Medical Records section.
Hospital should be provided with water
coolers and refrigerator in wards and
departments depending upon the local
needs.
Public Health Engineering
Committee Room: A meeting or a
committee room for conferences,
trainings with associated furniture.
Water Supply
Arrangement should be made for round the
clock piped water supply along with an
overhead water storage tank with pumping
and boosting arrangements. Approximately
10000 litres of potable water per day is
required for a 100 bedded hospital.
Residential Quarters
All the essential medical and para-medical
staff will be provided with residential
accommodation.
38
IPHS for 301 to 500 Bedded District Hospitals
8. MANPOWER REQUIREMENTS
8.1.
MAN POWER - DOCTORS
f
i
S. No
I
__X_
Staff
District Headquarters Hospital
301-500 Bedded
Chief Medical Superintendent
1
2
Medical Specialist
4
3
Surgery Specialists
3
4
O&G specialist
8
5
Psychiatrist
1
6
Dermatologist / Venereologist
2
7
Paediatrician
4
8
Anesthetist (Regular / trained)
8
9
ENT Surgeon.
2
10
Qpthalmologist
2
11
Orthopedician
2
12
Radiologist
5
13
Microbiologist
1 Recruited in Integrated Disease
Surveillance Programme
14
Pathologist and Blood Bank In-charge
15
^Say-
Casualty Doctors / General
Duty Doctors
16
Dental Surgeon
1
17
Forensic Specialist
1
18
Public Health Manager1
1
19
AYUSH Physician2
4 (2 specialists and 2 GDMOs)
20
Environmental Officer
1
21
Waste Management Officer
1
Total
77
Wls
1
24 (at least 10 lady doctors of
allopathy)
1 May be a Public Health Specialist or Management Specialist trained in public health.
2 Provided there is no AYUSH Hospital/dispensary in the District Headquarter.
39
IPHS for 301 to 500 Bedded District Hospitals
8.2.
MAN POWER - PARA MEDICAL
District Headquarters Hospitai
301-500 Bedded
Staff
S. No
200-250
1
Staff Nurse
2
Infection Control Nurse____________ __
2
3
Hospital worker (OP/ward +OT+ blood bank)
50
4
Sanitary Worker____________
30
5
Ophthalmic Assistant / Refractionist
2
6
Social Worker / Counsellor
2
7
Dermatology/STD/Leprosy Technician - Lab
1
8
AIDS/STD Counselor cum field Support
9
Cytotechnician
1
10
ECG Technician
1
11
ECHO Technician
1
12
Audiometrician
1
13
Laboratory Technician ( Lab + Blood Bank)
6+3
14
Laboratory Attendant (Hospital Worker)
2+1
15
Dietician
2 ’
16
PFT Technician
1
17
Maternity assistant (ANM)
4
18
Radiographer
12
19
Dark Room Assistant
8
20
Pharmacist1
10
21
Matron
9
22
Physiotherapist
2
23
Statistical Assistant
1
24
Medical Records Officer/Technician
2
25
Electrician
2
26
Plumber
2
s
l
2 Dedicated
■
ItfiB
A
11 nq 1
1
5
1 Two from AYUSH.
40
pr*5’
!^r
IPHS for 301 to 500 Bedded District Hospitals
8.3.
MANPOWER- ADMINISTRATIVE STAFF
S. No
Staff
1
2 .
3
4
5
6
7
8
9
10
Hospital Superintendent
Manager (Administration & Procurement)
Manager (Finance)
Manager (HR)
Account Officer
Accountant
Assistant oum Computer Operator
Driver
”
—
Peon
District Headquarters Hospital
plus JD-HS office
301-500 Bedded
1
1
1
1
1
4
6
4
2
2
23
—
——r—
Security Staff*
Total
~
* The number would vary as per requirement and to be outsourced.
8.4.
MAN POWER - OPERATION THEATRE
SI. No Category
Emergency /
FWOT
OPTH/
ENT
A&E
Elective
5
2
1
3
OT Assistant
4
2
2
2
Sweeper
2
1
1
1
Total
11
5
4
6
Staff Nurse
2
3
■
8.5.
■
'
■;
District Headquarters Hospital
301-500 Bedded
4-
MAN POWER - BLOOD BANK
Blood Bank
Staff
S. No
Blood Bank In-charge (Doctor - Pathologist)
1
2
Staff Nurse
3
o
MNA/FNA
1
4
Blood Bank Technician
1
5
Sweeper
1
41
IPHS for 301 to 500 Bedded District Hospitals
9.
EQUIPMENT NORMS
Equipment norms are worked out keeping in mind the assured service recommended for various
grades of the district hospitals. The equipments required are worked out under the following headings
Imaging equipments
X Ray Room Accessories
Cardiac Equipments
Labour ward & Neo Natal Equipments
Ear Nose Throat Equipments
Eye Equipments
Dental Equipments
Operation Theatre Equipment
Laboratory Equipments
Surgical Equipment Sets
Physio Therapy Equipments
Endoscopy Equipments
Anaesthesia Equipments
Funriture & Hosptial Accessories
PM equipments
Linen
Teaching Equipments
Administration
Refrigeration & AC
Hospital Plants
Hospital Fittings & Necessities
Transport
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
A
I. IMAGING EQUIPMENT_________________
S. No.
1
2
3
4
5
6
7
8
9
10
District Headquarters Hospital
301-500 Bedded
1
500 M.A. X-ray machine*____________
1
300 M.A. X-ray machine_____________
1
100 M.A. X-ray machine_____________
1
60 M.A. X-ray machine (Mobile)_______
1
C arm with accessories *__________ ,
1
Dental X ray machine______________
___
2+1 ■
Ultra Sonogram (Obs & Gyne. department
should be having a separate ultra-sound
machine of its own)________________
1
C.T. Scan_______________________
1
Mammography Unit *__________ ___
tti
1
Echocardiogram*
Name of the Equipment
* To be provided as per need.
42
QI
F
IPHS for 301 to 500 Bedded District Hospitals
II. X-RAY ROOM ACCESSORIES
S. No.
y Y'.’WW
Name of the Equipment
District Headquarters Hospital
301-500 Bedded
1
X-ray developing tank
2
Safe light X-ray dark room
3
4
Cassettes X-ray______
4; J
X-ray lobby single
5
X-ray lobby Multiple
1
6
Lead Apron
3
7
Intensifying screen X-ray
3
3
■
■
■/.
4
<
20
•
10
III. CARDIAC EQUIPMENTS
S. No.
■
Name of the Equipment
District Headquarters
Hospital 301-500 Bedded
1
ECG machine computerized________
1
2
ECG machine ordinary
2
3
12 Channel stress ECG test equipments
Tread Mill *
1
- '4^
Cardiac Monitor
6
5
Cardiac Monitor with defibrillator
2
Ventilators (Adult)
2
7'
Ventilators (Paediatrics)
1
8
Pulse Oximeter
6
9
Pulse Oximeter with NIB.P*
1
10
Infusion pump________________
2
11
B.P.apparatus table model_______
20
12
B.P.apparatus stand model
20
13
Stethoscope
30
. 6
* To be provided as per need.
J
43
IPHS for 301 to 500 Bedded District Hospitals
IV. LABOUR WARD & NEO NATAL EQUIPMENTS
S. No.
District Headquarters
Hospital 301-500 Bedded
Name of the Equipment
1
Baby Incubators
2
2
Phototherapy Unit
4
3
Emergency Resuscitation Kit-Baby
4
4
Radiant Warmer
5
5
Room Warmer
2-
6
Foetal Doppler
2
7
CTG Monitor
3
8
Delivery Kit
20
9
Episiotomy kit
10
10
Forceps Delivery Kit
3
11
Crainotomy
1
12
Vacuum extractor metal
2
13
Silastic vacuum extractor
3
14
Pulse Oximeter baby & adult
2 each
15
Cardiac monitor baby &
2 each
16
Nebulizer baby
2
17
Weighing machine adult
4
18
Weighing machine infant
4
19
CPAP Machine
1
20
Head box for oxygen
8
441
_______
-
IPHS for 301 to 500 Bedded District Hospitals
V. EAR NOSE THROAT EQUIPMENT
S. No.
Name of the Equipment
District Headquarters
Hospital 301-500 Bedded
1
Audiometer
2
2
Operating Microscope (ENT)
2
3
Head light (ordinary) (Boyle Davis)
3
4
ENT Operation set including headlight,
Tonsils
2
5
Mastoid Set
2
6
Micro Ear Set myringoplasty
2
7
Stapedotomy Set
1
8
ENT Nasal Set (SMR, Septoplasty,
Nasal Endoscopic Set (o° & 30°)
Polypetcomy, DNS, Rhinoplasty)
2
9
Laryngoscope fibreoptic ENT
1
10
Laryngoscope direct
2
11
Otoscope
4
12
Oesophagoscope Adult
13
Oesophagoscope Child
1
14
Head Light (cold light)
2
15
Tracheostomy Set
2
16
Tuning fork
4
1
s
i
17
Bronchoscope Adult & Child
2
18
Examination instruments set
(speculums, tongue dipressors, mirrors,
Bull’s lamp)
4
<45
I
IPHS for 301 to 500 Bedded District Hospitals
VI. EYE EQUIPMENTS
Name of the Equipment
District Headquarters
Hospital 301-500 Bedded
1
Cryo Surgery Unit
2 dedicated to dermatology
OPD
2
Opthalmoscope - Direct
3
3
Slit Lamp
2
S. No.
— r -
4
Retino scope
1 '
5
Perimeter
2
6
IOL Operation set
3
7
Laser Photocoagulometer*
1
* - to be supplied by Blindness Control Society
VII. DENTAL EQUIPMENTS
S. No.
Name of the Equipment
District Headquarters
Hospital 301-500 Bedded
■
1
Air Rotor
1
2
Dental Unit with motor for dental OP
1
3
Dental Chair
1
4
________
4
Dental Lab
________
5
Dental Kit
4
46
_
A
IPHS for 301 to 500 Bedded District Hospitals
VIII. OPERATION THEATRE EQUIPMENT
S. No.
District Headquarters
Hospital 301-500 Bedded
Name of the Equipment
j
Auto Clave HP Horizontal__________
1
2
Auto Clave HP Vertical (2 bin)______
4
3
Operation Table Ordinary Paediatric*
4
Operatibn Table Hydraulic Major
4
5
Operation table Hydraulic Minor_____
4
6
Operating table non-hydraulic field type
2
Operating table Orthopedic *_______
1
__ 8
Autoclave with Burners 2 bin*_______
9
Autoclave vertical single bin________
2
10
Shadowless lamp ceiling type major*
3
11
Shadowless lamp ceiling type minor*
2
12
Shadowless Lamp stand model
3
13
Focus lamp Ordinary_____________
4
14
Sterilizer big (Instrument)__________
4
15
Sterilizer Medium (Instrument) -
6
16
Steriliser Small (Instruments)
£
__ 17
Bowl Steriliser - big*
_4
__ 18
Bowl steriliser - Medium*__________
1
19
Diathermy Machine (Electric Cautery)
2
20
Suction Apparatus - Electrical
6
21
Suction Apparatus ■ Foot operated
5
22
Dehumidifier*__________________
1
23
Dosimetered Narrow band UV-B lamp
- machine for urb photo therapy
24
Ultra violet lamp philips model 4 feet
25
Ethylene Oxide sterilizer*_________
26
Microwave sterilizer*
2
27
Intense Pulse Light Machine
1
* To be provided as per need.
47
8
I
IPHS for 301 to 500 Bedded District Hospitals
I
IX. LABORATORY EQUIPMENTS
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
25
26
27
28
29
30
31
32
33
34
35
Name of the Equipment
Binocular Mircroscope____________
Chemical Balances______________
Simple balances__________ ;
Electric Colorimeter______________
Auto analyser *_________________
Semi auto analyser______________
Micro pipettes of different volume range
Water bath____________________
Hot Air oven*_______ ___________
Lab Incubator*__________________
Distilled water plant______________
Electri centrifuge table top__________
Cell Counter Electronic*_____ _____
_Hot_plates_____________ Rotor / Shaker__________________
Counting chamber_______________
PH meter_____
Paediatric Glucometer / Bilirubinometer*
Glucometer____________________
Haemoglobinometer______________
TCDC count apparatus____________
ESR stand with tubes_____________
Test tube stands *_______________
Test tube rack *_________________
Test tube holders*_______________
Spirit lamps*
___________
Microtome*
__________
Oven (Wax embedding)*___________
Tissue processor*_________
Timer stop watch________________
Alarm clock____________
Elisa Reader cum washer_________
Blood gas analyser*_________
Blood Component Separator________
Biosafety Cabinet
48
District Headquarters
Hospital 301-500 Bedded
10_______ _
2_________
2_________
_2_________
1
1
10________
2______ _
2
3
2
K
3
1
6__________
-/ I
2
4
3
1 _______ _
2 ______ __
3
2
6
10-20_______
10-20
10-20
10
1
i
2
H
_2__________
2
■
1______ _
1______ _
1
t
j
i
IPHS for 301 to 500 Bedded District Hospitals
36
37
38
39
40
4
Refrigerators_________
Platelet Agetator_______
Platelet Thawing Machine
Laboratory Autoclaves
Laminar Flow
4
1
* To be provided as per need.
X. SURGICAL EQUIPMENT SETS
S. No.
i
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
P.S.set________ _____________
MTP Set_____________________
Biopsy Cervical Set*____________
District Headquarters
Hospital 301-500
_____ Bedded_____
_______ 2________
_______ 5________
_______ 2________
D & C Set____________________
_______ 5________
I.U.C.D. Kit___________________
LSCS set____________________
MVA Kit___________ __ _______
Vaginal Hysterectomy___________
_______ 2________
_______ 5________
_______ 3________
_______ 2________
Proctoscopy Set*___________ "
3_
P.V. Tray*__________ _
Abdominal Hysterectomy set______
Laparotomy Set _____________
Formaline dispenser____________
Kick Bucket__________________
General Surgical Instrument Set Piles,
Fistula, Fissure*
____________
3_______
_______ 2________
_______ 5________
_______ 5________
_______ 15_______
2
Knee hammer_________________
5
2
2
1
20
10
2
1
1
Name of the Equipment
Hernia, Hydrocele*__________
Varicosevein etc*______________
Gynaec Electric Cautery
Vaginal Examination set*_________
Suturing Set*_________________
MTP suction apparatus__________
Thoracotomy set_______________
Neuro Surgery Craniotomy Set
49
r
IPHS for 301 to 500 Bedded District Hospitals
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
I M Nailing Kit__________________
~SP Nailing
2
I
2
!
Compression Plating Kit*________ ■
AM Prosthesis*_________________
2.
1
1
1
Dislocation Hip Screw Fixation*_____
Fixation Fracture Hip_____________
Spinal Column Back Operation Set
Thomas Splint
____________
Paediatric Surgery Set____________
Mini Surgery Set*_______________ _
Urology Kit
______________
h
1
.10
2
2
2
Surgical Package for Cholecystectomy*
Surgical package for Thyroid_______
Gl Operation Set*_________ ______
■
_________
•
1
1
<
4
Appendicectomy set *____________
L.P.Tray*_____________
2
7
Uretheral Dilator Set_____________
6
1
TURP resectoscope *_________ '
Haemodialysis Machine *__________
Amputation set_________________
Universal Bone Drill_____________
Crammer wire splints_____________
-
2
Heamo dialysis machine___________
Skin Priopsy Sets___________
2
2
12
_____
2
___
_____
___
5
* To be provided as per need.
XI. PHYSIOTHERAPY EQUIPMENTS
S. No.
Name of the Equipment
District Headquarters
Hospital 301-500 Bedded
1
Skeleton traction set
3
2
Interferential therapy unit
2
WWW''
______
3
Short Wave Diathermy
1
50
Wt?;
K
IPHS for 301 to 500 Bedded District Hospitals
XII. ENDOSCOPY EQUIPMENTS
3
District Headquarters
Hospital 301-500 Bedded
Endoscope fibre Optic (OGD) *____________ __________1_________
Arthroscope______ 5_____ _ ____________ __________ 1_________
Laparoscope operating major with accessories * _________ 1_________
4
Laparoscope diagnostic and for sterilisation *
——5——.
Colonoscope and sigmoidoscope*
Hysteroscope *______
-_________
Colposcope ‘
S. No. Name of the Equipment
/'T
2
6
7
________ 2_________
_________ 1_________
1
1
* - to be provided as per need
XIII. ANAESTHESIA EQUIPMENTS
S. No.
District Headquarters
Hospital 301-500 Bedded
•|
Anaesthetic - laryngoscope magills with
four blades____________________
8
2
Endo tracheal tubes sets
3
3
Magills forceps (two sizes)
4
Connector set of six for E.T.T
10
Tubes connecting for ETT
10
>.■-5/.
I
Name of the Equipment
6
y
Air way female*
10
Air way male*
20
8
Mouth prop*_______ _ __________
10
9
Tongup depressors*
__________
15
10
02 cylyinder for Boyles____________
16
11
N2O Cylinder for Boyles___________
16
12
CO2 cylinder for laparoscope*_______
10
13
PFT machine
1
14
Boyles Apparatus with Fluotec and circle
absorber
2
15
Exchange Transfusion Sets*
* - to be provided as per need
pH
51
j
l
10
-
pH-WO
u-
Jtp
U
L*
IPHS for 301 to 500 Bedded District Hospitals
XIV. FURNITURE & HOSPITAL ACCESSORIES
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
25
26
27
28
29
30
31
32
I
District Headquarters Hospital
301-500 Bedded
Name of the Equipment
Doctor’s chair for OP Ward, Blood Bank,
Lab etc._______________________
Doctor’s Table___________________
60
:■
Foot Stools *____________________
Filing Cabinets (for records) *________
40
20
20
50
50
20
40
20
15
50
20
15
15
40
12
M.R.D.Requirements (record room use) *
1
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____________________
Paediatric cots with railings__________
Cradle*________________________
Fowler’s cot_____ _______________
Ortho Facture Table*__________ _
Hospital Cots (ISI Model)___________
Hospital Cots Paediatric (ISI Model)
Wooden Blocks (Set)*_____________
Back rest*______________________
Dressing Trolley (SS)______________
Medicine Almairah________________
Bin racks (wooden or steel)*_________
ICCU Cots_____________________
Bed Side Screen (SS-Godrej Model)A
Medicine Trolley(SS)______________
Case Sheet Holders with clip(S.S.)*
52
,
J
■
10
_____ 7_____
_____ 3_____
1
,480
40
7
10
10
5
15
_____ 8_____
As per requirement
10
150
IPHS for 301 to 500 Bedded District Hospitals
33
34
35
36
37
38
39
40
41
42
43
0
7
Instrument Trolley (SS)
Instrument Trolley Mayos (SS)
Surgical Bin Assorted
Wheel Chair (SS)
j5
Stretcher / Patience Trolley (SS)
Instrument Tray (SS) Assorted
Kidney Tray (SS) - Assorted_____
Basin Assorted (SS)
Basin Stand Assorted (SS)
(2 basin type)
(1 basin type)__________ -
Delivery Table (SS Full)________
44
45
46
47
48
49
Blood Donar Table*
02 Cylinder Trolley(SS)________
Saline Stand (SS)____________
Waste Bucket (SS)*___________
50
Bed Pan (SS)*_________ _
51
Urinal Male and Female________
Name Board for cubicals*_______
Kitchen Utensils* >_____ ______
Containers for kitchen*_________
52
53
54
55
56
57
■
Bed Side Lockers (SS)*
Examination Couch (SS)________
Dispensing Table Wooden______
8
50
15
15
75
75
75
15
20
12
2
15
60
100
2
50
50
1
Plate, Tumblers*_____________
ZK
59
Waste Disposal - Bin / drums
Waste Disposal - Trolley (SS)
Linen Almirah_____ __________
Stores Almirah_______________
60
61
62
63
64
65
66
Arm Board Adult*_____________
Arm Board Child*_____________
SS Bucket with Lid____________
Bucket Plastic*______________
Ambu bags
___________
02 Cylinder with spanner ward type
Diet trolley - stainless steel
53
20
3
5
5
20
20
15
20
10
50
2
f
IPHS for 301 to 500 Bedded District Hospitals
67
68
69
70
71
72
73
74
75
76
Needle cutter and melter_______
Thermometer clinical *_________
25
40
5
12
15
6
7
2
2
10
Thermometer Rectal*______
Torch light*_________________
Cheatles forceps assortted*_____
Stomach wash equipment*______
Infra Red lamp*_____________ _
Wax bath*__________________
Emergency Resuscitation Kit-Adult*
Enema Set*
ft
itliBi
* - to be provided as per need
A - At least one screen per five beds except female wards
XV. POST MORTEM EQUIPMENTS
S. No.
Name of the Equipment
District Headquarters Hospital
301-500 Bedded
1
Mortuary table (Stainless steel) *
2
2
P.M.equipments (list)
6
3
Weighing machines (Organs)
_____
2
4
Measuring glasses(liquids)
4
5
Aprons*
10
■
_
_______
6
PM gloves ( Pairs )*
20
7
Rubber sheets*
8
Lens
2
9
Spot lights
4
* - to be provided as per need
54
_____
IPHS for 301 to 500 Bedded District Hospitals
XVI. LINEN
S. No.
1
Bedsheets
2000
2
Bedspreads
3000
Blankets Red and blue
125
4
Patna towels
1500
5
Table cloth
100
6
Draw sheet
200
7
Doctor’s overcoat
150
8
Hospital worker OT coat
500
9
Patients house coat (for female)
1500
10
Patients Pyjama (for male) Shirt
600
11
Over shoes pairs
150
12
Pillows
600
13
Pillows covers
1500
14
Mattress (foam) Adult
500
15
Paediatric Mattress_________
3
‘
I
District Headquarters Hospital
301-500 Bedded
Name of the Equipment
1
\:
55
'
250
16
Abdominal sheets for OT
17
Pereneal sheets for OT
250
18
Leggings
200
19
Curtain cloth windows and doors
20
Uniform / Apron
21
Mortuary sheet
100
22
Mats (Nylon)
300
23
Mackin tosh sheet (in meters)
500
■■
24
Apron for cook
J:
55
r
IPHS for 301 to 500 Bedded District Hospitals
XVII. TEACHING EQUIPMENT
S. No.
Name of the Equipment
District Headquarters Hospital
301-500 Bedded
1
Furniture for class room,
committee/meeting room
As per requirement
2
O.H.P
1
3
Screen
.1
4
White / colour boards
2
5
Television colour
2
6
Tape Recorder* (2 in 1 )
1
7
VCD Player
1
"V
8
Radio
1
9
LCD Projectors
1
10
Computer
1
* - to be provided as per need
XVIII. ADMINISTRATION
SI. No.
1
Name of the Equipment
District Headquarters Hospital
301-500 Bedded
Computer with Modem with UPS,
Printer with Internet Connection**
6
2
Xerox Machine
1
3
Typewriter (Electronic )*
1
4
Intercom (15 lines)*
5
Intercom (40 lines)*
1
6
Fax Machine
1
7
Telephone
2
8
Paging System*_____
9
Public Address System*
10
Library facility*
1
* - to be provided as per need
At least one for Medical Records and one for IDSP
56I
181®!
IPHS for 301 to 500 Bedded District Hospitals
XIX. REFRIGERATION & AC
S. No.
' a;
Name of the Equipment
District Headquarters Hospital
301-500 Bedded
1
Refrigerator 165 litres
5
2
Blood Bank Refrigerator
2
3
ILR
2
4
Deep Freezer
2
5
Coolers*
6
Air conditioners
16
7
Central A/C for OT
1
As per requirement
* One cooler per 8 beds in the wards.
XX. HOSPITAL PLANTS
S. No.
District Headquarters Hospital
301-500 Bedded
Name of the Equipment
1
Generator 40 / 50 KV
2
Generator 75 KV
3
Generator 125 KV
1
4
Portable.2.5 KV
2
5
Solar Water heater *
6
Incinerator*
7
Central supply of 02, N20, Vacuum *
8
Cold storage for mortuary *
* - to be provided as per need
57|
F
IPHS for 301 to 500 Bedded District Hospitals
XXI. HOSPITAL FITTINGS & NECESSITIES
S. No.
District Headquarters Hospital
301-500 Bedded
Name of the Equipment
1
Ceiling Fans*
120
2
Exhaust Fan*
24
3
Pedestal Fan*
4
4
Wall Fan*
6
5
Hotwater geiser*
3
6
Fire extinguishers*
7
Sewing Machine*
2
8
Lawn Mover*
2
9
Vaccum cleaner*
4
10
Aqua guard*
11
Solar water heater *
12
Neon sign for hospital*
13
Garden equipment*
14
Borewell motor OHT *
15
Water dispenser / Water cooler*
16
Laundry (steam) *
17
Emergency lamp
18
Emergency trauma set*
3
19
Tube lights*
200
20
Drinking Water Fountain*
5
9
* To be provided as per need
58
■"'■5
IPHS for 301 to 500 Bedded District Hospitals
XXII. TRANSPORT
S. No.
District Headquarters Hospital
301-500 Bedded
Name of the Equipment
4
1
Ambulance
2
Van (Family Welfare)*
3
Pickup vehicles Maruti (Omni) / RTV
4
Mortuary Van*
5
Administrative vehicle (Car)*
6
Minidor 3 wheeler / Tates ace*
7
Bicycle*
8
Camp Bus*
9
Progamme vehicle*
10
Motorcycle*
1
* To be provided as per need
XXIII. RADIOTHERAPY
r
1.
Brachytherapy System.
2.
Rotational Cobalt Machine
3.
Radiotherapy Simulator
4.
Energy Linear Accelerator
5.
Treatment Planning System
6,
High Energy Linear Accelerator
7.
Copy of Specification for Major Equipment
8.
Copy of Specification for Major Equipment 1
9.
High Dose Linear Accelerator 1
10. Linear Accelerator
59
IPHS for 301 to 500 Bedded District Hospitals
10.
LABORATORY SERVICES AT DISTRICT HOSPITAL: Following services will
be ensured, for advanced diagnostic tests, a list of National Reference
Laboratories has been provided as annexure:
SI. No.
I.
Speciality
CLINICAL PATHOLOGY
Diagnostic Services / Tests
a. Haematology
Haemoglobin estimation
Total Leucocyte count
Differential Leucocyte count
Absolute Eosinophil count
Reticulocyte count______
Total RBC count________
E.S.R. .
Bleeding time
-----------------------fi,--------------------------------------------------------
- Immunoglobin Profile (IGM, IGG,
IGE, IGA)_________________
■ Filoram Degradation Product
Clotting time__________________
Prothrombin time_______________
Peripheral Blood Smear__________
Malaria/Filaria Parasite___________
Platelet count__________________
Packed Cell volume_____________
Blood grouping____________ _
Rh typing_____________________
Blood Cross matching____________
ELISA for HIV, HCV, HBs Ag_______
APTT___________________ _
ANA/ANF, Rhemmatoid Factor
b. Urine Analysis
Urine for Albumin, Sugar, Deposits, bite
salts, bile pigments, acetone, specific
gravity, Reaction (pH)_______
Stool for Ovacyst (Eh)______
Hanging drop for V.Cholera
Occultblood_________ '
Bacterial culture and sensitivity
Morphology, count_________
c. Stool Analysis
d. Semen Analysis
e. CSF Analysis
f. Aspirated fluids
Analysis, Cell count etc_____
Cell count cytology
601
IPHS for 301 to 500 Bedded District Hospitals
II.
PATHOLOGY
a. PAP smear
Cytology___________ _____
Sputum cytology___________
b. Sputum
Bone Marrow Aspiration
Immuno haematology
c. Haematology
Coagulation disorders_______
Sickle cell anaemia
Thalassemia
S. NO.
III.
d. Histopathology
All types of specimens, Biopsies
Speciality_____
MICROBIOLOGY
Diagnostic Services / Tests
KOH study for fungus_____________
Smear for AFB, KLB (Diphtheria)
IV.
SEROLOGY
Culture and sensitivity for blood,
sputum,pus, urine etc.
Bactriological analysis of water by H2S
based test_________ ___________
Stool culture for Vibrio Cholera and other
bacterial enteropathogene_________
Supply of different media* for peripheral
Laboratories___________________
Grams Stain for Throat swab, sputum etc.
RPR Card test for syphillis________
Pregnancy test (Urine gravindex)
Lepto spirosis, Brucellosis_________
WIDAL test
V
’ Bi
V
Elisa test for HIV, HBsAg, HCV
RA factor
Blood Bank
Services as per norms for the blood bank
including services for self component
separation
* Specimen collection and transport media only.
61
IPHS for 301 to 500 Bedded District Hospitals
SI. No.
VI.
Diagnostic Services / Tests_______
■Blood Sugar________
Glucose Tolerance Test__________
Glycosylated Hemoglobin_________
Blood urea, blood cholesterol_______
Serum bilirubin_________________
Icteric index___________________
Liver function tests______________
Kidney function tests_____________
Lipid Profile___________________
Blood uric acid_________________
Serum calcium____________
Serum phosphorous_____________
Serum Magnesium______________
CSF for protein, sugar____________
Blood gas analysis______________
Estimation of residual chrorine in water
Thyroid T3 T4 TSH__________ _
CPK________________________
Iodometry Titration
a) ECG______________________
b) Stress tests_________________
c) ECHO_____________________
a) Refraction by using Snellen’s chart
b) Retinoscopy_________________
c) Ophthalmoscopy______________
Audiometry___________________
Endoscopy for ENT______________
a) X-ray for Chest, Skull, Spine,
Abdomen, bones_______________
b) Barium swallow, Barium meal,
Barium enema, IVP_____________
c) MMR (chest)________________
d) HSG_________________ _
e) Dental X-ray_________________
f) Ultrasonography______________
g) CT scan____________________
Speciality_____
BIOCHEMISTRY
VII.
CARDIAC INVESTIGATIONS
VIII.
OPHTHALMOLOGY
IX.
ENT
X.
RADIOLOGY
h) MRI 0.5 TESSLA
62
s
IPHS for 301 to 500 Bedded District Hospitals
Diagnostic Services / Tests
Oesophagus___________
Stomach______________
Colonoscopy___________
SI. No. Speciality
ENDOSCOPY
XI.
Bronchuscopy__________
Arthros copy___________
Laparoscopy (Diagnostic)
Colposcopy____________
XII.
11.
Hysteroscopy___________
Pulmonary function tests
PHYSIOLOGY
RECOMMENDED ALLOCATION OF BED STRENGTH AT VARIOUS LEVELS
RECOMMENDED ALLOCATION OF BED STRENGTH
S. No Item
1
2
3
General Medicine____________
New born ward______________
Mothers room with dining and
toilets____________________
4
5
6
7
8
Paediatrics ward____________
Critical care ward - IMCU______
Isolation Ward______________
Dialysis unit (as per specifications)
Thoracic medicine ward with room
for pulmonary function test_____
9
10
Blood bank________________
11
12
13
14
15
16
General surgery ward (incl.
Urology, ENT)
_______
Post - Operative Ward________
Accident and Trauma ward_____
Labour room_______________
Labour room (Eclampsia)
Septic Labour room
Ante-natal ward
63
4
Type
District Headquarters
Hospital @
500 Bedded
Beds (M+F)
Beds
Beds
40+40
10
10
Beds
Beds
Beds
Beds
Beds (M+F)
40
10
5
3
10+10
Yes
Beds (M+F)
Beds (M+F)
Beds
Boards
Beds
Boards
Beds
35+35
15+15
15
8
3
2
30
r
IPHS for 301 to 500 Bedded District Hospitals
17
18
19
20
Post-natal ward
Postpartum ward
Post operative ward
Ophthalmology ward
21
Burns Ward
30
Beds
Beds
Beds
Beds
Beds
50
40______
20
10
* including ophthalmic ward. $ including post - caesarean patients # including paediatric beds
@ 10% Paying Wards
REQUIREMENTS FOR OPERATION THEATRE:
S. No
12.
District Headquarters Hospital
301-500 bedded
Item
1
Elective OT-Major
1
2
Emergency OT/FW OT
1
3
Ophthalmology /ENT OT
1
LIST OF MEDICINES / INSTRUMENTS / EQUIPMENTS /LAB REAGENTS /
OTHER CONSUMABLES AND DISPOSABLES FOR DISTRICT HOSPITALS
Sr. No
A)
1
2
3
1
5.
6
B)
7
8
9
10
11
12
13
14
Name of the item
Analqesics/Antipyretics/Anti Inflamatory
Tab. Aspirin 300mq_________________
Tab. Paracetamol 500mq
_________
Inj. Diclofenac sodium_______________
Tab.Diclofenac sod____________ ____
Tab. Dolonex DT 20mq______________
Tab. Ibuprofen__________________ Chemotherapeutics________________
Inj.Crystalline penicillin 5 lac unit______ _
Inj.Fortified procaine pen 4 lac_________
Inj.Ampicillin 500mq_________________
Inj.Gentamycin 40mq/2ml vial________ __
inj-crystalline penicillin 10 lac unit_______
Cap.Ampicillin 250mg
Cap.Tetracycline 250mq______________
TabTrimethoprim+Sulphamethazol ss
64
i
IPHS for 301 to 500 Bedded District Hospitals
■ ■
.
'
•
_
■
__
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
C)
______
______
■
■
35
36
37
38
39
40
41
42
43
44
D)
45
46
47
Tab.Ciprofloxacin 250mg
Tab.Ciprofloxacin 500mg__________
Inj.Ciprofloxacin 100ml____________
Tab. Roxithromycin 50 mg & 150 mg
Tab.Erythromycin 500mg__________
Syrup Cotrimoxazole 50ml_________
Syrup Ampicillin 125mg/5ml 60ml
Inj, Cefoperazone 1Gm___________
Inj. cefotaxime 500mg
________
Tab. Norfloxacin 200mg___________
Tab. Norfloxacin 400mg___________
Tab. Ofloxacin 200mg____________
Inj. Vionocef(Ceffixime)250mg______
Inj. Amikacin sulphate 500mg_______
Inj1. Amikacin sulphate IQOmg_______
Tab. Cefadroxyl 250mg___________
Cap. Amoxycillin 500mg & 250 mg
Tab. Acyclovir 200 mg / 400 mg_____
Syrup Anthromycin______________
Inj. Amoxycillin 500mg___________ _
Anti Diarrhoeal________________
Tab.Metronidazolq.200mg_________
Tab. Metronidazole 400mg_________
Syrup.Metronidazole
Tab.Furazolidone 100mg__________
Tab.Diolaxanide Fuzate___________
Inj. Ceftinaxone________________
Tab. Aziltmomycin _____________
Tab Thconazile 150 mg___________
Tab Chloroquinne / Hydry Chloriquinne
Tab.Tinidazole 300mg____________
Dressing Material/Antiseptic lotion
Povidone Iodine solution 500ml_____
Phenyl Slitr jar(Black Phenyl)______
Benzalkonium chloride 500ml bottle
1'
65
IPHS for 301 to 500 Bedded District Hospitals
48
Rolled Bandage a) 6cm
b)10cm
49
50
51
52
53
54
55
56
57
58
El
c)15cm
Bandage cloth(100cmx20mm) in Than
Surgical Guaze(50cmx18m) in Than
Adhesive plaster 7.5cm x 5mtr
Absorbent cotton I.P 500gm Net
P.O.P Bandage a) 10cm
b)15cm
Framycetin skin oint 100 G tube
Silver Sulphadiazene Pint 500gm jar
Antiseptic lotion containing :_______
a) Dichlorometxylenol 100ml bot_____
b) Haffkinol Slitre jar_____________
Sterilium lotion_________________
Bacillocid lotion_________ 2_____
Infusion fluids________________
59
60
61
62
63
64
65
66
67
68
69
70
fl
71
Inj.dextrose 5% 500ml___________
Inj.Dextrose 10% 500ml bottle______
Inj.Dextrose in Normal saline 500ml bt
Inj.Normal saline (Sod chloride) 500ml
Inj,Ringer lactate 500ml__________
Inj.Mannitol 20% 300ml___________
Inj.Water for 5ml amp____________
Inj. Water for 10ml amp___________
Inj. Dextrose 25%100ml bot_______
I.V. Metronidazole 100ml__________
Inj. Plasma Substitute 500ml bot
Inj. Lomodex__________________
Other Drugs & Material__________
All Glass Syringes 2ml___________
_______ 5ml_________________
10ml
_______ 20ml________________
72
Hypodermic Needle (Pkt of 10 needle)
a) No. 19
66
IPHS for 301 to 500 Bedded District Hospitals
b) No.20______
c) No.21
d) No.22______
e) No.23______
f) No.24______
q) No.25______
73
74
75
76
77
78
79
80
h) No.26_______
Scalp vein sets no
a) 19
b) 20
c) 21
d) 22
e) 23
f) 24
q) 25
h) 26
Geico all numbers__________
Tab.B.Complex NFI Therapeutic
Tab.Polyvitamin NFI Therapeutic
Inj.Dexamethasone 2mq/ml vial
Inj.Vitamin B Complex 10ml
Inj.BI 2 Folic acid___________
Surgical Gloves a) 6 “_______
i) 6.1/2"
c) 7"
81
■
82
83
84
85
____________ d) 7.5"
Catgut Chromic a) 1 No._____
____________ b) 2 No.
____________ c)_1-0 No
____________ d) 2-0 NO
____________ e) 8-0_______
Vicryl No.1__________________
Sutupak 1.1/0.2.2/0, 3/0_________
Prolene, 3/0, 4/0______________
X Ray film 50 film packet(in Pkt) size
_______ a) 6.1/2x8.1/2"________
b) 8"x10"
67
IPHS for 301 to 500 Bedded District Hospitals
86
87
88
89
90
91
92
93
94
95
96
97
c) 10"x12'
d) 12"x15"
Fixer_______________________
Developer___________________
CT Scan film_________________
Ultrasound scan film____________
Dental film___________________
Oral Rehydration powder 27.5g
Ether Anaesthetic 500ml_________
IV Sets______________________
Catheters____________________
Urine Bags___________________
Venflous_________________ _
Halothane___________________
Eye Drops___________________
G)
98
99
100
101
102
H)
103
104
105
Sulphacetamide eye drops 10% 5ml
Framycetin with steroid eye drops 5ml
Framycetin eye drops 5ml
Ciprofloxacin eye drops
Gentamycin eye drops___________
Other Material________________
Rubber Mackintosch Sheet in mtr
Sterile Infusion sets(Plastic)_______
Antisera l)A5ml______________
_______ ll)B 5ml______________
_______ lll)D 5ml _____________
_______ IV)AB 5ml_____________
106
107
108
109
110
111
112
113
114
Inj.MethylErgometrine 0.2mg/amp
Inj.Streptokinase 7,5lac vial_______
I nj. Streptokinase 15lac vial________
Inj.PAM_____________________
Tab. Antacid__________________
ARS________________________
Syp.Antacid_____ _____________
Inj.Rabipur___________________
Inj.Ranitidine 2ML
68
11®
IPHS for 301 to 500 Bedded District Hospitals
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
•I)
1
2
3
4
5
6
7
8
9
10
11
JI
12
13
Tab.Ranitidine
Tab.Omeprazole
Cough syrup Slitre Jar
Cough syrup with Noscapine 100ml_____
Coir Mattress,
Inj.Lignocaine 1%_________________
Inj.lignocaine 2%__________________
Inj.Lignocaine 5%
Inj.Marcaine
Inj.Diazepam
Inj. Benzathene Penicilline for Syphilis
Inj.Salbactum+Cefoperazone 2Gm
Inj.Amoxycillin with clavutanite acid 600mg
Cap.Amoxycillin250+cloxacillin 250
Inj.Cefuroxime 250/750
Tab.Pefloxacin 400mg
Tab.Gattifloxacin 400mg_____________
Tab.Valdecoxib 20mg
Tab.Atrovastatin IQmg
Sy.Himalt-X
-
Sy.Protein(Provita)
Antibiotics and Chemotherapeutics
Tab.Chloroguine phosphate 250mg
Inj.Chloroguine phosphate
Inj.Quinine
Tab.Erythromycine Esteararte 250mg
Syp.Erythromycine
Tab, phenoxymethyl Penicillinl 25mg
Cap. Rifampicin
Tab.Isoniazid IQOmg
Tab.Ethambutol 400mg
Cap. Neomycin
Inj.Benzathine penicillin 12lac
Antihistaminics/anti-allergic
Inj.Pheniramine maleate
Tab. Diphenhydramine (egv.Benadryl)
o
69I
IPHS for 301 to 500 Bedded District Hospitals
14
15
16
17
KI
18
19
20
21
22
23
24
25
26
27
28
29
30
L)
31
32
M)
33
34
35
36
37
38
Tab. Desloratedine__________________
Tab. Levocentirime 5 mg._____________
Tab.Chlorpheniramine maleate 4mg______
Tab.Diethylcarbamazin_______________
Drugs acting on Digestive system_____
Tab.Cyclopam_____________________
Inj.Cyclopam______________________
Tab.Bisacodyl_____________________
Tab.Perinorm______________________
Inj.Perinorm_______________________
Syrup. Furazolidone_________________
Inj.Prochlorperazine(Stemetil)______ ’
Tab. Albendazole 400 mg._____________
Tab.Mebendazole IQOmg_____________
Syp.Mebendazole________
Tab. Ivermedine 6 mg________________
Sy.Pyrantel Pamoate________________
Tab.Belladona_____________________
Drugs related to Hoemopoetic system
Tab. Ferrous sulphate200mg___________
Inj.lron Dextran/lron sorbitol___________
Eye ointment_____________________
Chloramphenicol eye ointment & applicaps
Chloramphenicol + Dexamethsone ointment
Gentamycin eye/ear drops____________
9
Dexamethasone eye drops____________
Drosyn eye drops___________________
Atropine eye ointment__________ _____
Drugs acting on Cardiac vascular system
N)
39
40
41
42
43
44
45
Inj.adrenaline____________________ _
Inj.atropine sulphate_________________
Inj.Digoxine_______________________
Tab.Digoxine______________________
Inj.Mephentine_____________________
Tab. Atenolol______________________
Tab.lsoxuprine -
70
i
IPHS for 301 to 500 Bedded District Hospitals
46
47
48
49
50
51.
p)
I
fl
1
'< i
4
Tab.Isosorbide Dinitrate(Sorbitrate)______________
Tab.Propranolol_________
Tab.Verapamil(lsoptin)
tab.Enalepril2.5/5mg________________________
Inj.Pentazocine (Fortwin)_____________________
Inj.Pavlon 2ml amp_________________________
lnj.Ch|orpromazine 25mg(like Largactil)___________
Inj.Promethazine Hol PJienergan________________
inj.Pethidine______________________________
Inj.Diazepam 5mg _________________________
Tab.Haloperidol____________________________
Inj.Haloperidol_________
Tab. Diazepam 5mg_________ ________________
Tab. Phenobarbitone 30mg____________________
Tab. Phenobarbitone 60mg____________________
Tab.Largactil 25mg__________
Tab.Pacitane____________________________
Tab.Surmontil_____________________________
Syrup. Phenergan >
____________________
Syrup Paracetamol_____
Ethyl chloride spray_________________________
Lignocaine pint / Gel 2 %______________________
Gentamycin eye/ear drops_____________________
Betnesol-N/Efcorlin Nasal drops_________________
Drugs acting on Respiratory system
72
Inj.Aminophylline___________________________
73
74
Tab.Aminophylline__________________________
Inj.Deriphylline_____________________________
75
Tab.Deriphylline____________________________
76
Tab.Salbutamol 2mg_________________________
77
Syrup Tedral_____________________________
Syrup.Salbutamol
78
1
Tab.Methyldopa___________________________
Drugs acting on Central/perlpheral Nervous system
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
I
Inj.Duvadilan______________________________
71
T
IPHS for 301 to 500 Bedded District Hospitals
Q)
79
80
Bl
Antiseptic Ointment_______________________
Betadine, Chlorhexidime_____________________
Framycetin skin pint________________________ _
Drugs acting on UroGenital system___________
81
82
83
84
85
Tab.Frusemide 40mg______________________ _
86
87
88
89
90
91
92
93
94
95
96
97
Inj.Pitocin_______________
Bl
T)
98
99
100
101
102
103
104
105
106
107
108
109
110
Inj.KCL______________________ __ ________
Liquid KCL_____________________ ______
Tab.Pyridicil____________________
Inj.Frusemide_____________________
Drugs acting on Uterus and Female Genital Tracts
lni. Prostodin_____________
lnj. Mesoprostol
Tab. Duvadilan___________
Inj. Duvadilan____________
Tab.Methyl Ergometrine_____
Inj Methyl Eosomel________
Tab.Primolut-N___________
Inj. Magnessium Sulphate
Haymycin vaginal tab_______
Inj Dilantin Sodium________
Inj.Ethacredin lact(Emcredyl)
Hormonal Preparation
Inj.Insulin Rapid__________
Insulin lente Besal
Tab Thyroxme___________
Inj.Cry Insulin
Inj.Mixtard______________
Inj.Testesterone plain 25mg
Testesterone Depot 50mg
Tab.Biguanide
Tab.Chlorpropamide lOOmg
Tab.Prednisolone 5mg / 20 mg
Tab.Tolbutamide 500mg
Tab.Glibenclamide________
Tab.Betamethasone 0.5 mg
72I
IPHS for 301 to 500 Bedded District Hospitals
U)
111
/ M / 112
113
7 \ ' 114
115
T<
116
'
117
V)
118
119
120
121
122
123
124
125
—
126
___
127
128
129
130
131 .
132
133
134
135
136
137
138
139
140
141
142
143
144
Vitamins________________ _
Ini-Vit "A”_______ n
;
-
Inj.CholcalciferoH 6lac
Inj.Ascorbic acid
Inj.Pyridoxin 50mg____________
._______
Inj.VitK_________
Tab.Vit “A” & “D”
___________
Tab.Ascorbic acid 100mg / 250 mg
Other drugs
_____
In).Antirabies vaccine______ ____
Inj.Antisnake venom_____ '
In).AntiDiphtheria Serum
Inj.Cyclophosphamide__________
Inj. Sodabicarb
Inj.Calcium Gluconate
Tab.Calcium lactate
Tr.lodine____________________
Tr.Benzoin___________________
Glcial acetic caid______________
Benedict solution____________ _
Caster oil_________________ __
Liquid paraffin
Glycerine______ _____________
Glycerine Suppositories
Turpentine oil________________
Potassium Permangnate
Formaldehyde
__________ __
Dextrose Powder
Methylated spirit
Cotrimazole lotion
Tab.Theophylline
ECG Roll____________________
Calamme Lotion BPC
Coat Tan / Salicyhic Acid Ointment
Salicyte Acid Ointment__________
Berzoyl Peroxide Gel 2.5/5%
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146
147
148
149
150
151
152
153
154
155
156
(W)
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Retmoic Acid 0.025% Cream / Gel
Burnilo Pint_________________
Flemigel ARC Ointment________
Syp.Himobin________________
APDYL Cough ANoscopin______
Tab. Septilin________________
Tab. Cystone_______________
Tab. Gasex_________________
Syp. Mentat________________
Pint. Pilex__________________
Rumalaya Gel_______________
Pinku Pedratic Cough Syp.______
Others____________________
Tab.Liv52
Syrup Liv52
Cap.Doxycycline 100mg
Inj.Heparin sod.lOOQIU_________
Tab.Dipyridamol_____________
Tab. Clofridogel______________
Inj.Dopamine_______________
Tab.Glyceryl Trinitrate
Tab.Amitryptilline_____________
Tab.trifluoperazine( 1 mg)_______
Tab.Nitrofurantine____________
Inj.Valethemide Bromide(Epidosyn)
Inj.lsolyte-M
Inj.lsolyte-P
_____________
Inj.lsolyte-G________________
Cap.Cephalexin 250mg
Tab.Taxim_________________
Inj.Metaclopramide___________
Tab.Folic acid_______________
Inj.Lignocaine Hcl 2%
Inj.Nor adrenaline
Betadine lotion.
Tab.stilboesteral
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IPHS for 301 to 500 Bedded District Hospitals
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Inj.Pyridoxine
_______
Hydrogen peroxide______________________
Inj.magnesium sulphate___________________
Inj. TriaminoIone Acetonide 40 mg/ml 1 ml Ampuok
Tab Pentoxyfylhine 40 mg__________________
Inj.Tetglobe____________ ________________
Inj.Paracetamol_________________________
Pilocarpine eye drops 1%__________________
Sy.Orciprenaline________________________
Suturing needles (RB,Cutting)_______________
Inj.Calcium pantothernate_____ ___________ _
Inj.Xylocaine 4% 30 ml____________________
Halothane_____________________________
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Xylocaine jelly__________________________
44
Formaldehyde Lotion______________________
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Cetrimide 100ml bott 3.5%, 1.5% 1
Bacitrium powder 1Qmg botts
____________
Bleaching Powder 5 Kg Pkts(ISI Mark)__________
Ether Solvent
,
Mixture Alkaline_________________________
Inj. Phenabarbitone 200mg_________________
Inj. B12 (Cynacobalamine)_________________
Neosporin, Nebasuef, Soframycin Powder
Magnasium Sulphate Powder_______________
Nadiflexaam Cream______________________
Sodium Hypochloride Sod. 5 ltrs/1 ltrs
Inj. Diphthoria antition ADS)10000I.U__________
Inj. Gas gangrene Antitoxin(AGGS) 10000
Inj. Hydroxy Progesterone500mg/2ml
Inj. Methyl Prednisolon 500mg vial
Inj.Multivitamin I.V________________________
Inj.Potassium chloride_____ ________________
Inj.Quinine Dihydrochloride
Tetanus Antitoxin 10000 I.U
______________
Inj.Tetanus Toxoid 5ml vial
_____________
Inj.Theophylline Etophylline
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Inj.Vitamin A__________________________ _
Tab.Ferrous sulphate200mg+Folic acid_______
Tab.Ferrous sulphate 300mg______________
Tab.Griseofulvin 250mg/scored (ultramminomind)
F
F
Tab. Phenobarbitone 30mg___________
Tab,Phenobarbitone 60mg
Tab. Pyridoxin 10mg_______________
Tab.Thyroxine sod 0.1 mg
Warfarin sod 5mg_________________
Tab.Alprazolam 0.25mg_____________
Tab.Amlodipine 5mg_______________
Chlorhoxidine munthmash________ ■
Glycerol Tanmic Acid Paint (oral)______
Betadine mouthwash
Triamuolone Acelomide in orabace paste
Immigimmod cream (Toprical-application)
Comp. Podophylhime in Timdime Benzom
Tab.Amlodipine 10mg______________
Tab.Nefidipine 20mg_______________
Tab.Nefidipine 30mg'
Tab.Riboflavin 10mg
Syp. Ferrous Gluconate 100ml bottle
Cream Fluconozole 15gm tube________
Sus.Furazolidone_________________ ;
Oint.Hydrocortisone acetate
Tab. Isoniazid 100mg/5ml 100ml bot
Liguid paraffin_______________ _
Linctus codein 500ml bot____________
Cream Miconozole 2% 15gm tube______
Syp.Nalidixic acid_________________
syp.Norfloxacin___________________
Phenylepinephrine eye drops_________
Pilocarpine eye drops 2%
Syp.Pottassium chloride 400ml bot
Syp.Primaguine
Suspension Pyrantel pamoate
76
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Sus Rifampicin__________________ ___________________
Syp.Salbutamol 100ml bot______ _ _____________________
Syp.Theophylline 100ml_______ _______________________
Syp.Vitamin B.Complex________ _ _____________________
Vit D-3 Granules_______________ _ __________________ _
Opthalmic & ear drops_________ __ ____________________
Glycerine Mag sulphate ear drops_______________________
Pilocarpine eye drops 4%______________________________
Pint Acyclovir 3% 5gm tube________ ___________________
Benzyl Benzoate emulsion 50ml bot
___________________
Pint. Betamethasone_______________ _ ________________
Gream Glotrimazole skin 1% 15gm
__
Pint Dexamethasone 1 %+ Framycetin
•
pint contain clotrimazole+Genta+Flucon___________________
Pint Flucanazole 10 mg_______________________________
Cream Framyctin 1% 20gm tube/100gm___________________
Lot.Gamabenzene hexachloride1% bt____________________
Glycerine Suppository USP 3gm bott/10___________________
Cream Nitrofurazone 0.2% jar of 500g_____________________
Pint Silversulpadiazene 1% 25g <
AIDS Protective kit
_________________________
Tab. Methotroxate 5 mg./IO mg
Tab cyclophosfharfiide______
_____________________
Tab. Azattnopssine
___________________________
EAR DRPP_______________ ________________________
Wax Solvent Ear Drops
____________________________
Antifungal + Antiliofic ear drops - plain (clotrimazole + polymyxin B)
Steroid + Antibiotec ear drops (PTEK Ae plus ear drops)
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IPHS for 301 to 500 Bedded District Hospitals
13.
Capacity Building
External Monitoring
Monitoring by PRI / Rogi Kalyan Samities
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.
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.
14.
Quality Assurance in Service
Delivery
Service / performance evaluation by
independent agencies
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
Internal Quality Assessment Scheme
External Quality Assessment Scheme
Record Maintenance
Computers have to be used for accurate
record maintenance and with connectivity
to the District Health Systems, State and
National Level.
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 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 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 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. These audits shall
be carried out by Rogi Kalyan Samiti of the
hospital.
16.
Citizen’s Charter
Each District hospital should display a
citizen’s charter for the district hospital indicating
78
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IPHS for 301 to 500 Bedded District Hospitals
Beds:
the services available, user fees charged, if any,
and a grievance redressal system. A modal citizen’s
charter is given as under.
Doctors wear white aprons and nurses are in
uniform.
OUR MOTTO ■ SERVICE WITH SMILE
All Staff member wear identity cards.
CITIZENS CHARTER
General Information
This charter seeks to provide a framework which
enables our users to know:
Enquiry, Reception and Registration Services:
What services are available in this hospital;
This counter is functioning round the clock.
The quality of services they are entitled to;
Location guide maps have been put up at various
places in this hospital.
The means through which complaints
regarding denial or poof quality of services
will be redressed.
Colour coded guidelines and directional signboards
are fixed at strategic points for guidance.
Telephone enquiries can be made over telephone
numbers:
Standards of Service:
This is a District, Sub-district/divisional
hospital;
, Fax:
, &
It provides medical care to all patients who
come to the hospital;
Casualty & Emergency Services:
All Casualty Services are available round the clock.
Standards are influenced by patients load
and availability of resources;
Duty Doctor is available round the clock.
Yet we insist that all our users receive
courteous and prompt attention.
Specialist doctors are available on call from
resident doctors.
Locations:
It is located on
Emergency services are available for all
specialities as listed in the OPD Services.
road in front of
Emergency Operations are done in-
This hospital has-
Doctors:
floor of
(including residents
OT located on
(including supervisory
Maternity OT
Orthopaedic Emergency OT
Burns and plastic OT
)■
Nurses:
staff).
79
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IPHS for 301 to 500 Bedded District Hospitals
In serious cases, treatment/management gets
priority over paper work like registration and medico
legal requirements. The decision rests with the
treating doctor.
Main OT for Neurosurgery cases
Emergency Operation Theatre is functioned round
the clock.
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
1
Paediatric Surgery
Neuro Surgery
Cardiac Surgery
Obstetric & Gynec.
Eye
ENT
ft:
Skin
Urology
Cardiology
Psychiatry
Radiotherapy
Neurology
Orthopaedics
• V «
Burns & plastics
■
Dental OPD
■
ISM Services:
Homeopathic
Ayurvedic
—
Any other
80
IPHS for 301 to 500 Bedded District Hospitals
In OPDs specialists are available for consultation.
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.
OPD services are available on all working days
excluding Sundays and Gazetted Holidays.
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On Saturdays, the hospital functions from
................. AM to................. PM.
Emergency: Emergency Laboratory Services are
available 24 hours for limited tests relating to clinical
pathology and bio-chemistry.
Medical Facilities Not Available:
Radio Diagnostic Services:
Organ Transplantation
Routine: These services include:
X-Rays
fl
Ultrasound and
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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
D-addiction
Ultrasound examination is done from 9:00 AM to
4:00 PM.
Dental
Nuclear Medicine
Emergency: Emergency X-Ray services are also
available round the clock. CAT Scan services are
also available round the clock.
Genetic Counselling
Endochronology
Geriatrics
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Indoor Patient Services:
Laboratory Services:
There are total of
indoor patient care.
Routine: Laboratory Services are provided in the
field of (as available):
Wards providing free
Emergency ward A admits emergency cases for
medical problems.
Bio-chemistry
Microbiology
Emergency ward B admits emergency cases for
surgical problems.
Haematology
Cytology
Histopathology including FNAC
There is a---------------- bedded Intensive Care Unit
for care of seriously ill patients.
Clinical Pathology
81
IPHS for 301 to 500 Bedded District Hospitals
Other Facilities:
A-------------------- bedded Intensive Coronary Care
Unit takes care of heart patients requiring intensive
treatment.
Other facilities available include:
Cold Drinking Water
In the Burns Department, there are-------------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.
Adequate toilet Facilities for use of patients and their
attendants are available.
Visitors are allowed only between 5:00 PM to 7:00
PM.
The cleaning staff, iri-house or on contract done
through local tender mechanism.
• ’
Investigations like CAT Scan, Ultra Sound, Bariummeal, ECHO, TMT etc. are charged for as per
Government approved rates.
Cleaning supplies such as brooms, phynile, harpic,
disinfectants, formalin, soaps etc. shall be there is
sufficient quantity.
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.
Complaints & Grievances:
A Staff Nurse is on duty round the clock in the ward.
There will be occasions when our services will not
be upto your expectations.
Admitted patients should contact the Staff Nurse for
any medical assistance they need.
Please do not hesitate to register your complaints.
It will only help us serve you better.
82
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IPHS for 301 to 500 Bedded District Hospitals
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Every grievance will be duly acknowledged.
On an average more than---------- lacs patients
We aim to settle your genuine complaints within 10
working days of its receipt.
attend the OPD annually and more than-------------- lacs patients are attended annually in the
casualty and emergency wards.
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Please do not inconvenience other patients.
Suggestions/Complaint boxes are also provided at
various locations in the hospital.
Please help us in keeping the hospital and its
surroundings neat and clean.
If we cannot, we will explain the reasons and the
time we will take to resolve.
Please use the facilities of this hospital with care.
Beware of Touts.
Name, designation and telephone number of the
nodal officer concerned is duly displayed at the
'Reception.
Dr
Designation....
Tele (0)
(M)
Meeting Hours
The Hospital is a “No Smoking Zone” and smoking
is a Punishable Offence.
Please refrain from demanding undue favours from
the staff and. officials as it encourages corruption.
Please provide useful feedback & constructed
suggestions. These may be addressed to the
Medical Superintendent of the Hospital.
(R)
to
“No Smoking Please”
Responsibilities of the Users:
Don’t split here & there
The success of this charter depends on the support
we receive from our uses.
♦
Use Dustbin
Keep Hospital Clean
Please try to appreciate the various constraints
under which the hospital is functioning. >
Give regards to Ladies and Senior Citizens
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IPHS for 301 to 500 Bedded District Hospitals
Annexure -1
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.
1.
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 treatment of
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).
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.
In connection with the implementation of the
Rules, it has been decided to take up pilot projects
in selected Government hospitals - Central and
State.
Purchase of equipments such as:
a)
Incinerator
b)
Microwave
c)
Autoclave
d)
Shredder
2.
Other equipments including colour coded
bags and puncture proof containers,
protective gears, etc.
3.
Civil and electrical works to house and
operate the waste treatment facilities.
4.
Training
5.
I EC activities.
Hospital Waste Management System must
be established in accordance with the Bio-Medical
Waste (Management & Handling) Rules, 1998
(Annexure).
Segregation must be done at the source of
generation of wagte. 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.
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:
84
IPHS for 301 to 500 Bedded District Hospitals
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used needles reducing it to ashes and cut
the syringe effectively preventing the re-use.
Incineration: The incinerator installed must
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.
5.
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, I EC 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.
1.
2.
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
-1 of the Bio-Medical Waste (Management
& Handling) Rules, 1998. it should be
ensured that waste is disinfected by
chemicals/microwaving/autoclaving before
shredding.
Incinerator or Microwave = Rs.35.00 lakhs
Shredder (Approx. 100 kg to 360 kg./hour)
= Rs.10.00 lakhs
3.
Autoclave (Approx. Cap. Vol. 1015 litrs)
= Rs.30.00 lakhs
4.
Waste transportation: Onsite-wheel barrow/
wheeled container or similar carriage
= Upto max. of Rs.50,000.00
5.
Civil and Electrical works = Rs.2.50 lakhs
6.
Literature/IEC/Training of Staff
= Rs.2.00 lakhs
7.
Procurement of equipments like needle
shredderpuncture 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:
The application for financial assistance
i.
should be forwarded to this Ministry through
Needle and Syringe Destroyer: These
units can be used for needles and syringes
at the point of use. These will destroy the
85
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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 301 to 500 Bedded District Hospitals
the State Government/UT Administration
concerned.
ii.
■
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.
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 uptp 3
maximum amount of Rs.1.5 crore.
Scrutiny of Applications:
iii.
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.
iv.
The grant will be subject to the condition that
the State Government / UT Administrationwill 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
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/Institutions, 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.
86
IPHS for 301 to 500 Bedded District Hospitals
Annexure ■ II
REFERRAL LABORATORY NETWORKS
I
1
Referral Laboratory Network for Advanced diagnostic facilities
North
Zone
East
Zone
South
Zone
IDSP
Level - 5
Labs
CMC
Vellore
PGIMER
Chandigarh
RMRC
Dibrugarh,
KEM
Mumbai,
NICED &
NICD
Trivandrum
Medical
College
Cuttack
AllMS
Medical
Delhi
CRI Kasauli College
AFMC
Pune
BJ MC
CMC
Vellore
AFMC,
Pune
VP Chest
Institute,
Delhi
Surat
Medical
College
CMC Vellore
& PGIMER
Chandigarh
IDSP Level - 4 Labs
South
Central
Zone
Zone
Advance Diagnostic Facilities
Bacterial diagnosis
Enteric bacteria:
Vibrio cholerae,
Shigella,
Salmonella
»
•
■
..
■.
<
■■■
Streptococcus
pyogenes and S
pneumoniae
Indore
Medical
College
St. John
Medical
College,
Bangalore
VP. Chest
University
of Delhi
Cdiphtheriae
BHU
CMC,
Vellore
NICD,
Delhi
Neisseria
meningitidis and
N. gonorrheae
SN Medical
College,
Agra
State PH
Lab
Trivandrum
PGIMER
Chandigarh
Staphylococcus
BHU
MGR
Medical
University
Maulana
Azad
Medical
College,
Delhi
STM,
Kolkata
AFMC,
Pune
NICD, Delhi
Leptospirosis
* •
DRDE
Virology
Institute,
Allepey
AllMS
IVRI
RMRC,
Bubaneswar
& Dibrugarh
BJMC
RMRC
Port Blair
STM,
Kolkata
i
1
1
I
I
I
I
Tamil, Nadu
University,
Chennai
VCRC,
Pondicherry
1
I
1
87
IPHS for 301 to 500 Bedded District Hospitals
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
NIV
CMC,
Vellore
AllMS &
NICD Delhi
Chest
Institute •
NICED
Kolkata
NICED
Kolkata
Myxoviruses
DRDE
Kolkata
NIV, HSADL
Bhopal
■
■
?
-
Hepatitis viruses
DRDE
CMC,
Vellore
AllMS
ICGEB,
Delhi
Neurotropic viruses
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
NIV
NIMHANS
HIV
DRDE
CMC,
Vellore
AllMS
NARI, NICD &
NACO
—
ICGEB, Delhi
NIV
Parasitic Diagnosis
Malaria
All State Public Health Laboratories
MRC, Delhi
ICGEB, Delhi
Filaria
All State Public Health Laboratories
NVBDCP, Delhi VCRC
Pondicherry
Zoonoses
Dengue
JE
DRDE
DRDE
VCRC,
AllMS
Pondicherry
Institute of
Virology,
Aleppey
NICED
CRME,
Madurai &
NIMHANS
NICED
AllMS
VCRC,
Pondicherry
NIV
NIV
ICGEB, Delhi
■
NIV
NIV /NICD
■ ■
_________
88
I
I
I
IPHS for 301 to 500 Bedded District Hospitals
1
Plague
DRDE
NICD
Bangalore
Rickettsial diseases
DRDE
CMC,
Vellore
NICD, Delhi
Haffikins
Institute
NICD, Delhi
AFMC
NICD
IVRI
'Others of Public Health Importance
1
I
1
Anthrax
DRDE
CMC,
Vellore
IGIB
NICED,
Calcutta
BJMC
NICD
IVRI
Microbial water
quality monitoring
NEERI,
Nagpur
CMC
Vellore,
PGIMER
Chandigarh
KEM
Mumbai,
NICED &
NICD
Trivandrum
Medical
College
AllMS
Delhi
CRI Kasauli
RMRC,
Dibrugarh,
Cuttack
Medical
College
HAFFKIN’s,
Mumbai
AFMC Pune
I
I
I
I
I
i
NIV, NICD, HSADL
Unknown pathogens
Other laboratories to perform support functions
Outbreak investigation
support
Medical Colleges and state public health laboratories NICD, NIV, NICED, VCRC
as L3/ L4
Laboratory data
management
Medical Colleges, state public health laboratories
and all the L4 & L5 laboratories (in their area of
expertise)
NIV, NICDNIV, NICD
Capacity building
All the L4 & L5 laboratories (in their area of
expertise)
NIV, NICD
All the L4 &,L5 laboratories (in their area of
expertise)
CMC, TRC, NTI, AFMC,
NARI, RMRC,Port Blair
NIV, NICD
___
Quality assurance
1
Quality control of reagents All the L4 & L5 laboratories (in their area of
expertise)
& kits evaluationi
CMC, TRC, NARI, RMRC,
Port Blair NIV, NICD, BJMC,
NICED
Production & supply of
reagents/ kits/ biological/
standard reference
materials
DRDE, NIV, IVRI, NICED,
NICD,MRC,Delhi
AFMC, Pune
NARI
TRC, Chennai
RMRC, Port Blair
4
Biosafety & biocontainment
Other laboratories to perform support function
89
HSADL, NIV/MCC,
DRDE, NICD
1
I
IPHS for 301 to 500 Bedded District Hospitals
List of Abbreviations
1
i
BJMC
BJ Medical College
CHC
Community Health Centre
CME
Continuing Medical Education
f
CSSD
Central Sterile and Supply Department
1
CRI
Central Research Institute
I
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
90
f
k
IPHS for 301 to 500 Bedded District Hospitals
References
1.
Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100 Beded 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.
1
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