Appendix 8. Measles inpatient unit organization (example)

8.1 General organization

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

Staff

Doctors31 per day, 1 per night, 1 off
Supervisor16 days a week
Nurses93 per day, 3 per night, 3 off
Nurse's aides62 per day, 2 per night, 2 off
Hospital cleaners42 per day, 2 off
Watchmen62 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)

FrequencySuggested schedule
Once daily7 am
2 times daily7 am / 7 pm
3 times daily7 am / 1 pm / 8 pm
4 times daily7 am / 1 pm / 8 pm / 2 am
Every hourIn 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)

UnitCompleted by the supervisor every week.
Handover bookWard

Completed by the nurse and the nurse’s aide.

Patient boardWardUpdated 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.