It would be most ironical if one suffered an injury in a hospital, a place where one looks only for a cure. The fire that took a heavy toll at a Kolkata hospital some time ago brought into focus the need for stringent norms on fire safety in healthcare centres.
The National Board for Accreditation for Hospitals and Healthcare Institutions (NABH) has laid stringent norms. Mock drills, smoke detectors and hydrants/fire extinguishers are mandatory. “NABH makes it mandatory for hospitals to have exits as per specifications, in order to carry out swift evacuation of patients and staff during a disaster,” says Medical Director (Super Speciality) of PSG Hospitals J.S. Bhuvaneshwaran.
Hospitals say that in addition to industrial safety standards, they also have to meet the stringent norms of the NABH in order to get its accreditation. Safety standards will improve even as the hospitals go through the process of meeting the norms.
Various committees have been formed by hospitals in the city that have obtained the accreditation and also by those that are working towards obtaining it. “For instance, we have a Condemnation Committee that checks the condition of implements, furniture and wheel chairs. Anything found to be in unsafe condition [for the patients] will be discarded,” Dr. Bhuvaneshwaran says. Three other key areas are bio safety, mercury safety and radiation safety.
The Ministry of Environment has a set of rules governing the storage and disposal of biomedical waste.
Amputated limbs (or fingers and toes), pus and blood-stained bandage, placenta, used needles, broken vaccine ampoules will have be segregated and store in separate containers as per colour codification. The bio-medical waste should be handed over to a common facility for disposal of such hazardous waste from all hospitals and laboratories.
Training is being provided to hospital staff, especially paramedical and those involved in conservancy, in safe handling and storage of bio-medical waste.
Hospitals in Coimbatore are trying to reduce the use of mercury as a spill can be very hazardous. The Coimbatore Medical College Hospital has replaced mercury thermometers with digital ones. Private hospitals too are gradually phasing out mercury thermometers. Radiation safety is another area that hospitals were working on. PSG Hospitals and the PSG College of Technology hold meetings for doctors and other experts every year to drive home the message of safety in catheterisation laboratories.
“We wanted to bring about awareness among the hospitals first on radiation hazards in the catheterisation laboratories and the need for the doctors and the support staff to wear lead jackets and other protective gear in order to prevent exposure to radiation,” says Dr. Bhuvaneswaran. “Hospitals in Coimbatore have taken a lot of efforts to cut out exposure to both the patients and also doctors and other laboratory staff,” he says.
The International Atomic Energy Agency has laid down separate guidelines for hospitals. These relate to even basis equipment such as the x-ray machine. There are norms for every field of medicine, such as cardiology and even scanning paediatric (children) cases.
Oncology was once associated with a lot of radiation risk. “Innovation in radiation technology has now reduced chances of exposure (to radiation) to a negligible level,” says Director of Sri Ramakrishna Institute of Oncology and Research P. Guhan.
The focus is on orthopaedics during the use of the C-arm and in catherisation laboratories where cardiac procedures are done. Thermo luminescent dosimeters (in badge form) are worn on the chest and wrist. These are sent once in three months to laboratories approved by Atomic Energy Regulatory Board to evaluate the level of exposure.
The effort is to minimise the risk of exposure to the medical personnel, as much as to the patients.