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Indian Public Health Standards (IPHJ)
for
101 to MO bedded District Hospitals
January
2007
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Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
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 12th 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
Samittee /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.
(Naresh Dayal)
Secretary (H&FW)
Ministry of Health & Family Welfare
Government of India
New Delhi
Dated : 16,h 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 stake
holders in bringing up these Hospitals to the level of Indian Public Health Standards.
(Dr. R.K. Srivastava)
Director General of Health Services
Ministry of Health & Family Welfare
Government of India
New Delhi
Dated: 16th May, 2007
iv
I
Acknowledgements
Indian Public Health Standards (IPHS) for the 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 101-200 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
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Contents
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1
Introduction
1—
2-
Objectives of IPHS for District Hospitals
...
3
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3.
Definition of District Hospital
3
4.
Grading of District Hospital
3
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Functions
5-
4
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Essential Services
6.
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Physical Infrastructure
7.
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_____________________________
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8.
Manpower
9-
Equipment
42
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' 10.
Laboratory Services
11
Recommended allocation of bed strength at various levels
to
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12.
65
List of Drugs
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13. Capacity Building
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14. Quality Assurance in Services
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15. Rogi Kalyan Samities 7 Hospital Management Committee
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79
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16. Citizen’s Charter
_ _____ *_______________ _____________________
5
84
Annexure -1: Guidelines for Bio-Medical Waste Management
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Annexure - II: Reference Laboratory Networks
90
List of Abbreviations
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Re,ererlces_______________ .____________________ 91
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IPHS for 101 to 200 Bedded District Hospitals
Introduction
District hospital system is required to work not only
as a curative centre but at the same time should be
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.
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 Systerp is the fundamental basis for
implementing various health policies and delivery
of healthcare, management of health services for
defined geographic area. District hospital 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
Centres, Primary Health Centers and Sub-centres.
As per the information available, 609 districts in the
country at present are having about 615 district
hospitals. However, some of the medical college
hospitals or a sub-divisional hospital is found to
serve as a district hospital where a district hospital
as such (particularly the newly created district) has
not been established. Few districts have also more
than one district hospital.
As per Census 2001, the population of a
district varies from as low as 32,000 (Yanam in
Pondicherry, Lahaul & Spiti in Himachal Pradesh)
-to as high as 30 lakhs (Ludhiana, Amritsar districts).
The bed strength also varies from 75 to 500 beds
depending on the size, terrain and population of the
district. As per the second phase of the facility survey
undertaken by the Ministry of Health & Family
Welfare, Government of India, covering 370 district
hospitals from 26 states have revealed that 59% of
the surveyed district hospitals have tap water facility.
The electricity facility is available in 97% of the
districts with a stand by generator facility in 92% of
the cases. Almost all the DHs in India have one
operation theatre and 48% of them have an OT
specifically for gynecological purpose. About 73%
of the surveyed district hospitals have laboratories.
A separate aseptic labor room is found in only 45%
of the surveyed district hospitals. Only half of the
total number of district hospitals have OPD facility
for RTI/STI. As regards manpower 10% of the district
hospitals do not have O&G specialists and
pediatricians. 80% of the DHs have at least one
pathologist and 83% of the total DHs have at least
The Government of India is strongly
committed to strengthen the health sector for
improving the health status of the population. A
number of steps have been taken to that effect in
the post independence era. One such step is
strengthening of referral services and provision of
speciality services at district and sub-district
hospitals. Various specialists like surgeon,
physicians, obstetricians and gynecologists,
pediatrics, orthopedic surgeon, ophthalmologists,
anesthetists, ENT specialists and dentists have
been placed in the district headquarter hospitals.
The district hospitals caters to the people
living in urban (district headquarters town and
adjoining areas) and the rural people in the district.
1
IPHS for 101 to 200 Bedded District Hospitals
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
with quality assurance in district hospitals services
to ensure efficiency and effectiveness of the services
rendered.
one anesthetist. The position of general duty officers,
staff nurses, female health workers and laboratory
technicians are available in almost all 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
continuation 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 care
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.
♦
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
There is lack of community participation and
ownership, management and accountability
of district hospitals through hospital
management committees.
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
2
IPHS for 101 to 200 Bedded District Hospitals
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 bedded hospitals;
Rationalisation of Service Norms for Secondary
Care Hospitals prepared by Govt, of Tamil Nadu;
District Health Facilities, Guidelines for Development
and Operations, WHO, 1998 and Indian Public
Health Standards (IPHS) for Community Health
Centres. This document contains the standards to
bring the District Hospitals to a minimum acceptable
functional grade with scope for further improvement
in it.
c
the needs of the people'bf the district. The specific
objectives of IPHS for DHs are:
i.
To provide comprehensive secondary health
care (specialist and referral services) to the
community through the District Hospital.
To achieve and maintain an acceptable
standard of quality of care.
iii.
To make the services more responsive and
sensitive to the needs of the people of the
district and the hospitals/centers from which
the cases are referred to the district hospitals
3.
Definition of District Hospital
Most of the existing hospitals below district
The term District Hospital is used here to
level (31-50 Bed category) are located in older
mean a hospital at the secondary referral level
buildings in urbanized areas / towns as compared
responsible for a district of a defined geographical
to most Primary Health Centres / Sub-centres. The
area containing a defined population.
expansions already done have resulted in
construction touching the boundaries walls with no
4.
Grading of District Hospitals:
scope of further expansions. As far as possible,
States should not dislocate the said hospitals to a
The size of a district hospital is a function of
new location (in case of dislocating to a new location, the hospital bed requirement, which in turn is a
the original client group will not be able to have same
function
of the size of the population it serves. In
access to the desired health facilities).
India the population size of a district varies from
35,000
to 30,00,000 (Census 2001). Based on the
Setting standards is a dynamic process. This
‘ document contains the standards to bring the District assumptions of the annual rate of admission as 1
per 50 populations and average length of stay in a
Hospitals to a minimum acceptable functional grade
hospital as 5 days, the number of beds required for
with scope for further improvement in it. These
a district having a population of 10 lakhs will be
standards are flexible as per the requirements and
resources available to the concerned State/UT around 300 beds. However, as the population of
the district varies a lot, it would be prudent to
Government. The timeframe for implementation and
prescribe norms by grading the size of the hospitals
aohievement of these Standards could be extended
as per the number of beds.
. for five years and to be done in phases.
2.
Grade I: District Hospitals norms for 500 beds
Grade II: District Hospitals norms for 300 beds
Grade III: District Hospitals norms for 200 beds
Grade IV: District Hospital norms for 100 beds.
Objectives of Indian Public Health
Standards (IPHS) for District
Hospitals:
The overall objective of IPHS is to provide
health care that is quality oriented and sensitive to
The disease prevalence in a district varies
widely in type and complexities. It is not possible to
3
IPHS for 101 to 200 Bedded District Hospitals
Secondary level health care services
regarding following specialties will be assured at
hospital:
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 at least 80%.
Consultation services with following
specialists:
6.1
General Medicine
. General Surgery
Obs & Gyne
The minimum functional grade of the
different grades of district hospitals requiring the
physical infrastructure, manpower, diagnostic and
investigation facilities, equipment norms, drugs and
other supportive services etc. has been given.
5.
Paediatrics including Neonatology
Emergency (Accident & other emergency)
(Casualty)
Critical care (ICU)
Anaesthesia
Functions
■
1.
A district hospital has the following functions:
ENT
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
Dermatology and Venerology including STI/
RTI
Orthopaedics
Radiology
Dental care
concern. It covers both urban population
(district headquarter town) and the rural
population in the district.
2.
3.
6.
Ophthalmology
Public Health Management
6.2
Function as a secondary level referral centre
for the public health institutions below the
district level such as Sub-divisional
Hospitals, Community Health Centres,
Primary Health Centres and Sub-centres.
Paraclinical services
Laboratory Services
X-Ray Facility
Sonography (Ultrasound)
To provide wide ranging technical and
administrative support and education and
training for primary health care.
ECG
Blood transfusion and storage facilities
Physiotherapy
Essential Services
Dental Technology (Dental Hygiene)
Services include OPD, indoor, emergency
services.
Drugs and Pharmacy
4
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IPHS for 101 to 200 Bedded District Hospitals
6.3
for computerized medical records with anti
virus facilities whereas alternate records
should also be maintained)
Support Services
Medico-legal/postmortem*
Ambulance services
(ii)
Procurement
Laundry services
(iii)
Personnel
Security services
(iv)
Housekeeping and Sanitation
(V)
Education and Training
(vi)
Inventory Management
Dietary services
Counseling services for domestic violence,
gender violence, adolescents, etc. Gender
and socially sensitive service delivery be
assured.
Waste management
Finalcial powers of Head of the Institution
Ware housing/central store
Medical Superintendent to be authorized to
incure and expenditure up to Rs. 17.00 lakhs for
repair/upgradating 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.
Maintenance and repair
Electric Supply (power generation and
stabilization)
Water supply (plumbing)
Heating, ventilation and air-conditioning
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
Communication
Medical Social Work
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.
Nursing Services
Sterilization and Disinfection
Horticulture (Landscaping)
Lift and vertical transport
6.5.
Services under various National Health
and Family Welfare Programmes
6.6.
Epidemic Control
Preparedness
Refrigeration
* Subject to location at District Headquarter.
6.4.
(')
Disaster
Administrative services
Following services mix of procedures in
medical and surgical specialties would be available:
Medical records (Provision should be made
5
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IPHS for 101 to 200 Bedded District Hospitals
4
SERVICE MIX OF PROCEDURES IN MEDICAL AND SURGICAL SPECIALITIES
Name of Procedure
S. No.
I
MEDICAL
1
Pleural Aspiration
2
Pleural Biopsy
3
Bronchoscopy
4
Lumbar Puncture
5
Pericardial tapping
6
Skin scraping for fungus / AFB
7
Skin Biopsies
8
Abdominal tapping
9
Liver Biopsy
10
Liver Aspiration
11
Fibroptic Endoscopy
12
Peritoneal dialysis
13
Hemodialysis
14
Bone Marrow Biopsy
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OPD Procedures (Including IPD)
1
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Dressing (Small, Medium and Large)
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2
Injection (1/M & 1/V)
3
Catheterisation
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4
Steam Inhalation
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5
Cut down (Adult)
6
Enema
7
Stomach Wash
8
Douche
9
Sitz bath
10
CVP Line
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IPHS for 101 to 200 Bedded District Hospitals
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11
Blood Transfusion
12
Hydrotherapy
__
Bowel Wash
Skin Procedures
___
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!,L Chemical Cautery
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2
Electro Cautery
3
Intra Lesional Injection
__
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Biopsy
Paediatric Procedures
1
immunization (BCG, OPV, DPT, Measles, DT) / Children Ward / ORT corner
-2
Services related to new borne care + all other procedures as mentioned in IMNCI
2.1
-only cradle
2.2
-Incubator
2.3
- Radiant Heat Warmer
2.4
- 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
__________________________________________
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2.12
213
- Ventilator
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- Live Biopsy u/s guided
1'
Cardiology Procedures and Diagnostic Tests
1
ECG
TMT
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Holter
Thrombolytic Therapy
4
7
IPHS for 101 to 200 Bedded District Hospitals
5
C V P Line
6
Defibrilator Shock
7
NTG/Xylocard Infusion_______________
8
ECHO Cardiography___________________ _
♦
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Endoscopic Specialised Procedures and Diagnostic
1
Gastroscopy (Oesophagus, stomach, deudenum) (Diagnostic and Therapeutic)
2
Sigmoidoscopy and Colonoscopy
3
Bronchoscopy and Foreign Body Removal________________ __ _______ _
4
Arthros copy (Diagnostic and Therapeutic)
5
Laproscopy (Diagnostic and Therapeutic)
6
Colposcopy
7
Hysteroscopy
_
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Psychiatry Services
1
Modified ECT
2
Narcoanalysis
a
Physiotherapy Services
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)
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IPHS for 101 to 200 Bedded District Hospitals
FExercycle
rS ~ - Shoulder Wheel
C-I f [2.4
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-Shoulder Pulley
2-5
- Supinator Pronator Bar
2-6
-Gripper
2-7
- Visco Weight Cuffs
2.8
- Walking Bars
2.9
- Post Polio Exercise
2.10
- Obesity Exercises
2.11
- Cerebral Palsy - Massage
2.12
- Breathing Exercises & Postural Drainage
1
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Eye Specialist Services (Ophthalmology)
/1
OPD Procedures
1.1
-Refraction (by using snellen’s chart)
1.2
- Refraction (by auto refrectro meter)
1.3
- Syringing and Probing
- Foreign Body Removal (cohjuctival)
,1:5
- Foreign Body Removal (Corneal)
1.6
- Epilation
1.7
- Suture Removal
1.8
- Subconj Injection
1.9
- Retrobular Injection (Alcohol etc.)
1.10
- Tonometry
1 f 11
■ Biometry / Keratometry
1.12
- Automated Perimetry
1.13
- Pterygium Excision
1-14
- Syringing & Probing
1.15
-1 & C of chalazion
1.16
- Wart Excision
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IPHS for 101 to 200 Bedded District Hospitals
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
2
1PD Procedures
2.1
- Examination under GA
2.2
- Canthotomy
2.3
- Paracentesis
2.4
- Air Injection & Resuturing
2.5
- Enucleation with Implant
2.6
- Enucleaion without Implant
2.7
- Perforating Coneo Scleral Injury Repair
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- 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
■ I
1
OPD Procedures
1.1
- Foreign Body Removal (Ear and Nose)
1.2
- Syringing of Ear_______________
1.3
- Chemical Cauterization (Nose & Ear)
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__________ _
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ENT Services
1
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2.8
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10
IPHS for 101 to 200 Bedded District Hospitals
1.4
- Eustachian Tube Function Test
J
1.5
- Vestibular Function Test/Caloric Test
J
2
Minor Procedures
-J1
2,1
- Therapeutic Removal of Granulations (Nasal, Aural, Oropharynx)
t 2.2
- Punch Biopsy (Oral Cavity & Oropharynx)
2.3
- Cautrization (Oral, Oropharynx, Aural & nasal)
3
Nose Surgery
3.1
- Packing (Anterior & Posterior Nasal)
3.2
- Antral Punchure (Unilateral & Bilateral)
-1
r-i
.
J
J
-4
3.3
- Inter Nasal Antrostomy (nilateral & Bilateral)
3,4
-1 & D Septal Abscess (Unilateral & Bilateral)
3.5
-SMR__________________________________ _______________
3.6
- Septoplasty
3.7
- Fracture Reduction Nose
3.8
- Fracture Reduction Nose with Septal Correction
3.9
- Transantral Procedures (Biopsy, Excision of cyst and Angiofibroma Excision)
3.10
- Transantral Biopsy
3.11
- Rhinoplasty
3.12
- Septoplasty with reduction of terbinate (SMD)
4
Ear Surgery
4.1
- Mastoid Abscess I & D
4/ ‘ 0 •
- Mastoidectomy
——
1
'.
•
-
t
- Stapedotomy
4.3
4.4
- Examination under Microscope
4.5
- Myringoplasty
- Tympanoplasty
I
47
■I
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- Myringotomy
■ Ear Piercing
4.9
- Hearing Aid Analysis and Selection
11
IPHS for 101 to 200 Bedded District Hospitals
I ■
5
Throat Surgery
5.1
- Adenoidectomy
5.2
- Tonsillectomy______
5.3
- Adenoidectomy + Tonsillectomy
5.4
- Tongue Tie excision
6
Endoscopic ENT Procedures
6.1
- Direct Laryngoscopy
6.2
- Hypopharyngoscopy
6.3
. Direct Laryngoscopy & Biopsy
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
|
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7.3
- Tracheostomy
______
8
Audiometry
____ _
ai
- Audiogram (Pure tone and Impedence)
4®
I
Obstetric & Gynecology Specialist Services
1
Episiotomy ______________
2
Forceps delivery__________
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
■ : IC
■
_______
a
I
I
i
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——
■
h-
__
7
_____________
■’ik ■■■
■ -W
____________
—-
____
I I
12
-
r
IPHS for 101 to 200 Bedded District Hospitals
J
12
Vaginal Hysterectomy
13
Haematocolpes Drainage Colpotomy
14
Gasserian Hystrectomy
15
Assisted Breech Delivery
•...................... '■
-I
1
-
Cervical Biopsy
16
17
Cervical Cautery
t
18
Nomal Delivery
l
-
■
■
•
■
19
Gasserian
20
EUA
21
Midtrimestor Abortion
22
Ectopic Pregnancy Ruptured
23
Retain Placenta
24
Suturing Cervical Tear
25
Assisted Twin Delivery
B
Penta! Services
*.•
■ \
5
—
'■
1
Dental Caries/Dental Abcess/Gingivitis
Cleaning
Periodontitis
-, y
Surgery
______
__ _
•
■
3
Minor Surgeries, Impaction, Flap
4
Malocclusion
5i
Prosthodontia (Prosthetic Treatment)
O
Trauma including Vehicular Accidents
7
Maxillo Facial Surgeries■
8
Neoplasms
9
Sub Mucus Fibrosis (SMF)
10
Scaling and Polishing
11
RootCanaHTeatment
12
Extractions
13
IPHS for 101 to 200 Bedded District Hospitals
r
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
22
Complicated Extractions (including suturing of gums)
h
r
■
’
■
i’'"
■■
-
_______ _____
SURGICAL
1
Abcess drainage including breast & perianal
2
Wound Debridement
3
Appendicectomy_______
4
Fissurotomy or fistulectomy
! S
I
i
______________
________
-
5
Hemorrohoidectomy
6
Circumcision
7
Hydrocele surgery
8
Herniorraphy
9
Suprapubic Cystostomy
10
Urethral Dilatation
--------------------------
11
Cystoscopy
_______________
12
Endoscopy
_____
13
Esophagoscopy
---------- - --------------
14
Diagnostic Laparoscopy
15
Colonoscopy
16
Sigmoidoscopy
17
Colposcopy
_____
■
:
-
llil
___
■
■■
:
•
■
_
■
MBS
■
IO;
7
14
■
I
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i
IPHS for 101 to 200 Bedded District Hospitals
-I
18
Hysteroscopy
-I
19
Arthroscopy
-I
20
Tonsillectomy
-I
21
Mastoidectomy
22
Stapedotomy
23
Craniotomy (Neurosurgical)
24
Episiotomy
25
Forceps delivery
3
26
Craniotomy-Dead Fetus/Hydrocephalus
27
Caeserean section
“I
28
Female Sterilisation ( Mini Laparotomy & Laparoscopic)
29
Vasectomy
30
D&C
31
MTP
I
32
Hysterectomy
■ I
33
FNAC
r
34
Total Parotidectomy
35
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
H
d
I
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-I
Breast
Excision fibroadenoma - Lump
• 2
Simple Mastectomy
3
Halstead’s Radical, Mastectomy/Patey’s Operation
4
Sectoral Mastectomy/M icrodochectomy/Lumpectomy
15
IPHS for 101 to 200 Bedded District Hospitals
5
Wadge Biopsy
6
Excision Mammary Fistula
_____
1
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
_
Hernia
I
______
*
____
-
—
—
>
■
Abdomen
■AO..'"
.
■
1
Exploratory Laparotomy
2
Gastrostomy or Jejuncstomy
3
Simple Closure of Perforated Ulcer
4
Reamstedt's Operation
5
Gastro-Jejunostomy
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________
if
-------------------- —
___________
TT
.
__
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>
———
" I
——
______
____
Spleen and Portal Hypertension
1
Splenectomy
__
Pancreas
1
Drainage of Pseudopancreatic Cyst
2
Retroperitoneal Drainage of Abscess
__
••
____
—— —
—
lilt
16
I
IPHS for 101 to 200 Bedded District Hospitals
-I
r
I
1
Appendix
1
Emergency Appendisectomy
2
Interval Appendisectomy
3
Appendicular Abscess Drainage
—— .........
Small Intestine
1
Resection and Anastomosis
1
I
2
g
Intussusception
I
4
Multiple Resection and Anaestomosis
5
intestinal Performation
Intestinal Fistula
Liver
1
Open Drainage of liver abscess
2
Drainage of Subdia, Abscess/Perigastric Abscess
Biliary System
1
Cholecystostomy
2
Cholecystectomy
3
Cholecystectomy and Choledocholithotomy
Colon, Rectum and Anus
1
Fistula in ane low level
2
Fistula in ane high level
3
Perianal Abscess
4
Catheters
5
IV Sets
■
*1
. 6
Colostomy Bags
7
Ischiorectal Abscess
8
Ileostomy or colostomy alone '
J
9
Sigmoid Myotomy
-I
10
Right Hemicolectomy
11
Sigmoid & Descending Colectomy ,
J
17
IPHS for 101 to 200 Bedded District Hospitals
12
Haemorroidectomy
13
Sphincterotomy of Fissurectomy
14
Tube Caecostomy
15
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
—
A
J
• :
Penis, Testes, Scrotum
1
Circumcision
2
Partial amputation of Penis
3
Total amputation of Penis
4
Orchidopexy (Unilateral & Bilateral)
5
Orchidectomy (Unilateral & Bilateral)
6
Hydrocele (Unilateral & Bilateral)
7
Excision of Multiple sebaceous cyst of scrotal skin
8
Reduction of Paraphimosis
1
■ k
■ i
1
Other Procedures
1
Suture of large laceration
2
Suturing of small wounds
3
Excision of sebaceous cyst
4
Small superficial tumour
5
Large superficial tumour
6
Repair torn ear lobule each
7
Incision and drainage of abscess
8
Lymph node biopsy
J
■
_
—
18
IPHS for 101 to 200 Bedded District Hospitals
9
Excision Biopsy of superficial lumps
10
Excision Biopsy of large lumps
11
Injection Haemorrhoids/Ganglion/Keloids
12
Removal of foreign body (superficial)
13
Removal of foreign body (deep)
14
Excision Biopsy of Ulcer
15
Excision Multiple Cysts
16
Muscle Biopsy
17
Tongue Tie
.18
Debridment of wounds
19
Excision carbuncle
20
Ingroving Toe Nail
21
Excision Soft Tissue Tumour Muscle Group
•22
Diabetic Foot Asnd carbuncle
*
Urology
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
10
Cystolithotomy Superopubic
11
Dialatition of stricture urethra under GA
12
Dialation of stricture urethra without anaesthesia
13
Meatotomy
-
19
s
IPHS for 101 to 200 Bedded District Hospitals
14
Testicular Biopsy
15
Trocar Cystostomy
—
Plastic Surgery_______
1
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
____
_I
I
■
6
Cleft Lip - One side
7
Small wound skin graft
■,
•
‘
’41
■
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)
14
Reconstruction of Hand (Tendon)
15
Polio Surgery
16
Surgery concerning disability with Laprosy
17
Surgery concerning with TB
1 •
_____________
-
_____________
'
Paediatric Surgery
1
Minor Surgery, I & D, Prepuceal Dilatation, Meatotomy
2
Gland Bipsy, Reduction Paraphimosis, small soft Tissue tumour (Benign)
3
Rectal Polyp removal, deep abscess
4
Big soft tissue tumour
5
Branchial cyst/fistula/sinus
6
Ingunial Herniotomy (Unilateral & Bilateral)
7
Orchidopexy 9Unilateral & Bilateral)
8
Pyoric Stenosis Ramsteadt operation
20
;
■
IPHS for 101 to 200 Bedded District Hospitals
9
Exploratory Laprotomy.
"IO
Neonatal Intestinal Obstruction / Resection / Atresia
11
Gastrostomy, colostomy
12
Umbilical Hernia / Epigastric Hernia
13
Sacrocaccygeal Teratoma
14
Torsion of Testis_______ _________________
15
Hypospadius single stage (first stage)
Orthopaedic Surgery
1
Hip Surgery
1.1
Femoral Neck nailing with or without plating replacement prosthesis / Upper Femoral
Osteotomy; Innominate Osteotomy/Open Reduction of Hip disclocation; DHS/Richard Screw
Plate
1.2
Synovial or bone biopsy from HIP
1.3
Girdle stone Arthoplasty
■T2
.
Fractures____________ _______ _____________________________________
■
2.1
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_____________________________
2.2
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
____________________________________
2.3
External Fixation Appleication Pelvis femur, tibia humerus forearm__________________
2.4
Ext, fixation of hand & foot bones
2.5
Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula, lower and of Inia
2.6
Drainage of fracture
2.7
Interlocking nailing of long bones
2.8
Debridement & Secondary Closure
2-9
Percutaneous Fixation (small and long bones)
3
Closed Reduction
'j-Q-l
Hand, Foot bone and cervicle
3.2
Forearm or Arm, Leg, Thigh, Wrist, Aknle
, . ....... .
_____________________________________
21
I
IPHS for 101 to 200 Bedded District Hospitals
(
3.3
Dislocation elbow, shoulder, Hip, Knee
3.4
Closed Fixation of hand / foot bone
4
Open Reduction __________________
4.1
Shoulder dislocation, knee dislocation
4.2
Acromiocalvicular or sternoclavicular Jt. Clavicle
4.3
Ankle Bimalleolar Open reduction, Ankle Trimalleolar open reduction
4.4
Wrist dislocation on intercarpal joints
4.5
MP & IP Joints
4.6
Knee Synovectomy / Menisectomy
•I
4.7
Fasciotomy leg/forearm________________________
4.8
High Tibial Osteotomy________________ ________
4.9
Mhodesis (Shoulder/Knee Ankle, Triple/elbow, Wrist/Hip)
4.10
Arthodesis - MP & IP Joints
L
L
Ik
4.11
Excision Exostosis long bones, single / two
4.12
Currentage Bone Grafting of Bone Tumour of fumur/tibia Humerus & forearm
4.13
Surgery tumours of small bone hand and foot______________________
4.14
Debridement primary closure of compounds fracture of tibia, femur forearm without fixation
-------------------------------------- -------------------- ------------- -
_____
I
I
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r
. A.
r
——————-r——
4.15
Debridement of hand/foot
4.16
Debridement primary closure of compound fractures of tibia, femur forearm with fixation
4.17
Tendon surgery soft tissue release in club foot__________________________
4.18
Internal fixation of small bone (Single, Two , More than two)
4.19
Tendon Surgery (Repair and Lengthening)
4.20
Surgery of chronic Osteomlitis (Saucerization.Sequentrectomy of femur, Humerus, Tibia)
4.21
Fibula Radius Ulna (Clavicle) and Wrist, Ankle, Hand foot
4.22
Amputation (Thigh or arm, leg or forearm, feet or hand, digits)
4.23
Disarticulation of hip or shoulder (Disarticulation of knee elbow/wrist/ankle; Fore-quarter or
hind-quarter) ___________________ ___________ ________________ ______ _
4.24
POP Aplication (Hip Spica, Shoulde spica POP Jacket; A-K/A-E POP; B-K/B-E POP)
4.25
Corrective Osteotomy of long bones
--------------------------------------------------
_________
■■
1
22
r
r
IPHS for 101 to 200 Bedded District Hospitals
4.26
Excision Arthoplasty of elbow & other major joints; Excision Arthoplasty of small joints
4.27
Operation of hallus valgus
4,28
Bone Surgery (Needle biopsy, Axial Skelton, Non-Axial)
4.29
Removal K Nail AO Plates
4.30
Removal Forearm Nail, Screw, Wires
4.31
Skeltal Traction Femur, Tibia, Calcanlum, Elbow
4.32
Bone Grafting (small grafting and long bone)
4.33
Ingrowing toe-nail
4.34
Soft tissue Biopsy
■.
........................... ..........
I
■
4.35
Skin Graft (small, medium and large)
4-36
Patellectomy
4.37
Olacranon fixation
4.38
Open Ligament repair of elbow, Ankle & Wrist
4.39
Arthrotomy of hip/shoulder/elbow
4.40
Carpal Tunnel Release
4.41
Dupuytrens contracture
4.42
Synovectomy of major joint shoulder/hip/ Elbow
4.43
Repair of ligaments of knee
4.44
Closed Nailing of long bones
, 4,45
External fixator readjustment dynamisation removal of external fixation/removal of implant
‘ 4.46
Excision of soft tissue tumour muscle group
.
23
__
IPHS for 101 to 200 Bedded District Hospitals
RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) FOR DIFFERENT
ILLNESSES CONCERNING DIFFERENT SPECIALITIES:
OBSTETRIC & GYNECOLOGY
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Bleeding during first trimester
Treat and provide blood transfusion
2
Bleeding during second trimester
Treat and provide blood transfusion
3
Bleeding during third trimester
Treat and provide blood transfusion
4
Normal Delivery
Yes
5
Abnormal lablour (Mai presentation,
prolonged labour, PROM, Obstructed
labour)
Treat
6
PPH
Treat
7
Puerperal Spesis
Treat and refer if necessary
8
Ectopic Pregnancy
Treat
9
Hypertentive disorders
Treat and refer if necessary
10
Septic abortion
Treat
11
Medical disorders complicating
pregnancy (heart disease, diabetes,
hepatitis)
Refer and follow up’services
Bronchial asthma
Treat
s.
No
12
if
_
B/B.
.
.
_____________
___
r
!
1
r
Treat
RTI / STI
?J ’
T
Treat
2
DUB
3
Benign disorders (fibroid, prolapse,
ovarian masses)
Initial investigation at PHO / Gr III level
Treat
Breast Tumors
Instigate and refer
B 0^1’
Collection of PAP SMEAR and biopsy
B.
Cancer Cervix screening Initial
investigation at PHC / Grade III level
24
I
_______
I
■
5
I
I
• •
”
4
I
_____________ .
Gynecology
1
I
■ B.B .
1^
; B
IPHS for 101 to 200 Bedded District Hospitals
7
Cancer cervix /ovarian Initial
investigation at PHC / Gr III level
Diagnose and refer
Infertility*
Investigate and refer
Prevention Of MTCT
Pretest and post test and couseling and
treatment
■
8
. -1
-1
•
:W • *«. ..,v ' A’
9
MTP / MVA services
Treat
10
Tubectomy
Yes
GENERAL MEDICINE
-1
y
h
NAME OF THE ILLNESS
b.
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
No
■ i
I
i
y
y
Fever -a) Short duration
(<1 week)
Basic investigation and Treatment
Fever -b) Long duration
(>1 week)
Investigation and treatment
Refer if necessary
■
c) Typhoid
_____
Treat
d) Malaria / Filaria
Treat
e) Pulmonary Tuberculosis.
Treat
f) Viral Hepatitis
Treat
If MBs, Ag +ve refer to tertiary care
y
1
I
J
y
>
■
g) Leptospirosis / Menningitis and
fever 1_____
___ Haemorrhagic
.__________
_____
2
-j
•
-d
y
Refer to Gr-l/G-ll District
/
COMMON RESP. ILLNESSES i
■
3
■
Bronchial Asthma / Pleuraleffusion /
Pneumonia / Allergic Bronchitis/COPD
Diagnose and Treat
COMMON CARDIAC PROBLEMS
a) Chest pain (IHD)
.
■'
Treat and decide further management
4 :?
GI TRACT
a)
G I Bleed / Portial hypertension /
Gallblader disorder
Emergencies - Ref. To Gr-ll /
Gr-I - District Hospital
AGE / Dysentry / Diarrhoreas
Treat
■■
' I
h) Malignancy
Refer to Gr-I / G-ll District level
■
b)
25
IPHS for 101 to 200 Bedded District Hospitals
r5
NEUROLOGY
a)
Chronic Hpeadache
Investigate, treat & decide further
b)
Chronic Vertigo/CVA/TIA/Hemiplegia/
Paraplegi
Ref. To Gr-1/G-ll district
6
HAEMATOLOGY
a)
Anaemia
Bleeding disorder
Stabilise
Ref. To tertiary
c)
Malignancy_______
Ref. To Gr -1 / G-ll district
7
COMMUNICABLE DISEASES
■
I111
Is
Treat
Cholera
Measles
Mumps
Chickenpox______
8
S ?'
Basic investigation and Treatment
Refer if necessary
b)
I
II
11
I
11
i
M
rt,:
PSYCHOLOGICAL DISORDERS
i—
Screening, emergency care and referral
Acute psychosis / Obsession / Anxiety
neurosis
PAEDIATRICS_____________
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
S.
No
NAME OF THE ILLNESS
1
ARI/ Bronchitis Asthmatic
Investigate
Diagnose with facility for
nebulisation,
Treat
Refer if no improvement
Diarrohoeal Diseases
Diagnose
Treat
Protein Energy Malnutrition and Vitamin
Deficiencies
Investigate
Diagnose
Treat
Refer
Pyrexia of unknown origin
Investigate
Dagnose
2
3
4
26
I III
!
Sil
' .
■
..
■1^
. ■ • 1.
■■
-
-s
-J
r—
IB
*1
_
IPHS for 101 to 200 Bedded District Hospitals
-I
-I
Treat
Refer if no improvement
5
Bleeding Disorders
Investigate
diagnose
Treat
Refer if no improvement
Diseases of Bones and Joints
Investigate
diagnose
Treat
Refer if no improvement
Childhood Malignancies
Early Diagnosis and Refer
I
■I '
6
k': '
J
k'-k
"I
7
k-->
_____
■ 'r'
8
Liver Disorders
9
Paediatric Surgical Emergencies
10
Investigate and Diagnose
Refer
_
—
I
Investigate
diagnose
Treat
Refer if no improvement
Poisoning, Sting, Bites
Treat
NEONATOLOGY
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Attention at birth (to prevent illness)
5 cleans warm chain
Hypothermia
Warm chain
Birth asphyxia
Resuscitation And Treatment
Hypoglycemia
Treat
5
Meconium aspiration syndrome
Treat & refer if no improvement.
6
Convulsions (seizures)
Treat and Refer if no improvement.
S.
No
n
. 1-
fc
n
Neonatal Sepsis
J
It
Investigate & Treat
t
8
LBW
9
Neonatal Jaundice
Treat including exchange transfusion
10
Preterm
Warm chain, feeding, kangaroo care, Treat
Treat
■
11
Congenital malformations
11
Examine and refer
27
IPHS for 101 to 200 Bedded District Hospitals
12
R.D.S.ARI
Manage and Refer
13
Dangerously ill baby
Identify and manage & refer if needed.
14
Feeding Problems
Identify and manage_________ _______
15
Neonatal diarrhoea__________
16
Birth injury _______________
Minor -manage; major -refer
17
Neonatal Meningitis
Manage
18
Renal problems/Congenital heart
disease/ Surgical emergencies
Refer
---------------------- ------
19
HIV/AIDS
Exclusive breast feeding & refer to ART Centre
20
Hypocalcemia
Manage______
21
Metabolic Disorders
Identify & Refer
22
Hyaline Membrane diseases
Diagnose & refer
23
Neonatal Malaria
Manage
24
Blood disorders
Manage
25
Developmental Delays
CBR
26
UTIs
Manages refer
27
Failure to Thrive
Manage & Refer
Diagnosis and manage
■ "t. . •' -
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I
DERMATOLOGY
s.
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)______________
Infections
a) Viral - HIV - Verrucca
Molluscum Contagiosa
Treat
Pityriasis Rosea
LGV
HIV
Treat
No
1
r
II
Hr
____
r
r
\ .
b) Bacteria
Pyoderma
Chancroid
i
Treat
________
' .<a<. H *;-.
Gonorrhea
Leprosy
Tuberculosis
N
K
'i
-
'
r
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L
28
IPHS for 101 to 200 Bedded District Hospitals
■
I
n
__
c) Fungal
Sup. Mycosis
Subcut - Mycetoma
(I
d) Parasitic Infestation
Scabies / Pediculosis/Larva Migrans
Treat
e) Spirochaetes
Syphilis
Diagnosis and Treat
-I
J
Identify/Treat and refer
't"
tl
J
J
J
r
■
Papulosquamous
Psoriasis (classical)-uncomplicated/
2
Treat
___________________
“
n:—.
______
Pi„ 0,30^
Vitiligo
Treat
Keratimsation Disorder
Ichthyosis/Traumatic Fissures
Treat
Autoimmune
Collagen Vascular
DLE, Morphea
Treat/
Refer
4
I
5
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6
a.-v
7
-
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11
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_
II
11
f
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■■
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•
■
'
■
•
<
.
Skin Tumors, Seb.Keratosis, Soft
Fibroma,Benign Surface,Tumors /
Cysts, Appendageal Tumors
Treat
Miscellaneous
a) Acne Vulgaris, Miliaria, Alopecia,
Nail disorder,Toxin induced
Treat
_____
-
Treat/
Refer
b) Leprosy - Resistant/
Complications / reaction
Allergy - EMF / SJS / TEN Psoriasis/
Collagen Vascular/Auto immune
Disorders
11
Ir
■
•
—MM■■■M■■■
■
c) Deep Mycosis, STD Complications
Treat / Refer
d) Genetically Determined
Disorders
Refer
—
I ElI..
~11 N°
CHEST DISEASES
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Fever
Investigation and Treatment
11
I B
29
IPHS for 101 to 200 Bedded District Hospitals
2
Cough with Expectoration / Blood Stained
Treatment
3
Hemoptysis
Investigation and Treatment, Bronchoscopy
4
Chest Pain
Investigation Treatment
5
Wheezing
Treatment, PFT
6
Breathlessness
Investigation and Treatment Chest
Physiotherapy
-
■
-
r
------------------------------------------------------------------------------------
I
k
k
k
PSYCHIATRY
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
S.
No
NAME OF THE ILLNESS
1
Schizophrenia
Follow up
2
Depression
Follow up
3
Mania
Follow up
4
Anxiety Disorders
Follow up
________
5
Mental Retardation
Follow up
________
6
Other Childhood Disorders .
Follow up
7
Alcohol and Drug Abuse
Follow up
______
8
Dementia
Follow up
______
I
t-
______
I_____________
■
■■
■
___
h
I-
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DIABETOLOGY
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
S.
No
NAME OF THE ILLNESS
1
Screening for Diabetes
Diagnose and Treat
2
Gestational Diabetes/DM with Pregnancy
Diagnose and Treat
1 Diagnose and Treat
3
DM with HT
4
Nephropathy/Retinopathy
Diagnose and Refer
5
Neuropathy with Foot Care
Diagnose and Treat
6
Emergency
i) Hypoglycemia
ii) Ketosis
iii) Coma
,i
■■
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■
--------—
4
I
L
—— —
______
..
■
■
■:
______
lief
Diagnose and Treat
I
30
■L.
IPHS for 101 to 200 Bedded District Hospitals
NEPHROLOGY
s.
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
UncomplicatedUTI
Treat
2
Nephrotic Syndrome - Children/ Acute
Nephritis
Treat
3
Nephrotic Syndrome - Adults
Refer to Tertiary
4
HT, DM
Treat
5
Asymptomatic Urinary Abnormalities
Refer to the District
6
Nephrolithiasis
Refer to District Hospital
7
Acute renal Failure/ Chronic Renal
Failure
Suspect /
Refer to District level
8
Tumors
Refer to Tertiary
No
L.
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1
Li
NEURO MEDICINE AND NEURO SURGERY
S.
No
NAME OF THE ILLNESS
RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
1
Epilepsy
~ Investigate and Treat
2
C.V.A.
Investigate and Treat
3
Infections
Investigate and Treat
4
Trauma
Investigate and Treat, Refer if necessary
5
Chronic headache___________
Investigate and Treatment
6
Chronic Progressive Neurological
disorder
Referral
J
GENERAL SURGERY
J
S Major
No Classification
NAME OF THE ILLNESS
Basic
1
s-d. Techniques
a. Minor Cases
under LA Abcess l&D/Suturing,Biopsy/
Excision of Lipoma / Ganglion / Lymph
of Lipoma / Ganglion / Lymph Node,
Seb-Cyst / Dermoid / Ear Lobe Repair /
Circumcision
J
I
I
J
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
31
Treat
I?,
d
dll
IPHS for 101 to 200 Bedded District Hospitals
Elective
Surgeries
2
b. FNAC Thyroid, Breast Lumps,
Lymphnodes, Swelling
Investigate/Diagnosis and Refer
a. Genitourinary tract
Hydrocele, Hernia, Circumcision,
Supra pubic cystostomy
Treat
I
b. Gastrointestinal disorder
Appendicitis/Anorectal abscesses /
Rectalprolapse/Liver abscess/
Haemorrhoids/Fistula
Treat
Emergency
surgeries
Assault injuries/Bowel injuries/
Head injuries/Stab injuries/Multiple
injuries/ Perforation/lntestinal obstruction
Benign/
Malignant
Diseases
Breast/Oral/GI tract/Genitourinary (Penis,
Prostate, Testis)
Treat
5
Others
Thyroid, Varicose veins
Treatr
6
Burns
Burns
<15%
>15%
3
4
Medico legal
7
Treat
r
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.
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1
■
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1
Treat first and then Refer
U;
a) Assault / RTA
AR entry/Treat
b) Poisonings
■AR entry/Treat
c) Rape
AR entry/Treat
1
d) Postmortem
_______
_____
Done
OPTHALMOLOGY
s.
h
r
r
NAME OF THE ILLNESS
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
l‘
1
Superficial Infection
Treatment with drugs
-
2
Deep Infections
Treat
J
3
Refractive Error
4
Glaucoma
Treat
5
Eye problems following systemic disorders
Treat
6
Cataract
Treat
7
Foreign Body and Injuries
Treat
No.
s
,4W'-
32
Treat
________ _
a*
-
T.
IPHS for 101 to 200 Bedded District Hospitals
8
Squint and Amblyopia/Corneal Blindness (INF, INJ,
Leucoma)/ Oculoplasty
Refer
9
Malignancy/Retina Disease
Refer
Paediatric Opthalmology
Refer
I
I
EAR, NOSE, THROAT
s.
EAR
1
ASOM/SOM/CSOM
Treat/Surgical if needed
2
Otitis External / Wax Ears
Treat
Polyps
Surgical Treatment
4
Mastoiditis
Treatment
(Medical), Surgery if needed
5
Unsafe Ear
Diagnose and Refer
■
L
-i
-I
-I
THROAT
Tonsillitis/Pharyngitis/Laryngitis
Treat
2
Quinsy
Surgery
3
Malignancy Larynx
Diagnose and Refer
4
Foreign Body Esophagus
Diagnose and Refer
NOSE
J
1
J
J
I
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
No.
I
1
-I
-I
NAME OF THE ILLNESS
Epistaxis
Treat
Foreign Body
Treat
3
Polyps
Treat (Removal)
4
W?
5
Sinusitis
Treat (surgery if needed)
Septal Deviation
Treat (surgery if needed)
1
—
■
33
IPHS for 101 to 200 Bedded District Hospitals
ORTHOPADICS
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
S.
No.
NAME OF THE ILLNESS
1
Osteomyelitis
All Stabilisations
Surgery
2
Rickets /Nutritional Deficiencies
Manage
with Physiotherapy
3
Poliomyelitis with residual
Deform ities/JRA/R A
Corrective Surgery/
Physiotherapy___
4
RTA/Polytrauma
Manage
A
•
F
r
r
______
UROLOGY
S.
No.
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
NAME OF THE ILLNESS
r
CHILDREN
1
Hydronephrosis
Diagnose and refer
2
Urinary Tract Injuries
Diagnose and refer
3
PUV/ Posterior Urethral Valve
Diagnose and refer
4
Cystic Kidney
Diagnose and refer
5
Urinary Obstruction
Urethral Catheter Insertion Referral
6
Undesended Testis
Diagnose and refer
7
Hypospadias and Epispadias
Diagnose and refer
8
Mega Ureter
Diagnose and refer
9
Extrophy
Diagnose and refer
10
Tumours - Urinary Tact
Diagnose and refer
_____________
r
I-
\
f'■
■
■
ADULT
_
—————
_____________
All above and
1
Stricture Urethra
Diagnose and refer
2
Stone Diseases
Diagnose and refer
3
Cancer - Urinary and Genital Tract
Diagnose and refer
34
r
r
r
l
DB
IPHS for 101 to 200 Bedded District Hospitals
4
4
Trauma Urinary Tact
Diagnose and refer
5
GUTB
Diagnose and refer
1
OLD AGE
1
Prostate Enlargement and Urinary Retention
Urethral Catheter Insertion Referral
I
2
Stricture Urethra
Diagnose and refer
-i
3
Stone
k 4' -
5
■
Diagnose and refer
Cancer
(Kidney, Bladder, Prostate,
Testis,Penis and Urethra) ;
Diagnose and refer
Trauma Urinary Tract
Diagnose and refer
DENTAL SURGERY
.
-i
-1
.■
s.
NAME OF THE ILLNESS
RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
Dental Caries/Dental Abcess/Gingivitis
Treat
No.
1
.Cleaning
"I
d
d
-I
2
Periodontitis
Treat
Surgery
3
Minor Surgeries, Impaction, Flap
Cleaning
Treat
Surgery if necessary and refer
Malocclusion
Refer
■-
“I
■ d
□
Prosthodontia (Prosthetic Treatment)
Treat with appliances
d
6
Trauma
Treat (wiring and planting)
d
7
Maxillo Facial Surgeries
Refer
d
d
d
-I
8
Neoplasms
Refer
d
j
I
35
F
I
IPHS for 101 to 200 Bedded District Hospitals
7.
Physical infrastructure
7.1.
Size of the hospital:
(physically and visually handicapped) friendly.
Provision should be made for water harvesting,
generating back-up, solar energy / power back-up,
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.
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:
Too old building may be demolished and
new construction done in its place.
4
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.
The location may be near the residential
area.
.
Bed days per year = 20,000 x 5 = 100,000
♦
Total number of beds required when
occupancy is 100% = 100000/365 = 275
It must be serviced by public utilities: water,
sewage and storm-water disposal,
electricity, gas a’nd telephone. In areas .
where such utilities are not availaplp,
substitutes must be found, such as a deep
well for water, generators for electricity and
radio communication for telephone.
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 be.reasonable. 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.
7.3.
li
7.4. . Factors to be considered in locating a
district hospital
The total number of admissions per year =
10,00,000 x 1/50 = 20,000
7.2.
c
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f
I
♦
Necessary environmental clearance will be
taken.
I
Disability Act will be followed.
Site information:
7.5.
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 or centers, 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
Site selection criteria
f
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
36
I
I
f
IPHS for 101 to 200 Bedded District Hospitals
/•
conditions, utilities available, natural features and
limitations.
X
7.6
In the already existing structures of a
district hospital
Ir
♦
It should be examined whether they fit into
the design of the recommended structure
and if the existing parts can be converted
into functional spaces to fit in to the
recommended standards.
n
I
-f
Clinics
The clinics should include general, medical,
surgical, ophthalmic, ENT, dental, obsetetric and
gynaecology, paediatrics, dermatology 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.
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.
11
it
;f
Main entrance, general waiting and
subsidiary waiting spaces are required adjacent to
each consultation and treatment room in all the
clinics.
♦
7.7.
If they are too old and dilapidated then they
must be demolished. And new construction
should be put in place.
Nursing Services
Various clinics under Ambulatory Care Area
require nursing facilities in common which include
dressing room, side laboratory, injection room, social
service and treatment rooms, etc.
Building and Space Requirements
Administrative Block:
5
Administrative block attached to main
hospital along with provision of MS Office and other
staff will be provided.*
Circulation Areas
)
i
Nursing Station: 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 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
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 be provided in the
department for loading, unloading, developing and
processing of X-ray films. Separate Reporting Room
for doctors should be there.
Floor Height
The room height should not be less than
approximately 3.6 m measured at any point from
floor to floor height.
i
Entrance Area
Physical Facilities
I
I
Ambulatory Care Area (OPD)
i
Waiting Spaces
Registration, assistance and enquiry counter
facility be made available in all the clinics.
37
I
IPHS for 101 to 200 Bedded District Hospitals
Clinical Laboratory
Separate Reporting Room for doctors
should be there.
kept to the minimum. Ward unit will include nursing
station, doctors’ duty room, pantry, isolation 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.
Blood Bank
Private ward:
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. Blood
Bank should follow all existing guidelines and fulfill
all requirements as per the various Acts pertaining
to setting up ofthe Blood Bank.
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.
For quick diagnosis of blood, urine, etc., a
small sample collection room facility shall be
provided.
I
t
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I
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(
Pharmacy (Dispensary)
i
Separate Reporting Room for doctors
should be there.
(
!•
t
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
I
Pharmacy should have component of
medical store facility for
indoor patients and separate pharmacy with
accessibility for OPD patients.
Nursing care should fall under following
categories:
General Wards: Male / Female
I
I
I
(
Private Wards:
Wards for Specialities
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.
Intensive Care Unit and High Dependency Wards
I
General
F
■ 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
Location
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
(
j
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38
9
*
*
IPHS for 101 to 200 Bedded District Hospitals
T>
Hi
T
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:s
ir
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a
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s
High Dependency Wards. For example, in a 500bedded 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.
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 ancillaribs 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
r
I
i
i
i
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.
Therapeutic Services
Operation Theatre
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 facilityjt
should have a single leaf door with self closing
device and viewing window to communicate with
the operation theatre. A pair of surgeon's sinks and
elbow or knee operated taps are essential.
Operation Theatre should also have a SubSterilizing unit attached to the operation theatre
limiting its role to operating instruments on an
emergency basis only.
39
r
IPHS for 101 to 200 Bedded District Hospitals
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.
Hospital Services
Hospital Kitcheri (Dietary Service)
The dietary service of a hospital iS hn
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.
Delivery Suite Unit
The delivery suit unit be located near to
operation theatre.
Central Sterile and Supply Department (CSSD)
The delivery Suit Unit should include the
facilities of accommodation for various facilities as
given below:
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.
Reception and admission
Examination and Preparation Room
Labour Room (clean and a septic room)
Hospital Laundry
Delivery Room
st
D€
ro
v(
ex
IVl(
Sterilizing Rooms
It should be provided with necessary
facilities for drying, pressing and storage of soiled
and cleaned linens.
Sterile Store Room
Medical and General Stores
de
Scrubbing Room
There are of medical and general store
should have vehicular accessibility and ventilation,
security and fire fighting arrangements.
da
Mortuary
Pl
Neo-natal Room
Dirty Utility
Physiotherapy
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.
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 toilets
separate for male and female. Normative standards
will be followed.
'3
pn
I
wa
Engineering Services
Electric Engineering
Sub Station and Generation
Electric sub station and standby generator
room should be provided.
40
be].
( 1
IPHS for 101 to 200 Bedded District Hospitals
Illumination
i.
Drainage and Sanitation
The illumination and lightning in the hospital
should be done as per the prescribed standards.
Emergency Lighting
ar
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.
>e
n.
Shadow less light in operation theatre and
delivery rooms should be provided. Emergency
portable light units should be provided in the wards
and departments.
Io
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.
Trauma Centre
Ventilation
Fire Protection
The ventilation in the hospital may be
achieved by either natural supply or by mechanical
exhaust of air.
Telephone and Intercom
i
>)
e
u
a
3
)
I
Guidelines to be followed
Medical Gas
Laboratory Gas: Liquefied petroleum gas (LPG)
and other specified gases.
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
Hospital should be provided with water
coolers and refrigerator in wards and departments
depending upon the local needs.
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.
Public Health Engineering
1
National guidelines on Bio-Medical Waste
Management and a Notification of Environment and
Forests are at Annexure -1
Cooking Gas: Liquefied petroleum gas (LPG)
Mechanical Engineering
y
d
Waste Disposal System
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 beded hospital.
Separate provision for fire fighting and water
’ softening plants be made available.
Committee Room: A meeting or a committee room
for conferences, trainings with associated furniture.
Residential Quarters
All the essential medical and para-medical
staff will be provided with residential
accommodation.
41
I
IPHS for 101 to 200 Bedded District Hospitals
8.
MANPOWER REQUIREMENT
8.1.
MAN POWER - DOCTORS
District HeadquartersHospital
(101-200) bedded
Staff
S.
No
1
Hospital Superintendent____________
2
Medical Specialist___________ _
3
*
—
. •
3
_ ______
Surgery Specialists_______________
2
Beil s
4
O&G specialist_________________
4
_______
5
Psychiatrist________________ _
6
Dermatologist / Venereologist________
1
7
Paediatrician____________________
2
8
Anesthetist (Regular / trained)_______
2
9
ENT Surgeon________________ '
1
10
Opthalmologist_________ "________
1
11
Orthopedician__________________ _
1
12
Radiologist_____________________
1
13
Microbiologist_______ ____________
1
14
Casualty Doctors / General Duty Doctors
15
Dental Surgeon__________________
1
16
Forensic Expert________________ _
1
17
Public Health Manager1____________
1
18
AYUSH Physician2_______________
2
19
Pathologists
2
Total
34
■B
1
_
■’
6
■
4 ! Y" 7
Note:
'May be a public Health Specialist or mangement specialist trained in public health
’Provided there is no AYUSH hospital/dispensary in the district haedquarter
I
42
■
L
IPHS for 101 to 200 Bedded District Hospitals
8.2.
MAN POWER - PARA MEDICAL
s.
Staff
No
E
*
2
District Head quarters Hospital
(101-200) bedded
_______
Staff Nurse*
75 to 100
_______
Hospital worker (OP/ward +OT+
blood bank)
_ _________ •_
___ _ _________________
zzzzz
20
3
Sanitary Worker
4
Ophthalmic Assistant / Refractionist
1
5
Social Worker / Counsellor
1
6
Cytotechnician
1
15
■■
7
o
8
ECG Technician
1
ECHO Technician
—
1
Audiometrician
10
Laboratbry Technician ( Lab + Blood Bank)
12
11
Laboratory Attendant (Hospital Worker)
4
12
Dietician
1
13
PFT Technician
14
Maternity assistant (ANM)
6
15
Radiographer
2
16
Dark Room Assistant
17
Pharmacist1
18
Matron
19
Assistant Matron
2
20
Physiotherapist
1
21
Statistical Assistant
1
22
Medical Records Officer/Technician
1
23
Electrician
1
■
24
------------------ -----------------
1
W I:
-H
5
1
_____
H
. ....... .............. ..... .....
Plumber
1
*1 Staff Nurse for every eight beds with 25% reserve.
1 One may from AYUSH
I
43
IPHS for 101 to 200 Bedded District Hospitals
8.3.
MANPOWER- ADMINISTRATIVE STAFF
1
2
3
4
5
6
7
8
-9
10
11
12
District Headquarters Hospital
plus JD-HS Office
101-200 Bedded Hospitals
Staff
S. No.
Manager (Administration)
Junior Administrative Officer
Office Superintendent
Assistant______________ ___
Junior Assistant / Typist
Accountant____________
Record Clerk__________
Office Assistant_________
Computer Operator______
Driver_______________
Peon________________
Security Staff*__________
Total
■*
___
■
1
1
2
2
2
1
1
1
2
2
2
17
______
' ’ b •SOW'1’
Note : Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be required if outsourced
* The number would vary as per requirement and to be outsourced.
8.4.
MAN POWER - OPERATION THEATRE
S.
No.
1
2
3
8.5.
Staff
Staff Nurse
OTAssistant
Sweeper
Total
District Headquarters Hospital
Saw
101-200 Bedded Hospitals
__ _
—
General
OT
Emergency / FW OT
8
4
.... 3
• 4
4
15
MAN POWER - BLOOD BANK / STORAGE
S. No
1
2
3
4
______ Staff
Staff Nurse
MNA/FNA
Lab Technician
Safar Karamchari ,
Total
Blood Bank
y '
■ 8
___ J
1
_____ 1^
_____ 1_
_____ 1_
3
1
1
6
44
Blood Storage__
y-'
1
•V'J'
__
t
I
IPHS for 101 to 200 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
1.
Imaging equipments
2.
X Ray Room Accessories
3.
Cardiac Equipments
I 4.
Labour ward & Neo Natal Equipments
5.
Ear Nose Throat Equipments
6.
Eye Equipments
7.
Dental Equipments
8.
Operation Theatre Equipment
9.
Laboratory Equipments
10.
Surgical Equipment Sets
11.
PhysioTherapy Equipments
12.
Endoscopy Equipments
13.
Anaesthesia Equipments
14.
Funriture & Hosptial Accessories
15.
PM equipments
16.
Linen
17.
Teaching Equipments
18.
Administration
19.
Refrigeration & AC
20.
Hospital Plants
21.
Hospital Fittings & Necessities
22.
Transport
45
I
IPHS for 101 to 200 Bedded District Hospitals
I. IMAGING EQUIPMENT
S.
No.
1
District Headquarters Hospital
101 -200 Bedded Hospitals
Name of the Equipment
I
500 M.A. X-ray machine*
■
2
300 M.A. X-ray machine
3
100 M.A. X-ray machine
4
60 M.A. X-ray machine (Mobile)
'
'
i
1
1
———T-
5
C arm with accessories *
6
Dental X ray machine
7
Ultra Sonogram (Obs & Gyne. department
should be having a separate ultra-sound
machine of its own)
w
1
i
1 +1
8
C.T. Scan
9
Mammography Unit *
I
I
10
Echocardiogram*
W
“T--
* To be provided as per need.
II. X-RAY ROOM ACCESSORIES
S.
No.
District Headquarters Hospital
101-200 Bedded Hospitals
T
Name of the Equipment
1
X.ray developing tank
1
2
Safe light X.ray dark room
3
3
Cassettes X.ray
12
_________
4
X.ray lobby single
6
_________
5
X.ray lobby Multiple
1
6
Lead Apron
2
7
Intensifying screen X-ray
1
■■
46
i k
IPHS for 101 to 200 Bedded District Hospitals
III. CARDIAC EQUIPMENTS
Name of the Equipment
No.
1
ECG machine computerized
2
ECG machine ordinary______
3
12 Channel stress ECG test
equipments Tread Mill *_____
4
Cardiac Monitor___________
__ 5_ Cardiac Monitor with defibrillator
6
Ventilators (Adult)
_______
__ 7
Ventilators (Paediatrics)______
8
Pulse Oximeter
_______
Pulse Oximeter with NIB.P*
9
10
Infusion pump_____
11
B.P.apparatus table model
12
B.P.apparatus stand model
Stethoscope
13
District Headquarters Hospital
101-200 Bedded Hospitals
___________ 1___________
1
4
2
1
1
3
1
2
10
10
5
* To be provided as per need.
IV. LABOUR WARD & NEO NATAL EQUIPMENTS
S.
No.
__ 1
2
3
4
5
6
7
* ■
8
9
10
11 ,
1^
13
14
15
16
17
18
Name of the Equipment
Baby Incubators_____________
Phototherapy Unit____________
Emergency Resuscitation Kit-Baby
Radiant Warmer
_________
Room Warmer______________
Foetal Doppler______________
CTG Monitor______ _________
Delivery Kit_______ _________
Episiotomy kit ______________
Forceps Delivery Kit__________
Crainotomy________________
Vacuum extractor metal________
Silastic vacuum extractor_______
Pulse Oximeter baby and adult
Cardiac monitor baby__________
Nebulizer baby
_________
Weighing machine adult,_______
Weighing machine infant
47
District Headquarters Hospital
101-200 Bedded Hospitals
___________ 1___________
___________ 2___________
___________ 2___________
___________ 2___________
___________2___________
___________ 2___________
___________ 2___________
__________ 10___________
___________2___________
___________2___________
___________1___________
__________ 2___________
__________ 2___________
________ 1 each_________
__________ 1___________
__________ 2___________
__________ 3___________
3
F
IPHS for 101 to 200 Bedded District Hospitals
V. EAR NOSE THROAT EQUIPMENT
S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Name of the Equipment
Audiometer______________
Operating Microscope (ENT)
Head light (ordinary) (Boyle Davis)
ENT Operation set including
headlight, Tonsils__________ '
Mastoid Set_____________ _
Micro Ear Set myringoplasty_______
Stapedotomy Set___________
Stapeidoplasty____________ _
ENT Nasal Set (SMR, Septoplasty,
Polypetcomy, DNS, Rhinoplasty)
District Headquarters Hospital
101-200 Bedded Hospitals
1
■
J
2
<
1
1
■
S-
___
1
1
1
I
1,
Laryngoscope fibreoptic ENT
Laryngoscope indirect
Otoscope______ ■
Oesophagoscope Adult
1“
Oesophagoscope Child
Head Light (cold light)
Tracheostomy Set __
Tuning fork
___
2
2
1
,1
t
1
2
1
W
VI. EYE EQUIPMENTS
S.
No.
1
2
3
4
5
6
7
Name of the Equipment
Cryo Surgery Unit______
Opthalmoscope - Direct
Slit Lamp____________
Retino scope_________
Perimeter____________
IOL Operation set______
Laser Photocoagulometer*
District Headquarters Hospital
101-200 Bedded Hospitals
1
2
T
2
2
* - to be supplied by Blindness Control Society
48
IPHS for 101 to 200 Bedded District Hospitals
VII. DENTAL EQUIPMENTS
s«
■
No.
1
____
Name of the Equipment
Air Rotor
Dental Unit with motor for dental OP
Dental Chair
—
Dental Lab
Dental Kit
< ■
____
5
District Headquarters Hospital
101-200 Bedded Hospitals
1
___________ 1___________
1
2
VIII. OPERATION THEATRE EQUIPMENT
Name of the Equipment
No
*
r~
___ 2
3
4
5
6
7
8
___ 9
___ 10
___ 11
12
13
14
15
16
17
"
18
19
20
21
22
23
24
25
Auto Clave HP Horizontal
______
Auto Clave HP Vertical (2 bin)______
Operation Table Ordinary Paediatric*
Operation Table Hydraulic Major
Operation table Hydraulic Minor_____
Operating table non-hydraulic field type
Operating table Orthopedic *_______
—
Autoclave with Burners 2 bin*_______
Autoclave vertical single bin
Shadowless lamp ceiling type major*
Shadowless lamp ceiling type minor*
Shadowless Lamp stand model_____
Focus lamp Ordinary________ _
Sterilizer big (Instrument)
Sterilizer Medium (Instrument)
Steriliser Small (Instruments)
Bpwl Steriliser - big*_____________
Bowl steriliser - Medium*
Diathermy Machine (Electric Cautery)
Suction Apparatus - Electrical_______
Suction Apparatus - Foot operated
Dehumidifier*
Ultra violet lamp philips model 4 feet
Ethylene Oxide sterilizer*__________
Microwave sterilizer*_____________
* To be provided as per need.
49
District Headquarters Hospital
101-200 Bedded Hospitals
2
2
2
1
J
1
1
1
2
2
2
2
2
2
1
4_
2
1
4_
1
1
IPHS for 101 to 200 Bedded District Hospitals
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
District Headquarters
Hospital (101-200 bedded)
6
Binocular Microscope
;w ■
Chemical Balances
_________£o
2
Simple balances
__2_
2
Electric Calorimeter
—
Auto analyser_____
1
Semi auto analyser__________ _
_
10
Micro pipettes of different volumes_____ _
Water bath
|
2
3
Hot Air oven_________
3
Lab Incubator________
2
Distilled water Plant
3
Electricentrifuge, table top
\ ' •"W’ 1
Cell Counter Electronic
3
Hot plates___________
____
3
Rotor / Shaker________
____
3
Counting chamber_____
J
2
PH meter__________________
Paediatric Glucometer / Bilirubinometer
____
1
Glucometer_______________ _
2
Haemoglobinometer
1
TCDC count apparatus
__
• 4
ESR stand with tubes
6
Test tube stands______
____
6
Test tube rack________
____
6
Test tube holders______
____
8
Spirit lamp___________
——
1
Rotatry Microtome_____
_________
_ n.
■
Wax Embel Bath______
Auto Embedic Station
Timer stop watch______
Alarm clock__________
Elisa Reader cum washer
Blood gas analyser
Electrolyte Analyser
Glycosylated Haemoglobinometer
2
____
■
_____
f
——
2
2
2
2
1
zzzz
_____
_____
!
. nn
jj
50
I
1
IPHS for 101 to 200 Bedded District Hospitals
___ 36
___ 37
38
39
___ 40
41
42
___ 43
44
45
48
49
50
Blood Bank Refrigerator_____________
Haematology Analyser with 22 parameters
Blood Collection Monitor____________
Laboratory Autoclaves
___________
Blood Bank Refrigerator
Ordinary Refrigerator_______________
Floatation Bath
________________
Emergency Drug Trolley with auto cylinder
Dialected Tube Scaler______________
Class -1 Bio Safety Cabinet________
Knife Sharpner
____________
Air Conditioner with Stabilizer_________
Cyto Spin______ __ _____________
RO Plant_______ ________________
Computer with UPS and Printer
3
_1_
2
4_
3
1
J
1
J
2
i
1
X. SURGICAL EQUIPMENT SETS
S.
No.
___ 1
2
3
___ 4
5
6
___ 7
8
9
10
11
12
13
14
15
16
17
18
Name of the Equipment
P.S.set
MTP Set
Biopsy Cervical Set__________
D & C Set_______ __________
I.U.C.D. Kit
___________
LSCS set_______
MVA Kit________
Vaginal Hysterectomy_________
Proctoscopy Set
_________
P.V. Tray_______
Abdominal Hysterectomy set
Laparotomy Set ___________
Formaline dispenser__________
Kick Bucket_____ g__________
General Surgical Instrument Set
Piles, Fistula, Fissure______ _
Knee hammer
_____
Hernia, Hydrocele____________
Varicosevein etc
District Headquarters
Hospital (101-200 bedded)
_________ 2_________
_________ 2_________
__________ 1___________
__________ 2__________
__________ 2__________
__________ 2__________
__________ 2__________
__________ 2___________
__________ 2___________
__________ 2___________
__________ 2___________
__________ 2___________
_________ 3_________
8
2
5
2
1
7^
51
CEQ
V
)
t-'
5<' Z.'*
IPHS for 101 to 200 Bedded District Hospitals
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Gynaec Electric Cautery__________
Vaginal Examination set______ _
Suturing Set__________________
MTP suction apparatus___________
Thoracotomy set___________
Neuro Surgery Craniotomy Set_____
I M Nailing Kit__________________
SP Nailing
Compression Plating Kit__________
AM Prosthesis_________________
Dislocation Hip Screw Fixation______
Fixation Fracture Hip
Spinal Column Back Operation Set
Thomas Splint_________________
Paediatric Surgery Set________ '
Mini Surgery Set
Urology Kit______________ "s
Surgical Package for Cholecystectomy
Surgical package for Thyroid_______
Gl Operation Set
Appendicectomy Set
_________
LP.Tray
Uretheral Dilator Set_____________
TURP resectoscope_____________
Haemodialysis Machine__________
Amputation set_________________
Universal Bone Drill_____________
Crammer wire splints________ ’
Heamo dialysis machine
~T
1
8
5
1
■ ■II
1
1
1
Ulfj
—
1
“I
7
2
2
1
—
2_
2_
5_
4_
1
■
1
____
8
■
XI. PHYSIOTHERAPY EQUIPMENTS
S.
No.
District Headquarters
Hospital (101-200 bedded)
Name of the Equipment
1
Skeleton traction set
1
2
Interferential therapy unit
1
3
Short Wave Diathermy
1
52
1
IPHS for 101 to 200 Bedded District Hospitals
XII. ENDOSCOPY EQUIPMENTS
s.
Name of the Equipment
*
No.
4'
........................................................................................ ■
__ 1_
___ 2_
3 •
A-/
...
5
6
■
District Headquarters
Hospital (101-200 bedded)
Endoscope fibre Optic (OGD) *
Arthroscope_____ _______ _
Laparoscope operating major with
accessories *
Laparoscope diagnostic and for
sterilisation *
Colonoscope and sigmoidoscope*
Hysteroscope *
|
Colposcope *
1
I
..................................................
1
1
* - to be provided as per need
XIII. ANAESTHESIA EQUIPMENTS
S.
No.
1
2
—» I. NN.
:
3
4
g
Name of the Equipment
______________ X_-__
Anaesthetic - laryngoscope
magills with four blades____
Endo tracheal tubes sets
Magills forceps (two sizes)
District Headquarters
Hospital (101-200 bedded)
3
2
—
6
Connector set of six for E.T.T
Tubes connecting for ETT
____
Air way female*
7
8
Air way male*
Mouth prop*
9
10
Tongue depressors*
02 cylyinderfor Boyles
11
N2O Cylinder for Boyles_______
CO2 cylinder for laparoscope*
iT13
14
15
l..........................................................
■■■ ............................. .........................................................
I
• ■'
t'V'
■
PFT machine________ _______
Boyles Apparatus with Fluotec and
circle absorber
_________
Exchange Transfusibn Sets*
* - to be provided as per need
53
6
6
6
10
20
8
10
10
10
1
1
IPHS for 101 to 200 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
33
34
35
36
37
38
39
District Headquarters
Hospital (101-200 bedded)
Name of the Equipment
Doctor’s chair for OP Ward, Blood Bank,
Lab etc.____________________ ___
Doctor’sTable__________________ _
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_____________ ________
Footstools *____________________
Filing Cabinets (for records) *________
M.R.D.Requirements (record room use) *
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)
Medicine Trolley(SS)___________ _
Case Sheet Holders with clip(S.S.)*
Bed Side Lockers (SS)*_______
Examination Couch (SS)____________
Instrument Trolley (SS)_______ _____
Instrument Trolley Mayos (SS)________
Surgical Bin Assorted________ ______
Wheel Chair (SS)
Stretcher / Patience Trolley (SS)
-v
30 ■
8
10
8
30
30
10
20
10 ,
10
20
10
6
6
20
■'
I
8
1
5
3
1
1
200
10
. 3
6
6
3
8
6
6
6
80
0
3
8
4
30
6
5
_
?
ft.
54
(
r
IPHS for 101 to 200 Bedded District Hospitals
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
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)_____
Blood Donar Table* ______
02 Cylinder Trolley(SS)
Saline Stand (SS)______ _
Waste Bucket (SS)* ______
Dispensing Table Wooden
Bed Pan (SS)*
Urinal Male and Female_____
Name Board for cubicals*
~ Kitchen Utensils*
Containers for kitchen'
Plate, Tumblers*
_____
Waste Disposal - Bin / drums
Waste Disposal ■ Trolley (SS)
Linen Almirah_____ _____
Stores Almirah___________
Arm Board Adult*
_____
Arm Board Child*_________
SS Bucket with Lid
Bucket Plastic*
Ambu bags________________
02 Cylinder with spanner ward type
Diet trolley - stainless steel_______
Needle cutter and melter________
Thermometer clinical *__________
Thermometer Rectal*
Torch light*_______ _______ _
Cheatles forceps assortted*______
Stomach wash equipment*_______
Infra Red lamp*
________ __
Wax bath*________
Emergency Resuscitation Kit-Adult*
Enema Set*_______
Ceiling Fan$
«■!
* - to be provided as per need
$ - One fan per four beds in the ward.
55
50
50
50
8
10
8
1
10
30
50
1
30
1
10
2
3
3
10
15
8
10
6
30
2
20
25
4
10
10
4
5
1
2
_____ 6_____
As per requirement
I
IPHS for 101 to 200 Bedded District Hospitals
POST MORTEM EQUIPMENTS
s.
Name of the Equipment
No.
1
2
3
4
5
6
7
8
9
Mortuary table (Stainless steel) *
P.M.equipments (list)________
Weighing machines (Organs)
Measuring glasses(liquids)
Aprons*__________________
PM gloves ( Pairs )*_________
Rubber sheets*____________
Lens____________________
Spot lights
"'L
District Headquarters
Hospital (101-200 bedded)
2
4
2
3
10
10
2
2
* - to be provided as per need
XVI. LINEN
S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Name of the Equipment
Bedsheets__________________
Bedspreads_________________
Blankets Red and blue__________
Patna towels_________________
Table cloth__________________
Draw sheet__________________
Doctor’s overcoat___________;
Hospital worker OT coat_________
Patients house coat (for female)
Patients Pyjama (for male) Shirt
Over shoes pairs___________
Pillows___________________
Pillows covers_____________
Mattress (foam) Adult________
Paediatric Mattress__________
Abdominal sheets for OT_____
Pereneal sheets for OT_______
Leggings_________________
Curtain cloth windows and doors
Uniform / Apron__________
Mortuary sheet__________
Mats (Nylon)____________
Mackin tosh sheet (in meters)
Apron for cook
District Headquarters
Hospital (101-200 bedded)
800
1200
___________ 50_
___________ 300
60
'________ ioo
f
T"
.•
z
60
250
600
'300
80
300
600
200
20
150
150
100
—
■
50
100
200
.
■
V
56
I
t
i
IPHS for 101 to 200 Bedded District Hospitals
XVII. TEACHING EQUIPMENT
S.
MA
NO.
1
2
3
___ 4__
5
6
■7
8
9
Name of the Equipment
___________
Slide Projector
_____ ~
O.H.P
Screen__________ \
White / colour boards
Television colour
Tape Recorder* (2 in 1 )
VCD Player
Radio_______
LCD Projectors
District Headquarters
Hospital (101-200 bedded)
__________1__________
__________1__________
__________1__________
_________ 1__________
__________1__________
__________1__________
_________ 1__________
1
* - to be provided as per need
XVIII. ADMINISTRATION
S.
Name of the Equipment
No. ; _______________________________
1
Computer with Modem with UPS,
Printer with Internet Connection**
2
Xerox Machine
__________
3
Typewriter (Electronic )*
Intercom (15 lines)* _________
5
Intercom (40 lines)* _________
6
Fax Machine______ ________ "
Telephone__________________
7
8
Paging System*______________
9
Public Address System*
io” Library facility*
District Headquarters
Hospital (101-200 bedded)
4
1
1
1
1
1
* - to be provided as per need
** At least one for Medical Records and one for IDSP
XIX. REFRIGERATION & AC
SI.
No.
1
2
___ 3
4
___ 5
6
7
I
Name of the Equipment
Refrigerator 165 litres ______
Blood Bank Refrigerator
ILR _______
Deep Freezer
Coolers*_____
Air conditioners
Central A/C for 07
■ One cooler per 8 beds in the wards.
57
District Headquarters
Hospital (101-200 bedded)
_________ 4__________
__________1__________
_________ 1__________
1_
As per requirement
_________ 8__________
1
I
IPHS for 101 to 200 Bedded District Hospitals
I
XX. HOSPITAL PLANTS
S.
No.
1
2
3
4
5
6
7
8
District Headquarters
Hospital (101-200 bedded)
Name of the Equipment
I
I
■
Generator 40 / 50 KV
Generator 75 KV
Generator 125 KV
Portable 2.5 KV
Solar Water heater *
Incinerator*_____
Central supply of 02, N20, Vacuum *
Cold storage for mortuary *
1-
1
I
* - to be provided as per need
J
XXI. HOSPITAL FITTINGS & NECESSITIES
S.
District Headquarters
Hospital (101-200 bedded)
Name of the Equipment
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Ceiling Fans*_____________
Exhaust Fan*_____________
Pedestal Fan*_____________
Wall Fan*________________
Hotwater geiser*___________
Fire extinguishers*__________
Sewing Machine*___________
Lawn Mover*______________
Vaccum cleaner*___________
Aqua guard*______________
Solar water heater *_________
Neon sign for hospital*_______
Garden equipment*_________
Borewell motor QHT *_______
Water dispenser / Water cooler*
Laundry (steam) *__________
Emergency lamp___________
Emergency trauma set*______
Tube lights*m_____________
Drinking Water Fountain*
* - to be provided as per need
58
■ 50
10
2
I
3
2
2
2
. 2
<
—
_
___________
————
_____
__
■
_
""
__
__
4
2
70
3
_________
I
IPHS for 101 to 200 Bedded District Hospitals
XXII. TRANSPORT
s.
Name of the Equipment
No.
District Headquarters
Hospital (101-200 bedded)
_
i
1
Ambulance
2
Van (Family Welfare)*
3
Pickup vehicles Maruti (Omni)*
4
Mortuary Van_______
3
■
'V
5
Administrative vehicle (Car)*
6
Minidor 3 wheeler*
7
Bicycle*
8
Camp Bus*
n - 9^
10
1
—
•
Progamme vehicle*
Motorcycle*
■''
•
r -r/
* To be provided as per need.
!
59
IPHS for 101 to 200 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:
S.
No.
Speciality
T~
CLINICAL
PATHOLOGY
a. Haematology
Diagnostic Services/Tests
Haemoglobin estimation
Total Leucocyte count
Differential Leucocyte count
Absolute Eosinophil count
Reticulocyte count______
Total RBC count
__
E.S.R.________
Bleeding time
Clotting time
Prothrombin time
Peripheral Blood Smear
Malaria/Filaria Parasite
Platelet count_______
Packed Cell volume
ft
Blood grouping .
Rh typing________
Blood Cross matching
ELISA for HIV, HBS AG, and
HCV
<■
S.
No.
Speciality
Diagnostic Services/Tests
Urine for Albumin, Sugar,
Deposits,bile salts, bile
pigments,acetone,specific
gravity,Reaction (pH)
c. Stool Analysis Stool for Ovacyst (Eh)
Culture and Sensitivity
Hanging drop for V.Cholera
Occultblood
_____
d. Semen Analysis Morphology, count
District Hospitals
(101-200 bedded)
X
Yes_________
Yes_________
Yes_________
Yes_________
Yes________
Yes_________
Yes_________
Yes_________
Yes_________
Yes
Yes
_____
Yes
Yes
T
----------Yes
____
Yes
Yes_________
' Yes
Yes
District Hospitals
(101-200 bedded)
b. Urine Analysis
60
Yss____
Yes
Yes
Yes'
'
Yes________ _
IPHS for 101 to 200 Bedded District Hospitals
Cell count, culture sensitivity
etc, Gram Staining__________
____________
f. Aspirated fluids Cell count cytology
PATHOLOGY
Cytology_________________
a. PAP smear
b. Sputum_____ Sputum cytology___________
Bone Marrow Aspiration
c. Haematology
Coagulation disorders
Ma___________ Sickle cell anaemia_________
7*
_______ Thalassemia______________
d. Histopathology All types of specimens, Biopsies
e. CSF Analysis
S.
No.
Speciality
III.
MICROBIOLOGY
Smear for AFB
Bacilli), KLB (Diphtheria Bacilli)
Culture and sensitivity for blood,
sputum,pus, urine etc.________
Stool culture for enteco
pathogene________________
Supply of different Specimen
collection and transportation
media for peripheral Laboratories
KOH Study for Fungus_______
Grams Stain for Throat swab,
sputum etc.________________
Bacteriological analysis of water
by Rapid H2S test to be done in
districts where there is ho
separate public health laboratory
'a-1'
■
■
a MM:
IV.
Diagnostic Services/Tests
SEROLOGY
______
■
Yes
Yes
Yes
District Hospitals
(101-200bedded)
Yes
Yes
__ __________________________
Pregnancy test (Urine gravindex)
Coomb’s tests,
______
Lepto spirosis (Rapid test /
ELISA) WIDAL test__________
RPR test_________________
Elisa test for HIV, HBs Ag, HCV
RA factor test
61
Yes
Yes
Yes
Yes
Yes
IPHS for 101 to 200 Bedded District Hospitals
S.
No.
V.
S.
No.
VI.
VII.
vm.
IX.
Speciality
BIOCHEMISTRY
Speciality
CARDIAC IN
VESTIGATIONS
OPHTHALMO
LOGY
ENT
RADIOLOGY
Diagnostic Services/Tests
Blood Sugar________
Glucose Tolerance Test
Glycosylated Hemoglobin
Blood urea, blood cholesterol
Serum bilirubin
Liver function tests
Kidney function tests
Lipid Profile
Blood uric acid
Serum calcium, sodium,
potassium
Serum Phosphorous
Serum Magnesium
CSF for protein, sugar
Blood gas Analysis
Estimation of residual chrorine in
water by OT test
Thyroid T3 T4 TSH
■J.W
CPK__________
Chloride
Iodometry Titration
Diagnostic Services/Tests
District Hospitals
(l01-200bedded)
Yes
Yes
Yes
...•J
Yes
Yes
Yes
Yes
Yes
Yes
I
Yes
Yes
Yes
Yes
Yes
Yes
__________
District Hospitals
(1D1-200bedded)
.
a) ECG____________ _
b) Stress tests
c) ECHO
~
a) Refraction by using Snellen’s
chart
Retinoscopy
Ophthalmoscopy
Audiometry
Endoscopy for ENT
a) Xray for Chest, Skull, Spine,
Abdomen, bones
Yes
Yes
i.
Yes
Yes
Yes
Yes
I
Yes
62
I
4
F
IPHS for 101 to 200 Bedded District Hospitals
IITB X-Ray - CR Digital________
PPG_____________________
d)HSG
__________ __
f) Ultrasonography Colour Doppler
g) Spiral CT scan
MRl 0.5 TESSLA
Yes
Yes
|i
I
SI.
No.
X
Speciality
Diagnostic Services / Tests
ENDOSCOPY
Oesophagus_________
Stomach __________
Colonoscopy_________
Bronchuscopy________
Arthros copy_________
Laparoscopy (Diagnostic)
Colposcopy__________
Hysteroscopy________
Pulmonary function tests
.
|
......... T .
xi
11.
PHYSIOLOGY
District Hospitals
(101-200 bedded)
Yes
Yes
Yes
RECOMMENDED ALLOCATION OF BED STRENGTH AT VARIOUS LEVELS
RECOMMENDED ALLOCATION OF BED STRENGTH
S. No
i
Item
Type
District Headquarters
Hospitals
(101-200 bedded)
1
General Medicine
Beds (M+F)
15+15
2
New born ward
Beds
5
3
Mothers room with dining and
toilets
Beds
5
4
Paediatrics ward
Beds
10
5
Critical care ward - IMCU
Beds
5
6
7
8
Isolation Ward
Beds
Beds
Beds (M+F)
4
I
9
Dialysis unit (as per specifications)
Thoracic medicine ward with
room for pulmonary function test
Blood bank
Yes
63
IPHS for 101 to 200 Bedded District Hospitals
10
General surgery ward (incl.
Urology, ENT)
Beds (M+F)
15+15
11
Post - Operative Ward
Beds (M+F)
10+16$
12
Accident and Trauma ward
Beds
10
13
14
Labour room
Boards
3
Labour room (Eclampsia)
15
Septic Labour room
Beds
Boards
——
16
Ante-natal ward
Beds
15
17
Post-natal ward
18
Postpartum ward
15
20
19
Post operative ward
Beds
Beds
Beds
20
Ophthalmology ward
Beds
21
Burns Ward
Beds
—
* including ophthalmic ward.
$ including post - caesarean patients
# including paediatric t)eds @ 10% Paying Wards
REQUIREMENTS FOR OPERATION THEATRE:
S. No
Item
District Headquarters
Hospital (101-200 Bedded)
1
Elective OT-Major
1
2
Emergency OT/FW OT
•1
3
Ophthalmology /ENT OT
1
a
3?
64
4
IPHS for 101 to 200 Bedded District Hospitals
12.
LIST OF MEDICINES / INSTRUMENTS / EQUIPMENTS /LAB REAGENTS /
OTHER CONSUMABLES AND DISPOSABLES FOR DISTRICT HOSPITALS
Sr. No
Name of the Item
Analgesics/Antipyretlcs/Antl Inflamatory
A)
1
Tab.Aspirin 300mg
2
Tab. Paracetamol 500mg
3
Inj.Diclofenac sodium
. V ’
.
Y'
__________
/J: ’
4
Tab. Diclofenac sod
5
Tab.Dolonex DT 20mg
6
Tab.lbuprofen
......... 1
Chemotherapeutics ___________
•B)
7
Inj.Crystalline penicillin 5 lac unit
8
Inj.Fortified procaine pen 4 lac
Inj.Ampicillin 500mg
~~~L
9
10
Inj.Gentamycin 40mg/2ml vial
_______
11
Inj.crystallipe penicillin 10 lac unit
12
3ZZ 13
14
■
) Cap.Ampicillin 250mg
Cap.Tetracycline 250mg
Tab.Trimethoprim+Sulphamethazol ss
-------------- - ----------- --------------------------;----------------------
- 15
[ Tab.Ciprofloxacin 250mg
16
Tab.Ciprofloxacin 500mg
17
Inj.Ciprofloxacin lOOml
18
Tab.Erythromycin 250mg
________
Tab.Erythromycin 500mg
19
20~ Syrup Cotrimoxazole 50ml
________
21
Syrup Ampicillin 125mg/5ml 60ml
22
Inj.Cefoperazone IGm
________ 23
Inj.cefotaxime 500mg
L__
.
t
24
Tab.Norfloxacin 200mg
25 gg Tab.Norfloxacin 400mg
26
Tab.Ofloxacin 200mg
65
IPHS for 101 to 200 Bedded District Hospitals
27
lnj.Vionocef(Ceffixime)250mg
28
Inj.Amikacin sulphate 500mg
29
Inj.Amikacin sulphate 100mg
30
Cap.Cefodroxyl 250mg
31
Inj.Amoxycillin 500mg
■ Il
111
.•"r. I' '
_____
V?
Anti Diarrhoeal
C)
_____
ft
32
Tab.Metronidazole 200mg
33
34
Tab.Metronidazole 400mg
Syrup.Metronidazole
ft
35
Tab.Furazolidone 100mg
36
Tab.Diolaxanide Fuzate
w
37
Tab.Tinidazole 300mg
—-
■■
■
_
I
i
111
I
Dressing Material/Antiseptic lotion j<
D)
38
Povidone Iodine solution 500ml_____
39
Phenyl 5litr jar(Black Phenyl)
40
Benzalkonium chloride 500ml bottle
41
Rolled Bandage a)6cm
■
' •...... 1
b) 10cm
c) 15cm
42
Bandage cloth(100cmx20mm) in Than
43
Surgical Guaze(50cmx18m) in Than
44
Adhesive plaster 7.5cm x 5mtr
45
Absorbent cotton I.P 500gm Net
46
P.O.P Bandage a) 10cm
__
i
L'..
b)15cm
■
47
Framycetin skin pint 100 G tube
48
49
Silver Sulphadiazene Pint 500gm jar
Antiseptic lotion containing :________
a) Dichlorometxylenol 100ml bot_____
___________.
b) Haffkinol Slitre jar
50
Sterilium lotion
51
Bacillocid lotion
||
T.''
■
66
IPHS for 101 to 200 Bedded District Hospitals
EL
Infusion Fluids
52
Inj.dextrose 5% 500ml,
53
Inj.Dextrose 10% 500ml bottle
54
Inj,Dextrose in Normal saline 500ml bt
55
Inj.Normal saline (Sod chloride) 500ml
56
Inj.fiinger lactate 500ml
___ 57_
Inj.Mannitol 20% 30bml
58
Inj.Water for 5ml amp
■ ■
.-r-ll'
_______
___
—
____
Inj.Water for 10ml amp
Pl
60
Inj.Dextrose 25%100ml bot
_
61
I. V. Metronidazole 100ml
62
Inj.Plasma Substitute 500ml bot
63
Inj.Lomodex
n
Other Drugs & Material_________
64
All Glass Syringes 2ml
________
-------------- i---------
.
——
_______
10ml________ f
■
———
; L
20ml___________
65
.
Hypodermic Needle (Pkt of 10 needle)
■
a) No. 19
b) No.20
■
d) No,22
''
J
c) No.21
w
e) No.23
■
0 No.24_____________
g) No.25
h) No.26_________ ;
66
—
■LL -L
Scalp vein sets no a) 19
b)20
fc_____________ c) 21
________________ d) 22
e) 23
67
IPHS for 101 to 200 Bedded District Hospitals
______________ f) 24_________
■S'
______________ 9)25_________
j: J/z
h)26
—
67
Geico all numbers
68
Tab.B.Complex NFI Therapeutic
69
Tab.Polyvitamin NFI Therapeutic
70
Inj.Dexamethasone 2mg/ml vial
71
Inj.Vitamin B Complex 10ml
72
Inj.BI2 Folic acid
73
Surgical Gloves a)6 “
_______
■sfe
f
s
_____________ b)6.1/2"
——
_____________ c)7"
74
_______
__
_____________ d)7.5"
B
Catgut Chromic a)1 No.
_____
-
_____________ b)2 No.
c)1-0 No
■v;
—
_____________ d)2-0 NO
e)8-0
..
-
___
\
i
75
Vicryl No.1
76
Sutupak 1,1/0,2,2/0
77
Prolene
__
78
X Ray film 50 film packet(in Pkt) size
8
____
—
t
_______ a)6.1/2x8.1/2"_________
________ b)8"x10"________ _
c)10"x12'
:S
d)12"x15"
79
Fixer
80
Developer
81
CT Scan film
82
Ultrasound scan film
83
Dental film
84
Oral Rehydration powder 27.5g
■f
-------- -
■
68
■
8
——_
I
— ■I
4" :
—
—
—
1
.....
__________
IPHS for 101 to 200 Bedded District Hospitals
*
______
Ether Anaesthetic 500ml
85
----------------------------- - -------------------------
86
Halothane
Eye Drops_______ ____________
'J......
G)
_______
<
'■
*
87
88
Sulphacetamide eye drops 10% 5ml
89
Framycetin eye drops... 5ml
90
91
Ciprofloxacin eye drops
Framycetin with steroid eye drops 5ml
Gentamycin eye drops________ _
Other Material
H)
4
______
■.
92
93
Rubber. Mackintosch Sheet in mtr
94
Antisera I) A
Sterile Infusion sets(Plastic)
_________ ll)B
_________ lll)D
5ml
5ml
5ml________ __
5ml
———
IV)AB 5ml
■
■
•
•
,
-
; v? <
95
lnj.MethylErgometrineO.2mg/amp
96
97
98
Inj.Streptokinase 7.5lac vial
99
Tab. Antacid
100
ARS
101
102
103
Syp.Antacid______ __________
Inj.Ranitidine 2ML
__________
104
105
106
107
108
109
110
Tab.Ranitidine
__________
■
Inj.Streptokinase 15lac vial______
Inj.PAM____________________
Inj.Rabipur_______ __________
Tab.Omeprazole_____________
Cough syrup Slitre Jar_________
Cough syrup with Nbscapine 100ml
.
■
Coir Mattress________________
Inj.Lignocaine 1%
Inj.lignocaine 2%
69
I
.....
*
IPHS for 101 to 200 Bedded District Hospitals
111
Inj.Lignocaine 5%____________
112
Inj.Marcaine________________
113
Inj.Diazepam_______________
114
lnj.Salbactum+Cefoperazone2Gm________
115
Inj.Amoxycillin with clavutanite acid 600mg
116
Cap.Amoxycillin250+cloxacillin 250
117
Inj.Cefuroxime 250/750__________
118
Tab.Pefloxacin 400mg___________
119
Tab.Gattifloxacin 400mg__________
120
Tab.Valdecoxib 20mg___________
121
Tab.Atrovastatin IQmg___________
122
Sy.Himalt-X_____
123
Sy.Protein(Provita)_____________
1 " •"' — __
7 / -
1.
' ' '"77--
—
*
1
————
IS
Antibiotics and Chemotherapeutics
I)
1
Tab.Chloroquine phosphate 250mg
2
Inj.Chloroquine phosphate
3
Inj.Quinine___________
4
Tab.Erythromycine Esteararte 250mg
5
Syp.Erythromycine__________
6
Tab.Phenoxymethyl Penicillinl 25mg
7
Cap.Rifampicin__________
8
Tab. Isoniazid IQOmg
9
Tab.Ethambutol 400mg___________
10
Cap.Neomycin_________
11
Inj.Benzathine penicillin 12 lac
li
____
■
■■'
<
'.
•
st?* ■
Antihistaminics/anti-allergic
J)
12
Inj.Pheniramine maleate
13
Tab.Diphenhydramine (eqv.Benadryl)
14
Tab.Cetrizine________
15
Tab.Chlorpheniramine maleate 4mg
16
Tab.Diethylcarbamazin
7
------'
■
■
I
■7
_____
_______________
____________ —
70
IPHS for 101 to 200 Bedded District Hospitals
| Drugs acting on Digestive system
K)
. .. .......
17
Tab.Cyclopam
18
Inj.Cyclopam
19
Tab.Bisacodyl
2Q
Tab.Perinorm
21
Inj.Perinorm
22
syrup.Furazolidone
OQ
Inj.Prochlorperazine(Stemetil)__________
24
Tab.Piperazine citrate_______________
25
Tab.Mebendazole 100mg_____________
26
Syp.Mebendazole
27
Sy. Piperazine Cjtrate _______________
28
Sy. Pyrantel Pamoate_________________
29
Tab.Belladona
"—
II *
_______________
_______________
30
Tab. Ferrous sulphate200mg
31
Inj.lron Dextran/lron sorbitol
■
Eye ointment
M)
r
32
Chloramphenicol eye ointment & applicaps
33
Chloramphenicol + Dexamethsone ointment
34
Gentamycin eye/ear drops_____________
[ _______ 35
I
11
Drugs related to Hoemopoetic system
L)
-
_____________
Dexamethasone eye drops
_______
.
36
Drosyn eye drops
37
Atropine eye ointment________________
Drugs acting on Cardiac vascular system
N)
38
Inj.adrenaline
_______ 39
Inj.atropine sulphate
I
40~
I_____ 41_
I
^3
Inj.Dicjoxme
Tab.Digoxine
|
43
Tab.Atenolol
I
44
Tab.lsoxuprine
Inj.Mephentine
71
IPHS for 101 to 200 Bedded District Hospitals
45
Inj.Duvadilan
46
Tab.Methyldopa
47
Tab.Isosorbide Dinitrate(Sorbitrate)
48
Tab. Propranolol____________________________
49
Tab.Verapamil(lsoptin)________________________
50
tab.Enalepril2.5/5mg
.
Drugs acting on Central/peripheral Nervous system
0)
51
Inj. Pentazocine (Fortwin)______________________
52
Inj.Pavlon 2ml amp__________________________
53
Inj.Chlorpromazine 25mg(like Largactil)____________
54
Inj.Promethazine Hcl Phenergan_________________
55
inj.Pethidine_______________________________
56
Inj.Diazepam 5mg___________________________
57
Tab.Haloperidol_________ -__________________
58
Inj.Haloperidol____________________
59
Tab.Diazepam 5mg__________________________
60
Tab. Phenobarbitone 30mg_____________________
61
Tab.Phenobarbitone 60mg_____________________
62
Tab.Largactil 25mg_____
63
Tab.Pacitane_________
64
Tab.Surmontil_________
65
Syrup. Phenergan______
66
Syrup Paracetamol
67
Ethyl chloride spray
68
Lignocaine pint________
69
Gentamycin eye/ear drops
70
Betnesol-N/Efcorlin Nasal drops_____
»
'_____
—
Iff
Drugs acting on Respiratory system
P)
71
Inj.Aminophylline
72
Tab.Aminophylline
73
Inj.Deriphylline
74
Tab.Deriphylline
r. ■ 1
72
OH
■
.■
IPHS for 101 to 200 Bedded District Hospitals
:
75
Tab.Salbutamol 2mg
______
76
Syrup fedral
_____
Q)
Tl
Syrup.Salbutamol
Antiseptic Ointment
. ._
78
Furacin skin oint
79
Framycetin skin oint
Drugs acting on UroGenital system
EQ
..
S)
80
Tab.Frusemide 40mg
81
Inj.KCL_____________________________________
82
Liquid KCL_______________________________
83
Tab.Pyridicil
84
Inj.Frusemide
■■
Drugs acting on Uterus and Female Genital Tracts
_
85
Inj.Pitocin
86
Inj.Prostodin
87
Tab. Mesoprosl
88
Tab.Duvadilan
89
Inj Duvadilan
90
Tab.Methyl Ergometrine
91
Tab.Primolut-N
92
Sysran N
93
________
94
-
Haymycin vaginal tab
Inj. Magsulph
Hormonal Preparation
_
95
Inj.lnsulin Rapid
96
Insulin lente Besal
97
Inj.Cry Insulin_____
98
Inj.Mixtard ■
99
Inj.Testesterone plain 25mg
100
Testesterone Depot 50mg
101
Tab.Biguanide
102
Tab.Chlorpropamide 100mg
_____ _
73
IPHS for 101 to 200 Bedded District Hospitals
103
Tab.Prednisolone 5mg
i-
104
Tab.Tolbutamide 500mg
_________
105
Tab.Glibenclamide
106
Tab.Betamethasone
Il_____
■
—
.
Vitamins
U)
107
Inj.Vit "A”____________
108
lnj.Cholcalciferol16lac
109
Inj.Ascorbic acid
110
Inj.Pyridoxin 50mg
111
Inj.Vit K
112
Tab.Vit “A” & “D”
113
Tab.Ascorbic acid lOOmg
_____
______
■
—
-
Other drugs_________
V)
____
114
lnj.Antirabies vaccine
115
lnj.Antisnake venom
116
Inj.AntiDiphtheria Serum
117
Inj.Cyclophosphamide
118
Inj.Sodabicarb________
119
Inj.Calcium Gluconate
120
Tab.Calcium lactate
121
Tr.lodine
______
122
Tr. Benzoin
__
123
Glcial acetic caid
______
124
Benedict solution
125
Caster oil
126
Liquid paraffin
127
Glycerine___________
128
Glycerine Suppositories
129
Turpentine oil
130
Potassium Permangnate
131
Formaldehyde
132
Dextrose Powder
i
I- . '/VIV
. .......................................
i
....
_______________
Si
I
i
__
■f
___________
■■ ■■
___________
................... ■■■—
'111
.w.
______
■
——
__
■
■■
•
-
-
zzzzz
J___
'
'
■■■
;
/ ill
_______
__________________
__________________
__________________
74
IPHS for 101 to 200 Bedded District Hospitals
______ 133
Methylated spirit
134
Cotrimazole lotion
135
Cotrimazole cream —
136
137
Tab.Theophylline
138
Burnion Oint
i®®
I
-> ■ ’c
_
'
'
' '
.... ...
■w
ECG Roll
————■
s
139
Flemigel ARC Ointment
140
Syp.Himobin
141
APDYL Cough SNoscopin
142
Tab. Septilin_;
143
Tab. Cystone
144
Tab. Gasex
145
Syp. Mental
146
Oint. Pilex
147
Rumalaya Gel
148
Pinku Pedratic Cough Syp.
Others_________
(W)
1
---------------2~
II
______
SOI
J
j
Tab.Liv52____________
Syrup Liv52___________
3
Cap.Doxycycline lOOmg
4
Inj.Heparin sod.1000IU
5
Tab.Dipyridamol(Like Persentine)
6
Inj.Dopamine
7
Tab.Glyceryl Trinitrate
8
9
Tab.Amitryptilline
10
Tab.Nitrofurantine
Tab.trifluoperazine(lmg)
Inj.Valethemide Bromide(Epidosyn)
______
——
______
12
Inj.lsolyte-M
13
Inj.lsolyte-P
14
Inj.lsolyte-G
15
Cap.Cephalexin 250mg
75
IPHS for 101 to 200 Bedded District Hospitals
16
17
Tab.Taxim______
—
Inj.Metaclopramide
—
18
Tab.Folic acid
19
Inj.Lignocaine Hcl 2%
f
20
Inj.Nor adrenaline
1
21
Betadine lotion
22
Tab.stilboesteral
23
Inj.Pyridoxine
24
Hydrogen peroxide
25
Inj.magnesium sulphate_____
26
Benzyl Benzoate
27
GammaBenzene Hexachloride
28
Inj.Tetglobe
29
Inj.Paracetamol'
30
Pilocarpine eye drops 1%
31
Sy.Orciprenaline
32
Suturing needles (RB,Cutting)
33
Inj.Calcium pantothernate
34
Inj.Xylocaine 4% 30 ml
35
Halothane
36
Mixture Alkaline
37
Inj. Phenabarbitone 200mg
_____
—______ L----.... a-.
tlltl
%
/
_______
________
—
_____
Z : ■
;z
—
__ ;_____ 1
__________________
z z?
; ZZ“;.
■
zz
.
;
■
----------------------—
---------- ---------------
■'...............................................................................................
38
Inj. B12 (Cynacobalamine)
39
Neosporin, Nebasuef, Soframycin Pow
40
Magnasium Sulphate Powder
41
Furacin Cream
42
Xylocaine jelly
43
Formaldehyde Lotion
44
Cetrimide 100ml bolt 3.5%, 1.5% 1
----1-—
45
Bacitrium powder 10mg botts
_____
46
Bleaching Powder 5 Kg Pkts(ISI Mark) _____
47
Ether Solvent
--_____
7
:
—
■ ■
o
■
*
------------------1—
"I ■ Z7
Z
_____
76
___ J_________
_________________
—
IPHS for 101 to 200 Bedded District Hospitals
_
___
■
48
Sodium Hypochloride Sod. 5 ltrs/1 ltrs
49_
Inj. Diphthoria antition ADS)100001.U
50
51
52
53
54
55
Inj. Gas gangrene Arititoxin(AGGS)1000
Inj. Hydroxy Progesterone500mg/2ml
Inj. Methyl Prednisoldn 500mg vial.
Inj.Multivitamin I.V
_____________
Inj.Potassium chloride_____ _______
Inj.Quinine Dihydrochloride
1 'ch
00
Tetanus Antitoxin 10000 I.U
__ 57
58
59
60
lii 61
62
63
64
65
66
Inj.Tetanus Toxoid 5rnl vial
? ■
'
Inj.Theophylline Etophylline
Inj.Vitamin A
,
Tab.Ferrous sulphate200mg+Folic acid
Tab. Ferrous sulphate 300mg
Tab.Griseofulvin125mg____________
Tab.Phenobarbitone 30mg__________
Tab. Phenobarbitone 60mg__________
Tab. Pyridoxin 10mg_______ __
Tab.Thyroxine sod 0.1 mg
67
Warfarin sod 5mg
68
69
Tab.Alprazolam 0.25mg__________
70
71
72
Tab.Amlodipine IQmg_____________
______________
Tab.Amlodipine 5mg
Tab.Nefidipine 20mg
Tab.Nefidipine 30mg
~7T Tab.Riboflavin 10mg
:S : 74 ■
75
76
77
78
79
SB
Syp.Ferrous Gluconate 100ml bottle
Cream Fluconozole 15gm tube
Sus.Furazolidone
Oint.Hydrocortisone acetate______
Syp.isoniazid 100mg/5ml 100ml bot
Liquid paraffin
77
IPHS for 101 to 200 Bedded District Hospitals
79A
Linctus codein 500ml bot
80
Cream Miconozole 2% 15gm tube
81
Syp.Nalidixic acid
82
Syp.Norfloxacin
83
Phenylepinephrine eye drops
84
Pilocarpine eye drops 2%
85
Syp.Pottassium chloride 400ml bot
86
Syp.Primaquine
87
Suspension Pyrantel pamoate
88
Sus Rifampicin
89
Syp.Salbutamol 100ml bot
90
Syp.Theophylline 100ml
91
Syp.Vitamin B.Complex____________
92
Vit D-3 Granules
93
Opthalmic & ear drops
94
Glycerine Mag sulphate ear drops
95
Pilocarpine eye drops 4%__________
96
Oint Acyclovir 3% 5gm tube
97
Benzyl Benzoate emulsion 50ml bot
98
Pint. Betamethasone______________
99
Cream Clotrimazole skin 1% 15gm
it-:
_____________
_____
______
_______
S
___
—
_____
_______________
_______
■.
100
Oint Dexamethasone 1%+ Framycetin
101
Oint contain clotrimazole+Genta+Flucon
102
Oint Flucanazole 10 mg____________
103
Cream Framyctin 1% 20gm tube/100gm
104
Lot.Gamabenzene hexachloride1% bt
105
Glycerine Suppository USP 3gm bott/10
106
Cream Nitrofurazone 0.2% jar of 500g
107
Oint Silversulpadiazene 1 % 25g
108
AIDS Protective kit
4:
78
_
IPHS for 101 to 200 Bedded District Hospitals
•13.
Service / performance evaluation by
independent agencies
QAPACITY BUILDING
•
At the time of entry into .service, induction
training of at least six months duration must be made
mandatory for all categories of health care workers.
This must be a comprehensive training and must
have components of requisite skill enhancement,
management and knowledge about the drugs/
equipments and services offered at all levels of
health care.
District Monitoring Committees formed
under NRHM shall monitor the upgradation
of Hospitals to IPHS. Annual Jansamvad
may also be held as a mechanism of
monitoring.
Monitoring of laboratory
Secondly, at a duration of every two years,
on the job training must be provided to all categories
of health care personnel to upgrade their knowledge
and skills in technical and management fields.
14.
QUALITY
ASSURANCE
SERVICE DELIVERY
IN
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.
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
•.
ROGI KALYAN SAMITIES (RKS) /
HOSPITAL
MANAGEMENT
COMMITTEE (HMC)
Internal Monitoring
Social audit through Rogi Kalyan Samities /
Panchayati Raj Institutions
Medical Audit, Technical Audit, Financial
Audit, Disaster Preparedness Audit,
Monitoring of Accessibility and equity issues,
information exchange.
16.
External Monitoring
CITIZEN’S CHARTER
Each District hospital should display a
citizen’s charter for the district hospital indicating
the services available, user fees charged, if any,
Monitoring by PRI / Rogi Kalyan Samities
79
IPHS for 101 to 200 Bedded District Hospitals
and a grievance redressal system. A modal citizen’s
charter is given as under.
General Information
Enquiry, Reception and Registration Services:
OUR MOTTO - SERVICE WITH SMILE
CITIZENS CHARTER
This counter is functioning round the clock.
•
This charter seeks to provide a framework which
enables our users to know:
Location guide maps have been put up at various
places in this hospital.
What services are available in this hospital;
Colour coded guidelines and directional signboards
are fixed at strategic points for guidance.
The quality of services they are entitled to;
The means through which complaints
regarding denial or poor quality of services
will be redressed.
Telephone enquiries can be made over telephone
numbers:
■ &
, Fax:
Standards of Service:
Casualty & Emergency Services:
This is a District, Sub-district/divisional
hospital;
It provides medical care to all patients who
come to the hospital;
All Casualty Services are available round the clock.
•
Duty Doctor is available round the clock.
Standards are influenced by patients load
and availability of resources;
Specialist doctors are available on call from
resident doctors.
Yet we insist that all our users receive
courteous and prompt attention.
Emergency services are available for all
specialities as listed in the ORD Services.
Locations:
Emergency Operations are done in-
It is located on
road in front of
OT located on
This hospital has-
Doctors:
)•
floor of
building.
Maternity OT
(including residents
Orthopaedic Emergency OT
Burns and plastic OT
Nurses:
staff).
(including supervisory
Main OT for Neurosurgery cases
Emergency Operation Theatre is functioned round
the clock.
Beds:
In serious cases, treatment/management gets
priority over paper work like registration and medico
legal requirements. The decision rests with the
treating doctor.
Doctors wear white aprons and nurses are in
uniform.
All Staff member wear identity cards.
80
IPHS for 101 to 200 Bedded District Hospitals
OPD Services:
Various outpatient services available in the hospital are detailed below (as available):
I
_ °">
Place
Time of Registration
General Medicine
I
I_____ _____________
________ —
>
pi sdiatrics
i
.
I
1
■
,
,1
.. • .
teral Surgery
S,
, ,u Gynec.
Obstetric
1I
_
■
I
ENT
|
Skin
■
MB
—
ology
__________
________
1
s
.
.
■
'———
■
Ji.'.
______
__
_L_2__
_____________
fc ■■■-.
S •
----------- ——
:
Cardiology
—
|
r
p.vchiAtrv
Psychiatry
' . _
Radiotherapy
I ____________22
___
i
Neurol°gy &
'
O^opaedics
_____________
_____________
I
I
------------- —
’
Burns & plastics
'
Dental OPD
.1I
__________________
I
I
Homeopathic
ISM Services:
. 7? .
_
__________
__
_________________________
I
'"B
J
®
.....
____________ —
________ _____ _______
fiw
;”v<
■■
Ayurvedic
V
'
Anyolher
______________
81
Time of OPD
IPHS for 101 to 200 Bedded District Hospitals
In OPDs specialists are available for consultation.
Radio Diagnostic Services:
OPD services are available on all working days
excluding Sundays and Gazetted Holidays.
Routine: These services include:
X-Rays
Ultrasound and
On Saturdays, the hospital functions from
................. AM to................. PM.
CAT Scan
Medical Facilities Not Available:
Routine X-Rays are done from 9:00 AM to 1:00 PM.
Registration is done from 9:00 AM to 11:30 AM.
Ultrasound examination is done from 9:00 AM to
4:00 PM.
Emergency: Emergency X-Ray services are also
available round the clock. CAT Scan services are
also available round the clock.
Indoor Patient Services:
Wards providing free
Ther§ are total of
indoor patient care.
Emergency ward A admits emergency cases for
medical problems.
' ’
Organ Transplantation
Some specialities do not have indoor patients
services:
Psychiatry
D-addiction
Dental
Nuclear Medicine
Genetic Counselling
Emergency ward B admits emergency cases for
surgical problems.
There is a---------------- bedded Intensive Care Unit
for care of seriously ill patients.
A------------------- bedded Intensive Coronary Care
Unit takes care of heart patients requiring intensive
treatment.
In the Burns Department, there are------------ bedded Intensive Care Unit to treat seriously injured
burns patients.
There are-------------------- labour rooms for
conducting deliveries round the clock.
------------------------- nurseries provide necessary
care to the newborns - normal as well those born
with disease.
All indoor patients receive treatment under the
guidance and supervision during office hours i.e.
9:00 AM to 4:00 PM.
Outside office hours, treatment is given by doctor
on duty and specialists are available on call.
Endochronology
Geriatrics
Laboratory Services:
Routine: Laboratory Services are provided in the
field of (as available):
•
Bio-chemistry
•
Microbiology
•
Haematology
•
Cytology
•
Histopathology including FNAC
•
Clinical Pathology
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.
Emergency: Emergency Laboratory Services are
available 24 hours for limited tests relating to clinical
pathology and bio-chemistry.
Free diet is provided to all patients in the General
Wards.
82
o
IPHS for 101 to 200 Bedded District Hospitals
Every patient is given one attendant pass.
Visitors are allowed only between 5:00 PM to 7:00
PM.
Investigations like CAT Scan, Ultra Sound, Bariummeal, ECHO, TMT etc. are charged for as per
Government approved rates.
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.
A Staff Nurse is on duty round the clock in the ward.
Admitted patients should contact the Staff Nurse for
any medical assistance they need.
Other Facilities:
Other facilities available include:
Cold Drinking Water
Wheel chairs and trolleys are available in the OPD
and casualty.
patients from their places (on payment of nominal
charges) and also for discharged patients.
Mortuary Van is available on payment between 9:00
AM to 4:00 PM.
Public Telephone Booths are provided at various
locations.
Stand-by Electricity Generators have been provided.
Chemist Shops are available outside the hospital.
Canteen for patients and their attendants is
available.
Lifts are available for access to higher floors.
Adequate toilet Facilities for use of patients and their
attendants are available.
Complaints & Grievances:
There will be occasions when our services will not
be upto your expectations.
Please do not hesitate to register your complaints.
It will only help us serve you better.
Every grievance will be duly acknowledged.
We aim to settle your genuine complaints within 10
working days of its receipt.
Suggestions/Complaint boxes are also provided at
various locations in the hospital.
If we cannot, we will explain the reasons and the
time we will take to resolve.
Name, designation and telephone number of the nodal
officer concerned is duly displayed at the Reception.
Dr
Designation....
Tele (O)
(R)
(M)
Meeting Hours
to
Responsibilities of the Users:
The success of this charter depends on the support
we receive from our uses.
Please try to appreciate the various constraints
under which the hospital is functioning.
On an average more than----------- lacs patients
attend Ambulances
the OPD annually
and more
are available
to than
pick ----------up
----- lacs patients are attended annually in the
-casualty and emergency wards.
Please do not inconvenience other patients.
Please help us in keeping the hospital and its
surroundings neat and clean.
Please use the facilities of this hospital with care.
Beware of Touts.
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.
•
“No Smoking Please”
•
Don’t split here & there
•
Use Dustbin
•
Keep Hospital Clean
•
Give regards to Ladies and Senior
Citizens
IPHS for 101 to 200 Bedded District Hospitals
Annexure-1
Guidelines for the Project providing financial support to the selected Government
Hospitals for Hospital Waste Management.
The Ministry of Environment & Forests
notified the “Bio-Medical Waste (Management &
Handling) Rules, 1998” in July, 1998.
In accordance with the rules (Rule 4), it is
the duty of every “Occupied, 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.
1.
Purchase of equipments such as:
Incinerator
a)
Microwave
b)
Autoclave
c)
Shredder
d)
2.
Other equipments including colour coded
bags and puncture proof containers,
protective gears, etc.
Civil and electrical works to house and
operate the waste treatment facilities.
Training
3.
4.
IEC 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 waste. As 80-85% of waste generated
in hospitals is non-hazardous or general waste,
segregation will reduce the quantum of waste that
needs special treatment to only 15-20% of the total
waste. The categories for segregation of waste and
colour coding and type of container should be as in
Schedule 1 and 2 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.
5.
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.
The various options are:
1.
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
In connection with the implementation of the
Rules, it has been decided to take up pilot projects
in selected Government hospitals - Central and
State.
AIM: The aim of the scheme is to implement
pilot projects to have a demonstration effect by
providing financial assistance to identified hospitals/
institutions under Central/State Governments for:
84
IPHS for 101 to 200 Bedded District Hospitals
Central Pollution Control Board for design
and construction of bio-medical waste
incinerator (circulated th all States/UTs vide
letter no. Z.28015/50/2003-H, (fated
18.11.2003) - a certificate may be taken
from the State Pollution Control Board.
Waste category, 1, 2, 3, 5, & 6 as stated in
the Schedule - I of the bio-Medical Waste
(Management &■ Handling) Rules, 1998.
Wherever common facilities for treatment
and disposal of bio-medical waste are
available, installation of incinerators by
individual hospitals may not be encouraged
and such waste should be transported to the
common facility for proper treatment.
2.
3.
4.
5.
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.
The assistance will be given direct to the
hospital/institute for purchase of equipments for
waste treatment facilities/installation of equipment
and civil/electrical works to house the waste
treatment facilities, training, IEC activities including
preparation and publication of literature, posters,
pamphlets, etc. The financial assistance will be
limited to Rs.85 lakhs per hospital or Rs.1.50 crore
per State/UT. The estimated costs are as under:-
Autoclaving/Microwavinq: Standards for
autoclaving and 'microwaving are provided
in the Bio-Medical Waste (Management &
Handling) Rules, 1998. The equipment for
autoclaving or microwaving waste should
conform to these standards. These options
can be selected for waste categories 3, 4,
6,7 of Schedule -1 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.
1.
Incinerator or Microwave = Rs.35.00 lakhs
2.
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 = Upto max. of
container or similar carriage
Rs.50,000.00
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.
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
shredder
puncture proof containers for sharps, colour
coded bags,
Needle and Syringe Destroyer: These
units can be used for needles and syringes
at the point of use. These will destroy the
used needles reducing it to ashes and cut
the syringe effectively preventing the re-use.
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:
I.
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/
85
The application for financial assistance
should be forwarded to this Ministry through
the State Government/UT Administration
concerned.
IPHS for 101 to 200 Bedded District Hospitals
ii.
iii.
iv.
v.
vi.
vii.
The State Government/UT Administration
should ensure that the existing facilities are
inspected by a responsible officer and
deficiencies pointed out. The proposal for
additionalities, if any, in the form of
equipment should be, as far as possible, by
way of complementary equipments
supported by estimates of concerned
authorities.
The cost of equipments to be purchased
should be indicated. The equipments will be
purchased as per prescribed procedure.
These will be entered into an Assets
Register to be maintained by the hospital.
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 Sfate/
UT. The State/UTs will have the option to choose
any equipment (s) from the list above to cover as
many hospitals as possible. However, the financial
assistance per State will be provided upto a
maximum amount of Rs.1.5 crore.
Scrutiny of Applications:
The applications received from the State
Government/UT Administrations for setting up of
facilities for disposal of hospital waste in the
hospitals under their administrative control will be
considered in the Ministry in a Committee headed
The grant will be subject to the condition that
by Additional Secretary and proposals cleared for
the State Government / UT Administration
will give an undertaking that adequate- 9ivin9 financia] assistance. The proposals then will
be processed for sanction of financial assistance to
arrangements for running the equipments
the Government Hospitals/institutes. In the case of
and their maintenance for disposal of
Central Government Hospitals/lnstitutions, the Head
hospital waste shall be made.
of the Institutions may send their proposal through
Dte.GHS.
The grant will be subject to the condition that
the State Government/UT Administration/
The Joint Secretary (Hospital), DDG level
Hospital will give an undertaking that they
officer in the Dte.GHS concerned with hospitals
will provide the required trained manpower
matters will be the Nodal Officer for implementation
for running of the equipments and their
of the scheme. The proposals will be examined
maintenance for proper treatment and
through a Committee consisting of Additional
disposal for the bio-medical waste.
Secretary, Chairman, the Joint Secretary dealing
with hospital matters, Joint Secretary (FA) or his
The funds sanctioned will be utilized for the
representative, DDG level officer dealing with
purpose for which it is sanctioned.
hospitals in Dte.GHS and one representative of
Central Pollution Control Board/Ministry of
The accounts of the hospital about purchase
Environment & Forests as members. The Member
of equipment/maintenance of the
Secretary of the Committee will be Director/Deputy
equipments/transportation of thw waste/
Secretary dealing with hospital matters. The funds
expenditure incurred on civil/electrical works
for setting up facilities for disposal of hospital waste
will be audited by the Accountant General
will be sanctioned to the State Government/UT
of the State Government/UT Administration
Administration/Occupier and it will be implemented
and its utilization certificate will be forwarded
by the concerned Government and to the concerned
to the Ministry of Health & Family Welfare
Head of the Hospital in case of Central Government
within a period of six months after the expiry
Hospitals/lnstitutions.
86
i
IPHS for 101 to 200 Bedded District Hospitais
Annexure - II
REFERRAL LABORATORY NETWORKS
Referral Laboratory Network for Advanced diagnostic facilities
*
North
Zone
—
KasT
Zone
South
Zone
IDSP
Level - 5
Labs
PGIMER
Chandigarh
RMRC
Dibrugarh,
KEM
Mumbai,
NICED &
NICD
■
IDSP Level - 4 Labs
South
Central
Zone
Zone
Advance Diagnostic Facilities
CMC
Vellore
Bacterial diagnosis
Enteric bacteria:
Vibrio cholerae,
Shigella,
Salmonella
•>
■. 1
Trivandrum
Medical
College
Cuttack
AllMS
Medical
Delhi
CRI Kasauli College
AFMC
Pune
-
Streptococcus
pyogenes and S
pneumoniae
Indore
Medical
College
VP. Chest
St.John
University
Medical
of Delhi
College,
Bangalore^
BHU
CMC,
Vellore
il’kW® ■ '■ •
C.diphtheriae
NICD,
Delhi
STM,
Kolkata
BJ MC
CMC
Vellore
AFMC,
Pune
VP Chest
Institute,
Delhi
Surat
Medical
College
CMC Vellore
& PGIMER
Chandigarh
I ■ • I'
______________
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
Neisseria
meningitidis and
N. gonorrheae
1
■
' ■
11
S,.
S
Tamil Nadu
University,
Chennai
VCRC,
Pondicherry
______________
87
IPHS for 101 to 200 Bedded District Hospitals
Viral Diagnosis
Enteric viruses
DRDE
CMC,
Vellore
AllMS &’
Villupuram
Chest
Institute
NICED
EVRC,
Mumbai,
NIV & NICD
Kolkata
-_______
Arboviruses
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
Chest
Institute
NICED
Kolkata
*
NIV
■
__________ __
Myxovi ruses
DRDE
CMC,
Vellore
Hepatitis viruses
DRDE
CMC,
Vellore
Neurotropic viruses
DRDE
CMC,
Vellore
HIV
DRDE
CMC,
Vellore
AllMS &
NICD Delhi
Chest
Institute
NICED
Kolkata
NIV Hqadi
B
______________
■
AllMS
ICGEB,
Delhi
NICED
Kolkata
• ft
NIV
_________
J
AllMS &
NICD Delhi
ZhaNS- '
__ gft
AllMS
NARI, NICD &
NACO
ICGEB, Delhi
1
Parasitic Diagnosis
Malaria
All State Public Health Laboratories
Filaria
All State Public Health Laboratories
i
MRC, Delhi
ICGEB, Delhi
NVBDCP, Delhi VCRC
Pondicherry
Zoonoses
Dengue
DRDE
VCRC,
AllMS
Pondicherry
Institute of
Virology,
Aleppey
NICED
r I
Niv
NIV
ICGEB, Delhi
n
w
ft. r,..„
1
■
.
■
•'
JE
DRDE
CRME,
Madurai &
NIMHANS
AllMS
NICED
/
■
VCRC,
Pondicherry
■■
■
t
; - 'ft • 'ft
NIV
‘ft*
"
NIV/NICD
;
■
ft';?ft
■
______________
88
J
IPHS for 101 to 200 Bedded District Hospitals
[Plague
DRDE
NICD, Delhi
AFMC
NICD
IVRI
NICED,
Calcutta
BJMC
NICD
IVRI
RMRC,
Dibrugarh,
Cuttack
Medical
College
KEM
Mumbai,
NICED &
NICD
Bangalore
BHMM_________
HnnMial diseases
m
Haffikins
Institute
NICD, Delhi
NICD
■s
>
■■.":
DRDE
______
CMC,
Vellore
Others of Public Health Importance
DRDE
Anthrax
■B-
Microbial water
quality monitoring
NEERI,
Nagpur
I
BL
IGIB
Vellore,
•
PGIMER
Chandigarh
Trivandrum
Medical
College
AllMS
Delhi
CRI Kasauli
AFMC Pune
_______
■
1 : ?.
4
V
,1,
Other laboratories to perform support functions
Unknown pathogens
■ -:
HAFFKIN’s,
Mumbai
NIV, NICD, HSADL
B,- ' '
Outbreak investigation
support
Medical Colleges and state public health laboratories I NICD, NIV, NICED, VCRC
asL3/L4 B
Laboratory data
management
Medical Colleges, state public health laboratories
and all the L4 & L5 laboratories (in their area of
expertise)
______________________________ '.'/."A
Y t_____
I Capacity building
___
.................. ,.................... .
All the L4 & L5 laboratories (in their area of
' expertise)
... ; ;
Quality assurance
All the L4 & L5 laboratories (in their area of
expertise)
_______________
__________________
Quality control of reagents All the L4 & L5 laboratories (in their area of
expertise)
& kits evaluation
____________
_
Production & supply of
reagents/ kits/ biological/
standard reference
____
Biosafety & bio
containment
_
-
NIV, NICDNIV, NICD
NIV, NICD
CMC, TRC, NTI, AFMC,
NARI, RMRC,Port Blair
NIV, NICD
CMC, TRC, NARI, RMRC,
Port Blair NIV, NICD, BJMC,
NICED
DRDE, NIV, IVRI, NICED,
NICD,MRC,Delhi
AFMC, Pune
NARI
TRC, Chennai
RMRC, Port Blair
B
A.
_________
1? B
I
muriate
.
....................................
I - ■
Other laboratories to perform support function
__________
89
HSADL, NIV/MCC,
DRDE, NICD
IPHS for 101 to 200 Bedded District Hospitals
List of Abbreviations
BJMC
BJ Medical College
CHC
Community Health Centre
CME
Continuing Medical Education
CSSD
Central Sterile and Supply Department
■
■
•
■
CRI
Central Research Institute
CRME
Centre for Research in Medical Entomology
DRDE
Defense Research and Development Establishment
ICGEB
International Centre for Genetic Engineering and Bio-technology
EVRC
Enterovirus Research Centre
FRU
First Referral Unit
HSADL
High Security Animal Diseases Laboratory
IGIB
Institute of Genomics and Integrative Biology
IPHS
Indian Public Health Standards
IVRI
Indian Veterinary Research Institute
KEM
King Edmund Memorial Hospital
MRC
Malaria Research Centre
NARI
National AIDS Research Institute
NEERI
National Environmental Engineering Institute
NICED
National Institute of Cholera and Endemic Diseases
NIV
National Institute of Virology
NRHM
National Rural Health Mission
■>
■
■
...
,a.
____________
;
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
I 90
■
—
___
•
PRI
/.
I”
.
■
'
>
''
'
—————
______
'
-
■'<'
'•
■
''
- ?
.
fi
IPHS for 101 to 200 Bedded District Hospitals
References
1. ' ‘ Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100 Bedded Hospital, Bureau
of Indian Standards, New Delhi, January, 2001
2.
Rationalisation of Service Norms' for Secondary Care Hospitals, Health & Family Welfare
Department, Govt, of Tamil Nadu. (Unpublished)
3.
District Health Facilities, Guidelines for Development and Operations; WHO; 1998.
4.
Indian Public Health Standards (IPHS) for Community Health Centres; Directorate General of Health
Services, Ministry of Health & Family Welfare, Govt, of India.
5.
Population Census of India, 2001; Office of the Registrar General, India.
91
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