Appendix 8. Measles inpatient unit organization (example)

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    8.1 General organization

    Capacity
    40 to 50 beds:
    10 intensive care beds
    30 to 40 inpatient beds

     

    Staff

     

    Doctors 3 1 per day, 1 per night, 1 off
    Supervisor 1 6 days a week
    Nurses 9 3 per day, 3 per night, 3 off
    Nurse's aides 6 2 per day, 2 per night, 2 off
    Hospital cleaners 4 2 per day, 2 off
    Watchmen 6 2 per day, 2 per night, 2 off

     

    Shift schedule: 6 am-6 pm (12 hrs.); 6 pm-6 am (12 hrs.); supervisor: 8:30 am-1 pm/ 3 pm-5:30 pm

     

    Schedule for monitoring vital signs and administering treatments (oral and parenteral)

     

    Frequency Suggested schedule
    Once daily 7 am
    2 times daily 7 am / 7 pm
    3 times daily 7 am / 1 pm / 8 pm
    4 times daily 7 am / 1 pm / 8 pm / 2 am
    Every hour In intensive care, according to doctor’s orders

     

    8.2 Documentation

    Register of admissions/discharges

    Admissions

    Completed by the supervisor or the nurse.

    Patient’s file

    At patient’s
    bedside

    Completed by the doctor. Nurses and nurse’s aides enter the monitoring data and orders carried out.

    Hourly monitoring sheet

    At patient’s
    bedside

    Completed by the nurse and nurse’s aide, at doctor request.

    Monitoring record of consumption (drugs and medical supplies)

    Unit Completed by the supervisor every week.
    Handover book Ward

    Completed by the nurse and the nurse’s aide.

    Patient board Ward Updated by the supervisor.

     

    8.3 Staff duties

    Doctor
    – Performs daily rounds with the supervisor and a nurse.
    – Notes the prescriptions and procedures to be carried out.
    – Makes admission and discharge decisions; handles emergencies.
    – Does handovers to the on-call doctor, nurses and supervisor.
    – Updates the records (including the patient’s health record at discharge).
    – Manages patient discharges: patient information, treatments, discharge authorization.
    – Helps supervise and train health staff.

     

    Supervisor
    – Makes sure that the unit runs correctly: quality of care; supply (drug and supply orders and consumption); hygiene; and meal distribution.
    – Makes sure that documents are used correctly: handover book, monitoring records, etc.
    – Accompanies the doctor on his or her rounds.
    – Sets up the staff schedules and makes sure the personnel are present.
    – Checks and records daily the number of patients, admissions, discharges, and deaths.
    – Supervises and trains the staff; writes job descriptions; organises and leads the unit’s meetings (once weekly).
    – Collects weekly data and archives the records of discharged patients.
    – Reports any problems to the person in charge.

     

    Nurse
    – Administers treatments, performs laboratory exams, etc. and monitors the patients.
    – Informs the doctor of any problems found.
    – Notes the prescriptions and procedures carried out.
    – Participates with the doctor in rounds.
    – Prepares and keeps carts organized (rounds and treatment).
    – Briefs team at change-of-shift and updates the handover book.

     

    Nurse’s aide
    – Gets the patient settled and gives him the necessary supplies (blanket, eating utensils, etc.).
    – Explains the organisation of the service to the patient and the person accompanying him (meal schedule, visiting hours, location of bathrooms).
    – Helps the patient with taking medications, eating, and personal hygiene, if necessary; reports all useful information to the nurse.
    – Assists the nurse with certain care procedures.

     

    Hospital cleaner
    – Cleans the premises, both inside and outside.