District Hospital BSC NURSING 4 year ppt.pptx

district hospital presentation slide

1. DISTRICT HOSPITAL The term District Hospital is used here to mean a hospital at the secondary referral level responsible for a district of a defined geographical area containing a defined population. District hospital is essential component of the district health system and functions as a secondary level of health care which provides curative, preventive and promotive healthcare services to the people in the district.

2. Objectives The overall objective of IPHS is to provide health care that is quality oriented and sensitive to the needs of the people of the district. The specific objectives of IPHS for DHs are : To provide comprehensive secondary health care (specialist and referral services) to the community through the District Hospital. To achieve and maintain an acceptable standard of quality of care.

3. Functions A district hospital has the followings function;- It provides effective, affordable health care services (curative including specialist services preventive and promotive ) for a defined population, with their full participation and in-cooperation with agencies in the district that have similar concern. It covers both urban population (district headquarter town) and the rural population in the district . Function as a secondary level referral centre for the public health institutions below the district lever such as Sub-divisional Hospitals, Community Health Centres, Primary Health Centres and Sub-centres .

4. PHYSICAL INFRASTRUCTURE Grading of District Hospitals The size of a district hospital is a function of the hospital bed requirement, which in turn is a func tion of the size of the population it serves. Based on the assumptions of the annual rate of admission as 1 per 50 populations and average length of stay in a hospital as 5 days, the number of bedste quired for a district having a population of 10 lakhs will be around 300 beds.

5. Grading …. However, as the population of the district varies a lot, it would be prudent to prescribe norms by grading the size of the hospitals as per the number of beds. Grade I: District hospitals norms for 500 beds. Grade II : District hospitals norms for 400 beds . Grade III: District hospitals norms for 300 beds. Grade IV: District hospitals norms for 200 beds . Grade V: District hospital norms for 100 beds.

6. Size of the Hospital The size of a district hospital is a function of the hospital bed requirement which in turn is a function of the size of the population serve. In India the population size of a district varies from 50,000 to 15,00,000. For the purpose of convenience the average size of the district is taken in this document as one million population. Based on the assumptions of the annual rate of admission as 1 per 50 population. And average length of stay in a hospital as 5 days.

7. Continue…. The number of beds required for a district having a population of 10 lakhs will be as follows : The total number of admissions per year = 10,00,000 × 1/50-20,000 Bed days per year 20,000×5100,000 Total number of beds required when occupancy is 100% 100000/365-275 Total number of beds required when occupancy is 80% = 100000/365 x 80/100 = 220

8. Area of the hospital An area of 65-85 m² per bed has been considered to be reasonable. The area will include the service areas such as waiting space, entrance hall, registration counter, etc. In case of specific requirement of a hospital, flexibility in altering the area be kept.

9. Essential services Services include OPD, indoor emergency services: General Medicine including Nephrology, Cardiology and Pulmonary medicine, general surgery including Urology and plastic surgery , casualty, critical care (ICU) Anesthesia , Orthopedics , Anesthesia , Ophthalmology, ENT, Dermatology. Paraclinical services: Laboratory services, X-ray , ECG , EEG, Echocardiogram, Pathology, Blood Bank, Physiotherapy Dental Technology (Dental Hygiene), Drugs and Pharmacy.

10. Continue …. Support services: Medico-legal/ postmortem , Ambulance services, Dietary services, Laundry services, Security services, Counselling services for domestic violence, gender violence, adoles - cents, etc . Administrative services: Finance, Medical records (provision should be made for computerized medical records with anti-virus facilities whereas alternate records should also be maintained ), Personnel, Housekeeping and Sanitation, Education and training, Inventory Management, Financial accounting and auditing

11. District is the basic unit of administrative in India and collector is responsible for administration at the district. All the health care programmes in a district are placed under a unified control. The district officer with the overall control is designated as the Chief/sub-centre Health Officer (CM and HO) or as the District Medical and Health Officer (DM and HO). These officers are popularly known as DMOs or CMOs and are overall incharge of the health and family welfare programmes in the district. These DMOs/CMOs are assisted by Dy. CMOs and programme officers . There are 642 districts in India in 2010. For administration purpose, district is explained two categories of administrative areas. Health organization at district level

12. Health organization at district level

13. Urban administration Municipal corporation- Mayor is the head of the Municipal Corporation. The Municipal Commissioner is the official incharge of this organization. Executive Officers monitor the implementation of all the programmes related to planning and development of the corporation with the coordination of Mayor and Councillors Municipal Corporations in India or Mahanagar Palika or Mahanagar Nigam are urban local government that works for the development of a Metropolitan City, which has a population of more than one million.

14. Urban administration Municipality/Municipal Board - In India, a Nagar Palika or Municipality or Nagar Nigam headed by a chairman which is an urban local body that administers a city of population 10,000 to 2 lakh. It has 3 main components chair- man, board and municipal commissioner or executive member. Under the Panchayati Raj system it interacts directly with the state government, though it is administratively part of the district it is located in generally smaller district cities and bigger towns have a Nagar palika . Function- Water supply, Hospitals, Roads, Overbridge , Street lighting, Drainage, Record of birth and deaths.

15. Urban administration Town area Community- The town area committee covers the population 5,000 to 10,000 and administered under district collector . Commonly towns are such areas which are the areas between the village and city. Some laws distinguish only towns and villages from each other, but by usage, settlement with large populations, such as those having a municipal committee or municipal corporation would be called cities.

16. rural administration Rural administration or Panchayati Raj Institutions is the third and last phase of three tier system of administration in rural area of country. Balwant Rai Mehta committee recommended for the launching of P anchayati Raj institutions throughout the country.

17. Rural area health care administration Panchayat raj The panchayat raj is a 3-tier structure of rural local self-government linking the village to the district. It includes Panchayat (at the village level) Panchayat samiti ( at the block level) Zila parishad (at the district level)

18. Rural area health care administration Panchayat (at the village level): The panchayat raj at the village level consists of The gram Sabha The gram panchayat The gram Sabha : It is the assembly of all The adults of the village , which meets at least twice a year. It considers proposals for taxation and elect members of the gram panchayat .

19. Rural area health care administration The Gram Panchayat Executive organ of the gram Sabha and an agency for planning and development at the village level. The population covered- 5000 to 15000 or more. The members of panchayat hold offices for a period of 3 to 4 years. Every panchayat has an elected president ( sarpanch or mukhiya ), a vice president and panchayat secretary. It covers the civic administration including sanitation and public health and work for the social and economic development of the village.

20. Rural area health care administration Panchayat samiti (at the block level ):- The block consists of about 100 villages and a population of about 80,000 to 1,20,000. It consists of Sarpanch , MLAs, MPs residing in block area, representative of women, SC, ST and cooperative societies. The primary function is to execute the community development programme in the block. The block development officer and his staff gives technical assistance and guidance in development work.

21. Rural area health care administration Zila parishad (at the district level )- The zila parishad is the agency of rural local self government at the district level. The members of zila parishad include all heads of panchayat samiti in the district, MPs, MLAs, representative of SC, ST and women and 2 persons of experience in administration, public life or rural development. Its functions and powers vary from state to state.