NABH Series4 PRE

CAHO ENTRY LEVEL SERIES
Patient Rights and Education (PRE)
BASIC PROGRAM TO TRAIN CPQIH

CONSORTIUM OF ACCREDITED HEALTHCARE ORGANIZATIONS
Summary of Standards
PRE2
PRE1
Patient Rights (7) Patient education
(2)
Patients rights
and education
(PRE)
BASIC PROGRAM TO TRAIN CPQIH 2

Intent of PRE
The NABH Patients Rights and Education (PRE) chapter aims at:
▪ Rights and responsibilities are defined.
▪ Same is informed to patients.
▪ Staff are aware of these and make every effort to protect patient’s rights.

PRE1: Patient rights are documented, displayed and
support individual beliefs, values and involve
the patient and family in decision making process.
▪ PRE 1a: Patient rights include respect for personal dignity and privacy during
examination, procedures and treatment.
▪ PRE 1b: Patient rights include protection from physical abuse or neglect.
▪ PRE 1c: Patient rights include treating patient information as confidential.
▪ PRE 1d: Patient rights include obtaining informed consent before carrying out
procedures.
▪ PRE 1e: Patient rights include information on how to voice a complaint.
▪ PRE 1f: Patient rights include information on the expected cost of the treatment.
▪ PRE 1g: Patient has a right to have access to his / her clinical records.

Transparency in Healthcare
▪ Advice patient about the expected

cost of treatment.
▪ Explain about the costs that can
incur on periodic basis.
▪ Enable access to clinical records.
▪ Hand photocopy of clinical record
within 72 hours, if requested.
Note: Patient’s rights should be displayed in prominent locations and staff should
be provided training to ensure them.

How to implement PRE1?
Ensure privacy Protect from physical abuse/neglect
▪ Provide curtains in general wards. ▪ List what constitutes neglect/abuse.

▪ Provide privacy in OP when ▪ Take special precautions to protect
patient is consulting the doctor. vulnerable patients.
▪ Avoid focussing CCTV camera on ▪ Adopt mechanisms to handle
patient in patient care areas. neglect/abuse.
▪ Examine patient after explaining. ▪ Provide contact details or
▪ Maintain confidentiality. webmaster where a complaint can
▪ Obtain consent. be raised.
▪ Address patient with respect. ▪ Provide printed forms and drop
boxes to write and post a complaint.

Maintain confidentiality Obtain informed consent
▪ Protect patient information from ▪ Provide bilingual consent form.

unauthorised usage. ▪ Explain in language patient can
▪ Avoid patient-related discussions understand.
in common places. ▪ Get patient’s and witness’s
▪ Do not mark HIV status. signature.
▪ Avoid documenting MTP patient ▪ Registration or admission team: Can
details. obtain general consent for OP and
▪ Use Form III for MTP patients. before each admission.
▪ Avoid witness when taking ▪ Performing surgeon / team member:
consent for HIV testing and MTP. Obtain informed consent for tests
and procedures.

Documentation
Apex manual
▪ List of areas and procedures where privacy should be ensured.
▪ Policies on protecting patients from physical abuse or neglect.
▪ Policies on maintaining confidentiality of patient’s information.
▪ Policy on storing consent forms and their retention period.
▪ Procedures for mechanism for handling patient’s complaint.
Audit report
▪ Consents should be audited for completion and documented.

PRE la: Patient rights include respect
for personal dignity and privacy during
examination, procedures and treatment
To ensure that patients personal
dignity and privacy is respected
in every point of interaction
Requirements / Implementation
Document policy on areas and procedures where patient requires privacy across the
organization
Train concerned healthcare providers on the aspects of provision of Privacy
Patient right display board on prominent places to have this information.
Privacy of patients should be provided at all areas of Patient Care
Screens for patients in general wards which should be put on when the patient is being
examined also when the patient desires to while sleeping.
Change rooms in X-Ray and other procedure areas in OP, with adequate privacy for Patients
Privacy in OP rooms
BASIC when the
PROGRAM patientCPQIH
TO TRAIN is consulting the doctor
Requirements / Implementation
No CCTV Monitoring focusing on patients

No examination of the patient, without explaining to them.
Addressing them with respect
Maintain Confidentiality and avoiding discussion about the
patient in public areas
Consent must be taken for clinical photographs and video

recordings. Patient identity should not be revealed in such
Photographs
PRE 1b: Patient rights include
protection from physical abuse or
neglect
To ensure that all patients especially
the vulnerable are protected from all
forms of Physical abuse
Requirements / Implementation Guidelines
Document policy in protecting patients from physical abuse or

neglect.
List out those constitute neglect/ abuse. For eg. patient fall due to
staff negligence, assault, batter, child abuse, man handling, repeated
unwarranted examinations, hazing, sexual abuse, etc.,
Special precaution shall be taken especially to prevent neglects/

abuse ofBASIC
vulnerable patients
PROGRAM TO TRAIN CPQIH
Mechanism to handle and redressal system if an

abuse occur.
Staff training on protection of patients from abuse
Patient right display board on promotional places to

have this information*
PRE 1c: Patient rights include
treating patient information as
confidential
To ensure that all patients
information is kept confidential
Document policy in protecting patient's

Information confidential.
Train staff on maintaining patient

information confidential

Protection of patients charts/ case sheets, electronic

medical records from unauthorized usage
Patient right display board on prominent

places to have this information
Patient related discussions by the staffs

should be avoided in common places

PRE 1d: Patients rights include
obtaining informed consent
before carrying out procedure
To ensure that informed consent
is obtained appropriately before a
treatment or a procedure
List the situations requiring consent, who will take consent, who
will give consent in apex manual
General Consent: Consent for treatment to be obtained on first
time registration as outpatient and before each hospital
admission (General consent is the consent for admission,
investigations and examinations)
List of consents: Consent for invasive procedures, surgeries,
blood and blood components, anesthesia and sedation, HIV
testing, photography, restraint, MTP, PC-PNDT, transplants
dialysis
When: Consent has to be taken before the

procedure.
Who takes the consent:
Registration or admission team for general consent
Performing surgeon / physician or a member of his
team for surgical. diagnostic or invasive procedure
Language: The consent should be bilingual and explained in a
language understandable by the patient (interpreter can be used)
Witness: He/ she must witness the signing procedure and sign the
forms with date, name and address.
During consent the person must explain about the procedure, risks,
benefits, complications of the procedure
Policy to be documented where the consent forms are stored and

retention period.
Consents will have to be audited for completion.
Patient right display board on Prominent Places to have this
information
PRE 1e: Patients rights include
information on how to voice a
complaint
To ensure to convey information
to the patient the mechanism to
voice out the complaint
Patient right display board prominent places to have this

information
Can provide drop boxes with printed forms
To display telephone numbers, email ID, social network, person

to be contacted or webmaster when a complaint has to be
raised.
Procedure to be documented [e. the mechanism of handling the
patient complaint
PRE 1f: Patient rights include
information on the expected cost
of the treatment
To ensure to convey cost
information to the patient on
treatment and other details
Patient right display board on prominent places to have

this information
Mechanism to be in place to explain the patient or the
immediate relative about the various costs that can be
incurred during a procedure / admission and on a periodic
basis
Printed estimate
BASIC PROGRAM TOcan
TRAINbe given
CPQIH
PRE 1g: Patient has right to have
an access to his / her clinical
records
To ensure that the patient is
aware of his rights to have a copy
of his clinical records
To have a Procedure where patient can access his or her

clinical record when required
The Photography of the record has to be handed over to

the patients within 72 hours

PRE2: Patient and families have a right to
information and education about their healthcare needs.
▪ PRE 2a: Patient and families are

educated on plan of care, preventive
aspects, possible complications,
medications, the expected results
and cost as applicable.
▪ PRE 2b: Patients are taught in a
language and format that they can
understand.

▪ Educate patient and their family

about medication-interactions and
adverse reactions.
▪ Explain in the language patient can
understand.
▪ Adopt simple format of education.
▪ Avoid technical language (medical
jargons).

What should be documented in the apex manual?
▪ Mechanism or procedure regarding who

will explain and educate plan of care.
▪ Preventive aspects.
▪ Possible complications.
▪ Medications.
▪ Expected results.
▪ Costs.
▪ Periodicity.
▪ Patient education methodology.

• Mechanism or procedure to be documented who will

explain and educate plan of care, preventive aspects,
complications, medications, the expected results and costs
as applicable and the Periodicity ( Counselors, Nurses,
Doctors, Dietician, Pharmacist, Therapists etc.)
• To assist education models , posters , pamphlets can be

used
• Educative pamphlets can be given to the patient or the family

member
• Educative videos can be played and can be given to the patient to

watch at home or video link can be shared
• To document in patients chart the info of education given

countersigned by the patient or his or her family member
PRE 2b: Patients are taught in a
language and format that they
can understand
To ensure that the patient
education was effective
To have document on Patient education methodology
To provide education inpatient's language
Format of education to be simple either orally, audiovisual,
posters, pamphlets

Any Questions

Thank You!

NABH Series4 PRE

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CAHO ENTRY LEVEL SERIES

Patient Rights and Education (PRE)

BASIC PROGRAM TO TRAIN CPQIH

BASIC PROGRAM TO TRAIN CPQIH 2

BASIC PROGRAM TO TRAIN CPQIH 3

BASIC PROGRAM TO TRAIN CPQIH 4

▪ Advice patient about the expected

BASIC PROGRAM TO TRAIN CPQIH 5

Ensure privacy Protect from physical abuse/neglect

▪ Provide curtains in general wards. ▪ List what constitutes neglect/abuse.

BASIC PROGRAM TO TRAIN CPQIH 6

Maintain confidentiality Obtain informed consent

▪ Protect patient information from ▪ Provide bilingual consent form.

BASIC PROGRAM TO TRAIN CPQIH 7

BASIC PROGRAM TO TRAIN CPQIH 8

Train concerned healthcare providers on the aspects of provision of Privacy

Patient right display board on prominent places to have this information.

Privacy of patients should be provided at all areas of Patient Care

No CCTV Monitoring focusing on patients

Consent must be taken for clinical photographs and video

Document policy in protecting patients from physical abuse or

Special precaution shall be taken especially to prevent neglects/

Mechanism to handle and redressal system if an

Staff training on protection of patients from abuse

Patient right display board on promotional places to

Document policy in protecting patient's

Train staff on maintaining patient

BASIC PROGRAM TO TRAIN CPQIH

Protection of patients charts/ case sheets, electronic

Patient right display board on prominent

Patient related discussions by the staffs

BASIC PROGRAM TO TRAIN CPQIH

When: Consent has to be taken before the

Policy to be documented where the consent forms are stored and

Patient right display board prominent places to have this

To display telephone numbers, email ID, social network, person

Patient right display board on prominent places to have

To have a Procedure where patient can access his or her

The Photography of the record has to be handed over to

BASIC PROGRAM TO TRAIN CPQIH

▪ PRE 2a: Patient and families are

BASIC PROGRAM TO TRAIN CPQIH 39

▪ Educate patient and their family

BASIC PROGRAM TO TRAIN CPQIH 40

▪ Mechanism or procedure regarding who

BASIC PROGRAM TO TRAIN CPQIH 41

• Mechanism or procedure to be documented who will

• To assist education models , posters , pamphlets can be

• Educative pamphlets can be given to the patient or the family

• Educative videos can be played and can be given to the patient to

• To document in patients chart the info of education given

To have document on Patient education methodology

To provide education inpatient's language

Format of education to be simple either orally, audiovisual,

BASIC PROGRAM TO TRAIN CPQIH

BASIC PROGRAM TO TRAIN CPQIH 49

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