ASSIGNMENT

Q.1 what are the objectives of Nursing services. AnswerNursing profession is considered a caring profession to begin with; it was an art and a vocation. Now it is considered a scientific profession nursing care is defined as the care of the patient with regard to nursing needs, with the ever increasing dimension of medical sciences quantitatively and qualitatively nursing care is becoming more and more complex with its management services. out of all the hospital staff, the best organized and most compliant are invariably the nurses, which makes the chief goal of a nursing department to provide continuous care to the patients, and to recognize a patients physical , social and emotional needs, below described are some of the
ORGANISATION OF NURSING SERVICES:CHIEF NURSING OFFICER | NURSING SUPDT | DY. NURSING SUPDT. | ASSTT. NURSING SUPDT. | WARD SISTER-CLINICAL SUPERVISOR | STAFF NUIRSE ----STUDENT NURSE

Key objectives of nursing services-

To organize the nurses in a manner so as to render high quality of nursing care. To support and assist the physicians in medical care and carry out the procedures prescribed by them. To establish and implement the philosophy, standards, policies, rules and procedures for the nursing service.

 To delineate the duties and responsibilities among the nursing staff at various levels. To estimate the requirement for nursing personnel, appointment of competent nurses and establishes policies and programmes for their orientation, placement, on the job training and supervision. To estimate the need for facilities, equipment and supplies. To develop and maintain a system of recording continuous patient care in the form of various forms and in patient records to enable doctors to check progress of the patient in terms of paramedical meter and important vitals. To organize and supervise the functioning of wards. To ensure healthy work environment. To periodically appraise the performance of nurses and carry out regular nursing audits and to train student nurses to evolve good staff for future needs whenever arises. The philosophy and objectives of the nursing service should aim to meet the personal need for status and reward of nurses in the delivery of competent services in the direct care of patients. It should evolve from the information presented by the staff nurses and it should reflect ideas gathered from literature related to nursing, hospital, medicine and social sciences, as well as nurses own values and attitude towards patient care services and to the accomplishment of hospital objectives.

Planning and directing orientation and in-service training programmes for professional and non-professional nursing staff.

Maintaining proper nursing records for clinical and administrative purposes. Assisting in the preparation of and administering the budget for the department. Coordination of activities of various nursing units.

 Promoting and maintaining effective and harmonious relationship among nursing personnel. Participating in community health and health education programmes. To keep stock of various disposables pertaining to patient care to enable timely delivery and enough stock

Q. What are the special features of a Hospital?

Answer- A hospital is a health care institution providing patient treatment by specialized staff and equipment and Hospital services is a term that refers to medical and surgical services and the supporting laboratories, equipment and personnel that make up the medical and surgical mission of a hospital or hospital system. Hospital services make up the core of a hospital's features. They are often shaped by the needs or wishes of its major users to make the hospital a one-stop or core institution of its local community or medical network. Hospitals are institutions comprising basic services and personnelusually departments of medicine and surgerythat administer clinical and other services for specific diseases and conditions, as well as emergency services. Hospital services cover a range of medical offerings from basic health care necessities or training and research for major medical school centers to services designed by an industry-owned network of such institutions as health maintenance organizations (HMOs). The mix of services that a hospital may offer depends almost entirely upon its basic mission(s) or objective(s).

Now a days the layout plan of the hospital emphasizes convenience, with all outpatient services located on the same floor to improve efficiency. The smooth patient flow from

registration, examination, investigations, treatment, referral, payment of prescribed medications, along with sophisticated computer system, reduces waiting times. Todays Hospital uses advanced software and hardware to automate patient care. All hospital beds are fixed with private phones and complete equipment set-up. There are modern operation rooms. Advanced Softwares are used to automate information for surgery and medical care.

Below mentioned are various special features of a HospitalHospital is an entity which fulfils the health needs of the society by various means, depending on the persons requirements, The basic features of a Hospital remain the same regardless of the type of Hospital, The types of Hospital ranges from voluntary Hospitals, public Hospitals, private Hospital, Specialized hospitals, rural Hospitals, etc. but their main goal remains the same to serve the community. The hospital consists of various special departments like OPD, IPD, pathology, front desk, Nursing, OT, Radiology, emergency and ICU services etc which are unique in their own area and serves a useful support to a run a Hospital smoothly, Most importantly a department upon which a Hospital is dependent is Hospital Administration department because its the core of every department which directs the information and provides a strong framework to run the Hospital smoothly.

Other features of a Hospital includes Well-Planned Space Design In order to be as thoughtful and as considerate to the public as possible, hospitals are made with very careful planning in advance on all matters. For example: registration counters, out-patient service and physical check-up center are all on the same floor,; escalators leading to all floors; all examination units are usually made around the Emergency Department, such as X-Ray, MRI, CT, etc, are designed to give the patients fast and easy access

to services. Therefore, all patients admitted to hospital for medical care can enjoy the most dignified, comfortable and respected medical services Ultra-Advanced Medical Facilities In order to get the most comprehensive and fast treatment results, a large portion of Hospitals expenses goes into the purchasing of the most advanced medical instruments and systems, such as MRI (Magnetic Resonance Imaging), CT (Computerized Tomography), PET (Positron Emission Tomography), IMRT (Intensity Modulated Radiotherapy), Tomotherapy, LIS (Laboratory Information System), PACS (Picture Archiving and Communication System) and other various advanced diagnostic equipment and systems. These advanced technologies, together can offer better and more effective medical care for the patients. Computerized Express Services Aiming at offering excellent medical services, the hospitals now a day places much emphasis on managing the flow of medical information. In order to achieve fast information delivery so as to increase medical care efficiency, the information flow and medical information are entirely processed by an efficient system. For example: examination results delivered by computer, computer online registration system and medical information broadcasted by monitors throughout the whole hospital to provide every patient with the most efficient medical services. Medical Education and Research For Mankind & society Hospital does not only care about medical quality and service, but also hopes to contribute to the health and well-being of mankind in the future. Therefore, involve them in the elevation of medical care quality, and devote in the medical education and research to create healthier tomorrow for the public. Providing statistical data to government- Hospital provides various data related to various diseases, mortality and morbidity, so they help figuring out prevalence and surveillance .

Q.3 Explain the types of medical Audit

Answer- a medical audit can be defined as a review of all the papers related to patient care when the patient is admitted or after the patient is discharges, Its a quality improvement process to measure efficiency and continuity of care, It also serves as a basic framework for scrutinizing the care pattern by various doctors and streamlining in one, it can be of various types but the four main types are1. Concurrent audit as the name suggests, the audit is done while the patient is still under treatment, it usually involves reviewing various services rendered to patient like doctors notes, date and time, legibility, nursing care etc. 2. Primary Audit this is a review to measure patient outcomes after the treatment is given and to develop the proper pattern of care if any discrepancies are found, 3. Prospective review audit in this all the papers are made ready before the patient is admitted to ensure proper administration and care to the patient, this is usually done to ensure correct diagnosis and to provide right treatment to the right patient, 4. Retrospective review audit- this is done to evaluate necessity and appropriateness of medical care given once the patient is discharges, to check whether proper and right treatment was given and if there is any need to modify the course of treatment in future clients

Q.4 What are medical record contents? Answer a medical record is typically a structured file of a patient information pertaining to patients illness history in a detailed way. This may vary from hospital to hospital and patient , but the standard contents remains the same which are as follows, and are divided in major two types CONTENTS OF A MEDICAL RECORD 1. Admissions Record. The first part of the medical record, the admissions Record, is compiled when the patient is first admitted to the hospital. The admission record includes the patient's name, age, and reason for admission, admission consent, initial assessment forms, initial investigation, diagnosis and any other pertinent information on the patient's history. b. The Clinical Record. The second part of the medical record is the patient'sclinical or treatment re cord. It provides a continuing history of the treatment Provided. It includes various papers like Various Consent forms- This fulfils the medico legal obligations and enables the hospital and the patient to be on the safeguard, Medication administration record This shows the name, dose, timing the medications given to the patient time to time. of

Input output chart This is a valuable tool to measure the fluid intake and output by measuring urine, vomit etc. Doctors orders This describes any orders given by doctors in terms of change in treatment or related.

 Vital record chart This is recorded by nurses to keep a eye on patient physical status. Investigation from laboratory Radiological finding Medical and surgical history of patient Post operative records etc. Continuous assessment plan

Q. 5 Explain in detail about MTP Act.

AnswerAn enabling Act to provide for the termination of certain pregnancies by registered medical practitioners and for matters connected therewith or incidental thereto. This act came in force in the year 1971 and the amendments were done in 2002 It extends to the whole of India except the State of Jammu and Kashmir Lays down three basic parameters when pregnancies can be terminated Where pregnancies can be terminated who can terminate the pregnancy When can pregnancies be terminated? Up to 20 weeks gestation With the consent of the women. If the women is below 18 years or is mentally ill, then with consent of a guardian With the opinion of a registered medical practitioner, formed in good faith, under certain circumstances

 Opinion of two RMPs required for termination of pregnancy between 12 and 20 weeks

MTP Act: Indications Continuation of pregnancy constitutes risk to the life or grave injury to the physical or mental health of woman Substantial risk of physical or mental abnormalities in the fetus as to render it seriously handicapped Pregnancy caused by rape (presumed grave injury to mental health) Contraceptive failure in married couple (presumed grave injury to mental health) In determining whether the continuance of pregnancy would involve such risk of injury to the health (as mentioned above), account may be taken of the pregnant womans actual or reasonable foreseeable environment.

MTP Act: Place for conducting MTP A hospital established or maintained by Government A place approved for the purpose of this Act by a District-level Committee constituted by the government with the CMHO as Chairperson

MTP rules: Who can perform? A medical practitioner (RMP) who has a recognized medical qualification as defined in clause (h) of section 2 of Indian Medical Council Act, 1956

 Whose name has been entered in a State Medical Register and Who has such experience or training in Gynecology and Obstetrics as prescribed by Rules made under the Act MTP rules: training requirement 1 For termination up to 12 weeks: A practitioner who has assisted a registered medical practitioner in performing 25 cases of MTP of which at least 5 were performed independently in a hospital established or maintained or a training institute approved for this purpose by the Government For termination up to 20 weeks A practitioner who holds a post-graduate degree or diploma in Obstetrics and Gynecology A practitioner who has completed six months house job in Obstetrics and Gynecology A practitioner who has at least one-year experience in practice of Obstetrics and Gynecology at a hospital which has all facilities A practitioner registered in state medical register immediately before commencement of the Act, experience in practice of Obstetrics and Gynecology for a period not less than three years.

Approval of a place by trimester For sites up to 12 weeks (1st trimester) Gynecology examination/ labor table Resuscitation and sterilization equipment Drugs & parental fluids

 B ack up facilities for treatment of shock Facilities for transportation

For sites up to 20 weeks (1st and 2nd trimester): All requirements for up to 12 weeks + Operation table and instruments for performing abdominal or gynecological surgery Anesthetic equipment, resuscitation equipment and sterilization equipment Drugs & parental fluids notified for emergency use, notified by Government of India from time to time