pharmacy

Drug Safety
1)List of EDL - to be  displayed outside Pharmacy (in Tamil also). A copy to be available in all departments
2)No Stock Out situation
3)Safe storage of medicines at appropriate temperature. List of storage temperature of all drugs to be available
4)Policies for storage and analysis - FEFO, VEN, FSN, LASA, High risk, NDPS etc.
5)Safe dispensing with proper instructions about use.
6) Verification of identity before administration
7)Safe injection policy - one patient one syringe one needle, policy for multidose vials, policy for sedation,labeling of preloaded syringes,  policy for NDPS drugs, RIGHTS- right drug,patient,time,dose,route, rate, documentation ;checking expiry date , condition of drug
8)Prevention of HAI- standard precautions
9)Safe disposal - BMW segregation- syringes, expiry medicines, vaccines
10)Safe immunization
11)Safe blood transfusion
12)Medication charts - signed by SN and MO
13)Documentation of history of Drug Allergy in Case sheet and Medication chart- in Red
14)Drug Recall - RCA
15)Medication errors, Adverse events, Adverse Drug Reactions- Incident reporting and RCA and CAPA
16)Availability of emergency  drugs at point of use - Emergency drug tray, Crash Cart, PPH tray, Eclampsia tray etc.
17)Prescription auditing - deficiencies and action taken
18)Antibiotic policy and prevention of Antibiotic resistance
19)High Risk medications - double check
20)List of High Alert drugs , therapeutic and maximum dose
21)List- Drug and Food interactions
22)List- Drug-Drug interactions
23)Monitoring after drug administration
24) Patient education and information
25)Verbal order and Read back policy
26)Precription-Avoiding abbreviations, legible, sign and seal ,dose, route, time, instructions .
27) Policy for self medications - doctor should record in case sheet, SN should record in medication chart
28)Expiry and Near expiry policies
29)Inventory management and Buffer stock calculation
30)NSI management
31)Occupational hazard - Immunization of staff
32)Monitoring charts in special situations and during  infusions - eg. oxytocin, blood, nitroglycerine , streptokinase etc.
33)Infusion pump , Paedia set, Diginfusa usage
34)Temperature chart maintenance for all refrigerators where drugs are stored .
35)Control chart- in BB,  for ILR
36)Licenses
37)Training
38) Safe nebulization - dose for adult and child , dilution and monitoring
39)Oxygen supply - Central and cylinders . Manifold room maintenance .Colour coding for medical gas  pipelines . CAD for piped medical gas supply. Valves location.  Measures to detect leakage . Chart maintenance for usage. Safe transport of cylinders  .
40. Prevention of HAI- blood stream, mask associated
 41. Stock maintenance - drugs and supplies
42.5S method for Storage
43.Drug Committee.
 44.Safe administration of Contrast in Radiological procedures
45. Safe anaesthesia and monitoring - formats used
46.Chemotherapy

Food Safety - Auxiliary services-kitchen

Food Safety
1)Raw materials- ingredients required for preparation -grocery items, vegetables,milk etc.
a)procurement
b)stock maintenance
c)safe storage - perishable items in refrigerator . Grocery items - stored above floor level . Prevention of pilferage. Measures against  insects and rodents  
d)External quality testing of supplies
e)MOU with contractor. Penalty clauses
f)Quality and quantity of vegetables received- register maintained by Kitchen staff  

2)Preparation of food
a)Cook and helpers - tested for communicable diseases . Immunized- typhoid, HepatitisA  Dewormed regularly
b)Personal hygiene - hair, nails, cap and mask , kitchen apron worn during cooking . Clean chappals .Social  Hand wash . Washing feet after visiting restroom.
c)Clean vessels. Vessels washed and dried in sunlight. Vessels cleaned with boiling water before cooking .
d)Cutting of vegetables with knife on raised platform or table
e) Hygienic preparation , washing the ingredients well. Clean maintenance of Kitchen.
f)Using clean water for cooking - RO water tested every month
g)Storage of cooked food - separately. All items in clean containers with lids
h)Food sample sent for Internal quality - Duty MO . Storage of Sample food in refrigerator

3)Distribution of food
a)Food trolley - clean. Cleaned well after food distribution
b)Food items arranged in closed containers
c)PPE - worn during distribution
d)Diet supplied as per Diet order
e)Gas Stove used- clean
f)sop for food preparations
g)training of staff in infection prevention measures
h)Food distributed in clean trays .

4)Appropriate diet provided - as per condition of patient
a)Nutritional screening by treating doctor. Diet instruction written every day in case sheet . Nutritional assessment using format - for high risk cases by Dietician (where available)
b)Diet order- documentation in Diet sheet - type of diet- IOD, child, hypertensive, diabetic, postpartum diet, iron rich, protein rich, liquid etc.
c)Diet calculation by Kitchen staff - no. of diets of each type required
d) Calculation of raw materials for preparation - by Office staff

5)Kitchen surveillance using format by Kitchen staff and monitored by Kitchen MO
6)Supervision- NS, JAO, Kitchen MO, CMO.  
7)Stock maintenance
8)Analysing Patient views in PSS.
9)Root Cause analysis of Food related complaints/ problems
10)Maintaining registers, sop, culture surveillance, external and internal quality testing reports, house keeping checklist

11)Provision of safe Drinking water in the facility - tested every month.
12)Kitchen waste disposal - in compost .

arrange the documents in this order for ease of review by the External Assessors

new building constructed

In any new building constructed please make sure they have all these Nqas requirements .
1. Uniform signages.
2. Elbow taps in all patient care areas and labs .( except toilets )
3. IN ops and wards towel rings and hand wash stands .
  3.one disabled friendly toilet .
4. All toilets with flush .
5. Wire mesh work for all windows
6. Provision for connection of pipes for fire extinguishing from above water tank .
7. Floor directing tiles for blind people .
8 .  A common chamber for liquid waste management .

These are all to be provided by pwd civil people ,only if we mention