A

HOSPITAL TRAINING REPORT FILE (BP707P)

Submitted

In the partial fulfillment of the requirement for the degree of

BACHELOR OF PHARMACY
By

Student name – Praveen Chaudhary

(Roll No - 2000660500037)

Under the supervision of

Dr. Mayank Kulshreshtha Dr. Devender Pathak

(Professor) (Director & Dean)

Rajiv Academy for Pharmacy, Mathura

To the
Dr. A.P.J. ABDUL KALAM TECHNICAL UNIVERSITY
(Formerly Uttar Pradesh Technical University)
LUCKNOW
2023
 CERTIFICATE

This is Certified that Praveen Chaudhary, (Roll No - 2000660500037) has carried out the
hospital training as a part of the curriculum of Bachelor of Pharmacy (2023-24). The report
embodies results of training activities performed by the student and the contents of report do not
form the basis for the award of any other degree to the candidate or to anybody else from this or
any other University/Institution.

Dated:
Signature:
Dr. Mayank Kulshreshtha Dr. Devender Pathak
Professor Director & Dean
Rajiv Academy for Pharmacy, Mathura Rajiv Academy for
Pharmacy, Mathura

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 DECLARATION

I hereby declare that this project report entitled “HOSPITAL TRAINING PROJECT”
embodies my original work. It has not submitted in part on fully for any other diploma or degree
of any university. My indebtedness to other works has been duly acknowledged at relevant places.

Place: Rajiv Academy for Pharmacy, Mathura Student name – Praveen Chaudhary

Dr. A.P.J. Abdul Kalam Technical University, Lucknow Roll No -2000660500037

Date: …. /….../2022

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 ACKNOWLEDGEMENT

This is my proud privileges to be attached to Maheshwari Hospital PVT LTD. It is

highly professionalized hospital with modern outlook. I have learned a lot during my training
duration of 45 days ( 12/07/2023 to 30/08/2023) and contain has been fortunate in getting
and opportunity of working in this
hospital.

I would like to thanks Dr. Shashank Maheshwari providing necessary training

facilities and guidance during entire period of my training.

I would like to thanks all trainees and staffs, who help me very much and without
whom support and guidance it was impossible for me to complete the project successfully.

I would like to express my gratitude towards my parents & member of

Maheshwari Hospital pvt Ltd for their kind co-operation and encouragement which
help me in completion of this project.

Student name – Praveen Chaudhary

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TABLE OF CONTENTS
S.No. Topic Page No.
1. Hospital Training Letter 3
2. Hospital Training Certificate 4
3. Objective of Hospital Training 6
4. objectives 7
5. Facilities Provided 9
6. Sections 9
7. Outpatient department 10
8. General Wards 11
9. Emergency Department 12
10. Pharmacy Department 13
11. First Aid Treatment 15
12. Cardiopulmonary Resuscitation 18
13. Injections 19
14. Dressing 21
15. Prescription 22
16 Dispensing Procedure 24
17. Diagnostic Report 25
18. Patient Observation Chart 28
19. Conclusion 30

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 DECLARATION

I Praveen Chaudhary, the under-mentioned, solemnly declare that this internship report on
MAHESHWARI HOSPIAL PVT LTD. Is my original work. I further declare that I have
strictly observed reporting ethics and duly discharged copy-right obligation and properly
referred all outsourcing of materials used in this report and nothing is confidential in this
report in respect of the company of my internship. I take the responsibility for all legal and
ethical requirements regarding this report.

___________________
(Signature of student)

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 HOSPITAL

MAHESHWARI HOSPIAL PVT LTD is a recognized name in patient care. It was incepted in
the year 1992. They are one of the well-known Government Hospitals in Anantnag. Backed with
a vision to offer the been patient care and equipped with technologically advanced healthcare
facilities, they are one of the upcoming names in the healthcare industry. Located in, this
hospital is easily accessible by various means of transport. A team of well-trained medical staff,
non medical staff and experienced clinical technicians work round-the-clock to offer various
services that include OPD Services from 10.00 AM to
2.00 PM and 6.00 PM to 8.00 PM and Ambulance Services also. Their professional services
make them a sought after Private Hospitals in Delhi. A team of doctors on board, including
specialists are equipped with the knowledge and expertise for handling various types of
medical cases.

At MAHESHWARI HOSPIAL PVT LTD, the various modes of payment accepted are Cash.

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FACILITIES PROVIDED
❖ 24 hrs Emergency
❖ 24 hrs Ambulance Services
❖ 24 hrs Admission
❖ 24 hrs Canteen

SECTIONS

❖ OPD
❖ General Wards
❖ Emergency Wards
❖ Operation Theatre
❖ ICU Department
❖ Injection Room
❖ Pathology Laboratory
❖ Ultrasound Department
❖ X-Ray Department
❖ ECG Department
❖ Dressing Department
❖ Pharmacy

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.
In Jeevan Hospital & Stone Centre, there is separate outpatient department. Timing for OPD
is 10:00 AM to 2:00 PM and 6:00 PM to 8:00 PM.

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HOSPITAL TRAINING REPORT

GENERAL WARDS
❖ 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.

Fig. General Ward

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HOSPITAL TRAINING REPORT

EMERGENCY DEPARTMENT

❖ 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 Department

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PHARMACY DEPARTMENT

❖ Hospital pharmacy can usually be found with in 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.
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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

Fig. First Aid Kit

❖ 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. Steps of First Aid
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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 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.

FIRST AID SERVICES

Some people undertake specific training in order to provide first aid at public or private
events, during filming or other places where people gather. They may be designated as a first
aider, or use some other title. This role may be undertaken on a voluntary basis with
organizations such as the Red Cross and St. John Ambulance or as paid employment with a
medical contractor.

CONDITIONS THAT OFTEN REQUIRE 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.
❖ 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.
❖ Choking, 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.
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❖ Childbirth.
❖ Cramps in muscles due to lactic acid build up caused either by inadequate
oxygenation of muscle or lack of water or salt.
❖ Gender-specific conditions, such as dysmenorrhea and testicular torsion.
❖ Heart attack or inadequate blood flow to the blood vessels supplying the heart
muscle.
❖ Hair tourniquet a condition where a hair or other thread becomes tied around a toe or
finger tightly enough to cut off blood flow.
❖ 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.
❖ Joint dislocation.
❖ Poisoning, which can occur by injection, inhalation, absorption, or ingestion.
❖ Seizures, or a malfunction in the electrical activity in the brain. Three types of seizures
include a grand mal (which usually features convulsions as well as temporary respiratory
abnormalities, change in skin complexion, etc.) and petit mal (which usually features
twitching, rapid blinking, or fidgeting as well as altered consciousness and temporary
respiratory abnormalities).
❖ Muscle strains and Sprains, a temporary dislocation of a joint that immediately reduces
automatically but may result in ligament damage.
❖ Stroke, a temporary loss of blood supply to the brain.
❖ Toothache, which can result in severe pain and loss of the tooth but is rarely life
threatening, unless over time the infection spreads into the bone of the jaw and starts
osteomyelitis.
❖ 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 in.

CARDIOPULMONARY RESUSCITATION
❖ Cardiopulmonary Resuscitation (CPR) is a first aid technique to help people who suffer
a “Cardiac Arrest” (their heart stops beating).
❖ It involves chest compressions and rescue breaths to keep the casualty alive until a
defibrillator arrives.
❖ A defibrillator is an electrical device which can be used to help restart someone’s heart.
❖ CPR on its own is unlikely to restart someone’s heart; however it will increase the
chance of a defibrillator being successful.
 Fig. Defibrillator

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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,
intracardiac, intraarticular and intracavernous injection. ❖ Injection is generally
administered as a bolus, but can possibly be used for continuous drug administration as well.

Various Methods of Injections

 Fig. Routes of Injections

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.

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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.

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.

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.

5. Intra arterial route

This method is used for chemotherapy in cases of malignant tumors and in angiography.

6. Intra cardiac route

Injection can be applied to the left ventricle in case of cardiac arrest.

7. Intra thecal route

Intrathecal route involves the subarachnoid space. Injection may be applied for the
lumbar puncture, for spinal anesthesia and for diagnostic purposes. This technique
requires special precautions.

8. Intra-articular route
Intra-articular route involves injection into the joint cavity. Corticosteroids may be
injected by this route in acute arthritis. lOMoARcPSD|11826054

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

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
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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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DISPENSING PROCEDURE
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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:
⮚ 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 labeled.
⮚ Clear instructions are delivered verbally to the patient.
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DIAGNOSTIC REPORT
❖ A diagnostic report is the set of information that is typically provided by a diagnostic
service when investigations are complete.
❖ The information includes a mix of atomic results, text reports, images and codes.
❖ The Diagnostic Report resource is suitable for the following kinds of reports – ⮚
Laboratory – Clinical Chemistry, Hematology, Microbiology, etc.
⮚ Pathology/ Histopathology related disciplines
⮚ Imaging Investigations – X-Ray, CT scan, MRI, etc.

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 PATIENT OBSERVATION CHART
An observation and response chart is a document that allows the recording of patient
observations and specifies the action to be taken in response to deterioration from the
normal. The purpose of these charts is to support accurate and timely recognition of clinical
deterioration and prompt action when deterioration is observed. The way in which
observation charts are designed and used can contribute to both the poor recording of
observations and failure to interpret them correctly. Ensuring that patients who deteriorate
receive appropriate and timely care is a key safety and quality challenge.

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.

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.

d) Non track and trigger - Other observations charts may include the collection of vital
signs with no scoring or no criteria for a response.

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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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