Paediatric department daily rounds checklist.doc

Paediatric department daily check list to improve health care quality assurance and reduce adverse events

1. PAEDIATRIC WARD
DEPARTMENT CHECK LIST

Monitoring & QA

Dr.N.Varatharaj, D.C.H.,

2. Month & Year :
S.No. Check points 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Service provision.
1.1 Availability of OAE test.
2 Patient Rights.
2.1 Information access to facility.
a) Departmental signage.
b) Directional signage.
c) List of services provided.
d) Entitlements under RSBY.
e) Contact details of referral transport / ambulance.
f) Visiting hours and visitor policy.
g) IEC (Breast feeding, Immunization, ORS, Zn, Hand washing, Nutrition, etc.).
2.2 Informed consent for procedures.
2.3 Complaint box with grievance redressal mechanism.
3 Inputs.
3.1 Patient amenities.
a) Drinking water.
b) Functional hand wash area for patient / visitor.
c) Functional and clean toilets with flush and running water for visitors.
d) TV for entertainment and health promotion.
3.2 Functional telephone and intercom services.
3.3 Temporary connections and loosely hanging wires.
3.4 Fire safety measures.
a) Fire exit sign and fire escape route.
b) Functional status of fire extinguishers.
c) Competency of staff for operating fire extinguisher.
3.5 Availability of staff on duty as per duty roster.
3.6 Availability of drugs and consumables.

3. a) Emergency medications
b) IV fluids – RL, NS, DNS, 10% D
c) Antibiotics – Ampicillin, Gentamicin, Cefotaxime, Ceftriaxone.
d) Oral drugs
e) IV infusion sets, IV cannulas, Scalp vein set, tubes, syringes.
f) Resuscitation consumables -NG tube, Suction catheter,
Uncuffed ET tube, Oropharyngeal airway.

3.7 Functional equipments and instruments for examination and monitoring.
a) Thermometer
b) BP apparatus with paediatric cuff.
c) Weighing scale (infant & adult)
d) Stethoscope
e) Stadiometer
f) Infantometer
3.8 Functional diagnostic instrument – Glucometer.
3.9 Functional instruments and equipments for resuscitation.
a) Face masks (Neonate, infant and paediatric).
b) Self inflating ventilation bag
c) Laryngoscope
d) ET tube
e) Suction machine
f) Nebulizer
g) Oxygen
3.10 Equipments for storage of drugs, instruments and consumables.
a) Functional Refrigerator
b) Crash cart / Drug trolley
c) Instrument trolley with sterile instruments.
d) Dressing trolley with dressing tray.
4 Support Services.
4.1 Equipments.

4. a) PPM schedule available and implemented.
b) Timely breakdown maintenance of equipments.
c) Calibration of measuring equipments / instruments.
4.2 Inventory management.
a) Labeling of empty and full cylinders.
b) Storage of drugs requiring controlled temperature.
c) Maintenance of temperature logs for drug storage refrigerators.
d) Regular defrosting of storage refrigerators.
e) Maintenance of buffer stock of drugs and consumables.
f) Secure storage of NDPS.
4.3 Safe and comfortable environment.
a) Adequate illumination at patient care areas.
b) Monitoring and recording room temperature (25 – 30
0
C)
c) Re-warming blankets.
d) Availability of identification bands (age below 5 years).
e) Functional CCTV.
4.4 Maintenance and upkeep of facility.
a) Cleanliness of circulatory area and patient are area.
b) Cleanliness of surface of fixtures.
c) Cleanliness of surface of furniture.
d) Toilets are clean with functional flush and running water.
e) Condemned / junk material in SNCU.
4.5 Water supply and power backup.
a) Running and potable water.
b) D.G. set power backup.
c) Emergency light.
4.6 Quality checks.
a) Diet quality.
b) Linen quality.

5. c) Outsourced services adequacy and quality.
5 Clinical Services.
5.1 Records / Registers management.
a) Availability of standard formats.
b) Referral-in and Referral-out registers.
c) Maintenance of handover register.
5.2 Availability of high alert drugs list with maximum dose value.
5.3 Availability of critical value of various tests.
5.4 Blood transfusion procedures – consent, monitoring, transfusion reaction.
6 Infection control.
6.1 Availability of materials for antisepsis, cleaning and disinfection.
a) Anti-microbicidal liquid hand wash solution.
b) Alcohol based hand rub.
c) Detergents.
d) Disinfectants – Chlorine solution, glutaraldehyde, carbolic acid.
6.2 Availability of autoclaved dressing material.
6.3 Fumigation as per schedule (PREM unit).
6.4 Availability of PPE.
a) Caps
b) Masks
c) Apron / Gown
d) Plastic apron
e) Clean and Sterile gloves
f) PPE for infectious patients
6.5 Mothers are practicing hand wash- after changing diaper, before feeding, after
using the toilet.

6.6 Biomedical Waste Management.
a) Availability of colour coded bins and bin liners.
b) Availability of functional needle cutters.
c) Availability of puncture proof containers for sharps disposal.

6. d) Display of work instructions for segregation and handling of BMW.
e) Disinfection of liquid waste before disposal.
f) Disposal of transfused bags & bags with residual/discarded blood products.
6.7 Display of posters.
a) Steps of hand hygiene.
b) Five moments of hand hygiene.
c) Standard precautions.
d) NSI protocols.
e) Preparation of chlorine solution.
f) Spill management protocols.
7 Quality Management.
7.1 Availability of updated SOPs.
7.2 Display of work instructions / protocols at point of use.
a) Patient safety.
b) Formula for calculation of paediatric doses.
c) CPR.
Signature of Paediatric ward Staff nurse


Signature of Paediatric ward Nodal officer

7. Month & Year :
S.No. Check points 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Service provision.
1.1 Availability of OAE test.
2 Patient Rights.
2.1 Information access to facility.
a) Departmental signage.
b) Directional signage.
c) List of services provided.
d) Entitlements under RSBY.
e) Contact details of referral transport / ambulance.
f) Visiting hours and visitor policy.
g) IEC (Breast feeding, Immunization, ORS, Zn, Hand washing, Nutrition, etc.).
2.2 Informed consent for procedures.
2.3 Complaint box with grievance redressal mechanism.
2.4 Availability of prescribed drugs and consumables.
2.5 Availability of prescribed investigations.
3 Inputs.
3.1 Patient amenities.
a) Drinking water.
b) Functional hand wash area for patient/ visitor.
c) Functional and clean toilets with flush and running water for visitors.
d) TV for entertainment and health promotion.
3.2 Functional telephone and intercom services.
3.3 Temporary connections and loosely hanging wires.
3.4 Fire safety measures.
a) Fire exit sign and fire escape route.
b) Functional status of fire extinguishers.
c) Competency of staff for operating fire extinguisher.

8. 3.5 Availability of staff on duty as per duty roster.
3.6 Availability of drugs and consumables.
a) Emergency medications
b) IV fluids – RL, NS, DNS, 10% D.
c) Antibiotics – Ampicillin, Gentamicin, Cefotaxime, Ceftriaxone.
d) Oral drugs
e) IV infusion sets, IV cannulas, Scalp vein set, tubes, syringes.
f) Resuscitation consumables -NG tube, Suction catheter,
Uncuffed ET tube, Oropharyngeal airway.

3.7 Functional equipments and instruments for examination and monitoring.
a) Thermometer
b) BP apparatus with paediatric cuff.
c) Weighing scale (infant & adult)
d) Stethoscope
e) Stadiometer
f) Infantometer
3.8 Functional diagnostic instrument – Glucometer.
3.9 Functional instruments and equipments for resuscitation.
a) Face masks (Neonate, infant and paediatric).
b) Self inflating ventilation bag
c) Laryngoscope
d) ET tube
e) Suction machine
f) Nebulizer
g) Oxygen
3.10 Equipments for storage of drugs, instruments and consumables.
a) Functional Refrigerator
b) Crash cart / Drug trolley
c) Instrument trolley with sterile instruments.
d) Dressing trolley with dressing tray.

9. 4 Support Services.
4.1 Equipments.
a) PPM schedule available and implemented.
b) Timely breakdown maintenance of equipments.
c) Calibration of measuring equipments / instruments.
4.2 Inventory management.
a) Labeling of empty and full cylinders.
b) Storage of drugs requiring controlled temperature.
c) Maintenance of temperature logs for drug storage refrigerators.
d) Regular defrosting of storage refrigerators.
e) Maintenance of buffer stock of drugs and consumables.
f) Secure storage of NDPS.
4.3 Safe and comfortable environment.
a) Adequate illumination at patient care areas.
b) Monitoring and recording room temperature (25 – 30
0
C)
c) Re-warming blankets.
d) Availability of identification bands (age below 5 years).
e) Functional CCTV.
4.4 Maintenance and upkeep of facility.
a) Cleanliness of circulatory area and patient are area.
b) Cleanliness of surface of fixtures.
c) Cleanliness of surface of furniture.
d) Toilets are clean with functional flush and running water.
e) Condemned / junk material in SNCU.
4.5 Water supply and power backup.
a) Running and potable water.
b) D.G. set power backup.
c) Emergency light.

10. 4.6 Quality checks.
a) Diet quality.
b) Linen quality.
c) Outsourced services adequacy and quality.
5 Clinical Services.
5.1 Records / Registers management.
a) Availability of standard formats.
b) Referral-in and Referral-out registers.
c) Maintenance of handover register.
5.2 Availability of high alert drugs list with maximum dose value.
5.3 Availability of critical value of various tests.
5.4 Blood transfusion procedures – consent, monitoring, transfusion reaction.
6 Infection control.
6.1 Availability of materials for antisepsis, cleaning and disinfection.
a) Anti-microbicidal liquid hand wash solution.
b) Alcohol based hand rub.
c) Detergents.
d) Disinfectants – Chlorine solution, glutaraldehyde, carbolic acid.
6.2 Availability of autoclaved dressing material.
6.3 Fumigation as per schedule (PREM unit).
6.4 Availability of PPE.
a) Caps
b) Masks
c) Apron / Gown
d) Plastic apron
e) Clean and Sterile gloves
f) PPE for infectious patients
6.4 Mothers are practicing hand wash- after changing diaper, before feeding, after
using the toilet.

11. 6.5 Biomedical Waste Management.
a) Availability of colour coded bins and bin liners.
b) Availability of functional needle cutters.
c) Availability of puncture proof containers for sharps disposal.
d) Display of work instructions for segregation and handling of BMW.
e) Disinfection of liquid waste before disposal.
f) Disposal of transfused bags & bags with residual/discarded blood products.
6.6 Display of posters.
a) Steps of hand hygiene.
b) Five moments of hand hygiene.
c) Standard precautions.
d) NSI protocols.
e) Preparation of chlorine solution.
f) Spill management protocols.
7 Quality Management.
7.1 Availability of updated SOPs.
7.2 Display of work instructions / protocols at point of use.
d) Patient safety.
e) Formula for calculation of paediatric doses.
f) CPR.
Signature of Paediatric ward Staff nurse


Signature of Paediatric ward Nodal officer