xv) The committee
members shall be reimbursed for the contingencies, honorarium and travel as per
Govt. of India rules and regulation framed for such committees.
1.
The Veterinary Council of India shall be the appellate
authority for matters connected therewith and related thereto accreditation or
licensing of veterinary practice in India. The Appeal shall be filled by the
affected party within 30 days of the receipt of the reply to request for
Accreditation or licensing.
2.
Save where otherwise expressly provided in the Indian
Veterinary Council Act of 1984 or by any other law for the time being in force,
an appeal shall lie to the Council against any adverse communication on the
Accreditation of the Veterinary practice, by the aggrieved party with in 60
days of such communication or against any order passed or against any complaint
made for or against. The decision of the Council as Appellate Authority shall
be final.
3.
Where an Appeal has been admitted by the Council, the
Appeal shall be decided in accordance with the opinion of the majority of the
members present in that meeting.
4.
Where there is no majority, the President of the
Council shall have the casting vote.
5.
In an Appeal, the memorandum filed by the aggrieved
party shall be in prescribed proforma and the memorandum shall contain
precisely the substantial points being challenged. The Council may allow the
aggrieved party to argue only on these points. There will be no additional
evidence or submission of new facts, which were not brought to the original
authority or to the Accreditation/licensing Committee against whose appeal, has
been brought up.
6.
The Council will have, however, power to summon an
individual/expert/or organisation to appear before it or provide in writing any
evidence/opinion for which it can take recourse to News paper publication too.
The Council shall have power to get exhibited any document related to the
point/order in question.
7.
The Council shall have power to constitute a
commission to examine any person, inspect any veterinary practice or place of
incidence.
8.
The Council will have however, no power to call any of
the members of the accreditation committee to appear before it. However, they can
be requested to give their opinion as and when required.
9.
The Council shall have power to obtain evidence or
statements on oaths.
10. The Veterinary Council will have
powers to frame Guidelines appropriate enough for the smooth functioning and to
provide working mechanism for the issues related to accreditation of veterinary
practice.
1. A person, an agency, an institution or state providing veterinary
service shall display, in local or acceptable language, the type of the unit
depicting the nature of service being provided as defined in these regulations
so that the public can request for the available service. The institution shall
be responsible for making available the necessary facilities by way of
building, equipment(s), medicine, trained personnel as prescribed for a Good
Veterinary Practice.
2.
These regulations by no way
make or intend to make it mandatory on any person, agency, institution or state
to undertake veterinary practice or prohibit them from doing so. But an agency,
person or State who undertakes the onus of providing veterinary service shall
do so as prescribed and shall maintain a record of all such activities to be
made available to the accreditation agency on demand.
3.
Since as per the Act,
Veterinary practice includes the responsibility to supervise and guide minor
Veterinary services, every registered veterinary practitioner shall do so
without any negligence on his part and as laid down in the guidelines to be
issued by the council.
4.
While governments currently
hold the responsibilities of Veterinary services, there is and shall be no bar
on any institution, co-operative, non-government organizations, and/or
individual to provide any (aspect of) Veterinary service, provided that such
veterinary practice (or part thereof) shall be performed consistent with the
laws prevailing for the time being and as per the provisions of the Indian
Veterinary Council Act, 1984 (52, of 1984) and the regulations made there
under.
5.
Institutions other than the
government and/or individuals involving themselves in veterinary practice can
choose to provide either the holistic primary veterinary service, a specialist
service or a specialized professional service, provided that registered
veterinary practitioners with the prescribed competence/qualifications are
engaged to perform such service.
6.
The basics for regulating
veterinary practice shall be "Good Veterinary Practice" (GVP).
Guidelines on GVP, circulated by the council for achieving an acceptable
standard of Veterinary Practice shall be based on the presence of a holistic
veterinary service system in the institution, state/region/country.
7.
Prevention of animal
diseases shall be done by registered veterinary practitioners and as per the
rules and regulations regulating such activity and as adopted by the State/UT.
1.
The Veterinary professionals
in charge of the Veterinary Institutions or services shall possess a
qualification included in the First or Second schedule to the Act and shall
have a valid registration in the veterinary Council of the state where he/she
is practicing.
2.
All associated staff must be
trained for the tasks performed by them. The assistant veterinary
technician/compounder (by whatever name called) should obtain training from a
recognized by the State/UT Government/Institution or shall be prepared to
undertake study, at the earliest, towards such training/qualifications.
3.
A high standard of
professional behavior, cleanliness, and personal appearance must be maintained
by all members of the Veterinary Institutions at all times.
4.
The Veterinary Institutions
must have, and implement, a written policy that provides for the ongoing
professional development of its veterinary surgeons and veterinary technicians
adequate to maintain a high standard of professional care. The Veterinary
Institutions should encourage regular consultations, attendance at conferences,
seminars, and meetings of the relevant professional
institutions/organization/society etc.
5.
There must be sufficient
trained nursing staff for proper care and observation of caged animals. There
must be a dedicated trained veterinary technician available at the time
when animals are undergoing
elective anaesthesia by a registered veterinary practitioner. At these times,
they must not have other duties.
6.
Every Veterinary Institution including District Veterinary Centre,
Polyclinics, Veterinary Hospital, Veterinary Dispensary must have the
residential accommodation for the staff of the institutions in the premises
(veterinarian, veterinary assistants, animal attendants etc.) for providing
better and effective services.
7.
The Veterinary Institution must have a library of reference books or a
Reference Library in electronic form. This should include latest editions
covering all of the major clinical disciplines relating to zoo and companion
animal medicine and surgery. The Veterinary Institutes must subscribe to at
least one current clinical small animal, livestock, and zoo animal journal.
8.
Direct supervision of non-veterinarians: Individuals not possessing
recognized veterinary qualifications and not registered with Veterinary Council
are prohibited from practicing veterinary medicine, which includes treatment,
embryo transfer, surgery, treatment of reproductive diseases/disorders or any
other related services on animals, as defined in the Indian Veterinary Council
Act, 84, except under the direction and supervision of a registered
veterinarian. Direct supervision includes the following:
(1)
The licensed veterinarian must have established a
veterinarian-client-patient relationship.
(2)
The treatment must be performed on the direction of a registered
veterinarian.
(3)
The registered veterinarian must be available on the premises and/or
should be readily available.
(4)
The registered veterinarian must assume liability for the quality of
any treatment performed.
(5)
The fee for services rendered, if any, shall be paid to the licensed
veterinarian or institution providing the facility.
1.
There must be a waiting room for clients that are of an adequate size
and with sufficient seating for the workload of the Veterinary Institutions.
Allow a seating area sufficient for three people (owner of patient) per
consulting veterinarian.
2.
There must be at least one consulting room that provides a clean and
hygienic environment for consultation in private. The room must be have running
tap water. There must be an examination table, the surface of which is
impervious and able to be cleaned and disinfected easily. Sufficient diagnostic
equipment (thermometer, stethoscope, otoscope, opthalmoscope, examination
gloves, lubricant, fluorescing strips, ophthalmic local anaesthetic drops, and
weighing scales - these being the minimum essential) to carry out routine
physical examinations of the patients should be available. At least one room
must be able to be darkened or a dark room suitable for examining patients must
be available. Examination rooms should be equipped with a suitable ventilation
system or an exhaust facility to remove offensive odours rapidly. There must be
a covered area/space with Travis for examination of large animals.
3.
There must be an operating room that is used solely for carrying out
sterile surgical procedures. Specifically, this room must not be used for
dental work (other than that required to have aseptic conditions) or abscess
drainage. This must be equipped with a table and suitable surgical lighting.
Surgical instruments, drapes, and surgeon's clothing must be provided that is
suitable for the types of operations performed.
4.
A legible system (facility) of documenting the records of all the case
histories of all the current patients must be provided. There must be an
efficient system for filing and retrieving patient records manually or by
computer .
5.
Pet care accessories can be displayed for retail sale, provided that
the display is of an acceptably professional nature. The shop area must be
clean and tidy, and well organised. Merchandising signs and displays must not
contain misleading messages. Toxic and hazardous drug/chemicals must be
displayed according to the requirements of the Drug and Cosmetics Act, 1941 and
Rules framed thereunder. Merchandising should, however, not be encouraged in
the Govt. Veterinary institution which are primarily meant for public services.
6.
There must be separate room(s) for the accommodation of patients. The
number of cages/rooms must commensurate with the workload of the clinics. The
cages/room must be of an adequate size for the animal to be housed. The
cages/rooms must be of safe construction and maintained in a hygienic
condition. There must be solid partitions between cages. Cages must not be able
to drain waste into adjoining cages. The cage room(s) must be well ventilated
and maintained at a comfortable temperature. There must be facilities for the
hygienic preparation and storage of food and for the cleaning and storage of
utensils and food bowls. The wall and floor surfaces of cages must be
impervious to permit thorough cleaning and disinfection. If there is a door in
the kennel room opening to the outside of the building, it must be:
a) protected by an escape-proof room/frame with a second door to the
outside. This safe place between the kennel room and the outside must be big
enough to hold at least one person with an animal.
b) If there are
windows in the kennel room, they must be permanently secured in a way that
prevents animals from escaping. These windows must be kept closed or have an
animal-proof mesh fitted.
An additional accommodation
facility for client(s) of an indoor patient must be made available within the
premises.
7.
There must be a written guideline for dealing with infectious cases.
This guideline must ensure that any other animals being treated at the clinics
are not exposed to increased risk of infection. The guideline must specify
where infectious cases will be examined and treated, and the method of
disinfection used afterwards. Either facilities for the isolation of infectious
cases must be provided which are separate and remote from the other animals or
where accommodation is not available, a written guideline for dealing with such
cases must be formulated and written confirmation of the ability to refer such
cases to another clinic with correct isolation facilities must be implemented.
All Accredited Veterinary Clinics must have facilities for the isolation of
infectious cases on the premises. These facilities must have the same standard
of cages as described in (6) above.
8.
The floors of all of the rooms used for client waiting, the dark room,
examination, treatment, surgery, or animal accommodation must have an
impervious surface to allow effective cleaning and disinfection. The walls of
the rooms used for examination, treatment, surgery, or accommodation of animals
must be lined with materials that are coated with an impervious surface or
scrub-able (with disinfectants) painted surfaces, to the height of 1.2 meters
above the floor.
9.
The inside of the premises must be maintained to a high standard, kept
clean, and in good decorative order, with offensive odour eliminated as far as
possible. The outside of the building must be maintained in a good state of
repair. The immediate area surrounding the building must be kept clean and
tidy. There should be car parking available for clients, with easy access to
the main entrance of the premises.
10. All premises where veterinary
facility (including its various branches) is being practiced, and all
instruments, equipment, apparatus, and apparel used in connection with those
practices, shall be kept clean and sanitized and shall conform to the standards
specified for different types of facilities.
11. Emergency service either by
staff veterinarians or by pre-arranged referral to another veterinarian within
a reasonable distance shall be provided at all times. Referral must be
acknowledged and agreed upon by both the referring and referred veterinarians.
12.
Every veterinary service shall maintain the following facilities:
A sanitary environment to
include the proper routine disposal of waste material, proper sterilization or
sanitation of all equipment used in diagnosis or treatment, and adequate
storage to provide a neat and orderly appearance.
(1)
An adequate library of textbooks, journals or other current veterinary
reference materials, readily available on the premises or available through
electronic access.
(2)
Proper storage and environmental control for all medicines and
biologics, based on the manufacturer's recommendations.
(3)
Properly maintained records.
(4)
Legally accessible methods for the disposal of deceased animals and
infectious waste.
13. Ambulatory services may be made
available for 24 hours a day at the polyclinics and district veterinary
centers.
14. Facilities for disposal of
cadavers should be available at the Veterinary Hospitals with proper hygiene
and measures to prevent spread of pathogens. Incinerator may be set up in the
hospitals, polyclinics and district veterinary centers.
a)
Various equipments and veterinary service aids in use at the veterinary
institution(s) shall conform to the highest standards. Proper hygiene and
sanitary measures have to be practiced to avoid any contamination/infection
during its use on the patient (livestock/animal). Equipments requiring
sterilization should be sterilized before use.
b)
The anaesthetic machine must be serviced and calibrated at intervals as
recommended by the manufacturer (at least every two years for precision
vapourisers). Maintenance records must be kept. Regular daily maintenance must
be carried out to detect leaks, prevent condensation build up, and monitor soda
lime activity.
c)
There must be some form of monitoring of anaesthetised animals. This
can take the form of equipment (e.g. electronic devices such as an apnoea
monitor or a pulse oximeter) or a trained assistant who is present at all times
during the anaesthesia. Where equipment is used for this purpose, staff must be
trained in its use.
d)
There must be a scavenging system taking waste anaesthetic gases out of
the building, this may be active or passive.
e)
A recognised and successful method of sterilization must be used to
sterilize instruments, gowns, and drapes in sufficient quantities to meet the
workload of the practice. Steam, gamma irradiation, and ethylene oxide are
acceptable alternatives. Boiling, cold sterilization, and ultraviolet cabinets
are not acceptable unless for specific equipment such as cold sterilization of
endoscopic equipment. Sterility indicators must be used to monitor the
efficiency of the system. Instruments must be cleaned and re- sterilized prior
to use for each new surgical case.
f)
Face masks, gloves and suitable protection gears for staff using oral
or surgical or gynecological or microbiological procedures or any other
procedures involving infections must be sterilized.
g)
The veterinary service must provide facilities for the induction and
maintenance of general anaesthesia. This must include equipment for the
maintenance of inhalation anaesthesia and oxygen for emergency resuscitation.
Anaesthetic systems and circuits used must be appropriate for all types and
sizes of animals treated.
1.
Radiology facilities may be limited to the District Veterinary Center,
Polyclinic and teaching institution. They must have an x-ray machine and
associated ancillary equipment capable of consistently producing diagnostic
survey radiographs of all species commonly being treated at the institution and
where necessary
2.
All records pertaining to the recent cases of radiographic study should
be kept as records.
3.
The X-ray facilities and procedures must comply with the guidelines of
"Safe Practice for the Use of X-rays in Diagnosis (Veterinary)" .
4.
Veterinarians and staff who are required to take radiographs must be
fully conversant with the operation of all of the radiographic and associated
equipment.
5.
A veterinarian or a person operating the X-ray machine of the
Veterinary institution having the facilities for radiography must have a
current licence, issued by the competent authority to use an x-ray machine for
the purposes of veterinary diagnosis and shall comply with relevant safety
guidelines.
6.
The clinics must provide, or have access to, a dark room and processing
system for the development of radiographs. The Veterinary institution must be
able to have radiographs developed at any time, at emergency also.
Where the
processing of radiographs is carried out by the clinics/polyclinics/hospital
required preventive measures must be adopted to avoid undesired exposure to
X-rays and other radiation hazards.
7.
The veterinary service institutions should display a technique chart of
exposure factors. This should be used and modified as necessary. Calipers
should be available to measure body part thickness.
8.
The clinics must use a system to permanently identify radiographs.
9.
Suitable arrangements must be made for the efficient filing, storage,
and retrieval of x-ray films.
10. In a institution where, on
average, more than forty films are taken per week, film badge monitoring of
staff working with or near the x-ray machine must be carried out. Records of
personal dosimeter must be kept. X-ray machines must be maintained in
accordance with manufacturer specifications.
11. There must be provision for all
types of protective devices to minimize undue exposure to X-ray.
12. Non-manual restraining aids such
as sandbags, foam blocks and wedges, V- troughs, ropes and tapes must be
available and used to reduce the need for personnel to restrain the animal
during radiography. Where the animal's health or condition permits, it should
be anaesthetised or tranquillised to facilitate the efficiency of the
procedure.
1.
The clinics/dispensaries/hospitals/veterinary institutions must keep
adequate* supplies of medicines and animal remedies including emergency
medicine that must be stored in a vermin-proof, clean, tidy, permanent, and
secure building.
(*adequate - means the type and
quantity as may be required to handle the number and type of cases recorded,
and the policy of the institution on dispensing of medicines. However, attempts
should be made to keep the medicines for dealing with emergencies and acute
disease conditions in order to alleviate pain and save the life of the animal.
In this regard, the experience/records available about the prevalence of a
particular disease/emergency situation may be used as guide to select the
medicines. In all cases, the quality of the medicines should be high with
required efficacy.)
The adequacy of
the medicines shall since vary with the type of institution and its ambit of
services, the same shall be examined while considering the proposals for
accreditation on case to case basis.
2.
Smoking, eating, or storage of food for human consumption must not be
permitted in areas where medicines are stored or dispensed.
3.
Drugs must be stored according to the manufacturers instructions and,
where appropriate, protected from the adverse effects of light, temperature,
humidity and rodents.
4.
There must be an efficient stock rotation system that prevents the use
of out of-date stock. Expired medicines must never be prescribed.
5.
All Controlled Drugs that are not required for immediate use must be
kept in a locked metal or concrete cupboard or safe, that is securely fixed to
the building. When the building is unattended, keys for the cupboard must not
be left on the premises. For safety reasons, all Controlled Drugs should be
stored in this manner.
6.
An "Emergency Box" must be kept and maintained with the
necessary equipment to treat crises such as cardiac arrest.
This box should:
-
a)
contain a range of different caliber syringes and needles appropriate
for emergency use;
b)
contain the drugs adrenaline, atropine, calcium gluconate 10% or
calcium chloride 10%, lignocaine, dextrose solution and normal saline and
lactated Ringer's solution, antihistamine and other life saving drugs in
adequate quantity for intravenous use;
c)
have the relevant dose rates written on the lid of the box;
d)
include a cardiopulmonary resuscitation flow sheet;
e)
be stored in one place at all times, and be close to where most
anesthetics are carried out.
7.
Tablets and capsules must be dispensed in re-sealable and preferably
crush-proof containers. Plastic or paper envelopes are unacceptable unless the
product is marketed in a child-resistant pack (foil or plastic blister).
Child-resistant containers must be available if requested.
8. Adverse drug reaction and
inefficacy report forms must be readily available in the institution. These
should be used to report all adverse drug reactions and apparent drug failures
to the Council as well as the manufacturer of the drug.
9.
The container in which medicines and animal remedies are dispensed must
be legibly and indelibly labelled with the following information:
Name and address
of the veterinary clinic
Contact phone
number
Emergency phone
number
Date dispensed
Name and strength
of drug
Directions for
use, method and frequency
Number of tablets
or volume of liquid
Name of owner
Name and species
of animal
Auxiliary labels
and warnings
Name of
prescribing veterinarian
The statement
"Keep Out of Reach of Children"
The statement in BOLD PRINT
"FOR ANIMAL TREATMENT ONLY"
10.
Where licensed animal remedies are repackaged into smaller containers,
the new containers and labelling must meet the requirements.
Each Veterinary
Institution offering surgical intervention services should have high qualify
surgical apparatus, equipments etc. as per the type of services. However,
attempts should be made to maintain all the necessary items in good working
condition with facilities for sterilization/ disinfection. Also, there should
be required number of operation desk/tables both for large and small animal
surgery. Suitable anaesthetic machine, gas etc. protective aprons, gears etc.
should also be available.
The Veterinary institutions offering gynaecological services should
atleast have the facilities for artificial inseminatrion, semen storage,
microscope for semen evaluation, equipment sterilizer, vaginal speculum for
different species of animals, dystokia set for large and small animals, common
medicinal and surgical items required for gynaecological and obstetrical
intervention. All these items should be maintained in good working condition.
CHAPTER V
8. Diagnostic
Laboratory Services
A. GENERAL
1) Veterinary Hospitals/Veterinary
Polyclinics/Teaching Veterinary Clinical Complexes, District Veterinary Center
(but not limited) must provide or have access to veterinary diagnostic
laboratory services that perform routine clinical pathology, bacteriology,
parasitology and toxicological tests, rapidly and accurately. They must have
adequate qualified staff and should also act as collection center.
2)
Where samples are submitted to an outside laboratory for testing, they
must be collected, stored, packaged, and dispatched in a manner which:
a)
ensures the safety of people in contact with the samples; and
b)
minimises sample deterioration to ensure the best test result.
3)
Where diagnostic tests are performed by the clinic/institution itself:
a)
any diagnostic test other than routine urine and blood smear
examination must be conducted in room or designated area used specifically for
that purpose and which is kept clean and organised;
b)
Quantities of stain, reagents, chemicals, diagnostic kits adequate for
the number of animal patients/samples shall be provided.
c)
Registered veterinary practitioners are engaged for diagnosis/
interpretation. Each such laboratory shall specify the tests they conduct and
shall maintain a record of the sample profile and results in each case. They
shall also declare the methods they used (in each case) for various diagnostic
tests and the normal values while providing the results. Each result shall be
signed by the registered veterinarian concerned along with her/ his name and
registration number appearing conspicuously.
d)
Veterinarians and staff must have an understanding of the principles of
quality control as it relates to all diagnostic testing conducted by the
institution/clinic etc. Controls should be used to ensure accurate results.
Records of quality control programmes must be kept(stored). These should
demonstrate that periodic evaluations are made of equipment, reagents, and
technical integrity;
e)
protective clothing and disposable gloves must be provided;
f)
the clinic must maintain diagnostic equipment to a high standard that
ensures accurate results are obtained consistently ;
g)
The diagnostic laboratory should have a well ventilated room preferably
with walls, work table and laboratory furniture that can be easily
sanitized/disinfected. It shall have regular water supply, electricity and
waste disposal facility. The diagnostic clinic shall have rooms/areas where
animals can be handled with minimal stress on them. It should have provision
for ultra violet lamp/ray treatment.
h)
there must be provision for the correct disposal of Special Waste.
i) it is
recommended that any diagnostic service provider should be able to provide a
minimum of diagnostic laboratory services themselves like Skin scrapings,
faecal sample examination, routine semen function test, cytology, urine
analysis, urine sediments, and routine Hematological tests. A binocular
microscope, microhematocrit centrifuge and urinary refractometer should be
provided for these examinations.
j) Biopsy, if
necessary, shall normally be performed in a room provided for the purpose and
shall be conducted under proper analgesia prescribed only by a registered
veterinarian.
B. LOCATION, INFRASTRUCTURE AND
MANPOWER
1)
A diagnostic laboratory may be established independently or attached to
a polyclinic/ hospital/Teaching Veterinary Clinical Complex/Clinic. The
laboratory shall not be in the same building housing the post mortem facilities
or shall be at a considerable distance and well protected to avoid
contamination.
2) The laboratory should have an
attached inoculation room/shed, staff room and wash room.
3) The diagnostic laboratory shall
have facility for microbiology, pathology, parasitology and clinical
bio-chemistry procedures leading to diagnosis of disease/ surveillance.
4)
The laboratory staff may opine on the samples received from prevailing
field problems and should refer the unsolved problems or if the laboratory does
not have proper equipments or chemicals or technique for conclusive diagnosis
to the state diagnostic laboratory or university or regional or reference
laboratories as may deemed fit for confirmatory diagnosis/interpretation.
5)
All samples while referred should be properly labeled to indicate the
species, identification No. and owner of the animal, the type of sample
(tissue/organ etc), method of preservation, test to be carried out etc.
6)
No sample shall be referred to any agency/laboratory/individual outside
India for diagnosis without prior approval of the State Government Animal
Husbandry authorities.
7)
Independent diagnostic clinic shall have the facility for restraint of
animals and for collection of material as the case may be. Diagnostic clinic
shall have all the facilities and equipment as a diagnostic Lab.
8)
The diagnostic laboratory shall have -
(i)
Binocular microscope
(ii)
Incubators
(iii)
Hot air oven
(iv)
Autoclave
(v)
Water bath
(vi)
Inoculation hood
(vii)
Centrifuge machines
(vii)Electrophoresis apparatus
(ix)
Spectrophotometer
(x)
Glucometer
(xi)
Hand refractometer
(xii)
Analytical Balance
(xii)
Computer with Internet
connectivity & Printer
(xiii)
Refrigerator
(xiv)
Deep freezer
(xv)
pH Meter
(xvi)
Telephone and fax
facilities
9) Every
diagnostic laboratory may be provided with at least the following staff :
i.
Atleast one registered veterinary practitioner with professional P.G.
Degree/Diploma must be available at the institution undertaking such
procedure/tests. The number of such personnel shall, however, vary depending
upon the number and types of material handled/tests carried out.
ii.
Veterinary laboratory technician - one
iii.
Laboratory Assistants - Two
(a)
One for pathology, microbiology, parasitology
(b)
One for Haematology and clinical chemistry
iv.
Sweeper cum post-mortem attendant - as per need
v.
Laboratory attendant-cum-animal attendant - one
C. STANDARD OPERATIVE PROCEDURE :
The standard
procedures laid down in the relevant scientific books/documents etc. should be
followed for handling each type of sample in the laboratory. Simultaneously,
every care should be taken to avoid spread of infection either to humans or to
other animals. Further,
1)
Whenever there is a need the staff of the diagnostic laboratory can
also collect the appropriate materials as suggested/ required by the clinician.
2)
The results of the tests should be communicated without delay, so that
the results can be efficiently used by the clinician.
3)
The diagnostic laboratory attached to a Veterinary Hospital should be
able to analyse :
(i)
Urine (qualitative)- pH, albumin, glucose, bile pigment, sediment
(ii)
Faecal sample - Parasitic and protozoan ova/cyst.
(iii)
Skin scrapings for mites.
(iv)
Milk sample for clinical and sub-clinical mastitis by strip cup CMT.
(v)
Blood - Protozoa, microfilaria, DLC, haemoglobin/PCV.
(vi)
C.S.F.
4) The diagnostic laboratory attached to polyclinic should have
facility to analyse :
(i)
Urine - (quantitative or qualitative) complete
(ii)
Faecal sample - Parasitic ova, cysts of protozoa/ egg.
(iii)
Haematology, TLC, DLC, Hb, PCV, platelets
(iv)
Skin scrapping - Mites and dermal mycosis.
(v)
Milk - CMT, culture and sensitivity
(vi)
Microbial culture and sensitivity. (Saliva, urine, pus, uterine
discharge etc.)
(vii)
Detection of infectious diseases like Brucellosis, TB, Anthrax,
Pasteurellosis, PPR, FMD, Blue Tongue etc.
5)
At the end of every day the results along with patient number etc. may
be entered/ recorded in the computer or any other practical method and provided
on "read only" mode so that the results can be accessible to all, but
not changed.
6)
The results of laboratory tests and the trend of various etiological
agents may be discussed periodically (preferably at the end of every month)
with the field clinicians to appraise them of the type of organisms, their
antibiotic/drug sensitivity in that area. The diagnostic laboratory may also
draw macro epidemiological maps to make treatment more effective.
7)
The diagnostic Laboratory shall depute/ send its staff to various
workshop/ meeting and/ or participate in such related forum where exchange of
information can influence to achieve better service delivery and preparation of
effective National programmes.
8)
Any diagnostic laboratory run by an organization, Institutions or
individual(s) may also participate in the discussion of results or shall, sent
information on the tests they conduct every month to the district veterinary
officer/ chief of polyclinic/ sub-divisional veterinary administration of the
state/ UT concerned. Such information shall form part of the epidemiological
data generated in the district.
Standard established procedures
for sampling should be followed in all the cases without causing undue stress
or damage to the animal or danger to the owner. Guidelines for sampling methods
will be circulated by the Council.
1.
Vaccines must be used in conjunction with national/regional/State/local
disease control or eradication programmes. For vaccination of individual animal
on the request of the owner, the decision about the justification of such
vaccination shall depend on the registered veterinary practitioner.
2.
Vaccination shall be done by only those registered veterinarians who
have been requested by the animal owner for providing medical/surgical
assistance/consultation and has complete knowledge of past and present history
of the client's animal. He /she must have taken the client into confidence
before undertaking a vaccination.
3.
Revaccination recommendations should be designed to maintain clinically
relevant immunity while minimizing adverse event potential. Additional
information, including vaccine-specific scientific data on minimum, average,
and maximum duration of immunity is desired to craft optimal revaccination
frequency recommendations.
4.
Vaccines, including polyvalent products, should be selected to include
only those antigens appropriate for the specific risk needs of the patient,
thereby eliminating unnecessary immune system stimulation and lowering
potential risks of adverse events.
5.
Multiple dose vaccine vials must be carefully managed to:
a)
minimize the potential for delivering inappropriate levels of antigen
or adjuvant
b)
optimize the potential for maximum potency of the antigens present and
minimize the opportunity for contamination with extraneous microbes or
chemicals .
6.
Veterinarians should consider creating a core vaccine program, intended
for use in the majority of animals in their jurisdiction/practice area. (Explanation - Core vaccines are those that
protect from diseases that are widely distributed in the region, virulent, and
highly infectious, thereby posing a risk of severe disease. Core vaccines are
efficacious and exhibit patient benefit: risk ratios high enough to warrant
their use, and/or are of significant public health significance, or required by
law.)
7.
Information about the benefits and risks of vaccination shall be
provided to the owner(s) to enable him/her to make a decision about individual
vaccine selection and vaccination program choices.
8.
There may be a more developed, scientifically based, and statistically
valid evaluation of vaccine products to provide practitioners with a basis for
developing vaccination programs that maximize benefits and minimize associated
risks for the patients under their care.
9.
Proper cold chain for all types of vaccine should be ensured by the
veterinary institution and professional for the benefit of the end users.
1.
It must be the established policy of all Polyclinics/Veterinary
Hospitals/Dispensaries/Clinics/Teaching Veterinary Clinical Complexes/
Institutions to do all that is necessary to ensure the health, safety, and
welfare of all of its members, employees and clients. To meet this end,
veterinary practices must adopt policies related to matters of health and
safety compatible with the guidelines issued for the purpose by respective
branches of veterinary profession. Personnel should receive annual updates and additional
training when procedures or policy changes.
2.
The Heads of clinics/polyclinic/Veterinary institutions have a
responsibility to:
a.
provide and maintain a safe working environment;
b.
provide and maintain facilities for the safety and health of all staff
at work;
c.
ensure that the equipment in the work place is designed, set up, and
maintained to be safe for the users;
d.
ensure that staff are not exposed to hazards in the course of their
work;
e.
the inherent emergency procedures pertaining to the respective field of
veterinary procedure should be followed.
3.
Each Veterinary institution must establish the following management
systems:
a) All
institutions must have a written general guideline on health and safety that
reflects a positive commitment to protecting people in the work place. The
guidelines must be easily understood, be visible, and form the basis for the
development of rules and safety procedures for various location providing
veterinary services.
b)
Separate rules must be drawn up and displayed for each area of the
institution(clinics/ polyclinics etc. waiting room, pharmacy, laboratory,
treatment room for anaesthesia and radiography, kennel room, etc). These must
cover general and specific aspects of health and safety that relate to
potential hazards that may occur in those areas. The general rules at
veterinary institutions must cover cleanliness, tidiness, restraint of animals,
first aid boxes, and fire rules/guidelines. Specific rules must cover relevant
protective clothing and equipment, proper use of equipment, handling of drugs,
poisons, waste, and chemicals. Specific precaution against zoonotic disease
should be displayed.
c)
The practice must identify and assess all hazards, and appropriate
controls must be developed to protect people from these. Hazards must be
monitored in the work place. Staff may need to be personally monitored for
their exposure to particular hazards. The work environment must be periodically
re-evaluated for new or changed hazards, and safety standards upgraded
accordingly.
d)
Each Veterinary Institute must have a written, effective, general
emergency plan to cope with all types of emergency likely to occur in any part
of the clinic. This plan should cover what detection and alarm systems are
needed, what emergency equipment is required and its positioning, the
development and display of evacuation plans, emergency services required, and
staff responsibilities in an emergency.
e)
Each Veterinary Institute must record and report all occupational
illnesses and accidents. (as specified in guidelines-to be prepared) to the
concerned authority.
f)
Any Poisons or Harmful Substances as defined in Drug & Cosmetic
Act, 1940 & Veterinary Pharmacopoeia must not be stored on or above, or in
any cupboard or place where food, drink, or medicines are stored or displayed.
g) Any Standard Poisons or Harmful
Substance as defined in the relevant Act and Veterinary Pharmacopoeia should be
label properly and displayed and must be kept at a higher place (more than 1.5
metres above the floor).
h) All veterinarians must be
immunized against the risk of infectious diseases of zoonotic importance.
4.
Any other safety procedure promulgated by the state and/or Central
Government related to Veterinary practice or delivery, from time to time shall
be binding on all Veterinary Institutions.
5.
All persons who work in a laboratory bear responsibility to minimize
risk of infection through consistent good safe microbiological practice and
procedure. There is need to adopt recommended bio-safety level for dealing with
pathogens.
1.
Waste must be segregated depending on whether it is of the General or
Special category. The Veterinary Institute must have facilities for the
hygienic
storage of waste prior to
disposal. This must not create an offensive appearance or allow the development
of bad odours. Special waste may need to be refrigerated prior to collection.
2.
General waste (non-infectious waste, packaging materials,
non-infectious animal bedding, etc) can be disposed of by Local Authority
through landfill, recycling or incineration.
3.
Special wastes include anatomical waste, blood-soaked swabs and
dressings, infected animal carcasses, soiled dressings, contaminated or
infectious waste from examination, treatment, and kennel rooms, pharmaceutical
waste, cytotoxic waste, sharps, and syringes. Special wastes (other than
sharps) must be bagged in Polythene bags (with a minimum thickness of 50
microns if of low density and 25 microns if of high density). Cytotoxic wastes
are to be placed into coloured cytotoxic waste containers with Eye-catching
colours used for the label. Also representative colours for different waste
should be used Where a professional medical waste service is available to the
Veterinary Institute, it must be used to collect and incinerate special waste.
Where there is no such service available, special waste must be disposed of in
the same way that the Veterinary Institute disposes of cadavers. Eco-friendly
waste disposal should be practiced with help of trained person.
4.
Sharp waste poses a potential hazard because of the risk of injury.
They must be placed directly into approved containers. They must be stored in
non -reusable, leak-proof, and puncture-proof containers with an aperture that
must inhibit removal of the contents.
5.
The practice must have facilities for the hygienic storage of cadavers.
The disposal of dead animals must give the client no cause for complaint and
cause no public offence or nuisance. They may be incinerated in a suitable pet
crematorium or buried in a manner which meets the approval of the local
authority.
6.
All rooms used for the examination, treatment, or housing of animals
must be provided with lined waste containers that are emptied regularly and
kept in a hygienic manner.
Every veterinarian involved in a
veterinarian-client-patient relationship and performing any act requiring a
license to work on any animal or group of animals in his or her custody or in
custody of an animal hospital, shall prepare a legible, written, individual (or
group) animal and client record concerning the animal(s), which shall contain
the following information:
1.
Name, address, and phone number of the client.
2.
Name or identity of animal(s), including species, breed, age, sex,
weight, and color, where appropriate.
3.
The medical record shall contain:
(a)
A history of pertinent information as it pertains to the animal's
medical status.
(b)
Notation of the physical examination findings.
(c)
Treatment or intended treatment plans, or both, including medications,
medication strengths (when available in more than one strength) and amounts
administered, dispensed, or prescribed and frequency of use as well as route of
administration, including those medications used for sedation, induction, and
maintenance of anesthesia.
(d)
Data and interpretation(s) of diagnostic procedures including, but not
limited to, radiographs, laboratory, ultrasound, and ECG.
(e)
A diagnosis or tentative diagnosis.
(f)
When pertinent, a prognosis.
(g)
Progress notes and disposition of the case.
(h)
Dates (beginning and ending) of custody of the animal with daily
notations.
(i)
In the case of vaccination clinics, a certificate, including the
information required by (1) and (2) above may serve as the medical record.
(j) Name or initials of the veterinarian responsible
for entries. (k) Name or initials of all ancillary and authorized individuals
responsible for
entries. (l) Records for surgical procedures that include a description of the
procedure, surgical findings when pertinent, and response to or recovery from
anesthesia.
4.
Group records are acceptable for herds, flocks, or litters of animals that
lack individual identification by name or that include a number of individuals
to which the same medical record applies. Records shall contain the
requirements listed in (3) above.
5.
Record Storage.
(a) All records shall be the
property of the veterinary facility or institution that created such records
and shall be kept for a minimum of three years after the visit by the animal.
(b) Copies of records and
radiographs or a summary of records will be made available within a reasonable
time upon the client's request.
1.
Certification should be based on the highest possible ethical
standards, the most important of which is that the professional integrity of
the certifying veterinarian must be respected and safeguarded.
2.
It is essential not to include in the certification requirements
additional specific matters which cannot be accurately and honestly signed by a
veterinarian. For example, these requirements should not include certification
of an area as being free from non- notifiable diseases, the occurrence of which
the signing veterinarian is not necessarily informed about. Certification for
events which will take place after the document is signed and when these events
are not under the direct control and supervision of the signing veterinarian is
not acceptable.
3.
Certification of freedom from diseases based on purely clinical freedom
and herd history is of limited value. This is also true of diseases for which
there is no specific diagnostic test, or the value of the test as a diagnostic
aid is limited.
4.
Procedure for issue of Certificates :
1.
Paper certificates should be pre-printed, if possible on one sheet of
paper, serially numbered, and issued by the Veterinary Administration on
officially headed notepaper and, if possible, printed using techniques which
prevent forgery. Electronic certification procedures should include equivalent
safeguards.
2.
Certificates should be written in terms that are as simple, unambiguous
and easy to understand, without losing their legal meaning.
3.
If so required, certificates should be written in the language understood
by the certifying veterinarian.
4. Certificates should include
appropriate identification of animals and animal products except where this is
impractical (e.g. day-old birds).
5.
A veterinarian should not be required to certify matters that are
outside his/her knowledge or which he/she cannot ascertain and verify.
6. Where appropriate, the
veterinarian, by order enquire, test or examine animal, bird or animal by
product before the certificate is signed.
7.
The text should not be amended except by deletions which must be signed
and stamped by the certifying veterinarian. The signature and stamp must be in
a colour different to that of the printing of the certificate.
8.
Certificates should be signed by the veterinarian after due
consideration of the event. They should not sign blank or incomplete
certificates, or certificates relating to animals or animal products which are
not under their control;
9.
Certifying veterinarians should ensure before signing that certificates
have been completed fully and correctly, and that no part of it is left blank;
where a certificate is signed on the basis of supporting documentation, the
certifying veterinarian should be in possession of that document before
signing;
5. Electronic
certification
1. Electronic
certificates should carry the same information as conventional certificates.
2.
The Veterinary Administration must have in place systems for the
security of electronic certificates against access by unauthorised persons or
organizations.
3.
The certifying veterinarian must be officially responsible for the
secure use of his/her electronic signature.
4.
Certificate should be written in language understood by the
Veterinarian and/or client.
1. All notifications and all
information sent by the Central Government to the States shall be regarded as
having been sent to the State concerned and action and steps be initiated by
all the registered veterinary practitioners to implement them as directed by
the State Director of Animal Husbandry and Veterinary Services.
2.
All efforts including furnishing of disease related information should
be made to minimize the spread of important animal diseases and to assist in
achieving National/regional control of these diseases.
3.
States shall be responsible to comply with the specified notification
requirements about the control and spread of animal diseases and provide
information on the measures taken to prevent the spread of diseases as and when
required by the Central Government.
4.
States shall send to the Central Govt.
notification
by the earliest mode of communication (telegram, fax or e-mail) within 24
hours, of any of the following events:
a)
for List A diseases, (as defined by Office International des
Epizooties), the first occurrence or re-occurrence of a disease, if the State
was previously considered to be free from that particular disease;
b)
important new findings which are of epidemiological significance to
other states;
2.
monthly reports on the absence or presence and evolution of diseases in
List A, and findings of epidemiological importance to other states with respect
to diseases which are not in List A;
3.
annual reports on all diseases considered to be of socio- economic importance
or of major veterinary interest.
4.
the Veterinary Administration of a State in which an infected zone
(district) was identified shall inform the Central Government when this
zone/State is free from the disease.
5.
a state/district shall be considered to have infection for a particular
disease until a period exceeding the infective period has elapsed after the
last reported
case, and when full prophylactic
and appropriate animal health measures have been applied to prevent possible
reappearance or spread of the disease.
1.
The quality of the Veterinary Services depends on a set of factors, which
include fundamental principles of an ethical, organisational and technical
nature. The Veterinary Services shall conform to these fundamental principles,
regardless of the political, economic or social situation. The VCI (Standards
of Professional Conduct, Etiquette and Code of Ethics for veterinary
professionals) Regulations, 1992 as amended from time to time shall be the
basis of ethical practice.
2.
It is necessary that these fundamental principles are complied by the
Veterinary Services to establish and maintain confidence for a veterinary
certificate issued by a State veterinary service to be acceptable by the
Veterinary Services of other States.
3.
The same fundamental principles should apply to the organization(s)
other than veterinary services who are establishing and applying animal health
measures and issuing various certificates.
4.
Fundamental principles of quality: -
The Veterinary Services shall
comply with the following principles to ensure the quality of their activities:
a)
The officials of Veterinary Services should have the relevant
qualifications, scientific expertise and experience to give them the competence
to make sound professional judgments. - Professional judgment
b)
.Care shall be taken to ensure
that Veterinary Services' staff are free from any commercial, financial,
hierarchical, political or other pressures which might affect their judgment or
decisions -
Independence
c)
The Veterinary Services
shall be impartial. In particular, all the parties affected by their activities
have a right to expect their services to be delivered under reasonable and non-
discriminatory conditions - Impartiality
d) The Veterinary Services will
make an endeavor to see that the work of each of their officials is of a
consistently high level of integrity. Any fraud, corruption or falsification by
the officials shall be identified and efforts will be made to correct them by
the veterinary service. -
e) The Veterinary Services shall at
all times act in an objective, transparent and nondiscriminatory manner - Objectivity
5.
General - Organisation
(i) The Veterinary Services must
be able to demonstrate by means of an appropriate legislation or order or
gazette notification that they are in a position to have administrative control
of the establishment and powers to apply animal health measures, and of
veterinary certification activities. The veterinary service shall define and
document the structure responsibilities of the organisations engaged in animal
identification, control of animal movements, animal disease control and its
reporting, epidemiological surveillance and in communication of epidemiological
information and animal welfare.
(ii) A similar demonstration as in
5(i) above should be made by Veterinary Services when they are in charge of
veterinary public health activities
(iii)
The responsibility, power and jurisdiction of the personnel's in each
position, having an impact on the quality of veterinary services shall be
described within the Veterinary Services. The job descriptions shall include
the requirements for education, training, technical knowledge and required
experience of veterinary personnel.
6.
Procedures and standards
The Veterinary Services shall
develop and document appropriate standards and procedures for the
implementation and management of animal health measures as and when required
and periodically reviewed and revised. These procedures and standards may
besides others to be identified as per requirements relate to:
-
programming and management of activities.
-
prevention and control of disease outbreaks;
-
epidemiological surveillance and zoning;
-
inspection and sampling techniques;
-
diagnostic tests for animal diseases;
-
preparation, production and control of biological products for use in
the diagnosis or prevention of diseases;
-
disinfection and disinsectisation;
-
treatments intended to destroy, if appropriate, pathogens in animal
products.
7.
Information, complaints and appeals
*(a) The
Veterinary Administration shall undertake to reply to legitimate requests from
Veterinary Administrations of other States or any other authority, in
particular ensuring that any requests for information, complaints or appeals
that they may present are dealt with in a timely manner.
(b) A record
shall be maintained of all complaints and appeals and of the relevant action
taken by the Veterinary Services. (Complaints and Disciplinary actions to be
taken as per Standards of Professional conduct, etiquette and code of ethics
for veterinary practitioners,1992 regulations).
8.
Documentation - The Veterinary Services shall have at their disposal a
reliable and up to date documentation system suited to their activities.
9.
Self-evaluation - The Veterinary Services should undertake periodical
self-evaluation especially by documenting achievements against goals, and
demonstrating the efficiency of their organisational components and resource
adequacy.
10.
* Communication -
Veterinary Services should have effective internal and external systems of
communication covering administrative and technical staff levels and parties
affected by their activities.
Explanation - The licensing
authority in consultation with VCI OR VCI alone, while issuing such license
shall include an undertaking to abide by the proposed regulation at 7(a). The
appellate body for the institutions shall be the Central Government.
Self-evaluation may be included as the basis of evaluation for ACR by the
employee. The appellate body in this case may be the Head of the State
administration.
1)
Veterinary institutions undertaking professional service shall analyse
the needs of the animal, client, household, society, village, block/mandal,
district and state in that order. A macro level (regional or national) policy
shall be developed for the country on the basis of this grass root data.
2)
The primary objective of Veterinary service is animals welfare and well
being that optimising (as against maximise) its health and performance. Any
effort therefore must sustain environment, compliment human development and
deliver social justice. The principles under which the primary Veterinary
Service is delivered area) The health promotion, essential animal health care
and at least a minimal veterinary
medical service
must be delivered under the principle of equity; for this there should be
universal coverage.
b)
Besides curative aspects, primary Veterinary care should include
promotive, preventive and development services.
c)
The service for development should be effective, efficient, affordable
and acceptable to local communities, through choice of appropriate methods and
in a manner that it can be delivered at all levels.
d)
Individuals and community should be encouraged to be involved in
developing a self reliant promotive system whose basis would be awareness of
feeding, breeding and management through a knowledge delivery system as part of
a professional service.
e)
Because of close inter-relation among animal, man (community) and
environment, veterinary sector must reach beyond health care and veterinary
medical service, to include other support systems needed for feeding, breeding
and the overall development of animals.
f)
Veterinary centres shall seek to promote overall development of the
animals through overall development of the society in which they are brought up
so that animals and society play a mutually complementary role, rather then
veterinarians seeking isolated development of animals without involving the
society.
2.
The Veterinary Dispensary shall generally undertake
the following jobs :-
a)
Timely diagnosis & appropriate treatment of common ailments,
deficiencies and injuries.
b)
Referring or seeking specialist service from professionals trained for
the purpose.
c)
Studying the prevailing husbandry, health and animal development
practices and identifying problems through Participatory Developmental Approach
(PDA) and deriving methods to solve problems that are encountered and
preventing their recurrence;
d)
Advising community on feed & fodder supply and proper nutrition
after assessing economic viability, availability, socio-economic status of the
animal owners etc.
e)
Sensitizing the community on the role of essential nutrients,
micronutrients, feed and fodder, safe water, shelter (housing) and basic
hygienic as part of the management.
f)
Ensuring regular breeding (breedability) of animals through health
promotion, sexual health care, proper breeding policy, reproduction technology,
care of pregnant animals etc.
g)
Maternal and offspring care, early nutrition & care of growing
animals, including animal welfare.
h)
Collection of data in respect of animal, client, her/ his family and
the society, through village level workers or stock assistants.
i)
Assisting in Surveillance & monitoring (epidemiology), control
& prevention: Immunisation against major diseases; control of parasites,
macromanagement of grasslands & other feed sources, environmental
assessment, risk assessment etc. Advise the department on control &
prevention of endemic diseases or intoxication through observing environment
residues, risk areas etc.
j) Vetero legal cases should be handled as per
guidelines for the same.
k) Authority to inspect slaughter
house and meat shop as may be authorized by the State/UT Government.
A veterinary
hospital shall essentially perform the function as the dispensary, but shall
have facilities for admitting cases and for Veterinary medical attendance
indoors. There shall be exclusive facilities for diagnosis, nursing and client
accommodation; the rest of the function & duties remaining the same as
dispensary. The Veterinary Hospital should have atleast one animal ambulance at
its disposal.
In Veterinary
Polyclinic, the specialists shall provide support service to all cases referred
to them or seek their support for diagnosis, prevention, treatment or advise,
from the OPD, Veterinary Dispensaries or Veterinary Hospital(s). A Veterinary
Polyclinic may also have specialised services as is needed and relevant to the
area. A Polyclinic shall have causality, indoor wards etc required for the
number of cases, out-patient and indoor patient etc. and shall provide 24 hours
service. There shall be at least one animal ambulance with each polyclinics.
The polyclinic
shall invariably provide specialist veterinary medical service, in surgery,
radiology, clinical medicine, laboratory diagnostics (lab. medicine),
epidemiology & preventive medicine, reproduction technology, gynecology
& obstetrics. The Polyclinic shall normally provide reach out service to
support the function of the Veterinary Dispensaries in promotive, preventive,
therapeutic or rehabilitative health service. When they are established in a district
head Quarters they may be part of the district veterinary centre.
The district
veterinary centers shall be the nodal center for Support, Supply and
Maintenance and shall provide professional and administrative support to all
the activities of the Veterinary Dispensaries/hospitals of the district. Apart
from managing the stockpiles, they shall provide specialist and specialised
support in Veterinary service viz. in Animal health, production management, veterinary
medical attendance, feed analysis, marketing, animal resource development,
conservation, community development, animal welfare and veterinary public
health as is relevant to the need of the district in question.
A. LOCATION AND STRUCTURE
a.
Veterinary Dispensary must ideally be located at a prominent place
which is easily approachable to the animal owning public. In house veterinary
service delivery should be limited to a specific time that is convenient to the
animal owning community or as decided by the State/UT Government and announced
to them.
b.
There may to be a reach out facility where service can be delivered at
farmers door as and when requested. A Veterinary Dispensary shall have the
following minimum facilities (emphasis minimum): -
2. Dispensary
shall have the following structure
i)
Registration cum dispensing room (30 to 40 Sq. ft).
ii)
An examination room/chute room in a well-lighted area protected from
direct sun rays preferably not in the open; but shall never be next door to a
school or in full vision of juvenile pupil. (8' X10' in case of small animal
10' x 12' in case of large animal).
iii)
Fly proofing and/or fly flaps at entry gate (desirable).
iv)
A shaded waiting area (well lighted, well drained and airy, but
protected from sun rays)
v)
Availability of clean running water.
vi)
Proper drainage and Water disposal facility.
vii)
Easily cleanable restraining equipments like Hobbles, Ropes, Muzzle
etc. as needed.
viii)
System of disposal of animal waste and biomaterial as per Rule
enforced.
ix)
The trevis shall be placed in a well ventilated & elevated ground
with adequate light and good drainage. The trevis shall be protected from
direct-sun/rain.
x)
A stand alone Travis with suitable facility for A.I. It must be covered
from the view of public etc.
xi)
Semen storage facility and facility for periodic testing of semen
straws.
xii)
Where relevant there has to be a meeting cum extension room for
interacting with public and for assessing public need.
Minimum
facilitates needed for veterinary hospital are the same as that of the
Dispensary but would have an indoor ward and reasonable client facilities in
addition and will have a higher emphasis on health care, prevention and
treatment of disease of animals (usually when daily admission more than 20, a
dispensary be upgraded to a hospital).
The Veterinary
Hospital should have the facilities for small and large animal surgery with
proper surgical room, equipped with necessary equipments and medicines.
The major infrastructure,
components of a polyclinic shall be as listed below: - SECTION AND COMPONENTS
OF POLYCLINIC - It is important to plan the lay out unit wise or section-wise
and in tune with the nature of work, personnel being (and to be) involved (employed)
etc. A suggested distribution is given below:-
|
Section
|
Components (Activities)
|
|
Section A
|
Admission -Record room - main computer etc. Animal
holding
(waiting room) for large animals Reception-cum-
waiting for small
animals.
Pharmacy
Store
Garage - Mobile Clinical unit Weigh bridge/
Casually, Emergency Section
|
|
Section B'
|
Administration Office Office of Doctors
Work Room, Injection/Infusion Rooms.
Library-cum-conference room
|
|
Section C
|
Health Care Unit
Artificial Insemination Unit, Embryo Transfer Unit
Epidemiological data processing unit.
Gynecology and obstetrics unit with parturition
room, minor surgical unit
|
|
Section D
|
Diagnostic laboratory Unit Poultry diagnostic Unit
|
|
|
Disease Investigation Unit
|
|
Section I
|
Preventive room
Post operative care room (Recovery room) Parking
facilities should also be kept.
|
|
II BACK OFFICE
|
|
Section -E
|
Small animal operation theatre with ancillary Large
animal operation theatre with ancillary parturition (delivery)/obstetrical
room for large animal I.C.U/Critical Care Unit
|
|
Section - F
|
X-ray Unit, Ultrasound Unit,
Physiotherapy Unit, E.C.G Unit
|
|
III INDOOR UNIT
|
Section G
|
Wards
|
|
|
Wards for large animals
-Animal rooms (Single byre type etc.
|
|
|
Loading/Unloading platform,
|
|
|
Client dwelling ,Kitchen,
Conveniences etc.
|
|
|
Small animal
wards-cum-client room.
|
|
|
Run, Open Hold/Tie out
|
|
|
IV SUPPORTING
FACILITIES/DISPOSAL SYSTEMS
|
Section -H
|
Disposal of animal waste- animal waste recycling
as per Biomedical wastes (management and handling) Rules,1995 issued under
Environmental (Protection) Act, 1986 as amended from time to time.
Post-mortem rooms
Isolation wards (Infectious Disease Ward, Skin
Ward, Rabies Ward as per need) Sewerage and Biomaterial disposal unit
(recycling units/rendering units) disposal units, fish farms, slurry
gardens farms etc. for recycling
|
|
Section - I
|
(Support facility),
Cafeteria, stores, & Supplies, Water, Light, Emergency Lamps/ Power
Generator or gas light/solar light, Steriliser, Laundry , Kitchen,
Maintenance Section,
Central Oxygen Facility with
manifolds
|
|
Section -J
|
(Accommodation)
Staff Quarters/Doctors and Supporting Staff,
Staff/Trainee Hostel
Rest House, Recreation Facility etc.
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5.
Tehsil/Mandal/Block Veterinary Centre:
Where districts are large, there
can be an intermediary support centre that may be established as per need and
relevance of the State/region. Each State/UT Government establishing such
centre shall develop an organograph for working and co-ordination of these
units/centres. Such centres can be primary referral centres for lending
technical support for " in health care" (Promotional & Preventive
Health Care), Production Management, Technology, Clinical Service, Consultancy
(for P.V.C's sphere of activity). There may be 24 hours service, animal
transport facility or arrangement for an ambulance where possible.
6. District Veterinary Centre:- (can include a
polyclinic)
A district veterinary centre is
a place where specialists provide support for production management
,technology, clinical service, in health care and health management
(epidemiology included). The Polyclinic provide a referral service (Secondary)
for clinical service in respect of surgery, medicine, gynecology and laboratory
diagnostics etc.. This center would normally not attend to primary cases and
would exclusively provide professional support to the veterinary hospitals or
primary veterinary centers in the region under their command. They would also
work as nodal agencies or conduits for the network and provide for need
analysis, semen production and/or distribution, quality control, confirmatory
diagnostic, consultancy and special services. The polyclinics invariably shall
have reach out facilities to be provided on demand or should normally render
their services in a roistered time table. There shall be normal transport
facility, intensive care, their services in a roistered time table. There shall
be animal transport facility, intensive care, casualties and isolation wards.
There would be a senior extension officer cum information office who would
manage and conduit information from the primary veterinary centre to head
quarters and vice versa. The centre may also manage stock-piling and
distribution and shall also take care of disaster management.
1
There shall be one Travis per 20 daily admission / a table one per
every 10 small animal Admission. There shall be an additional trevis/ table for
every 10 additional admission.
2
A dispensary must have a diagnostic lab/desk/cabin of 25 to 30 sq Ft.
area with laboratory furniture, minimal containment & waste disposal
facilities. The lab may be provided with at least the following equipments
& Instruments:-
a)
Microscope (Preferably Binocular)
b)
Glassware like test tube, beaker glass slides, petridishes etc.
c)
Two sinks with proper draining boards, work tables
d)
Chemicals needed for gram's staining, Lieshman's staining, Urinalysis,
Preparation and dispatch of slides and samples, stool test, blood testing
(TLC,DLC, Hemoglobin etc & Platelet counting where relevant).
e)
A Fridge
f)
A centrifuge: micro-haematocrit
g)
Laboratory Stools
h)
Vertical Autoclave (electric/non-electric)
i)
A laboratory balance j) Hot air oven
3.
The Dispensary may also have the following equipments/instruments.
Note:- So much depends on the
choice of veterinarians themselves in the matter. The list of instruments &
equipments may therefore, be prepared by the veterinarian, who would keep in
view the need for :-
Special examination with
diagnostic aids and investigation, Routine treatment-medical or surgical etc,
Special therapy such as critical care of acutely ill patient, resuscitation
facility etc., Infra-red lamp, Animal Transport trolley, Post-Mortem Set,
Stretcher for dogs.
4.
There shall be an instrument cabinet as per need and Number of daily
admissions. The cabinet may contain Thermometer, Stethoscope, Percussion
Hammer, Pleximeter, Probang/Stomach Tube, Mastitis Testing Kit, Tennaculum,
Castrator Obstetrical sets, Whelping Set 1, Surgical pack 2, Holm's needle 2,
Vaginal clamp 2, Vaginal clamp (small ) 2, Vaginal speculum (cow, goat, dog,
cat as per need), Incubator, Semen shippers as per need, Thermos flask, Storage
tubes (Cylinders), Swab holder 2, Front aprons, Gum boots, Full rubber aprons,
Rubber sleeves, Metal funnels, Measures, Drop pipettes with rubber nipples,
Filter Paper as per need, Syringe Sterilizers, Cannulas, Nose Tongs, Suction
pump, Instrument trolley with glass top, Foot operated waste bins, Dressing
drums (small) 2, Dressing Drums (large) 2, enameled iron/stainless steel trays
8'x10",12"x15",15"x18", Clipping scissors, Cheatle
forceps, Shadowless lamp (where relevant), Ward screens as per need,
Intravenous drip stand 2, Foot or elbow operated faucets, Foot or elbow soap
dispenser, gray's mouth gag for dogs, endotracheal tube (cuffed/non cuffed) 2
each of 5,6,7,8,(as per need), Ambu's respirator, Catheters (Urinary) as per
need, Cotton tape muzzles, Gloves, sleeves, rubber wares (disposable &
rubber) as per need, McIntosh (rubber sheets) as per need, Ropes, E.I./S.S
buckets, irrigators as per need, Weighing machine, Tooth rasp, Tooth Chisel,
Tooth Shear, Dental instruments for dogs (where needed), Teat instruments,
Cryocan for LN2 and semen storages, Syringe and Needle, Artificial Insemination
kits (AI gun & Sheath etc.) Milk recording device, electric dehorner.
5. DRUGS, CHEMICALS AND
CONSUMABLES
Much depends on
the policy of the State/UT Government, Institute, Organisation or the choice of
veterinarians themselves in the matter. Therefore, the list of drugs for
dispensaries or hospitals may be prepared within the policy by the veterinarian
who would keep in view the type of common disease, ailments, condition etc. But
depending upon the need for diagnosis and treatment a minimum stock of the some
of the basic drugs that can be used in their pure or compounded forms shall be
available in each Dispensary or hospital. They may include among other agents
the following (these agents or their combination may find use in a most
situations:-
Soda Salicylas,
Oil of Turpentine, Methylated Spirit, Zinc Oxide, Iodoform, Soda Bicarb (tri
Carb), Salicylic acid, Carbolic acid, Copper sulphate, Zinc Sulphate, Magnesium
Sulphate, Lead Acetate, Liquid Paraffin, Phenyl, Potassium Permanganate,
Sulphuric acid, Boric acid, Calcium gluconate, Olium Chinapodium, Potassium
iodide, Liquid paraffin
Beside these,
some basic deworming drugs ingredient for preparing carminative/stomachic
powders, dyes (methylene blue, trypan blue, mercurochrome) counter irritants, controllable
caustics like silver nitrate, pain killers ,sulpha drugs, arsenicals, specific
drugs for blood parasites (if needed) etc. shall be normally available.
In addition, the
syringes, needles, infusion sets and other necessary equipments in required
numbers should be available. A list of life saving drugs be prepared by the
head of the organisation in consultation with district veterinary officer and
stocked on the basis of a policy decided and announced. In the fitness of
things an anti-biotic policy may be evolved on the basis of epidemiology on a
fixed time basis. This list is not meant to be exhaustive nor is it
restrictive.
HOSPITAL
The equipments , drugs or
furniture shall be essentially similar to that of the Veterinary Dispensary,
except that they shall have equipment and infrastructure sufficient for indoor
patient care, surgical procedures, imaging diagnostic, emergencies etc. The
number and quantity of material shall be more to commensurate with average
number of cases of that hospital.
VETERINARY POLYCLINIC
The actual requirement and type
of equipment, drugs, chemicals and consumables may be decided as per the design
and field of services to be provided by a Polyclinic. The guidelines above for
Veterinary Dispensary and Hospital may be used for this purpose.
1. Veterinary Dispensary shall have at least the
following personnel in position:
a)
Registered Veterinary Practitioner holding its charge. The Veterinarian
shall renew his/her registration with State/UT Veterinary Council duly as
provided in the IVC Act,
b)
One trained compounder or veterinary assistant, by what ever name
called, who is qualified to do minor veterinary service under the direction and
supervision of the registered veterinary practitioner,
c)
One Peon cum attendant,
d)
One Chowkidar cum attendant,
e)
One Sweeper/Safaiwala
Apart from other
duties assigned to her/him, a Registered Veterinary Practitioner in charge of a
Dispensary shall supervise and guide all minor Veterinary services in the area
under her/his command. In an area or institution where there are more than one
registered veterinary practitioners in attendance, such supervision and
guidance shall be shared among them as assigned/ agreed upon. Such a registered
practitioner shall be responsible for their technical & (if) administrative
control and shall regularly seek relevant data and information in respect of
their work for the purpose of supervision and guidance.
Person(s) carrying out minor
veterinary practice in their private/ personal capacity shall do so (as
provided under clause (b) of section 30 of IVC Act, 1984 as notified by the
state government) provided such minor veterinary service is done under the
direction and supervision of one registered veterinary practitioner and
provided that the name and registration number and address of the Registered
Veterinary Practitioner under whose direction and supervision and such practice
is done is conspicuously displayed for the information of the public in the
place or occasion where such minor veterinary service is undertaken. Such
display should be in language(s) including the official language of the
state/UT.
2. Veterinary Hospital shall have atleast the
following personnel in position:
i)
One registered veterinary practitioner who possesses a minimum
professional standing of 3 years. The Professional standing may be
equated/substituted by Postgraduate degree in Veterinary Science preferably in
one of the clinical subjects.
ii)
There shall normally be at least two additional veterinarian to support
veterinary service i.e. Promotion, production management, technology, community
development, animal welfare, extension etc. (like the primary veterinary
Dispensary) if there is more than 40 daily average attendance and for attending
to the indoor patients round the clock.
iii)
There shall be a trained laboratory technician in Veterinary Hospitals
handling more than 20 cases per day, provided that the daily workload in
laboratory goes beyond 10 samples.
iv)
Besides, these, the supporting staff as at b, c, d and e under
Veterinary Dispensary also be provided.
3.
Veterinary Polyclinic shall have the following
personnel in position:
Besides senior
Veterinarian(s) in attendance at out panel in patient departments round the
clock, a Polyclinic should have atleast one specialists in each of the fields
of Veterinary Medicine, Surgery, Gynaecology, Reproduction Technology,
Laboratory diagnosis, and Radiology/Imaging Technology.
There shall be a
Superintendent possessing a recognized Veterinary qualification who shall be
the over all in-charge.
Besides this
there shall be the following para Veterinary and supporting staff:-
1 Office staff as per the norms
of the State/institution; 2 Para Veterinary staff - technical 3 Laboratory
technician 4 Radiographer 5 Operation Theater Master, Theater Technician 6 One
Compounder 7 Trained Inseminators/Technicians 8 Pharmacists 9 Lab attendant cum
animal attendant 10 Animal house cum indoor house attendants 11 Ambulatory
staff 12 Record keeper 13 Store keeper 14 Sweeper cum attendant 15 Peon 16
Electrician cum maintenance mechanic.
Note :- Polyclinic can be a part
of District Veterinary Center or a separate entity as is relevant. The main
function of the District Veterinary Center is to provide support service to
primary Veterinary centers, veterinary hospitals, specialised units etc.
including supply and maintenance.
4.
District Veterinary Center shall include support service
in the following areas: -
Veterinary
Clinical Medicine & Ambulatory Clinical Practice
Epidemiology
& Preventive Veterinary Medicine
Veterinary
Gynecology & Obstetrics
Anaesthesiology
& Veterinary Surgery
Veterinary
Radiology & Orthopaedics
Veterinary
Laboratory Diagnostics
Animal
Reproduction Technology
Veterinary
Public Health
Livestock
Production & Management (as relevant to that district/area)
Feed
and Fodder & Food Technology
Veterinary
Ethology & Animal Welfare (Bio-ethics)
Veterinary
& Animal Husbandry Extension
Laboratory
Animal Production & Management
Zoo/Wild
Animals Management and Health Care
Meat
& Meat Product Technology
Professionals
engaged in Veterinary administration should have undertaken some advanced
training. Such training could be distance learning or training's of small
duration. It shall be the responsibility of the State/UT Government to train
the persons suitably including administrative and Managemental training.
It shall be the
basic duty of all Veterinary professionals to undergo some Continuing
Veterinary Education (CVE) programme, In such cases, the State/UT Government
shall provide all necessary permission to undergo such a programme.
Note: district veterinary
centres shall be headed by a Veterinary Officer who shall have undergone
training in professional administration or shall undergo such training.
Section - 1
Medical Records
Medical records
serve as a basis for planning patient care and promote communication among
members of the hospital staff. The records furnish documentary evidence of the
patient's illness, hospital care, and treatment and serve as a basis of review,
study, and evaluation of medical care rendered by the hospital. As per
Sub-section (d) of Section 30 of Indian Veterinary Council Act, 1984 "A
veterinarian is entitled to give evidence at an inquest or any court of law as
an expert" whereupon the medical records are of vital importance.
A. Procedures
Medical records
shall communicate all valuable information; they must be legible. The patient
identification used must follow through all departments on other records (such
as radiographs, laboratory reports, and necropsy records.)
Medical records must be kept
long enough as per regulations (usually three to 10 years ). They must contain
the following or as applicable :-
1.
Serial number & date
2.
Patient Information
3.
Client Information
4.
Laboratory examination/diagnostic tests (if any)
5.
Physical Examination
6.
Vaccination Record (if any)
7.
Progress Notes
8.
Medication Records including sample data & Biopsy Reports, Necropsy
(if any).
Section - 2
Examination Facilities
Examination
facilities are necessary for the complete physical examination of patients.
History taking, Physical examination, vaccination, minor therapy, special
examination and client education; outpatient treatment are often intended
functions of an examination room.
1.
The hospital superintendent is responsible for proper procedures being
performed. Care of the animals must be the responsibility of a registered
veterinarian.
2.
The hospital superintendent must see that the techniques and methods
employed by the Veterinary staff and Veterinary technicians are continually
updated.
3.
Examination table with a readily sanitized (a) fluid-impervious clean
surface (b) materials for vaccination injections etc. (c) Stethoscope (d)
Scales & Restraints equipment (c) Thermometer.
4.
Cleaning materials, disinfectants, clean/disposable / towels, gauze and
a waste receptacle.
5.
Facility for hand washing between each patient (a
sink/handwash/handpit)
6.
A radiograph viewer must be located in or convenient to each
examination room.
Section - 3
Pharmacy
Facilities must be provided for
storage, safekeeping, and use of drugs in accordance with regulations. Norms be
prepared for internal use or dispensing. Internal controls should be in effect
for substances that can be abused (by simple norms).
1. The hospital in-charge (Hospital Superintendent/Director of
Polyclinics) is responsible for maintenance of the pharmacy and required to
maintain records of controlled substances.
2.
The drugs must be stored in the locked cabinet but not stored in the
store of drugs to which it applies.
3.
Adequate quantities of drugs and supplies must be available at all
times.
4.
The hospital in-charge must ensure that all outdated drugs are returned
or disposed off, in accordance with set norms.
5.
When dispensing medication; label, name and date of expiry, (if
appropriate); include warning labels, if appropriate.
6.
Each label must have recorded thereon (a) Client's name, (b) Patient's
name, (c) date (d) name of the drug, usage directions including route of
administration (f) Quantity dispensed; Hospital's name and address and phone
number; Name of the veterinarian prescribing the drug.
7.
Use a child-resistant container where needed.
8.
Drugs must only be dispensed or administered on the order of a
registered veterinarian
9.
Drugs used exclusively in euthanasia procedures must be stored in a
locked cabinet. It is recommended that these agents be identified and
segregated.
10.
Each dose of any medication administered, dispensed or prescribed must
be recorded on the medical records, including usage directions, quantity and
number of refills (could be a counterfoil of label).
11.
Telephone calls, instruction changing medications or dosages also may
be recorded on the patient's chart or record.
12.
If clients bring their own medications to the hospital these drugs must
not be administered unless they can be identified. Orders to administer these
medications must be given by the veterinarian in charge of the animal. Drugs
which are not to be used should be stored and returned to the client upon the
discharge of the animal from the hospital.
13.
Hazardous medications (e.g. chemotherapeutic medications ) must be
handled in accordance with drug regulations enforce from time to time.
Equipments &
General Facilities
1.
Equipment must include cabinets or shell units for storage of drugs and
supplies; shelves for reference materials, clean surfaces for preparation of
drugs; fixed, lockable units.
2.
Storage of drugs must not allow for any cross-contamination, but it
should permit all preparations to be found readily and easily.
3.
The container of the drugs being dispensed must in no casual way be
changed.
4.
Each pharmacy must contain at least one reference text or compendium of
pharmaceuticals which is current (within 3-5 years) and provides the necessary
information on drugs, chemicals and biologicals in use within the hospital or
dispensed for use by the client.
5.
Current antidote information must be readily available for emergency
reference in addition to the telephone number of the nearest toxicologist.
Recommendations
1. The client
should be made aware of possible adverse drug reactions and the proper
procedure to follow if problems should occur.
2. Staff
education about adverse reactions and contraindications for the use of all
drug, chemicals, and biological used within the hospital is encourage.
Section - 4 Laboratory
Laboratory Diagnosis services
are necessary for the proper diagnosis and treatment of many cases. Whether the
procedures are performed within or outside the hospital will be determined by
the services available, economics, proximity of the hospital to outside
laboratories and qualifications of such laboratories to handle animal samples.
When an outside laboratory is used, except for histopathological services,
result of life-dependent procedures should be available within 12 hours
following sample collections. Results for periodic health monitoring, geriatric
examinations, histopathology, and other tests of this nature should be timely.
The choice of procedures used with any particular patient is a professional
decision.
A. Personnel and
Procedures
1. Lab
diagnostics available must include the following :-
(a)
Hematology and serology
(b)
Blood chemistry analysis
(c)
Urinalysis, including urine sediment examination and urolith analysis.
(d)
Microbiology, culture and antibiotic sensitivity
(e)
Parasitological examination (fecal, blood and skin)
(f)
Exfoliative cytology
(g)
Histology or histopathology
(h) Toxicology
2.
Specimen Data
Each Specimen
must be identified with the identification of the patient
3.
Necropsy Data:
Each necropsy procedure and
record thereof must be thorough and detailed. Tentative diagnosis, where
appropriate, must be recorded promptly in the patient's medical record. The
final report must be made a part of this record.
Equipment
1.
Instrumentation for tests performed on the premises must be adequate. Minimum
equipment must include :-
(a)
Micro-haematocrit
(b)
Microscope (binocular preferred )
(c)
Clinical centrifuge
(d)
Urinometer or refractometer
(e)
Refrigerator
(f)
Deep freezer,
(g)
Sterlisation unit for wet and dry type,
(h)
Laminar flow,
(i)
Glassware and laboratory wares, (j) Computer with internet facility,
(k) Telephone and fax.
Laboratory
2. If the services of an outside laboratory are not used, the following
equipment and necessary supplies must be available :-
(a)
Haemocytometer or electronic cell counter
(b)
Incubator,
(c)
Blood chemistry analyzer
(d)
In-house serology kit(s)
Section 5 - Diagnostic Imaging/
X- ray, MRI, ultrasound etc.
The hospital must have the
capacity to generate quality radiographic and other images as is considered
necessary from time to time on the premises. Diagnostic imagine exists to aid
in the accurate diagnosis and evaluation of medical and surgical problems and
to assist in determining an appropriate course of management.
A. Standards
1.
Education and Training
Radiographic
and imaging equipment must be operated only be persons aware of all hazards,
actual and potential, to themselves, assisting personnel, patients, and other
nearby individuals in order to eliminate or reduce hazards to minimum
acceptable levels.
Education
information must be available to all staff concerning radiation safety
Documentation
of a radiation safety program must be on file.
Radiation
safety procedures must be in compliance with all safety regulations.
2.
Monitoring of Exposure
Dosimeter
or a device for monitoring of exposure levels must be provided for all
personnel working with or near an X-ray generator.
The
individual badge must be worn near the collar on the outside of the leaded
apron.
Records
of the results must be maintained indefinitely and be readily available.
Exposures
result must be communicated to the staff.
3.
Inspections
Machines
must be inspected in accordance with regulations (BARC/Department of atomic
Energy safety verification )
Results
of inspections must be posted.
4.
Hospital personnel must be made aware of the medical and legal
importance of proper
image
identification and of organized storage of these imaging records.
5.
Images of patients must be identified properly and filed for easy
location and retrieval.
Because radiographic images are an element of the
medical record, they must also be
retained.
6.
Processing
If
manual processing is performed, processing tanks should be cleaned, and
solutions replaced as prescribed. Solutions must be kept covered to minimize
evaporation.
Agitation
of the solutions atleast twice each day is recommended and must occur before
the first films and processed.
If
automatic processing is used, the processor must be well maintained and capable
of good-quality film processing. A regular cleaning schedule should be
established and documented.
A
chart must be maintained to monitor the solution changing schedule.
B Equipment
1.
Loaded cassettes must be stored in a manner to protect them from
unintended exposure. Two or more of each size of cassette used should be
available.
2.
Radio-opaque character must be used to identify right (R) and left (L)
sides of the patient.
3.
Permanent identification of each image is required Additionally,
owner's name and patient description should be included.
4.
Measuring calipers to determine accurately the thickness of the part
being radiographed must be used to reduce non-diagnostic exposures.
5.
Lead aprons and gloves must be used during exposure. They must be in
safe condition and properly cared for to ensure a reasonable life.
6.
Proper safelight(s) with lamps of correct wattage.
7.
Radiograph Machine.
The X-ray machine, generator,
tube, stand must have a capacity which is adequate to produce consistent films
of diagnostic quality on patients treated routinely in the hospital.
8. Diagnostic
Ultrasonography/MRI / Doppler/ other imaging:
a.
If ultrasonography services are provided, equipment for this
alternative imaging modality must be of a type that is appropriate for patients
imaged. For example the transducers used are relatively specific for anatomical
areas and types of study. It is recommended that the machines used be equipped
to record the study as it is being performed.
b.
The darkroom must be light-tight and sufficient in size. The
light-tight darkroom should be painted a light colour to enhance safe light
effectiveness.
c.
It is desirable to have a separate room devoted to radiography. The
protective barrier effect of the walls and doors should be such that adjacent
occupied areas would not receive radiation above recommended levels.
Section 6 -
ANAESTHESIOLOGY
A. Standards
1.
Anesthesia service must include performance of routine pre-anaesthetic
examinations and exercise of proper safeguards in selection and use of
anesthetics. Although the type of anesthesia for each procedure is left to the
discretion of the attending veterinarian, the continued study, evaluation, and
use of newer and safer anesthetic agents and equipments is recommended.
2.
Anesthesia service must include performance of routine pre-anaesthetic
examinations and exercise of proper safeguards in selection and use of
anesthetics.
3.
Anesthetic agents must be administered by veterinarian or by persons
trained in their administration and then only under supervision of a
veterinarian who must be on the premises. Administration must be in compliance
with regulations.
4.
It is the direct responsibility of the hospital i/c to provide support
staff anesthetic safety and training programs and ensure supervision of the
programs.
5.
Some method of respiratory monitoring must be used such as observing
chest movements, watching the re-breathing bag, or use of a respirator monitor.
6.
If endotracheal tubes are used, they must remain in place during
anesthesia until appropriate protective reflexes have returned.
7.
In the events of cardiac arrest, standard procedures for cardiac
resuscitation should be followed using drugs and equipment to be found in an
emergency cabinet, or on an emergency tray. Doses and dosages should be printed
on all emergency drugs or be readily available in chart form.
B. Equipment
1.
All equipment needed for the administration of local and general
anesthesia must be readily available and in good functioning order.
2.
The anesthetic areas must have emergency lighting available.
3.
The anesthetic area must contain the following :-
a.
Pre-anaesthetic agents
b.
Induction anesthetic agents for intravenous administration
c.
Anesthetic and pre-anaesthetic antagonists, as appropriate
d.
Appropriately sized endotracheal tubes and tube adapters
e.
Antiseptic agent for venipuncture preparation
f.
Sterilized needles and syringes
g.
A stethoscope
h.
A machine for the administration of gaseous anesthesia that includes a
canister containing a fresh agent to absorb carbon dioxide.
i.
Gaseous agent for the induction and maintenance of general anesthesia
j. An oxygen source and a device for administration of the oxygen
k. A gas scavenging system that complies with safety regulations. l. A
re-breathing bag or similar device for monitoring respiration.
4.
Support equipment
a.
Emergency medications and equipment required in the event of a cardiac
arrest (may be located in the operating room) must be available.
b.
Intravenous catheters, administration sets, intravenous fluids and/ or
other cardiovascular support medications( plasma expanders fluids ) must be
readily available.
5. Some means of
assisting ventilation must be readily available during general anesthesia,
either manual or mechanical.
C. Structure
1.
The facility must contain an area for the administration of general
anesthesia.
2.
A recovery area outside the operating room or a recovery room where the
patient can be observed closely until appropriate protective reflexes have
returned must be available. Observation should occur at frequent intervals
until the patient is in sternal recumbency.
Section 7 -
SURGERY
For the purpose
of convenience of categorization of surgical interventions, the following
definitions can
be used: -
Surgery - The act
of incising living tissue an operative procedure; and/or in a room or
facility where an operative procedures done(i.e. the
operating room)
Aseptic Surgery - Surgery
performed in ways or by means sufficiently free of microorganisms so that
significant infection or suppuration does not occur
Minor Surgery - Any surgical
intervention that neither penetrates and exposes a body cavity or bone nor
produces permanent impairment of physical or physiologic functions, Example are
superficial wound suturing and cutaneous biopsy.
Major Surgery - Any surgical
intervention that penetrates and exposes the body cavity or bone; and procedure
that has the potential for producing permanent physical or physiological
impairment; and/ or any procedure associated with extensive transaction or
dissection of tissue.
A. Standard
1. Preparation of Patient
a.
A standard, accepted procedure must be used to prepare the patient for
surgery.
b.
All personnel assisting in the pre-surgical preparation of the patient
must be aware of the danger and sources of bacterial contamination. They must
be adequately trained and under the direct supervision of a veterinarian
consistent with law.
2.
Surgical Attire
a.
Surgical assistants and the surgeon must be properly attired with cap,
mask, sterile gown, and sterile gloves* when major surgery is performed.
b.
Surgeons, surgical assistants, and operating room attendants must wear
a surgical cap and mask at all times while in the surgical suite and when a
sterile field exists therein. All scalp and facial hair must be completely
covered by the cap and mask. Operating room attendants should remain outside of
the sterile field. The sterile field is the area above the sterile drapes on
the operating table and adjacent instrument trays. The sterile field extends
from the edges of these drapes in a vertical plane to the ceiling.
3.
Sterility
a.
Surgical procedures require the use of sterilized instrument, gowns,
towels, drapes, and gloves* as well as clean caps and masks.
b.
A regular maintenance program for autoclaves and other sterilizing
equipment must be instituted. Employee training must be adequate for the proper
operation of the equipment and awareness of any malfunction that may occur.
In large animal surgery where
gloves are not used, extra precaution needs to be taken for scrubbing.
c.
When gas or steam sterilization procedures are used, sterility
indicators must be in evidence on the exterior surface of each unit.
d.
When large surgical bundles (gowns, drapes, instrument placks ) are
sterilized, monitors that verify appropriate steam temperature and time must be
used in the center of each pack. Steam must penetrate every fiber of the
material sufficient to kill both spore-forming and nonspore-forming bacteria.
However,
penetration of stream into large
surgical bundles will be slower, so at least 30 minutes must be allowed for
sterilization
e.
When a pressure cooker is used for sterilisation, packs will be moist
upon removal and drying must be completed immediately in an oven.
f.
The drapes, laparotomy sheets, towels, gauze sponges, suture materials,
and gowns to be sterilized must be properly wrapped. The contents of the
bundles must be in good repair, cleaned or laundered, dried, wrapped and
sterilized.
g.
Surgical packs must be dated. If not used, packs must be re-autoclaved
every 30 days. Shelf life may be extended by using alternative wraps i.e. double
wrap, steripeel, and dust covers.
h.
Latex rubber gloves must be prepared for re-sterilisation by sorting
them into pairs by sizes, testing for holes, and dusting inside and outside
with powdered starch preparation. They then must be autoclaved after being
placed in a suitable pack. The usual time for processing is only 15 minutes at
15 pounds pressure; but sterility must be verified by a monitor placed within
each pack if the pouch does not have a self indicator. The surgeon must remove
excess power from the glove surface at the beginning of a surgical procedures
4.
Steam under pressure is best for sterilisation of gowns, gloves,
towels, laparotomy sheets, and gauze sponges. Any autoclave type apparatus
equipped with a pressure gauge must maintain steam at a pressure high enough
and for a period long enough to kill all bacteria and their spores.
5.
Brushes used for scrubbing surgeon's hands must be thoroughly washed
and sterilized. Reusable caps and masks should be laundered after each day's
use. Disposable caps, and their spores.
B. Equipment that
must be present in the operating room :-
a)
Surgical light of adequate candle power to illuminate the surgical
field, preferably the type of lamp which is completely enclosed to avoid dust
accumulation.
b)
Instrument table(s) constructed of impervious material
c)
Surgical table(s) constructed of impervious material.
d)
Intravenous fluid hanger(s).
e)
A gas anesthetic machine capable of being able to provide respiratory
assistance with a vaporizer's compatible with the agent(s) used.
f)
A bucket receptacle of impervious material (kick/bucket), preferably
mobile.
g)
A supply of oxygen
h)
Battery-operated or alternate power supply emergency lighting.
i)
Adequate drugs for emergency used readily available in an accessible
emergency box or designate place (may be located in the anesthetic induction
area).
6.
Proper venting of all excess anesthetic waste gases must be provided in
accordance with all federal, state provincial and local regulations.
7.
Surgical instrumentation must be properly cleaned, in good repair, and
sufficient in number and variety to match the requirements of the surgical case
load.
C. Infrastructure
1.
Surgical Preparation Room
a. Primary
preparation must be performed outside the operating room. The preparation room
should be a separate room convenient to the operating room and well lit.
Floors, walls, and counter tops should be smooth, impervious material which is
easily cleaned. The room might double as a laboratory, scrub room, treatment
room, or extra examination room.
2.
Operating Room
a.
The operating room must be a separate, closed, single-purpose room for
the performance of only aseptic surgical procedures.
b.
An aseptic surgical suite can be located anywhere in the hospital
provided it is convenient to the recovery rooms and the preparatory room. It
must be out of traffic areas.
The operating room must be so constructed and equipped
that cleanliness can be easily
maintained.
c.
Flooring must be of an impervious material.
d.
Walls must be of a washable, impervious material.
e.
Doors must be well fitted and should be wide enough to permit passage
of patients.
f.
Doors must be kept closed and traffic into the surgical suite kept to a
minimum. A viewing will reduce the need for support personnel to open the door
to see into the room.
Section 8 -
NURSING CARE
1.
Nursing care must include the provisions of diagnostic, pre-surgical,
surgical, and recovery procedures as well as limited custodial care(where
relevant).
2.
All patient care provided by the nursing staff must be under the
supervision of a veterinarian.
3.
All patients must be positively and properly identified (sufficient to
differentiate between two like animals) during their hospital stay.
4.
Each medication must be entered on the patient's medical record showing
date, name of drug, type, dose, route of administration (when more than one
route is acceptable ), and frequency of administration.
5.
Referred ECG patients must have results and interpretation returned to
the referring facility for inclusion in the patient's file.
6.
The practice staff must demonstrate humane care of animals. The
facility must provide for the fare and prevention of animal abuse or neglect of
patients.
7.
Nursing personnel must ensure that all animals are individually housed.
8.
Nursing personnel must be trained to know the proper maintenance of
optimum body temperature of all patients and to ensure patient's comfort and
cleanliness.
9.
Nursing personnel must be trained in the proper restraint and
compassionate handling of the patients.
10.
Therapeutic bathing and dipping must be performed by personnel trained
in proper techniques.
11.
Nursing personnel must be trained in the principles of contagious
nursing care. Proper hand washing between patients is considered to be the most
effective way to prevent cross-contamination.
12.
The nursing staff must be familiar with the proper handling and disposal
of all waste materials and the cleaning and disinfection of compartments,
exercise areas, and runs.
13.
If the exterior exercise area cannot be easily cleaned, all fecal waste
must be removed promptly.
Section-9. ANIMAL HOLDING AREAS
1.
There are no specific ward requirements; however, all animals holding
areas must be secure, escape-proof and easily cleaned.
2.
Runs and exercise areas must be available, maintainable, secure,
escape-proof, and adequate in relation to the normal case load.
3.
If cages and runs are provided they must be large enough to be
comfortable for the largest patients admitted to the facility.
4.
All cages and runs must be comfortable to animals and easy to keep
clean.
5.
All runs should be sloped and individually drained to prevent
cross-contamination. If drained by a common trough, the trough must be covered.
Section 10 -
HOUSEKEEPING AND MAINTENANCE A. Standard
The house keeping goal is to
maintain an environment that is safe for the patients, clients, and employees.
This programme must provide maximum disease control through out the hospital.
1. Housekeeping Plan
a.
there must be a written housekeeping and maintenance program ( a check
list at a minimum) for establishing and maintaining a safe, sanitary,
functional, and pleasant environment for clients, patients, and employees.
b.
The planning, administration and development of a written comprehensive
housekeeping plan is the responsibility of the housekeeping supervisor.
c.
The implementation of the written comprehensive housekeeping plan must
be aware of the written house keeping program and practice standards.
2.
Personnel responsible for the supervision of housekeeping must have a
basic knowledge of health care and sanitation, including the principles of
bacteriology, chemistry and related sciences an they apply to diseases control
and prevention.
3.
All cleaning supplies must be used in accordance with bio-safety
regulations.
4.
Furnishings must be properly maintained and conveniently arranged in
order to be pleasing to the client and conducive to the patient's comfort.
5.
All fixtures, furnishings, and equipments must be maintained, free from
excessive wear, and good repair.
6.
Linens must be stored in such a way as to minimize contamination from
surface contact or airborne sources.
7.
Soiled or contaminated linens must be handled in such a way as to
prevent cross contamination of other areas of the hospital.
8.
Faucets and drains must be inspected regularly and maintained in proper
working order.
9.
Compressed gas tank valves, regulators, lines, and washers must be
checked periodically for leakage.
10.
Mechanical systems, throughout the hospital must be maintained in
accordance with written preventive maintenance programs.
11. Waste
Disposal
a.
Waste disposal must be carried out in accordance with good public
health practice and biomedical waste disposal rules.
b.
Deceased animals not disposed of within 24 hours must be sealed safely.
12. Recommended
Building Exterior
Grounds
surrounding an animal hospital must be neat, attractive and in safe condition
at all times
Lawns,
flowers, and plantings must be regularly cut, watered, and trimmed.
Rubbish,
papers and fecal material from animals must be picked up from lawns, side
walks, and parking areas on a daily schedule.
Sings
must be of a professional appearance and in good repair, and lighting must be
in good taste and useful in identifying the facility.
B. Equipment
1.
The hospital must be equipped to operate under safe and sanitary
conditions.
2.
An adequate supply of clean or disposable lines and supplies must be
available and in good repair.
3.
Tools and materials for simple building maintenance and repair must be
available.
4.
All hospitals must provide adequate emergency lighting. The hospital's
battery - operated lights or alternate power source must be maintained on a
regular basis. If flashlights are used, they also must be maintained on a
regular basis.
5. Appropriate
fire extinguishers must be readily available and maintained in accordance with
federal, state, provincial, and local regulations.
C. Structure
1.
ventilation and heating systems* and air conditioning* and heating
equipment must be installed in accordance with applicable codes and appropriate
standards. *(if used)
2.
The ventilation system must ensure that a fresh air supply is provided
in critical areas, such as the surgical suite, preparation areas, special care
units, and ward areas.
Section 11 - CONTINUING VETERINARY EDUCATION
A medical library
consisting of basic textbooks and current periodicals must be provided.
Continuing education requirements must be met as per requirements and
Veterinarians' oath.
1.
The professional library must include current books, periodicals, and
other multimedia material appropriate to the needs of the staff. Or internet
down loading/referring facility.
2.
Adequate shelves for the orderly cataloging & storage of books and
periodicals must be provided.
Section 12 -
EMERGENCY SERVICES
Emergency services (professional diagnosis and
emergency treatment) must be provided and
must be readily available at all times in the
Veterinary Institutions under the charge of a
Registered Veterinary Practitioner. Such services
should invariably be avoidable in the
Institutions
designated for this purpose.
1.
Every accredited Veterinary Hospital must have a procedure by which a
sick or injured animal may be assessed and either treated or referred to an
appropriate facility or received from a Veterinary Dispensary.
2.
Emergency services or referral to an appropriate facility must be
available 24 hours a day.
3.
Emergency service must be adequate to ensure the treatment of the
patient within a reasonable period of time.
4.
When a patient is transferred for emergency service, a copy or summary
of the medical record must accompany the patient.
A.
Essential element of Good Veterinary Practice is "write what you
do and do what you write'. It shall be the duty of a registered Veterinary
practitioner to make note of all his actions (in professional service
delivery). She/ he will act similarly while directing and supervising minor
Veterinary services.
B.
Each Registered Veterinary Practitioner shall display his registration
number along with her/his name in the nameplate, visiting card (if any),
prescription, Veterinary medical reports, sample dispatch records or any such
or similar professional records/reports which are written and submitted by
him/her.
C.
Medical Attendance: - A Registered Veterinary practitioner will record
the following in medical attendance: -
1.
the identification of the patient, such as name (if any), species, sex
and may add other information/descriptions like approx. age, colour, markings
etc.
2.
the history of the case as provided or elicited from the client
3.
method of restraint/handling used, if any,
4.
the observations of the physical examinations made
5.
the clinical tests proposed, conducted or got done
6.
the status or condition of the patient
7.
the treatment provided or prescribed
8.
prognosis or advice given to the client, if any
9.
the clients' perspective, if any
10.
instructions if any for drug delivery, follow-up etc. to para
veterinary staff or clients
11.
the protocol or salient point of protocol of it which (if) she / he
considers useful
12. any other information which she
/ he considers useful
D.
Collection of samples and dispatch: - For collection of sample
examination or/and dispatch, the standard guidelines provided in relevant
Books/Manuals may be followed.
E.
For conduct of Artificial Insemination the following process may be
followed
-
Ascertain standing heat
-
Decide time of Artificial Insemination
-
Collect the semen straw.
-
Thaw the Straw.
-
Ensure quality of semen & record the number
-
Clean the animal's hind part (s)
-
Deposit semen in the right place (aseptically)
-
Allow rest (do not allow animal to run or get excited)
F.
To conduct any minor surgical intervention the following guidelines
shall be followed:
- assess the status of the patient by
method(s) as considered essential
-
inform the client
-
preparation of instrument(s)
-
decide on the restraint, anesthesia,
-
preparation of site, scrubbing
-
intervention medication or dressing
-
post operative instruction(s)
|
sedation etc. as per need as per need
|
-
follow-up/follow-up instruction(s)
Major surgical
operation shall normally be conducted in the operation theaters or rooms
prepared for the purpose. But circumstances may and do arise where the
registered veterinary practitioner is compelled to perform a major surgery in a
situation where facilities are far from ideal but a life saving treatment or
action is required. The primary consideration of registered veterinary
practitioners in such situation shall be final as to the risk of surgery
whether it is greater than the risk of disease or the problem.
(b) To conduct
major surgical operation, guidelines for Good surgical practice have to be
followed. However, the following minimal guideline should also be considered:-
assess the status of the patient through a pre-anaesthetic clinic or tests
-
obtain the consent of the client after explaining the status &
indication
-
preparation of instrument(s),
-
decide on the control sedation, anesthesia etc. as per need
-
anesthesia**
-
preparation of site.
-
scrubbing of hands, wearing of glove/sleeves is necessary
-
perform surgery adopting standard aseptic precautions medication or
dressing as per need
-
post operation instruction(s)
-
follow up
•
* It is advisable to scrub first with anionic detergent (soap) followed
by a cationic detergent (two) scrubbing. This shall be followed by rising with
sprit or 70% alcohol where possible. When this is not possible one may scrub
hands thrice with soap. Use clean water to scrub & wash. If only hard water
is available use more soap. Alternatively, one may do one scrubbing less and use
a pair sterile rubber gloves, for surgery of short duration.
•
** Much decisions on the choice of surgeon and the clinical situation:
minimal discomfort shall be the primary consideration: but risk of anesthesia
shall not overweigh the risk of discomfort.
G.
For gynaecological (non-surgical) handling involving internal
examination, or treatment the following guidelines shall be followed:-
securing the animal ensuring safety of animal and that of the handler
-
preparation of instruments
-
cleaning of the part and preferably wear a front apron
-
sedation/ anesthesia be given where essential
-
scrubbing of the arm with soap and water at each examination.
-
use sterile sleeve/ glove/ finger stall (as per the species) and
lubricating with a bland or medicated material before insertion of hand into
female organ
-
after manipulation dry the part to prevent soiling.
H.
For rectal examination following guidelines shall be followed:
- secure the animal ensuring safety of animal and that
of the handler
-
clean the part and preferably wear a front apron
-
lubricate hand & arm before insertion of hand into female organ
-
do slow stage by stage manipulation to ensure minimal discomfort to
animal and maximum safety
-
remove hand and clean the area if any suspected or infected fluid oozes
out, before next animal is to be handled in the same crush/ trevis
-
clean the arm and change/ clean the front apron
I. For gynaecological (surgical)& obstetrical
handling involving internal examination, or
treatment the same guidelines as for major surgical intervention shall
be followed. J. For consultation:- The good ethical practices demand that for
reference and for consultation registered veterinary practitioners shall abide
by regulation 25 to 37 of Standard of Professional Conduct Etiquette and code
of Ethics for Veterinary Practitioners) Regulations, 1992. K. For referring
cases too similar guidelines as above (J) may be followed. L. For simple
diagnostics, Good Laboratory Practice may be followed. M. For conducting post
mortem:- The standard procedures shall be followed. N. For Livestock Product
Technology the registered veterinary practitioner shall primarily
abides by the
guidelines framed under these regulations. O. For Veterinary Public Health by regulation
39, all veterinarians shall be bound by regulation 38 of (Standard of
Professional Conduct Etiquette and Code of Ethics for Veterinary Practitioners)
Regulations, 1992.
Person(s) who
carry out minor veterinary services shall do as notified by the state
government and strictly as provided under the Indian Veterinary Council Act,
1984. For the purpose, the State Governments, institutions, organisations or
agencies concerned shall declare the names of persons employed by them by
whatever name called for minor veterinary services and shall also declare the
name of the registered Veterinary practitioners under whose direction and
supervision such (notified) minor Veterinary services shall be carried out. The
place or an occasion where such notified minor veterinary service is carried
out shall exhibit the name of the registered Veterinary practitioner under
whose supervision and direction the minor veterinary service is being carried
out for the benefit of the public. The Registered Veterinary Practitioner shall
be responsible to declare immediate closure of any such institution where
sub-standard and/or illegal veterinary practice is being followed and will
report the matter to the respective State/UT Veterinary Council immediately.
Every registered
Veterinary Practitioner shall record the name of all the persons undertaking or
carrying out minor Veterinary service under their supervision and direction as
provided under section 30(b) and shall exhibit the same along with the place or
occasion such activities are carried out conspicuously where the public can
see/ read it.
A registered
Veterinary practitioner for the purpose of supervision and direction of minor
Veterinary service may visit the place/ occasion by whatever name called on a
date and time declared and announced to the public. While doing so she/ he
shall verify the minor veterinary service carried out and recorded till that
date. Such records shall invariably include:-
a)
the date
b)
name & address of the client
c)
description of the animal
d)
the ailment and
e)
the service provided/ rendered each day
f)
and any other data like the total number of animals, households,
problems, diseases etc. of the area as is required of her/ him from time to
time.
Person(s) or
agencies who are organising/ providing minor Veterinary service shall declare
the name of the registered Veterinary practitioner under whose direction and
supervision, any of the minor Veterinary service, by whatever name called is
being done. They also shall keep a record of what they do in the same manner
described pre-para, [except (f)] and shall submit the same for the purpose of
inspection, supervision and direction what so ever. The same shall apply to all
the minor Veterinary service as notified by the state and for artificial
insemination, vaccination etc. where they are carried out as part of minor
veterinary service.
Person(s) who
carryout A.I. shall do so as notified by the state government and strictly as
provided under the Indian Veterinary Council Act, 1984. For this purpose, the
state governments, institutions, organisations or agencies concerned shall
declare the names of persons employed by them, by whatever name called, for
minor veterinary service and shall also declare the name of the registered
Veterinary practitioner under whose direction and supervision such (notified)
minor Veterinary service shall be carried out. The place or an occasion where
process is carried shall exhibit the name of the registered Veterinary
Practitioner under whose supervision and direction the A.I. is being carried
out for the benefit of the public. Registered veterinary practitioner shall
declare immediate closure of any such institutions where sub-standard and or
illegal Veterinary practice is being followed and will report the matter to the
respective State/UT Veterinary Council immediately.
For the purpose of direction and supervision, a registered Veterinary
practitioner shall verify the records of A.I. regularly. Such records shall
invariably include: -
a.
the date, place and time where service was provided
b.
name and address of the client
c.
description of the animal,
d.
the source of semen straw/ semen with batch number and identification
number
e.
the number of any previous A.I. done with reference number & date
f.
any failure of A.I. shall be reported to the Registered Veterinary
Practitioner who shall inspect the total A.I. performed every three months, and
report on any problem (animal or semen) to a specialist.
g.
for this purpose, he/she may seek any other data like the total number
of animals, households, problems, diseases etc. of the area as is required from
time to time
CONSULTANCY: a consultant can renders
veterinary service delivery (treatment or professional advice) at a place on an
occasion provided he/she is a registered veterinary practitioner, as provided
in the Indian Veterinary Council Act. She/he shall be doing so as a desk
practice or in a clinic of her/ his own or that of an organisation. While there
is no bar on her/ his undertaking any type of veterinary practice, she/ he is
normally expected to equip herself/ himself to deliver the professional
service, whatsoever, or procure them for the occasion. A consultant shall
display her/ his registration number along with her/ his name and announce the
nature of practice, time of practice etc. conspicuously. He/ she shall display
any fee and/ or other charges for the service(s), conspicuously for the clients
to read and understand.
SPECIALIST SERVICES : Being a qualified veterinary
practitioner there is no restriction on registered veterinary practitioners to
render any treatment, medication or advice in any branch of veterinary science
and shall always use their veterinary medical skill and knowledge for the
benefit of any animal requiring their attention. But professional ethics demand
that they normally do not indulge in such activity or specialized service
unless they acquire the necessary skill to do so.
Any announcement
indicating specialised qualification and/ or competence to undertake
specialised job routinely without experience or qualification to do so shall
constitute self aggrandisement.
SPECIALIST CONSULTANCY : A specialist renders veterinary
service delivery (treatment or professional advice) in a specific field or
specialty at a place or an occasion as is announced. A specialist should
invariably have the required training/ experience/ competence to perform the
service. His/ her performance shall be judged by the standards expected out of
a specialist of the field as is claimed and announced. She/ he shall be doing
so as a desk practice or in a clinic of her/ his own or that of an
organization, society, government or institution. While there is no bar on her/
his undertaking any aspect of veterinary practice, she/ he is normally expected
to engage herself/ himself primarily in the specialty. While there is no bar on
her/ his undertaking general veterinary practice, she/he is normally expected
to equip herself/ himself or procure them whatsoever for the occasion. A
specialist consultant shall display her/ his registration number and
qualification (including her/his additional qualification) along with her/ his
name and announce the nature of practice, time of practice conspicuously for
clients. They shall display conspicuously the fee for her/ his service or any
other charges (as provided under section 29) for the clients to read and
understand. But charge(s) may also be announced to client by the registered
veterinary practitioner or agreed upon by both. Any charges paid to registered
veterinary practitioner for rendering Veterinary service by the Client shall be
treated as agreed charges.
Principles of cleaning, sterilisation
and disinfection :
There are numerous pieces of
equipment and appliances that regularly come into contact with patients; e.g.
tonometer heads, chin rests, refractor heads, trial frames, gonioscopes,
contact lenses etc., and it is essential that all of these are properly
maintained to ensure maximum safety. It is important to establish the
difference between cleaning, disinfection and sterilisation.
Standard practices for cleaning,
disinfection and sterilization should be followed in all the Veterinary
Institutions wherever required.
To be effective all items must
be physically cleaned before being exposed to any sterilisation or disinfection
process.
Not all
equipment, however, needs to be sterilised before use and the following is a
general guideline:-
Sterile: - Equipment introduced
into a sterile body area or is in contact with a break in the skin or mucous
membrane.
Disinfected: - Equipment in
close contact with body surfaces of intact mucous membranes, such as the ocular
surface, e.g. tonometer heads, gonioscopes.
Clean: - Equipment not coming
into close contact with mucous membranes or sterile body areas e.g. chin rests,
trial frames, refractor heads.
It is fairly evident that it is
not always necessary to sterilise all equipment for use in general optometric
practice.
All surfaces used as a
preparation area for dealing with patients and disinfected/sterile appliances
must also be cleaned and disinfected regularly. It is considered good practice
for the consulting room to contain a handwash basin and for the clinician to
wash his/her hands thoroughly between patients and certain procedures as
necessary.
Secretary Veterinary Council of India
File No. 7-9/2003-VCI
(Statutory body established
under Indian Veterinary Council Act, 1984)
A-Wing, 2nd Floor, August Kranti Bhavan
Bhikaji Cama Place, New Delhi-110 066
Accreditation
No. VCI/
Type of
Institution: Veterinary Hospital/Veterinary Polyclinic/Veterinary
Dispensary/Veterinary Clinic.
This is to certify that
the above specified institution has been accredited under the provisions of
Regulation 2 (3) of VCI - (Veterinary Practice) Regulations, 2005.
