XXX HOSPITAL Doc. No.
XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
1.0 PURPOSE:
1.1 To delineate policy for the planning and provision of uniform care of patients in all settings of
the organization which is guided by the applicable laws, regulations and guidelines.
2.0 SCOPE:
2.1 All Patient-care areas
3.0 RESPONSIBILTY:
3.1 Medical Director
3.2 Nursing Director
3.3 Departmental HODs
4.0 ABBREVIATION:
4.1 NABH : National Accreditation Board For Hospitals and Healthcare providers
4.2 COP : Care Of Patients
4.3 HOTA : Human Organ Transplantation Act
4.4 PCPNDT : Pre Conception Pre-Natal Diagnostic Test
4.5 MTP : Medical Termination of Pregnancy
5.0 DEFINITIONS:
5.1 Evidence based medicine: It is the conscientious, explicit and judicious use of current best
evidence in making decisions about the care of individual patients.
5.2 Clinical practice guidelines: These are systematically developed statements to assist
practitioner and patient decisions about appropriate health care for specific clinical
circumstances (Field and Lohr 1990, page 38).
6.0 REFERENCE:
6.1 NABH: NABH Standards for Hospitals, Fifth Edition, Apr. 2020.
6.2 COP.1: Uniform care to patients is provided in all settings of the organization and is guided by
the applicable laws, regulations and guidelines. (OE a – h).
XXX HOSPITAL Doc. No. XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
7.0 POLICY:
7.1 This policy embraces Diversity, Dignity and Inclusion in line with emerging Human Rights for
uniformity of patient care. We recognize, acknowledge and value difference across all people
and their backgrounds. We will treat everyone with courtesy and consideration and ensure that
no one is belittled, excluded or disadvantaged in any way, shape or form. The Uniformity of
patient care is guided up on the prevailing national and international laws and the laws of the
land.
7.2 All patients are treated alike irrespective of their religion, cast, social status, financial ability, etc.
The safety of all patients seeking health care at this hospital is the prime responsibility of this
hospital. A uniform patient care system shall be laid down in all areas so as to provide excellent
service.
7.3 When the doctor issues a treatment order, it shall be given in writing and signed mentioning
date and time. The nursing staff administering the medicines prescribed by the doctor also shall
make the necessary entry in the patient’s case sheet with date, time and signature. When a
drug known to produce reactions is to be given by injection, it shall be done only after giving the
patient a test dose. The full dose is given only after the test dose result is studied and found to
be safe.
7.4 Similar care is given in different settings which are guided by applicable laws and regulations;
care delivery shall be uniform in emergency and ambulance services, Cardio Pulmonary
Resuscitation, use of blood and blood products, care of patients in the ICUs, and other high
dependency areas, Post-surgical recovery rooms, etc. and shall be excellent and adequate
number of experienced nursing staff shall be detailed for duties.
7.5 The medical and life supporting equipment should be kept in prime serviceable condition. All
staff working in the critical areas should be familiar with the working of these equipments. As far
as possible one nursing staff for each patient (patients on ventilator support) and one nursing
for every two patients (for non-ventilator patients) should be available in these areas to look
after a patient, thus maintaining 1:1 ratio / 1: 2 ratio respectively. The nursing staff should
observe and monitor the patient’s health status and keep updating the treating doctor from time
to time. All the emergency drugs and critical care equipment should be kept ready for use at all
times in these areas.
XXX HOSPITAL Doc. No. XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
7.6 It is the responsibility of all medical and non medical staff to identify risk area and to highlight
these to the appropriate authority, usually via the Critical Incident Reporting Procedures.
Employees also have a responsibility to cooperate with concerned authority and to contribute
the process of identifying risk areas and reducing risks.
7.7 The Supervisors and staff working at these units will ensure the best possible care is provided
to all patients giving priority attention to the serious category.
7.8 This Hospital has the policy for delivering uniform care to all patients irrespective of the care
setting right from the admission to discharge for IPD cases, in OPD services and emergency
services.
7.9 Laboratory facility, OT facility, Diagnostics and Nursing Care services are uniformly provided to
all patients irrespective of category of patients.
7.10 All protocols are uniformly given in the same manner to all patients irrespective of the category
status.
7.11 Uniform care is guided by laws & regulations applicable to the hospital.
7.12 It is further ensured that the care and treatment orders are legibly signed, named, timed and
dated by the concerned doctors and nurses, the main idea being that the authors of these
orders are identifiable by all and the chronology of care process is maintained.
7.13 The care plan needs to be countersigned by the clinician in-charge of the patient within 24
hours. The care plan is reviewed every 24 hrs.
7.14 The Hospital ensures same quality of healthcare facility emergency care, infusive care, and
operation theaters throughout the organization irrespective of the category of wards.
7.15 The organization adapts evidence-based clinical practice guidelines and / or good clinical
practices to guide the uniform patient care.
7.16 Clinical care pathways are developed based on International published guidelines (NCBI / NHS
/ others…..), consistently followed across all settings of care (Emergency / ICU/CCU/wards..)
and reviewed periodically.
7.17 Also it shall be ensured that the care delivery is uniform for a given clinical condition when
similar care is provided in more than one setting (Emergency / ICU/HDU/Wards..).
7.18 It is also to be ensured that all is done as per the applicable laws and regulation.
XXX HOSPITAL Doc. No. XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
7.19 Planning of multidisciplinary and Multispeciality care wherever appropriate shall be done as per
best clinical practice guidelines and delivered in a uniform manner across the Organization.
8.0 PROCEDURE:
8.1 The Uniformity of patient care is guided by the prevailing national and international laws. The
hospital abides and complies with the statutory and regulatory guidelines published from time to
time by the Local Government Rules.
8.2 The hospital shall ensure that patients with the same health problems and care needs, receive
the same quality of healthcare throughout the organization irrespective of category of ward.
8.3 A patient admitted to the hospital shall be looked after excellently by experienced nursing staff
and other support personnel.
8.4 The policy embraces Diversity, Dignity and Inclusion in line with emerging Human Rights for
uniformity of patient care.
8.5 The patient care given at high dependency areas like ICUs, and High Dependency unit areas,
Casualty unit, Post-surgical recovery etc. should be excellent and adequate number of
experienced nursing staff should be detailed for duty.
8.6 The medical and life supporting equipment should be kept in prime serviceable condition. All
staff working in these areas should be familiar with the working of these equipments.
8.7 At least one nursing staff for each patient (patients on ventilators) should be available in these
areas to look after a patient, thus maintaining 1:1 ratio; in case of non-ventilator patients, the
ratio shall be 1:2 (for every two patients there shall be a nurse).
8.8 The nursing staff should observe and monitor the patient’s health status and keep updating the
treating doctor from time to time.
8.9 Care and treatment orders shall be signed, named, timed, and dated by the concerned. When
the doctor issues a treatment order, it should be given in writing and signed mentioning date
and time.
8.10 The nursing staff administering the medicines prescribed by the doctor also should make the
necessary entry in the patient’s case sheet with date, time and signature.
8.11 The verbal orders are authenticated within 24 hours from the time of the issue of the order.
Each verbal order is dated and is identified by the names of the individuals who gave it and
received it, and implemented it.
XXX HOSPITAL Doc. No. XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
8.12 The record should indicate who implemented it. Individuals who receive verbal orders are
qualified to do so and are authorized by the medical staff to do so as identified by title or
category of personnel.
8.13 The care plan is signed by the clinician in charge of the patient within 24 hours. The treatment
of patient could be initiated by a junior doctor, but the same shall be countersigned and
authorized by the treating doctor within 24 hours.
8.14 The uniform care should reflect applicable laws, regulations and guidelines like Clinical
Establishment Act, PCPNDT for Ultra sonograms/ Labour cases, (Human Organ Transplant Act
(HOTA), MTP Act; wherever deemed necessary appropriate Consents are taken from patients
after proper information (Consent before surgery, Consent for HIV test, Consent for Blood
Transfusion, Consent for Anaesthesia, etc.); in cases of medico-legal cases prior police
intimation shall be done.
8.15 Multidisciplinary & multi-speciality care shall be planned where ever appropriate based on HCO
clinical practice guidelines to ensure response responses to treatment is shared among
medical ,nursing and other care providers and same is recorded in medical records with team
members names ,signatures ,date & time
8.16 Evidence-based medicine Evidence Based Clinical Practice (EBP): Evidence-based
medicine requires careful and judicious use of current best evidence in making decisions about
the care of individuals.
8.17 Evidence-based practice is an approach that promotes the collection, interpretation, and
integration of valid, important, and applicable patient-reported, clinician-observed, and derived
evidence. In addition to the collection, evaluation, and interpretation of data, EBP emphasizes
the dissemination of information so that the evidence can reach clinical practice.
8.18 Clinical care pathways have been adopted for various clinical interventions as per NCBI / NHS
published care pathways (Refer Annexure-A)
8.19 Therefore, well thought-out and careful clinical planning involves both individual clinical
expertise and the best available external clinical evidence in addition to data collected from the
individual. Levels of Evidence take on significance when making clinical decisions.
8.20 Telemedicine facility not offered in HCO.
XXX HOSPITAL Doc. No. XXX / NABH / COP / 01
NABH Std Ref COP / 01 / a –h
Issue No. 01
POLICY AND PROCEDURE TO GUIDE Rev. No 00
UNIFORM CARE OF PATIENTS
Date DD/MM/YYYY
9.0 ANNEXURE-A:
01-ccp-nhs-rightcare-copd-pathway-v18
02-ccp-cvd-pathway
03-ccp-nhs-rightcare-toolkit-cvd-prevention
04-ccp-progressive-neuro-toolkit
05-ccp-stroke-pathway
06-ccp-nhs-rightcare-pathway-diabetes
07-ccp-falls-fragility-fractures-pathway-v18
