Quality Manager

List of Supporting Task - Quality Manager Does for HR  & Training Department

1. Provides Hospital wide policies

2. Supports in Formulation of HR & Training SOP

3. Frequently Audits & Checks for File Management Systems as per NABH Requirements

4. Adjoins HR while formulation of Committees - HR be a member of Various Committees in Hospital Management

5. Conducting Training classes or Awareness Programs for All employees  with the support of HR & Training Team

6. Coordinating and Directing All types of Colour Code Mock Drills Asper Schedule & Requirement Norms

7. Quality Coordinator Collects & compiles monthly quality parameters & achievements of HR & Training

8. Invites & Conducts HR Achievements & Gaps as Review Meetings - Unit Head or Chairman will be Invited as Guest of Honor

9. Assessing - NABH Initial Status Report

10. Assessing & Reporting - NABH Pre assessment and Gap Analysis & Recommendations to fulfill the same

11. Quality Manager can be a part in Performance Evaluation & an Employee Satisfaction Survey- .Org wide process

12. Quality Coordinator can be an observer of Skill Matrix and Skillset evaluation & management process

13. The Quality team conducts Mock NABH Audits and submit reports of Haves & Have nots, Do's and Don'ts

Employee Info

1. What's your Name ?

2. From which Department you are from ?

3. What's your Employee ID ?

Organizational Inputs

1.      What is our Hospital Mission statement?

* What are Hospital Culture and value system?

* What is our Vision Statement?

2.      What is the significance of hospital Logo?

3.      What is the Motto of our hospital?

4.      Which year was your hospital opened?

5.      Who's Who?

Founder & Chairman

Executive Vice Chairperson

Managing Director

Director of Medical Services

COO/ DMS

Head-Unit Operations & Medical Services

General Manager-Operations

Manager HR

6.      What is the total number of beds in our hospital?

XX  Total Beds Available, XX beds are operational

7.      How do you wish patient and each other?

Namasthe/Vanakkam – No Shake Hands

8.      What is NABH? How is it good for us?

NABH stands for National Accreditation Boards for Hospital & Health care providers. It is an accreditation body, which sets and addresses standards for the health care providers. Standards are set for the progress of Health Industry. Focus is on Patient Safety and Quality Patient Care & employee safety.

9.      List the benefits of NABH?

✓ High Quality Care & Patient Safety

✓ Continuous improvement

✓ Provides Continuous Learning

✓ Quality improvement in Clinical & Support services 

11. Have you signed the confidentially Agreement? What is the purpose of it?

Yes, to maintain the confidentiality of information (Patient & Organisation).

12. In assessment of patients what are the types of primary process?

  (a) Physical

(b) Psychological

(c) Social

         (d) Economic status

         (e) Functional

 13. Have you received any further training?

 Yes, I have received training on Fire Safety. Hazmat Safety, Patient Safety and BLS etc.,

 14. Do you have training by the Hospital?

Yes, Hospital provides us with Induction training, BLS training with certificate.

15. When was your last performance evaluation done / knowledge skill evaluation done?

Performance evaluation is done yearly.

 16. What is our organizational quality improvement model?

 PDCA model - Plan - Do - Check - Act

17. Do you have enough doctors' coverage?

Yes doctors are available round the clock 24 hours a day.

 I8. What is the visiting hour of Hospital?

Ward: 4pm - 5pm.

ICU:

NICU: Mother-At any time. Fathers- Twice a day

 19. How do you identify a patient?

Name of the Patient & UHID No.

  20. List the scopes of services

 Specialties:

·   Anaesthesiology

·   Dentistry

·   General Medicine

·   Gynaecology

·   Immunization

·   Neonatology

·   Obstetrics

·   Paediatrics

·   Intensive Care Unit

- Neonatal NICU

- HDU

·   Infection Control

• Lab Services

- Biochemistry

- Blood storage centre

- Haematology & Clinical Pathology

- Histopathology & Cytology

-   Microbiology & Serology

-   IUI Facility

·   Radiology & Imaging Services

·   Other Diagnostic Services like ECG, etc.,

Departments and Locations

Floor Wise Departments

Ground Floor

1. Car Parking

2. Engineering Department (STP,WTP,CGSS,UPS Room, Sub Panel Room)

3. Bio Medical Waste Segregation Area

4. Security Office

5. Housekeeping Soiled Linen Segregation area

6. Triage Area

First Floor

Write your Hospital Info Here

Second Floor

Write your Hospital Info Here

Third Floor

Write your Hospital Info Here

Fourth Floor

Write your Hospital Info Here

Terrace

Write your Hospital Info Here - Ex:

Solar Plant

AHU

Lift Control Room 

Patient Rights & Education

Few Basic & Common Patient Rights?

·         Right to access to medical care

·         Right to Respect & dignity

·         Right to privacy & confidentiality

·         Right to know the identity of individuals providing service.

·         Right to information about the ailment.

·         Right to consent

·         Right to participate in decision involving your Healthcare

·         Right to refusal or change of treatment.

·         Right to make suggestions & express grievances.

·         Right to know the expected cost of treatment.

·         Right to have an interpreter in case you don’t understand the medium of communication.

Few Basic & Common Patient Responsibilities of Patient?

·         Provide complete & accurate information about you and your ailment.

·         Follow the treatment plan recommended by the doctors.

·         Take care of your belongings.

·         Be on time for your appointment with doctor.

·         Pay your bills on time

Where and when is consent forms signed? How long they are valid?

·         Consent forms are signed as and when required. Eg.:

·         During Admission

·         For Procedures

·         For Special critical care consent

·         For Operation Theatre

·         For AMA

·         For Blood Transfusion

·         For Anaesthesia

·         Validity varies as per each procedures.

What sort of education is given to patients?

·         Care decisions and care processes

·         Informed consents

·         Safe use of medication

·         Safe use of medical equipment

·         Food & Drug Interactions

·         Making sure that the patient understands the information given to them by explaining in a language understandable by the patient.

If a patient is not able to understand the language spoken by you (care provider) how do we interact?

We interact through the language interpreters and translators.

How do we provide patient education / information?

We educate the patient through counselling, brochures, displays.

Where are the medications stored for patients?

 All medications are kept in bed side lockers except narcotics, high alert & high risk medications.

Do we help the patient / caretakers in spiritual assistance?

We ask the patient and family if they would like to access spiritual support and arrange for the same through GR - Guest Relation.

Information Management System

Can you access medical record information at any time?

Yes. We can access medical records at any time after proper approval.

What are key areas of patients' confidentiality?

 (a) Do not disclose patient information to anyone except the patient or a person approved by patient

(b) Do not discuss patient details in the lifts and other public places

 (c) It is essential to keep medical record in a safe custody.

 Safety Inputs

What colour bag is used for disposal of infectious waste ?

Yellow colour bags.

What are the colored bags used for the disposal of stationary waste ?

Green colour bags.

What color indicate vulnerable patients ?

Bright Orange

What Is PPE?

Personal Protective Equipment.

Have you heard of sentinel event?

Yes, A Sentinel event is an incident, which results in or has the potential to cause serious harm / death to the patient. Examples are unexpected death, major transfusion reaction,  major medication error, major adverse drug reaction, unexpected OT death etc.

How do you report safety related issues at your organization?

Incident Reporting Form.

In case of a gas leak what is the number you will dial ?

Close the valve in consultation with Nursing dept. and call XXXX Engineering Department.

Who are the vulnerable patients  &What special care is given to vulnerable patients?

The vulnerable patients are aged >65 yrs old, Children below <16 yrs old,  pregnant and post operative patients, differently abled patients.

* Priority in OP and waiting areas.

* In the Inpatient wards placing the patients  near nursing station, side railing, safety belts .

How do you prevent infection spread in patient care areas?

Hand rub before and after patient contact, file handing, hand washing after toilet usage. We should ensure regular clean linen, regular floor mopping and timely disposal of garbage.

Usage of Sterile equipment, Monitor Blood Spills.

 What is the procedure when a patient goes into medical emergency?

·         Attend to patient & Call for help.

·         Activate Code Blue by Paging XX & Call XXXX.

·         Start CPR ( If trained)

·         MET team arrives.

When do you Wash hands?

·         Before Touching a patient

·         Before clean/septic procedure

·         After body fluid exposure risk

·         After touching a patient

·         After touching patient surrounding

Do we allow patient/attenders/guest to smoke?

As per law smoking is prohibited in all public utility areas and since hospital is a public utility area we follow the law of NO SMOKING.

What do you do when you cut your hand accidentally?

To inform everybody around about the blood spill.Wrap the wounded area in clean cloth, inform the immediate superior and go to Emergency. File and Incident.

Why have you placed belts on the wheel chair /stretcher ?

To prevent patient falls.

What should be done when a patient falls?

Call for help. Stabilize the patient, inform superior and file an incident Reporting form.

What will you do if you get a needle stick injury?

·         Immediately wash the hand under running water with soap.

·         Allow the blood to flow

·         Don’t squeeze or suck

·         Report Immediately to the emergency medical officer and the infection control incharge/nurse.

·         File an incident reporting form

How do you identify patients before transporting for a procedure?

We ask the patients name and look at the ID band for UHID no and tally with the file.

Hazmat Input

What are hazardous chemicals?

Chemicals, which are flammable, explosive/ corrosive and harmful in nature.

Name two hazardous chemicals?

Cidex, Formalin.

How many hazardous chemicals do we use?

There are XX Hazardous chemicals available in our hospital.

What is MSDS 

Material Safety Data Sheet.

Where is MSDS available?

Available in all departments where hazardous materials are available.

Name the type of cupboard where hazardous chemical can be stored?

Hazardous cupboard

What is major spill and minor spill?

Minor spills - less than 30 ml

More than 30 nil - Major spill

Who will clean the minor spill? And How?

The user department personnel will clean the minor spill.

 Place the caution board

Wear safety gears (Gloves, Mask, etc.,)

Clean the area as per the cleaning procedure and hand over to bio-medical wastage in a yellow bag.

Who will clean the major spill?

The HAZMAT response team from housekeeping will clean the spill.

What is HAZMAT control room number and where is the HAZMAT room?

The number is XXX and is situated at housekeeping department.(___Floor)

What are the different types of colour bags being used to segregate the bio-medical waste?

Yellow -Infectious Waste

Red -Clinical plastic waste

Blue -Broken & unbroken ampoules & bottles

Sharp container- Blades, Scalpels, Slides and any sharp item that can make an injury

Green -Stationary and food waste

How the biomedical waste disposed?

They are disposed through _____. The company is at _____. The Government authorizes it.

When do you use spillage management kit?

 When there is blood and body fluid spill, we use spillage management kit.

How will you discard the liquid chemical waste from lab?

Liquid chemical waste is discarded in the area available near the bio-medical waste management area, which will go to the sewage treatment plant.

What are the items available in HAZMAT kit?

 I. Chemical absorbing powder

 2. Sodium hydrochlorite

3. Nitrile gloves - chemical resistant gloves

 4. Orange gloves

 5. Tissue paper

6. Tongs

In case of a chemical spill on eye or body, where do you find the perforated eye fountain and body shower in the Hospital?

  _____Floor -_____ Ward & also at Treatment Room

In what color bag will you deposit the minor chemical spill?

White Colour

In case of major spill of chemicals, what number you will dial for help.

XXX - HAZMAT Control Room.

Fire Safety

In case of fire what will you do?

In case of fire rescue yourself, patients and inform XXX and go to nearest MANUAL CALL POINT Press and Activate. If it is a small fire, put off the fire with the fire extinguisher (If trained) If the fire is big, wait for the attack team to come. Mean time rescue patient and remove fire prone materials.

What is PASS

P for Pull the Pin in the Handle

A for Aim the nozzle at the base of the Fire

S for Squeeze the Nozzle lever slowly

S for Sweep from side to side

What is RACE?

 R for RESCUE

 A for ALARM

 C for CONFINE

 E for EVACUATE OR EXTINGUISH (IF TRAINED)

Which is the nearest fire extinguisher in your area?

 All the fire extinguishers are numbered & placed in designated area. In my area no……..type……….

Can you use lifts in case of fire?

No

Are you aware of fire exit routes?

Yes

Are you aware of assembly zone in the Hospital?

Open Area- Out Gate

In case of an electrical fire can we extinguish by water?

 No. We should use co2 or DCP.

What is a smoke detector?

Smoke detector detects the smoke in unmanned and unnoticed area. It is fixed in false ceiling. Whenever there is a fire, an alarm is heard in the panel board at the Security Office. Repeater panel at engineering department.

What is a water Sprinkler? How will you identify it?

Water sprinkler operates automatically when the temperature in that area reaches 67 degree Celsius, bulb explodes and water starts sprinkling. This safety system is available in all patient areas.

What is fire exit door?

Fire exit door are provided in work areas where normally more than used for free separations. The significance of this door is that the door will not catch fire for 4 hours. This is made up of metal.

Where is the main fire panel board installed?

At the security office

Where are the fire hooters and manual call point (MCP)?

Fire hooters are available all over the hospital; they are used to raise alarm when activated.

What are the different types of fire extinguisher?

1. Dry Chemical Powder (DCP)

2. Foam

3. Carbon-dioxide.

Are you aware of pipeline carrying colorcarvib ?

Oxygen - Yellow

Vacuum- Blue & Black Strips

Nitrous Oxide-yellow with Black Strips

Dry Nitrogen - Light Green

What should be done in case of gas leak?

 Reach the nearest trap door immediately and shut the valve. Call: XXX for help.

What are all the gas cylinders we are using?

Oxygen, CO2 and Nitrous oxide, N20

How do we transport gas cylinders?

Through trolleys only.

How should gas cylinders be handled?

Gas cylinders to be kept vertically, chained and ensure that the safety cap is available over nozzle.

Emergency Codes

Code Blue - Medical Emergency

Code Orange - Hazardous materials spills & leaks

Code Pink - Child Abduction

Code Purple - Missing Patient

Code Grey - Security Threats

Code Red - Accident and Emergency - Internal Disaster

Code Brown - External Disaster

Emergency Fire Plan

Information from any source

Announce Code Red with location

Fire safety officer, Fire fighting team leader, security officer will Act as Action Team

I. Action Team (Maintenance)

1. Restrict fire spread

2. Extinguish fire with, appropriate available fire extinguishers and control the fire.

3. Seek additional support if required from Fire Brigade.

 II. Salvage, Team (Housekeeping, Security)

1. Assist attaching party for providing fire hose and extinguishers as required

2. If necessary isolated electrical equipment medical equipment and all fire hazards near to the place of occurrence.

Ill. Evacuation Team (HK, Nursing, support staff)

 I. This party will evacuate if required all the patient and attendants from the fire site to safer place though the evacuated route.

2. If anybody hurt from above party evacuate them and provide the First Aid.

3. If required seek the assistance from transport department.

IV. Cordon Party (security)

1. Immediately cordon that area and not allow any unauthorized person at the place of occurrence. 

2. Receive Fire Brigade if required and help to reach the site of occurrence.

3. Assist the coordinator to call Fire Brigade / Police if required. 

Patient Safety Goals

WHO - IPSG International Patient Safety Goals

1.     Patient Identification

2.     Improve Effective Communication

3.     Improved Hand Hygiene to Prevent Health Care-Associated Infection

4.     High Alert , High Risk , Look-Alike, Sound-Alike Medication 

5.     Performance of Correct Procedure at Correct Body Site

6.     Control of Concentrated Electrolyte Solutions

7.     Assuring Medication Accuracy at Transitions in Care

8.     Avoiding Catheter and Tubing Misconnections

9.     Single Use of Injection Devices

1 - Identify Patients Correctly

Use at least two (2) identifiers for patients - NAME AND UHID NUMBERS

(Bed Numbers not to be used)

Use Identifiers before

•       Prior to shifting of patients to other departments/wards

•       Evaluating the patients

•       Administering medicines

•       Administering blood and blood products

•       Taking blood samples and other specimens

•       Providing any treatment or procedure

2 - Improve Effective Communication

Improve Process of Verbal Orders -Allowed only in the case of  urgency situations and diabetic medications. Orders to be written down and READ BACK

Communication during Patient Handovers

• Make entries in the kardex form; ensure that the caregiver taking charge of the patients understands the patient’s treatment completely.

• Allocate sufficient time for communicating information to the caregiver talking charge.

• Effective communication between 2 healthcare professionals

•         Dr.  & Dr.; Dr. & Nurse; Nurse & Nurse; Nurse & Dietician; Nurse & Physiotherapist, Nurse & technician and many more...

•         Improve Process for Critical Value reporting (To follow feedback procedure and document properly) Information to consultants & doctors 

3- Reduce the Risk of healthcare associated Infections

Hand Hygiene, (Infection control is everybody's responsibility Follow hand Hygiene before and after contact with patient Use 5-10 ml; 30-40 Seconds; 7 Steps, We follow, WHO Guidelines

Improve Hand Hygiene to Prevent Health Care-Associated Infection

4- Improve the Safety of High Alert, High Risk, and LASA Medications 

Potassium chloride (2 nffiq/mlor more concentration)

Sodium chloride (more than 0.9%)

Magnesium Sulphate (50%or more concentration)

We do not keep them in patient care areas; they are indented from IP pharmacy whenever required.  Beware of high alert& High-risk caution sticker (RED) on these medications

Administer concentrated solutions using an infusion pump

Verify that the doctor’s orders include the rates of infusion of these solutions.

Look-Alike, Sound-Alike Medication Names

Have a list of LASA drugs

Read the label carefully.

Store medicines that sound alike or look alike in separate location under LASA.

Minimize the use of verbal & telephone orders.

Training of all clinical and pharmacy staff

5 - Eliminate Wrong patient Wrong Site Wrong Surgery/ Procedure

Ensure Pre-op Checklist completion prior to shifting of patient to OT

Practice Site Marking (It has to be done in the ward itself by any of the doctors belonging to the operating team), - prior to the shifting of patient to OT

 Implement Surgical Safety Checklist  -, (Verification of Correct Patient /Correct Sire / Correct Procedure by the entire surgical team in the OT prior to Induction)

6-Assuring Medication Accuracy at Transitions in Care

The patient s’ current medication to be written in the uniform locations in patients Medication chart.

Name of the Drugs in capital letters

Use standard abbreviations

Refer to ‘Do not Use abbreviation’ chart (Ref: ASHT-PO-MOM 4a)

Reconciliation of medication: comparison of the patient’s medication list with the medications being ordered to avoid omissions, duplications, and inconsistencies.

7 - Avoiding Catheter and Tubing Misconnections

Non-clinical staff, patients and families are never to connect or disconnect devices.

Label all the lines/catheters attached to the patient.

Caregivers are required to trace all lines from their origin before administering medicine.

8 - Single Use of Injection Devices

Use the syringe only once.

Discard the needle in the sharps bin. In addition, the syringe in the blue bin.

No recapping is allowed

9 - Reduce the Risk of Patient Harm resulting from Falls

Identification on Vulnerable Patients (pink band) & Safety First stickers

Fall Risk Assessment by Nurses

Side Railings, Safety Belt on wheelchair, COTS while transfer

Department of NURSING

1.      Does the Nursing assessment include things such as allergies, medications taken etc?

All these are documented in the "Nursing Admission Assessment Form “through online.

2.      Is Psycho / Socio Assessment needed and why?

 Yes. Psycho/social assessment is important for the overall care of a patient. It is well known that depressed patients have a worse prognosis and if we can improve their morale, patient outcomes are better, they have a shorter length of stay.

3.      Who does patient education?

Doctors, Nurses, Dietician, Physiotherapy and Guest Relation personnel are mainly involved in education of patient. All patient receive education brochures at the time of admission other education material are provided when requested.

4.      Do we do spiritual assessment and how do we assess?

We ask the patient and families if they would like to see a religious leader of their community. We have such a list available by us and we arrange the same.

5.      Do you have enough physician coverage?

Yes. Doctors are available round the clock 24 hours a day.

6.      Describe your medication process?

We take the medication chart to the bedside along with the patient chart. Patient is identified by name and UHID number. Required medications are taken out of the locker. Injection are prepared one by one and labelled. Nurses will administer the medications. After cross checking.

Right patient

Right drug

Right dose

Right time

Right route

Right documentation

Patient is observed that he/she has taken the oral medications. Observed for any adverse drug reactions and these are documented.

7.      Can patient self-medicate?

No

8.      Can patients keep medication at bedside?

All medications are kept in bedside cupboards.

9.     What is the procedure to be followed when there is an Adverse Drug reaction?

•       Stop the medication

•       Assess the patient

•       Call MET if there is severe reaction

•       Inform the supervisor concerned, pharmacist and consultant

•       Fill in the ADR (Adverse Drug Reaction) Form

10.   What is the difference in how you manage chronic and acute pain? Does the hospital provide any education for you? Do you use a pain scale?

 The doctors manage acute pain more aggressively. Psychological factors are also very important while treating chronic pain. We are all undergoing training on pain management. Everyone, including doctors, use the pain scale for documentation.

11.   What happens when patients shows up with tons of pills?

Patients are requested to send the drug back home.

12.   Where / how do you control your narcotics? Where is the log for the controlled substances? 

We keep all controlled substances under double lock. The charge nurse has the key. We keep a detailed inventory of the narcotics.

13.   Do you keep Inj. KCL in ward/ICU?

No. KCL is stocked in the pharmacy only. But 1 amp0ule is kept in all the care areas for emergency purpose.

14.   Will you keep 2 different drugs in one container?

No

15. How long the vials (Liquid & Powder form of medication) be kept after the opening?

Liquid form - 1 month except inj-xylocaine & powder form - 24 hours after dilution. Sometimes as directed by the manufacturing company.

16. How long ointment & jelly (Ex. Xylocaine) can be kept after the opening?

Ointment-1 month or as directed by the manufacturing company; Jelly-only once used & the remaining is discarded.

17. Do you know to differentiate SOUND ALIKE & LOOK ALIKE medications?

 Yes. Copy is available at ward desktop computer.

18. What are the high alert medications ?

KCL, 3% Nacl, Magnesium sulphate > 50%. High alert sticker is pasted on these medicines.

19. What are the criteria for MET?

Tachycardia (HR > 130 beats / min).

Bradycardia (HR <40 beats / min)/ (> 200 mm Hg)

Hypotension (SBP < 90 / mmHg).

Multiple seizures

 Desaturation (SPO2 <90%. Despite with 6 litres of 02 Administration)

 Urine Output < 30 ml.

 (If baseline GCS gradually deceases by 2)

Respiratory rate < 8 or > 30 Breaths / min.

20. Who are the vulnerable patients?

Age group below 16 yrs and above 65 yrs.

Critically ill patient

immunocompromised patient

Physically / Mentally challenged

Any patient who cannot perform ADL (Action of daily living)

21. What special care is given to vulnerable patient?

The following measures are advanced for their safety.

Side rails are always put upon the beds

Care is taken to ensure that safety belts are always put when patients transferred by wheel chair.

A patient safety Brochures is given to the patient.

Like all other patients. Event Reporting from is filled in case some adverse happens with such a patient.

22.   Who order restraints? What is Restraints policy? How long are Restraint Orders valid for?  

Doctors order restraints, it is discussed with the family and obtain consent, which is valid for 24 hrs. We also document what we did prior to actually restraining a patient and why he needs the restraint.

23.   Why have you placed a belt on the wheel Chair / Stretcher?

To prevent falls.

24.   What happens when a patient falls?

We raise an alarm and call for help. Inform the concern superior and report the same on the Incident reporting from.

25.   Do you accept verbal orders? Within how many hours the oral orders are to be documented? 

No. We do not accept verbal orders except during a life-threatening emergency and for anti-diabetic drugs. Oral orders are to be documented within 24 hours.

26.   How do you identify patients before transport?

We ask the patient's name and look at the ID band for UHID number tally with the file.

27.   Is soiled linen segregated form other linens?

Yes. Soiled linen is separated at source.

28.   How do you dispose SHARPS?

They are disposed through puncture proof containers.

29.   Is soiled linen from the infectious patient segregated from other linens?

Yes. It’s collected in the yellow color cover separately & disposed.

30.   What do you do in case of spillage of hazardous materials?

Place tissue or newspaper over the spill, place caution board, call HAZMAT to clean large spill.

31.   Have you heard of sentinel events?

Yes. A Sentinel event is an incident, which result in or has the potential to cause serious harm/death to the patient. Examples are; unexpected death, major transfusion reaction, major medication error, major adverse drug reaction, unexpected Death etc.

32.   What would you do if you had a sentinel event?

I would inform the doctor and Nursing officer / Nursing Superintendent. Fill sentinel event reporting form send it to the Medical Superintendent Office.

33.   What do you do when a patient refuses treatment?

I try to explain to the patient why they need this treatment/medication and if they still refuse. I document this and call the doctors. They will also try to reason with patient and involve the family.

34.   Do you practice advanced directories?

There is no system of advance directives in India.

35.   What is discharge planning and who does this?

The admitting doctor does discharge planning at the time of admission. And during our nursing care we educate the patient on various care aspects and prepare them for home care.

36.   Is the patient's family involved in decisions making for patient care?

Yes. All treatment decisions are made after the doctor has discussed the treatment plan with the patient and/or family.

37.   Who obtains Informed Consent?

The doctors.

38.   What is the process to move patients in and out?

Doctors fill out a "transfer" form. We, nurses will call up and inform the area where the patient is going to be shifted and inform the conditions of the patient to ensure their preparedness. Transfer notes are documented in the nurses record and we accompany the patient and hand over to the nurse of the receiving ward.

39. How do you treat the International patients and VIP patients?

We have to treat them like other patients. If any language barrier we have to call the interpreter.

1. The consent form is valid for 30 days.

2. Blood transfusion, Restraint consent to be obtained on each admission, valid for 24 hours. 

40. How often the trays are to be sent for Autoclaving.

5 days

41. What is the age group of paediatrics?

Below 16 years.

42. When the patient collapses what will you do?

Check for response, Shout for help, keep the patient in safe place, Request someone to call CODE BLUE  in ground floor & Basement, Start CPR if needed.