IN PATIENT DEPARTMENT

PRESENTATION BY
MANASI P. BHOSALE
PG DHM& HC
ROLL No. 1
 IN PATIENT DEPARTMENT
It is a department where in patient care is given to a
patient whose condition requires admission to a hospital
when they are extremely ill.
Inpatient ward are for those patients who need treatment
under healthcare personal’s supervision.
Patient are admitted in Inpatient Ward for short and long
term depending on severity of their disease.
Inpatient Department consists of a wards with Nursing
Station, Beds, and all other facility & services necessary for
good patient care.
 OBJECTIVES
To provide Medical and Nursing Care.
To make provision of equipments, drugs,& other items
required for patient care in an organized manner.
To provide most comfortable and desirable
environment to patient on temporary substitution of
Home.
To provide suitable atmosphere and facilities for highest
degree of job satisfaction of nursing and medical staff.
To provide opportunity for Education, Training and
Research.
 Features of IPD
The IPD forms 33%-50% of the structure of hospital
construction.
The equipment and staffs are in this department with
maximum amount of patient care, training, medical
teaching and research concentrated in this department .
IPD is the area which gives maximum output of services
and name and fame to the hospital too and so maximum
vigilance is required to prevent litigation and to gain
patient satisfaction.
 Types of Inpatient Ward
There are different types of ward design
Open ward or Nightingale Ward
 Rig’s Pattern Ward (Unilateral or Bilateral)
 Modified Rig’s Pattern Ward
 “T” and ‘Y” Shaped Ward
 ‘L” , ‘H’, ‘E” Shaped Ward.
 Nightingale Ward
This type of ward was designed in 1770 by Frenchman, Later it was
 

adopted by Florence Nightingale and is known by her name.

The characteristics of Nightingale ward is :

Patient Bed in two row at right angle to the longitudinal wall.

It may have side rooms for utilities and perhaps one or two side rooms,
that can be used for patient occupancy when patient isolation or patient
privacy is important.

Nursing Station, Doctor’s room and others facility at one end.
Bathroom and WC at the other end.

Good Visibility and economical and easy to construct,

Plenty of fresh air & ventilation.
 Rigg’s Ward
It was first made in Rigg hospital in 1910 in Copenhagen.
Ward unit is divided into small compartments separated from each other
Each compartments having 4-6 or more beds arranged parallel to the longitudinal
wall.
Bed may be on one side or both side of nursing station.
Isolation room (1 or 2) can be kept in ward.
Advantage of RIG’s Ward :
Privacy for patient,
Risk of cross infection minimized
less noisy,
Isolation of infectious cases can be easier.
Disadvantage of RIG’S ward:
Communication between patient and nurse is more difficult
Direct observation of patient is difficult.
More staffing required.
Costly and difficulty to maintain than Open ward.
 PLANNING & DESIGNING

Hospital policy and plan

Function and location
Relationship with other departments
Staffing pattern
Workflow Communication
Safety issue
Emergence of hospital infection
 Dignity and privacy of patient
 Nightingale Ward
Disadvantages:
Noisy and no privacy for patient Risk of cross infection
Fatigue of Nurses Space between bed reduced
 Modified Nightingale ward:
 It has got a nursing station in centre of ward
 Ancillary and Auxiliary service at one end and utility
service at other end.
The nurse travel time has been reduced and the
supervision over patients condition also improved in
modified pattern of ward.
 Aim of ward design
General ward :Healthy Environment
Pediatric/ psychiatric ward- Safety
Geriatric ward- Safety/ comfort
Obs/Gynaec ward – Privacy
 ICU- Nursing Care
 OT-Infection control
 Location
Away from parking and crowded area
 Adjacent to support and diagnostic services,
Should be away from mortuary.
Direct access from OPD, Emergency and OT
Single door entrance to ward to restrict traffic and visitors.
 Circulation

Vertical or horizontal
Vertical circulation can be arranged with less space with
central vertical spine for lifts, conveyers and stairs and pipe
lines.
Reduces patient errors and cross infections.

Horizontal circulation: eliminates requirement of

expensive vertical transportation system. suitable for
inpatient up to 300 bed strengths.
 Size of ward
Depending upon type of patient .
Size of the ward varies from 20 ft to 90 ft.
ICU,CCU,post operative where constant attention is
requires 20-30 beds
Patient requiring frequent attention 40-50 beds
 For chronic and long duration stay of patient 70-90 beds.
 Infrastructure
Ceiling Height : At least 3 meter.,
Height of suspended ceiling fan –at least 2.6 meter.
Windows: if only in one wall then it should be 20% of floor
area , if multiple windows then 15% of floor area.
Corridors: the width of corridor recommended is 2.4 m to
facilitate movement of trolley, bed ,stretchers
Door : should not be less than 1.2 meter wide and 2.25 m
tall.
 Bed side locker/cupboard-must Chair sofa/sofa cum
bed- for visitors
Other facilities-depending upon rooms
(private/semiprivate/deluxe/semi deluxe)
IMAGES OF BED & WARD
 Components of Ward
Primary Accommodation:
Patient Housing area
Nurses Station

Patient Housing area

Distance between center of two bed -2.25 meter, not less than 2
meter.
Distance between two bed -1.25 meter
Width of corridor -2.4 meter
Distance between bed end and wall-0.25m
Distance between bed wall and bed nearest to side wall-0.65 meter.
 Nurses station
Should not be less than 60 sq. feet.
It must be centered between the wards to make maximum
observations.
It should have direct access from corridor.
It should be provided with changing room &toilet facilities to the nurse
It must be provided with tables, chairs, electrical panels to indicate call
from patients.
Treatment and Dressing room should be provided. Cupboard for
medicines.
Hanging pockets for forms & case studies
Case sheet racks.
Table, Stool, Chairs.
 Auxiliary Accommodation
 Doctors room :120 sq ft
Nurse room :120 sq feet
 Space for stretcher trolley 21 sq ft
Store room :200 sq ft
Clean utility room -80 sq ft
Sluice room -120 sq ft
 Sanitary Accommodation
 Toilet with washroom/bathroom 50-70 sq ft
Only WC -4-5 sq ft
Only shower -6.5 sq ft
Dirty utility -120 sq ft
Janitors closet -7 sq ft
 Recommended- urinal (1 for 16 bed )
WC- (1 for 8 bed )
bathroom (1 for 12 bed )
wash basin (1 for 10 bed )
 Ancillary Accommodation
Service for Direct support of Treatment
Portable X ray
Side Lab
Pantry- 100 Sq ft
Dietician service in ward
Mobile pharmacy
 Other facilities
 Water supply :300 ltr water /bed/day round the clock supply
 Electricity: Point should be carefully designed with every cubicle having
switches.
Switch for machine like portable x ray
Natural lights should be planned
Provision of night light
 Communication: There should be effective communication source
between nurse and patient and nurse and other units.
  Fire safety : There must be provision for fire extinguisher ,
fire exit stairs with ramp width-1.5 meter , 4.8 degree angle
 Hot and cold water supply Nurse call system
 Clock
 Oxygen cylinder/suction pipe /thermometer holder/ IV stand etc.
 Staffing
Ward staffing depend on size of the ward
Specialist 1 per 100 beds
GDMO 1 per 12 beds
Sr. Resident 1 per 12 beds
Jr. Resident 1 per 12 beds
Sister In charge 2
Staff Nurse 1 per 6 beds
Group D staff 1 per 2 beds