Setting up a nursing home can be tough, but if done systematically, a great learning experience too. A tremendous amount of research and meticulous planning has to be done to execute a well-functioning nursing home. Here are a few guidelines to help you iron out the kinks in your plan before you get down to brass and tacks.
1. Location
The most important thing that is often a game changer for an institution is the location of the nursing home. The site should be such that it is easily accessible to people around. It should be away from noisy localities and should be spacious enough to accommodate all the basic necessities of a nursing home. It should have easy public access via facilities like being well-connected by public transport, 24-hour electricity and water supply, phone lines and a proper sewage system.
2. Building plan
The next key ingredient in setting up a bustling nursing home is the structure or construction of the nursing home. It should be sturdy and should have scope for further extensions and alterations. There should be proper ventilation facilities throughout the building. Clean areas like operation theatre should be separate from general areas. Provisions should be made for easy and quick evacuation in case of emergency. All the doors and passages must be wide enough to allow a stretcher trolley or a wheelchair to pass. There should be provisions for alternate sources of electricity should there be a power failure. Adequate provision should be made for large stairwells, corridors and entrance halls as these areas tend to get crowded quickly.
3. Infrastructure
The nursing home must have an out-patient department (OPD), an in-patient department (IPD) and an operation theatre (OT). These are a must-have in any nursing home. An OPD is the place where the patient is received, investigated and diagnosed for the ailment and is either treated on an out-patient basis or admitted in hospital for further management. The IPD comprises of beds where patients are admitted for diagnostic or therapy. Having a 10-bed IPD is optimum for a nursing home. Patient privacy should be borne in mind and arrangements should be made for the same like installing curtains/screens around the beds. Provisions must be made for relatives of in-patients too e.g. a separate retiring room.
The OT plays an important role for surgical nursing homes. It should be spacious so as to accommodate various equipments used in surgery. There should be a separate sterilization room, changing room and a hand wash area. It must be ensured that the air from wards does not enter the operation theatre for fear of contamination. There should be a separate cleaning area for soiled materials from OT. The Operation table is an expensive piece of equipment and many things should be considered before buying it- e.g. portability, ease of maintenance, maximum weight bearing capacity and adjustability. There are various other departments that are needed like pharmacy, utility area, cashier, quarters for doctors and nurses, X-ray, pathology etc that can be sized depending on the availability of the space.
4. Licenses
There are various licenses that are needed in order to use various facilities, drugs and equipments, etc. Thorough research should be done and all necessary licenses obtained prior to the opening of the nursing home.
5. Instruments/devices
Every surgeon has his/her own preferences for surgical instruments. Hence, a nursing home should be well-equipped to be able to cater to all its visiting surgeons. Instruments should be bought after consulting the anaesthetists and surgeons to be involved later.
6. Waste disposal
Provisions should be made for appropriate disposal of biomedical waste so as to avoid pollution. The necessary permissions should be obtained from the State Pollution Board and arrangements made for eco-friendly disposal of biomedical waste as directed by board.
All in all, in a country where doctors are equated with Gods, a nursing home is akin to a temple. The sanctity and sanity both must be maintained.
– Original piece by Dr. Rachita Narsaria, MD