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PRAVARA RURAL HOSPITAL

WEL-COME TO. PRAVARA RURAL HOSPITAL. INTRODUCTION. PRH is established in 1976 with 100 beds to provide primary & secondary level medical care. Over a period of time, the hospital grew into an 800 bedded multi-disciplinary super speciality referral institute.

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PRAVARA RURAL HOSPITAL

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  1. WEL-COME TO PRAVARARURALHOSPITAL

  2. INTRODUCTION PRH is established in 1976 with 100 beds to provide primary & secondary level medical care. Over a period of time, the hospital grew into an 800 bedded multi-disciplinary super speciality referral institute. Recognized by MCI as UG & PG teaching institute. Hospital caters for the needs of constituent institutions of PIMS (DU). Assist state & central Govt. to implement their National Public Health Programmes.

  3. SERVICES AVAILABLE Provides modern diagnostic treatment facilities for all diseases and disorders. Casualty & emergency services Out patients services by clinical and para-clinical departments. Inpatients services Clinical Departments: Medicine and allied specialities Surgery and allied specialities Diagnostic Services Supportive services

  4. MEDICINE & ALLIED SPECIALTIES General medicine Chest and Tuberculosis Super-specialist services through consultant Neprhopathy & Haemodialysis Neurology Cardiology Paediatrics Dermatology and venereology Psychiatry Radiotherapy & Oncology

  5. SURGERY & ALLIED SPECIALTIES General Surgery Super-specialist services Urology Neuro surgery Paediatric surgery Paediatric cardiac surgery Reconstructive surgery Orthopaedics Gynaecology and Obstetrics Oto Rhino Laryngology (ENT) Ophthalmology Oral and Maxilo facial surgery Anesthesiology

  6. Organization Chart Medical Director Medical Superintendent Nursing Superintendent Dy. Nursing Superintendent Ward In-charge Night Supervisor Rector Staff Nurse Student Attendant

  7. Maintenance of Record

  8. Documents in Nursing Office Duty Roaster Master roll call Personnel record Incident record Meeting Record In-service education record Higher education record Requirement record

  9. Ward routine record Admission and Discharge Census Book Diet Book Indent Book Death Register Birth Register Daily Report book

  10. ACTIVITIES CARRIED OUT & STAFF DEVELOPMENT PROGRAMMES

  11. Activities carried out Orientation Programme In service education programme In house training programme Deputation for workshop and conference Exchange programme in Sweden Educational trip Days celebration : WHO, Breast feeding week, midwife day, Nurses' day

  12. ICU & CCU ICU is one of the most qualified department for care and supervision of patients in the hospital It is a part of the department of anesthesiology ICU is provided with Medical officer, Doctors on call, In-charges, staff nurses with specialized training We are always ready to give the best possible care

  13. AIMS Aim of the ICU is to provide excellent nursing care to the critically ill patient by specialized nurses and their professional colleagues Develop the skills, attitude and creative thinking essential for providing critical nursing care and practice ICU attached department • Cardiac care unit • Stress test/ T.M.T • Haemodialysis • ABG Room

  14. Special Facilities Multi module/Three lunar monitors are attached to each bed in the ICU and CCU giving specialty cardiac monitoring and recording facilities, high risk alarms and storage and printing facilities. Central monitor in cardiac care unit for continuous cardiac monitoring of each patient. E.C.G. machine, Temporary space maker, Halter monitoring for 24 hrs ECG monitoring, D Defibrillator machine for cardioversion.

  15. Ventilator 13 full functioning ventilators are available (10 in ICU & 3 in CCU). Central O2 and suction for each bed. Single and Double syringe pumps for micro drip infusion of medication at specified rate. Infusion pump for continuous intravenous infusion at specified rate. Portable X-Ray Machine unmovable patients and to prevent delayed radio diagnosis.

  16. Standing instruction to ICU staff When new admissions or transfer from OT, Casualty, or other floor Confirm patient is stable If ventilated, check RS, ETT position, ventilator settings and airway pressure Get details of patient from transferring doctor and fill up transfer summary

  17. Staff must learn in the first week Defibrillation Ventilators and O2 connections Setting up monitor and zeroing and setting up lines CPR management Vascular access Inform the Doctor on call: Any new patient needs intubation, ventilation or inotrops Any patient develops Hypotension, dyspnoea, oliguria etc. Read and be familiar with all protocols: Be familiar with Admission, Discharge and Death procedure, Airway protocols: ETT, Mechanical ventilation.

  18. Shift cheklist Oxygen, suction Ambu Bag and face mask Laryngoscopes IV lines and infusion: when new infusion will be needed, dose and rate of running infusion, inotropes and TPN each in separate lines Check alarm limits Confirm ventilator settings Listen chest sound

  19. Nasogastric tube on free drainage, unless patient being fed Check drug prescriptions Change Betadine gauze on bi valves Re stock sedation at the bed side Re check 24 hours fluid balance Check syringe pumps settings

  20. Infection control Remove Shoes at the entrance of the ICU/CCU and use Shoe covers or sleepers of ICU/CCU. Bedside infection control prevention: Sterillium hand wash solution at bedside. Wash hands with Sterillium before initial patient contact. Rewash hands every time either a vascular catheter and its connections or the tracheal tube and its connections are touched. Separate/ disposable face mask per bedside. Ambubag, face mask and stethoscope to be cleaned with spirit when new patient arrives.

  21. Dressing trolleys: Do not move a common trolley from bed to bed. Trolley should be cleaned and loaded before a bedside procedure is done. Disinfectant solutions: For sterilizing airway equipment: 2% Gluteraldahyde (Cidex) For cleaning contaminated materials: Hypochlorite solution 5% solution, 75ml is diluted in 12 L of water. Lysol 10ml in 1 liter of water can be used. Savalon solution 10ml diluted in 1 liter of water used for article disinfection For general cleaning of walls and floor, and toilet: Dump cleaning with detergent solution is done in ICU. Separate mops are used for toilet, bathroom, corridors and patient's cubic area, walls and floor.

  22. Ventilator and tubing sterilization: Use disposable circuit as frequently as possible Use humidified expiatory filter at Y-connection for all patients, to be changed every 24 – 48 hours, not to be removed from circuit except at time of changing Two disposable catheter mounts per patient One is used and one kept in cidex solution at the patient's bed side. Alternated every 24 hours. Both discarded after use.

  23. Care of Endotracheal tube: Endotracehal tube to be tied and taped to prevent accidental extubation Circuit not to be broken for suction. If stericath not in used, suction to be done by uncapping catheter mount and not by disconnecting catheter mount and not be disconnecting catheter mount from tracheal tube. New pair of sterile gloves and new suction catheter for all such suction. If catheter mount cannot be uncapped then the catheter mount to be disconnected from the tracheal tube and placed on a sterile surface, either on the glove wrapping or on a sterile towel.

  24. Care and changing of vascular (arterial and venous) catheter: Inset all central catheters with full sterile precautions Daily dressing for all vascular catheters All 3 ways stopcocks to be kept wrapped in Betadine soaked gauze (changed 8 hrly). Routine change catheter between 5 to 7 days. More frequent change if catheter is suspected source of fever or infection or if puncture site looks infected Wash hands each time the catheter or its connections are touched

  25. CARE OF URINARY CATHETERS As little disconnection as possible If closed collection system used, change every 7 to 14 days if open system, every 3 to 5 days No routine change of urinary catheter

  26. Practical tips to prevent errors: Set alarm limits Inform at slightest change Never suspend/put off alarms One Nurse or Doctor can be monitor the central station if installed Constant attention secure the lines and tubes

  27. If patient is on Ventilator keep Ambu Bag with reservoir at bedside Protect patient from injury All life saving equipments to be connected to the UPS system Follow infection control protocol Good intravenous access use common language Telephone manners Be specific

  28. DIALYSIS UNIT • Located in close proximity of ICU & OT complex. Equipped with : • 2 beds & 2 Haemodialysis machine with RO plant • Central Oxygen, suction & medical air supply • Multipara monitors • Datas last 5 years: Dialysis and ICU

  29. ICU& ICCU

  30. CASUALTY & EMERGENCY

  31. NICU • Kangaroo Mother Care

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