Quick removal of bodies from hospital beds and wards, disinfecting beds, and initiating further action for disposal, are among the 21-point bare-minimum requirements the Bihar health department has prescribed for its tertiary healthcare institutions treating coronavirus disease (Covid-19) patients.
The directions, which were put out on Monday, also include expeditious issuance of the death certificate to patients, who succumb to Covid-19.
The department has directed Covid-19 care facilities to have dedicated teams of personnel to bring medicines required for patients or source them from suppliers rather than asking attendants to fetch them.
It directed hospital administrators to have a calling-bell facility alongside each bed for an immediate response from hospital staff.
It allowed Covid-19 patients to use their own mobile phones to keep in touch with their family members.
It instructed hospitals to ensure regular cleaning and disinfection of washrooms with no-touch handwashing facility via sensor-fitted taps.
It asked hospitals to issue medical bulletin of patients twice a day for the dissemination of information to relatives and attendants of patients and also have a dedicated 24×7 helpline number.
The guidelines asked doctors to treat Covid-19 patients with pre-diagnosed ailments, or comorbidities such as diabetes, a heart condition, etc; and keep a diet chart handy alongside each patient’s bed.
It asked hospital authorities to ensure pulse oximeter with each bed for patients to measure their oxygen saturation level.
It directed that beds, dedicated to Covid-19 patients, must have an oxygen pipeline with oxygen supply. It instructed them to ensure a fully functional ICU (intensive care unit), equipped with ventillators and other essential equipment for better management of Covid-19 patients.
A doctor and a nurse with personal protective equipment (PPE) should always be available in a Covid-19 ward to handle emergencies and other situations.
“We have asked officials attached to control rooms of Covid-19 hospitals to keep regular tabs on these parameters,” said an official.
The control rooms are headed by probationary Indian Administrative Service (IAS) and India Police Service (IPS) officers, along with healthcare workers at All India Institute of Medical Sciences (AIIMS), Nalanda Medical College Hospital (NMCH), both being dedicated Covid-19 hospitals in Patna, and the Patna Medical College Hospital (PMCH).
A 100-bed isolation ward for the treatment of Covid-19 patients has been set up at the PMCH.
“We have listed specific areas and indicators on Covid-19 management for principals and superintendents of medical colleges. On Monday, I held a meeting with them and the respective district magistrates and have told them that the minimum process laid down should be strictly followed,” said Pratyaya Amrit, principal secretary, health, Bihar.
The Bihar chapter of the Indian Medical Association (IMA) has welcomed the state department’s move.
“The initiatives laid down are no doubt excellent, but constraint related to their implementation should also be addressed. Manpower deficiency remains the biggest lacunae in the healthcare sector. Almost 60% of the vacancies against sanctioned posts of doctors should be filled up soon. Principals and superintendents should be authorised to hire healthcare workers and support staff on contract, while also extending insurance coverage to such employees and their family members,” said Dr. Sunil Kumar, secretary, IMA-Bihar.
The health department, through these patient-centric initiatives, is making a concerted effort to salvage the tarnished image of the state’s healthcare sector. It had earned infamy, when videos of bodies lying unattended for a couple of days in the ward of the NMCH went viral on July 20, a day after a three-member Central team inspected it, as reported by HT (https://www.hindustantimes.com/patna/bodies-lie-in-covid-19-ward-in-patna-s-nmch-a-hospital-without-mortuary/story-mgr1YAmi6BIauMttjvt5yL.html).
The video was shot by an attendant of a Covid-19 patient.
Similar videos had also surfaced from PMCH.
Other key decisions
■ Sufficient availability of ambulances and mortuary vans
■ Disposal of PPE kits for ambulance drivers ferrying Covid-19 patients and disinfection of these medical vans
■ 24×7 facility to conduct rapid antigen detection (RAD) tests
■ Sufficient availability of ward and trolley boys equipped with PPE kits
■ Safe disposal of Covid-19-related medical waste
■ Separate dustbins for each bed, sterilisation of waste and incineration
■ Dedicated waiting arena for patients’ attendants with intercom and public announcement (PA) system to reduce exposure to SARS-CoV-2 that causes Covid-19
■ Non-Covid-19 patients to undergo Covid-19 (RAD) test before admission to hospitals