INNOVATIVE COLLEGE OF PHARMACY, GREATER NOIDA

Approved by AICTE, New Delhi and affiliated to AKTU, Lucknow

HOSPITAL TRAINING REPORT

SUBMITTED IN PARTIAL FULFILLMENT FOR THE DEGREE OF
BACHELORS OF PHARMACY
BY
ISHIKA KUMARI

UNDER THE SUPERVISION OF

Dr. AMARJEET SINGH
H.O.D (DEPARTMENT OF PHARMACOLOGY)
INNOVATIVE COLLEGE OF PHARMACY
AKNOWLEDGEMENT

 It is my proud privilege to be attached to Prathmik Swaasthya Khendra, Badlapur,

Gautam Buddha Nagar, UP. A highly professionalized hospital with modern outlook. I
have learnt a lot during my training duration of 45 days and content has been fortunate
in getting an opportunity of working in this hospital.

 I would like to thank Sir Deepak Sharma for providing necessary training facilities and
guidance during entire period of my training.

 I would like to thank all the trainees and staffs for their support and guidance. It would
have been impossible for me to complete the project successfully without them.

 I would like to say how deeply indebted I am to my supervisor Dr. AMARJEET SINGH
for his help, guidance and support throughout this entire project report.

ISHIKA KUMARI
B.Pharm (4th Year)
Roll no. 1902270500017
Innovative College of Pharmacy
OBJECTIVE OF TRAINING
 Hospital training is an observational oriented procedure in which a person is able to
learn practically from their theoretically knowledge.
 Hospital training provides practical knowledge to the student.
 Hospital training helps to study closely the ground level problem regarding their job
profile.
 Hospital training promotes an environment in which student are induced to adapt
themselves quickly to changed circumstances.
 Training provides practical knowledge to the students.
 Training puts the students in real life situation.
 Training removes the hesitation of the student regarding their working skill and
personality development.
 Training is mandatory as per A.I.C.T.E. and affiliating universities and Pharmacy
council of India
INDEX
Serial No. Contents Page No.

1 Introduction 1-3
2 Sections in hospital 4
3 OPD 5
4 General ward 6
5 Emergency ward 7
6 Pharmacy department 8
7 Hospital internship activity 9
8 First aid treatment 10-13
9 Injections 14-17
10 Dressing 18-19
11 Prescription 20-21
12 Dispensing procedure 22-23
13 Conclusion 24
LIST OF FIGURES
Serial no. Contents Page no.

1 PHC Badalpur 2-3

2 General ward 6
3 Emergency ward 7
4 Pharmacy department 8
5 First aid kit 10
6 CPR 11
7 First aid of burns 12
8 First aid of chocking 12
9 First aid of heavy bleeding 13
10 Various method of injection 14
11 Intramuscular 15
12 Subcutaneous 16
13 Intravenous 16
14 Intradermal 17
15 Dressing 18
16 Prescription 21
17 Drug dispensing steps 23
INTRODUCTION:
Prathmik Swaasthya Khendra referred to as Primary Health Centres, are state-owned rural and
urban health care facilities in India.

They are essentially single-physician clinics usually with facilities for minor surgeries.

They are part of the government-funded public health system in India and are the most basic
units of this system.

As on 31 March 2019 there are 30,045 PHCs in India in which 24,855 are located on rural areas
and 5,190 are on urban areas. Suggest of PHC is given by Bhore committee in 1946.

Primary health care is a whole-of-society approach to health and well-being centred on the
needs and preferences of individuals, families and communities. It addresses the broader
determinants of health and focuses on the comprehensive and interrelated aspects of physical,
mental and social health and wellbeing.

It provides whole-person care for health needs throughout the lifespan, not just for a set of
specific diseases. Primary health care ensures people receive comprehensive care - ranging
from promotion and prevention to treatment, rehabilitation and palliative care - as close as
feasible to people’s everyday environment.

Stronger primary health care is essential to achieving the health-related Sustainable

Development Goals (SDGs) and universal health coverage. It contributes to the attainment of
other goals beyond the health goal (SDG3), including those on poverty, hunger, education,
gender equality, clean water and sanitation, work and economic growth, reducing inequality
and climate action.

WHO recognizes the central role of primary health care for achieving health and well-being
for all, at all ages.

Primary Health Centres programmes are listed below:

 Provision of medical care

 Maternal-child health including family planning

 Safe water supply and basic sanitation

 Prevention and control of locally endemic diseases

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 Collection and reporting of vital statistics

 Education about health

 National health programmes, as relevant

 Referral services

 Training of health guides, health workers, local dais and health assistants

 Basic laboratory workers

 First PHC established in 1952.

Fig: PHC BADLAPUR

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Fig: PHC BADLAPUR

Fig: PHC BADLAPUR HALL

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SECTIONS IN HOSPITAL:
OPD

General Wards

Emergency Wards

Operation Theatre

ICU Department

Injection Room

Pathology Laboratory

Ultrasound Department

X-Ray Department

ECG Department

Dressing Department

Pharmacy

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OUTPATIENT DEPARTMENT (OPD):

An outpatient department is the part of hospital designed for the treatment of outpatients. This

department provides diagnosis and care for patients that do not need to stay overnight.

It is an important part of the overall running of the department. The outpatient department will

usually be on the ground floor of the hospital. Wheel chairs and stretchers are available

for non-ambulatory patients. Close at hand will be X-rat facilities, laboratories, the medical

record office and a pharmacy. In the main waiting area there are a range of facilities for the

patients and their families including toilets, public telephones, canteen, and water dispenser.

Some of the hospitals have no separate department for outpatients, so they may be treated

in same department as patients that stay overnight.

OPD is Out Patient Department, whereas in Hindi it stands for बाह्य रोगी विभाग. In the

medical department, this OPD is constructed for primary communication between medical

professionals and patients. The OPD employees have to be highly skilled and alert because

they are the person who has detailed information regarding the medical conditions of a

patient and in future, they will suggest the treatment required to give a patient. Hence this

department is considered as extremely important.

Generally, OPD is structured on the ground floor of the hospital. So when the patient

arrives at the hospital for the first time he/she can easily approach the OPD and it is the

OPD that decides which department the patient needs to be admitted to on completion of

the paperwork. OPD plays an important role for a smooth running of a hospital.

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GENERAL WARD:
A general ward is a large room where people who need medical treatment stay in
general wards.
General wards have a cubicle room having six to eight patient bed and toilet in the wings
of the ward.
These wards are fully-equipped nursing station, Attendant couch, Qualified dietitian for
diet advice and diet service.
In general ward, those patients are only stay who is not suffered from any chronic
disease.
General ward is a common unit where patients who are admitted share the same room. The
ward is equipped with health monitoring systems with one-to-one care assistance for patients
as required. Facilities are catered as per patient's diagnosis, age, comfort and other essential
factors.

At most of the medical facilities, there are separate male and female general wards. Wards for
female patients follow guidelines that are independent from the other types of general wards.
To accompany female patients, only female family members or friends are allowed to wait at
the healthcare facility.

Fig: General Ward

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EMERGENCY WARD:
An Emergency Department (ED), also known as an Accident and Emergency department
(A&E), Emergency Room (ER) and Casualty Department (CD).

It is a medical treatment facility specializing in emergency medicine.

The emergency department is usually found in a hospital or other primary care center.

Due to the unplanned nature of patient attendance, the department must provide initial
treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening
and require immediate attention.

In some countries, emergency departments have become important entry points for those
without other means of access to medical care.

The emergency departments of most hospitals operate 24 hours a day, although staffing
levels may varied in an attempt to reflect patient volume.

Fig: Emergency Ward

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PHARMACY DEPARTMENT:

Hospital pharmacy can usually be found within the premises of the hospital.

Hospital pharmacy usually stock a large range of medications including more specialized
and investigational medications (medicines that are being studied but have not yet been
approved), then would be feasible in the community setting.

Hospital pharmacies typically provide medications for the hospitalized patients only and are
not retail establishments.

They typically do not provide prescription service to the public.

Some hospitals do have retail pharmacies with in them, which sell over the counter as well as
prescription medications to the public, but these are not the actual hospital pharmacy.

Fig: Pharmacy Department

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HOSPITAL INTERNSHIP ACTIVITY:

Hospital Internship Activities include –

1. First Aid Treatment

2. Injections

3. Dressing

4. Prescription

5. Dispensing Procedure

6. Diagnostic Report

7. Patient Observation Chart

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FIRST AID TREATMENT:

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.

It includes initial intervention in a serious condition prior to professional medical help being
available, such as performing CPR while awaiting an ambulance, as well as the complete
treatment of minor conditions, such as applying a plaster to a cut.

First aid is generally performed by the layperson, with many people trained in providing
basic levels of first aid, and others willing to do so from acquired knowledge.

Fig: First Aid Kit

AIMS OF FIRST AID:

The key aims of first aid can be summarized in three key points, which known as “3 P’s”-

1. Preserve Life – The overriding aim of all medical care which includes first aid is to save
lives and minimize the threat of death.

2. Prevent further harm – Also sometimes called prevent the condition from worsening or
danger of further injury, this covers both external factors such as moving a patient away from

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any cause of harm and applying first aid techniques to prevent worsening of the condition, such
as applying pressure to stop a bleed becoming dangerous.

3. Promote recovery – First aid also involves trying to start the recovery process from the
illness or injury and in some cases might involve completing a treatment, such as in the case
of applying a plaster to a small wound.

CONDITIONS THAT OFTEN REQUIRE FIRST AID:

 Cardiac Arrest: Cardiac arrest which will lead to death unless CPR (Cardiopulmonary
resuscitation) 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.

Fig: CPR (Cardiopulmonary resuscitation)

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 Burns: Burns, which can result in damage to tissues and loss of body fluids through the
burn site.

Fig: First Aid of Burns

 Choking: chocking blockage of the airway which can quickly result in death due to
lack of oxygen if the patient’s trachea is not cleared, for example by the Heimlich
Maneuver.

Fig: First aid of Chocking

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 Heavy bleeding: Heavy bleeding is treated by applying pressure (manually and later
with a pressure bandage) to the wound site and elevating the limb if possible.

Fig: First aid of Heavy bleeding

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INJECTIONS:

An injection is the act of putting a liquid, especially a drug into a person’s body using a needle
and a syringe.

Injection is a technique for delivering drugs by parenteral administration, that is,

administration via a route other than through the digestive tract.

Parenteral injection includes subcutaneous, intramuscular, intravenous, intraperitoneal, intra

cardiac, intraarticular and intra cavernous injection.

Injection is generally administered as a bolus, but can possibly be used for continuous drug
administration as well.

Fig: Various method of injection

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Various methods of injection:

1. Intramuscular injection: It is deliver a substance deep into a muscle where they are quickly
absorbed by blood vessels. The injection is often given at a 90 degree angle. Common
injections sites include the deltoid, vastus lateralis and ventrogluteal muscles. Most
inactivated vaccines like influenza are given by I.M. injection. Medical professionals are
trained to give I.M. injections but patients can also be trained to self-administer medications
like epinephrine.

Fig: Intramuscular Injection

2. Subcutaneous injection: In it, the medication is delivered to the tissues between the skin
and the muscle. The injection is often given at a 45 degree angle. Absorption of the
medicine is slower than that of intramuscular injections. Since the needle does not need to
reach the muscles so often a bigger gauge and short needle is used. Usual site of
administration is fat tissue behind the arm. Insulin injection is a common type of
subcutaneous injection medicine. Certain vaccines including MMR (Measles, Mumps and
Rubella), Varicella (Chickenpox), Zoster (Shingles) are given subcutaneously.

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Fig: Subcutaneous injection

3. Intravenous injection: It involves needle insertion directly into the vein and the
substance is directly delivered into the blood stream. The injection is often given at a 25
degree angle. In medicine and drug use, this route is the fastest way to get the desired
effect since the medication moves immediately into blood circulation and to the rest of
the body.

Fig: Intravenous Injection

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4. Intradermal injection: In this, medication is delivered directly into the dermis, the
layer just below the epidermis of the skin. The injection is often given at a 5 to 15 degree
angle with the needle placed almost flat against the patient’s skin. Absorption takes the
longest as compared to other parenteral routes. This route is often used for sensitivity tests
like tuberculin and allergy tests and local anesthesia tests. Common sites of this are the
forearm and the lower back.

Fig: Intradermal injection

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DRESSING:
A dressing is a sterile pad or compress applied to a wound to promote healing and
protect the wound from further harm.

A dressing is designed to be in direct contact with the wound as distinguished from a

bandage, which is most often used to hold a dressing in place. Many modern dressings are
self –adhesive.

Dressings serve a variety of purposes depending on the type, severity and position of the
wound.

Dressings are also important to help:

 Stop bleeding and start clotting so the wound can heal

 Absorb any excess blood, plasma or other fluids
 Wound debridement
 Begin the healing process

Fig: Dressing

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What type of wound care dressing is right for my wound?

Hydrocolloid: Hydrocolloid dressings are used on burns, light to moderately draining

wounds, necrotic wounds, under compression wraps, pressure ulcers and venous ulcers.

Hydrogel: This type of dressing is for wounds with little to no excess fluid, painful wounds,
necrotic wounds, pressure ulcers, donor sites, second degree or higher burns and infected
wounds.

Alginate: Alginate dressings are used for moderate to high amounts of wound drainage,
venous ulcers, packing wounds and pressure ulcers in stage III or IV.

Collagen: A collagen dressing can be used for chronic or stalled wounds, ulcers, bed sores,
transplant sites, surgical wounds.

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PRESCRIPTION:

A prescription contains handwritten instructions for the dispensing and administering of

medications. It can be more than an order for drugs as it can also include instructions for a
therapist, the patient, nurse, caretaker, pharmacist or a lab technician for orders for lab tests,
X-rays, and other assessments.

SECTIONS OF PRESCRIPTION:

Superscription - the heading with the date and the patient’s name, address, age, etc.

Symbol Rx - the Rx stands for "recipe" which in Latin means "to take."

Inscription - the information about the medication. It has the name of the ingredients and the
amount needed. It includes the main ingredient, anything that helps in the action of the drug,
something to modify the effects of the main drug, and the "vehicle" which makes the medicine
more pleasant to take.

Subscription - The subscription section tells the pharmacist how to dispense the drug. This
will have instructions on compounding the drug and the amount needed.

Signature- The signature has the directions that are to be printed on the medicine. The word
"sig" means "write on label."

VARIANCES IN PRESCRIPTION WORDING:

Prescriptions vary from state to state and doctor to doctor:

Sometimes the doctor will write "dispense as written," "do not substitute," or "medically
necessary."

Sometimes the age of the child is required and often the doctor will put the condition that is
being treated.

Sometimes there is a label box. If the doctor checks this, the pharmacist labels the medicine;
if not, he only puts the instructions for taking it.

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Fig: Prescription

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DISPENSING PROCEDURE:
Drug dispensing is often portrayed as merely being the process of giving a drug product to a
patient.
Dispensing Procedure:

 Ensure that the prescription has the name and signature of the prescriber and the stamp of
the health centre.
 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 centre, the prescriber of
the centre should endorse it.
 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.
 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.
 Issue a receipt for all payments.

Dispensing prescription on part- payment:

 When a patient does not have enough money to pay for all the drugs as prescribed, the
dispenser is faced with a difficult situation.
 The dispenser follows these things at that time –
1. Like doctor prescribed medicines for 7 days so, you can dispense only 3-5 days
medicines according to money.
2. If you know the medical treatment is gone long, then write the left amount on
prescription so you can take the left money on next time dispensing.

Correct drug dispensing:

Dispensed drugs should be appropriately labeled so that the patient can benefit optimally
from the use of the drug. Expired drugs should not be dispensed.

Correct dispensing ensures that:

1. The right patient is served.

2. A desired dosage form of the correct drug is given.

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3. The prescribed dosage and quantity are given.
4. The right container that maintains the potency of the drugs is used.
5. The container is appropriately labeled.
6. Clear instructions are delivered verbally to the patient.

Fig: Steps involved in Drug dispensing

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CONCLUSION:

During training procedures I have got lot of knowledge about flowing-

Stated project a training regarding each and every first aid procedures. It includes checking the
symptoms and treating at small scale in first aids and later transferring for surgical procedures.

I got known regarding artificial respiration process and wound dressing.

Sites of injection which includes knowledge of syringes, routes of injections. Routes of

injections such as I.V., I.M., I.D., Subcutaneous etc.

In Prescription reading, its parts and the abbreviations used are studied by me in this project
it’s truly a scandalous matter for pharmacists study.

Later the dispensing procedure is stated therefore which was practiced by me all around
the training at regular intervals.

I also learn about patient observation chart and how to fill it, use it.

In Simple diagnostic reports that are easy to study in case of pathological reports but a bit of
difficulty arises in reading radiological reports.

Therefore I have got a marvelous experience by this training.

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