Internal Medicine Department

DEPARTMENT OF INTERNAL MEDICINE NATIONAL HOSPITAL ABUJA

QUALITY OF CARE POLICY AND OPERATIONAL GUIDELINES

NHA/CD/QOCP/INT/001

Dr. ALIMI.S,A.

HEAD OF DEPARTMENT

1.0 INTRODUCTION

The Department of Internal Medicine started as one of the major clinical departments of the

Directorate of clinical services of the National Hospital for women and children in July 1999.  Skeletal services mainly outpatient care started then and in-patient services followed a few months later.  The renal services with haemodialysis started fully in December, 1999.

Gradually other services became available as more consultant staff joined the department either full time or on part time basis.  The department has since evolved and has been rendering full patient care and services.  This became more pertinent with change in status of the hospital from women and children hospital to National Hospital Abuja.

The mandate of the hospital entails high level medical care by well trained and competent staff using the available modern diagnostic equipment.  Right from her inception, the department forged ahead to ensure that research and training is given adequate priority. The department has full accreditation for training of resident doctors in internal medicine with both the West African College of physicians and National Post Graduate Medical College of Nigeria. 

The department of internal medicine NHA is now an examination centre for the membership and fellowship exams of the WACP since 2019 and has successfully hosted 6 exams so far, from which we have received a lot of accolades from both the College and examiners. 

The department has successfully trained 25 Physicians across different subspecialties.

1.1       Vision Statement

The department is poised to provide high level specialist care as a first-class department to Nigerians and to strengthen post graduate training of resident doctors in the various specialties of Internal Medicine.

1.2       Mission Statement

To train competent and highly qualified physicians that will treat communicable and non-communicable diseases, provide compassionate, competent and efficient care, and conduct relevant research while providing continuing and comprehensive care to all adult patients without discrimination. 

2.0 QUALITY ASSURANCE POLICY

The department of Internal Medicine has cultivated excellence In-patient care, training and research. The department of Internal Medicine has put in place protocols and standard operating procedures (SOPs) for the different units of the department to ensure that mandatory standards of care and residency training programs are being met. This quality assurance policy is designed to analyse health care requirements of the different units of the department, determine ways of ensuring that the developed SOPs and protocols are implemented across the various units and have a system in place to audit the protocols for compliance and institute performance improvement plans when standards are not met. 

Our long-term goal is to establish a first-class department of internal medicine that can be compared favourably with those of advance countries, and to set the pace for patient care, research and medical training in Nigeria and sub-Saharan Africa.

3.0 STRENGTH OF THE DEPARTMENT

1. Internal medicine is a field of practise focused on treating adult.
2. Physicians are specialists who apply scientific knowledge and clinical expertise to diagnose and treat adult diseases from chronically ill patients to short term care
3. Physicians are skilled in the management of patients who have undifferentiated or multisystem disease processes.
4. Physicians care for hospitalised and ambulatory patients.
5. As physicians we play a major role in training and research.
6. Physicians has sub-speciality interest in diseases affecting particular organs or systems.
7. Physicians have the ability to communicate effectively with patients, family and other health professionals.
8. In internal medicine we are committed to professionalism, sticking to ethical principles, and being sensitive to our diverse patients’ population.

3.1 SERVICES PROVIDED

1. Emergency Services

• In-Patient Care
  • Intensive Care Unit (ICU)
    • Isolation Care
    • Adult Male and Female Medical Wards

• Medical Outpatient Care Services

Cardiology Clinic

• Hypertension
  • Heart failure
  • Coronary artery diseases
  • Other cardiac related diseases

Neurology Clinic

• Strokes
  • Seizure disorders
  • Space occupying lesions
  • Other neurological diseases

Pulmonology

• Tuberculosis
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Other respiratory diseases

Endocrinology

• Diabetes Mellitus
  • Thyroid disease
  • Cushing’s Syndrome
  • Other endocrine disorders

Gastroenterology

• Peptic ulcer diseases
  • Gastro Oesophageal Reflux Disease (GERD)
  • Liver diseases
  • Upper Gastro-Intestinal (GI) Bleeding
  • Pancreatitis
  • Other GI Diseases

Dermatology

• Atopic dermatitis
  • Allergic contact dermatitis
  • Psoriasis
  • Lichen planus
  • Sexually transmitted diseases
  • Albinism
  • Skin cancers
  • Nail and hair disorders
  • Other Dermatological Diseases

Nephrology

• Acute kidney injury
  • Chronic kidney diseases
  • Glomerulonephritis
  • Lupus nephritis
  • Other renal diseases

Rheumatology

• Systemic Lupus Erythematosus (SLE)
  • Ankylosing Spondylitis
  • Dermatomyositis
  • Systemic sclerosis
  • Rheumatoid arthritis
  • Other Rheumatological Disorders

Geriatrics

• Arthritis
  • Osteoporosis
  • Parkinson’s Disease
  • Dementia
  • Other Geriatric Conditions

Infectious Diseases

• Human Immune Deficiency Virus (HIV)
  • Tuberculosis
  • Covid-19
  • Viral Haemorrhagic Diseases 
  • Other Infectious Diseases

• Haemodialysis, central line insertion, renal biopsy

• Echocardiography, Electrocardiography (ECG), Thread mill, Holter and ambulatory blood pressure monitoring.

• Spirometry, Bronchoscopy

• Upper and lower GI endoscopy

• Skin biopsy, minor dermatological procedures, phototherapy, cryotherapy, dermoscopy, intra lesional injections.

1. Electro encephalography (EEG)

3.2 Training and Research

• Provides residency training
  • Provides clinical medicine training to house officers and undergraduate medical students
    • Conducts research directly (or in collaboration with other institutions) and publish findings in reputable medical journals.

4.0 OPERATIONAL GUIDELINES

4.1 Medical outpatient care (MOPD)

• the medical outpatient unit clinic is computerized and appointment based
• patients are batched on hourly intervals
• the clinics runs from Mondays to Fridays, with morning clinics running from 9:00am to 12:00pm while the afternoon clinic runs from 12:00pm to 4:00pm at all times the clinics are under the supervision of the overseeing consultant
• all consultations are subject to the laid down hospital procedures

4.2       In-Patient Care

• 24 hours emergency care services
  • 1^st on call – Registrar/House Officer
  • 2^nd on call – Senior Registrar
  • 3^rd on call – Consultant
• All emergencies are attended to either as they arrive or based on the severity of the condition.
• Two Consultant ward rounds in a week
• Two Senior Registrar’s wards rounds in a week
• One Junior Registrar’s ward round in a week

Which are all supervised by the consultant.   

• In suspected cases of infectious disease outbreaks or epidemics patients are isolated and treated appropriately pending confirmation of diagnosis 

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5.0   WEEKLY ACTIVITIES AND SCHEDULES

TIME	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
8AM	Morning Review	Morning  Review	Morning Review	Morning Review	Morning  Review
8.20AM	Morning Review	Case  Presentation	Grand Rounds	Post Graduate Seminar	Journal  Club/ Drug Presentation
Afternoon 2pm	Unit  Presentation	Mortality Meeting/ ClinicoPathological Meeting/ Clinico Radiological  Meeting/ Consultant’s Presentation	Hospital  Grand Rounds Unit Presentations

Hospital grand rounds occur one a month and are arranged by CME committee usually on a Wednesday afternoon

6.0 ORGANISATIONAL CHART

7.0 HEALTH AND SAFETY POLICY

The health and safety of all staff of the Department of Family Medicine is a priority. 

• Staff are expected to observe universal safety precautions at ALL times.

Wearing of facemask, hand washing, use of hand sanitizer and recapping of needles etc. 

• Written copies of safety policy are easily accessible within the department. 
• Post-exposure prophylaxis for infectious diseases will be offered where necessary.
• Work-related hazards should be brought to the notice of supervisory staff as soon as noticed.
• Staff unable to work should report to the staff clinic for proper assessment
• Serious problem or complaint should be reported to management using A.I.R form

8.0 MINIMUM STANDARDS POLICY

Every staff in the department of Internal medicine is expected to adhere to these minimal standards:

• Punctuality: staff should be at their duty posts latest by 8am daily
• Dressing: staff should be clothed in appropriated dressing.
• Privacy and patient confidentiality 
• Follow department Standard Operating procedures (SOP) at all times•Care for patient with empathy and patient-centred approach

9.0 LIST OF STAFF AND QUALIFICATIONS

The current members of staff of the department of Internal medicine and their specific qualifications are listed as follows. 

LIST OF CONSULTANTS

S/N	Name	Year of Fellowship	College	Sub Specialty	Appointment
1	Dr T Uwaezuoke	1999	WACP	Cardiology	Full time
2	Dr D Osunkwo	1999	WACP	Cardiology	Full time
3	Dr O Osi-Ogbu	2004	WACP	Geriatrics	Full time
4	Dr F Fiberesima	2004	WACP	Pulmonology	Full time
5	Dr O Falodun	2007	NPMCN	Dermatology	Full time
6	Dr K. Osagie	2009	WACP	Pulmonology	Full time
7	Dr H Haruna	2010	WACP	Nephrology	Full time
8	Dr H Galadanci	2011	WACP	Nephrology	Full time
9	Dr L Sabir	2012	WACP	Dermatology	Full time
10	Dr S Alimi	2013	WACP	Neurology	Full time
11	Dr O Fasan	2015	WACP	Cardiology	Full time
12	Dr A Eguagie	2016	NPMCN	Gastroenterology	Full time
13	Dr R Shuaibu	2019	NPMCN	Endocrinology	Full time
14	Dr S Oyakhire	2018	NPMCN	Neurology	Full time
15	Prof F Anumah	2000	NPMCN	Endocrinology	Part time
16	Prof A Oyati	2003	NPMCN	Cardiology	Part time
17	Dr Y Zubair	2015	WACP	Neurology	Part time
18	Dr W Tiamiyu	2016	NPMCN	Infectious Diseases	Part time

LIST OF SENIOR REGISTRARS

S/NO	NAME	SPECIALTY	COLLEG E	COMMENTS
1	BELLO, HARAZUMI	CARDIOLOGY	WACP
2	ODUMODU, KENECHUKWU	ENDOCRINOLOGY	NPMCN	POST PART 2
3	ODOH-OYAKHIRE N.	DERMATOLOGY	NPMCN	POST PART 2
4	JIBRIL, IHSAN M.	DERMATOLOGY	NPMCN
5	EJIGAH, FOLAKE	CARDIOLOGY	WACP	POST PART 2
6	IHEME, CHIOMA PEACE	CARDIOLOGY	WACP	POST PART 2
7	MONWUBA, JOY	NEPHROLOGY	WACP
8	UMORU, MOHAMMED B.	CARDIOLOGY	WACP
9	OKWUASABA, UZOH G.	GERIATRICS	WACP
10	SARKI, ABDULSHAHID	NEPHROLOGY	WACP	POST PART 2
11	AGBURUM, IFEOMA F.	NEPHROLOGY	WACP	POST PART 2
12	EMMANUEL, E.T.	CARDIOLOGY	WACP	POST PART 2
13	WADZANI, OLUSAYO M.	NEUROLOGY	NPMCN
14	OKPECHI SOPHIA	NEPHROLOGY	WACP
15	DR ULU, DORCASOBIDIYA OKORO,	PULMONOLOGY	WACP
16	OBAMIYI, HENRY TOPE	NEUROLOGY	WACP
17	OKORAFOR, SAM	GASTROENTEROLOGY	WACP
18	BATURE, AMINA	NEUROLOGY	WACP
19	OKEKE, CATHERINE	CARDIOLOGY	NPMCN
20	BAYERO, JAMILLAH	GASTROENTEROLOGY	NPMCN / WACP
21	ADEKEYE, ADEOLA	DERMATOLOGY	WACP
22	MOMODU, JAFARU	PULMONOLOGY	NPMCN / WACP
23	ALYU, FARIDA	NEUROLOGY	WACP
24	BALOGUN, OMOYEME	NEUROOLOGY	WACP
25	DAWUDU, BLESSING	NEPHROLOGY	NPMCN / WACP
26	KOLLERE, FATIMA	NEPHROLOGY	WACP
27	SAMBO, S.A.	CARDIOLOGY	WACP

LIST OF REGISTRARS

S/NO	NAME
1	AJEMIGBITSE HELEN
2	DRABDULLAHI, SHAMSU DANGULBI
3	Dr OZOR, CHIBUEKE INNOCENT
4	DR LANRE-AREMO, O. OPEYEMI
5	DR EGBON, NKECHI ANITA
6	DR OBI, CHUKWUNONSO OKECHUKWU
7	DR IBEAWUCHI, UGO NNENA ANN
8	DR OLAREWAJU, FOYEKE TOLUSE
9	DR BALA, NAFISA JA’AFAR
10	DR KARAYE, RABI SURAJ
11	DR OHWEVWO, EFETUWERE W.
12	DR C. UDU
13	DR PERE

ADMINISTRATIVE STAFF

S/N	NAME	RANK	QUALIFICATION
1	Mrs. Esther Sylvester:	Departmental Secretary	HND
2	Mr. Uyi Johnson	Clerical officer	National Diploma in Hospital Management

List of Support Staff for Specialized Services

The Neurology Laboratory has two trained EEG Nurse and One EEG Technician 

Mrs. Kemi Ekpen:        EEG Nurse

Miss Nike Aibu            EEG Nurse

Mr. Mike Obarudi        ECG Technician

Mrs. Dorcas                    ECG Technician 

Supporting Department/services

Full radio-diagnostic services: CT-Scan (including 64 slides CT-Scanner), MRI (1.5T), Doppler.

Full automated Chemical Pathology, Haematology, Medical microbiology and

Morbid Anatomy and Molecular Biology Laboratories

Full Oncology- clinical oncology, chemotherapy, radiotherapy

Nuclear Medicine for both diagnosis and therapeutic purposes

Computerized medical records

Computerized accounting system

Dietetics

Physiotherapy

Contact email: hod.internalmedicine@nationalhospital.gov.ng