Care of Vulnerable Patients

Enhanced Training Module: Care of Vulnerable Patients

Module Code: CVP-TRN-01
Based on Policy: BCMCH/POL/1002.06 (Policy On Care Of Vulnerable Patients)
Referencing: NABH Accreditation Standards for Hospitals (6th Edition, Effective 1 Jan 2025), JCI Accreditation Standards for Hospitals (6th Edition, based on typical IPSG, PFR, AOP, COP chapters)
Date of Training: [Insert Date]
Trainer: [Insert Trainer Name/Department]

1. Target Audience:

• All clinical staff (Doctors, Nurses, Allied Health Professionals)

• Patient care assistants and support staff

• Administrative staff involved in patient admission and interaction

2. Duration:

• 2.5 - 3 hours (to accommodate the additional detail)

3. Learning Objectives:
Upon completion of this training module, participants will be able to:

• Define "vulnerable patient" according to BCMCH policy.

• Identify various groups of patients considered vulnerable as per BCMCH policy and recognized by NABH/JCI.

• Understand the importance of risk assessment and individualized care planning for vulnerable patients.

• Describe specific care considerations and safety measures for various vulnerable patient groups, aligning with BCMCH policy and NABH/JCI objective elements.

• Explain the procedure for obtaining informed consent for vulnerable patients, referencing relevant NABH/JCI standards.

• Recognize their role in protecting the rights, dignity, and safety of vulnerable patients.

• Understand the importance of documentation related to the care of vulnerable patients as per NABH/JCI requirements.

4. Materials Required:

• Copy of BCMCH/POL/1002.06

• Excerpts or summaries of relevant NABH Objective Elements (e.g., from COP, PRE, AAC chapters)

• Presentation slides (PowerPoint)

• Case studies/scenarios

• Handouts summarizing key policy points and NABH/JCI cross-references

• Attendance sheet

• Post-training quiz/assessment form

5. Training Module Content & Agenda:

(0:00-0:10) Introduction & Purpose (10 mins)

• Welcome, introductions, overview.

• BCMCH Policy 1.1: "To define a mechanism of assessment and management of the vulnerable patients and identify the groups of patients who will be considered as 'vulnerable'."

• NABH/JCI Rationale: Emphasis on patient safety, patient rights, risk mitigation, and individualized care for vulnerable populations as a core component of quality healthcare.

(0:10-0:40) Defining and Identifying Vulnerable Patients (30 mins)

• What makes a patient "vulnerable"? (BCMCH general understanding)

• BCMCH Policy Definitions (Section 3.1 & 3.2.1 - 3.2.19): Review the list.

• NABH Link (Connecting BCMCH Policy to NABH Standards):

  • NABH COP.16 (Care of Patients): "The organisation identifies and manages patients who are at high-risk of morbidity / mortality." (This is the overarching NABH standard for vulnerable patient care)

    • COP.16.a (Objective Element - CORE): "The organisation identifies and manages vulnerable patients. *"

      • Interpretation (NABH): This OE expects the organization to define vulnerable patients (beyond just age) and have processes for their identification and management. This directly aligns with BCMCH's list in 3.2.

    • COP.16.b (Objective Element - CORE): "The organisation identifies and manages patients who are at a risk of fall. *" (Relates to BCMCH 3.2.2 elderly, 3.2.3 physical disabilities, 3.2.19 high fall risk)

    • COP.16.c (Objective Element - CORE): "The organisation identifies and manages patients who are at risk of developing / worsening of pressure ulcers. *" (Relates to BCMCH comatose, terminally ill, elderly)

• JCI Link:

  • JCI PFR.1.5 (Patient and Family Rights): "Patients are protected from physical assault, and populations at risk are identified and protected from additional vulnerabilities." (Intent aligns with identifying and safeguarding)

  • JCI AOP.1.6 (Assessment of Patients): "Individualized medical and nursing initial assessments are performed for special populations cared for by the hospital." (Intent: This would include many of BCMCH's listed vulnerable groups, requiring specific assessment).

(0:40-1:40) Assessment and Specific Care Strategies (60 mins)

• Initial and Ongoing Assessment (BCMCH Policy 3.1 - risk assessment):

  • NABH AAC.4 (Access Assessment and Continuity of Care): "Patients cared for by the organisation undergo an established initial assessment."

    • AAC.4.a (Objective Element - CORE): "The initial assessment of the out-patients, daycare, in-patients and emergency patients is done in a standardised manner. *"

    • AAC.4.b (Objective Element): "Interpretation modied for incorporating psychological, spiritual, cultural, social and economic aspects to be part of initial assessment." (Relevant for vulnerable patients with emotional/psychiatric disorders, victims of abuse)

  • NABH AAC.5: "Patients cared for by the organisation undergo a regular re-assessment."

    • AAC.5.a (Objective Element - CORE): "Patients are re-assessed at appropriate intervals to determine their response to treatment and to plan further treatment or discharge." (Interpretation would emphasize reassessment for vulnerable aspects).

  • Use of screening tools as per BCMCH 3.2.19 (Braden, Fall risk).

• Tailored Care and Support (BCMCH Policy 3.3):

  • NABH COP.1: "Uniform care to patients is provided in all settings of the organisation and is guided by written guidance.*"

    • Interpretation (NABH): Care should be appropriate to patient needs, which includes vulnerability.

  • JCI AOP.1.6: (As above, individualized care plans)

• Specific Policy Mandates & Best Practices:

  • Constant Supervision (BCMCH Policy 3.4):

    • NABH COP.16.a interpretation would guide the management aspect which could include supervision.

    • JCI PFR.1.5 (protecting from additional vulnerabilities) and COP standards for safe environment.

  • Gender-Specific Care (BCMCH Policy 3.5 - Female attendant):

    • NABH PRE.1 (Patient Rights and Education): "The organisation protects and promotes patient and family rights and informs them about their responsibilities during care.*"

      • PRE.1.b (Objective Element): "Patient and family rights include respect for personal dignity and privacy during examination, procedures and treatment."

    • JCI PFR.1.2: "The hospital provides care that supports patient dignity, is respectful of the patient’s personal values and beliefs..."

  • Care of Minors (BCMCH Policy 3.6 - attendant except ICU):

    • NABH PRE.1.a (Objective Element): "Patient and family rights and responsibilities are documented, displayed, and they are made aware of the same. *" (This would include rights of minors and family involvement).

    • JCI PFR: Chapter generally covers rights and family involvement.

  • Respecting Patient/Family Requests (BCMCH Policy 3.7):

    • NABH PRE.2 (Objective Element): "Patient and family rights support individual beliefs, values and involve the patient and family in decision making processes."

    • JCI PFR.1.2 (respectful of values and beliefs).

  • Environmental Safety (BCMCH Policy 3.8 - skid tiles, ramps, railings):

    • NABH FMS.1 (Facility Management and Safety): "The organisation has a system in place to provide a safe and secure environment."

    • NABH FMS.4: "The hospital plans and implements a program to provide a safe physical facility through inspection and planning to reduce risks."

    • JCI FMS Chapter (Ensuring a safe and supportive environment).

    • Link to NABH COP.16.b (managing fall risk).

  • Abuse and Neglect (BCMCH 3.2.13 - Victims of abuse and neglect):

    • NABH PRE.1.c (Objective Element): "Patient and family rights include protection from neglect or abuse." (CORE)

    • JCI PFR.1.5: "Patients are protected from physical assault..."

  • Suicide/Self-Harm Risk (BCMCH 3.2.12):

    • NABH COP.16.a interpretation would include managing patients with suicidal ideation as vulnerable.

    • JCI PFR.1.5 and specific AOP/COP standards for mental health assessment and safety.

(1:40-2:10) Informed Consent and Patient Rights (30 mins)

• Informed Consent for Vulnerable Patients (BCMCH Policy 3.9 - consent from relatives if patient unable):

  • NABH PRE.4 (Patient Rights and Education): "Informed consent is obtained from the patient or family about their care."

    • PRE.4.a (Objective Element): "The patient and / or family members are explained about the proposed care (including the risks, benets, alternatives), expected results and possible complications."

    • PRE.4.e (Objective Element): "The organisation describes who can give consent when a patient is incapable of independent decision making and implements the same. *" (Directly relevant to BCMCH 3.9).

  • JCI PFR.5.1 (Patient and Family Rights): "Patient informed consent is obtained through a process defined by the hospital..."

  • JCI PFR.5.4: "The hospital establishes a process, within the context of existing law and culture, for when others can grant consent." (Directly relevant)

• General Patient Rights (NABH/JCI Core):

  • NABH PRE.1: (As above, protection and promotion of rights).

    • PRE.1.d (Objective Element): "Patient and family rights include the refusal of treatment."

  • NABH PRE.2: (As above, support for beliefs, values, involvement in decisions).

  • JCI PFR Chapter: Generally covers dignity, privacy, confidentiality, information, participation in care decisions, refusal of treatment.

(2:10-2:35) Staff Responsibilities, Teamwork & Documentation (25 mins)

• Staff Training (BCMCH Policy 3.10):

  • NABH HRM.3 (Human Resource Management): "Staff are provided induction training at the time of joining the organisation."

  • NABH HRM.4: "There is an on-going programme for professional training and development of the staff."

    • Interpretation (HRM.4.a - CORE): "Written guidance governs training and development policy for the staff.*" (This would include training on vulnerable patients).

  • JCI SQE (Staff Qualifications and Education): Chapter generally covers orientation, ongoing education, and competency.

• Documentation (General Requirement, not one specific BCMCH point, but implied):

  • NABH IMS.3 (Information Management System): "The patients cared for by the organisation have a complete and accurate medical record."

    • Interpretation (IMS.3.b): "The contents of the medical record are identied and documented. *" (This would include assessment of vulnerability, care plan, consent).

  • NABH IMS.5: "The organisation maintain condentiality, integrity and security of records, data and information."

  • JCI MOI (Management of Information): MOI.9 (Standardized medical record), MOI.9.1 (Record contains sufficient information), MOI.2 (Privacy, confidentiality, security).

• NABH COP.16 Interface (from BCMCH Policy 2.1): Reinforce the centrality of NABH COP.16 in guiding the care of vulnerable patients.

(2:35-2:50) Interactive Session: Case Studies/Scenarios (15 mins)

• Present 1-2 short case studies.

• Facilitate discussion:

  • Identify vulnerabilities based on BCMCH policy.

  • Which NABH Objective Elements (e.g., COP.16.a, PRE.4.e) are most relevant?

  • What JCI standards (e.g., PFR.1.5, PFR.5.4) apply?

  • Outline key care and consent strategies.

(2:50-3:00) Q&A, Summary, and Post-Training Assessment (10 mins)

• Address questions.

• Summarize key BCMCH policy points and their alignment with NABH/JCI requirements, especially CORE elements.

• Administer quiz.

  • Sample Questions:

    1. As per BCMCH Policy 3.1 and NABH COP.16.a, who is considered vulnerable and requires risk assessment?

    2. A 12-year-old child needs bathing. According to BCMCH Policy 3.5 and NABH PRE.1.b, who should assist?

    3. A patient is unable to consent for a procedure. Which BCMCH policy and NABH objective element (PRE.4.e) guide how consent is obtained?

    4. How does BCMCH policy on environmental safety (3.8) align with NABH FMS chapter standards?

• Thank participants.

6. Follow-up & Reinforcement:

• As per BCMCH Policy 3.10 and NABH HRM.4.

• Audits referencing BCMCH policy and relevant NABH/JCI Objective Elements (e.g., documentation of consent as per PRE.4, individualized care plans as per COP.1).

This enhanced module now directly cross-references specific NABH 6th Edition Objective Elements (and their CORE status) and relevant JCI standard areas, making the training more robust and directly aligned with accreditation requirements. Remember that the interpretation sections of the NABH standards often provide detailed expectations that are invaluable for training.