201-300 Beded District Hospitals - MCI
201-300 Beded District Hospitals - MCI
201-300 Beded District Hospitals - MCI
for
201 to 300 bedded District Hospitals
January
2007
i
Foreword
District Hospital is an integral part of the District Health System (DHS), which is, the point of
origin for implementing various health policies and delivery of health care. It fulfills the need of
secondary level of health care acting as a centre for curative, preventive, and promotive health care
services as well as interface with institutions controlled by non-government and private voluntary
health organizations. The current functioning of most of the District Hospitals is below the level of
expectations due to non-uniformity in staff/bed strength, equipments and service availability and
population coverage.
The National Rural Health Mission (NRHM) launched by the Honble Prime Minister of India
th
on 12 April, 2005 aims to restructure the delivery mechanism for health towards providing universal
access to equitable, affordable and quality health care that is accountable and responsive to the
peoples needs, reducing child and maternal deaths as well as stabilizing population and ensuring
gender and democratic balance. As envisaged under NRHM, Sub-districts/Sub-divisional Hospitals
would be upgraded from its present level to a level of set of Standards called Indian Public Health
Standards (IPHS).
The Indian Public Health Standards (IPHS) for District Hospitals has been worked out by
constituting an Expert Group comprising of various stakeholders under the Chairmanship of Director
General Health Services, Ministry of Health & Family Welfare, Government of India. These Standards
have been prepared bed strength-wise for 101-200 beds, 201-300 beds and 301-500 beds. The
Indian Public Health Standards (IPHS) for District Hospital has been prepared, keeping in view the
minimum resources available and mention functional level of the Hospitals in terms of space,
manpower, instruments, drugs and other basic health care services. Constitution of Rogi Kalyan
Samittee /Management Committee with involvement of PRIs, Citizen Charter are expected to make
improvement in the functioning and accountability of these Hospitals.
Of course, setting Standards is a dynamic process and this document provides at this
stage the standards for a minimum functional grade for a District Hospital. I hope that this document
will be useful to all the stake holders. Any comment for further improvement is most welcome.
I would like to acknowledge the efforts put in by the Director General of Health Services and
Infrastructure Division in preparing the Guidelines.
(Naresh Dayal)
Secretary (H&FW)
New Delhi Ministry of Health & Family Welfare
Dated : 16th May, 2007 Government of India
iii
Preface
District Hospitals function as a secondary level of health care which provides curative,
preventive and promotive healthcare services to the people in the district. It is also the fundamental
platform for implementing various health policies and delivery of healthcare and management of
health services for defined geographical areas. The Government of India through the National
Rural Health Mission (NRHM) is committed to strengthen these Hospitals to a level of Indian Public
Health Standards (IPHS).
Standards are a means of describing a level of quality that health care organizations are
expected to meet or aspire to. The performance of these Hospitals can then the assessed against
the set of Standards prescribed. For the first time under National Rural Health Mission (NRHM), an
effort has been made to prepare Indian Public Health Standards (IPHS) for District Hospitals in the
country.
The Standards have been prepared in consultation with the Expert Group constituted for
this purpose and taking in to consideration the minimum functional level needed for providing a set
of assured services.
Setting Standards is a dynamic process and this document is not an end in itself. Further
revision of Standards will occur as and when these Hospitals achieve a minimum functional grade.
The contribution of the Expert Group members, and the efforts made by the Infrastructure Division
of the Ministry of Health & Family Welfare in bringing out the first document of IPHS for District
Hospitals is well appreciated.
I hope that this document will be of immense help to the State governments and other
stakeholders in bringing up these Hospitals to the level of Indian Public Health Standards.
iv
Acknowledgements
Indian Public Health Standards (IPHS) for the District Hospitals fulfill the needs of secondary
level of healthcare providing curative, preventive and promotive healthcare services to the people
in the district. The document is the result of efforts put in by both the government and non-government
organizations. As the population and geographical area of a district varies in different States and
UTs, an attempt has been made to formulate IPHS for District Hospitals having different bed
strengths such as 101-200, 201-300 and 301-500 bedded hospitals. This document contains the
Standards set for 201-300 bedded hospital at district level.
I gratefully acknowledge the valuable contribution made by all the members of the Expert
Group constituted to formulate Indian Public Health Standards (IPHS) for the District Hospitals. I
am thankful to them individually and collectively.
I also gratefully acknowledge the initiative, encouragement and guidance provided by Dr.
R.K. Srivastava, Director General of Health Services and Smt. S. Jalaja, Additional Secretary. The
help and encouragement provided by Shri Amarjeet Sinha, Joint Secretary(H&FW), M/o Health &
Family Welfare, Government of India is also gratefully acknowledged.
I would specifically like to thank Dr. R.N. Salhan, Addl D.G. and Medical Superintendent
(Safdarjang Hospital), Dr. Shivlal, Additional D.G. and Director(NICD) and Shri S. Majumdar, Chief
Architect, Bureau of Design, Ministry of Health & Family Welfare for their valuable contribution and
guidance in formulating the IPHS for the District Hospitals.
The preparation of this document has been made possible by the assistance provided by
Smt. Sushma Rath, Under Secretary (ID/PNDT) and the secretarial and typing assistance provided
by Sh. Brij Mohan Singh Bhandari. The assistance provided by the staff of Rural Health Section of
the M/o Health & Family Welfare is duly acknowledged.
v
Contents
1. Introduction 1
5. Functions 4
6. Essential Services 4
7. Physical Infrastructure 32
8. Manpower 38
9. Equipment 41
List of Abbreviations 90
References 91
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IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
one anesthetist. The position of general duty officers, evaluating the care being rendered through district
staff nurses, female health workers and laboratory hospitals has gained strength of late. There is an
technicians are available in almost all district urgent need to provide guidance to those concerned
hospitals. Only 68% of the district hospitals have with quality assurance in district hospitals services
linkage with the district blood banks. to ensure efficiency and effectiveness of the services
rendered.
Most of the district hospitals suffer from large
number of constraints such as
Standards are a means of describing the
Buildings are either very old and in level of quality that health care organization are
dilapidated conditions or are not maintained expected to meet or aspire to. The key aim of the
properly. standard is to underpin the delivery of quality
The facilities at district hospitals require services which are fair and responsive to clients
continuation upgradtion to keep pace with needs, which should be provided equitably and
the advances in medical knowledge, which deliver improvements in health and well being
diagnostic procedures, storage and retrieval of the population. Standards are the main driver for
of information. It has been observed that continuous improvements in quality. The
development of hospitals is not keeping performance of district hospitals can be assessed
pace with the scientific development. against a set of standards.
A typical district hospital lacks modern The National Rural Health Mission (NRHM)
diagnostics and therapeutic equipments, has provided the opportunity to set Indian Public
proper emergency services, intensive care Health Standards (IPHS) for various health
units, essential pharmaceuticals and institutions at various levels starting from Sub-
supplies, referral support and resources. centres, Primary Health Centres, Community Health
There is a lack of trained and qualified staff Centres and so on up to the district level hospitals.
for hospitals management and for the
management of other ancillary and The present draft guidelines are an effort to
supportive services viz. medical records, prepare Indian Public Health Standards for the
central sterilization department, laundry, District Hospitals. This is not to say that standards
house keeping, dietary and management of for various hospitals do not exist in the country. The
nursing services. Bureau of Indian standards(BIS) have developed
standards for hospitals services for 30 bedded and
There is lack of community participation and
100 bedded hospitals and standards for 250
ownership, management and accountability
bedded, 500 bedded teaching and non teaching and
of district hospitals through hospital
750 bedded teaching and non teaching will be
management committees.
published by BIS later. However, these standards
District Hospitals have come under are considered very resource intensive and lack the
constantly increasing pressure due to increased processes to ensure community involvement,
utilization as a result of rapid growth in population, accountability, the hospital management, and
increase awareness among common consumers, citizens charter etc peculiar to the public hospitals.
biomedical advancement, resulting in the use of In this context a set of standards are being
sophisticated and advanced technology in diagnosis recommended for district hospitals to be called as
and therapies, and constantly rising expectation Indian Public Health Standards (IPHS) for
level of the use of the services. The need for District Hospitals. Setting standards is a dynamic
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IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
ENT
5. Functions
Dermatology & Venerology including RTI/
A district hospital has the following functions: STI
Echocardiogram
6.1 Services include OPD, indoor,
emergency services. Pathology
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IPHS for 201 to 300 Bedded District Hospitals
(i) Medical records (Provision should be made Following services mix of procedures in
for computerized medical records with anti- medical and surgical specialties would be available:
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IPHS for 201 to 300 Bedded District Hospitals
2 Electro Cautery
3 Intra Lesional Injection
4 Biopsy
Paediatric Procedures
1 Immunization (BCG, OPV, DPT, Measles, DT) / Children Ward / ORT Corner
2 Services related to new borne care + All other procedures as mentioned in IMNCI
2.1 - only cradle
2.2 - Incubator
2.3 - Radiant Heat Warmer
2.4 - Phototherapy
2.5 - Gases (oxygen)
2.6 - Pulse Oxementer
2.7 - Lum bar Puncture
2.8 - Bone Marrow
2.9 - Exchange Transfusion
2.10 - Cut down
2.11 - Plural/Acite Tap
2.12 - Ventilator
2.13 - Live Biopsy u/s guided
Cardiology Procedures and Diagnostic Tests
1 ECG
2 TMT
3 Holter
4 Thrombolytic Therapy
5 C V P Line
6 Defibrilator Shock
7 NTG/Xylocard Infusion
8 ECHO Cardiography
Endoscopic Specialised Procedures and Diagnostic
1 Gastroscopy (Oesophagus, stomach, deudenum) (Diagnostic and Therapeutic)
2 Sigmoidoscopy and Colonoscopy
3 Bronchoscopy and Foreign Body Removal
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3.11 - Rhinoplasty
3.12 - Septoplasty with reduction of terbinate (SMD)
4 Ear Surgery
4.1 - Mastoid Abscess I & D
4.2 - Mastoidectomy
4.3 - Stapedotomy
4.4 - Examination under Microscope
4.5 - Myringoplasty
4.6 - Tympanoplasty
4.7 - Myringotomy
4.8 - Ear Piercing
4.9 - Hearing Aid Analysis and Selection
5 Throat Surgery
5.1 - Adenoidectomy
5.2 - Tonsillectomy
5.3 - Adenoidectomy + Tonsillectomy
5.4 - Tongue Tie excision
6 Endoscopic ENT Procedures
6.1 - Direct Laryngoscopy
6.2 - Hypopharyngoscopy
6.3 - Direct Laryngoscopy & Biopsy
6.4 - Broncoscopic Diagnostic
6.5 - Broncoscopic & F B Removal
7 General ENT Surgery
7.1 - Stiching of LCW (Nose & Ear)
7.2 - Preauricular Sinus Excision
7.3 - Tracheostomy
8 Audiometry
8.1 - Audiogram (Pure tone and Impedence)
Obstetric & Gynecology Specialist Services
1 Episiotomy
2 Forceps delivery
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3 Craniotomy-Dead Fetus/Hydrocephalus
4 Caeserean section
5 Female Sterilisation ( Mini Laparotomy & Laparoscopic)
6 D&C
7 MTP
8 Hysterectomy
9 Bartholin Cyst Excision
10 Suturing Perimeal Tears
11 Ovarian Cystectomy / Oophrectomy
12 Vaginal Hysterectomy
13 Haematocolpes Drainage Colpotomy
14 Casserian Hystrectomy
15 Assisted Breech Delivery
16 Cervical Biopsy
17 Cervical Cautery
18 Nomal Delivery
19 Casserian
20 EUA
21 Midtrimestor Abortion
22 Ectopic Pregnancy Ruptured
23 Retain Placenta
24 Suturing Cervical Tear
25 Assisted Twin Delivery
Dental Services
1 Dental Caries/Dental Abcess/Gingivitis
2 Cleaning
Periodontitis
Surgery
3 Minor Surgeries, Impaction, Flap
4 Malocclusion
5 Prosthodontia (Prosthetic Treatment)
6 Trauma including Vehicular Accidents
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16 Sigmoidoscopy
17 Colposcopy
18 Hysteroscopy
19 Arthroscopy
20 Tonsillectomy
21 Mastoidectomy
22 Stapedotomy
23 Craniotomy (Neurosurgical)
24 Episiotomy
25 Forceps delivery
26 Craniotomy-Dead Fetus/Hydrocephalus
27 Caeserean section
28 Female Sterilisation ( Mini Laparotomy & Laparoscopic)
29 Vasectomy
30 D&C
31 MTP
32 Hysterectomy
33 FNAC
34 Total Parotidectomy
35 Intra-oral removal of submandibular duct Calculous
36 Excision Branchial Cyst or Fistula/sinus
37 Lingual Throid
38 Thyroid Adenoma Resection / Enucleation
39 Hemithyroidectomy (Sub total Thyroidectomy/Lobectomy)
40 Cysts and Benign Tumour of the Palate
41 Excision Submucous Cysts
Breast
1 Excision fibroadenoma Lump
2 Simple Mastectomy
3 Halsteads Radical, Mastectomy/Pateys Operation
4 Sectoral Mastectomy/Microdochectomy/Lumpectomy
5 Wadge Biopsy
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Small Intestine
1 Resection and Anastomosis
2 Intussusception
3 Intestinal Fistula
4 Multiple Resection and Anaestomosis
5 Intestinal Performation
Liver
1 Open Drainage of liver abscess
2 Drainage of Subdia, Abscess/Perigastric Abscess
Biliary System
1 Cholecystostomy
2 Cholecystectomy
3 Cholecystectomy and Choledocholithotomy
Colon, Rectum and Anus
1 Fistula in ane low level
2 Fistula in ane high level
3 Catheters
4 IV Sets
5 Colostomy Bags
6 Perianal Abscess
7 Ischiorectal Abscess
8 Ileostomy or colostomy alone
9 Sigmoid Myotomy
10 Right Hemicolectomy
11 Sigmoid & Descending Colectomy
12 Haemorroidectomy
13 Sphincterotomy of Fissurectomy
14 Tube Caecostomy
15 Closure of loop colostomy
16 Rectal Prolapse Repair
17 Anal Sphincter Repair after injury
18 Thierschs operation
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19 Volvulus of colon
20 Resection anastomosis
21 Imperforate anus with low opening
22 Pilonidal Sinus
Penis, Testes, Scrotum
1 Circumcision
2 Partial amputation of Penis
3 Total amputation of Penis
4 Orchidopexy (Unilateral & Bilateral)
5 Orchidectomy (Unilateral & Bilateral)
6 Hydrocele (Unilateral & Bilateral)
7 Excision of Multiple sebaceous cyst of scrotal skin
8 Reduction of Paraphimosis
Other Procedures
1 Suture of large laceration
2 Suturing of small wounds
3 Excision of sebaceous cyst
4 Small superficial tumour
5 Large superficial tumour
6 Repair torn ear lobule each
7 Incision and drainage of abscess
8 Lymph node biopsy
9 Excision Biopsy of superficial lumps
10 Excision Bipsy of large lumps
11 Injection Haemorrhoids/Ganglion/Keloids
12 Removal of foreign body (superficial)
13 Removal of foreign body (deep)
14 Excision Bipsy of Ulcer
15 Excision Multiple Cysts
16 Muscle Biopsy
17 Tongue Tie
18 Debridment of wounds
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IPHS for 201 to 300 Bedded District Hospitals
19 Excision carbuncle
20 Ingroving Toe Nail
21 Excision Soft Tissue Tumour Muscle Group
22 Diabetic Foot and carbuncle
Urology
1 Pyelolithotomy
2 Nephrolithotomy
3 Simple Nephrostomy
4 Implantation of ureters Bilateral
5 Vesico-vaginal fistula
6 Nephrectomy
7 Uretrolithotomy
8 Open Prostectomy
9 Closure of Uretheral Fistula
10 Cystolithotomy Superopubic
11 Dialatition of stricture urethra under GA
12 Dialation of stricture urethra without anaesthesia
13 Meatotomy
14 Testicular Biopsy
15 Trocar Cystostomy
Plastic Surgery
1 Burn Dressing Small, medium (10% to 30%), large 30% to 60%, extensive > 60%
2 Ear lobules repair one side (bilateral)
3 Simple wound
4 Complicated wound
5 Face Scar Simple
6 Cleft Lip One side
7 Small wound skin graft
8 Simple injury fingers
9 Finger injury with skin graft
10 Multiple finger injury
11 Crush injury hand
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2 Medical concyle of humerus fracture lateral condyle of humerus Olecranen fracture, head of
radius lower end of radius, medial malleolus patella fracture and fracture of calcaneum talus
single forearm, bone fracture
3 External Fixation Appleication Pelvis femur, tibia humerus forearm
4 Ext. fixation of hand & foot bones
5 Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula, lower and of Inia
6 Drainage of fracture
7 Interlocking nailing of long bones
8 Debridement & Secondary closure
9 Percutaneous Fixation (small and long bones)
Closed Reduction
1 Hand, Foot bone and cervicle
2 Forearm or Arm, Leg, Thigh, Wrist, Aknle
3 Dislocation elbow, shoulder, Hip, Knee
4 Closed Fixation of hand / foot bone
Open Reduction
1 Shoulder dislocation, knee dislocation
2 Acromiocalvicular or stemoclavicular Jt. Clavicle
3 Ankle Bimalleolar Open reduction, Ankle Trimalleolar open reduction
4 Wrist dislocation on intercarpal joints
5 MP & IP Joints
6 Knee Synovectomy / Menisectomy
7 Fasciotomy leg/forearm
8 High Tibial Osteotomy
9 Arthodesis (Shoulder/Knee Ankle, Triple/elbow, Wrist/Hip)
10 Arthodesis MP & IP Joints
11 Excision Exostosis long bones, single / two
12 Currentage Bone Grafting of Bone Tumour of fumur/tibia Humerus & forearm
13 Surgery tumours of small bone hand and foot
14 Debridement primary closure of compounds fracture of tibia, femur forearm without fixation
15 Debridement of hand/foot
16 Debridement primary closure of compound fractures of tibia, femur forearm with fixation
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GENERAL MEDICINE
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Fever -a) Short duration (<1 week) Basic investigation and Treatment
Fever -b) Long duration (>1 week) Investigation and treatment
c) Typhoid Treat
d) Malaria / Filaria Treat
e) Pulmonary Tuberculosis. Treat
f) Viral Hepatitis Treat
If HBs, Ag +ve refer to tertiary care
g) Leptospirosis / Menningitis and Confirm by MAT / CSF Analysis and treat
Haemorrhagic fever
h) Malignancy Confirm diagnosis refer to tertiary care
2 COMMON RESPIRATORY ILNESSES
Bronchial Asthma / Pleuraleffusion / Diagnose and Treat
Pneumonia / Allergic Bronchitis/COPD
3 COMMON CARDIAC PROBLEMS
a) Chest pain (IHD) Treat and decide further management
b) Giddiness (HT) Diagnose and treat
4 G I TRACT
a) G I Bleed / Portial hypertension / Investigate and treat
Gallblader disorder
b) AGE / Dysentry / Diarrhoreas Treat
5 NEUROLOGY
a) Chronic Hpeadache Investigate, treat & decide further
b) Chronic Vertigo/
CVA/TIA/Hemiplegia / Paraplegia Treat
6 HAEMATOLOGY
a) Anaemia Basic investigation and Treatment
b) Bleeding disorder Stabilize
Ref. To tertiary
c) Malignancy Treat & decide further
7 Communicable Diseases
Cholera
Measles
Mumps
Chickenpox Treat
8 Psychological Disorders
Acute psychosis / Obsession / Anxiety
neurosis Treat
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PAEDIATRICS
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 ARI/ Bronchitis Asthmatic Investigate
Diagnose
Nebulisator Oxygen
2 Diarrohoeal Diseases Diagnose
Treat
ORT corner
3 Protein Energy Malnutrition and Investigate
Vitamin Deficiencies Diagnose
Treat with help of Dietician
4 Pyrexia of unknown origin Diagnose
Treat
5 Bleeding Disorders Investigate
Treat
6 Diseases of Bones and Joints Investigate
Treat
7 Childhood Malignancies Investigate for initial diagnose & treatment then
refer, support long term treatment in liaison with
tertiary care hospital.
8 Liver Disorders Investigate
Manage
9 Paediatric Surgical Emergencies Investigate
Manage
10 Poisoning, Sting, Bites Treat
Step down care and follow up care for patients being managed from tertiary
level hospital in liaison / tandem with them for close to home care in follow up
or after stabilization.
NEONATOLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Attention at birth (to prevent illness) 5 cleans warm chain
2 Hypothermia Warm chain
3 Birth asphyxia Resuscitation And Treatment
4 Hypoglycemia Treat
5 Meconium aspiration syndrome Treat
6 Convulsions (seizures) Investigate & Treat
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DERMATOLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Infections
a) Viral - HIV - Verrucca
Molluscum Contagiosa Treat
Pityriasis Rosea
LGV
HIV Treat
b) Bacteria
Pyoderma
Chancroid Treat
Gonorrhea, Leprosy
Tuberculosis Treat
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IPHS for 201 to 300 Bedded District Hospitals
c) Fungal
Sup.Mycosis Treat
Subcut - Mycetoma
d) Parasitic Infestation
Scabies / Pediculosis/Larva Migrans Treat
e)Spirochaetes
Syphilis Diagnosis and Treat
2 Papulosquamous
Psoriasis (classical)-uncomplicated/
Lichen Planus Treat
3 Pigmentary Disorder
Vitiligo Treat
4 Keratinisation Disorder
Ichthyosis/Traumatic Fissures Treat
5 Autoimmune
Collagen Vascular Treat /
DLE, Morphea Refer
6 Skin Tumors, Seb.Keratosis, Soft
Fibroma, Benign Surface,Tumors /
Cysts, Appendageal Tumors Treat
7 Miscellaneous
a) Acne Vulgaris, Malaria, Alopecia, Nail
disorder, Toxin induced Treat
b) Leprosy - Resistant/ Complications /
reaction Allergy - EMF / SJS / TENP
soriasis/ Collagen Vascular/Auto immune
Disorders Treat
c) Deep Mycosis, STD Complications Treat
d) Genetically Determined
Disorders Treat
CHEST DISEASES
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Fever Investigation and Treatment
2 Cough with Expectoration / Blood Stained Treatment CT Scan if necessary
3 Hemoptysis CT scan Bronchoscopy Treatment
4 Chest Pain Investigation and Treatment
5 Wheezing Treatment, PFT
6 Breathlessness Investigation and Treatment
Chest Physiotherapy
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PSYCHIATRY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Schizophrenia Treatment and Follow up IP Management
2 Depression Treatment and Follow up IP Management
3 Mania Treatment and Follow up IP Management
4 Anxiety Disorders Treatment and Follow up IP Management
5 Mental Retardation Treatment and Follow up IP Management
6 Other Childhood Disorders Treatment and Follow up IP Management
7 Alcohol and Drug Abuse Treatment and Follow up IP Management
8 Dementia Treatment and Follow up IP Management
DIABETOLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Screening for Diabetes Diagnose and Treat
2 Gestational Diabetes/DM with Pregnancy Diagnose and Treat
3 DM with HT Diagnose and Treat
4 Nephropathy/Retinopathy Diagnose and Treat
5 Neuropathy with Foot Care Diagnose and Treat
6 Emergency :-
i) Hypoglycemia Diagnose and Treat
ii) Ketosis
iii) Coma
NEPHROLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX
No (SUGGESTED ACTIONS)
1 Uncomplicated UTI Treat
2 Nephrotic Syndrome - Children/ Acute
Nephritis Treat
3 Nephrotic Syndrome - Adults Refer to Tertiary follow up care
4 HT, DM Treat
5 Asymptomatic Urinary Abnormalities Treat
6 Nephrolithiasis Treat
7 Acute renal Failure/ Chronic Renal Failure Treat
8 Tumors Refer to Tertiary
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GENERAL SURGERY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE
No MIX (SUGGESTED ACTIONS)
1 Basic a. Minor Cases
Techniques under LA Abcess I&D/Suturing,Biopsy / Treat
Excision of Lipoma / Ganglion / Lymph
Node, Seb-Cyst / Dermoid / Ear Lobe
Repair / Circumcision
b. FNAC Thyroid, Breast Lumps, Investigate / Diagnosis /
Lymphnodes, Swelling Treatment
2 Elective a. Genitourinary tract
Surgeries Hydrocele,Hernia,Circumcision, Supra Treat
pubic cysostomy,
b. Gastrointestinal disorder
Appendicitis/Anorectal Treat
abcesses/Rectalprolapse/Liver
abscess/Haemorrhoids/Fistula
3 Emergency Assault injuries/Bowel injuries/Head Treat
surgeries injuries/Stab injuries/Multiple
injuries/Perforation/Intestinal obstruction
4 Benign/ Breast/Oral/GItract/Genitourinary (Penis, Treat
Malignant Prostate, Testis)
Diseases
5 Others Thyroid, Varicose veins Treat
6 Burns Burns
< 15% Treat
>15% Treat
7 Medico legal a) Assualt / RTA AR Entry / Treat
b) Poisonings AR Entry / Treat
c) Rape AR Entry / Treat
d) Postmortem Done
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OPTHALMOLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE
No MIX (SUGGESTED ACTIONS)
1 Superficial Infection Treatment with drugs
2 Deep Infections Treat
3 Refractive Error Treat
4 Glaucoma Treat
5 Eye problems following systemic disorders Treat
6 Cataract Treat
7 Foreign Body and Injuries Treat
8 Squint and Amblyopia/Corneal Blindness
(INF,INJ,Leucoma)/ Oculoplasty Treat
9 Malignancy/Retina Disease Treat
10 Paediatric Opthalmology Treat
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4 Sinusitis Treat
(surgery if needed)
5 Septal Deviation Treat
(surgery if needed)
ORTHOPADICS
S. NAME OF THE ILLNESS RECOMMENDED SERVICE
No MIX (SUGGESTED ACTIONS)
1 Osteomyelitis Surgery
2 Rickets /Nutritional Defeciencies Manage
with Physiotherapy
3 Poliomyelitis with residual Joint Replacement / Rehab for
Deformities/JRA/RA Polio
4 RTA/Polytrauma Manage
UROLOGY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE
No MIX (SUGGESTED ACTIONS)
CHILDREN
1 Hydronephrosis Diagnose and refer
2 Urinary Tract Injuries Diagnose and refer
3 PUV/ Posterior Urethral Valve Diagnose and refer
4 Cystic Kidney Diagnose and refer
5 Urinary Obstruction Urethrral Catheter Insertion
SPC and Referral
6 Undesended Testis Diagnose and refer
7 Hypospadias and Epispadias Diagnose and refer
8 Mega Ureter Diagnose and refer
9 Extrophy Diagnose and refer
10 Tumours - Urinary Tact Diagnose and refer
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DENTAL SURGERY
S. NAME OF THE ILLNESS RECOMMENDED SERVICE
No MIX (SUGGESTED ACTIONS)
1 Dental Caries/Dental Abcess/Gingivitis Treat
2 Cleaning
Periodontitis Treat
Surgery
3 Minor Surgeries, Impaction, Flap Treat
4 Malocclusion Treat with appliances
5 Prosthodontia (Prosthetic Treatment) Treat with appliances
6 Trauma Treat (wiring and plating)
7 Maxillo Facial Surgeries Treat and refer
8 Neoplasms Treat and Refer if necessary
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IPHS for 201 to 300 Bedded District Hospitals
conditions, utilities available, natural features and Main entrance, general waiting and
limitations. subsidiary waiting spaces are required adjacent to
each consultation and treatment room in all the
7.6 In the already existing structures of a
clinics.
district hospital
Clinics
It should be examined whether they fit into
the design of the recommended structure The clinics should include general, medical,
and if the existing parts can be converted surgical, ophthalmic, ENT, dental, obsetetric and
into functional spaces to fit in to the gynaecology, paediatrics, dermatology and
recommended standards. venereology, psychiatry, neonatology, orthopaedic
and social service department. The clinics for
If the existing structures are too old to
infectious and communicable diseases should be
become part of the new hospital, could they
located in isolation, preferably, in remote
be converted to a motor pool, laundry, store
corner, provided with independent access. For
or workshop or for any other use of the
National Health Programme, adequate space be
district hospital.
made available.
If they are too old and dilapidated then they
must be demolished. And new construction Nursing Services
should be put in place. Various clinics under Ambulatory Care Area
7.7. Building and Space Requirements require nursing facilities in common which include
dressing room, side laboratory, injection room, social
Administrative Block: service and treatment rooms, etc.
Administrative block attached to main Nursing Station: On an average, one
hospital along with provision of MS Office and other nursing station per ward will be provided. However,
staff will be provided. it should be ensured that nursing station caters to
Circulation Areas about 40-45 beds. Out of these half will be for acute
and chronic patients.
Circulation areas like corridors, toilets, lifts,
ramps, staircase and other common spaces etc. in Diagnostic Services
the hospital should not be more than 55% of the
Imaging
total floor area of the building.
Role of imaging department should be radio-
Floor Height
diagnosis and ultrasound along with hire facilities
The room height should not be less than depending on the bed strength. The department
approximately 3.6 m measured at any point from should be located at a place which is accessible to
floor to floor height. both OPD and wards and also to operation theatre
department. The size of the room should depend
Entrance Area
on the type of instrument installed. The room should
Physical Facilities have a sub-waiting area with toilet facility and a
Ambulatory Care Area (OPD) change room facility, if required. Film developing
and processing (dark room) shall be provided in the
Waiting Spaces department for loading, unloading, developing and
Registration, assistance and enquiry counter processing of X-ray films. Separate Reporting Room
facility be made available in all the clinics. for doctors should be there.
33
IPHS for 201 to 300 Bedded District Hospitals
Clinical Laboratory kept to the minimum. Ward unit will include nursing
station, doctors duty room, pantry, isolation room,
For quick diagnosis of blood, urine, etc., a
treatment room, nursing store along with wards and
small sample collection room facility shall be
toilets as per the norms. On an average one nursing
provided.
station per ward will be provided. It should be ensure
Separate Reporting Room for doctors that nursing station caters to above 40-45 beds, out
should be there. of which half will be for acute and chronic patients.
Blood Bank Private ward: Depending upon the
Blood bank shall be in close proximity to requirement of the hospital and catchment area
pathology department and at an accessible distance appropriate beds may be allocated for private
to operation theatre department, intensive care units facilities. However, 10% of the total bed strength is
and emergency and accident department. recommended as private wards beds.
General Wards: Male / Female In this unit, critically ill patients requiring
highly skilled life saving medical aid and nursing care
Private Wards are concentrated. These should include major
Wards for Specialities surgical and medical cases, head injuries, severe
haemorrhage, acute coronary occlusion, kidney and
Depending upon the requirement of the
respiratory catastrophe, poisoning etc. It should be
hospital and catchment area, appropriate beds may
the ultimate medicare the hospital can provide with
be allowed for private facility. 10% of the total bed
highly specialized staff and equipment. The number
strength is recommended as private wards beds.
of patients requiring intensive care may be about 2
Location to 5 percent total medical and surgical patients in a
Location of the ward should be such to hospital. The unit shall not have less than 4 beds
ensure quietness and to control number of visitors. nor more than 12 beds. Number of beds will be
restricted to 5% of the total bed strength. Out of
Ward Unit these, they can be equally divided among ICU and
The basic aim in planning a ward unit should High Dependency Wards. For example, in a 500-
be to minimize the work of the nursing staff and bedded hospital, total of 25 beds will be for Critical
provide basic amenities to the patients within the Care. Out of these, 13 may be ICU beds and 12 will
unit. The distances to be traveled by a nurse from be allocated for High Dependency Wards. Changing
bed areas to treatment room, pantry etc. should be room should be provided for.
34
IPHS for 201 to 300 Bedded District Hospitals
35
IPHS for 201 to 300 Bedded District Hospitals
sink, slop sink, work bench and draining boards. departments. At the same time location should
involve the shortest possible time in delivering food
Delivery Suite Unit
to the wards.
The delivery suit unit be located near to
operation theatre. Central Sterile and Supply Department
(CSSD)
The delivery Suit Unit should include the
facilities of accommodation for various facilities as As the operation theatre department is the
given below: major consumer of this service, it is recommended
to locate the department at a position of easy access
Reception and admission to operation theatre department. It should have a
Examination and Preparation Room provision of hot water supply.
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IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
8. MANPOWER REQUIREMENTS
Note :
1
May be a Public Health Specialist or management specialist trained in public health
2
Provided there is no AYUSH hospital / dispensary in the district headquarter
38
IPHS for 201 to 300 Bedded District Hospitals
39
IPHS for 201 to 300 Bedded District Hospitals
Note : Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be required if outsourced
* The number would vary as per requirement and to be outsourced.
40
IPHS for 201 to 300 Bedded District Hospitals
9. EQUIPMENT NORMS
Equipment norms are worked out keeping in mind the assured service recommended for various
grades of the district hospitals. The equipments required are worked out under the following headings
1. Imaging equipments
2. X-Ray Room Accessories
3. Cardiac Equipments
4. Labour ward & Neo Natal Equipments
5. Ear Nose Throat Equipments
6. Eye Equipments
7. Dental Equipments
8. Operation Theatre Equipment
9. Laboratory Equipments
10. Surgical Equipment Sets
11. PhysioTherapy Equipments
12. Endoscopy Equipments
13. Anaesthesia Equipments
14. Funriture & Hosptial Accessories
15. PM equipments
16. Linen
17. Teaching Equipments
18. Administration
19. Refrigeration & AC
20. Hospital Plants
21. Hospital Fittings & Necessities
22. Transport
I. Imaging Equipment
S. No. Name of the Equipment District Headquarters Hospital
(201-300 bedded)
1 500 M.A. X-ray machine* 1
2 300 M.A. X-ray machine 1
3 100 M.A. X-ray machine 1
4 60 M.A. X-ray machine (Mobile) 1
5 C arm with accessories * 1
6 Dental X-ray machine 1
7 Ultra Sonogram (Obs & Gyne. department
should be having a separate ultra-sound
machine of its own) 2+1
8 C.T. Scan 1
9 Mammography Unit * 1
10 Echocardiogram* 1
* To be provided as per need.
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IPHS for 201 to 300 Bedded District Hospitals
42
IPHS for 201 to 300 Bedded District Hospitals
IV. Labour ward & Neo Natal Equipments for Nursery onwards
2 Phototherapy Unit 3
5 Room Warmer 2
6 Foetal Doppler 2
7 CTG Monitor 3
8 Delivery Kit 15
9 Episiotomy kit 10
11 Crainotomy 2
19 Head Box 6
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IPHS for 201 to 300 Bedded District Hospitals
1 Audiometer 1
5 Mastoid Set 1
7 Stapedotomy Set 1
8 Stapeidoplasty 1
11 Laryngoscope indirect 2
12 Otoscope 2
13 Oesophagoscope Adult 1
14 Oesophagoscope Child 1
16 Tracheostomy Set 2
17 Tuning fork 1
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IPHS for 201 to 300 Bedded District Hospitals
2 Opthalmoscope - Direct 2
3 Slit Lamp 1
4 Retino scope 1
5 Perimeter 1
7 Laser Photocoagulometer*
1 Air Rotor 1
3 Dental Chair 1
4 Dental Lab
5 Dental Kit 4
45
IPHS for 201 to 300 Bedded District Hospitals
46
IPHS for 201 to 300 Bedded District Hospitals
47
IPHS for 201 to 300 Bedded District Hospitals
34 Electrolyte Analyser 1
35 Glycosylated Haemoglobinometer 1
36 Blood Bank Refrigerator 3
37 Haematology Analyser with 22 parameters 1
38 Blood Collection Monitor 1
39 Laboratory Autoclaves 3
40 Blood Bank Refrigerator 4
41 Ordinary Refrigerator 3
42 Floatation Bath 1
43 Emergency Drug Trolley with auto cylinder 1
44 Dialected Tube Scaler
45 Class I Bio Safety Cabinet 1
46 Knife Sharpner 1
47 Air Conditioner with Stabilizer 1
48 Cyto Spin 1
49 RO Plant 1
50 Computer with UPS and Printer 1
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IPHS for 201 to 300 Bedded District Hospitals
14 Kick Bucket 10
15 General Surgical Instrument Set Piles,
Fistula, Fissure* 2
16 Knee hammer 5
17 Hernia, Hydrocele* 2
18 Varicosevein etc* 1
19 Gynaec Electric Cautery 1
20 Vaginal Examination set* 22
21 Suturing Set* 7
22 MTP suction apparatus 2
23 Thoracotomy set 1
24 Neuro Surgery Craniotomy Set 1
25 I M Nailing Kit 2
26 SP Nailing 2
27 Compression Plating Kit* 2
28 AM Prosthesis* 1
29 Dislocation Hip Screw Fixation* 1
30 Fixation Fracture Hip 1
31 Spinal Column Back Operation Set 1
32 Thomas Splint 9
33 Paediatric Surgery Set 2
34 Mini Surgery Set* 2
35 Urology Kit 1
36 Surgical Package for Cholecystectomy* 1
37 Surgical package for Thyroid 1
38 GI Operation Set* 2
39 Appendicectomy set * 2
40 L.P.Tray* 7
41 Uretheral Dilator Set 4
42 TURP resectoscope * 1
43 Haemodialysis Machine * 2
44 Amputation set 2
45 Universal Bone Drill 1
46 Crammer wire splints 10
47 Heamo dialysis machine 2
49
IPHS for 201 to 300 Bedded District Hospitals
50
IPHS for 201 to 300 Bedded District Hospitals
51
IPHS for 201 to 300 Bedded District Hospitals
25 Back rest* 8
26 Dressing Trolley (SS) 8
27 Medicine Almairah 5
28 Bin racks (wooden or steel)* 10
29 ICCU Cots 6
30 Bed Side Screen (SS-Godrej Model)^ As per requirement
31 Medicine Trolley(SS) 8
32 Case Sheet Holders with clip(S.S.)* 120
33 Bed Side Lockers (SS)* 0
34 Examination Couch (SS) 5
35 Instrument Trolley (SS) 10
36 Instrument Trolley Mayos (SS) 6
37 Surgical Bin Assorted 40
38 Wheel Chair (SS) 10
39 Stretcher / Patience Trolley (SS) 10
40 Instrument Tray (SS) Assorted 60
41 Kidney Tray (SS) - Assorted 60
42 Basin Assorted (SS) 60
43 Basin Stand Assorted (SS)
(2 basin type ) 10
( 1 basin type) 15
44 Delivery Table (SS Full) 10
45 Blood Donar Table* 2
46 O2 Cylinder Trolley(SS) 12
47 Saline Stand (SS) 50
48 Waste Bucket (SS)* 75
49 Dispensing Table Wooden 2
50 Bed Pan (SS)* 40
51 Urinal Male and Female 40
52 Name Board for cubicals* 1
53 Kitchen Utensils*
54 Containers for kitchen*
55 Plate, Tumblers*
56 Waste Disposal - Bin / drums 15
57 Waste Disposal - Trolley (SS) 3
58 Linen Almirah 5
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IPHS for 201 to 300 Bedded District Hospitals
59 Stores Almirah 5
60 Arm Board Adult* 15
61 Arm Board Child* 15
62 SS Bucket with Lid 10
63 Bucket Plastic* 10
64 Ambu bags 10
65 O2 Cylinder with spanner ward type 40
66 Diet trolley - stainless steel 2
67 Needle cutter and melter 25
68 Thermometer clinical * 30
69 Thermometer Rectal* 5
70 Torch light* 12
71 Cheatles forceps assortted* 12
72 Stomach wash equipment* 5
73 Infra Red lamp* 5
74 Wax bath* 2
75 Emergency Resuscitation Kit-Adult* 2
76 Enema Set* 8
77 Ceiling Fan$ As per requirement
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IPHS for 201 to 300 Bedded District Hospitals
XVI. Linen
54
IPHS for 201 to 300 Bedded District Hospitals
XVIII. Administration
55
IPHS for 201 to 300 Bedded District Hospitals
1 Generator 40 / 50 KV
2 Generator 75 KV
3 Generator 125 KV 1
4 Portable 2.5 KV 2
6 Incinerator*
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IPHS for 201 to 300 Bedded District Hospitals
1 Ceiling Fans* 70
2 Exhaust Fan* 12
3 Pedestal Fan* 3
4 Wall Fan* 4
5 Hotwater geiser* 2
6 Fire extinguishers*
7 Sewing Machine* 2
8 Lawn Mover* 2
9 Vaccum cleaner* 3
10 Aqua guard*
13 Garden equipment*
16 Laundry (steam) *
17 Emergency lamp
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IPHS for 201 to 300 Bedded District Hospitals
XXII. Transport
1 Ambulance 3
4 Mortuary Van 1
6 Minidor 3 wheeler*
7 Bicycle*
8 Camp Bus*
9 Progamme vehicle*
10 Motorcycle*
1 Elective OT-Major 1
2 Emergency OT/FW OT 1
3 Ophthalmology /ENT OT 1
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IPHS for 201 to 300 Bedded District Hospitals
59
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60
IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
X ENDOSCOPY Oesophagus
Stomach
Colonoscopy
Bronchuscopy
Arthros copy Yes
Laparoscopy (Diagnostic) Yes
Colposcopy
Hysteroscopy
XI. PHYSIOLOGY Pulmonary function tests Yes
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IPHS for 201 to 300 Bedded District Hospitals
* including ophthalmic ward. $ including post caesarean patients # including paediatric beds @ 10% Paying Wards
63
IPHS for 201 to 300 Bedded District Hospitals
17 Inj.Ciprofloxacin 100ml
18 Tab.Erythromycin 250mg
19 Tab.Erythromycin 500mg
20 Syrup Cotrimoxazole 50ml
21 Syrup Ampicillin 125mg/5ml 60ml
22 Inj.Cefoperazone 1Gm
23 Inj.cefotaxime 500mg
24 Tab.Norfloxacin 200mg
25 Tab.Norfloxacin 400mg
26 Tab.Ofloxacin 200mg
27 Inj.Vionocef(Ceffixime)250mg
28 Inj.Amikacin sulphate 500mg
29 Inj.Amikacin sulphate 100mg
30 Cap.Cefodroxyl 250mg
31 Inj.Amoxycillin 500mg
C) Anti Diarrhoeal
32 Tab.Metronidazole 200mg
33 Tab.Metronidazole 400mg
34 Syrup.Metronidazole
35 Tab.Furazolidone 100mg
36 Tab.Diolaxanide Fuzate
37 Tab.Tinidazole 300mg
D) Dressing Material/Antiseptic lotion
38 Povidone Iodine solution 500ml
39 Phenyl 5litr jar(Black Phenyl)
40 Benzalkonium chloride 500ml bottle
41 Rolled Bandage a) 6cm
b)10cm
c)15cm
42 Bandage cloth(100cmx20mm) in Than
43 Surgical Guaze(50cmx18m) in Than
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IPHS for 201 to 300 Bedded District Hospitals
65
IPHS for 201 to 300 Bedded District Hospitals
b) No.20
c) No.21
d) No.22
e) No.23
f) No.24
g) No.25
h) No.26
66 Scalp vein sets no a)19
b) 20
c) 21
d) 22
e) 23
f) 24
g) 25
h) 26
67 Gelco all numbers
68 Tab.B.Complex NFI Therapeutic
69 Tab.Polyvitamin NFI Therapeutic
70 Inj.Dexamethasone 2mg/ml vial
71 Inj.Vitamin B Complex 10ml
72 Inj.B12 Folic acid
73 Surgical Gloves a)6
b)6.1/2"
c)7"
d)7.5"
74 Catgut Chromic a)1 No.
b)2 No.
c)1-0 No
d)2-0 N0
e)8-0
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IPHS for 201 to 300 Bedded District Hospitals
75 Vicryl No.1
76 Sutupak 1,1/0,2,2/0
77 Prolene
78 X-Ray film 50 film packet(in Pkt) size
a) 6.1/2x8.1/2"
b) 8"x10"
c) 10"x12'
d) 12"x15"
79 Fixer
80 Developer
81 CT Scan film
82 Ultrasound scan film
83 Dental film
84 Oral Rehydration powder 27.5g
85 Ether Anaesthetic 500ml
86 Halothane
G) Eye Drops
87 Sulphacetamide eye drops 10% 5ml
88 Framycetin with steroid eye drops 5ml
89 Framycetin eye drops 5ml
90 Ciprofloxacin eye drops
91 Gentamycin eye drops
H) Other Material
92 Rubber Mackintosch Sheet in mtr
93 Sterile Infusion sets(Plastic)
94 Antisera I) A 5ml
II) B 5ml
III) D 5ml
IV) AB5ml
95 Inj.MethylErgometrine 0.2mg/amp
96 Inj.Streptokinase 7.5lac vial
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IPHS for 201 to 300 Bedded District Hospitals
68
IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
M) Eye ointment
32 Chloramphenicol eye ointment & applicaps
33 Chloramphenicol + Dexamethsone ointment
34 Gentamycin eye/ear drops
35 Dexamethasone eye drops
36 Drosyn eye drops
37 Atropine eye ointment
N) Drugs acting on Cardiac vascular system
38 Inj.adrenaline
39 Inj.atropine sulphate
40 Inj.Digoxine
41 Tab.Digoxine
42 Inj.Mephentine
43 Tab.Atenolol
44 Tab.Isoxuprine
45 Inj.Duvadilan
46 Tab.Methyldopa
47 Tab.Isosorbide Dinitrate(Sorbitrate)
48 Tab.Propranolol
49 Tab.Verapamil(Isoptin)
50 tab.Enalepril2.5/5mg
O) Drugs acting on Central/peripheral Nervous system
51 Inj.Pentazocine (Fortwin)
52 Inj.Pavlon 2ml amp
53 Inj.Chlorpromazine 25mg(like Largactil)
54 Inj.Promethazine Hcl Phenergan
55 inj.Pethidine
56 Inj.Diazepam 5mg
57 Tab.Haloperidol
58 Inj.Haloperidol
59 Tab.Diazepam 5mg
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IPHS for 201 to 300 Bedded District Hospitals
60 Tab.Phenobarbitone 30mg
61 Tab.Phenobarbitone 60mg
62 Tab.Largactil 25mg
63 Tab.Pacitane
64 Tab.Surmontil
65 Syrup.Phenergan
66 Syrup Paracetamol
67 Ethyl chloride spray
68 Lignocaine oint
69 Gentamycin eye/ear drops
70 Betnesol-N/Efcorlin Nasal drops
P) Drugs acting on Respiratory system
71 Inj.Aminophylline
72 Tab.Aminophylline
73 Inj.Deriphylline
74 Tab.Deriphylline
75 Tab.Salbutamol 2mg
76 Syrup Tedral
77 Syrup.Salbutamol
Q) Antiseptic Ointment
78 Furacin skin oint
79 Framycetin skin oint
R) Drugs acting on UroGenital system
80 Tab.Frusemide 40mg
81 Inj.KCL
82 Liquid KCL
83 Tab.Pyridicil
84 Inj.Frusemide
S) Drugs acting on Uterus and Female Genital Tracts
85 Inj.Pitocin
86 Inj.Prostodin
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IPHS for 201 to 300 Bedded District Hospitals
87 Tab. Mesoprost
88 Tab.Duvadilan
89 Inj. Devadilan
90 Tab.Methyl Ergometrine
91 Tab.Primolut-N
92 Haymycin vaginal tab
93 10 g. Magnesium Sulphate
94 Inj.Ethacredin lact(Emcredyl)
T) Hormonal Preparation
95 Inj.Insulin Rapid
96 Insulin lente Besal
97 Inj.Cry Insulin
98 Inj.Mixtard
99 Inj.Testesterone plain 25mg
100 Testesterone Depot 50mg
101 Tab.Biguanide
102 Tab.Chlorpropamide 100mg
103 Tab.Prednisolone 5mg
104 Tab.Tolbutamide 500mg
105 Tab.Glibenclamide
106 Tab.Betamethasone
U) Vitamins
107 Inj.Vit A
108 Inj.Cholcalciferol16lac
109 Inj.Ascorbic acid
110 Inj.Pyridoxin 50mg
111 Inj.Vit K
112 Tab.Vit A & D
113 Tab.Ascorbic acid 100mg
V) Other drugs
114 Inj.Antirabies vaccine
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IPHS for 201 to 300 Bedded District Hospitals
73
IPHS for 201 to 300 Bedded District Hospitals
74
IPHS for 201 to 300 Bedded District Hospitals
28 Inj.Tetglobe
29 Inj.Paracetamol
30 Pilocarpine eye drops 1%
31 Sy.Orciprenaline
32 Suturing needles (RB,Cutting)
33 Inj.Calcium pantothernate
34 Inj.Xylocaine 4% 30 ml
35 Halothane
36 Mixture Alkaline
37 Inj. Phenabarbitone 200mg
38 Inj. B12 (Cynacobalamine)
39 Neosporin, Nebasuef , Soframycin Pow
40 Magnasium Sulphate Powder
41 Furacin Cream
42 Xylocaine jelly
43 Formaldehyde Lotion
44 Cetrimide 100ml bott 3.5%, 1.5% 1
45 Bacitrium powder 10mg botts
46 Bleaching Powder 5 Kg Pkts(ISI Mark)
47 Ether Solvent
48 Sodium Hypochloride Sod. 5 ltrs/1 ltrs
49 Inj. Diphthoria antition ADS)10000I.U
50 Inj. Gas gangrene Antitoxin(AGGS)10000
51 Inj. Hydroxy Progesterone500mg/2ml
52 Inj. Methyl Prednisolon 500mg vial
53 Inj.Multivitamin I.V
54 Inj.Potassium chloride
55 Inj.Quinine Dihydrochloride
56 Tetanus Antitoxin 10000 I.U
57 Inj.Tetanus Toxoid 5ml vial
58 Inj.Theophylline Etophylline
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IPHS for 201 to 300 Bedded District Hospitals
59 Inj.Vitamin A
60 Tab.Ferrous sulphate200mg+Folic acid
61 Tab.Ferrous sulphate 300mg
62 Tab.Griseofulvin125mg
63 Tab.Phenobarbitone 30mg
64 Tab.Phenobarbitone 60mg
65 Tab.Pyridoxin 10mg
66 Tab.Thyroxine sod 0.1mg
67 Warfarin sod 5mg
68 Tab.Alprazolam 0.25mg
69 Tab.Amlodipine 5mg
70 Tab.Amlodipine 10mg
71 Tab.Nefidipine 20mg
72 Tab.Nefidipine 30mg
73 Tab.Riboflavin 10mg
74 Syp.Ferrous Gluconate 100ml bottle
75 Cream Fluconozole 15gm tube
76 Sus.Furazolidone
77 Oint.Hydrocortisone acetate
78 Syp.isoniazid 100mg/5ml 100ml bot
79 Liquid paraffin
79A Linctus codein 500ml bot
80 Cream Miconozole 2% 15gm tube
81 Syp.Nalidixic acid
82 syp.Norfloxacin
83 Phenylepinephrine eye drops
84 Pilocarpine eye drops 2%
85 Syp.Pottassium chloride 400ml bot
86 Syp.Primaquine
87 Suspension Pyrantel pamoate
88 Sus Rifampicin
76
IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
This charter seeks to provide a framework which This counter is functioning round the clock.
enables our users to know: Location guide maps have been put up at various
places in this hospital.
What services are available in this hospital; Colour coded guidelines and directional signboards
are fixed at strategic points for guidance.
The quality of services they are entitled to; Telephone enquiries can be made over telephone
numbers:
The means through which complaints
regarding denial or poor quality of services ., & , Fax:
will be redressed. ..
This is a District, Sub-district/divisional All Casualty Services are available round the clock.
hospital;
Duty Doctor is available round the clock.
It provides medical care to all patients who
come to the hospital; Specialist doctors are available on call from
resident doctors.
Standards are influenced by patients load
and availability of resources; Emergency services are available for all
specialities as listed in the OPD Services.
Yet we insist that all our users receive
courteous and prompt attention. Emergency Operations are done in-
79
IPHS for 201 to 300 Bedded District Hospitals
OPD Services:
Various outpatient services available in the hospital are detailed below (as available):
General Medicine
Paediatrics
General Surgery
Paediatric Surgery
Neuro Surgery
Cardiac Surgery
Eye
ENT
Skin
Urology
Cardiology
Psychiatry
Radiotherapy
Neurology
Orthopaedics
Dental OPD
ISM Services:
Homeopathic
Ayurvedic
Any other
In OPDs specialists are available for consultation.
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IPHS for 201 to 300 Bedded District Hospitals
OPD services are available on all working days Emergency: Emergency Laboratory Services are
excluding Sundays and Gazetted Holidays. available 24 hours for limited tests relating to clinical
pathology and bio-chemistry.
On Saturdays, the hospital functions from
. AM to .. PM. Radio Diagnostic Services:
Some specialities do not have indoor patients Routine X-Rays are done from 9:00 AM to 1:00 PM.
services: Registration is done from 9:00 AM to 11:30 AM.
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IPHS for 201 to 300 Bedded District Hospitals
All indoor patients receive treatment under the Public Telephone Booths are provided at various
guidance and supervision during office hours i.e. locations.
9:00 AM to 4:00 PM.
Stand-by Electricity Generators have been provided.
Outside office hours, treatment is given by doctor
Chemist Shops are available outside the hospital.
on duty and specialists are available on call.
Canteen for patients and their attendants is
Free diet is provided to all patients in the General available.
Wards.
Lifts are available for access to higher floors.
Every patient is given one attendant pass.
Adequate toilet Facilities for use of patients and their
Visitors are allowed only between 5:00 PM to 7:00 attendants are available.
PM.
Complaints & Grievances:
Investigations like CAT Scan, Ultra Sound, Barium-
meal, ECHO, TMT etc. are charged for as per There will be occasions when our services will not
Government approved rates. be upto your expectations.
A Staff Nurse is on duty round the clock in the ward. We aim to settle your genuine complaints within 10
working days of its receipt.
Admitted patients should contact the Staff Nurse for
any medical assistance they need. Suggestions/Complaint boxes are also provided at
various locations in the hospital.
Other Facilities:
If we cannot, we will explain the reasons and the
Other facilities available include:
time we will take to resolve.
Cold Drinking Water
Name, designation and telephone number of the
Wheel chairs and trolleys are available in the OPD nodal officer concerned is duly displayed at the
and casualty. Reception.
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IPHS for 201 to 300 Bedded District Hospitals
Responsibilities of the Users: Please refrain from demanding undue favours from
the staff and officials as it encourages corruption.
The success of this charter depends on the support
we receive from our uses. Please provide useful feedback & constructed
suggestions. These may be addressed to the
Please try to appreciate the various constraints Medical Superintendent of the Hospital.
under which the hospital is functioning.
No Smoking Please
On an average more than lacs patients
Dont split here & there
attend the OPD annually and more than
lacs patients are attended annually in the Use Dustbin
casualty and emergency wards.
Keep Hospital Clean
Please do not inconvenience other patients. Give regards to Ladies and Senior Citizens
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IPHS for 201 to 300 Bedded District Hospitals
Annexure I
The Ministry of Environment & Forests institutions under Central/State Governments for:
notified the Bio-Medical Waste (Management &
1. Purchase of equipments such as:
Handling) Rules, 1998 in July, 1998.
a) Incinerator
In accordance with the rules (Rule 4), it is
the duty of every Occupier, i.e. a person who has b) Microwave
the control over the institution and/or its premises, c) Autoclave
to take all steps to ensure that the waste generated
is handled without any adverse effect to human d) Shredder
health and environment. The Rules further state that 2. Other equipments including colour coded
every Occupier, where required, shall set up bags and puncture proof containers,
requisite bio-medical waste treatment facilities like protective gears, etc.
incinerator, autoclave, microwave system for the
3. Civil and electrical works to house and
treatment of waste, or ensure requisite treatment of
operate the waste treatment facilities.
waste at a common treatment facility or any other
treatment facility. No untreated bio-medical waste 4. Training
shall be kept stored beyond a period of 48 hours
5. IEC activities.
(Rules 5 & 6).
Hospital Waste Management System must
The hospitals, nursing homes, clinic,
be established in accordance with the Bio-Medical
dispensary, animal house, pathological lab, etc. are,
Waste (Management & Handling) Rules, 1998
therefore, required to set in place the biological
(Annexure).
waste treatment facilities. It is, however, not
incumbent that every institution has to have its own Segregation must be done at the source of
waste treatment facilities. The rules also envisage generation of waste. As 80-85% of waste generated
that common facility or any other facilities can be in hospitals is non-hazardous or general waste,
used for waste treatment. However, it is incumbent segregation will reduce the quantum of waste that
on the occupier to ensure that the waste is treated needs special treatment to only 15-20% of the total
within a period of 48 hours. Schedule VI of the rules waste. The categories for segregation of waste and
also provides the time limits by which the waste colour coding and type of container should be as in
treatment facilities are required to be in place. Schedule 1 and 2 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.
In connection with the implementation of the
Rules, it has been decided to take up pilot projects The various options for treatment of waste
in selected Government hospitals Central and can be selected according to feasibility and type of
State. waste as given in the Schedule I. The correct
colour bag should be used for the particular
AIM: The aim of the scheme is to implement
treatment option.
pilot projects to have a demonstration effect by
providing financial assistance to identified hospitals/ The various options are:
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IPHS for 201 to 300 Bedded District Hospitals
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IPHS for 201 to 300 Bedded District Hospitals
ii. The State Government/UT Administration The financial assistance will be limited to
should ensure that the existing facilities are Rs.85 lakhs per hospital or Rs.1.5 crore per State/
inspected by a responsible officer and UT. The State/UTs will have the option to choose
deficiencies pointed out. The proposal for any equipment (s) from the list above to cover as
additionalities, if any, in the form of many hospitals as possible. However, the financial
equipment should be, as far as possible, by assistance per State will be provided upto a
way of complementary equipments maximum amount of Rs.1.5 crore.
supported by estimates of concerned
authorities. Scrutiny of Applications:
iii. The cost of equipments to be purchased
The applications received from the State
should be indicated. The equipments will be
Government/UT Administrations for setting up of
purchased as per prescribed procedure.
facilities for disposal of hospital waste in the
These will be entered into an Assets
hospitals under their administrative control will be
Register to be maintained by the hospital.
considered in the Ministry in a Committee headed
iv. The grant will be subject to the condition that by Additional Secretary and proposals cleared for
the State Government / UT Administration giving financial assistance. The proposals then will
will give an undertaking that adequate be processed for sanction of financial assistance to
arrangements for running the equipments the Government Hospitals/institutes. In the case of
and their maintenance for disposal of Central Government Hospitals/Institutions, the Head
hospital waste shall be made. of the Institutions may send their proposal through
v. The grant will be subject to the condition that Dte.GHS.
the State Government/UT Administration/
Hospital will give an undertaking that they The Joint Secretary (Hospital), DDG level
will provide the required trained manpower officer in the Dte.GHS concerned with hospitals
for running of the equipments and their matters will be the Nodal Officer for implementation
maintenance for proper treatment and of the scheme. The proposals will be examined
disposal for the bio-medical waste. through a Committee consisting of Additional
Secretary, Chairman, the Joint Secretary dealing
vi. The funds sanctioned will be utilized for the with hospital matters, Joint Secretary (FA) or his
purpose for which it is sanctioned. representative, DDG level officer dealing with
vii. The accounts of the hospital about purchase hospitals in Dte.GHS and one representative of
of equipment/maintenance of the Central Pollution Control Board/Ministry of
equipments/transportation of thw waste/ Environment & Forests as members. The Member
expenditure incurred on civil/electrical works Secretary of the Committee will be Director/Deputy
will be audited by the Accountant General Secretary dealing with hospital matters. The funds
of the State Government / UT Administration for setting up facilities for disposal of hospital waste
and its utilization certificate will be forwarded will be sanctioned to the State Government/UT
to the Ministry of Health & Family Welfare Administration/Occupier and it will be implemented
within a period of six months after the expiry by the concerned Government and to the concerned
of the financial year during which the grants Head of the Hospital in case of Central Government
is sanctioned. Hospitals/Institutions.
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IPHS for 201 to 300 Bedded District Hospitals
Annexure - II
Tamil Nadu
University,
Chennai
VCRC,
Pondicherry
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IPHS for 201 to 300 Bedded District Hospitals
Viral Diagnosis
Enteric viruses DRDE CMC, AIIMS & NICED - EVRC,
Vellore Villupuram Kolkata Mumbai,
Chest NIV & NICD
Institute
Parasitic Diagnosis
Malaria All State Public Health Laboratories MRC, Delhi
ICGEB, Delhi
Zoonoses
Dengue DRDE VCRC, AIIMS NICED NIV NIV
Pondicherry ICGEB, Delhi
Institute of
Virology,
Aleppey
VCRC,
Pondicherry
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IPHS for 201 to 300 Bedded District Hospitals
Unknown pathogens Other laboratories to perform support functions NIV, NICD, HSADL
Outbreak investigation Medical Colleges and state public health laboratories NICD, NIV, NICED, VCRC
support as L3/ L4
Laboratory data Medical Colleges, state public health laboratories NIV, NICDNIV, NICD
management and all the L4 & L5 laboratories (in their area of
expertise)
Capacity building All the L4 & L5 laboratories (in their area of NIV, NICD
expertise)
Quality assurance All the L4 & L5 laboratories (in their area of CMC, TRC, NTI, AFMC,
expertise) NARI, RMRC,Port Blair
NIV, NICD
Quality control of reagents All the L4 & L5 laboratories (in their area of CMC, TRC, NARI, RMRC,
& kits evaluation expertise) Port Blair NIV, NICD, BJMC,
NICED
Biosafety & bio- Other laboratories to perform support function HSADL, NIV/MCC,
containment DRDE, NICD
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IPHS for 201 to 300 Bedded District Hospitals
List of Abbreviations
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IPHS for 201 to 300 Bedded District Hospitals
References
1. Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100 Beded Hospital, Bureau
of Indian Standards, New Delhi, January, 2001.
2. Rationalisation of Service Norms for Secondary Care Hospitals, Health & Family Welfare
Department, Govt. of Tamil Nadu. (Unpublished)
3. District Health Facilities, Guidelines for Development and Operations; WHO; 1998.
4. Indian Public Health Standards (IPHS) for Community Health Centres; Directorate General of Health
Services, Ministry of Health & Family Welfare, Govt. of India.
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