HOSPITAL TRAINING II

B. Pharm 7th SEM.

SESSION 20223-2024
DR.A.P.J ABDUL KALAM TECHNICAL UNIVERSITY LUCKNOW

LAKHMI CHAND PATWARI COLLEGE OF PHARMACY

KHEKRA BAGHPAT
SUBMITTED TO SUBMITTED BY
M.D. SHAMIM SAGAR
ROLL NO.2010770500009

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 DECLARATION

I SAGAR hereby declare that submission of my training Report and

that is to the best of my knowledge and belief, it contains no
Material previously published or written by any other person nor
material Which to a substantial extent has been accepted for the
award of any other Degree or diploma of the university or other
institute of higher learning, Except where due acknowledgment has
been made in the.

NAME SAGAR

ROLL NO. 2010770500009

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 CERTIFICATE

This is to certify that SAGAR studying in B. PHARM (4th YEAR) have

carried out project work presented in this report entitled “HOSPIAL
TRAINING-II” for the award of Bachelor of pharmacy Degree from
Dr.APJ.Abdul Kalam Technical University, Lucknow Under my
supervision. The project embodies result of original work and Studies
carried out by students themselves and the contents of this report
Don’t form the basis for the award of any other degree of the
candidate Or to anybody.

PROFESSOR EXAMINER’S SIGNATURE

MD.SHAMIM

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 ACKNOWLEDGEMENT

I have taken efforts in this project. However, it would not have been
possible without the kind support and help of many individuals and
organizations. I would like to extend my sincere thanks to all of them.
I am highly indebted to Mr.Rahul Sharma for the guidance and
constant Supervision as well as providing Necessary information
regarding this project and also for the support in completing the
project. Also, I would like to express my gratitude towards my
parents an member of Lakhmi Chand patwari college of pharmacy for
their kind co-operation and encouragement Which help me in
completion of this training report.

Name: SAGAR

Roll no: 201070500009

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 VISION

The vision of the Hospital training is to study the organisation of

various departments, the Working and development of the
organisation, the present status of the hospital & future Prospects of
the organisation. To promote civic sense and shoulder the
responsibilities with Full potential by being a ultimate healthcare
Professional and a Responsible Pharmacist.

The overall objectives of study:

 To study the Hospital structure.

 To know about its products and service activities.
 To know the different functions of all the departments.

 To know the responsibilities of top management and how to

execute responsibility.
 To analyse the working of Hospital using by analysis of various
departments.

 To know the duties of pharmacist

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 TABLE OF CONTENTS
S.NO. TOPIC PAGE NO.
1 ABOUT HOSPITAL 8
2 DIFFERENT 19
DEPARTMEWNT IN
THE HOSPITAL
3 DISPENSARY 10
4 FIRST AID 10-13
5 WOUND DRESSING 14-15
6 CARDIO 16
PULMONARY
RESUSCITATION
7 PARENTERAL 17-18
ROUTES OF
ADMINSTRATION
8 DISPENSING 19-20
PROCEDURE
9 PATIENT 20-21
OBSERVATION
CHART
10 PRESCRIPTIONS 22-23
11 INTENSIVE CARE 23
UNIT
12 OPERATION 24-25
THEATRES
13 OUT PATIENT 25-26
DEPARTMENT

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 1. ABOUT HOSPITAL

Hospitals are centres of treatment. People from all corners of

the society and all walks of life Converge here to cure
themselves of their diseases.I did my training in Community
Health center It is a Centre for all types of medical facilities
especially for the poor people.This training also made me
realize the importance of hospitals for people and how it
affects Even the day-to-day lives of them. Not only the patients
but also the people working in the hospital are truly dependent
on it. This training report comprises of the whole summary of
my training in this hospital and what I learned from that.

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2. DIFFERENT DEPARTMENTS IN THE HOSPITAL

There are a number of parts in a hospital. This large number of

departments is responsible for treating the patients of their
diseases.

The various departments of hospitals covered in the hospital

training are:-

1. Dispensary

2. In patient department

3. Emergency (trauma center)

4. Record room

5. Injection room

6. Waste management

7. Pathology

8. Out patient department

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 3. DISPENSARY
It is the place medicines are kept for the distribution and the
medicines are distributed to the patient by the dispensing. And
medicines are dispensed here. A dispensary can be defined as the
main area where the dispensing of the drugs takes place. It is mainly
present for the OPD patients. “Into the vein”. Intravenous
medication administration
Occurs when a needle is inserted into a vein and medication is
administered through that
Needle. The needle is usually placed in a vein near the elbow, the
wrist, or on the back of the
hand. Different sites can be used if necessary
4. FIRST AID

First aid is the assistance given to any person suffering a sudden

illness or injury, with care provided to Preserve life, prevent the
condition from worsening, and/or promote recovery.
Main aim of first aid: -

To preserve life – this is the main aim of first aid; to save lives. This
includes the life of the first aider, the casualty (the victim, the
injured/sick person), and bystanders.
To prevent further harm – the patient must be kept stable and
his/her condition must not worsen before medical services arrive.
This may include moving the patient out of harm’s way, applying First
aid techniques, keeping him/her warm and dry, applying pressure to
wounds to stop Bleeding, etc.

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Promote recovery – this may include applying a plaster (bandage) to
a small wound; anything that May help in the recovery process.
Primary steps for first aid: -
ABC The most common term referred to in first aid is ABC, which
stands for Airway, Breathing, and Circulation. In fact, the term also is
commonly used among emergency health professionals.
Airway – the first aider needs to make sure the casualty’s airway is
clear. Chocking, which results from the obstruction of airways, can
be fatal.
Breathing – when the first aider has determined that the airways are
not obstructed, He/she must determine the victim adequacy of
breathing, and if necessary, provide Rescue breathing.

Circulation – if the victim is not breathing the first aider should go

straight for Chest compressions and rescue breathing .The chest
compressions will provide Circulation .The reason is time – checking
circulation to a non-breathing victim Consumes time that could be
used with chest compressions and rescue breathing. With less
serious victim (those that are breathing), the first aider needs to
check the Impulse.
First Aid in accidental case:
Look for signs of breathing: Check if the person is breathing and if
he has a Pulse.
Call for help: Immediately call for an ambulance or rush the person
to a hospital.
Check for obstructions in the person’s mouth and throat: If you do
not hear any Breath sounds, check his/her mouth for any
obstructions. If there is something Obstructing the airway, use your
index and middle finger to clear the airway.
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 Perform life saving techniques: If there is no pulse, start CPR or EAR.
Keep the Person’s neck straight to start EAR (External Air
Resuscitation) or CPR (Cardio Pulmonary resuscitation). There are 3
types of EAR; Mouth-to-mouth, Mouth-to Nose, Mouth-to-Mask.
Ways to help him/her in grave situations: If there is bleeding from
the mouth or the Patient is vomiting, turn the person to his/her side.
This will avoid any chances of the person choking. Place the person’s
arm that is under him straight out and the arm closest to you across
his chest.
Deal with open wounds: If there are extensive wounds, try to
control the bleeding using pressure to the area using a cloth. Press
down with your palms rather than your fingertips.

Always suspect spinal injuries: If the person’s neck is in an awkward

position (not normally placed) or the person is unconscious, do not
move the patient. Get help immediately. This could mean that the
person’s neck is broken, and moving him/her in such a situation can
cause more harm.
Keep the person warm: Usually accident victims feel excessively
cold due to shock. Therefore, keeping them warm is essential to
survival.
Conditions that require further first aid
 Altitude sickness, which can begin in susceptible people at
altitudes as low as 5,000 Feet, can cause potentially fatal
swelling of the brain or lungs.
 Anaphylaxis, a life-threatening condition in which the airway
can become constricted And the patient may go into shock. The
reaction can be caused by a systemic allergic Reaction to
allergens such as insect bites or peanuts. Anaphylaxis is initially
treated With injection of epinephrine

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 Battlefield first aid—this protocol refers to treating shrapnel,
gunshot wounds, burns, Bone fractures, etc. as seen either in
the ‘traditional’ battlefield setting or in an area Subject to
damage by large-scale weaponry, such as a bomb blast.
 Bone fracture, a break in a bone initially treated by stabilizing
the fracture with a Splint.
 Burns, which can result in damage to tissues and loss of body
fluids through the burn Site.
 Cardiac Arrest, which will lead to death unless CPR preferably
combined with an AED, is started within minutes. There is often
no time to wait for the emergency Services to arrive as 92
percent of people suffering a sudden cardiac arrest die before
Reaching hospital according to the American Heart Association.
 Heart attack or inadequate blood flow to the blood vessels
supplying the heart Muscle.
 Heat stroke, also known as sunstroke or hyperthermia, which
tends to occur during Heavy exercise in high humidity, or with
inadequate water, though it may occur spontaneously in some
chronically ill persons. Sunstroke, especially when the victim
Has been unconscious, often causes major damage to body
system such as brain, Kidney, liver, gastric tract.
Unconsciousness for more than two hours usually leads to
Permanent disability. Emergency treatment involves rapid
cooling of the patient.
 Heavy bleeding, treated by applying pressure (manually and
later with a pressure Bandage) to the wound site and elevating
the limb if possible.
 Hyperglycemia (diabetic coma) and Hypoglycemia (insulin
shock).
  Insect and animal bites and stings.
  poisoning, which can occur by injection, inhalation,
absorption, or ingestion.

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  Muscle strains and Sprains, a temporary dislocation of a joint
that immediately reduces automatically but may result in
ligament damage.
 Wounds and bleeding, including lacerations, incisions and
abrasions, Gastrointestinal Bleeding, avulsions and Sucking
chest wounds, treated with an occlusive dressing to Let air out
but not.

5. WOUND DRESSING
A dressing is used by a doctor, caregiver and/or patient to help a
wound heal and prevent further issues like infection or

complications. Dressings are designed to be in direct Contact with

the wound, which is different from a bandage that holds the dressing
in Place.

 Dressings serve a variety of purposes depending on the type,

severity and position of the wound. Aside from the major
function of reducing the risk of infection, dressings Are also
important to help:

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 Stop bleeding and start clotting so the wound can heal
 Absorb any excess blood, plasma or other fluids
 Wound debridement
 Begin the healing process

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 6. CARDIO PULMONARY RESUSCITATION
Respiration is the act of assisting or stimulating respiration, a
metabolic process referring to the overall exchange of gases in the
body by pulmonary ventilation, External respiration, and internal
respiration. Assistance takes many forms, but Generally entails
providing air for a person who is not breathing or is not making
Sufficient respiratory effort on his/her own (although it must be used
on a patient With a beating heart or as part of cardiopulmonary
resuscitation to achieve the Internal respiration). This method of
insufflation has been proved more effective than methods which

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Involve mechanical manipulation of the patient’s chest or arms such
as the Silvester Method. It is also known as Expired Air Resuscitation

(EAR), Expired Air Ventilation (EAV), mouth-to-mouth resuscitation,

rescue breathing or colloquially the kiss of life. Artificial respiration is
a part of most protocols for performing Cardiopulmonary
resuscitation (CPR) making it an essential skill for first aid.
The performance of artificial respiration in its own is now limited in
most protocols to health professionals, whereas lay first aiders are
advised to undertake full CPR In any case where the patient is not
breathing sufficiently.
ROUTES OF ADMINISTRATION

7. PARENTERAL ROLES OF ADMINSTRATION

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An injection is an infusion method of putting fluid into the body,
usually with a syringe and a Hollow needle which is pierced through
the skin to a sufficient depth for the material to be administered into
the body.

INTRADERMAL INJECTION
Intradermal injection injection of small amounts of material into the
corium or substance of the skin, done in diagnostic procedures and in
administration of regional anesthetics, as well As in treatment
procedures. In certain allergy tests, the allergen is injected
intracutaneously
INTRAMUSCULAR INJECTION

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Intramuscular injection injection into the substance of a muscle,
usually the muscle of the Upper arm, thigh, or buttock. Intramuscular
injections are given when the substance is to be Absorbed quickly.
They should be given with extreme care, especially in the buttock,
because the sciatic nerve may be injured or a large blood vessel may

be entered if the injection is not made correctly into the upper, outer
quadrant of the buttock.
SUBCUTANEOUS INJECTION
Subcutaneous injection injection made into the subcutaneous
tissues. Although usually fluidMedications are injected, occasionally
solid materials such as steroid hormones may be injected in small,
slowly absorbed pellets to prolong their effect. Subcutaneous
injectionsMay be given wherever there is subcutaneous tissue,
usually in the upper outer arm or thigh.

INTRAVENOUS INJECTION
Intravenous is a term that means “into the vein”. Intravenous
medication administration Occurs when a needle is inserted into a
vein and medication is administered through that Needle. The needle
is usually placed in a vein near the elbow, the wrist, or on the back of
the Hand. Different sites can be used if necessary. Ok
8. DISPENSING PROCEDURE
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  Ensure that the prescription has the name and signature of the
prescriber and the Stamp of the health centre.
 Calculate the total cost of the drug to be dispensed on the
basis of the Prescription where applicable. Inform the patient
about the cost of the drug.
 Hand over the dispensed drug as Ensure that the prescription
is dated and has the name of the patient.
 If the prescription has not been written in a known (local)
health center, the Prescriber of the center should endorse
patient
 Avoid dispensing without a prescription or from an
unauthorized prescriber.
 Check the name of the prescribed drug against that of the
container.
 Check the expiration date on the container
Correct drug dispensing
Dispensed drugs should be appropriately labelled so that the patient
can benefit optimally from the use of the drug. Expired drugs should
not be dispensed. Correct Dispensing ensures that:
 The right patient is served,
 A desired dosage form of the correct drug is given,
 The prescribed dosage and quantity are given,
 The right container that maintains the potency of the drugs is
used,
 The container is appropriately labelled,

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  learn instructions are delivered verbally to the patient.

9. PATIENT OBSERVATION CHART

Ensuring that patients who deteriorate receive appropriate and
timely care is a key Safety and quality challenge. All patients should
receive comprehensive care Regardless of their location in the
hospital or the time of day. Even though a range Of systems have
been introduced to better manage clinical deterioration, this area
Needs to remain a high priority while patients continue to
experience preventable Adverse events because their deterioration
is not identified or properly managed.

The objective of an observation chart is to present the most

important vital signs for Detecting deterioration in most patients in a
user-friendly manner.

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 a. Single parameter tool (track and trigger) – Vital signs are
compared with a Simple set of criteria with predefined
thresholds, with a response algorithm Being activated when
any criterion is met”. The main vital signs are graphed So that
trends can be easily ‘tracked’. There are also color coded zones
to indicate when patient observations are likely to represent
deterioration, Where a response is ‘triggered’. Incorporating
call criteria in observation Charts is an effective way in which to
highlight possible deterioration and Assist clinicians with
making decisions as to when to ‘trigger’ a response, Whether
that be for a clinical review or rapid response call.
b. Aggregate scoring system – Core observations attract a
weighted Score. “Weighted scores are assigned to physiological
values and compared with Predefined trigger thresholds. The
main vital signs are collected and points are allocated. The
points for each observation are added to give a score that helps
identify patients with subtle signs of deterioration. A
supporting Action Plan triggers certain actions when certain
scores are reached.
c. Combination system – Single or multiple parameter systems
used in Combination with aggregate weighted scoring systems.

10. PRESCRIPTION
A prescription is a health-care program implemented by a physician
or other Qualified health care practitioner in the form of instructions
that govern the plan of Care for an individual patient. The term often
refers to a health care provider’s written authorization for a patient
to purchase a prescription drug from a Pharmacist.

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PARTS OF A PRESCRIPTION:
Date: Date must be written on the prescription by the prescriber at
the same time when it Is written. The date on the prescription helps
a pharmacist to find out the cases
Name, age, sex and address of the patient: Name, age, sex and
address of the patient must be written on the prescription. If it Is not
written then, the pharmacist himself should ask the patient about
these Particulars and put down at the top of the prescription.
Patient’s full name must be written instead of surname or the family
name.
Superscription: The superscription is represented by a symbol, Rx,
which is always written at the Beginning of the prescription. In the
days of mythology and superstition the symbol Was considered as a
prayer to Jupiter, the God of healing, for quick recovery of the
Patient but now this symbol is understood as an abbreviation of the
Latin word Recipe, meaning “take thou” or “you take”.
Inscription: This is the main part of the prescription. It contains the
names and quantities of the prescribed ingredients. The names of
the ingredients are written each on a separate Line, followed by the
quantity ordered and the last item written is generally the Vehicle or
diluent.

Signature/Sign: It is usually abbreviated as “Sig” on the prescriptions

and consists of the directions to be given to the patient regarding the
administration of the drug. It usually indicates the quantity Of
medicament or number of dosage units to be taken, how many times
in a day or at what Time it should be taken and the manner in which
it is to be administered or applied.

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Signature, Address and Registration Number of the Prescriber
All other parts of the prescription may be printed or type-written but
the prescriber’s name must be hand-written and should be signed
with ink. This eliminates the danger of Dispensing medicament on a
spurious order and it authenticates the prescription. The
Prescriptions containing narcotic or other habit-forming drugs must
bear the address and Registration number.

11 .INTENSIVE CARE UNIT (ICU)

An intensive care unit (ICU), also known as an intensive therapy unit
or intensive Treatment unit (ITU) or critical care unit (CCU), is a
special department of a hospital Or health care facility that provides
intensive treatment medicine. Intensive care unit (ICU) equipment
includes patient monitoring, respiratory and Cardiac support, pain
management, emergency resuscitation devices, and other life
Support equipment designed to care for patients who are seriously
injured, have a Critical or life-threatening illness, or have undergone
a major surgical procedure, Thereby requiring 24-hour care and
monitoring.
Purpose: An ICU may be designed and equipped to provide care to
patients with a range of Conditions, or it may be designed and
equipped to provide specialized care to Patients with specific
conditions. For example, a neuromedical ICU cares for Patients with
acute conditions involving the nervous system or patients who have
Just had neurosurgical procedures and require equipment for
monitoring and Assessing the brain and spinal cord. A neonatal ICU is
designed and equipped to Care for infants who are ill, born
prematurely, or have a condition requiring constant Monitoring. A
trauma/burn ICU provides specialized injury and wound care for
Patients involved in auto accidents and patients who have gunshot
injuries or burns.
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12 OPERATION THEATRES
An operating theatre (also known as an operating room, operating
suite, where surgical operations are carried out in a sterile
environment. Historically, the term "operating theatre" referred to a
non-sterile, tiered theater or amphitheater in which students and
other spectators could watch surgeons perform surgery.
TYPES OF OPERATION THEATRE
Minor OT: Minor OT is a place where minor surgeries are carried out.
Minor Surgery is any invasive operative procedure in which only skin
or mucus Membranes and connective tissue is resected e.g., vascular
cutdown for catheter Placement, implanting pumps in subcutaneous
tissue, ETC. Minor surgical procedures may be done in a laboratory
setting using appropriate Aseptic technique, including a clean work
area, preparation and disinfection of the Surgical site including
clipping of the hair and surgical scrub of the skin, draping of The
surgical site with sterile drapes, mask by the surgeon and any
assistants working In the surgical field.
MAJOR OT: Major surgeries are done in Major OT. Major surgery is
any invasive Operative procedure in which a more extensive
resection is performed, e.g., a body Cavity is entered, organs are
removed, or normal anatomy is altered. In general, if a Mesenchymal
barrier is opened (pleural cavity, peritoneum, meninges), the surgery
Is considered. A separate area, apart from the surgery room, must
provide for preparing the animal for surgery although the final
surgical preparation, not to include Clipping of hair, may be
conducted in the surgery. An area equipped with surgical scrub Sinks
should be apart from the operating room. A surgical- support area
should be provided For storing instruments and sterile supplies and
for washing and sterilizing instruments.
13. OUT-PATIENT DEPARTMENT

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An outpatient department or outpatient clinic is the part of a
hospital designed for the treatment of outpatients, people with
health problems who visit the hospital for Diagnosis or treatment,
but do not at this time require a bed or to be admitted for Overnight
care. Modern outpatient departments’ offer a wide range of
treatment Services, diagnostic tests and minor surgical procedures.
The outpatient department is an important part of the overall
running of the hospital. It is normally integrated with the in-patient
services and manned by consultant Physicians and surgeons who also
attend inpatients in the wards.
Many patients are Examined and given treatment as outpatients
before being admitted to the hospital At a later date as inpatients.
When discharged, they may attend the outpatient clinic For follow-
up treatment.
DENTAL
Dentistry is a branch of medicine that is involved in the study,
diagnosis, prevention, and treatment of diseases, disorders and
conditions of the oral cavity, Commonly in the dentition but also the
oral mucosa, and of adjacent and related Structures and tissues,
particularly in the maxillofacial (jaw and facial) area.Although
primarily associated with teeth among the general public, the field of
Dentistry or dental medicine is not limited to teeth but includes
other aspects of the Craniofacial complex including the tempero
mandibular and other supporting Structures.
The term dentistry comes from odontology– the study of the
structure, Development, and abnormalities of the teeth. Because of
their substantial concept, dentistry is often also understood to
subsume the now largely Defunct medical specialty of stomatology
(the study of the mouth and its disorders And diseases) for which
reason the two terms are used interchangeably in certain Regions.

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Dental treatment is carried out by the dental team, which often
consists of a dentist and dental auxiliaries (dental assistants, dental
hygienists, dental technicians, and Dental therapists). Most dentists
work in private practices (primary care), although some work in
dental hospitals and hospitals (secondary care) and institutions
(prisons, armed forces bases, etc

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