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Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007
Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007
Sections
1. Short Title, extent and commencement.
Section 12. Definitions.
Section 23. Authorities.
Section 34. Registration.
Section 45. Certificate of Registration.
Section 56. Renewal.
Section 67. Suspension or Cancellation of Registration.
Section 78. Appeal.
Section 89. Display of rates.
Section 910. Display of Registration number etc.
Section 1011. Fund of Registering Authority.
Section 1112. Annual Accounts.
Section 1213. Fees payable to the Authority.
Section 1314. Medical Records.
Section 1415. Medical Audit.
Section 1516. Offences and Penalties.
Section 1617. Interpretation of the Rules.
Section 172. Establishments offering Diagnostic Support. - The diagnostics services are offered by various laboratories
Section 22. Establishments offering Diagnostic Support.
Section 21. Medical clinic (consultation and examination room) with waiting area
Section 12. Surgical Clinic (consultation and examination room) with waiting area
Section 23. Casualty and emergency care (optional)
Section 34. Treatment and dressing and 5. Injection room
Section 41. Orthopedic and Trauma Care. - A hospital or nursing home irrespective of the bed strength offering Orthopedic surgical care and trauma care services should have the following equipment and facilities:
Section 11. Orthopedic and Trauma Care.
Section 12. ENT care. - A hospital offering the ENT speciality treatment basically to have the following equipment:
Section 22. ENT care.
Section 24. Obstetric and Gynaecology Care facilities. - The maternity care facilities should provide basic obstetric services and neonatal care services. All maternity homes should be able to carry out procedures like suction and evacuation, dilatation and curettage. Lower Segment Cesarean Section and Hysterectomy on an emergency basis. Blood transfusion facilities should be available within half to one hour. Also ultrasonography facilities should be available within half to one hour. A hospital or nurs
Section 44. Obstetric and Gynaecology Care facilities.
Section 45. Cancer Treatment Facilities. - A hospital offering radiotherapy services for the treatment of cancer should have the following facilities:
Section 55. Cancer Treatment Facilities.
Section 56. Specialist Qualifications. - (i) The Specialist for providing cardiology services should have M.D. D.M (Cardiology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.
Section 66. Specialist Qualifications.
Section 67. Urology and Nephrology care facilities. - The facilities offering these services should have full fledged Operation theatre facilities, Intensive care units, Full-fledged Dialysis units with dialysis machines and Complete renal replacement therapy machines (CRRT), Renal lab with facilities for Renal function tests, well set clinical lab support, and radiology and imaging support.
Section 77. Urology and Nephrology care facilities.
Section 78. Neurology and Neuro-surgery. - The neurology treatment facilities should have EEG machines, evoked potentials, C.T and MRI facilities, in addition to the hi-end diagnostic facilities, the hospitals to have operation theatres, Intensive care units, and Micro-Surgical Instrument sets.
Section 88. Neurology and Neuro-surgery.
Section 89. Neonatology and Paediatric Surgery facilities. - A hospital or nursing home offering Neonatology and Pediatric surgery services should have the following facilities: -
Section 99. Neonatology and Paediatric Surgery facilities.
Section 910. Plastic Surgery facilities.
Section 1011. Chest Diseases and Respiratory Medicine. - A Hospital or a facility offering treatment for the chest diseases and respiratory medicine should have the following facilities: -
Section 1111. Chest Diseases and Respiratory Medicine.
Section 1112. Gastroenterology and Surgical Gastroenterology care facilities. - The facilities offering these services should have full fledged Operation theatre facilities, Intensive care units, Full-fledged Endoscopy equipment, well set clinical lab support, and radiology and imaging support. The Endoscopy equipment include Upper G.I Endoscope, Colono Scope, Surgical Endoscope etc.
Section 1212. Gastroenterology and Surgical Gastroenterology care facilities.
Section 121. Obligations of The Medical Care.
Section 12. Responsibilities Towards a Patient.
Section 23. Obligation Towards Their Own Staff and Staff Training.
Section 31. Ceilings.
Section 12. Floor and walls.
Section 23. Water supply, Plumbing and other piping system.
Section 34. Fire-fighting system.
Section 45. Requirements for sanitary fitments in nursing homes for patients.
Section 56. Bio Medical Waste Management.
Section 67. Bio-safety Guidelines.
Section 71. Fever
Section 11. Only Fever
Section 12. With Rash
Section 23. With Bleeding
Section 34. With Daze/Semi consciousness/ Unconsciousness/
Section 42. Cough with or without fever
Section 22. Cough with or without fever
Section 23. Loose Watery Stools of Less than 2 Weeks Duration
Section 33. Loose Watery Stools of Less than 2 Weeks Duration
Section 34. Jaundice cases of less Than 4 Weeks Duration
Section 44. Jaundice cases of less Than 4 Weeks Duration
Section 45. Acute Flacid Paralysis Cases in Less Than 15 Years of Age
Section 55. Acute Flacid Paralysis Cases in Less Than 15 Years of Age
Section 56. Unusual Symptoms Leading to Death or Hospitalization not Conforming to the Above Syndromes
Section 66. Unusual Symptoms Leading to Death or Hospitalization not Conforming to the Above
Section 61. Name and address of the Allopathic Private Medical Care Establishment
Section 12. Name of Correspondent or any Authorised person for correspondence.
Section 23. Name and Address of the Society/Trust and date on which it was established: -
Section 34. Whether the accommodation is owned by the Establishment or on lease/rent. If so, please furnish the period of lease/rent along with the documentary proof. (Please Enclose the relevant copies)
Section 45. The date of establishment of Medical care establishment
Section 56. Total area of Establishment: (One set of photographs of the premises with its functional areas to be furnished) (a) Open area b) Constructed area
Section 67. Bed strength
Section 78. Types of Services offered
Section 89. Names of Doctors, along with Registration Number Allotted by MCI/APMC (Please Enclose the details)
Section 910. Names of qualified Nursing Staff, with their of Registration numbers of NCI/any other board (Please Enclose the details)
Section 1011. Names of Para Medical Staff and their Registration numbers (list to be enclosed)
Section 1112. No. of Supporting staff (list to be enclosed)
Section 1213. No. of Specialities available (Please Enclose the details)
Section 1314. The List of Equipment and Furniture available (Please Enclose the details)
Section 1415. Labour room with Paediatric care facilities
Section 1516. Operation theatres
Section 1617. Diagnostic Facilities including Clinical Laboratory and Imaging facilities
Section 1718. Whether registration is sought for main facility, or branches also, if so details (separate application shall be submitted for each branch)
Section 1819. The financial position of the Hospital/Institute (enclose Audit Report of the last two years)
Section 1920. Any other information relating to Hospital
Section 2021. Declaration on Stamp Paper for willingness to comply Yes/No with the prescribed rules is enclosed
Section 2122. Particulars of the Registration fee paid (D.D No., Name f the Bank, and Date)
Section 221. Name and address of the appellant:
Section 12. Number, date of the order and address of the authority which passed the order against which appeal is being made (certified copy of the order to be attached):
Section 23. Prayer / relief sought in the Appeal
Section 34. Grounds on which the appeal is made:
Section 45. Interim Relief/Prayer, if any sought
Section 56. List of enclosures (other than the order referred in item 2 above)
Section 67. Particulars of the D.D. (number, date and bank) enclosed
Section 78. Declaration that the contents mentioned in appeal are true and correct to the best of the knowledge of the appellant
Section 81. Appeal Number and Date:-------------------
Section 12. Registered notice number and date fixing hearing-------------
Section 23. File Number of Registering Authority------------------
Section 34. Date of hearing of appeal --------------------------------------------------------------
Section 45. What are the contents and documentary evidence produced bv the Appellant Establishment
Section 56. Are they relevant and satisfactory................Yes/No
Section 67. Additional document (s) submitted by the Compliant, if any
Section 78. Are they relevant to the Appeal.......................Yes/No
Section 89. Issues framed/Point(s) for consideration in the appeal
Section 910. Findings of the Appellate Board
Section 1011. Wheatear any interim order is considered Yes/No
Section 11
andhra-pradesh-allopathic-private-medical-care-establishments-registration-and-regulation-rules-2007.json
•
110 Sections
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Andhra Pradesh
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"id": 14336,
"slug": "andhra-pradesh-allopathic-private-medical-care-establishments-registration-and-regulation-rules-2007",
"title": "Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007",
"short_title": "Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007",
"act_number": "Published vide Notification No. G.O. Ms. No. 135, ",
"act_year": 2007,
"act_type": "STATE",
"location": "Andhra Pradesh",
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"description": "Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007",
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"number": "1",
"title": "1. Short Title, extent and commencement.",
"chapter": null,
"content": "",
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"number": "2",
"title": "2. Definitions.",
"chapter": null,
"content": "(a) 'Act' means the Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Act, 2002.\n(b) Rules' means the Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007\n(c) 'State Level Advisory Committee' means the Committee constituted under Section 5A of the Act.\n(d) 'District Level Advisory Committee' means the Committee constituted under Section 5C of the Act.\n(e) 'Establishment' means Allopathic Private Medical Care Establishment\n(f) The words and expressions used herein and not defined but defined in the Act, shall have the same meanings respectively assigned to them in the Act.",
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"number": "3",
"title": "3. Authorities.",
"chapter": null,
"content": "(a) A.P. Allopathic Private Medical Care Establishment Registering Authority (APMCERA)\n(b) State Level Advisory Committees (SLAC)\n(c) District Level Advisory Committees (DLAC)\n(d) State Level Appellate Board (SLAB)\n(e) District Registering Authority (DRA)",
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"number": "4",
"title": "4. Registration.",
"chapter": null,
"content": "(b) If a private medical care establishment is offering services in more than one category as specified in the table given below, the establishment shall apply for separate registration for each type of category: -\nCategory No.\nDescription of Establishment\n1.\nClinics/consultation rooms (Solo Practitioners)\n2.\nPoly Clinics (Group Practitioners)\n3.\nHospitals/Nursing Homes less than 20 beds\n4.\nHospitals/Nursing Homes with 21 to 50 beds\n5.\nHospitals/Nursing Homes with 51 to 100 beds\n6.\nHospitals/Nursing Homes with 101 to 200 beds\n7.\nHospitals/Nursing Homes with more than 200 beds\n8.\nDiagnostic Centers (Basic Lab facilities)\n9.\nDiagnostic Centres with Hi-end equipment (CT etc.)\n10.\nPhysiotherapy Units\n11.\nDental Clinics/Hospitals\n(c) If a diagnostic center is a part of a hospital, no separate registration is required...\n(d) The Chairman of the District Registration Authority or any person in his office authorized in this behalf, shall acknowledge the receipt of the application for registration immediately in the acknowledgement slip prescribed in Form II annexed to these rules if delivered at the office of the Authority, or not later than the next working day if received by post.\n(e) The fee shall be paid by a demand draft from any Nationalised Bank drawn in favour of the District Registering Authority of the District concerned.\n(f) As soon as an application is filed, a temporary registration certificate in Form-Ill annexed to these rules shall be issued for a period of ninety days from the date of issue to the Applicant-Establishment.\n(g) On receipt of an application for registration, the Registering Authority shall conduct an inspection of the establishment within ten days by a team of two doctors, one of whom shall be a Member of either the District Registration Authority or the District Level Advisory Committee.\n(h) The inspection Team so, constituted by the Registering Authority shall inspect and submit a report with reference to the availability of minimum standards prescribed in Appendix-I and also detailing the specific deficiencies to be corrected, if any.\n(i) Copy of the inspection report pointing out the deficiencies, if any, shall be communicated to the Applicant-Establishment within seven days from the date of receipt of inspection report with a direction to rectify the deficiencies pointed out and inform the Registering Authority within a period of two months.\n(j) The Applicant-Establishment shall cooperate and provide all the relevant information and necessary assistance to the inspection team for satisfactory completion of the inspection formalities. Refusal of entry of inspection teams to the Applicant-Establishment and non-cooperation during inspection is liable for rejection of the application for registration.\n(k) If the applicant-establishment does not comply with the direction to rectify the deficiencies pointed out in the inspection report within a period of two months, the defaulting applicant - establishment may be given extension of a further period of one month by imposing 50% of the registration fee as penalty.\n(l) If the defaulting applicant-establishment does not comply with the direction to rectify the deficiencies pointed out in the inspection report, even after the expiry of the extended period of one month, the temporary registration granted to Establishment shall be cancelled, under provisions of Section-9.",
"footnote": "",
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{
"number": "5",
"title": "5. Certificate of Registration.",
"chapter": null,
"content": "(1) Infrastructure including buildings\n(2) Essential medical equipment.\n(3) Equipment for protection from radiation.\n(4) Facility for disposal of bio-medical waste.\n(5) Effective maintenance of Sanitation and Hygienic Standards\n(6) Qualified Doctors.\n(7) Qualified paramedical staff.\n(8) Other essential staff.\n(9) Previous audit reports evidencing financial capability.\n(b) One copy' of the Certificate of Registration shall be displayed prominently at the reception/ entrance of the Establishment. The Authority shall clearly specify in the certificate the category under which the Establishment is registered.\n(c) If, after detailed enquiry and due opportunity to the applicant the Establishment does not satisfy the standards prescribed for registration, the registering Authority shall, for reasons to be recorded in writing, reject the application for registration duly cancelling the temporary registration granted earlier. Such rejection shall be communicated to the applicant in Form V annexed to these rules within a period of ninety days from the date of receipt of application for registration.\n(d) The Certificate of Registration shall be non-transferable.\n(e) In the event of any change of ownership, management or name of the establishment, the Registering Authority shall be intimated before such change and the Certificate of Registration shall be surrendered to the Registering Authority the so as to issue a revised certificate of Registration after the inspection incorporated the changes.\n(f) On ceasing to function as a Establishment, or in case there is a change of category or change in address, both copies of the certificate of registration shall be surrendered to the Registering Authority and fresh registration shall be obtained after following the prescribed procedure.\n(g) The Certificate of Registration shall be valid for a period of five (5) years from the date of issue, subject to the conditions of review.",
"footnote": "",
"is_definition": false,
"sort_order": 4
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{
"number": "6",
"title": "6. Renewal.",
"chapter": null,
"content": "",
"footnote": "",
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"sort_order": 5
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{
"number": "7",
"title": "7. Suspension or Cancellation of Registration.",
"chapter": null,
"content": "(b) The Registering Authority, immediately after suspending the Certificate of Registration shall send a registered notice to Establishment in writing in Form VIII informing the time, date and place at which the case will be heard by the Registering Authority. The registered notice shall be sent to the Establishment at least by giving 15 days time for hearing. The Registering Authority shall also direct the establishment to surrender their Certificate of Registration on or before date of hearing.\n(c) The establishment shall be entitled to be represented either an authorized person or a legal practitioner.\n(d) If the establishment dies not represent either by authorized person or a legal practitioner, the Registering Authority may proceed with the documentary evidence available with it and determine the case and order cancellation of Certificate of Registration or revoke the suspension of the Certificate of Registration by recording the reasons. The said order has to be communicated to the Establishment within three days from the date of such order in the prescribed Form IX annexed to these rules.",
"footnote": "",
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"sort_order": 6
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"number": "8",
"title": "8. Appeal.",
"chapter": null,
"content": "(i) Principal\n\t\t\t\tSecretary, to Government HM and FW Department\n-\nChairman\n(ii) Director of Medical Education, A.P., Hyderabad\n-\nMember-Convener\n(iii) Director of Health, A.P., Hyderabad\n-\nMember.\n(iv) Commissioner, APWP, Hyderabad\n-\nMember,\n(v) One member from IMA nominated by the Government\n\t\t\t\tafter duly consulting IMA\n-\nMember,\n(vi) One member from APNA nominated by Government\n\t\t\t\tafter duly consulting the APNA\n-\nMember.\n(b) Any Establishment, if aggrieved by the order of the Registering Authority, may prefer an appeal in the prescribed form (Form X) annexed to these rules, to the Appellate Board within thirty (30) days from the date of receipt of such order.\n(c) After receipt of the appeal, the Appellate Board shall fix the time and date for hearing and inform the same to the appellant and others concerned by a registered letter giving at least 15 days time for hearing of the case.\n(d) The appellant may represent by himself or authorized person or a Legal practitioner and submit the relevant documentary material if any in support of the appeal\n(e) The Appellate Board, shall hear all the concerned, receive the relevant oral/ documentary evidence submitted by them, consider the appeal and communicate its decision preferably within 90 days from the date of filing the Appeal in the prescribed Form-XI\n(f) If the Appellate Board considers that an interim order is necessary in the matter, it may pass such order, pending final disposal of the appeal.\n(g) The decision of Appellate Board shall be final and binding.\n(h) If no appeal is filed against the decision of the Registering Authority in the prescribed period (i.e) within 30 days from the date of receipt of the order, the orders of the Registering Authority stands final.",
"footnote": "",
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"number": "9",
"title": "9. Display of rates.",
"chapter": null,
"content": "(b) A copy of such list shall be sent to the Registering Authority by 1st of June every year for record.\n(c) The details of services and rates shall be explained to the patients or their attendants at the time of admission without any ambiguity.",
"footnote": "",
"is_definition": false,
"sort_order": 8
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{
"number": "10",
"title": "10. Display of Registration number etc.",
"chapter": null,
"content": "(b) The establishment shall indicate the name and registration number allotted to Doctors by the State Medical Council/Medical Council of India in all the Prescriptions, Certificates given to the patients.\n(c) Every Doctor shall display the registration number allotted to by the State Medical Council/Medical Council of India in clinic and in all prescriptions, certificates, money receipts etc. given to patients.",
"footnote": "",
"is_definition": false,
"sort_order": 9
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{
"number": "11",
"title": "11. Fund of Registering Authority.",
"chapter": null,
"content": "(b) The Chairman of the District Registering Authority i.e. DM and HO shall receive the moneys/fees through Demand Draft. Only. He shall open an account in a nationalized bank in the name of the Registering Authority and remit the same into the account.\n(c) The amount so collected shall be utilised by the Authority for the activities connected with the implementation of the provisions of the Act and these rules, viz, payments to professionals, legal counsels, honorarium to the Members of the Committees who attend meeting. Members of Inspection Teams etc.\n(d) The Chairman of the District Registering Authority is the custodian of the fund and he shall operate the fund.\n(e) The cheques of the Authority shall be signed by the Chairman and another authorized member of Registering Authority.\n(f) The Chairman shall maintain general cash book and enter therein all the amounts received and spent immediately.\n(g) The Chairman of the Registering Authority shall keep a sum of Rs. 2000/- (Rupees two thousand only) as office imp rest for the maintenance of day to day expenditure.\n(h) All the fees shall be paid by a Demand. Draft drawn on a nationalised bank at headquarters of the District concerned in favour of \"DRA and DM and HO\"\n(i) The Accounts shall be maintained properly, audited by engaging an approved Chartered Accountant for every financial year.s",
"footnote": "",
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"sort_order": 10
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"number": "12",
"title": "12. Annual Accounts.",
"chapter": null,
"content": "",
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"sort_order": 11
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{
"number": "13",
"title": "13. Fees payable to the Authority.",
"chapter": null,
"content": "SI.No.\nDescription of Establishment\nAnnual Fee (Rs.)\n1.\nClinics/consultation rooms (Solo Practitioners)\n250\n2.\nPoly Clinics (Group Practitioners)\n500\n3.\nHospitals/Nursing Homes less than 20 beds\n750\n4.\nHospitals/Nursing Homes with 21 to 50 beds\n1500\n5.\nHospitals/Nursing Homes with 51 to 100 beds\n2000\n6.\nHospitals/Nursing Homes with 101 to 200 beds\n3000\n7.\nHospitals/Nursing Homes with more than 200 beds\n7500\n8.\nDiagnostic Centers (Basic Lab facilities)\n500\n9.\nDiagnostic Centres with Hi-end equipment (CT etc.)\n2000\n10.\nPhysiotherapy Units\n750\n(b) For filing an appeal before the State Appellate Board: Rs.500/- (Rupees Five hundred only)",
"footnote": "",
"is_definition": false,
"sort_order": 12
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"number": "14",
"title": "14. Medical Records.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 13
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{
"number": "15",
"title": "15. Medical Audit.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 14
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{
"number": "16",
"title": "16. Offences and Penalties.",
"chapter": null,
"content": "",
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"sort_order": 15
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"number": "17",
"title": "17. Interpretation of the Rules.",
"chapter": null,
"content": "Appendix - I\nAppendix - I\n( See Rule 4 (h))\nMinimum Standards For The Registration of Private Medical Care Facilities\nPart - I\nI. Background and Rationale of setting minimum standards.\nII. Classification of the Private Medial Care Establishments.\nA. Classification Based on the Services offered by the facilities. - (1) Establishments offering Medical and Surgical Treatment. Clinics and Consultation rooms (Dispensaries)\nA. Classification Based on the Services offered by the facilities.\n(i) Hospitals or Nursing Homes offering Basic Services and Family Medicine (Primary)\n(ii) Hospitals or Nursing Homes Offering Basic Speciality Care Services (Secondary)\n(iii) Hospitals offering Super Speciality Services (Tertiary)\n(iv) Physiotherapy Centers\n(v) Dental Services\nThe services offered by these facilities are described in the following paras:\n(i) Clinics and Consultation rooms (Dispensaries). - The Clinics and Consultation rooms are facilities run by a Solo qualified allopathic doctor, either with M.B.B.S degree or with higher professional qualifications. These facilities offer \"out-patient\" treatment and drug prescriptions based on the investigation support sourced either from in-house labs or from out side lab facilities. The range of treatment offered by these clinics depends upon the qualifications of the medical practitioner. There are Poly Clinics which are operated by a group of two or more practitioners. These two types of facilities refer cases requiring hospitalization and for any surgical interventions to a hospital for further treatment. The poly clinics usually have attached medical laboratories (Clinical laboratories and Radiological and Imaging facilities) to cater to the needs of the doctors working in the clinics. The physical requirements of the Clinics are given in the Part II.\n(i) Clinics and Consultation rooms (Dispensaries).\n(ii) Hospitals offering Basic Services and Family Medicine (Primary care). - These facilities are basically manned by one or more qualified medical practitioners (M.B.B.S doctors) and offer basic level services to the patients irrespective of the bed strength, as described in the Part VI. These may also have an attached medical laboratory to cater to the investigation support needed for the clinical interventions. In addition to the wide range of out-patient services these hospital provide in-patient facilities. The physical requirements including space, equipment and man power needed for these facilities depending on the bed strength of the hospital are given in the Part II.\n(ii) Hospitals offering Basic Services and Family Medicine (Primary care).\n(iii) Hospitals or Nursing Homes Offering Basic Speciality Services (Secondary care). - These hospitals provide specialist care needed for the treatment of health conditions through the concerned specialist doctors with higher level qualifications in the following specializations, irrespective of the bed strength:\n(iii) Hospitals or Nursing Homes Offering Basic Speciality Services (Secondary care).\n* General Medicine (Medical care)\n* General Surgery (Surgical Care)\n* Obstetrics and Gynecology (Maternal Care)\n* Pediatrics (Child Care)\n* Orthopedics (Accidents and Trauma Care)\n* ENT\n* Ophthalmology (Eye care)\n* Radio-diagnosis and Radiotherapy (Cancer Care)\n* Physiotherapy\n* Dental Care Services\nThese hospitals to have functional areas such as Operation theaters, post operative wards, Intensive care units, general wards, and also other treatment areas needed for facilitating the surgical interventions of the concerned Speciality care. These may have attached medical laboratories including Clinical laboratories and Radiological and Imaging facilities to cater to the investigation needs of the specialists working in these facilities or the services may be taken from out side diagnostic centers. Some of the facilities may have multi-specialty care services. The hospitals offering multi speciality treatment services should have the complete range of equipment and facilities suitable to the area of specialization. The physical requirements including space, equipment and man power needed for these facilities depending on the bed strength of the hospital are given in the Part II.\n(iv) Hospital offering Super Speciality Services (Tertiary) - These hospitals provide super specialist care needed for the treatment of health conditions through the concerned super specialist doctors in the following specializations, and hospital may have different bed strength based on the range of services offered:\n(iv) Hospital offering Super Speciality Services (Tertiary)\n* Cardiology and Cardiothoracic Surgery\n* Neurology and Neuro-surgery\n* Nephrology and Urology\n* Gastroenterology and Surgical Gastroenterology\n* Surgical Oncology\n* Neonatology and Pediatric Surgery\n* Chest Diseases and Respiratory Medicine\n* Plastic Surgery\nTo facilitate the above services, the hospitals should have full set of functional areas and special types of equipment suitable to the needs of the Super-speciality services offered through the facility. The hospitals shall have Intensive care units, Ambulatory support, Blood Bank facilities, Communication network etc. equipped to meet the demands of an emergency case. In addition the hospitals need to engage well qualified staff with proper training to handle the specialist care required for the patients admitted to. The physical requirements including space, equipment and man power needed for these facilities depending on the bed strength of the hospital are given in the Part II.\n(v) Physiotherapy Units. - The Physiotherapy units function as support units to the Orthopedic Care Specialist centers or the facilities may function independently. These units need to be managed by qualified physiotherapists and to be equipped with a whole range of physiotherapy and rehabilitation equipment. The physical requirements including space, equipment and man power needed for these facilities depending on the bed strength of the hospital are given in the Part II.\n(v) Physiotherapy Units.\n(vi) Dental Care Services. - The Dental Services are offered as outpatient services through Clinics from basic dental services to multispecialty dental treatments. The minimum requirements including space, equipment and man power needed for these facilities is given in the Part II.\n(vi) Dental Care Services.",
"footnote": "",
"is_definition": true,
"sort_order": 16
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{
"number": "2",
"title": "2. Establishments offering Diagnostic Support. - The diagnostics services are offered by various laboratories",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 17
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"number": "2",
"title": "2. Establishments offering Diagnostic Support.",
"chapter": null,
"content": "(i) Clinical Biochemistry Labs and Pathology Labs\n(ii) Haemotology Labs\n(iii) Microbiology and Serology Labs\n(iv) Histopathology Labs and Cyto-pathology Labs\n(v) Cytogenetics Labs\n(vi) Immunology Labs\n(vii) Radio Immune Assays Labs\n(viii) Radiology and Imaging Services\n(i) Clinical Laboratories. - The laboratories may be comprehensive, performing tests related to several laboratory disciplines such as clinical biochemistry', clinical pathology, microbiology and serology, histopathology (anatomical pathology hematology, cyto-pathology, cy to-genetics, immunology, or may be limited its scope to a few disciplines.\n(i) Clinical Laboratories.\nThe type and extent of laboratory facility to be available for a nursing home would depend on the functional programme of the nursing home. But provisions shall be made for the following minimum procedures to be performed on site or at a nearby facility: Blood counts, urinalysis, blood glucose, blood urea and nitrogen, coagulation profile (bleeding time, clotting time, prothrombin time), Blood grouping, typing and cross matching, serum electrolytes, serum amylase\nThe physical requirements including space, equipment and man power needed for these facilities depending on the bed strength of the hospital are given in the Part II.\n(ii) Radiology and Imaging Centers. - The radiology and Imaging centers may be comprehensive, performing tests related X-ray imaging, Ultrasound imaging, Computer Tomography, Magnetic Resonance Imaging etc. or may be limited its scope to a few disciplines. Equipment and space for these centers would have to be planned according to the equipment services planned. In the minimum following X-rays should be possible: X-ray chest, abdomen, and pelvis in the basic X-ray units. In Big centers attached to any hospital providing emergency surgical facilities, the X-ray machine should be installed within the nursing home premises. In smaller facilities, it should be possible to have access to such X-ray facilities within one hour. Portable ECG facilities should be available in all nursing homes round the clock. The Ultra Sound Scanning facilities are also may be comprehensive providing services in Colour Doppler Imaging, Basic Abdominal Scanning facilities, and Obstetrics scanning facilities and in some centers may offer Ultrasound Guided Biopsy of the tumors for Cytology testing.\n(ii) Radiology and Imaging Centers.\nPart II\nGeneral Requirements\n(A) Functional Program.\n(1) Emergency First Aid. - Emergency first aid is care provided initially to stabilise a victim's condition and to minimise potential for further injury during transport to an appropriate service. At minimum each nursing home shall have provisions for emergency first aid treatment for staff as well as for persons who may be unaware of or unable to immediately reach services in other facilities. This is not only for minor incidents that may require minimal care but also for persons with severe injuries or in grave condition who must receive immediate first aid and assistance for transport to other facilities.\n(1) Emergency First Aid.\n(2) General Medical Care Services. - The medical care services do not require any special infrastructural input. It is mainly a question of medical skill and hence medical patients are normally admitted to hospitals or nursing homes, which provide care in other disciplines. All hospitals or nursing homes providing medical facilities should be able to provide Clinical diagnosis for infectious diseases, diabetes, hypertension, auto-immune disorders etc. Treatment and follow-up care for a majority of these conditions would also be possible by a physician. Medical personnel manning such a facility should be able to take a decision regarding cases which require higher medical skills or which may eventually need transfer to a better equipped facility (intensive care, surgical facility with ventilators, haemodialysis machine, cardiac monitors etc.) and accordingly transfer such patients at the earliest.\n(2) General Medical Care Services.\n(3) General Surgery services - A general surgery care facility should be able to provide elective general surgery services for benign anal conditions, inguinal hernia, hydrocele, varicose veins, testicular tumours and abscesses, vasectomy and splenectomy. Elective surgery for uncomplicated urolithiasis, gall bladder conditions and closed reduction of fractures can be performed, if portable X-ray facility is available. The emergency care for cases of acute abdomen, strangulated hernia, torsion testis, etc. can be provided, subject to condition that the facility have X-ray facilities within the hospital and access to Blood Bank and Ultra-Sonography facilities are available within half an hour.\n(3) General Surgery services\n(4) Pathology. - There should be provisions in hospitals or nearby location for minimum pathological tests to be performed on site or at a nearby facility.\n(4) Pathology.\n(5) Power Supply. - For the running of a hospital the availability of power supply is of utmost importance. Those with nonavailability of continuous power supply, a generator should be available.\n(5) Power Supply.\n(6) Water. - The hospitals should make arrangements for drinking water for regular usage either from the municipal/ gram panchayat authority and should have storage facility either underground or in an overhead tank.\n(6) Water.\n(7) Transportation and Communication facilities. - Communication and transport facilities should be a prerequisite for the functioning of a hospital as the time for providing any intervention is often critical. It should be the responsibility of the hospital to provide proper transportation facilities to the patients especially when they are referred by the hospitals. The hospitals should have the facility of a telephone in case of an emergency and to have a communication between the doctor and the supportive services and with patients.\n(7) Transportation and Communication facilities.\n(8) Fire fighting. - Fire fighting equipment should be available as per the requirements of the building spaces.\n(8) Fire fighting.\n(9) Facilities and Space. - A hospital should have certain basic facilities in terms of various zones for the provision of treatment. These arc the waiting room, dispensary/pharmacy counter, bathrooms, consulting room, dispensary/pharmacy counter, toilets, bathrooms, wards among others. Those providing surgical services and maternity services should have a operation theatre, labour room, sterilisation room, changing room etc.\n(9) Facilities and Space.\n(10) Waiting Room. - The waiting and consultant room are the first entry points of a patient visiting the hospital. Certain basic facilities need to be provided for the comfort of a patient during his waiting. The environment of the waiting room should be such that it is pleasing and not congested. Various types of information need to be provided. The doctors qualification, registration in the council and schedule of fees should be displayed in the waiting room prominently. There should be a proper system of entry to the doctors chambers. Enough space should be provided for the patients and their relatives to sit in the waiting room.\n(10) Waiting Room.\n(11) Consultancy Room. - Adequate with an examination table with mattress a revolving stool. The privacy of the patient is of utmost importance, especially for women. There should be either a screen with curtain or a separate room for examination of women patients. It is imperative that there is a wash basin and sufficient water in the consulting room, as the doctors examine different types of patients.\n(11) Consultancy Room.\n(12) Wards. - The wards should be separate for male and female patients, infectious and non-infectious diseases. There should be a floor.area of 50-90 Sq ft per bed, a minimum distance of 2.2sq ft between centres of two beds, and the beds should be laid out in such a way as to make the patient accessible for treatment from either side.\n(12) Wards.\n(13) Operation Theatre (OT)/Labour Room. - Hospitals providing surgical services should have a facility of an operation theatre. The hospitals providing Obstetrics and Gynaecology services exclusively and others in addition to medical and surgical services, should have an OT and a labour room.\n(13) Operation Theatre (OT)/Labour Room.\n(14) Equipment and instruments. - The equipment and instruments standards are given in the Part VII in detail inclusive of minor and major instruments and their number. The availability of equipment and instrument is of vital concern. They should be available in sufficient numbers and be in a working condition. They should be well maintained.\n(14) Equipment and instruments.\nB. Location and Design of the Buildings.\n(a) All Private Medical Care Establishments shall maintain the basic and adequate provisions for Toilets and Clean Drinking water as required for the patients, visitors and as well as their own staff working in the establishment. Efforts shall be made for water conservation and rain water harvesting methods in its premises. (Please see Part V)\n(b) All the rooms/ward should be properly ventilated and have adequate Lighting facilities.\n(c) All rooms, wards, operation theaters, labour room, special care areas, outpatient departments and diagnostic departments should be easily approachable by a stretcher and a wheel chair.\n(d) It should ensure that the required privacy is provided to the patient.\n(e) The duty staff room should be centrally located in the hospital and there must be a provision for every patient in the hospital to seek the attention of the duty staff immediately.\n(f) The special care areas of a hospital like the operation theaters, labour room, postoperative wards and intensive care units should be located close to each other for functional and administrative ease.\n(g) The outpatient and diagnostic services should be located away from the inpatient services.\n(h) Facilities to isolate an infected case should be available.\n(i) A telephone is a must for every hospital.\nC. Essential Equipment.\n(a) Cots-It is essential to have patient cots with a hard base because it facilitates cardiopulmonary resuscitation when the need arises.\n(b) Adequate linen-linen should be clean and changed at regular intervals.\n(c) Examination Table\n(d) Emergency Light\n(e) Stethoscopes and B.P. apparatus\n(f) Ophthalmoscope\n(g) Knee hammer\n(h) Measuring tape (i) Torch light\n(j) Weighing machine-adult and paediatric (k) I.V. stands (1) Wheel chair (m) Oxygen cylinders (at least two) with flow meter and mask or nasal prongs (n) Laryngoscope set and Endo-tracheal tubes (o) Suction apparatus (p) Resuscitation bag (Ambu bag)\n(q) Steriliser\n(r) Drums to carry sterile dressing and instruments (s) Bed side toilet equipment (urinals, bed pans, etc,)\n(t) Bed side screens (u) Thermometer (v) Tongue depressors\nD. Essential Drugs And Consumables.\n(a) Adrenaline\n(b) Atropine\n(c) Aminophyline\n(d) Cholorphenaramine\n(e) Hydrocortisone and Dexamethasone\n(f) Furesemide\n(g) Soda bicorbonate\n(h) Dopamine\n(i) Mephentine\n(j) Calcium gluconate (k) Pentazocine/pethidine or any other analgesics (1) Diazepam (m) Hemostyptics like ethamsylate, styptochrome and botropase (n) I.V. Fluids-Dextrose 5%, 10%, 25%, Dextrose saline, Normal saline, Electrolyte solution (Adult and Paediatric) and Plasma expanders (Hemaccel)\n(o) I.V. Sets and I.V. Cannula - (Adult and Paediatric)\n(p) Scalp vein sets of different sizes (q) Syringes-2, 5, 10, 20cc, disposable or sterilized (r) I.V. Mannitol 10%, 20%\n(s) Anti septic solutions - Dettol, savolon, spirit, betadine etc.\n(t) Plaster and Bandages\nE. Operation Theatre.\n(a) A clean and spacious room (minimum of 120-200 sft) sealed off from the surroundings\n(b) Complete Asepsis should be maintained\n(c) Adjustable theatre table for different manipulations either Hydrualic or Manual\n(d) Over head theatre light or Mobile Shadowless light\n(e) Electro Surgical Unit\n(f) Suction apparatus\n(g) Anaesthesia machine (no surgery including under regional anaesthesia should be performed in the absence of an anaesthesia machine)\n(h) Adequate supplies of gases specially oxygen\n(i) Ambu resuscitation bag\n(j) A high pressure autoclave\n(k) Linen and instruments depending on the nature of surgery\n(l) Laryngoscope with adult and paediatric blades\n(m) Paediatric anaesthesia circuit\n(n) Endo tracheal tubes of different sizes\n(o) Spinal anaesthesia sets - it is advocated to use disposable spinal needles and syringes, as they are reasonably cheap now and will go a long way in preventing some of the dreaded complications such as infections.\n(p) Stretcher with trolley for shifting patients\n(q) I.V. Stand with I.V administration facilities\n(r) In hospitals performing caesarean Parts, it is essential to have the neonatal resusciatation kits as mentioned in the maternity services item.\n(s) Drugs - adrenaline, neostigmine, aminophyline. pentathol sodium, succinlycholine, gallamine, pavulon, pentazocine, diazepam, xylocard, xylocaine 5, 2, 1%, hydrocortisone, chlorphenaramine, dexamethasone, dopamine, mcphentine, frusemide, mannitol, ether, halothane, soda bicarbonate, deriphyllin, metoclopromide, promethazine, I.V. Cannula, I.V. Sets, scalp vein tubes, Xylocaine zelly, antiseptic solutions, I.V. Fluids, hemaccel and airways.\n(t) Proper facilities should be available for scrubbing.\n(u) Air conditioned\nF. Labour Room.\n(a) A floor area of a minimum of 120 sq. ft\n(b) All precautions for asepsis must be taken\n(c) Good illumination with overhead O.T light\n(d) Electrical Cautry and Suction apparatus\n(e) Stethoscope, B.P Apparatus and Weighing machines-Adult and Paediatric\n(f) Resuscitation equipment and Paediatric resuscitation equipment (Paediatric resuscitation bag, endo tracheal tune (2 No.) Laryngoscope with neonatal blade, stomach tube (infant feeding tube etc.\n(g) Oxygen cylinders with connections and masks\n(h) Delivery table with basic manipulations\n(i) Autoclave\n(j) All emergency drugs (as in para D above)\n(k) IV stand and intravenous fluid administration facilities\n(l) Stretcher with trolley for shifting patients.\n(m) Forceps for delivery\nG. Important Zoning requirements of the Different Functional Areas.",
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"content": "Obstetric and Gynaecological Clinic. - In case of maternity home providing obstetrics and gynaecological services to have the clinic as described below:\nObstetric and Gynaecological Clinic.\nThe clinic should include a separate registration, consulting - cum - examination room and toilet in order to ensure privacy. The clinic should be planned close to inpatients ward units to enable them to make use of the clinics at times for ante and post natal care. The clinic should also be at a convenient distance from other clinics in the Outpatient Patient Department.\n(ii) Critical Zone. - This zone is required in surgical and maternity homes. This zone consists of the Operation Theater and Delivery Suite.\n(ii) Critical Zone.\nThis is technically a therapeutic aid in which a team of surgeons, anaesthetists, nurses, gynaecologists and sometimes pathologist/s and radiologist/s operate upon or care for the patient. The critical zone shall be located and arranged to prevent non-related traffic through the suites. When delivery and operating rooms in the same suite, access and service arrangements should be such that neither staff nor patients need to travel through one area to reach the other.\n(iii) Operation Theatre.\n(iii) Operation Theatre.\nProtective Zone. - Consisting of Nursing station with storage facility, changing rooms, staff arrive through this Zone and proceed via changing areas dressed for their task.\nProtective Zone.\nClean Zone. - This includes the recovery room. It is principally the corridor linking the transfer bay to the theatre suite. Patients are brought from the ward and should not cross this zone in their ward - clothing which is a great source of infection. Changeover of trolley should be affected just before the clean zone.\nClean Zone.\nAseptic or sterile zone. - It consists of operation theatres, sterilisation; theatre pack preparation and sterile storage, scrub up and gowning rooms.\nAseptic or sterile zone.\nDisposal zone. - Also erroneously called the dirty zone. Soiled instruments and dressings are transacted through this area for washing and sterilisation or disposal.\nDisposal zone.\n(iv) Delivery suite. - (Required for nursing homes providing maternity facilities)\n(iv) Delivery suite.\n(v) Nursery for New Born. - All nursing homes providing maternity facilities must also provide for a nursery for normal babies.\n(v) Nursery for New Born.\nH. Other Facilities.\nI. Special Care Units.\n* Post-operative wards\n* Intensive care units\n* Intensive Care Unit providing speciality care.\n(1) Post - Operative Wards. - The immediate post-operative period is as the intra-operative period in determining the final outcome of any operative procedure. A number of studies have clearly indicated that this is one of the factors contributing to post-operative morbidity and mortality. The essential requirements are:\n(1) Post - Operative Wards.\n(a) All facilities and drugs mentioned earlier under General requirements.\n(b) Monitors. - Monitoring is the basic purpose of post-operative wards. The basic parameters like - pulse rate, blood pressures, respiratory rate and urine output should be monitored and this dies not require any additional equipment. However, it is essential for every post-operative ward to have a pulse taximeter and an ECO monitor with a defibrillator. The big centers in addition may have capnography, ventilators, infusion pumps, NABP, temperature monitoring devices and arterial blood pressure monitoring. Oxygen delivery systems. There should be always be a crash cart available with emergency drugs and equipment as described in the Part 3 of General conditions.\n(c) Staff. - The most vital necessity of a post-operative ward is the presence of specially trained staff. The staff should have adequate knowledge of the possible post-operative complications and should be able to recognize them early and call for the concerned doctor.\n(2) Intensive Care Units.\n(2) Intensive Care Units.\n(a) Design Considerations. - he beds in an ICU should be laid out in such a way as to permit observation of every patient from the nursing station. The beds should have a firm base to permit cardio-pulmonary resuscitation and should be movable easily. Provision must be there to alter height of the head and foot ends of the patient and the plank at the head end must be detachable to facilitate endo-tracheal intubation when required. There should be adequate moving and working space around the beds. These units should be declared as restricted areas and attenders should be kept away. Adequate attention should be paid towards asepsis.\n(b) Staff. - A minimum of one Trained/ qualified nursing staff for 5 beds round the clock and a Duty doctor should be available round the clock. The staff nurses posted shall be well versed with the different equipment operation and should be trained to handle critical situations. An anaesthetist by virtue of his training in emergency care and being the best to maintain two vital body functions (Circulation and respiration) is the choice to manage the Intensive Care Units with the help and guidance from the concerned consultants.\n(b) Staff.\n(c) Materials and Supplies. - All the necessary emergency drugs as detailed in Part-I: General requirements should be made available. In addition to the essential equipment, the additional equipment required are: a Pulse Oximeter, ventilator, infusion pumps, ophthalmoscopes, glucometer and the resuscitation equipment viz i. Laryngoscope, ii. Endo-tracheal tubes of different sizes and connectors, iii. Oxygen cylinders, masks and connections, iv. Ambu bag etc. Preferably a Generator should be installed, as an alternate power supply requirement. Round the clock laboratory support in necessary.\n(c) Materials and Supplies.\n(3) Speciality Specific Intensive Care Units. - Intensive care units dealing with a single speciality (neuro-care units, coronary care units, respiratory care units and trauma care units) are the best way to provide the Intensive care services. The basic requirements are the same as general intensive care unit and each speciality care units need to have additional facilities specific to the speciality such as temporary pacing, critical Equipment such as Cardiac monitors and defibrillators for ICCUs, Incubators and warmers for NICUs.\n(3) Speciality Specific Intensive Care Units.\nJ. Hospital Staff.\n(1) The staff of a hospital or a nursing home may be classified in the following categories:\n* Specialists or Consultants\n* Duty Medical Officers\n* Nursing Staff\n* Helpers\n* Administrative staff\n* Maintenance staff\n* Other staff\n(i) Specialists or Consultants. - Consultants are specialists in different fields of medicine who provide expert medical care are services to the patients in a hospital. The number and type of consultants required by a hospital depends on the nature of services provided by each individual institution.\n(i) Specialists or Consultants.\n(a) Physician. - M.D. degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or equivalent from a local recognised body.\n(a) Physician.\n(b) Surgeon. - M.S. degree from a university OR Diploma from Diplomate of National Board or equivalent from a local recognized body.\n(b) Surgeon.\n(c) Obstetrician and Gynaecologist. - M.D. degree from a university or equivalent from a local recognized body OR diploma from Diplomate of National Board or local recognised bodies (like C.P.S) or university or equivalent from a local recognised body.\n(c) Obstetrician and Gynaecologist.\n(d) Anaesthetist. - M.D. degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies (like C.P.S) or university or equivalent from a local recognized body.\n(d) Anaesthetist.\n(e) Paediatrician. - M.D. degree in Pediatrics from university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognised body.\n(e) Paediatrician.\n(ii) Duty medical Officers. - It is a must for every hospital to have a doctor within the premises of the hospital round the clock. These doctors should be well oriented to the working of the hospital and should posses adequate skill to handle the emergencies, till the services of a consultant are available. There should be one duty medical officer available for every 20 inpatient beds or part thereof in every eight hour shift. A qualified doctor is a must for proper care to be provided to the patient. The practise of doctors trained in other systems of medicine providing care in Allopathy system of medicine is not permitted.\n(ii) Duty medical Officers.\n(iii) Nursing Staff. - There should be one trained/qualified nurse on duty round the clock for every 10 beds in the regular wards and for every 3 beds in a special care areas need additional training and care should be taken not to post untrained staff into these critical areas.\n(iii) Nursing Staff.\n(iv) Helpers. - The ratio of this category of staff to the number of beds remains the same as for the nursing staff and it is once again emphasised that only specially trained staff should be posted in labour rooms, operation theatres and intensive care areas.\n(iv) Helpers.\n(v) Administrative Staff. -This category of staff includes - Managers, receptionists, accountants, supervisors, security personnel etc. The requirement of this category of staff depends solely on the type of a hospital and its size. As the size of a hospital increases the need for this category of staff also increase proportionately.\n(v) Administrative Staff.\n(vi) Maintenance Staff. - The secret behind any successful organization is a foolproof maintenance mechanism, and today the emphasis is on preventive maintenance the maintenance staff include an electrician a plumber and a carpenter, and for the maintenance of medical equipment a smaller hospital could enter in to yearly service contract and a bigger hospital may find it more convenient to have a full fledged bio-medical engineering department in addition to AMC (annual maintenance contract).\n(vi) Maintenance Staff.\n(vii) Other Staff. - As the size of a hospital increases so do the facilities at the hospital and the requirement of other grades of Staff for example : a pharmacist is required when there is a pharmacy, a laboratory technician is required when there is a pathological laboratory and an X-ray technician is required for each X-ray plant.\n(vii) Other Staff.\n(2) Availability of Personnel. - As soon as a patient arrives at a nursing home, (in emergencies) he or she should immediately be seen by a Duty Medical Officer. A consultant should see the patient within half an hour.\n(2) Availability of Personnel.\n(3) Minimum requirement of personnel.\n(3) Minimum requirement of personnel.\n(a) Duty Medical Officer. - * One duty medical officer for every 20 inpatient beds or part thereof in every eight hour shift.\n(a) Duty Medical Officer.\n* Two duty medical officers to function as O.T. assistants during routine O.T. hours (8 hours) and one each for the next two shifts in those facilities providing emergency surgical care and obstetrics care (nurses could be trained to perform this function).\n* One duty medical officer for the labour ward in every eight hour shift (Optional). This function may be performed by the O.T. assistant or a trained nurse.\n(b) Nursing staff. - * One nurse for every 10 beds if on same floor on every eight hour shift and if on different floors then in same proportion on different floors. Here one nurse undergoing training may be posted along with a qualified nurse.\n(b) Nursing staff.\n* Two qualified operation theatre nurses for routine surgery. For nursing homes offering maternity facilities and emergency surgical facilities two more operation theatre nurses will be required on shifts. (In practise the number of Nurses posted specifically for this area would depend on the patient load there.)\n* Four qualified nurses for labour room. One in each eight hour shift. They may also function as O.T nurses when required.\n* One nurse should be kept available for emergency patients on every eight hour shift.\n* During regular OPD hours one more nurse should be kept available for OPD block.\n(c) Nursing Orderly. - * One Female Nursing Orderly or one Male Nursing Orderly for every 8 beds for every eight hour shift.\n(c) Nursing Orderly.\n* One Female Nursing Orderly for Obstetrics and Gynaecology OPD.\n* One Male Nursing Orderly for Surgical and Medical OPD\n* One Female Nursing Orderly for Labour room\n* One Female or Male Nursing Orderly for Operation Theater\n* One sweeper per eight beds for wards in ever 8 hour shift\n* One sweeper for Operation theatre and Labour room.\nCheck List of Appendix - I\nObstetrics And Gynaecology: Standard Services Recommended For Each Level\nSI.No.\nCondition/Procedure\nBasic Level Services\nSpecialist Care Services\nSuper Speciality Services\n1\nDeliveries\nNormal Deliveries\nAll deliveries including complicated deliveries\n2\nThreatened of incomplete abortion\nConservative management D and C\nTreatment\n3\nFamily Planning\nTubectomy IUD\nBasic Level services + Laproscopic tubectomy\n4\nLower abdominal pain and ectopic pregnancy\nStabilise and Refer\nExploratory tubectomy\n5\nVaginal disease\nDiagnosis and Management\nExam under anaesthesia\n6\nHigh risk pregnancy\nEarly diagnosis and timely referral\nInvestigate initiate management\n7\nPID\nDiagnosis and Therapy\nDiagnosis and Therapy\n8\nMenstrual irregularities\nRefer\nDiagnosis and Management\n9\nInfertility\nRefer\nDiagnosis and Management\n10\nCervical erosion\nRefer\nPAP Smear and Bio spy\nCader Surgery\n11\nMalignancies\nRefer\nDiagnosis\nSurgery radiotherapy\nInspection Report (Under Rule 4(h))\nInspection Report (Under Rule 4(h))\nPerforma of Inspection Report for Granting Licence to Private Medical Care Establishments under the Act\nPerforma of Inspection Report for Granting Licence to Private Medical Care Establishments under the Act\nName and Address of the Medical Care Establishment (MCE)\nName and Address of the Company/Director\nLocation of the MCE\n(Urban/Municipal/Rural/Tribal)\nIs the MCE attached to any Medical College/Research Institution\nName of Medical Director/Superintendent\nIs the accommodation owned by the Company? Or is it on lease? If\n\t\t\t\tit is on lease what is the period and conditions of lease\n\t\t\t\t(Evidence to be enclosed)\nState whether the above said accommodation suitable for running\n\t\t\t\tMedical Care establishment\nOne set of Photographs of the MCE with its functional facilities\nThe names of the Specialists/Consultants working in the MCE\nThe Equipment and Furniture available in the MCE (List to be\n\t\t\t\tenclosed)\nPassport size photos of Director/Medical Superintendent to be\n\t\t\t\tattached\nApplication No.:\nApplication date\nApplication Fee Particulars\nDate of Inspection (Enclosed Inspection format to be filled)\nInspection done by\nDetails of the major specialities offered in the Medical care Establishment with beds allotted\nDetails of the major specialities offered in the Medical care Establishment with beds allotted\nGeneral\nEmergency\nSpeciality-wise beds, pl. specify\nTotal\nActivity\nDate of Previous Years\nTotal Out Patients (Old + New)\nTotal Inpatients\nTotal No. of Major operations\nTotal No. of Deaths\nDeaths after 48 hours of admission\nBed Occupancy rate\nFinancial Accounts\nTotal Hospital Fee Collection. (Audited\nFinancial Statements to be enclosed)\nTotal reimbursements claimed from\nGovernment towards the treatment of referred patients, if any\nFlow of funds towards their Activities (External Aids/ Public/\n\t\t\t\tPrivate contributions, pl. specify)\nInspection Proforma to be filled by the Inspection Team\nInspection Proforma to be filled by the Inspection Team\n(Relevant to the Inspection of 100 beds and more Hospitals)\nIndex\nIndex\nNo\nItem\nPage No\n(1)\nOut Patient Department Services\n1\n(2)\nEmergency Services Department\n2\n(3)\nIntensive Care Unit\n3\n(4)\nClinical Laboratory\n4\n(5)\nBlood Bank\n5\n(6)\nRadiology Department\n5\n(7)\nOperation Theatre\n7\n(8)\nCentral Sterile Supply Department\n8\n(9)\nLabour Room\n9\n(10)\nWards\n10\n(11)\nDiet and Kitchen Facility\n11\n(12)\nLinen and Laundry Services\n11\n(13)\nMedical and Non Medical Stores\n12\n(14)\nMedical Records\n12\n(15)\nTraining, C M E and I E C Activities\n12\n(16)\nAmbulatory Services and Telecommunications\n12\n(17)\nCommitments to National Health Programmes\n12\n(18)\nEnvironment Sanitation and Water Supply\n13\n(19)\nPatient Attendant facilities\n13\n(20)\nResearch activities\n13\n(21)\nAdministrative Department\n14\n(22)\nMortuary\n14\n(23)\nImportant hints for computing Hospital Performance\n14\nImportant Hints For Computing Various Hospital\n\t\t\t\tActivity Indicators\nImportant Hints For Computing Various Hospital\n\t\t\t\tActivity Indicators\n1 Bed Occupancy Rate:\n1 Bed Occupancy Rate:\nTotal In Patient\n\t\t\t\tbed-days\n-----------------------X 100 = ----- Bed\n\t\t\t\tCapacity\n2 Average Length of Stay =\n2 Average Length of Stay =\nTotal In Patient\n\t\t\t\tbed-days during 12 months\n-----------------------\n\t\t\t\t= --------------------\nDischarge + Deaths during 12 months\n3 Turnover rate (interval) =\n3 Turnover rate (interval) =\n(Annual Bed Capacity\n\t\t\t\t- IP Bed – days)\n----------------------------------------------\n(Discharge + Deaths during 12 months)\n4 Case Flow Rate =\n4 Case Flow Rate =\nTotal Discharges +\n\t\t\t\tDeaths during 12 months\n----------------------------------------------\nTotal Beds existing in the Hospital.\n5 Gross Death Rate :\n5 Gross Death Rate :\nRatio of total deaths to total discharges. In\n\t\t\t\tGeneral Hospitals it should be about 3-5 per cent.\n6 Net Death Rate (Institutional Deaths):\n6 Net Death Rate (Institutional Deaths):\nNo. of deaths\n\t\t\t\toccurring 48 hours or more after admission, should not usually\n\t\t\t\t2.5 percent\nNo. of deaths due to\n\t\t\t\tanaesthesia\n---------------------------------------X 100\n7 Anaesthetic Death Rate:\n7 Anaesthetic Death Rate:\nNo. of patients anaesthetized during the period\n8 Post Operative Death rate\n8 Post Operative Death rate\nPost operative deaths\n---------------------------------------XI\n\t\t\t\t00\nTotal operations during a given period\n9 Maternal Death Rate:\n9 Maternal Death Rate:\nTotal deaths of obstetric clients\n\t\t\t\t----------------------------------------XI00\nTotal discharges\n\t\t\t\tincluding deaths of Obst....Ward\nNo.\nFacilities\nAvailability (Yes/No)\nRemarks, if not satisfied\n(1)\n(1)\nOut Patient Department (OPD)\nOut Patient Department (OPD)\n(b)\nReception Counter:\n(i)\nPosting of knowledgeable staff as a Receptionist\n\t\t\t\twith a board \"May i help You?\"\n\"May i help You?\"\n(ii)\nAll sections of the OPD numbered and depicted on\n\t\t\t\tflow chart near reception counter.\n(iii)\nBoards indicting days of Special Services and\n\t\t\t\tHospital timings near reception counter\n(b)\n(b)\nRegistration:\nRegistration:\n(i)\nSeparate registration windows with railing\n\t\t\t\tarrangements for Male/Female, Old/New, Freedom Fighters and\n\t\t\t\tGovernment Servants:\n(ii)\nBoard indicating hospital fees for various\n\t\t\t\tservices provided for OPD, IPD and Surgical Procedures\n(c)\n(c)\nOPD Sections:\nOPD Sections:\n(i)\nEvery OPD section should have : separate\n\t\t\t\tregister for diagnosis, Complete examination tray with BP\n\t\t\t\tApparatus, torch and hammer, x-ray view box, examination table\n\t\t\t\twith foot steps, writing table, stool for patients wash basin,\n\t\t\t\tadequate sitting arrangement for waiting OPD patients,\n\t\t\t\tappropriate Health Education material displayed.\n(ii)\nin addition to above.\nMedical OPD:\nMedical OPD:\nCNS examination tray, tuning fork, ECG Machine,\nSurgical OPD:\nSurgical OPD:\nPR examination tray with proctoscope and gloves,\n\t\t\t\tKidney trays, Tongue depresser\nGynaec. OPD:\nGynaec. OPD:\nPS and Pv examination Tray, iUD tray, Kidney\n\t\t\t\ttray, Weighing machine, pap smear tray, exam table with lithotomy\n\t\t\t\tfacility, table lamp.\nPediatric OPD:\nPediatric OPD:\nPaed. Weighing machine, Measure tape, Height and\n\t\t\t\tWeight Scale.\nOpthalmic OPD:\nOpthalmic OPD:\nNear and Distant vision charts, Refraction set\n\t\t\t\tOpthalmoscope, Dark room facilities for Retinoscopy.\nEar, Nose and Throat OPD:\nEar, Nose and Throat OPD:\nHead light mirror, indirect laryngoscopes,\n\t\t\t\ttounge depresser, Nasal and ear speculum, electric steriliser,\n\t\t\t\ttuning fork, audiometry, diagnostic ENT set, audiometry, wax\n\t\t\t\tsyringe etc.,\nDental OPD: Dental unit, Dental motor,\n\t\t\t\tDental x-ray, Continuos water supply, denture preparation\n\t\t\t\t(prosthesis), Bio-safety measures adopted etc.\nDental OPD:\nOrthopedic OPD: Emanination table, foot\n\t\t\t\tsteps, x-ray view box, patella hammer etc.\nOrthopedic OPD:\n(d)\n(d)\nDressing Room.\nDressing Room.\n(i)\nSeparate dressing rooms for male and female\n\t\t\t\tpatients.\n(ii)\nAutoclaved/Disposable material used.\n(iii)\nDressing table, sink for hand washing available.\n(iv)\nDresser wears Plastic apron, Face mask, gloves\n\t\t\t\tetc. while doing dressing.\n(v)\nAntiseptic lotions and dressing materials and\n\t\t\t\tfoot operated dustbins or adequately available\n(e)\n(e)\ninjection room\ninjection room\n(i)\nSeparate rooms for male and female available.\n(ii)\nStaff nurse is trained in management of\n\t\t\t\tinjection reactions\n(iii)\nUpdated emergency drug tray and Availability of\n\t\t\t\tOxygen Cylinder with accessories, Suction Machine (Electric and\n\t\t\t\tfoot operated), Cot and mattresses with arrangements for head low\n\t\t\t\tposition, venesection tray, chart of management of Anaphylactic\n\t\t\t\treaction, Availability of Wash basin, Bio-safety measures\n\t\t\t\tadopted, inventory maintained.\n(iv)\nSufficient No. of Disposable/Sterile syringes\n\t\t\t\tand needles depending upon OPD load.\n(f)\n(f)\nPharmacy\nPharmacy\n(i)\nAvailability of male and female windows\n\t\t\t\tseparately with railing arrangements\n(ii)\nDaily accounting of drugs kept? (Any proof of\n\t\t\t\tchecking of inventory)\n(iii)\nSurprise check by inspector for actual\n\t\t\t\tdispensing against prescription\n(iv)\nDrugs are dispensed in paper packets\n(v)\nMorbidity statistics kept up to date (verify the\n\t\t\t\trecord)\n(g)\n(g)\nPhysiotherapy\nPhysiotherapy\n(i)\nAvailability of short wave diathermy, infrared\n\t\t\t\tfacilities etc. for Myalagia\n(ii)\nAvailability of Lumbar/Cervical traction for\n\t\t\t\tSpondylitis.\n(iii)\nShoulder mobilization wheels, walking bars\n\t\t\t\tavailable\n(iv)\nWax bath and Muscle stimulator available\n(h)\n(h)\nMinor Operation Theatre and Plaster Room\nMinor Operation Theatre and Plaster Room\n(i)\nAvailability of Anaesthetic apparatus,\n\t\t\t\tshadowless lamp, operation table suction apparatus (electric and\n\t\t\t\tfoot operated), fumigation apparatus,\n(ii)\nAvailability for wash basin, cap, mask, gown,\n\t\t\t\tsleepers, etc.\n(iii)\nAvailability of autoclaved/sterile linen\n\t\t\t\tmaterial, dressing drums, minor surgery instruments, life saving\n\t\t\t\tdrugs and anaesthetic agents etc.\n(iv)\nAvailability of plaster room, plaster material\n\t\t\t\tand plaster cutting saw etc.,\n(v)\ni) Maintenance of records and registers of\n\t\t\t\tminor OT etc.,\n(i)\nSafe Drinking Water Facilities:\nSafe Drinking Water Facilities:\n(i)\nWater coolers available with adequate number of\n\t\t\t\ttaps for OPD\n(ii)\nWater samples are tested for potability. verify\n\t\t\t\tthe register and actions taken on unsatisfactory reports.\n(j)\n(j)\nSanitary Unit\nSanitary Unit\n(i)\nSeparate will-maintained arrangements of toilet\n\t\t\t\tfor male and female patients and their attendants\n(ii)\nSeparate toilets and wash basins for staff\n\t\t\t\tmembers?\n(k)\n(k)\nvehicle parking\nvehicle parking\n(i)\nSeparate stand for staff/public vehicles\n(l)\n(l)\nR.M.O. Office\nR.M.O. Office\n(i)\nAvailability of telephone for RMO and public\n(ii)\nFilm show arrangements made for OPD patients,\n\t\t\t\tverify the register.\n(iii)\nSuggestion book in OPD. Action taken, if any,\n\t\t\t\tfor valid suggestions made.\n(iv)\nAvailability of RMO during entire OPD period and\n\t\t\t\tmusters of interns, class iii and para medicals are available in\n\t\t\t\tRMO's chamber\n(v)\nAvailability of wheel chairs and stretchers for\n\t\t\t\tshifting Pts. From OPD to Ward.\n(m)\n(m)\nverifications of adequacy of treatment\n\t\t\t\t(Minimum 5 case sheets/prescription notes should be checked)\nverifications of adequacy of treatment\n\t\t\t\t(Minimum 5 case sheets/prescription notes should be checked)\n(i)\nClinical notes, Diagnosis, investigations and\n\t\t\t\tLegible hand writing\n(ii)\nProper prescription of drugs with dose schedule\n(iii)\nviews of the patients regarding treatment and\n\t\t\t\ttheir satisfaction\n(2)\n(2)\nEmergency Service Department (Casualty)\nEmergency Service Department (Casualty)\n(i)\nSeparate Medical Officer (CMO) available round\n\t\t\t\tthe clock\n(ii)\nContinuous availability of D.M.O (indoor M 0)\n\t\t\t\tduring night hours.\n(iii)\nBoard displaying doctors on call, Specialist and\n\t\t\t\tother staff on duty\n(iv)\nGlow sign board indicating 'Emergency Services\n\t\t\t\tDepartment'\n(v)\nCasualty Department annexed with Emergency ward\n\t\t\t\twith adequate number of beds and attached toilets facilities.\n(vi)\nWard well equipped with Fowler's bed, Oxygen\n\t\t\t\tCylinder With Accessories, Suction apparatus electric - foot\n\t\t\t\toperated, Emergency tray with essential drugs with Catheter tray,\n\t\t\t\tRules' tubes/stomach tube, flatus tube, venesection tray,\n\t\t\t\ttracheotomy set, L P tray, Suturing tray, Ambu bag, Laryngoscope,\n\t\t\t\tTourniquet, Splints - Thomus splint, Bowler's splint, Crammer\n\t\t\t\twire splints Emergency light/ Generator, BP Apparatus, Torch,\n\t\t\t\tThermometer, weighing machine, hammer, Refrigerator, stationary\n\t\t\t\tand forms\n(vii)\nTrained staff posted in Emergency department\n(viii)\nBoards displayed regarding management of Snake\n\t\t\t\tbite, Common poisoning, Anaphylactic reaction, Cardio respiratory\n\t\t\t\tarrest etc.\n(ix)\nAvailability of ARV services 24 hours. Board\n\t\t\t\tdisplayed accordingly.\n(x)\nKnowledge of M Os in classification of dog bite\n\t\t\t\twounds and their management, training in giving ARV.\n(xi)\nProper documentation of treatment card and\n\t\t\t\trecords/registers.\n(xii)\nUninterrupted Stock of ARv. Check the stock\n\t\t\t\tbook.\n(xiii)\nMedico legal register in prescribed format\n\t\t\t\teither central or individual. 1\n(xiv)\nCall book is in prescribed format and calls are\n\t\t\t\tattended promptly. verify\n(xv)\nAvailability of Disaster Management Plan and\n\t\t\t\tdisaster drill conducted regularly. (verify the record and stock)\n(xvi)\nRetiring room for MO with attached toilet\n\t\t\t\tlockers, Cooler, fan, and drinking water arrangements.\n(xvii)\nNight super nurse on duty should be available in\n\t\t\t\temergency ward after night rounds.\n(xviii)\nTreatment room cum minor operation theatre with\n\t\t\t\tall necessary instruments, equipment, trolleys, tables and trays.\n(xix)\nAvailability of separate telephone for Casualty\n\t\t\t\tDepartment as well as for public\n(xx)\nStore room with sufficient stock of essential\n\t\t\t\tand life saving drugs\n(xxi)\nAvailability of sufficient number of wheel\n\t\t\t\tchairs and stretcher trolleys.\n(xxii)\nAvailability of transport facilities (Ambulance)\n\t\t\t\tround the clock.\n(3)\n(3)\nintensive Cardiac Care Unit\nintensive Cardiac Care Unit\n(i)\nExistence of i C U with AC, bedside monitor,\n\t\t\t\tcentral monitors, defibrillators, ventilators, fowlers beds etc.\n\t\t\t\tand round the clock availability of qualified and trained staff.\n(ii)\nEquipment in working condition and history book\n\t\t\t\tmaintained\n(iii)\nSpace availability, cleanliness, generator\n\t\t\t\tfacilities etc.\n(iv)\nAdequate No. of trained Medical Officer and\n\t\t\t\tNursing Staff.\n(v)\nRecord keeping of patients treated so far.\n(vi)\nAvailability of central oxygen, suction machine\n\t\t\t\tand life saving drugs.\n(4)\n(4)\nClinical Laboratories\nClinical Laboratories\n(i)\nQualified Pathologist available, if not efforts\n\t\t\t\tmade for getting the post filled in or suitable alternative\n\t\t\t\tarrangements made.\n(ii)\nExamination of special tests like Widal, serum\n\t\t\t\tbilirubin, LFT, VDRL, BS for M.P., stool examinations, semen\n\t\t\t\tanalysis, electrolyte study, blood gas analysis, kidney function\n\t\t\t\ttests, CSF examination etc\n(iii)\nAccuracy or reports, monthly abstract drawn and\n\t\t\t\tverified by Pathologist.\n(iv)\nAvailability of round the clock laboratory\n\t\t\t\tservices\n(v)\nUse of aprons by laboratory technicians\n(vi)\nAvailability of sufficient wash basins, sinks\n\t\t\t\tfor staining\n(vii)\nProper dispose off of the soiled containers\n\t\t\t\tafter decontamination.\n(viii)\nUse of only autoclaves syringes and\n\t\t\t\tneedles/Disposable needles.\n(ix)\nAppropriate tests carried out as per indication.\n(x)\nObservance of bio safety measures\n(xi)\nRegular availability of staining material and\n\t\t\t\ttheir inventory maintenance.\n(5)\n(5)\nBlood Bank\nBlood Bank\n(i)\nAvailability of infrastructure as per GOi\n\t\t\t\tlicensing norms\n(ii)\nRound the clock availability of trained staff\n\t\t\t\tand services\n(iii)\nChecking of cross matching\n(iv)\nProper maintenance of cold room and\n\t\t\t\trefrigerators\n(v)\nAustralia antigen vDRL, Malaria parasite and H i\n\t\t\t\tv tests are carried out on every blood bottle of donor. verify\n\t\t\t\tthe record\n(vi)\nincidence of deaths due to non-availability of\n\t\t\t\tblood any time in a year\n(vii)\nissue of donor cards, certificate of\n\t\t\t\tappreciation (verify the records)\n(viii)\nProper documentation and examination of donors\n(ix)\nExhibition of posters and health education\n\t\t\t\tmaterials in the blood bank\n(x)\nAvailability of adequate quantity of Sera and\n\t\t\t\tAnti sera reagents\n(xi)\nAdequate stock of blood bags and transfusion\n\t\t\t\tsets\n(xii)\nRenewal of blood bank License as per GOi Rules\n\t\t\t\tand Records\n(xiii)\nDisposal of Hiv positive blood bags and\n\t\t\t\tBio-safety measures undertaken\n(xiv)\nTransfusion of feed back, and record maintenance\n\t\t\t\tof untoward incidences\n(xv)\nMaintenance of inventory of various sera,\n\t\t\t\treagent and consumables. verify.\n(6)\n(6)\nRadiology Department\nRadiology Department\n(i)\nRadiologist is available, if not efforts made\n\t\t\t\tfor getting the post filled in or any suitable alternative\n\t\t\t\tarrangement made for day to day supervision\n(ii)\nStatus of x-Ray machine available.\n(iii)\nAvailability of dark room safe light, film\n\t\t\t\tdrying cabinet x-ray illuminators etc.\n(iv)\nUsed of dosimeter and are they regularly sent to\n\t\t\t\tBARC for checking and steps taken on reports\n(v)\nSpecial investigations like ivP, barium swallow\n\t\t\t\tor barium studies, Hystosalphingography etc.\n(vi)\nAvailability of necessary contrast media for\n\t\t\t\tSpecial investigations (verify)\n(vii)\nRound the clock x-ray services by making x-ray\n\t\t\t\tTechnicians available\n(viii)\nAvailability of all life saving drugs, oxygen\n\t\t\t\tcylinder, suction apparatus etc. to tackle the Anaphylactic\n\t\t\t\treactopm.\n(ix)\nSeparate x-ray register for MLC and recording of\n\t\t\t\tsignature of thumb impressions along with identification mark\n\t\t\t\tetc.\n(x)\nAccurate records, register and inventory,\n\t\t\t\tchecked by Radiologist or RMO\n(xi)\nx-ray films and hypo solutions are preserved\n\t\t\t\t/Disposed as per rules.\n(xli)\nAvailability and use of protection devices like\n\t\t\t\tlead apron, lead gloves, goggles, badges and doismeter etc. by\n\t\t\t\tthe staff working in Radiology department.\n(xiii)\nx-ray diagnosis entered in the register and\n\t\t\t\tchecked/ reported by Radiologist.\n(xiv)\nAvailability of Sanitary block in x-ray\n\t\t\t\tdepartment.\n(xv)\nAvailability of dental x-ray facilities.\n(xvi)\nAvailability of Ultra Sound Scan facility &\n\t\t\t\ttrained Radiologist/Gynaecologist posted.\n(xvii)\nCompliance to the provisions of PNDT Act., in\n\t\t\t\tcase a US Scanner is available. PL verify\n(7)\n(7)\nOperation Theatre:\nOperation Theatre:\n(i)\nAvailability of staff in O.T. as per norms.\n(ii)\nConcept of clean, neutral and sterile zone\n\t\t\t\tfollowed by providing various self closing double doors or air\n\t\t\t\tcurtain etc.\n(iii)\nDimensions of operation theatre are measured and\n\t\t\t\tdoes of potassium permanganate (KMno 4) and formaldehyde\n\t\t\t\tcalculated for doing fumigation on fixed day or as and when\n\t\t\t\tindicated. verify the record.\n(iv)\nAvailability of separate OTs for septic and\n\t\t\t\tinfected cases and also different specialities.\n(v)\nSwabs from OT are sent for culture and action\n\t\t\t\ttaken on unfavourable report. verify the documents.\n(vi)\nPreoperative waiting room with toilet facilities\n\t\t\t\tavailable.\n(vii)\nAvailability of well equipped post operative\n\t\t\t\tward (Recovery room) with adequate No. of beds and resuscitation\n\t\t\t\tmeasures.\n(viii)\nUp to date maintenance of O.T. records like O.T.\n\t\t\t\tregisters, emergency OT, monthly abstract etc. Maintenance of\n\t\t\t\toperation postponement register.\n(ix)\nProper steps taken for disposal of OT waste as\n\t\t\t\tper Biomedical Waste Management Rules (operated specimens etc.)\n(x)\nEmergency light or generator facilities provided\n\t\t\t\tto OT. (verify)\n(xi)\nOT staff nurses available round the clock\n(xii)\nHousekeeping and biosafety measures adopted in\n\t\t\t\tOT\n(xiii)\nAvailability of Boyle's Apparatus, Hydraulic OT\n\t\t\t\ttable, Shadowless lamp, Suction apparatus, Air Conditioner,\n\t\t\t\tElectric cautery, Refrigerator, Electric sterilizers, Autoclaves\n(xvi)\nAvailability of portable mobile x-ray machines\n\t\t\t\tin OT along with dark room.\n(xv)\nCheck list attached to the patient posted for\n\t\t\t\toperation\n(xvi)\nArrangement of transport of patient from OT to\n\t\t\t\tward\n(xvii)\nAvailability of separate changing room for\n\t\t\t\tdoctors, nurses with attached toilet and locker facility and\n\t\t\t\tentrie staff use OT attire.\n(xviii)\nAvailability of fire fighting equipments and\n\t\t\t\tknowledge to use them.\n(8)\n(8)\nCentral Sterile Supply Department\nCentral Sterile Supply Department\n(i)\nAvailability of HP Horizontal Serilizers (H P H\n\t\t\t\tS)\n(ii)\nTrained OT Attendant under supervision of OT\n\t\t\t\tstaff nurse performs the autoclaving (interrogate and confirm\n\t\t\t\tknowledge and procedure)\n(iii)\nA detail chart showing how to operate H P H S\n\t\t\t\tdisplayed\n(iv)\nWall clock made available for noting the time\n\t\t\t\tduring autoclaving process\n(v)\nAll autoclave tape should be preserved and\n\t\t\t\tpasted on register date wise which is to be signed by Staff Nurse\n\t\t\t\tand checked by Anaesthetist (verify the register)\nvi)\nAnaesthetist/Pathologist should be in charge of\n\t\t\t\tC S S D\nvii)\nKnowledge of staff nurse for disinfection of\n\t\t\t\tfibre optic scopes, rubber catheter, linen, sharp instruments,\n\t\t\t\tetc.\n(9)\n(9)\nLabour Room\nLabour Room\n(i)\nSeparate Labour Room with automatic double door\n\t\t\t\tfor clean and septic cases available.\n(ii)\nMinimum 2 labour tables in Clean labour room\n\t\t\t\twith plastic curtain partition.\n(iii)\nFacilities available such as: Wall Clock, baby\n\t\t\t\tweighing machine, facility for head low position, baby\n\t\t\t\tresuscitation kit, mucus aspirator, suction apparatus (electric\n\t\t\t\tor foot operated) along with set of catheter, oxygen cylinder\n\t\t\t\twith accessories for baby and mother, emergency light/generator\n\t\t\t\tconnection, exhaust fan, coolers/fan, episiotomy tray and\n\t\t\t\tvenesection tray, shadowless lamp, forceps low, foetal monitor,\n\t\t\t\tvacuum extractor, B P apparatus, instrument sterilizer, plastic\n\t\t\t\taprons, sleepers, cap, mask, apron, foam mattress on table, Kit\n\t\t\t\tof all life saving drugs\n(iv)\nSame discipline as that of O T is also to be\n\t\t\t\tfollowed for labour room i.e., use of gown, cap, mask, etc.\n\t\t\t\tbefore entering in labour room\n(v)\nAvailability of deep freeze or wooden box with\n\t\t\t\tlock and key for preservation of still born, Placenta, till they\n\t\t\t\tare disposed off.\n(vi)\nEnough No. of aluminium/plastic badges for\n\t\t\t\tidentification of baby and mother.\n(vii)\nRegular washing and fortnightly fumigation of\n\t\t\t\tlabour room\n(viii)\nObservance of proper housekeeping.\n(ix)\nProper writing of delivery notes including the\n\t\t\t\tfoot prints of baby, thumb impression of mother with attestation\n\t\t\t\tof nurse conducting delivery.\n(x)\nMaintenance of call book in prescribed format\n\t\t\t\tand attendance of calls in time\n(xi)\ninterview of 5 mothers delivered recently about\n\t\t\t\ttheir experience regarding facilities, behaviour of staff and\n\t\t\t\tsanitation in labour room\n(xii)\nAvailability of attached toilet facility near\n\t\t\t\tlabour room.\n(xiii)\nArrangement to resuscitate newborn and to keep\n\t\t\t\tbaby warm\n(xiv)\nAvailability of well equipped premature baby\n\t\t\t\tunit with minimum 6 beds.\n(xv)\nAvailability of separate incubators for hospital\n\t\t\t\tdelivery cases and home delivery referred newborns\n(xvi)\nStaff trained in premature baby care.\n(xvii)\nArrangement for prevention of Hypothermia.\n(xviii)\nAvailability of Phototherapy unit, Oxygen hoods\n(xix)\nProper maintenance of record, registers of\n\t\t\t\tnewborns.\n(xx)\nPrecautionary measures adopted to prevent sepsis\n\t\t\t\tlike barrier nursing, change of cloths by staff\n(xxi)\nWritten instructions about operation of\n\t\t\t\tincubator displayed\n(10)\n(10)\nWards\nWards\n1.\nSatisfactory cleanliness of the wards.\n2.\nSatisfactory condition of the sanitary blocks\n3.\nif, floor beds in the wards present, analyze the\n\t\t\t\treason\n4.\nSatisfactory upkeepment of Cots, Mattresses,\n\t\t\t\tBedside lockers, Lenin etc.\n5.\nUse of hospital uniforms by all patients.\n6.\nAvailability of Suction apparatus (electric and\n\t\t\t\tfoot operated), oxygen cylinders with accessories, venesection\n\t\t\t\ttray, emergency tray emergency light, BP apparatus, equipments\n\t\t\t\tfor sterilization, wheel chair-es, stretcher troll and\n\t\t\t\tstationaries, forms etc\n7.\nSuggestion book in wards and cognizance taken\n8.\nConcept of progressive patient care i.e. serious\n\t\t\t\tpatients on fowlers bed with all essential equipments and drugs\n\t\t\t\tnear Nursing Station.\n9.\nDisplay of name at head end of patients\n10.\nAdequacy and working of fans and tubes\n11.\nAvailability of geysers in working conditions\n12.\nSrutinize 4 inpatient case sheets and ascertain\n\t\t\t\tadequacy of notes, prescriptions, provisional and final\n\t\t\t\tdiagnosis, operation and aesthesia notes, documentation of\n\t\t\t\tinvestigations, information to relatives about seriousness of the\n\t\t\t\tpatient. Evidence of cases seen by Specialist doctors. Patients\n\t\t\t\tand relatives satisfaction.\n13.\nSatisfaction of patients about type of diet,\n\t\t\t\tquality and quality, if provided by the facility\n(11)\n(11)\nDiet and Kitchen Facility\nDiet and Kitchen Facility\n(i)\nAvailability of different types of diets\n(ii)\nPhysical verification of dietary articles done\n\t\t\t\tany time. verify\n(iii)\nAvailability of diet charts for adult,\n\t\t\t\tpaediatric and special diet\n(iv)\nArrangements for washing vegetable and vegetable\n\t\t\t\tcutting platform\n(v)\nSatisfactory cleanliness of kitchen\n(vi)\nSatisfactory arrangements for preventing rat\n\t\t\t\tnuisance\n(vii)\nAvailability of modern gadgets like mixer\n\t\t\t\tgrinder, chapatti puffer, hot case, tea urns, bulk cooker,\n\t\t\t\trefrigerators, atta needing machines.\n(viii)\nAvailability of stainless steel with copper\n\t\t\t\tbased utensils for cooking\n(ix)\nSatisfactory arrangements for washing the\n\t\t\t\tutensils\n(x)\nSatisfactory arrangements for storing the food\n\t\t\t\tgrains\n(xi)\nRegular medical check up of food handlers.\n\t\t\t\t(verify the records)\n(xii)\nRegular organization of diet committee meeting\n\t\t\t\t(very the minutes)\n(xiii)\nAvailability of food testing register and\n\t\t\t\tremarks\n(xiv)\nSending of samples of dietary articles for PAF\n\t\t\t\tstudies and action taken on results\n(xv)\nAvailability of lactometer measuring unit,\n\t\t\t\tweighing machine and weights\n(xvi)\nAction taken on substandard supply of dietary\n\t\t\t\tarticles\n(12)\n(12)\nLinen and Laundry services\nLinen and Laundry services\n(i)\nAvailability of Linen Keeper/satisfactory\n\t\t\t\talternative arrangements.\n(ii)\nAvailability of linen as per norms.\n(iii)\nAvailability of buffer stock of linen to face\n\t\t\t\tDisaster Emergencies\n(iv)\nUpkeep of linen register\n(v)\nHospital linen stamped by Dhobi ink\n(vi)\nRegular disposal of condemned linen materials\n(vii)\nServices of tailor utilized adequately for\n\t\t\t\tmaking new OT wears eye shade and mending the torn cloths etc.\n(viii)\nA practise of Dirty/spoiled linen are\n\t\t\t\tdecontaminated/ washed and given to Dhobi, is followed\n(ix)\nWhether Linen is kept separately and washed\n\t\t\t\tseparately\n(x)\nUse of aprons by Doctors\n(xi)\nParamedical Uniforms\n(xii)\nClass iv Uniforms\n(xiii)\nConcept of Central Linen System implemented\n(13)\nMedical/Non Medical Stores\n(i)\nSuitability of location for all sections of\n\t\t\t\tHospital and adequate space for medical store\n(ii)\nStaff knowledge in materials management, system\n\t\t\t\tof FiFo, bin card, lead time, buffer stock reorder level are\n\t\t\t\tfollowed\n(iii)\nAvailability of vital, essential and desirable\n\t\t\t\tdrugs sufficient to last for at least three months.\n(iv)\nUpkeep of expiry date register and its regular\n\t\t\t\tinspection by RMO\n(v)\nProper arrangements of the drugs as per\n\t\t\t\tABC/v.E.D. category and storage or running stocks as per\n\t\t\t\tguidelines.\n(vi)\nKnowledge of minimum levels for each drug to\n\t\t\t\tstore keeper by bin card system\n(vii)\nAll ampoule's are stamped with hospital name\n(viii)\nSatisfactory storage drugs with reference to\n\t\t\t\ttemperature, sunlight, protection from moisture, availability of\n\t\t\t\trefrigerators and exhaust fans.\n(ix)\nSending of samples of chemical laboratory to\n\t\t\t\tcheck it as per specification and standard and action taken\n\t\t\t\tthereon\n(x)\nMaintenance of separate Register for the batches\n\t\t\t\tdeclared unfit for use\n(xi)\nAvailability of licenses for spirit, morphine,\n\t\t\t\topium\n(xii)\nAvailability of Fire Fighting equipment's and\n\t\t\t\tknowledge to operate.\n(14)\n(14)\nMedical Records\nMedical Records\n(i)\nAvailability of Medical Record Room with enough\n\t\t\t\tnumber of racks and cupboard etc.\n(ii)\nKnowledge of staff in keeping the medical\n\t\t\t\trecords in desired fashion\n(iii)\nRegular reporting of births and deaths to the\n\t\t\t\tappropriate authority (verify)\n(iv)\nRegular WHO (ICD 10)classification of diseases.\n(v)\nQuarterly submission of the morbidity, mortality\n\t\t\t\treports (Check the report of the last month to assess the\n\t\t\t\tcorrectness)\n(vi)\nMonthly Death audit Meetings held and minutes of\n\t\t\t\tmeeting recorded / reported\n(vii)\nOrganization of Hospital infection Control\n\t\t\t\tCommittee meetings. Action taken on minutes and investigation\n\t\t\t\tdone if any. (verify)\n(viii)\nOrganization of Clinical Meetings and recording\n\t\t\t\tof Minutes. involvement of iMA or Professional associations etc.\n(15)\n(15)\nTraining, C M E,ICE and Social Actives\nTraining, C M E,ICE and Social Actives\n(i)\nEstablishment of Hospital Training Team and\n\t\t\t\torganization of regular clinical meetings, journal clubs and\n\t\t\t\tinvolvement of iMA\n(ii)\nHospital Library with latest journals and basic\n\t\t\t\ttext books.\n(iii)\nServices of qualified staff made available in\n\t\t\t\tOPD for iEC Activities.\n(iv)\nPosters and Banners displayed in OPD, Wards and\n\t\t\t\tpremises\n(v)\nAnnual social gathering arranged for the staff.\n(16)\n(16)\nAmbulatory Services and Telecommunication\nAmbulatory Services and Telecommunication\n(a)\n(a)\nvehicles\nvehicles\n(i)\nStatus of Ambulances\n(ii)\nAvailability of Garages\n(b)\n(b)\nTelecommunication\nTelecommunication\n(i)\nAvailability of PBx and Telephone Operator\n(ii)\nAvailability of Public phone facility in\n\t\t\t\tCasualty and OPD\n(iii)\nAvailability of Telephone directory and\n\t\t\t\ttelephone numbers of Collector, Police Superintendent, Fire\n\t\t\t\tBrigade, Water supply, other ambulances., Electricity board and\n\t\t\t\tother private nursing homes to be contacted in case of emergency\n\t\t\t\treferral\n(17)\n(17)\nCommitment to National Health Programmes\nCommitment to National Health Programmes\n(a)\n(a)\nFamily Welfare, MCH and MTP Programme\nFamily Welfare, MCH and MTP Programme\n(i)\nCompletion of proportional target of\n\t\t\t\tSterilization\n(ii)\nCompletion of proportionate iUD target\n(iii)\nMaintenance of - iLR, Refrigerator or walk in\n\t\t\t\tcooler is satisfactory with break down of cold chain less than 2%\n(iv)\nUp to date para wise, religion wise breakup of\n\t\t\t\ttotal deliveries taking place in the institution month wise.\n(v)\nOrganization of diagnostic camps, adoption of\n\t\t\t\tPrimary Health Centres/Rural Hospitals for providing speciality\n\t\t\t\tservices, training of staff and officers in field.\n(vi)\nOrganization of MTP training (verify the\n\t\t\t\trecords)\n(b)\n(b)\nNational Malaria Eradication Programme:\nNational Malaria Eradication Programme:\n(i)\nBlood Smear Collection (15% to new OPD)\n(ii)\nBlood smear examination done in Lab. On same day\n\t\t\t\tand treatment given as malaria clinic\n(iii)\nKnowledge of M.Os about presumptive and radical\n\t\t\t\ttreatment of Pv and PF\n(c)\n(c)\nNational Tuberculosis Control Programme;\nNational Tuberculosis Control Programme;\n(i)\nSputum Collection 25% of total new OPD at DTC\n\t\t\t\tDisposal of Sputum Cups by burning or burial\n(ii)\n(d)\n(d)\nNational Programme for Control of Blindness:\nNational Programme for Control of Blindness:\n(i)\nCompletion of prop, target of Cataract cases for\n\t\t\t\tHospital\n(ii)\nFollow up study done for restoration of vision\n\t\t\t\tafter operation\n(e)\n(e)\nNational Leprosy Eradication Programme:\nNational Leprosy Eradication Programme:\n(i)\nAwareness of M.Os about M.D.T. Lepra reaction\n\t\t\t\tmanagement\n(ii)\nReconstructive surgery camps organised\n(iii)\nSanitation and management of temporary hospital\n\t\t\t\tward\n(f)\n(f)\nSTD/AIDS Control Programme\nSTD/AIDS Control Programme\n(i)\nTraining of Medical Officers and Paramedicals in\n\t\t\t\tSTD/ Hiv/AiDS\n(ii)\nVDRL Screening of all STD cases done\n(iii)\nANC Screening for vDRL done.\n(iv)\nSyndromic approach as per guidelines followed\n(v)\nCondom distribution to STD cases\n(vi)\nDrugs used as per National guidelines\n(vii)\nAttempt made for partner notification and\n\t\t\t\tappropriate steps\n(viii)\nReports sent regularly in precribed format\n(ix)\nBio-safety measures followed in regards to\n\t\t\t\tprevent Hiv .infection\n(g)\n(g)\nCancer Control Programme\nCancer Control Programme\n(i)\nAvailability of pap smears facilities and follow\n\t\t\t\tup study of positive cases (verify the records)\n(ii)\nTraining of qualified Pathologist or\n\t\t\t\tCynecologist and Technicians in papsmear materials\n(iii)\nAvailability of adequate equipments and\n\t\t\t\tuninterrupted supply of staining materials\n(iv)\nAvailability of adequate reagents and chemicals\n\t\t\t\tfor pap smear at clinic\n(v)\nOrganization of diagnostic camps for cancer\n\t\t\t\tcervix tobacco related cancers in the tribe; and difficult area\n\t\t\t\tof District with the help of NGOs\n(18)\n(18)\nEnvironment Sanitation and Water Supply\nEnvironment Sanitation and Water Supply\n(i)\nCondition of General sanitation of hospital\n\t\t\t\tpremises and placement of Dust bins at various places etc.\n(ii)\nEfforts made to prevent nuisance of stray\n\t\t\t\tanimals like pigs, donkeys, cows, goats in the premises by\n\t\t\t\tproviding compound wall and cattle trap etc. at Entrance and\n\t\t\t\tExist.\n(iii)\nArrangements for regular lifting of garbage with\n\t\t\t\tthe help of Municipality/Corporation\n(iv)\nArrangements made for the safe disposal of the\n\t\t\t\tBiomedical Waste generated in the hospital as per the Biomedical\n\t\t\t\tWaste Management and Handling Rules 2000.\n(v)\nAnti smoking, Spitting boards and other Health\n\t\t\t\tEducation boards depicted at prominent places in Hospital Campus\n(vi)\nCleanliness inside and outside Canteen\n(vii)\nArrangements of sufficient illumination\n\t\t\t\tarrangements in Hospital premises by Street light etc.\n(viii)\nProvision of Public latrines/toilets etc.\n(ix)\nSource of water supply is adequate, if not, then\n\t\t\t\tefforts made to augment it by Bore well or dug well etc.\n(x)\nSanitation, Cleaning and general Condition of\n\t\t\t\toverhead tank/sump well verify reports of OT test done by\n\t\t\t\tSanitary inspectors. Cross check done by RMO (OR)\n(19)\n(19)\nPatient Attendant facilities\nPatient Attendant facilities\n(i)\nAvailability of patient Attendant facilities\n(ii)\nif available a) Whether adequate rooms available\n\t\t\t\twith kitchen, plate form, condition of sanitary blocks\n\t\t\t\tsatisfactory, and electric tubes/bulbs, fans are provided in all\n\t\t\t\trooms and halls.\n(20)\n(20)\nResearch Studies\nResearch Studies\n(i)\nOperational Research study undertaken such as\n\t\t\t\tExit interviews of discharged patients, study undertaken to\n\t\t\t\treduce patients waiting time efforts made to investigate sources\n\t\t\t\tof material, infant mortality in hospital and remedy suggested\n\t\t\t\tbased on the results etc or Paper presentation in various State\n\t\t\t\tand National level conferences.\nPart-III\nMinimum Standards for Equipment and Furniture\nMinimum Standards for Equipment and Furniture\nFor Hospitals and Nursing Homes (Norms are Bed Strength Based)\nFor Hospitals and Nursing Homes (Norms are Bed Strength Based)\nName\n≥100 bedded\n50-100 bedded\n≤50 bedded\nO.T Equipment\nO.T Equipment\nOperating Table, Ordinary\n3\n2\n1\nOperating Table, Hydraulic\n3\n2\n1\nAutoclave, HP, Horizontal\n3\n2\n0\nAutoclave, HP, Vertical\n2\n1\n1\nAutoclave, Electrical with Burners, 2-Bin\n0\n1\n1\nShadowless Lamp, OT, Mobile\n4\n3\n2\nOT Lights, Ceiling (Shadowless)\n3\n2\n1\nFocusing Lights, OT(Mobile)\n3\n2\n1\nSuction Apparatus (High Vacume MTP)\n4\n2\n1\nSuction Apparatus, Electrical\n15\n4\n2\nFoot Suction Apparatus\n2\n1\n1\nVacuum Extractor\n2\n1\n1\nSteriliser Instrument\n25\n10\n5\nElectro-Surgery Machine\n2\n1\n0\nCautery Set, Electric(Gynae)\n3\n2\n1\nAuto-mist (OT Fumigator)\n3\n2\n1\nShort-Wave Diathermy\n1\n1\n0\nVentilator, Adult\n1\n0\n0\nAnesthetic M/C (Boyle's with Flotec)\n2\n1\n1\nPulse Oximeter\n1\n1\n0\nE.C.G. Machine (12-Lead)\n3\n2\n1\nCardiac Monitor\n2\n1\n0\nDefibrillator\n2\n1\n0\nPhototherapy Unit\n2\n1\n0\nRadiant Heater, 4KW\n1\n1\n0\nIncubators\n2\n1\nOpen Care Units\n1\n1\nNeonatal Resuscitation Unit\n2\n1\nGeneral Equipment\nGeneral Equipment\nRefrigerator, 165/300 Litres\n8\n5\n2\nAir Conditioners\n8\n5\n1\nWater Cooler, 60/120 Litres\n3\n2\n1\nGenerator, 15 KVA\n0\n1\n0\nGenerator, 50 KVA\n1\n0\n0\nIntercom (15 Lines)\n0\n1\n0\nIntercom (40 Lines)\n1\n0\n0\nFax Machine\n1\n0\n0\nTelephone Lines\n12\n6\n2\nVehicles\nVehicles\n1\n0\n0\nAmbulance\n2\n1\n1\nMinor Equipment\nMinor Equipment\nB.P. Machine\n24\n12\n6\nWeighing Scale, Adult\n12\n4\n2\nWeighing Scale, Infant\n4\n2\n1\nOxygen Cylinders\n40\n20\n10\nNitrous Oxide Cylinders\n20\n10\n5\nRegulator and Flow meters\n16\n8\n4\nHot Plate, Domestic\n6\n3\n1\nEmergency Lamp\n16\n8\n4\nFire Extinguishers (Various Types) Each\n8\n4\n2\nLaryngoscope's\n4\n2\n2\nOtoscope\n2\n1\n0\nResuscitation Equipment\n2\n1\n0\nHospital Furniture\nHospital Furniture\nExamination Table\n30\n15\n5\nLabour Table\n6\n4\n2\nFoot Steps\n30\n15\n5\nBedside Screens\n40\n20\n10\nRevolving Stool\n40\n20\n10\nSaline Stands\n50\n25\n10\nWheel Chairs\n12\n4\n1\nEmergency/Recovery Trolley-\n4\n2\n1\nStretcher on Trolley\n12\n4\n2\nOxygen Cylinder Stands\n16\n8\n3\nIron Cot\nAs per bed strength\nAs per bed strength\nAs per bed strength\nSide Rails\n10\n4\n2\nBaby Cot\n12\n6\n4\nBedside Locker\nAs per bed strength\nAs per bed strength\nAs per bed strength\nDressing Trolley\n12\n4\n2\nMayo’s Trolley\n4\n2\n1\nSurgical Instrument Cabinet\n8\n4\n2\nMedicine Cabinet\n10\n4\n1\nInstrument Trolley\n8\n4\n2\nLinen Trolley\n8\n4\n2\nKick Bucket\n16\n8\n4\nBucket (Galvanised)\n20\n8\n4\nBed Pans and Urinals\n20\n8\n4\nAttendant Stool\nAs per bed strength\nAs per bed strength\nAs per bed strength\nWash Basin Stands\n40\n20\n10\nInstrument/Medicine Tray with Cover\n24\n12\n4\nBowls and Kidney Trays\n40\n20\n8\nChair (Doctors, Nurses)\n50\n24\n12\nSwab Rack (OT)\n4\n2\n1\nFracture Table (POP)\n2\n1\n0\nMattress and Pillows strength\nAs per bed strength\nAs per bed strength\nper bed As strength\nBenches Numbers\nAdequate Numbers\nAdequate Numbers\nAdequate Numbers\nHeight Measuring Stand\n4\n2\n1\nArm Board (Child and Adult)\n60\n40\n20\nJar, Cheater forceps\n20\n10\n4\nPatella Hammer\n8\n4\n2\nTongue Depresser\n20\n12\n6\nOxygen Masks with Regulator\n8\n4\n2\nTorch Light\n12\n8\n2\nB. Equipment For Diagonistic Centers\nB. Equipment For Diagonistic Centers\nRadiology and Imaging Units\n500 MA/300 MA/100 MA X-Ray System\n60 MA Mobile X-Ray System\nUltrasonic Scanner, General Purpose\nUltrasonic Scanner, Obstetrics purposes\nHigh-End Diagnostic Centers\nC.T Scanner with Image Processors Mammography\nC.T Scanner with Image Processors Mammography\n500 MA X-Ray Unit with IITV\n500 MA X-Ray Unit with IITV\nAll other Imaging Equipment\nBio-Chemistry and Pathology Centers\nMicroscope, Binocular with Lamp\nPhoto-Electric Calorimeter\nSpectrophotometer\nMicro Pippette\nWater Bath\nHot Air Oven, 2 Levels\nIncubator, Laboratory\nWater Still, 4 Litres\nCentrifuge (Electrical)\nCentrifuge (Haematocrit)\nHot Plate, Laboratory\nRotor/Shaker (Laboratory)\nCounting Chamber (Haemocytometer)\nPh Meter\nGlucometer (in OPD)\nHaemoglobin Meter Microtome\nOven, Wax-Embedding\nTissue Processor\nBlood-Gas Analyser\nTimer Stopwatch and Alarm Clock\nAppendix-II\nAppendix-II\n( See Rule 5 (a))\nPart - I\nPhysical Requirements of Medical Care Establishments\nPhysical Requirements of Medical Care Establishments\nA. Clinics and consultation rooms.\n(2) Examination table\n(3) Stethoscope\n(4) BP apparatus\n(5) Knee hammer and Torch light\n(6) Weighing machine and Measuring tape\n(7) Adequate illumination\n(8) Thermometer and Tongue depressor\n(9) A small refrigerator\nB. General Hospital with bed strength of 20 or less.\n(2) Staff pattern: Trained/qualified nursing staff should be available round the clock. The doctor should be available round the clock. In case of short term non-availability of the doctor alternate arrangements should be made.\n(3) If surgery is to be performed, an operation theatre should be provided as per the General Requirements and in accordance with the following specific features:\n(a) A floor area of a minimum 120 sq. ft.\n(b) Operation table with basic manipulation facilities\n(c) Surgical Instruments needed for the individual surgical procedure to be performed\n(d) A Small Generator should be installed.\n(e) Post-Operative Ward as described in the General Requirements\n(f) The Zoning requirements as given in the General Requirements shall be strictly followed.\n(4) If the nursing home is run as a maternity and nursing home, it should have a labour room as per the General Requirements, and facilities for neonatal care, resuscitation and referral facilities.\n(5) If the nursing home or hospital is providing any specialist care, it should have the requirements as given in the Part III for the speciality concerned.\nC. General Hospital with bed strength of 21 to 50.\n(2) Staff pattern: Trained/qualified nursing staff should be available round the clock. The doctor should be available round the clock. In case of short term non-availability of the doctor alternate arrangements should be made.\n(3) If surgery is to be performed, an operation theatre should be provided with the following specifications and over and above other general features mentioned in the Para E of the General Requirements:\n(a) Floor area of a minimum of 200 sq. ft preferably away from public movement.\n(b) Hydraulic Operation Table\n(c) O.T Ceiling Light\n(d) Surgical Instruments needed for the surgical procedures to be performed in good condition.\n(e) Pulse-oxymeter\n(f) A small Generator should be installed.\n(g) Post-Operative Ward as described in the General Requirements\n(h) The Zoning requirements as given in the General Requirements shall be strictly followed.\n(4) If the nursing home is run as a maternity and nursing home, it should have a labour room with the specifications as given in the General requirements and to have an operation theater as per the requirements, and facilities for neonatal care, resuscitation and referral facilities.\n(5) If the nursing home or hospital is providing any specialist care, it should have the requirements as given in the Part III for the speciality concerned.\nD. General Hospital with bed strength of 51 to 100.\n(2) Staff pattern: Trained/qualified nursing staff should be available round the clock. The doctor should be available round the clock. In case of short term non-availability of the doctor alternate arrangements should be made.\n(3) If surgery is to be performed, operation theatre should have the following specifications and other general features mentioned in the Para E of the General Requirements:\n(a) Floor area of a minimum of 200 sq. ft preferably away from public movement.\n(b) Surgical Instruments needed for the surgical procedures to be performed in good condition.\n(c) One additional Operation table with basic manipulation facilities for Minor O.T.\n(d) Pulse-oxymeter\n(e) Cardiac monitor with defibrillator\n(f) For Un-interrupted power supply a suitable Generator should be installed.\n(g) Air conditioning should be provided.\n(h) Post Operative Unit Should be maintained as given in the General Requirements\n(4) If the nursing home is run as a maternity and nursing home, it should have a labour room with the specifications as given in the Para F of the General requirements and to have an operation theater. The additional requirements for the labour room include:\nSpace Requirements:\n(i) Ante-natal ward\n(ii) Post-natal ward\n(iii) Neonatal Care facilities\nEquipment Requirements:\n(1) Foetal monitor\n(2) Radiant warmer and\n(3) Phototherapy unit\n(4) If the nursing home is also offering speciality care services, then the specific requirements as Given in the Part III as applicable to the speciality concerned shall be made available.\nE. General or Speciality Hospital with d strength of 100 to 200.\n(2) Staff pattern: Trained/qualified nursing staff should be available round the clock. The staff to the bed ratio should be a minimum of 1 for 10 beds during working hours. The doctor should be available round the clock. In case of short term non-availability of the doctor alternate arrangements should be made.\n(3) If surgery, is to be performed, Two (2) operation theatres should be provided: one theater to be reserved for minor/ trauma/septic cases. The main operation theater should have the following specifications and other general features mentioned in the Para E of the General Requirements:\n(a) Floor area of a minimum of 200 sq. ft preferably away from public movement.\n(b) Surgical Instrument needed for the surgical procedures to be performed in good condition.\n(c) Pulse-oxymeter\n(d) Cardiac monitor with defibrillator\n(e) For un-interrupted power supply s suitable Generator should be installed.\n(f) Post Operative Unit and Intensive Care Units should be maintained as given in the General Requirements\n(g) It is ideal to have a separate minor operation theatre to perform smaller surgeries and to deal with infected cases hereby promoting greater, asepsis in the major theater.\n(4) If the nursing home is run as a maternity and nursing home, it should have a labour 'room with the specifications as given in the Para F of the General requirements, and facilities for neonatal care, resuscitation and referral facilities.\n(5) If the nursing home or hospital is also offering speciality care services, then the specific requirements as given in the Part III as applicable to the speciality concerned shall be made available.\nF. Speciality Hospital with bed strength more than 200.\n(2) Staff pattern: Trained/qualified nursing staff should be available round the clock. The staff to the bed ratio should be a minimum of 1 for 10 beds during working hours. The doctor should be available round the clock. In case of short term non-availability of the doctor alternate arrangements should be made.\n(3) If surgery is to be performed in various specialities accordingly operation theatres should be provided with minimum two operation heaters: one theater to be reserved for minor/ trauma/septic cases. The main operation theater should have the following specifications and other general features mentioned in the Para E of the General Requirements:\n(a) Floor area of a minimum of 200 sq. ft preferably away from public movement.\n(b) Surgical Instrument needed for the surgical procedures to be performed in good condition.\n(c) Pulse-oxymeter\n(d) Cardiac monitor with defibrillator\n(e) For un-interrupted power supply a suitable Generator should be installed.\n(f) Post Operative Unit and Intensive Care Units should be maintained as given in the General Requirements\n(g) It is ideal to have a separate minor operation theatre to perform smaller surgeries and to deal with infected cases thereby promoting greater asepsis in the major theater.\n(4) If the nursing home is run as a maternity and nursing home, it should have a labour room with the specifications as given in the Para F of the General requirements, and facilities for neonatal care, resuscitation and referral.\n(5) If the nursing home is also offering speciality care services, then the specific requirements applicable shall be made available.\nG. Physiotherapy unit.\n(1) Man Power Needed. - (a) Physiotherapists - Qualified Degree B.P.T or B.Sc. (P.T) or M.P.T. or M.Sc. (PT) are equally qualified.\n(b) Physiotherapy Diplorpa Holders/ Technicians - Trained for 1 year to 2 years with Certificate holders or Trained personal of Physiotherapy as Assistants to Physiotherapists.\n(c) Attenders-cum-Ward boys for mobilization of patients\n(d) Sweepers\n(e) Receptionist-cum-Office bearer and Administrative In charge\n(2) Instruments Needed.\n(2) Instruments Needed.\n(a) Electro Therapy. - Muscle Stimulators, S.W.D., U.S. Therapy, I.F.T/Tens, Traction Unit, Wax Therapy and CRYO Therapy\n(a) Electro Therapy.\n(b) GYM Instruments. - Adults:\n(b) GYM Instruments.\n(i) Parallel Bars\nChildren:\n(ii) Shoulder Wheel, Quadriceps table, Static Cycle, Wobble board Exerciser, Suspension - cum -Spring Exercising unit with accessories, Wheel chairs, Walkers, Crutches, Medicine Balls etc, Accessories\n(3) Required Premises. - Center needs easy approachability and transportability with sufficient parking space, since most of the patients are brought by means of transport.\n(3) Required Premises.\n(4) Unit Requirements. - Needful total area around 2000 sq.ft + 500 sq. ft (in-built area) for 20-30 patients for 8 hours of work of a day.\n(4) Unit Requirements.\n(a) Reception (Registration)\n(b) Office-cum-Manager's room\n(c) Waiting room for patients and Attenders\n(d) Examination-cum-Assessing com\n(e) Hall for Exercising (GYM) with suspension therapy unit\n(f) Electro therapy unity with No. of curtain cabins with Cots and machines\n(g) Attached toilets\n(5) End Note. - To make a full fledged Physical Rehabilitation Centre with inpatients facility. We need to add up space and qualified personal like\n(5) End Note.\n(a) Occupational therapist\n(b) Speech therapist as part time\n(c) Orthotic and prosthetic Engineer\n(d) Medical Social Worker\n(6) As on Call, Doctors Like. - (a) Neuro Surgeons and Neuro Physicians\n(6) As on Call, Doctors Like.\n(b) Orthopaedic Surgeons and Plastic Surgeons\n(c) General Physicians\nH. Dental Clinic.\n(1) A Dental Chair with spittoon, Halogen Light, Suction Apparatus, Aerator, micro-motor and 3 way syringe\n(2) Ultrasonic Scalar\n(3) Light Cure equipment\n(4) Sterilizer\n(5) Extraction Forceps, Scalars, Diagnostic and filling instruments\n(6) Emergency Drugs like Xylocaine, Stypitice corticosteroids, Mephetine, Nikethemide and other emergency drugs should be available all the time.\n(7) All consumable dental materials, Oxygen cylinder with ambu bag, resuscitation equipment etc.\n(8) A qualified dental assistant or an experienced assistant should be employed.\n(9) Intra-oral X-ray Machine may be attached (optional)\n(10) A Dental Laboratory may be attached (Optional)\n(11) Clinic Board should be according to rules of the State Dental council Manual.\n(12) A medical doctor on call to attend any emergency.\n(13) A register should be maintained for OP patients and surgery done with details.\n(14) Provision for Bio-Medical waste should be arranged.\n(15) Record for MLC cases, surgeries and OP Tickets with summery sheet in a standard draft should be kept ready in clinic.\n(16) Consultation fee, surgery charges, investigation charges, O.T. Charges etc should be displayed along with estimation before treatment be provided to the patients.\nI. Clinical Laboratories.\n(a) Attached Laboratory. - For a laboratory attached to a medical establishment the medical superintendent or doctor in charge will be signatory to reports and responsible for the results.\n(a) Attached Laboratory.\n(b) Small Laboratory. - The laboratory performing routine tests in the field of hematology, fluids and excretions and biochemistry up to 100 tests per day be manual or semi automated techniques and should be manned by qualified doctors/or Lab technician with a minimum qualification of M.Sc., with 5 years experience in Laboratory machine.\n(b) Small Laboratory.\n(c) Medium Laboratory. - The laboratory performing the above mentioned tests and special tests in the above-mentioned specialities or the other laboratory disciplines (such as histopathology, cyto-pathology etc.,) and doing 101 - 500 tests per day.\n(c) Medium Laboratory.\n(d) Large Laboratory. - The laboratory doing the above mentioned tests with a higher load than 500 tests per day and/.or sophisticated instruments such as automated Analysers, ELISA readers, fluorescent microscopes, etc.\n(d) Large Laboratory.\n(e) Super-Speciality Laboratory. - The laboratory is restricting its activity to one or two disciplines of laboratory medicine.\n(e) Super-Speciality Laboratory.\n(2) Staff and Education.\n(2) Staff and Education.\n(a) Supervisory personnel. - The large and super-speciality, laboratory shall be manned by a medical person with post -graduate qualification in pathology or microbiology or Biochemistry.\n(a) Supervisory personnel.\n(b) Technical Personnel. - The technical person performing the tests and reporting the results should be qualified personnel from an institution recognized by the Government.\n(b) Technical Personnel.\n(3) Facilities. - The space required by the laboratory shall be commensurate with the type and range of tests performed, the level of automation available, degree of computerization, workload and manpower. Adequate space should be provided to enable efficient maintenance of equipment.\n(3) Facilities.\n- Sample collection and Sample analysis -Storage of samples, reagents, chemicals, spares, stationary and records -Washing\n- Media preparation and autoclaving (applicable to microbiology laboratory) Storage of slides, tissue blocks, grossing (applicable to histopathology laboratory)\n- Toilets\n- Fire safety\n- Laboratory' must be well lighted and ventilated to provide healthy environment. Many tests and equipment require regulated temperature and therefore wherever necessary effective air conditioning and uninterrupted power supply must be available as per the manufactures recommendations. It is however understood that the laboratory performing simple tests need not have all the facilities.\nNote. - The laboratory shall limit and restrict entry to authorized personnel to testing areas to ensure confidentiality and safety of patients and visitors.\nNote.\n- Microhaematocrit tunes sealing compound\n(f) Bacteriological and Biochemical Apparatus. - Nickle-chromiumally (Nichrome) wire, 1mm diameter loop holders. Bunsen burner for use with butane gas.\n(f) Bacteriological and Biochemical Apparatus.\n(g) For Laboratories Performing Specialised Tests\n(g) For Laboratories Performing Specialised Tests\n(i) Immunology\n(i) Immunology\n- Water bath, temperature controlled\n- Elisa reader\n- Autoclaving facility\n- Laminar flow\n(ii) Cyto genetics.\n(ii) Cyto genetics.\n-Sterilization Equipment\n- Tissue culture facility\n- Provision for special stains\n- Provision for Video camera monitor\n- Staining facility\n- Photo microscopy\n- Fluorescent microscope\n- Co2 Incubator\n(iii) Cytopathology\n(iii) Cytopathology\n(7) Laboratory Records and Reports. - Should be maintained for at least 1 month. H.P. - Slides for 6 months and Blocks for 3 months.\n(7) Laboratory Records and Reports.\n(8) Subcontracting of Testing. - (a) Where a laboratory subcontracts any part of the testing, this work shall be placed with a laboratory complying with the minimum criteria. The laboratory shall ensure and be able to demonstrate that its subcontractors are competent to perform the activities in question and complies with the same criteria of the competence as the laboratory in respect of the work being subcontracted.\n(8) Subcontracting of Testing.\n(b) The laboratory shall record and retain details of its investigation of the competence and compliance of its subcontractors and maintain a register of all subcontracting.\n(9) Explanatory Remarks. - Laboratories must document their policy and procedure for subcontracting in any case the laboratory remains fully responsible for the subcontracted work, it shall ensure that the work is performed in accordance with criteria in this document. Preferentially only those laboratories should be selected that are accredited by an organization that are adequately equipped for such purpose and are manned by qualified and experienced professional. In all circumstances the patient must be informed of subcontracting or must approve of the subcontracting in writing.\n(9) Explanatory Remarks.\nJ. Genetic Centres.\n(4) Safety and Environment.\n(4) Safety and Environment.\n(a) Sample Collection, Handling And Pre-Analytical Storage. - All specimens received by the laboratory should be treated as potential infectious or hazardous. Universal precautions should therefore, observed in handling and transport of these specimens in conformity with National and International guidelines.\n(a) Sample Collection, Handling And Pre-Analytical Storage.\n(b) Disposal of Samples and Related Materials. - The laboratory shall dispose contaminated waste such as microbiology, Cultures, organs and tissues, blood and body fluids, contaminated swab tissue papers, towels, pipettes tips, storage vials, glassware, needles other sharps by dis-infections with chemicals or autoclaving before appropriate disposal such as through incineration, or transmitted to authorized waste disposal agency or secure land fills, meeting environmental regulations in force. Chemicals, auto calving or irradiation before washing shall disinfect reusable Chemical dis infections are carried out in a suitable receptacle kept at the workstation. Commonly used disinfectants are sodium hypochlorite, formaldehyde, glutasraldehyde, phenol and hydrogen peroxide.\n(b) Disposal of Samples and Related Materials.\n(5) Ethical Practises. - The laboratory shall maintain the highest standards of integrity and maintain utmost confidentiality with regard to the findings on the specimens sent to the laboratory.\n(5) Ethical Practises.\n(6) List of Apparatus Needed. - (a) Laboratory Instruments:\n(6) List of Apparatus Needed.\n(1) The Microscope (Essential)\n(2) The Centrifuge\n(3) Refrigerators\n(4) A Thermostatically controlled water bath (37c-56c)\n(5) A Rotating machine for VDRL tests\n(6) A Differential counter\n(7) A Photometer or calorimeter\n(b) Additional Items. - Not essential but useful\n(b) Additional Items.\n(1) The Autoclave, The Hot air oven, Balance, and deionizer or a still for making distilled water\n(c) Equipments for Collection of Specimens. - Syringes, Needles, Cotton, Glassware (Beakers, Tubes, Flasks, Slides, Cover slips) Pippettes, Capillary tubes, Measuring Cylinders, graduated, with stopper, glass bottles\n(c) Equipments for Collection of Specimens.\n(d) Haemotological Apparatus. - Pipettes, Sahli, 0.02ml. Rubber tubing Pipettes blood 0.05ml.\n(d) Haemotological Apparatus.\n(e) Counting chamber.\n(e) Counting chamber.\n-Improved Neubauer (bright line if possible)\n-Fuchs Rosenthal\n-Cover glasses optically plane for counting chambers\n-Tally counter\n-Tubes, Westergrcen for ESR\n-Stands for Westcgren tubes\nComputer for\n\t\t\t\tprinting of reports and accounting purpose\n50 - 60 Sq.ft\nEmergency drugs, oxygen cylinder, ambu's bag,\n\t\t\t\tSuction apparatus and Emergency - cum - observation bed with\n\t\t\t\tmonitor should be provided.\n60 - 100 Sq.ft\nDiagnostic Medical X-ray Unit 300/500/800 MA with\n\t\t\t\tIITV at 125 KVP\n260-320 Sq.ft (25-30 Sq.mtrs)\nCath lab with DSA 1000 MA - 1250 MA\n300-400 Sq.ft\nDiagnostic Medical X-ray Unit with Odeleca facility\n\t\t\t\t300 MA X-ray unit\n260 Sq.ft\nUltra sound unit (B and W) with linear / Convex /\n\t\t\t\tsector 7 endocavitary probe / Multi-frequently probe with multi\n\t\t\t\tformat camera / thermal photo paper printer.\n100 Sq.ft\nColour Doppler with echo facility ultra sound unit\n\t\t\t\twith convex, Micro-convex, linear, endo-cavitary probe with\n\t\t\t\tbiopsy attachment, multi frequency probe with multi format camera\n\t\t\t\tboth for colour and B and W prints and computer assisted report\n\t\t\t\tformat. Video recorder / camera for slide making facility.\n100 Sq.ft\nMammography with all accessories including special\n\t\t\t\tcassettes, intensifying screens, viewing Boxes with magnifying\n\t\t\t\tglass, paddling device, FNAC Biopsy Needle facilities must be\n\t\t\t\tavailable. (Lady x-ray technologist is preferred)\n100 Sq.ft\nWhole body C.T. Conventional scanner with camera\n\t\t\t\tand console should be outside in a separate room (site Plan\n\t\t\t\tattached)\n400 Sq.ft\nSpiral CT Scanner with work station and Laser\n\t\t\t\tCamera MR1 up to with 0.3 tesla permanent magnet with Laser\n\t\t\t\tCamera, UPS, RF coils (5x7 mtrs = 35 mtrs)\n600 Sq.ft\nMagnetic field leakage 5 Gauze line should be\n\t\t\t\tmeasured from center for magnet length - wise (3.0 (X, Y) x 4.7\n\t\t\t\t(Z) Over and above 1.5 Tesla supercon MR1 will need further\n\t\t\t\tbigger Area according to specification of manufacturer.\n100 Sq.ft\nDrying area for images and X-ray films\n100 Sq.ft\nDark room with accessories\nAutomatic films processor unit\n100 Sq.ft\nComputer with reporting facilities and storage\nEmergency trolley with drugs, suction pump\n150 Sq.ft\nTwo emergency cum observations bed with monitor\n\t\t\t\tshould be provided for patients Gamma Camera with Speck\nPlanning and Radioactive pharmaceutical material\n\t\t\t\tpreparation\n400 Sq.ft\nTreatment room with 2 beds\n200 Sq.ft\nStorage and decontamination\n200 Sq.ft\nNuclear Cardiac Stress Lab\n200 Sq.ft\nNote. - Apart from above, patient waiting area, with proper facilities and toilets, reporting room, storage room and library should be provided in the Radiology Department.\nNote.\nK. Infertility Centres .\n(1) Qualified personnel with adequate experiences\n(2) Adequate laboratory facilities for conducting tests\n(3) Services of a trained Embryologist\n(4) Laminar flow equipment\n(5) Inverted fluorescent microscope\n(6) Deep-freezing facilities\n(7) Operation theater as per general requirements\n(8) Sample collection facilities\n(9) Consultation and waiting areas\n(10) SteriliSation equipment\nL. Radiology And Imaging Centres.\n(a) Radiological Equipments and Area required for small Hospitals.\nArea Required\nDiagnostic Medical X.-ray unit - 60/100/300 MA\n180-260 sq.ft\nDark room with accessories\n60-100 sq.ft\nEmergency drugs and Oxygen cylinder or Ambu's bag and Suction\n\t\t\t\tapparatus must be provided in Radiography room\n(b) Radiological Equipments and Area required for Medium Hospitals\nDiagnostic\n\t\t\t\tMedical X-ray Unit - 200/300/500 MA at 100/125 KVP\n260 Sq.ft. (25 Sq.mtrs)\nDiagnostic Medical X-ray Unit - 500 MA/800 MA\n\t\t\t\t(Adjacent patients toilet facility) with IITV\n260 to 300 Sq.ft. (25 to 30 Sqmtr)\nUltra sound Unit (B and W) with linear / convex\n\t\t\t\t/ sector / endovavitary probe / multi - frequently probe with\n\t\t\t\tmulti-format camera / thermal photo photo paper printer\n100 Sq.ft\nDart room with accessories\n80-100 Sq.ft\nPortable / mobile x-ray unit /portable ultra\n\t\t\t\tsound/ ECG unit\n80-100 Sq.ft\nCheck List of Part - 1 of Appendix - II\nMedical: Standard Services Recommended for each Level\nSI. No.\nCondition\n\t\t\t\tProcedure\nBasic\n\t\t\t\tLevel Services\nSpecialist\n\t\t\t\tCare Services\nSuper Speciality Services\n1.\nConvulsions\nSymptomatic\n\t\t\t\ttreatment and refer\nInvestigate,\n\t\t\t\tinitiate, L.P, manage and refer\nCT scan, advanced neurological treatment\n2.\nLoss\n\t\t\t\tof consciousness/coma\nSymptomatic\n\t\t\t\tand supportive\nInitiate\n\t\t\t\ttreatment, manage and refer\nCT scan, advanced neurological treatment\n3.\nEn-cephalities,\n\t\t\t\tmcningities CNS infections\nSymptomatic\n\t\t\t\ttreatment and refer\nManage,\n\t\t\t\tSupport and\nCT scan, advanced, neurological treatment\n4.\nHead\n\t\t\t\tinjuries\nFirst\n\t\t\t\tAid, refer\nManage,\n\t\t\t\tstabilise, refer for advanced management\nAdvanced management with altered sensorium with fracture\n5.\nRespiratory\nInitiate,\n\t\t\t\tmanage and refer\npH\n\t\t\t\tchange, severe distress\n-\n6.\nAsthma\nSymptomatic,\n\t\t\t\tmanage and refer\nSevere\n\t\t\t\tCondition (status)\n-\n7.\nC.O.P.D\nSymptomatic\n\t\t\t\ttreatment and refer\nInvestigate,\n\t\t\t\tmanage, followup\n-\n8.\nEar\n\t\t\t\tinfection\nManage\n\t\t\t\tand Refer\nTreatment\n-\n9.\nCardio-vascular\n\t\t\t\tproblems hypertension\nMild\n\t\t\t\tmoderate:manage\nAccelerated\n\t\t\t\tand severe conditions\n-\n10.\nC.V.A.\nSymptomatic\n\t\t\t\tmanagement, refer\nManage\n\t\t\t\tand follow up\n-\n11.\nAngina,\n\t\t\t\tinfractions\nSymptomatic\n\t\t\t\tmanagement, refer\nInvestigate,\n\t\t\t\tmanage refer, follow up\nComplications\n12.\nC.H.F\nSymptomatic\n\t\t\t\tmanagement, refer\nComplicated,\n\t\t\t\tfollow up\n-\n13.\nRheumatic\n\t\t\t\tfever and Rheumatic heart\nSymptomatic\n\t\t\t\tmanagement, refer\nInvestigate,\n\t\t\t\tmanage refer, follow up\nComplications\n14.\nGI\n\t\t\t\tbleeding, ulcers, Diseases\nSymptomatic\nEndoscopic\n\t\t\t\tinvestigation, treatment\nComplications\n15.\nG.E.\nManage\n\t\t\t\tmild, moderate refer\nTreat\n-\n16.\nHepatitis\nSymptomatic\n\t\t\t\ttreatment\nConfirm\n\t\t\t\tdiagnosis, manage\n-\n17.\nCirrhosis\nSymptomatic\nInvestigate,\n\t\t\t\tmanage, follow up\nComplications\n18.\nRenal\n\t\t\t\tUTI\nSymptomatic,\n\t\t\t\trefer\ndiagnosis,\n\t\t\t\tmanage\n-\n19.\nAcute\n\t\t\t\tRenal failure\nSymptomatic\n\t\t\t\trefer\nInvestigate,\n\t\t\t\tmanagement, refer\nDialysis and advanced management\n20.\nMusculoskeletal\nSymptomatic\n\t\t\t\trefer\nManage\nRecurrent: further evaluation, complications\n21.\nAnaemia\nManage\n\t\t\t\tmoderate\nManage\n\t\t\t\tsevere\n-\n22.\nTetanus\nSymptomatic,\n\t\t\t\tinitiate\nManage\n-\n23.\nMalaria\nManage\nSevere\n-\n24.\nAIDS\nDiagnosis,\n\t\t\t\tinitiate management\nDiagnose and manage\n25.\nPsychiatric\nSymptomatic\n\t\t\t\tmanagement\nSevere\n26.\nPsychiatric\n\t\t\t\tdisorder\nManage\n\t\t\t\tmild, Moderate\nSevere\n27.\nPoioning\nInitiate,\n\t\t\t\tManage, refer\nInvestigate,\n\t\t\t\tmanage\n-\n28.\nNeonatal\n\t\t\t\trescusciatation\nInitiate\n\t\t\t\tand refer\nManage\n-\n29.\nNeonatal\n\t\t\t\tcardio pulmonary defects\nInitiate\n\t\t\t\tand refer\nInvestigate,\n\t\t\t\tmanage, followup\nComplications\n30.\nDiabetes\nDiagnosis,\n\t\t\t\tinitiate\nComplications\n-\n31.\nSnake\n\t\t\t\tbite and dog bite\nManage\nComplications\n-\n32.\nSkin\n\t\t\t\tdisorders\nRefer\nManage\n-\n33.\nS.T.Ds.\nManage\nDiagnose\n\t\t\t\tand Treat\n-\nPart II\nSpeciality Services and its Requirements\nSpeciality Services and its Requirements\nA. Basic Speciality Services.",
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"number": "1",
"title": "1. Orthopedic and Trauma Care. - A hospital or nursing home irrespective of the bed strength offering Orthopedic surgical care and trauma care services should have the following equipment and facilities:",
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"number": "1",
"title": "1. Orthopedic and Trauma Care.",
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"content": "(a) Basic instrumentation sets for fractures, large fragment and small fragment external fixators, Portable X-ray machine, C-arm image intensifier (Optional), Arthroscope (Optional), Plaster room equipment with plaster table, Operation room equipment and instrument sets, and attached Physiotherapy and occupational therapy facilities.\n(b) Trauma Care centers: In addition to the orthopedic surgery equipment, the hospital should have a CT scan equipment, Resuscitation ward Post Operative ward, Intensive Care Unit, Full fledged Operation Theatre, Blood Bank, and Full fledged Clinical lab support and Radiology and Imaging support, ambulatory and communication equipment support.",
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"number": "2",
"title": "2. ENT care. - A hospital offering the ENT speciality treatment basically to have the following equipment:",
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"number": "2",
"title": "2. ENT care.",
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"content": "(a) Basic Equipment: - Nasal Speculum, Tongue depressor, Laryngel mirrors, Nasopharyngeal mirrors, Aural speculum, Ear suction, Nasal suction, Suction apparatus, Seigles speculum, Tuning fork, Otoscope, Bulls lamp, Head lamp, ENT examination chair, Sterilizer, B.P. Apparatus, and Stethoscope\n(b) O.T. Instruments: - Tonsillectomy and Adenoidectomy sets, Sets for nasal bone fracture, Septoplasty set, Antrostomy set, Tracheostomy set, FESS set, Direct laryngoscope set, Microlaryngoscopy set, Tympanoplasty set, Mastoidectomy set, Staoedectomy set, Oesophagoscopy set, and Bronchoscopy set\n(c) O.T. Equipment: - Operating Microscope, Pure Tone audiometer, Impedance Audiometer, Temporal bone lab microscope, Mastoid Set, and Micro motor with Drill,\n3, Eye (Ophthalmic) Care. - A hospital offering Ophthalmic care facilities should have the following equipment and facilities:\n3, Eye (Ophthalmic) Care.\n(a) Basic Equipment: - Snellen's Chart or Drum, Trail Set with frame, Near vision charts with different languages, 3 Cell torch, Ophthalmoscope and, Retinoscope, Slit Lamp, Applanation tonometer, Kerato meter, Indirect ophthalmoscope, and a Gonioscope\n(b) O.T. Equipment: - Operating microscope, Cryo unit, Cataract set, Glaucoma set, Entropian set, Enucleation set, Squint set, O.T. Table, and O.T Light",
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"number": "4",
"title": "4. Obstetric and Gynaecology Care facilities. - The maternity care facilities should provide basic obstetric services and neonatal care services. All maternity homes should be able to carry out procedures like suction and evacuation, dilatation and curettage. Lower Segment Cesarean Section and Hysterectomy on an emergency basis. Blood transfusion facilities should be available within half to one hour. Also ultrasonography facilities should be available within half to one hour. A hospital or nurs",
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"number": "4",
"title": "4. Obstetric and Gynaecology Care facilities.",
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"content": "(a) Basic O.T Equipment: O.T Table, O.T Light, High Suction Apparatus, vacuum extractor etc., Resuscitation tray, Cervical biopsy set, MTP set, D and C' set, and Delivery sets and Episiotomy set and feuotal Doppler, Ophthalmoscope and Pulse Oxymeter.\n(b) Surgical Instrument sets: - Abdominal Hysterectomy set, Vaginal Hysterectomy set, Tuboplasty set, Myomectomy set, Diagnostic Laparoscopy set, Operating Laparoscopy set (Optional), Hysteroscopy set (Optional), and Rectoscope (Optional)\n(c) Support Equipment: - Electrocautery, Multi channel monitors (Optional), C.T.G machine, Ultrasound Machine (Optional), and Supported by Lab facilities for investigations",
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"number": "5",
"title": "5. Cancer Treatment Facilities. - A hospital offering radiotherapy services for the treatment of cancer should have the following facilities:",
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"number": "5",
"title": "5. Cancer Treatment Facilities.",
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"content": "(a) Radio-diagnostic facilities: - Conventional X-ray Unit, Mobile X-ray Units, Computer Tomography, Magnetic Resonance Imaging (Optional), and Mammography\n(b) Radiotherapy facilities: - Treatment Planning and Mould room including: Computerized treatment planning system, Simulator, Immobilization Cast making system, Brachytherapy set-up, Teletherapy set-up, Dosimetry system, Radiation Protection Set-up, and Linear Accelerator (Desirable)\nB. Super Speciality Services.\n(b) Diagnostic and Support Services: - Radiology services including C.T., MRI, Angiography facilities, Stress test, echo-cardiography, and Full fledged clinical laboratory, well equipped operation theatres of high aseptic conditions, Intensive Coronary Care units, Acute medial care units, Heart Lung machines, Intra-arotic balloon pumps, Catheterization equipment, Infusion pumps, angioplasty equipment, blood gas and electrolyte analyzers, blood bank facilities etc.",
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"number": "6",
"title": "6. Specialist Qualifications. - (i) The Specialist for providing cardiology services should have M.D. D.M (Cardiology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.",
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"number": "6",
"title": "6. Specialist Qualifications.",
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"content": "(ii) The Specialist to provide C.T Surgery should have M.S, M.Ch (C T Surgery) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.",
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{
"number": "7",
"title": "7. Urology and Nephrology care facilities. - The facilities offering these services should have full fledged Operation theatre facilities, Intensive care units, Full-fledged Dialysis units with dialysis machines and Complete renal replacement therapy machines (CRRT), Renal lab with facilities for Renal function tests, well set clinical lab support, and radiology and imaging support.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 33
},
{
"number": "7",
"title": "7. Urology and Nephrology care facilities.",
"chapter": null,
"content": "(i) The Specialist for providing Urology services should have M.S. D.Ch (Urology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.\n(ii) The Specialist to provide Nephrology care should have M.D., D.M (Nephrology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National board or local recognised bodies or university or equivalent from a local recognized body.",
"footnote": "",
"is_definition": false,
"sort_order": 34
},
{
"number": "8",
"title": "8. Neurology and Neuro-surgery. - The neurology treatment facilities should have EEG machines, evoked potentials, C.T and MRI facilities, in addition to the hi-end diagnostic facilities, the hospitals to have operation theatres, Intensive care units, and Micro-Surgical Instrument sets.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 35
},
{
"number": "8",
"title": "8. Neurology and Neuro-surgery.",
"chapter": null,
"content": "(i) The Specialist for providing Neurology services should have M.D. D.M (Neurology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National board or local recognised bodies or university or equivalent from a local recognized body.\n(ii) The Specialist to provide Neuro Surgery should have M.S, M.Ch (Neurosurgery) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National board or local recognised bodies or university or equivalent from a local recognized body.",
"footnote": "",
"is_definition": false,
"sort_order": 36
},
{
"number": "9",
"title": "9. Neonatology and Paediatric Surgery facilities. - A hospital or nursing home offering Neonatology and Pediatric surgery services should have the following facilities: -",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 37
},
{
"number": "9",
"title": "9. Neonatology and Paediatric Surgery facilities.",
"chapter": null,
"content": "(a) Basic O.T Equipment: - Basic resuscitation equipment, Nebuliser, Incubators, Phototherapy units, Open Care system, Infusion pumps, CPAP and Ventilator facilities, O.T Table, O.T Light, Suction Apparatus, Cysto-scope, Rigid bronchoscope, Oesophagal dialators, and padiatric sigmoidoscope and Special Intensive Care Unit\n(b) Support Equipment: - Lab facilities for investigations\n(i) The Specialist for providing Neonatology services should have M.D. D.M (Neonatology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.\n(ii) The specialist offering Paediatric Surgery services should have M.S. M.Ch (Paediatric Surgery) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.",
"footnote": "",
"is_definition": false,
"sort_order": 38
},
{
"number": "10",
"title": "10. Plastic Surgery facilities.",
"chapter": null,
"content": "(a) Basic O.T Equipment: Basic O.T equipment such as O.T Table, O.T Light, Suction Apparatus, and Anaesthesia machine etc.\n(b) Other Equipment: - Operating Microscope, Skin grafting machines, Skin cutters and whole range of microsurgery instrumentation.\n(c) Support Equipment: - Lab facilities for investigations",
"footnote": "",
"is_definition": false,
"sort_order": 39
},
{
"number": "11",
"title": "11. Chest Diseases and Respiratory Medicine. - A Hospital or a facility offering treatment for the chest diseases and respiratory medicine should have the following facilities: -",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 40
},
{
"number": "11",
"title": "11. Chest Diseases and Respiratory Medicine.",
"chapter": null,
"content": "(a) Peak flow meters, Nebulizers, Intercostal drainage facility, Plueral biopsy needles, pulse oximeters, Fibre optic bronchoscopes and rigid bronchoscopes, Pulmonary function test machine with facility for spirometry, lung volume and diffusion capacity and Blood gas machine and O.T support with Ventilator.\n(b) Support Equipment:- Lab facilities for investigations",
"footnote": "",
"is_definition": false,
"sort_order": 41
},
{
"number": "12",
"title": "12. Gastroenterology and Surgical Gastroenterology care facilities. - The facilities offering these services should have full fledged Operation theatre facilities, Intensive care units, Full-fledged Endoscopy equipment, well set clinical lab support, and radiology and imaging support. The Endoscopy equipment include Upper G.I Endoscope, Colono Scope, Surgical Endoscope etc.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 42
},
{
"number": "12",
"title": "12. Gastroenterology and Surgical Gastroenterology care facilities.",
"chapter": null,
"content": "(i) The Specialist for providing Gastroenterology services should have M.D D.M (Gastroenterology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.\n(ii)The Specialist to provide Surgical Gastroenterology care should have M.S., M.Ch (Gastroenterology) degree from a university or equivalent from a local recognised body OR diploma from Diplomate of National Board or local recognised bodies or university or equivalent from a local recognized body.\nCheck List of Part - II of Appendix-II\nCheck List of Part - II of Appendix-II\nSurgical: Standard Services Recommended for each Level\nSI. No.\nCondition/ Procedure\nBasic\n\t\t\t\tLevel Services\nSpecialist Care Services\nSuper Speciality Services\n1.\nBasic techniques\nIncision\n\t\t\t\tand Drainage Wound debridements\nSplit\n\t\t\t\tskin graft Biopsy of skin\n2.\nTrauma and Life Support\nResuscitate,\n\t\t\t\tstabilise and refer\nBasic\n\t\t\t\tlevel care + Securing airway; circulatory support, stabilisation\n\t\t\t\tof fractures, Investigate and manage, Follow-up\nSevere head injuries and injuries of spinal cord\n3.\nEye\nRemoval\n\t\t\t\tof foreign bodies\nManagement\n\t\t\t\tof corneal abrasion, ulcer, cataract and glaucoma surgery\nCorneal grafting Retinal diseases Vitreous surgery Intra-ocular\n\t\t\t\tforeign bodies\n4.\nEar Nose and Throat\nRemoval\n\t\t\t\tof foreign bodies Epistaxis control\nI\n\t\t\t\tand D of peri tonsillar and retro pharyngeal abscesses,\ntonsillectomy, Laryngoscopic removal of FB and drainage of\n\t\t\t\tmastoid abscess All requiring microsurgery\n5.\nChest\nResuscitate\n\t\t\t\tand refer\nBasic\n\t\t\t\tServices + stabilise and refer mediastinal Injuries Tracheostomy,\n\t\t\t\tThoracocentensis\nMediastinal Injuries and tumours. Heart and lungsurgery\n6.\nGastrointestinal\nN/A\nAll\n\t\t\t\tsurgical procedures\nAbdominal malignancies. Hepatic surgery\n7.\nGenitourinary\nAcute\n\t\t\t\turinary retention, hydrocoele, circumcision and. vasectomy\nBasic\n\t\t\t\tLevel Services + urethral dilition, management of ruptured\n\t\t\t\tbladder and urethra, Urolithiasis and prostatectomy\nGU malignancies\n8.\nMuscloskeletal\nClosed\n\t\t\t\treduction of uncomplicated fractures, POP, traction\nOpen\n\t\t\t\treduction of fractures Spinal fractures Joint reconstruction\nSpinal fractures, Joint reconstructions.\nPart III\nObligations of The Private Medical Care Establishments.\nObligations of The Private Medical Care Establishments.\n* Accountable to the health and well being of the community it serves;\n* Responsible to the patient who receives treatment and care in dignity, fairness, without discrimination and in consonance with the basic tenets of a patients charter;\n* Accessible at all times and at all facilities - that is, none being denied care on grounds of time, distance or place of residence;\n* Participatory-provide leadership in bringing about behaviour change for adoption of healthy lifestyles and practises that promote well-being and good health values; and\n* Recognising the special value of mother, children and senior citizens in society.",
"footnote": "",
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"number": "1",
"title": "1. Obligations of The Medical Care.",
"chapter": null,
"content": "(i) Administer necessary first aid and take other life saving or establishing emergency measures in all medico legal or potentially medico-legal cases such as victims of road accidents, accidental or induced burns or poisoning or criminal assaults and the like which patient themselves at the establishment.\n(ii) Ensure proper comprehensive treatment and provide with postoperative treatment precautions to the discharged Patient - Dos and Dont's\n(iii) If the doctor is not qualified for a particular speciality but the hospital has the facilities to manage the case, the patient should be admitted and the concerned consultant called for. The doctor should start treatment by the time the consultant arrives.\n(iv) If the doctor is qualified for a particular speciality but the hospital does not have the facilities, and also when there are inadequate facilities and the doctor is not qualified to handle the case then the patient should be shifted to another hospital where facilities are available.\n(v) Maintain proper medical records in the forms prescribed in Appendix-I to VI; perform statutory duties in respect of communicable diseases to prevent the spread of the disease to other persons and report the same to the concerned public health authorities immediately\n(vi) Establishment shall be under obligation to inform the details of charges to be levied and any miscellaneous amounts charged shall not exceed 5% of the total bill.",
"footnote": "",
"is_definition": false,
"sort_order": 44
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{
"number": "2",
"title": "2. Responsibilities Towards a Patient.",
"chapter": null,
"content": "(a) Credentials of the Doctors (Training and qualification) to be made available to Patients.\n(b) Skill and experience of the doctors treating patient should be informed to the patients.\n(c) List of Facilities, Equipment, and treatment protocols to be followed to be given to the patient\n(d) Ethical practises to be followed in respect of patients right for information",
"footnote": "",
"is_definition": false,
"sort_order": 45
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{
"number": "3",
"title": "3. Obligation Towards Their Own Staff and Staff Training.",
"chapter": null,
"content": "(a) All the medical staff should follow the Medical Council of India regulations on Professional conduct, Etiquette and Ethics.\n(b) To maintain the honour and sanctity of the profession\n(c) To discharge their duties honestly, sincerely and humanly\n(d) They should be told of the vital need for absolute asepsis in the medical care establishment\n(e) They should also discharge their duties towards the society by educating the patients and their attenders about the importance of cleanliness, breast-feeding, Immunization and family planning\nPart IV\nEngineering And Environmental Standards\nEngineering And Environmental Standards",
"footnote": "",
"is_definition": false,
"sort_order": 46
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{
"number": "1",
"title": "1. Ceilings.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 47
},
{
"number": "2",
"title": "2. Floor and walls.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 48
},
{
"number": "3",
"title": "3. Water supply, Plumbing and other piping system.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 49
},
{
"number": "4",
"title": "4. Fire-fighting system.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 50
},
{
"number": "5",
"title": "5. Requirements for sanitary fitments in nursing homes for patients.",
"chapter": null,
"content": "A. Inpatient Wards And Nursing Units.\nA. Inpatient Wards And Nursing Units.\ni. Water closets\n1 for every 8 beds or part thereof (Male) 1 for every 6 beds or\n\t\t\t\tpart thereof (female)\nii. Ablution taps\n1 for each water closet plus one water tap with draining\n\t\t\t\tarrangement in the vicinity of water closets.\niii. Urinals\n1 for every 12 beds or pat thereof (males only)\niv. Wash basin\n1 for every 12 beds or part thereof\nv. Baths\n1 bath with shower for every 12 beds or part thereof\nvi Bed pan washing sinks\n1 for each ward in dirty utility and sluice room\nvii Cleaners sinks and sink/slab for cleaning mackintosh\n1 for each ward\nB. Outpatient Block. - For the OPD Block separate toilets are to be provided for the use of males and females. The same toilets may be used by the staff also. The pathology department must maintain a separate toilet. The radiology department must have following special toilet facilities in case it carries out procedures like IVP.\nB. Outpatient Block.\nFor Males\nFor females\ni. Water closes\n1\n\t\t\t\t\tfor every 40 persons or part thereof\n2 for every 50 or part thereof with draining arrangements water\n\t\t\t\t\tcloset and urinals per\nii. Ablution taps\n1\n\t\t\t\t\tin each water closet + 1 water tap shall be provided in the\n\t\t\t\t\tvicinity of lavatory block.\niii. Urinals\n1\n\t\t\t\t\tfor every 25 persons or part thereof\niv. Wash basin\n1\n\t\t\t\t\tfor every 50 persons or part thereof",
"footnote": "",
"is_definition": false,
"sort_order": 51
},
{
"number": "6",
"title": "6. Bio Medical Waste Management.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 52
},
{
"number": "7",
"title": "7. Bio-safety Guidelines.",
"chapter": null,
"content": "(2) Staff should be provided with aprons for working in the laboratory and restricted zones.\n(3) Work surfaces should be disinfected when procedures are completed and at the end of each working day, (o. 1% Hypochlorite solutions is effective for the same)\n(4) Gloves should be worn for all manipulations of infectious material. In operation theaters and delivery rooms, cleaning must be carried out every day. Cleaning with carbolic acid/ phenol has to be carried out every week and swabs should be sent to laboratory for cultures. Fumigation must be done in case cultures turn out positive. All horizontal surfaces including floor should be mopped between cases.\n(5) All Medical instruments should be soaked for 30 minutes in chemical disinfectant before cleaning. This will give further protection to the personnel from exposure to HIV during the process of cleaning. The best form of disinfection is autoclaving. After this comes boiling for 20 minutes.\nAppendix-III\nAppendix-III\n( See Rule 9 (a))\n(Minimum list of services for which rates are to be displayed)\nName of the Service\nType of Service\nCharges (in Rs.)\nRoom Charges:\nRoom Charges:\n(Includes Room/Bed Charges, Nursing charges Medical utilities\n\t\t\t\t\tCharges)\nGeneral Ward\nPrivate rooms:\nPrivate rooms:\nSemi Deluxe - Shared\nDeluxe with A/C\nIntensive Care Units :\nIntensive Care Units :\n(Charges incudes the ICU Bed Charges Medical Utilities,\n\t\t\t\t\tMonitoring and Nursing charges)\nMICU and ICU\nNeuro\nPOW\nNeonatal ICU\nPediatric ICU\nOT Charges\nOT Charges\nGeneral Anaesthesia 1/2 hour\nGeneral Ward\nTwin/Triple Sharing\nGeneral Anaesthesia 1 hour\nGeneral Ward\nTwin/Triple Sharing\nLocal Anaesthesia\n1/2 hour\n1 hour\nSurgical Procedure Charges (Package):\nSurgical Procedure Charges (Package):\n(Includes Surgeons charges + Aesthetics charges + Nursing Home\n\t\t\t\t\tcharges and Inpatient medicines Charges)\nGeneral Surgical Procedures\nOb and Gy. procedures\nOrthopedic Surgical procedures\nCardiac Surgical procedures\nDoctors consultation Charges : OP\nDoctors consultation Charges : OP\nOther super Speciality improved procedures\nIP\nPer Visit\nEmergency Visits\nPer Visit\nEmergency care Team charges\n3 shifts per day\nDiagnostic Charges\nDiagnostic Charges\nCommon diagnostic Tests X-ray per film\nUltra sound, General and Obstetric care\nAbdomen\nFemale Pelvic\nKUB\nCT Scan:\nCT Scan:\nBrain Plain\nMulti slice/Spiral/CT Scan\nChest/Abdomen/Neck/ Spine others\nContract\nMRI 0 .5/1/1.5\nMRI 0\nBrain Plain\n(Magnetic Reasonance Imaging)\nChest/Abdomen/ Neck/ Spine others\nECG/TMT/ECHO/EMG/EEG\nContrast\nUpper GI Endoscopy/Lower GI Endoscopy\nLab Investigations:\nLab Investigations:\nRandom Blood Sugar\nBlood Urea\nSerum Creatinine\nCBP/ESR/CUE\nBlood Group\nBlood for MP\nLFT\nLipid Profile\nHBSAG/VDRL/HIV\nElectrolytes\nT3, T4, TSH\nNote: - Other Service Charges for Inpatients such as Drug s and\n\t\t\t\t\tDisposables, investigations and Concessions, if any shall be\n\t\t\t\t\tdisplayed at appropriate places for the benefit of the patient.\nAppendix: IV\nAppendix: IV\n( See rule NO. 14)\nMedical Records\nThe various medical records to be maintained by the Medical\n\t\t\t\tCare Establishments:\n(1) Out Patient Data\n(2) Inpatient register\n(3) Operation theatre register\n(4) Labour room register\n(5) MTP register\n(6) Case sheet\n(7) Case sheet for procedure\n(8) Case sheet for F.P\n(9) Medico - legal certificate in duplicate\n(10) Medico - legal register\n(11) Laboratory register\n(12) Radiology and Imaging register\n(13) Discharge summary\n(14) Medical certificate in duplicate\nNotifiable to such medical officers as authorized by Government\n\t\t\t\tin such format as prescribed by Government/State Level\n(15) Birth Register\n(16) Death Register\n(17) Notified diseases Information\n(a) Cerebro-spinal fever,\n(b) Chicken- pox,\n(c) Cholera,\n(d) Diphteria,\n(e) Leprosy,\n(f) Measles,\n(g) Plague,\n(h) Rabbies,\n(i) Scarlet fever,\n(U) Small-pox,\n(k) Typhus, or\n(l) T.B\n(m) HIV - AIDS\nFormats For Certain Important Medical Records.\n(a) Maintain a In-Patient Register with the following columns: -\nI.P. No.\nPt. Name\nAge\nAddress\nDate of Admission\nDate of Discharge\nFinal Diagnosis\nBill No\n(b) The case sheet is the most important document. It should include admission notes, consent, investigation reports, progress notes of any procedures conducted, condition at time of discharge and the discharge advice. It is important to record all the happenings during the Patients stay in the hospital and the consultants, duty doctors and nurses should write notes in the case sheet every time they visit the patients. The case sheets after the patients discharge should be preserved carefully.\n(c) The outpatients Register is another important document which is very often neglected. An out-patient Register with following columns should be maintained.\nSl.No.\nName\nAge\nAddress\nDate\nDiagnosis\nAdvice\nConsent Form.\nPatient Name\nPatient Name\nAge\nAge\nSex\nSex\nDate\nDate\nL.P. No.\nL.P. No.\n(a) The patient is suffering from ..........and needs............\n(b) The risk of the above procedure is very high / moderate / regular. There is a possibility that the patient may move into a higher risk category during the course of treatment.\n(c) The possibility of allergic reactions to drugs, I.V. fluids and blood.\n(d) The possibility of cardiac arrest, cardiac arrhythmia's, hypotension, Renal Failure, cerebro-vascular accidents, Respiratory failure and other such severe complications occurring during the course of treatment, aesthesia, surgery' or post-operative periods.\n(e) Some of these complications may need prolonged hospitalization and some are even fatal.\nSignature:\nRelationship to Patient:\nName:\n2.\nWitness\nAppendix - V\nAppendix - V\nReporting Format for Laboratory Surveillance (Form L2)\nReporting Format for Laboratory Surveillance (Form L2)\n(To be filled by in charge of Laboratories at District level and Private Laborataries)\nState Andhra Pradesh\nDistrict:\nBlock...................... Year 2006\nName of\n\t\t\t\tDoctor/Office-in charge\nDesignation Name of the Reporting Unit (Centre, Hospital)\nID.No./Unique Identifier\nID.No./Unique Identifier\nReporting From week to\nReporting\nFrom\nweek\nto\nTarget Disease\nInvestigation\nNo. of Tests Done\nMale\nFemale\nTotal\n<5yr\n> 5yr\nTotal\n< 5Yr\n> 5Yr\nTotal\nMalaria\nP.Falciparum\nP/s for MP\nRapid Test\nP/S for MP\nP. vivax\nRapid Test\nTuberculosis\nSputum for AFB\nCholera\nStool Culture\nTyphoid\nSidal test\nBlood Culture\nStool Cuture\nTyphi dot test\nHepatitis\nB\nRapid Test\nC\nTapid Test\nDengue\nRapid Strip Test (could be done)\nLeptospirosis\nRapid Dot Test\nHIV\nRapid Test\nOthers (Specify)\nElisa\nSignature\nAppendix - IV\nAppendix - IV\nReporting Format for Presumptive Surveillance (Form P)\nReporting Format for Presumptive Surveillance (Form P)\n(To be filled by Medical Officer at PHC/CHC, Government/Non-Government/Private Hospitals, Private Prectitioners)\nState: Andhra Pradesh\nDistrict:\nBlock.............Year: 2006\nName of Doctor:\nDesignation: DM. & H.O.\nName of the Reporting Unit\nD.M&H.O\n\t\t\t\tOffice, Krishna,Machilipatnam\nID NO./Uniqueldentifier\nReport From\nWeek\nTo\na\nc\nd\ne\nf\ng\nh\ni\nj\nk\nl\nm\nn\nCase\nDeaths\nMale\nFemale\nTotal\nMale\nFemale\nTotal\n<5yr\n>5yr\nTotal\n<5Yr\n>5Yr\nTotal\n<5yr\n>5yr\nTotal\n<5yr\n>5yr\nTotal",
"footnote": "",
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{
"number": "1",
"title": "1. Fever",
"chapter": null,
"content": "Fever < 7 days\nFever < 7 days\nSuspect Cases\nSuspect Cases",
"footnote": "",
"is_definition": false,
"sort_order": 54
},
{
"number": "1",
"title": "1. Only Fever",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 55
},
{
"number": "2",
"title": "2. With Rash",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 56
},
{
"number": "3",
"title": "3. With Bleeding",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 57
},
{
"number": "4",
"title": "4. With Daze/Semi consciousness/\n\t\t\t\tUnconsciousness/",
"chapter": null,
"content": "Fever > 7 days\nFever > 7 days\nProbable Cases\nProbable Cases\nMeasles\nMeasles\nDengue (Epi linked cases)\nlapanese Encephalitis\n(Epi linked cases)\nTyphoid",
"footnote": "",
"is_definition": false,
"sort_order": 58
},
{
"number": "2",
"title": "2. Cough with or without fever",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 59
},
{
"number": "2",
"title": "2. Cough with or without fever",
"chapter": null,
"content": "Case of Cough\nProbable Cases\nProbable Cases\n< 3 weeks - ARI\n< 3 weeks",
"footnote": "",
"is_definition": false,
"sort_order": 60
},
{
"number": "3",
"title": "3. Loose Watery Stools of Less than 2 Weeks\n\t\t\t\tDuration",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 61
},
{
"number": "3",
"title": "3. Loose Watery Stools of Less than 2 Weeks\n\t\t\t\tDuration",
"chapter": null,
"content": "Cases of watery stools of < 2 weeks\nSuspect Cases\nSuspect Cases\nWith Some/Much Dehydration\nWith no Dehydration\nWith Blood in Stool\nProbable Cases\nProbable Cases\nEpidemiological linked cases of Cholera",
"footnote": "",
"is_definition": false,
"sort_order": 62
},
{
"number": "4",
"title": "4. Jaundice cases of less Than 4 Weeks\n\t\t\t\tDuration",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 63
},
{
"number": "4",
"title": "4. Jaundice cases of less Than 4 Weeks\n\t\t\t\tDuration",
"chapter": null,
"content": "Cases of Acute Jaundice\nSuspect Cases\nSuspect Cases\nProbable Cases\nProbable Cases\nEpidemiological Linked\nCases of Hepatitis A/E",
"footnote": "",
"is_definition": false,
"sort_order": 64
},
{
"number": "5",
"title": "5. Acute Flacid Paralysis Cases in Less Than\n\t\t\t\t15 Years of Age",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 65
},
{
"number": "5",
"title": "5. Acute Flacid Paralysis Cases in Less Than\n\t\t\t\t15 Years of Age",
"chapter": null,
"content": "Cases of Acute Flacid Paralysis\nSuspect Cases\nSuspect Cases\nProbable Cases\nProbable Cases\nEpidemiological liked cases of Polio",
"footnote": "",
"is_definition": false,
"sort_order": 66
},
{
"number": "6",
"title": "6. Unusual Symptoms Leading to Death or\n\t\t\t\tHospitalization not Conforming to the Above Syndromes",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 67
},
{
"number": "6",
"title": "6. Unusual Symptoms Leading to Death or\n\t\t\t\tHospitalization not Conforming to the Above",
"chapter": null,
"content": "Cases of unusual symptoms leading to death or\n\t\t\t\thospitalization not\nconforming to the above syndromes\nSuspect Cases\nSuspect Cases\nProbable Cases\nProbable Cases\nWrite clinical diagnosis\nNote: Information related to State Specific Diseases (if any) may be added.\nSignature\nForm I\nForm I\n( See rule 4 (a))\nApplication for Registration of Andhra Pradesh Allopathic Private Medical Care Establishments\nApplication for Registration of Andhra Pradesh Allopathic Private Medical Care Establishments\n(to be submitted in Duplicate)",
"footnote": "",
"is_definition": false,
"sort_order": 68
},
{
"number": "1",
"title": "1. Name and address of the Allopathic Private Medical Care Establishment",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 69
},
{
"number": "2",
"title": "2. Name of Correspondent or any Authorised person for correspondence.",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 70
},
{
"number": "3",
"title": "3. Name and Address of the Society/Trust and date on which it was established: -",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 71
},
{
"number": "4",
"title": "4. Whether the accommodation is owned by the Establishment or on lease/rent. If so, please furnish the period of lease/rent along with the documentary proof. (Please Enclose the relevant copies)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 72
},
{
"number": "5",
"title": "5. The date of establishment of Medical care establishment",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 73
},
{
"number": "6",
"title": "6. Total area of Establishment: (One set of photographs of the premises with its functional areas to be furnished) (a) Open area b) Constructed area",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 74
},
{
"number": "7",
"title": "7. Bed strength",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 75
},
{
"number": "8",
"title": "8. Types of Services offered",
"chapter": null,
"content": "(1) Basic (2) Speciality\n(3) Super Speciality\n(4) Diagnostics",
"footnote": "",
"is_definition": false,
"sort_order": 76
},
{
"number": "9",
"title": "9. Names of Doctors, along with Registration Number Allotted by MCI/APMC (Please Enclose the details)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 77
},
{
"number": "10",
"title": "10. Names of qualified Nursing Staff, with their of Registration numbers of NCI/any other board (Please Enclose the details)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 78
},
{
"number": "11",
"title": "11. Names of Para Medical Staff and their Registration numbers (list to be enclosed)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 79
},
{
"number": "12",
"title": "12. No. of Supporting staff (list to be enclosed)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 80
},
{
"number": "13",
"title": "13. No. of Specialities available (Please Enclose the details)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 81
},
{
"number": "14",
"title": "14. The List of Equipment and Furniture available (Please Enclose the details)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 82
},
{
"number": "15",
"title": "15. Labour room with Paediatric care facilities",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 83
},
{
"number": "16",
"title": "16. Operation theatres",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 84
},
{
"number": "17",
"title": "17. Diagnostic Facilities including Clinical Laboratory and Imaging facilities",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 85
},
{
"number": "18",
"title": "18. Whether registration is sought for main facility, or branches also, if so details (separate application shall be submitted for each branch)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 86
},
{
"number": "19",
"title": "19. The financial position of the Hospital/Institute (enclose Audit Report of the last two years)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 87
},
{
"number": "20",
"title": "20. Any other information relating to Hospital",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 88
},
{
"number": "21",
"title": "21. Declaration on Stamp Paper for willingness to comply Yes/No with the prescribed rules is enclosed",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 89
},
{
"number": "22",
"title": "22. Particulars of the Registration fee paid (D.D No., Name f the Bank, and Date)",
"chapter": null,
"content": "(Signature)\n(Name and Designation and full address with official seal.)\nForm II\nForm II\n( See rule 4 (d))\nAcknowledgement\n* The list of enclosures attached to the application in Form I has been verified with the enclosures submitted and found to be correct.\nOr\n*On verification it is found that the following documents mentioned in the list of enclosures are not actually enclosed.\ni.\nii.\niiii.\niv.\nv.\n(..............................)\nSignature and Designation of Registration Authority, or authorized person in the Office of the Appropriate Authority.\nSeal\nForm III\nForm III\n( See Rule 4 (F))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nCertificate of Temporary Registration of Allopathic Private Medical Care Establishments\n(Valid for 90 days from the date of issue)\ni..............................:.........\nii.......................................\nSignature of the\n(Office seal)\nForm IV\nForm IV\n( See Rule 5 (A))\nGovernment of Andhra Pradesh Health Medical and Family Welfare Department\nDistrict Registering Authority\nCertificate of Registration of Allopathic Private Medical Care Establishments\ni. - - -----------\nii.-------------\nSignature and name of the District Registering Authority\n.................District\n(Office seal)\nForm - V\nForm - V\n( See Rule 5 (C))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority.........................\n................................... Rejection of Application For Grant/renewal of Registration Reference Number and Date:\nRejection of Application For Grant/renewal of Registration\nReference Number and Date:\n(1) Name and address of the Allopathic Private Medical Care\n\t\t\t\tEstablishment\n(2) Reasons for rejection of application for grant / renewal of\n\t\t\t\tregistration\nSignature, name and designation of the Registration Authority with office seal.\n* Strike out whichever is not applicable or necessary\nForm - VI\nForm - VI\n( See Rule-6)\nApplication for Renewal of Certificate of Registration\nApplication for Renewal of Certificate of Registration\nThe Registering Authority\n(1) Date of issue of Certificate of Registration to be renewed (enclosed the original Certificate in duplicate)\n(2) Date of Expiry of Certificate of Registration to be renewed.\n(3) File number of the Registering Authority\n(4) Particulars of Renewal fee paid (D.D.No., Name of the Bank, and date) (Original D.D. enclosed)\n(5) I hereby declare that the contents mentioned in this application are true and correct to the best of the my knowledge\n(Signature)\n(Name, Designation and full address with office seal.)\nForm VII\nForm VII\n( See Rale 6)\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\n...........................\nCertificate of Renewal of Registration of Allopathic Private Medical Care Establishments\nM/s-----------------located at----------------is hereby renewed under the provisions of A.P. Allopathic Private Medical Care Establishments Registration and Regulation) Act, 2002. to provide following medical care services:\ni.----------------\nii. --------------\nSignature and Name of the District Registering Authority\n(Office deal)\nForm - VIII\nForm - VIII\n( See Rule 7(b)\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nNotice\nM/s--------------\nOr\nSignature and name of the District Registering Authority\n(Office seal)\nForm IX\nForm IX\n( See Rule 7 (d))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nOrder\n(1) Reference Number and Date:-------------\n(2) Registered notice number and date-------------------\n(3) File Number of Registering Authority-------------\n(4) Date of hearing---------------------\n(5) Whether Establishment has submitted answer in writing................................. Yes/No\n(6) If so, what are the contents and documentary evidence produced by the Applicant-Establishment\n(7) Are they satisfactory.........................Yes/No\n(8) Additional document (s) submitted by the Complaint, if any------------\n(9) Are they relevant to case.........................Yes/No\n(10) Point(s) for consideration in the case------------\n(11) Findings of the District Registering Authority-------\nOr\nSignature and name of the District Registering Authority\n(Office seal)\nForm-X\nForm-X\n( See Rule 8(b))\nApplication for Filing an Appeal Against the Orders of Registration Authority\nChairman.\nAppellate Board and Principal Secretary to Government,\nHealth, Medical and Family Welfare Department.\nA.P. Secretariat Hyderabad-22\nAppeal filed under Section 10 (1) of the A.P. Private Medical Care Establishment (R and R) Act, 2002",
"footnote": "",
"is_definition": false,
"sort_order": 90
},
{
"number": "1",
"title": "1. Name and address of the appellant:",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 91
},
{
"number": "2",
"title": "2. Number, date of the order and address of the authority which passed the order against which appeal is being made (certified copy of the order to be attached):",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 92
},
{
"number": "3",
"title": "3. Prayer / relief sought in the Appeal",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 93
},
{
"number": "4",
"title": "4. Grounds on which the appeal is made:",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 94
},
{
"number": "5",
"title": "5. Interim Relief/Prayer, if any sought",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 95
},
{
"number": "6",
"title": "6. List of enclosures (other than the order referred in item 2 above)",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 96
},
{
"number": "7",
"title": "7. Particulars of the D.D. (number, date and bank) enclosed",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 97
},
{
"number": "8",
"title": "8. Declaration that the contents mentioned in appeal are true and correct to the best of the knowledge of the appellant",
"chapter": null,
"content": "Signature and Name\n(Address of the Allopathic Private Medical Care Establishment)\nForm-XI\nForm-XI\n( See Rule-8(e))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nState Appellate Board, Hyderabad\nOrder",
"footnote": "",
"is_definition": false,
"sort_order": 98
},
{
"number": "1",
"title": "1. Appeal Number and Date:-------------------",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 99
},
{
"number": "2",
"title": "2. Registered notice number and date fixing hearing-------------",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 100
},
{
"number": "3",
"title": "3. File Number of Registering Authority------------------",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 101
},
{
"number": "4",
"title": "4. Date of hearing of appeal --------------------------------------------------------------",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 102
},
{
"number": "5",
"title": "5. What are the contents and documentary evidence produced bv the Appellant Establishment",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 103
},
{
"number": "6",
"title": "6. Are they relevant and satisfactory................Yes/No",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 104
},
{
"number": "7",
"title": "7. Additional document (s) submitted by the Compliant, if any",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 105
},
{
"number": "8",
"title": "8. Are they relevant to the Appeal.......................Yes/No",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 106
},
{
"number": "9",
"title": "9. Issues framed/Point(s) for consideration in the appeal",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 107
},
{
"number": "10",
"title": "10. Findings of the Appellate Board",
"chapter": null,
"content": "",
"footnote": "",
"is_definition": false,
"sort_order": 108
},
{
"number": "11",
"title": "11. Wheatear any interim order is considered Yes/No",
"chapter": null,
"content": "Or",
"footnote": "",
"is_definition": false,
"sort_order": 109
}
],
"metadata": {
"Act ID": "Last Updated 19th September, 2019 [ap525]",
"Act Number": "Published vide Notification No. G.O. Ms. No. 135, Health, Medical and Family Welfare (K2), dated 28.04.2007",
"Enactment Date": "",
"Act Year": "2007",
"Short Title": "Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007",
"Type": "STATE",
"Location": "Andhra Pradesh"
},
"updated_at": "2026-09-29 21:55:18"
}