Ssssihms PG Department Manual - Ortho Dept

SRI SATHYA SAI INSTITUTE OF HIGHER MEDICAL SCIENCES
Prasanthigram, Anantapur Dt.515134

SSSIHMS-PG/Manual/ Orthopaedics Issue Date: 17th March 2015
Issue No: 01
Department Manual -Orthopaedics Rev Date: 1st June 2017
Rev No: 01
Reference NABH standard 3rd Edition Effective Date: 5th June 2017
ORTHOPAEDIC
DEPARTMENT
MANUAL
Issued By Approved by:

Prepared By (Department DIRECTOR
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REFERENCE NO. SSSIHMS-PG/Manual/ ORTHOPAEDICS
AUTHOR RESPONSIBLE: Dr Koushik Narayan S
APPROVED ON 1st June 2017
NEXT REVIEW DATE 1st June 2018
RATIFIED BY Director Dr. Gurumurthy
DATE RATIFIED 5th June 2017

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Distribution List
Authorized holders of the Controlled copy of Departmental Manual.
CONTROLLED COPY NO CONTROLLED COPY HOLDER

01 HOD
02 Director/NABH Coordinator

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Amendment Record Sheet
S. Page Clause Date of Amendment Reasons for Sign of

N No. No. Amendment Made Amendment Quality
o Coordinator
1
2
3
4
5
6
7
8
9
10
11
12
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Table of Contents
S. No. Particulars
1 Introduction
2 Scope of Services (Available & Not Available)
3 Glossary of terms
4 Departmental Hierarchy
5 Objectives
6 Roles and responsibilities
7 Core departmental procedures
8 Protocols
9 Process Flow Charts
10 Departmental Future Plans
11 Professional Continuing Education
12 List of Forms, Formats and registers

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1. INTRODUCTION
With the Divine Blessings of Bhagawan Sri SathyaSai Baba, the Department of Orthopaedics, SSSIHMS - PG,
started functioning on 11th July, 2006. The Department has shown consistent progress in all aspects of
Orthopaedics as a specialty. The facility is equipped with the most modern technologically advanced
equipment and is staffed by well qualified, experienced consultants. The Department is approved by the
National Board of Examination, New Delhi, for Post-Graduate training in Orthopaedics.
2. SCOPE OF SERVICES:
The Department of Orthopedics is steadfast in providing quality treatment, excellent care combined
with teamwork in the service of our people.
The SSSIHMSPG provides services to multinational expatriates and natives draining in from the whole
of India as well as neighboring countries.
We specialize in providing the best possible Orthopaedic services in the areas of Orthopedic Trauma,
Pediatric Orthopaedics, Arthroscopy and Sports Medicine, Arthroplasty, Lumbar Spine Surgery, and
Deformity Correction such as Illizarov methodology.
We provide 24 hours orthopedic services for Emergency Orthopaedic cases
Our Orthopedic Services include:
o Orthopaedic Trauma services: management of fractures of long bones both in adults and
children, treatment of open fractures, management of Non Union, Malunion and post

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traumatic deformity, soft tissue injuries such as tendon injury, muscular tears, open joint
injuries and similar other cases.
o Joint Replacement
Hip Hemiarthroplasty
Total Hip Arthroplasty
Total Knee, Arthroplasty
Surgical management of small joint arthritis of hand
o Sports Medicine Including Arthroscopic Surgery Diagnostic and Surgical Procedure:
Knee Elbow
Shoulder Hip
Ankle
Wrist
o Pediatric Orthopedic Surgery:
DDH- Treatment Leg lengthening limb length
TalipesEquinovarus inequality
deformity management Foot disorders complex foot
Cerebral palsy surgery
Polio/ Congenital Spine deformities
o Tumor Surgery Benign bone and soft tissue tumors

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Simple excision Curettage with bone graft
o Spinal Surgery
Standard lumbar Thoraco-lumbar Spine: Management of
laminectomy dissectomy fracture and/or dislocation
Multiple level extensive Injuries of Thoraco-lumbar Spine:
decompression for lumbar Anterior fusion with or without fixation
spinal stenosis Infections such as Tuberculosis Thoraco-
Surgical management of lumbar Spine: Anterior/Posterior fusion
lumbar/lumbosacral with or without fixation
spondylolisthesis
o Hand Surgery
Congenital hand problems Fracture fixation
Peripheral nerve conditions Ligament repair
Tendon Repair and/or
Reconstruction
Hand space infections
Occupational injuries of the
hand not requiring
reimplantation

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Services not offered in the specialty are
o Malignant musculoskeletal tumors
o Trauma with associated visceral injuries
o Elective Amputations
o Scoliosis
o Cervical spine cases
o Microvascular surgery and re-mplantation

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3. Glossary of abbreviations used
HOD Head Of The Department
OPD Out Patient Department
OT Operation Theatre
OR Operation room
ICU Intensive Care Unit
MM Medical Management
MRD Medical Record Department
BP Blood Pressure
Inj Injection
I/V Intravenous
G. A. General Anaesthesia
ECG Electrocardiogram
ABG Arterial Blood Gas
POP Plaster of Paris
CSSD Central Sterile Supply Department

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ETO Ethylene Di oxide
EL Earned Leave
HPL Half Paid Leave
CL Casual Leave
ML Maternity Leave
DNB Diplomate Of National Board
4. Regulatory
Not Applicable
5. ORGANOGRAM

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Director
Chairman
HOD
Meidcal Staff
Manager
In-Charge nurse
Nursing staff
Technicians
OT Assistants
Sweepers

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6. Roles & Responsibilities (Job Title, Reporting to, Qualification, Experience & Skill
sets)
Sl Job Title Reporting Qualification Experience Skills

N To
o
1 Chairman Director MS, Ortho / Senior Professor Orthopaedic surgery
DNB
2 HOD Chairman MS, Ortho / Sr. Consultant Orthopaedic surgery

DNB
3 Sr. Consultant HOD MS, Ortho / 14 years of Orthopaedic surgery

DNB experience post
MS/ DNB
4 Addl Sr. HOD MS, Ortho / 10 years of Orthopaedic surgery

Consultant DNB experience post
MS/ DNB
5 Consultant HOD MS, Ortho / 6 years of Orthopaedic surgery

DNB experience post
MS/ DNB
6 Jr. Consultant HOD MS, Ortho / 3 years of Orthopaedic surgery

DNB experience
post MS/
DNB

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7 Sr. Resident HOD MS / DNB- Orthopaedic surgery

Ortho
8 DNB HOD M.B.B.S
Students
9 Manager HOD M.B.A. General management
10 Sister In- HOD & BSc Nursing/

charge manager Diploma
Nursing/Nursi
ng
Assistant/AN
M
11 Staff Nurses Sister in- BSc
Charge Nursing/Diplo
ma
Nursing/Nursi
ng
assistant/ANM
12 Technicians Manager Graduates Physiotherapist, Anesthesia
13 Assistants Manager 12th OT & ICU
Sister in-
Charge
14 Sweepers Manager OT, ICU & Ward
Sister in-
Charge
15 Volunteers Sister in- Assisting ward boys in non-
(sevadal) Charge clinical areas

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7. Core Departmental procedures
General administration
Front office management
Liaisoning activities
HOD office management
Departmental meetings
Asset management
Capital budgeting
Personnel management
Patient communication
In OPD
Patient and his accomplice demographic verification
Screening and Registration
Data entry
Daily Outpatient clinics

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Specialty clinics
Investigation
Treatment plan
Pre-admission documentation of the patient
Issuing authenticated medical reports and certificates
Surgical scheduling
Referral procedure
Revisit appointment
Plaster application
Patient education and Counselling
Physiotherapy
Admission order
In Ward
Patient identification
Inpatient documentation verification
Data entry

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Allocation of beds
Patient assessment
Treatment procedures
Investigation
Pre-operative preparation
Daily Rounds
Grand Round
Diet
Patient Shifting procedures
Referral/cross consultation procedures
Blood transfusion
Post-surgical management
Inpatient documentation and maintenance of medical records
General nursing procedures
Minor procedures like Catheterisation, Wound dressing, wound suction, epidural
catheter removal, I/V line access and maintenance

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Barrier nursing
Physiotherapy
Patient education and Counselling
Discharge plan
Discharge advise
Discharge summary
Sub store management
Linen maintenance
Equipment maintenance
Inpatient dispensary
Crash cart maintenance
Inpatient census board
Nurses record maintenance
OT list preparation and scheduling
Audit

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In OT (Dedicated to only Ortho surgeries)
Patient identification
Surgical team identification
Verification of instrument ,implant and equipment
Nursing trolley preparation
Surgical site verification
Anaesthesia procedures
Preparing patient for surgery (Catheterisation, Intubation, tourniquet application,
Scrubbing the surgical site)
Operative procedures
Investigations
Blood transfusion
Shifting to ICU
Cleaning operation theatre
Preparation of instrument sets and packs
Instrument cleaning and maintenance procedure
Sterility procedures

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Inventory maintenance and management
Use of narcotic drugs
Daily meetings
Documentations of OR records, anaesthesia records ,surgical records and nursing
records
Cross consultation and referral activity
Audit
Surgical demonstration
Orientation
Biomedical waste management
Data entry
Post op patient management discussion and strategies
Personnel safety measures and activities
Patient safety measures
Liaison activities through front office

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Emergency surgical procedure activities
In Orthopaedic emergency
All patients needing orthopaedic emergency care will be attended to
Patient receiving and identification
Registration
Emergency care activities
Investigations
Biomedical waste management
Crash cart management
Minor procedures like Cast application, splint application, wound dressing, wound
suturing, incision and drainage, arthrocentesis, close reductions and bandage
Issuing of medical reports and certificates
Admission
Patient shifting activities
Patient preparation activities
Patient documentation and maintenance of medical records
Patient appointment

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Cross consultation and referral activities
Diet
Nursing reports and records
Sub store management
Linen maintenance
Emergency dispensary
Cleaning operation theatre
Preparation of instrument sets and packs
Instrument cleaning and maintenance procedure
Inventory maintenance and management
Liaison activities with front office
Maintenance of emergency services

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In ICU
Patient verification and receiving
Nursing assessment
Bed allocation
Surgical site identification and marking
Treatment procedures
Ventilation procedures
Intubation and extubation procedure
Catheterisation
Wound dressing
Suction
Daily rounds
Diet
Patient dispensary
Linen maintenance

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Patient resuscitation
Crash cart maintenance
Nursing record
I/V line and airway monitoring
Referrals and cross consultation
OT record and register maintenance
Audit
Investigation
Monitoring
Data recording
Patient care procedure
Blood transfusion
Infection control procedure
Shifting procedures

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Academic activities
Scheduled academic meetings
Bedside clinics
Case demonstration
Case discussion
Journal clubs
Guest and faculty lectures
In house Nurses training
Continuous Medical Education
Surgical demonstration
8. Protocols (Outpatient services, Inpatient services)
Outpatient Services
Definition
New patient Reporting to the hospital for the 1st time
1st Visit patient Patients who are registered under Orthopaedics in SRB and sent for further
evaluation in Orthopaedic OP clinics

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Revisit patient
Regular OPD follow up patients
Post-operative follow-up patients
Discharged follow up patients
Post treatment follow up patients
Referred to speciality clinic
Surgical scheduled patients
Cross consultation referrals
Screening And Registration Block
Examination of Patient and report Reviewing :
o All new patients are examined thoroughly by adopting standard clinical
procedure
o All the pertinent reports of patients are reviewed
o Patient needing further evaluation are registered in Ortho OPD as 1st visit
patient
o All the other patients are treated for relevant conditions/ referred
Performer Orthopaedic Resident Doctor

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Registration -
Patient who need further evaluation are registered as 1st visit for Ortho OPD
Performer - Screening and registration block Registration clerk
OUT PATIENT DEPARTMENT
Registrations
o First visit registrations as per SRB protocols
o Revisit registrations are registered at the front office in accordance
with the appointment system
Performer Front office clerk, OPD nurse
Evaluation of 1st visit patients -
o Patient are from the SRB registrations

o Thorough clinical evaluation and relevant laboratory and radiological
investigations
o Appointment for revisit / surgical scheduling / Follow up / Treatment
/ Referral
Performer- Orthopaedic Resident Doctor

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Evaluation of revisit
o Scheduled patients re-evaluation carried out
o Patient treatment protocol strategies
IP admission
Surgical scheduling
Referral to speciality clinics
Further advice, evaluation and management
Referral
Discharge from further follow up
Performer Senior residents, Consultant
IN-PATIENT SERVICES
In Ward
All patients admitted should have the following information charted as soon as
possible:
o Patient is identified and documents are verified
o Diagnosis and treatment plan
o A complete history and examination sheet should be documented

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o Relevant investigations should be attached in the case file.
o All such patients above the age of 40 scheduled for surgery underproposed
G.A. should have recent E.C.G. (within last 2 weeks) and above 50 should
have X-ray chest (within last 4 weeks).
o Patients with co-morbid medical problems such as diabetes mellitus,
epilepsy,drug reactions etc should be labeled as "Diabetic" or "Epileptic", etc.
as per institution procedures
o Patients previous/present drug history must be recorded
o Patients who are already on medications other than prescribed by the
attending Physician must be checked and confirmed. Same must be
documented.
o Patient with medically hazardous condition/patient requiring barrier nursing
should be highlighted as per institution procedures and admitted in isolation
cubicle.
o Communicable disease/ Allergies, a warning sticker on top of the file.
Performer Nurse in-charge of the patient in the ward
The bed is allocated to the patient by the In-Charge nurse of the ward

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Nursing assessment and investigations are verified by the nurse In-Charge
Ward Nurse in-charge verifies preoperative medical records (informed consent, PAC,
medical consultation, cardiac / dental / urology / plastic surgery / Paediatric
consultations for elective procedures has been obtained.)
Actual side and site of the operation is verified. (Performer : nurse In-Charge)
The surgical site is prepared for surgery in the ward(Performer : nurse In-Charge)
The pre-operative patient is shifted to ICU on call (Performer : nurse In-Charge)
In ICU (Pre operative)
The pre-operative patient scheduled for surgery/patient shifted from casualty/any
orthopaedic patient requiring intensive care is identified by the nurse in the ICU
The patient documents are verified in the ICU(Performer : nurse In-Charge)
Nursing assessment is done pre-operatively.(Performer : nurse In-Charge)
Bed is allocated to the patient.(Performer : nurse In-Charge)
The patients are evaluated by the anesthesiologist pre-operatively.
Pre anaesthesia treatment procedures are carried out by nurse In-Charge/Anaesthesia
technician
The surgical site is identified and marked by the nurse.

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The patient is shifted to operation theatre on call for surgery.(Performer : nurse In-
Charge)
In OT
The patient is identified in O.R. (Performer: OT I/C Nurse and )
the patient is identified by the surgical team and anesthesiologist
The instrument, implant and equipment required for the surgical procedure are
verified(Performer: Physician)
Surgical site of the patient is verified in the O.R.(Performer: Physician and Nurse)
The Anaesthesia procedures such as catheterisation, intubation are performed by the
anaesthesia team.
The patient is prepared for the surgery.(Performer: OT Technician/Assistant surgeon)
The proposed surgical procedure is performed in the O.R.(Performer: Surgical Team)
In ICU (Post operative)
After recovery from anesthesia, the patient is shifted to ICU under supervision post-
operatively.(Performer : Anaesthesia team)
Patient is monitored and due post-operative care is begun in the ICU(Performer :
Anaesthesia team)

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Patient monitoring is carried out.(Performer : Nurse In-Charge)
Anaesthesia procedures are performed
the patient is stabilized and declared fit for shifting. (Performer : Anaesthesiologist)
Patient is shifted to the ward and verified. (ICU nurse and ward nurse)
In Ward
The patient is verified in the ward.(Performer : Nurse In-Charge)
The bed is allocated in the post-op ward.
General nursing procedures are performed on the patient.(Performer : Nurse In-
Charge)
Minor procedures such as catheterisation, wound dressing are performed by the
concerned nurse as ordered by the physician.
Due post-operative care is performed. (Performer: Surgical team and Nurse In-Charge)
Barrier nursing is performed for infected patients.(Performer : nurse In-Charge)
Physiotherapy procedures are performed as per the orders of
physician.(Physiotherapist)
Patient is counselled for further post-operative care.(Performer: Physician)

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The discharge plan is made by the physician as per the condition of the
patient.(Performer: Surgical Team)
The patient is discharged from the ward.(Performer: Physician)
9. Process flow charts
Definition:
Elective patient: Patient with chronic orthopaedic problem
Chronicity: Symptoms more than one week
Emergency patient: Patient presenting immediately or within 24 hours of injury/any life
threatening or limb threatening Orthopaedic conditions

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Elective Patient Process Flow

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Emergency Patient Process Flow

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10. Departmental Future plans
Goals of the Department
o To follow principles of Sai Ideal healthcare.
o Our Goal is to provide the best and complete orthopaedic care with love, free of
cost, using evidence-based, modern medical and surgical treatment, and inculcating the
principles of our Founder and Inspiration, Bhagawan Sri Sathya Sai Baba.
Clinical (Patient Care) Objectives
o To develop patient education program in accordance with the local prevailing
health problems particularly skeletal fluorosis and osteoporosis
o To develop preventive healthcare strategies
o To provide quality patient care with love, irrespective of caste, colour, creed,
religion, place or financial status.
o To improve pain management and rehabilitation procedures for better
healthcare delivery.
o To provide comprehensive orthopaedic care
o To incorporate evidence based medicine in clinical practice
o To develop research based facilities

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o Providing established standards of Orthopaedic surgical practice
o Continued up gradation and incorporation of developing surgical trends.
o To further strengthen and reinforce resident training program
o To develop comprehensive orthopaedic sub specialty practice
o To develop a model for achieving excellence in academic training
o To establish an Implant Bank for the Department.
o To establish and maintain well-equipped Emergency Care.
o To follow the standard guidelines of the Infection Control Committee and
achieve international standards for orthopaedic infection rates (< 1%).
Academic Objectives
o To teach evidence-based, modern orthopaedics integrated with Human Values.
o To train DNB candidates in their psychomotor skills for surgical excellence and
intellectual discrimination in diagnosis in modern orthopaedic science.
o To increase the number of presentations and publications of scientific papers.
o To improve the academic standards of the Department.
o To obtain recognition as a DNB Orthopaedic Examination Centre.

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o To integrate the Department of Orthopaedics, Whitefield General Hospital,
Bangalore with the Department of Orthopaedics, SSSIHMS, Prasanthigram
o To successfully host the Sri Sathya Sai International Orthopaedics Conference -
2015 on "Ilizarov - Evolution and Applications" in December 2015.
o To expand Orthopaedic books in the Central / Orthopaedic Library.
Research Objectives
o To improve Basic Science Research Activities in collaboration with SSSIHL.
o To establish an Orthopaedic Basic Science Research Wing.
11. Professional Continuing Education
Academic Programs:
Every Saturday academic meeting is held from 3:30 to 4:30 pm
Academic discussion on Monday and Tuesday from 7am to 8 am
Clinical Meetings: Discussions of important and rare cases on Friday and Saturday.
Grand Rounds: Each unit of the department assembles in the ward on their out-patient
days to assess pre op, post-op and admitted patients to discuss the cases.

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Case Presentations of various categories of Orthopaedic cases as a preparation for
practical examinations.
Journal Club: Presentations on topics concerning recent advances or interesting case
reports.
12. List of forms, formats & registers
Register maintained in Ortho O.T.
Ortho O.T Register.
Utilization form. ( For patient consumption.)
Inventory register.
Linen register.
Donation item register.
Emergency register.
Infected cases register.
Arthroscopy register.
Arthroplasty register.
Spine instrument register.
DHS implant register.

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Intramedullary nail register.
DCP, LCP register.
Cortical, CCS, Drill bit register.
Suture register.
Drug register.
Narcotic register.
Blood transfusion register.
Epidural steroid cases register.
Monthly stats report.
ACL patient register.
Instrument register.
Bio-medical dispatch register.
Illizarov & JESS fixator register.
Radiation exposure register.
CSSD register.
VM implant DC register.

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Sharma implant DC register.
Implant monthly requirement register.
Sutures register.
Surveillance Form
Ortho Emergency Register List
Ortho emergency duty register.
Minor O.T register.
POP register.
Referred MLC register.
Fumigation & Carbolization registration.
Statistics register.
Emergency O. T register.
Infection register.
Diet book.
CSSD book.
Investigation book.

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Sentinels events register.
Observation patients register.
Linen, Equipment & Furniture registration.
Nurse's duty roster book.
Leave register.
Emergency patient's report book ( Admission & Emergency patients posted for
surgery)
Complaint form. ( mrd no -128 ).
Prescription. ( mrd/ com 06).
Outpatient / Inpatient requesting or physiotherapy. (mrd 137 ).
Admission form. ( sssihms/pg/mrd/com-42).
To whomsoever it may concern form. (SSSIHMS/DO/93MRD). (mrd -121).
Application for casual leave form. ( mrd 120 A ).
Application for Earned/Halfpay/Extra oridinary/Commuted/Maternity leave
Joining report form. ( mrd 120 ).
Clinical chart. ( mrd/com/18).

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Nurses chart. ( mrd 13 Modified ).
Consent for surgery. ( mrd 141 ).
Checklist before skin incision. ( mrd / com 44 ).
Checklist before patient leaves the OT. ( mrd /com 44 ).
Pre anesthesia record / Intra Operative anesthesia record. ( mrd / com 28 ).
Doctor's order form.(sssihms/pg /mrd/com 12).
Physician progress notes. ( mrd 142 ).
History & Physical examination form. ( mrd 140 ).
Physiotherapy record. ( mrd 136 ).
Consultant notes. ( mrd 135).
Discharge summary with review date for sutures removal.
Ortho ICU forms and Registers
Doctor's order form. ( mrd -14 ).
Clinical chart. ( mrd -55).

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I/O Charts. ( mrd 36 ).
Specific consent for high risk procedure. ( mrd 7 A ).
Operation record. ( mrd 8 ).
Consultant notes. ( mrd 135)..
Transfer-register.
Inventory & linen registration.
Wound debridement register.
Nurses report book.
Narcotic register.
Leave register.
Nurses day censes book.
Needle prices register.
Blood transfusion book.

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Dustbin covers dispatching register.
MRD Death tiles dispatching register.
Report on sentinel events register.
General indent book.
Laundry book.
Dietary register.
Crash card daily checking register.
Drugs maintaining register.
Ortho OPD Registers and forms
Speciality
clinic register
Arthritis register
Dietary register
Inward and outward Register

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register for visiting consultant
Dispatch register
Leave register
Email answer book
Laundry register
Store register
Attendance register
stock register
Outpatient requesting for

physiotherapy
patient registration card
Admission authorization form
doctor's order form
History and physical examination form
Anaesthesia record form
Pre aneasthesia record form
Physician progress notes

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Nurses chart
Consent for surgery
Clinical chart
Consultant notes
Physiotherapy record
Declaration of free treatment
Discharge with medical advice
Register maintained in O.T.
Ortho O.T Register.
Utilization form. (For patient consumption)
Inventory register.
Linen register.
Donation item register.
Emergency register.
Infected cases register.
Arthroscopy register.

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Arthroplasty register.
Spine instrument register.
DHS implant register.
Intramedullary nail register.
DCP, LCP register.
Cortical, CCS, Drill bit register.
Suture register.
Drug register.
Narcotic register.
Blood transfusion register.
Epidural steroid cases register.
Monthly stats report.
ACL patient register.
Instrument register.
Bio-medical dispatch register.
Illizarov & JESS fixator register.

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Radiation exposure register.
CSSD register.
VM implant DC register.
Sharma implant DC register.
Implant monthly requirement register.
Sutures register.
Surveillance Form
Emergency Register List
Ortho emergency duty register.
Minor O.T register.
POP register.
AR copy register.
Fumigation &Carbolization registration.
Statistics register.
Emergency O. T register.
Infection register.

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Diet book.
CSSD book.
Investigation book.
Sentinels events register.
Observation patients register.
Linen, Equipment & Furniture registration.
Nurse's duty roster book.
Leave register.
Emergency patient's report book ( Admission & Emergency patients posted for
surgery) :-
Complaint form. ( mrd no -128 ).
Prescription. ( mrd/ com 06).
Outpatient / Inpatient requesting or physiotherapy. (mrd 137 ).
Admission form. ( sssihms/pg/mrd/com-42).
To whomsoever it may concern form. (SSSIHMS/DO/93MRD). (mrd -121).
Application for casual leave form. ( mrd 120 A ).

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In Charge/HOD)
Issue No: 01
Rev No: 01
Application for Earned/Halfpay/Extra oridinary/Commuted/Maternity leave
Joining report form. ( mrd 120 ).
Clinical chart. ( mrd/com/18).
Checklist before skin incision. ( mrd / com 44 ).
Checklist before patient leaves the OT. ( mrd /com 44 ).
Doctor's order form.(sssihms/pg /mrd/com 12).
Physiotherapy record. ( mrd 136 ).
Consultant notes. ( mrd 135).
Discharge summary with review date for sutures removal.
ICU forms and Registers
Doctor's order form. ( mrd -14 ).

Page 51 of 55
In Charge/HOD)
Issue No: 01
Rev No: 01
Clinical chart. ( mrd -55).
I/O Charts. ( mrd 36 ).
Specific consent for high risk procedure. ( mrd 7 A ).
Operation record. ( mrd 8 ).
Consultant notes. ( mrd 135)..
Transfer-register.
Inventory & linen registration.
Wound debridement register.
Nurses report book.
Narcotic register.
Leave register.

Page 52 of 55
In Charge/HOD)
Issue No: 01
Rev No: 01
Nurses day censes book.
Needle prices register.
Blood transfusion book.
Dustbin covers dispatching register.
MRD Death tiles dispatching register.
Report on sentinel events register.
General indent book.
Laundry book.
Dietary register.
Crash card daily checking register.
Drugs maintaining register.
OPD Registers and forms
Paediatric orthopaedics clinical register
Spine Clinic register
Arthritis Clinic register

Page 53 of 55
In Charge/HOD)
Issue No: 01
Rev No: 01
Review Arthritis register
Dietary register
Inward and outward Register
register for visiting consultant
Dispatch register
Leave register
Email answer book
Laundry register
Store register
Attendance register
stock register
Outpatient requesting for physiotherapy
patient registration card
Admission authorization form
doctor's order form
History and physical examination form

Page 54 of 55
In Charge/HOD)
Issue No: 01
Rev No: 01
Anaesthesia record form
Pre anaesthesia record form
Physician progress notes
Nurses chart
Consent for surgery
Clinical chart
Consultant notes
Physiotherapy record
Declaration of free treatment
Discharge with medical advice

Page 55 of 55
In Charge/HOD)

Ssssihms PG Department Manual - Ortho Dept

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SRI SATHYA SAI INSTITUTE OF HIGHER MEDICAL SCIENCES

Prasanthigram, Anantapur Dt.515134

Issued By Approved by:

REFERENCE NO. SSSIHMS-PG/Manual/ ORTHOPAEDICS

AUTHOR RESPONSIBLE: Dr Koushik Narayan S

APPROVED ON 1st June 2017

NEXT REVIEW DATE 1st June 2018

RATIFIED BY Director Dr. Gurumurthy

DATE RATIFIED 5th June 2017

Issued By Approved by:

CONTROLLED COPY NO CONTROLLED COPY HOLDER

Issued By Approved by:

Amendment Record Sheet

S. Page Clause Date of Amendment Reasons for Sign of

Issued By Approved by:

Issued By Approved by:

National Board of Examination, New Delhi, for Post-Graduate training in Orthopaedics.

with teamwork in the service of our people.

of India as well as neighboring countries.

Deformity Correction such as Illizarov methodology.

We provide 24 hours orthopedic services for Emergency Orthopaedic cases

Our Orthopedic Services include:

Issued By Approved by:

injuries and similar other cases.

Total Hip Arthroplasty

Total Knee, Arthroplasty

Surgical management of small joint arthritis of hand

o Sports Medicine Including Arthroscopic Surgery Diagnostic and Surgical Procedure:

o Pediatric Orthopedic Surgery:

DDH- Treatment Leg lengthening limb length

deformity management Foot disorders complex foot

Cerebral palsy surgery

Polio/ Congenital Spine deformities

o Tumor Surgery Benign bone and soft tissue tumors

Issued By Approved by:

Simple excision Curettage with bone graft

Standard lumbar Thoraco-lumbar Spine: Management of

laminectomy dissectomy fracture and/or dislocation

Multiple level extensive Injuries of Thoraco-lumbar Spine:

decompression for lumbar Anterior fusion with or without fixation

spinal stenosis Infections such as Tuberculosis Thoraco-

Surgical management of lumbar Spine: Anterior/Posterior fusion

lumbar/lumbosacral with or without fixation

Congenital hand problems Fracture fixation

Peripheral nerve conditions Ligament repair

Tendon Repair and/or

Hand space infections

Occupational injuries of the

hand not requiring

Issued By Approved by:

Services not offered in the specialty are

o Malignant musculoskeletal tumors

o Trauma with associated visceral injuries

o Cervical spine cases

o Microvascular surgery and re-mplantation

Issued By Approved by:

3. Glossary of abbreviations used

HOD Head Of The Department

OPD Out Patient Department

ICU Intensive Care Unit

MRD Medical Record Department

ABG Arterial Blood Gas