Inpatient Department (IPD)

Inpatient Department (IPD)

Introduction

• Inpatient services refer to the care provided to patients admitted to a hospital for at least 24 hours or more, requiring observation, treatment, or surgery.
• It is the core of hospital services as majority of medical care is delivered here.
• Inpatients may be admitted through OPD, Emergency, or direct referral from another hospital/healthcare provider.
• Quality of inpatient services reflects the overall efficiency and reputation of a hospital.

Features of Inpatient Services

• Continuous Care: 24×7 medical, nursing, and supportive care.
• Multidisciplinary Approach: Involves doctors, nurses, paramedics, technicians, and support staff.
• Planned Admission & Emergency Admission: Both elective and urgent cases are managed.
• Infrastructure Intensive: Requires beds, wards, equipment, nursing stations, sanitation, food, and housekeeping.
• Documentation: Proper medical records, treatment charts, nursing notes, discharge summaries.
• High Cost & Resource Utilization: Major contributor to hospital expenditure.

Location of Inpatient Department (IPD)

• Ideally located in a quiet, accessible area of the hospital.
• Should be near diagnostic, pharmacy, ICU, and operation theatres for efficiency.
• Wards must have separate male and female sections, with isolation units for infectious cases.
• Proximity to lifts and ramps is important for patient transfer.

Types and Forms of Wards

(a) Based on Specialty

• Medical Wards – General medicine, pediatrics, psychiatry.
• Surgical Wards – General surgery, orthopedic, obstetric & gynecology.
• Specialized Wards – ICU, NICU, CCU, Burn unit.

(b) Based on Admission Class

• General Ward: Large hall with many beds, minimum facilities.
• Semi-private Ward: 2–4 beds in one room, shared facilities.
• Private Ward: Single bed per room, attached washroom, higher amenities.
• Deluxe/Suite: Luxurious, hotel-like facilities, high charges.

(c) Based on Requirement

• Isolation Ward: For infectious cases.
• Day-care Units: For short procedures without overnight stay.
• Emergency/Observation Wards: Short-term admission for evaluation.

Size and Bed Strength

• Determined by:
• Population served
• Hospital category (primary, secondary, tertiary)
• Specialty requirements
• General Norms:
• General ward: 7–9 m² per bed.
• Private room: 12–15 m² per bed.
• ICU: 20–25 m² per bed.
• Ward size should be 30–40 beds maximum for better supervision.

Space and Facilities in IPD

• Patient Space: Bed, bedside locker, chair.
• Nursing Station: Central control for ward management.
• Sanitary Facilities: Toilets, bathrooms, handwashing stations.
• Support Facilities: Pantry, linen room, treatment room, doctors’ duty room.
• Ventilation & Lighting: Adequate natural light and cross-ventilation.
• Accessibility: Ramps, wide corridors, lifts for patient movement.

Objectives of Ward Management

• Ensure safe, comfortable, and hygienic environment for patients.
• Provide continuous medical and nursing care.
• Maintain discipline, order, and infection control.
• Promote efficient utilization of resources (beds, staff, supplies).
• Foster patient satisfaction and build confidence.
• Maintain accurate records and communication among staff.

Personnel Management in Wards

• Ward-in-Charge/Nursing Superintendent: Supervises nursing staff, allocates duties.
• Medical Officers/Residents: Provide day-to-day treatment.
• Consultants: Visit and monitor specific cases.
• Nursing Staff: Bedside care, administering medications, monitoring patients.
• Paramedical Staff: Physiotherapists, dieticians, technicians.
• Support Staff: Ward boys, ayahs, cleaners, housekeeping.
• Clerical Staff: Maintain records, registers, discharge formalities.

Role of Nursing Services

• Backbone of inpatient services; nurses spend maximum time with patients.
• Functions:
• Administer medicines, injections, IV fluids.
• Monitor vitals, maintain charts, and report changes.
• Provide emotional support and counseling.
• Maintain ward cleanliness and infection control.
• Educate patients and families about treatment & follow-up.

Nursing Needs of Patients

• Physical Needs: Food, hygiene, rest, mobility, elimination.
• Medical Needs: Timely medication, wound dressing, monitoring.
• Psychological Needs: Compassion, reassurance, reducing anxiety.
• Social Needs: Communication with family, social interaction.
• Spiritual Needs: Religious support, prayers if desired.

Factors Influencing Inpatient Care

• Hospital Infrastructure: Bed strength, space, equipment.
• Staffing Pattern: Number and quality of doctors, nurses, and support staff.
• Patient Load: Bed occupancy rate, turnover.
• Infection Control Measures: Isolation facilities, sterilization, waste disposal.
• Administrative Support: Policies, supervision, supply chain.
• Patient Factors: Socioeconomic status, cultural beliefs, family support.

Functions of Nursing Services in Inpatient Care

• Direct Patient Care: Observation, treatment, nursing procedures.
• Supportive Role: Assisting doctors during rounds and procedures.
• Administrative Role: Allocation of staff, supervision, ward records.
• Educational Role: Training nursing students and educating patients.
• Research Role: Participate in clinical audits, quality improvement.
• Coordination Role: Liaison with diagnostic, dietary, and physiotherapy services.

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