Staff Requirement for 10-bedded ICU

Staff Requirement for 10-bedded ICU

Draft guidelines developed by AIIMS, New Delhi have recommended minimum standards for ICUs to be adopted throughout the country.

 

Following are calculations for the staff requirement for a 10-bedded ICU as follows based on the committee recommendations:

1.    Full Time Director (1)

2.    Full Time Senior accredited specialist: PG with 5 - 7 years, available during "off duty hours" (2)

3.    Consultants: 3 years post PG, available on call on weekends and general holidays. (4)

4.    Resident doctors: minimum 2, 24X7, (1 PG, 1 trainee): 1 for 5 patients (2 x 3 +3 =9)

5.    Other specialty doctors: on call 24h/Day basis (10)

6.    Head nurse: full time, 5 years’ experience (1)

7.    One senior nurse (1)

8.    In-charge Nurse: MSc, 3 years’ experience, 2/shift for 12 beds, One infection control nurse (8)

9.    Nurse staff: 1:1 ratio, BSc  (40)

10. Physiotherapist: 1 /shift per five beds on 24 hours x 7 days basis (8)

11. Technicians: 1/5 beds, per shift (8)

12. Additional technician in charge (4)

13. Radiographer: One each for 6 -12 bedded ICU: available 24h/day basis. (4)

14. Dietician: One each for 6 -12 bedded ICU: available 24h/day basis. (4)

15. Psychologist I Counselor: One each for 6 -12 bedded ICU: available 24h/day basis. (4)

16. Pharmacist: One each for 6 -12 bedded ICU: available 24h/day basis. (4)

17. Computer operator: One each for 6 -12 bedded ICU: available 24h/day basis. (4)

18. Two data entry operator/ medical secretary for06 - 12 bedded ICU (2)

19. Biomedical engineer: Available 24hrs x 7 days basis from hospital engineering section: in charge of equipment repair & maintenance. (4)

20. Biomedical waste sanitary attendant: Two each in 1" & 2"d shift, one each in 3'd shift per day per 10-12 bedded ICU (7)

21. Security guard: 24hrs x 7 days basis availability of security personnel must be ensured. (4)

Health is a state subject in India. Hence, the responsibility of delivery of healthcare lies with the state governments.

If these recommendations are correct, then tertiary ICU care would be un-affordable to majority of general public unless all ICUs are subsidized by the government.

(Source: The draft prepared by the committee constituted (vide memo F. No 35-17/2012/Ministry/Co-ordination cell/Estt. I, dated May 24, 2012 issued at AIIMS, New Delhi) for suggesting the “minimum standards for ICUs to be adopted throughout the country” under the chairmanship of Prof MK Arora, Dept. of Anesthesiology at AIIMS, New Delhi)

Draft guidelines: Obligations of doctors/hospitals concerning seriously ill/injured persons

Draft guidelines: Obligations of doctors/hospitals concerning seriously ill/injured persons It may be noted that in the case of Pt. Parmanand Katara v. Union of India [AIR 1989 SC 2039], the Medical Council of India (MCI) has submitted and that has been recorded in the judgment of the Hon’ble Supreme Court as under: “It is further submitted that it is for the Government of India to take necessary and immediate steps to amend various provisions of law which come in the way of Government Doctors as well as other doctors in private hospitals or public hospitals to attend the injured/serious persons immediately without waiting for the police report or completion of police formalities. They should be free from fear that they would be unnecessarily harassed or prosecuted for doing his duty without first complying with the police formalities..... It is further submitted that a doctor should not feel himself handicapped in extending immediate help in such cases fearing that he would be harassed by the Police or dragged to Court in such a case. It is submitted that Evidence Act should also be so amended as to provide that the Doctor’s diary maintained in regular course by him in respect of the accident cases would be accepted by the courts in evidence without insisting the doctors being present to prove the same or subject himself to cross-examination/ harassment for long period of time.” Whereas, the Council after consultation with the representatives of the Indian Medical Association has prepared the annexed format for Medico-legal cases that may be included as an Annexure to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. The suggested format is annexed (as below). In order that, this record be considered as evidence in Court’s proceedings, without requiring the concerned registered medical practitioner to attend Court’s proceedings, it must be ensured that the Record is legible. Therefore, a typed copy of the record should be submitted to the Court. Further, in criminal cases, information regarding the nature of injury is crucial. Therefore, in the Medico-Legal Case Sheet/Doctor’s Diary that is prepared the Registered Medical Practitioner should clearly record: i. Findings ii. Diagnosis iii. Reasons for declaring the injury as simple/grievous iv. Whether such injury is caused by accident/assault/unascertainable A proposal in this regard if deemed appropriate may be drafted by the Ministry of Law and Justice for amending the Indian Evidence Act, 1972, in a time bound manner considering the requirement of criminal investigation and trial. The above proposal after approval of the General Body of the Council be transmitted to the Ministry of Health and Family Welfare, Government of India for appropriate action at their end. Suggested Format for Medico-Legal Cases 1. Name of the patient: 2. Age: 3. Sex: 4. Identification Marks (i) (ii) 5. Address: 6. Occupation: 7. Brought by: 8. Date of 1st visit: 9. History: 10. Clinical note (summary) of the case: 11. Prov.: Diagnosis: 12. Investigations advised with reports: 13. Diagnosis after investigation: 14. Nature of Injury: 15. Advice: (Including Procedure Done) 16. Reasons for declaring the injury as simple/grievous 17. Whether the injury is caused by accident/assault/unascertainable 18. Whether the injury under reference can be caused by other means also? 19. Follow up: 20. Observations: 21. Date: Signature in full …………………………. Name and Designation of Treating Physician: Registration No: Registered with (Council Name): Name and Place of the Hospital: Note: The entries made in the above format should be typed.