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HOSPITAL WARD

MANAGEMENT
BY
MS. SUSMITA BHAUMIK
LECTURER,
POST GRADUATE INSTITUTE OF
HOSPITAL ADMINISTRATION
Hospital ward - block forming a
division of a hospital (or a suite of
rooms) shared by patients who need a
similar kind of care; "they put her in a
4-bed ward"
Hospital in patient services basically covers 1/3 rd of the total
hospital complex. The functions of inpatient services are
•To render nursing care to all patients
•To provide necessary equipments, essential drugs and all other
stores requirements for patients care in an organized manner in the
wards
•It provides opportunity for training medical, nursing and
paramedical, nursing and medical staffs besides conducting
research work.
CONSTITUENTS
 Patient space
 Nursing space
 corridors
Types of wards

 General wards

 Speciality wards
Factors to be kept in mind while designing a
ward
 Movement space
 Number of beds in a room
 Bed spacing
 Position of nursing station
 Category of the ward
 Ancillary rooms
 Ratio of toilet accommodation
PLANNING AND DESIGNING-PHYSICAL
FACILITIES

 AREA
 LOCATION
 SIZE
 SHAPE
 ANCILLARY ACCOMODATION
 WATER AMD ELECTRICITY SUPPLIES
 COMMUNICATION
 AIR-CONDITIONING
Physical facilities
 Area requirement per bed= 70-90 sq. feet

 Area separated from noise and disturbances

 Approachable from support services like-

CSSD, Blood Bank, imaging and laboratory


 Movement space

 Wards can be T-shaped, L-shaped,

Rectangular shaped
 Can have single/double corridor

 Nightingale pattern, Riggs pattern


Riggs pattern
Modern trend is to have cubicles of 1,2,3,4,5 beds in each cubicle

 Advantages
1.Patient beds not visible to outside visitors except for visiting hours
2. Gives a more clean and tidy look
3. It provides as a barrier against psychological shock for other patients
during emergency situations.
4. More privacy

 Disadvantages
1.Communication between nurses and patient becomes more difficult
2. Patients deprived of direct observation from nurses
3. Wards become longer, consequently nurses have to run more
4. More nurses are required
5. Costly to build and maintain
ANCILLARY ACCOMODATION

The nurses station should have min space requirements of


20’x20’ and should have
•Nursing station with attached bathroom and medicine storage
cupboards
•Counter in open space outside to carry out work
•A built in drug cupboard for daily use medicines
•House physicians room
•CLEAN UTILITY ROOMS (100-200 sq ft)
•TREATMENT ROOMS(120-150 sq. feet)
•WARD KITCHEN / PANTRY (100-120 sq. feet)
•DAY ROOM
•STORES (80-130 sq. feet)
•BATHROOMS
1.URINAL- 1 FOR 12 BEDS
2.WC- 1 FOR 08 BEDS
3.BATH- 1 FOR 12 BEDS
WASH HAND BASIN- 1 FOR 10 BEDS
•JANITORS ROOM (40-60 sq. feet)
•SLUICE ROOM(150-170 sq. feet)
Auxiliary Accommodation

•This includes ward laboratory, seminar rooms,


nurses rest rooms, visitors room
•This is usually common for 2-3 floors
Staffing pattern
 Norms for nursing staffs
NS 1 per hospital
DNS 1 for 400beds
ANS 1 for 25-30 beds
Teaching hospital 1 for every 3 beds
Non-teaching hospital 1 for every 3 beds
ICU/ITU 1 for each bed
FOR EVERY 250 BEDS THERE SHOULD BE ONE INFECTION
CONTROL NURSE.
Provisions for ward coordinator for controlling ward functions in each
ward

Norms for nursing aids


30-50 beds 15-25 gr D staffs(1 employee for 02 beds)
100 beds 50 gr D staffs(1 employee for 02 beds)
Correlation with bed space and
hospital engineering grid
 Door 1.2m or 3/4th grids
 Veranda 1.5 grids
 Windows 1.2-1.6m
 Corridors 2.4m
 Distance between bed centers 7 ft/8 ft
 Clearance between wall and side of bed in
respect of bed
Closer to wall: 2 ft
Isle between two row of beds: 5 ft

 Area per bed within the ward therefore need


not be more than 70 sq ft
 * 1 grid1.6x1.6=2.56 sq m
Specialised wards
(Neonatal unit)
Set up as an independent unit for care of new-born under supervision of a pediatrician
Area requirements in sq ft

•Nursery
•Premature 230
•Septic 150
•Normal 150
•Nurses station with toilet 190
•Doctors room 190
•Breastfeeding room 115
•Store 115
•Phototherapy room 115
•Sluice room 115
Duties and responsibilities of personnel for effective
functioning of wards
 Nursing personnel
 Endorse patients and give attention to patients’ comfort and safety
 Delivers clean medical supplies to patient care units and collect used
supplies, instrument sets, rubber goods, etc.
 Makes general assessment of patients in the recovery room and
confers with head nurse nursing management of each patient
 Accompanies physician on rounds to answer questions, receives
instructions and notes patients’ care requirements. Reports to
replacement on next tour on condition of patients or of any untoward
or unusual actions taken. May render professional nursing care and
instruct patients and members of their families in techniques and
methods of home care after discharge
•Assigns duties to professional and ancillary nursing personnel based on
patients’ needs, available staff, and service needs. Supervises and
evaluates work performance in terms of patient care, staff relations and
efficiency of service. Provides for nursing care and cooperates with other
members of medical care team in coordinating patients’ total needs.
Identifies and studies nursing service problems and assists in their
solutions. Observes nursing care and visits patients to insure that nursing
care is carried out as directed and treatment is administered in
accordance with physician’s instructions and to ascertain needs for
additional or modified services. Maintains safe environment for patients.
Operates or supervises operation of specialized equipment assigned to
unit and provides assistance and guidance to nursing team as required.
•Visit clinical nursing divisions to oversee nursing care and to ascertain
condition of patients. Gives advice for treatments medications, and
narcotics, in accordance with medical staff policies in absence of
physician. Arranges for emergency operations and relocations of
personnel during emergencies. Admits or delegates admissions of new
patients.
•Cooperates with individual/group in other departments or services in
carrying forward the work of the hospital as a whole.

• Supervises and coordinates activities of nursing personnel engaged in


specific nursing services such as Obstetrics, Pediatrics, Surgical or
Medical, or from two or more clinical nursing divisions.

•Determines and makes recommendations concerning hospital


wards’ facilities, equipment and surgical supplies affecting nursing
care, and plans for allocation and utilization of space and
equipment to ensure safe environment for patients and working
personnel
MEDICARE AND BILLING SECTION - Admits, classifies Pay and Medicare
Patients, orients patient with regard to privileges, obligations,
responsibilities during the course of confinement. Prepares statement of
account on service and bills rendered to patient. File records, bills and
statement of account.

DIETARY SERVICE – Maintain or enhances the health of the patients and


personnel by providing them with high quality and nutritious food through
an efficient Dietary Service; Provides or serves safe, nutritious and
attractive food through careful planning, wise procurement and proper
preparation of balanced and satisfying meals within budgetary limits;
Implements diet prescription in coordination with physician and nurse;
Provides nutrition consultation and education services to patients as well
as in-service training to both dietary personnel and other related fields;
Promotes and maintains cooperation with other department in the
hospital towards total patient care.
SECURITY FORCE - Ensure safety of hospital patients, facilities and
personnel, maintain peace and order, and enforce hospital rules and
regulations
PERSONNEL SECTION - Development and administration of a
comprehensive manpower development program which includes
recruitment and selection, promotion, training, employee welfare
and benefits, manpower planning and research.

PROPERTY AND SUPPLY SECTION - Procurement, storage, inventory,


distribution and disposition of hospital supplies, materials, and
equipment.

HOUSEKEEPING SECTION - Develop and maintain clean, safe and


sanitary environment for patients and hospital personnel.

LINEN AND LAUNDRY SECTION - Ensure adequate supply of clean


linens for patients and hospital units.

ENGINEERING AND MAINTENANCE SECTION - Installation, operation


and maintenance of electrical, mechanical and communication
equipment and allied facilities including buildings and vehicles.

MOTOR POOL SECTION (TRANSPORT) - Convey transport patients,


hospital officials and personnel to their destination.
THANK YOU