NABH - Nursing Excellence

1. NABH: NATIONAL
ACCREDITATION BOARD FOR
HOSPITALS & HEALTHCARE
PROVIDERS
M.Sc. Nursing.
Rajiv Gandhi University of
Health Science.
PRESENTER :
DEV KUMAR MAHANTA

2. INTRODUCTION
• Is a constituent board of Quality Council of India.
• Set up to establish and operate accreditation programme for healthcare organisations.
• MISSION : To be apex national healthcare accreditation and quality improvement body,
functioning at par with global benchmarks.

4. About 5,000
germs live on
our hands at
any given time

5. MICROSCOPIC VIEW

6. 7 STEPS OF HAND WASHING

12. Blood and Body
Fluid Spill

18. • How you will prepare the site – before giving
injection/inserting iv line
Use 70 % alcohol (sprit) for cleaning the site from
centre to periphery and wait for 30 second

19. CLASSIFICATION OF SURGICAL WOUNDS(NATIONAL RESEARCH COUNCIL)
SSUURGRGIICCAALLWWOOUUNNDDTTYYPEPESS::
• ClCleeaannwwoouunndd––nnoossiiggnnssooffiinnffeectctiioonn//iinnffllaammmmaattiioonnee..g.g.;;sskkiinn,,eeyyee,,
vvaasscucullaarrssyysstteemm..
•CClleeaanncoconnttaammiinnatateeddwwoouunnd:d:ee..g.g.ppoosstt––ooppiinnffeectcteeddcacasseess,,
aabsbscceessss..
•CCoonnttaammiinnatateeddwwoouunndd::ee..g.g.gugunnsshhoottiinnjjuurryy..
•DiDirrttyycoconnttaammiinnaatteed:d:wwhheerreetthheerreeiisseexxpopossuurreettooffeecacallmmaassss,,
oopepennffiissttuullaass..

20. MANAGEMENT:
•Clean wound: clean with Betadine 10%.
•Wound surroundings to be cleaned and keep dry.

21. CONTAMINATED WOUND:
•Wound surface 1stto be cleaned with Betadine 10%.
•Internal wound cleaned by H₂O₂ / Saline.
•Removal of slough, (Debridement, +dressing vac +Hydrogen).
•Send pus for culture sensitivity reporting.
•Antibiotics according to culture sensitivityreport.

22. DIRTY CONTAMINATED WOUND:
•Proper irrigation withsaline.
•Betadine 10% H₂0₂ /saline cleaning.
•Inj TT/TT Immunoglobulin.
•Adequate Hydration –I.V. fluids/ pcv transfusion.
•Antibiotics.
•Prepare pt for wound debridement ± # Stabilization, ± Dressing.

23. WOUNDCARE GUIDELINES
• In poly-trauma cases Provide Airway
and Urgent resuscitation
• Treat open fractures as emergencies
• Immobilise injured extremity and cover wound with sterile dressing -
cover with saline soaked gauze
• IV Antibiotics within 3 hours of injury and continue for 72 hours
• Serial neurovascular examinations
• Vascular repair ≤6 hours
• Urgent optimum wounddebridement
• External fixation for damage control, definitive internal fixation at the
earliest (within 72 hours and not exceed 7 days)
• Early bone grafting
• Delayed wound closure with SSG/Flap

26. SUCTION PROTOCOL
• The purpose of suctioning is to maintain a patent airway and improve
oxygenation by removing mucous secretions and foreign material (vomit
or gastric secretions) from the mouth and throat (oropharynx).
• PROCEDURE:
• Wash hands and wear personal protective equipment as indicated.
• Adjust vacuum between-80 to -120 mmHg for adults or -60 to-80 mmHg
for pediatrics.
• Provide semi-fowler’s position (30 to 40 degree elevation).

27. • Check heart rate before, during and after procedure .(If tachycardia or
bradycardia occurs discontinue the procedure until it resolves).
• Put clean gloves on both hands.
• Open suction catheter exposing only the connector, attach to connective tubing
and maintain sterility ofcatheter.
• If patient has an artificial airway in place, hyper oxygenate with a resuscitations
bag or mechanical ventilator.

28. • Insert the catheter through the nose or endotracheal tube to the point
of restriction without applying suction (do not aggressively force the
tip of the catheter)
• Slowly insert catheter & ask patient to take deep breaths or watch for
inspiration.
• Pinch and Pass catheter into trachea, and slowly withdraw while
applying intermittent suction and rotating.
• Hyper oxygenate the intubated patient or request the non-intubated
patient to take several deep breaths.
• Auscultate the patient’s chest if secretions can still be heard repeat the
suctioning procedure

29. • Before re-suctioning, clear catheter with normal saline
• Discard gloves and catheters in an aseptic manner, clear connective
tubing with remaining NS and turn off suction.
• Note: - Coat tip of catheter with lubricant only if nasotracheal
suctioning is to beperformed.
• Remember:
- Suction should notbe applied formore than10 sec.
- First oral suction tobe done and followed by ET suctioning.
- ET tube pressure - 25-30mmHg.

30. THANK YOU