HOSPITAL DAILY MONITORING CHECKLIST

1 . OP D 1.1 Reception & Help Desk - Patient guidance, Information regarding services & Doctor. 1.2 Registration - Availability as per made of staff, stationary, prescription slips, HMIS (Hospital statistics). 1.3 Senior Citizen Counter display. 1.4 Complaint Box.

(W RITE YES/NO) DATE/TIME

6 . Di ag nos ti c Fac i l ity

6.1 Patho lo gy Lab

6.11 Staff 6.12 Equipments & their functioning status. 6.13 Consumables 6.14 Whether range of investigation is consistent with the Medical Services provided. 6.15 Reports - whether being released in time to O.P.D/Wards.

1.5 Chambers of Doctors & Specialist, Patient's sitting arrangement, Patient disposal. 1.6 Dispensary- Availability of drugs, Pharmacist, duty roster. 1.7 Grievance Redressal by RMO/ Superintendent. 1.8 Minor O.T. - Dressing material, instruments, sterilised drums, Gloves etc. 1.9 Plaster Room, Injection Room Availability of material & performance status. 1.10 Referral Register 1.11 Enquire whether Patients are getting Medicine or Not.

6.2 Radio I ma ging

6.21 X-Ray/CT Scan Machine & functioning status. 6.22 Availability and Quality of Fixer developer, X-Ray Film. 6.23 USG - Functioning status. 6.24 Radiation Safety officer nominated. 6.25 Reports- whether being released in time to OPD/Ward. 6.26 Status of Radiation Protection Protocol, Badges is being regularly used.

2. Caus al ity
2.1 Availability of Doctor, Nurse, compounder, other support staff Duty Roster. CMO daily report. 2.2 Availability of emergency tray having drugs, oxygen, Ambubag, suction, equipment functioning, support staff, Duty Roster. 2.3 Status of emergency ward. 2.4 Skill of Medical/paramedical in life saving practices emergency ward, emergency Box having drugs stitching material, dressing material for Disaster.

7. Store
7.1 Store Keeper/Pharmacist - Availability. 7.2 Storage of Drugs in order, cleannes.

7.3 7.4

Security status. Drugs- sample stock check, expiry (FEFO).

3. Dis pens ary

3.1 Availability of sufficient drug stock. 3.2 Stock Book entry, Daily expenditure entry verification.

8. O.T/IC U
8.1 Anaesthetist- Specialist/ M.O. 8.2 Support staff 8.3 Functioning status of Equipment. 8.4 Duty Roster, OT checklist, Infection Control Measures -fumigation / Culture 8.5 swabs. Emergency/OT Drugs/sterilization of linen/instrument.

3.3 Drug dispensing in envelops.

4. H.R . s tatus check Atte nda nce

4.1 Medical, Para Medical 4.2 Support staff, Behaviour of staff am ong colleagues and with patient.

9. La bo ur Roo m
9.1 Availability of Staff, Drugs, Five trays. 9.2 Availability & status of Resuscitation equipment 9.3 Status of Labour Table, Mattress Macintosh. 9.4 Cleanliness Status, Availability of dustbins, water supply etc.

5. Ambula nce
5.1 24x7 Availability & functioning, Diesel, Petrol. 5.2 Driver - Available round the clock. 5.3 Daily Log Book verification.

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HOSPITAL DAILY MONITORING CHECKLIST

10. Wa rds 10.1 Status of Mattress, Sheets, Drugs. 10.2 Staff - Regular Rounds by Medical Officer/Specialist to be ensured. 10.3 Record Keeping- Drugs, Case sheet etc. 10.4 Nursing & support staff. 10.5 Enquire patients regarding services behaviour of the staff.

(W RITE YES/NO) DATE/TIME

17. Pat ient' s/ Att e nda nt's feed backs for 18. saaisfactor y dr/eator t uatr y arra nge ments / C t re o f Dea t M men . Post- mo rte m.. 19. Hosp ital Fur nit ure- woode n, steel, 20. HospitaFurnitureM anage me nt measures Rusted l Waste & remedial
20 .1 Co l le c t io n 20 .2 Se g re g a t ion 20 .3 M a in t e n a nc e o f Re c o rd 20 .4 T ra ns p o rta t io n 20 .5 D is p os al- i f in -h ou s e wh e t h er p rot oc o l is o e st v e i . 20 .6 Dbserru c tdon & Dis p o sa l o f sh a rps. 20 .7 De st ru c t io n & D is in fe c t io n o f rub b e r, g la s s & Plas t ic s . 20 .8 Co lo u rs c o d e d Bin s a re in p la ce in OPD , in wgu a r n a j g ig o f po ly t t e 20 .9 Re a rdls , iChinne citno n roo m ehc.n e s . 20 .10 Us e o f pro t e ct iv e ge a r, boo ts , a p ro n e t c by wa se van l n s t P 21. O bst erh andcie g &aff. ract ice of I nfe ction

11. House Kee pi ng

11.1 OPD 11.2 Wards 11.3 OT/ICU 11.4 L.R. 11.5 Premises 11.6 Drainages 11.7 Toilets cleanliness, Lights 11.8 Toilets for OPD patients, use of Disinfectants.

12. Wate r Supply

12.1 Drinking water RO/Aqua guard. 12.2 Water Cooler- Maintenance. 12.3 Overhead tanks 12.4 Taps & fittings, Leakages. 12.5 Washroom 12.6 Washbasins

Cont rol Pro tocols .

21 .1 In O. T. 21 .2 In I CU 21 .3 In L. R. 21 .4 Ha nd wa sh Pra ct ic e 21 .5 P ro te c t iv e g lo v es , a p ron e t c

13. Ele ctric Supply

13.1 General- Switches, wiring, Lights. 13.2 Generator- Functional status. 13.3 Availability of Electrician during routine/Emergency Hours.

22. R e cord Roo m

22 .1 C le an l in e ss/ p es ts / Ro den ts 22 .2 P ro pe r f i lin g s t oc kin g

14. D ie t
14 .1 A v a i la b i lit y o f Sta ff 14 .2 A v a ilab il it y o f Foo d it e ms & Ti min gs o f Fo o d sup p ly. 14 .3 Ut e n sils - Av a ila bi l it y & C le an l in es s . 14 .4 Fo o d Tro lley 14 .5 W a t er s u p ply 14 .6 Ge n era l C lea n l in es s 15 . Ho s p it al S ig na g e , Dis p la y Bo a rd s , Timin g s d is p lay . 16 . Fi re f igh t in g Eq u ip me n t

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date

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HOSPITAL DAILY MONITORING CHECKLIST

(W RITE YES/NO) DATE/TIME

REMARKS OF HOSPITAL SUPERINTENDENT/ INCHARGE:

Checked by : www.health.mp.gov.in)

date

(Enclose remarks of improvement if any as per Guidelines on