The Internal Regulations of NH Hospital a.s. - Hospital Hořovice are binding for all inpatients and outpatients.
In accordance with Act No. 372/2011 Coll. on Health Services and Conditions of their Provision, the Internal Regulations set out the rules, rights and obligations of all persons who are present in the NH for the purpose of seeking, providing and ensuring health care.
If a patient has consented to the provision of health services and seriously restricts the rights of other patients, deliberately and consistently fails to comply with the proposed individual treatment procedure, or fails to comply with the Internal Regulations of NH Hospital a.s. - Hospital Hořovice and his/her behaviour is not caused by a medical condition, NH may terminate the patient's care.
Admission of the patient
Upon admission to the hospital (inpatient/outpatient care), the patient is obliged to present his/her ID card and health insurance card at the request of an NH employee.
In order to ensure the safety of the health care provided, on admission to the hospital in the outpatient clinic, central reception or the destination ward, patients are provided with a personal identification bracelet containing the following data: first name, surname, date of birth, unique numerical code generated by the hospital information system.
The patient is admitted to hospital on the basis of a written informed consent, which is signed by the medical staff within 24 hours of admission.
When providing health services to a minor patient, the opinion of the minor patient shall be sought with regard to the provision of the intended health services, if this is appropriate to the patient's mental and volitional maturity. This opinion must be taken into account as a factor which increases in importance in proportion to the age and degree of mental and voluntary maturity of the minor patient.
The patient may withdraw his or her consent to the provision of health care services. Withdrawal of consent shall not be effective if the performance of a medical procedure has already begun, the interruption of which may cause serious damage to the health or endanger the life of the patient.
The patient has the right to express informed consent to the provision of health services. This shall be recorded in writing in the form of a negative reverse in the patient's medical record. If time conditions permit, it is recommended that the patient's expression of disagreement be repeated at least twice within a time interval of 30 minutes. Prior to signing the negative reversal, the patient must be informed by the physician of the seriousness of the medical condition to the extent and in a manner that makes it clear that failure to provide medical services may seriously harm the patient's health or endanger his/her life, and is informed of possible alternative solutions. All information provided to the patient is recorded on the negative reverse and placed in the patient's medical record with the signature of the informant, the informed and the witness.
As part of the informed consent, the patient provides the names of the persons, the relationship of these persons to the patient and the contacts of the persons to whom information about the patient's condition may/may not be communicated, within a predetermined scope. These persons, as well as the scope of the information to be communicated, may be changed during the course of the hospitalisation.
In the case of a minor patient or a patient with limited legal capacity, the right to health information and the right to ask questions shall be vested in the patient's legal representative or guardian and in the patient if he or she is of reasonable mental capacity and freedom to do so.
If the court assigns a guardian or legal deputy to the patient, everything outside the acute procedures must be discussed with these persons and informed consent is subject to their decision.
In order to ensure the protection of personal and sensitive data, information about the patient's medical condition may only be communicated to the persons named in the informed consent and on the basis of a communication of a predetermined password.
On admission to the hospital, the patient brings with him/her the required documentation (e.g. laboratory results, X-rays, admission referral, pre-operative examination, disability certificate, etc....).
If the patient has any type of allergy, he/she is required to disclose this information to the medical staff of the department.
Decision on temporary incapacity for work, on the need for treatment
The employed person is entitled to be issued the following upon the decision of the attending physician:
- Decision on temporary incapacity for work
- A decision of temporary incapacity for work is issued on admission for inpatient/outpatient treatment, up to a maximum of 3 days back. In cases where the patient's health condition does not allow for a statement on the issuance of temporary incapacity for work within the statutory period of 3 days, a request for retroactive recognition of incapacity for work can be submitted to the relevant department of the CSSA.
- Decision on the need for treatment
- Decision on the need for long-term care
It is issued at the request of the person being treated, his/her legal deputy, guardian or a person designated by the person being treated. The decision must be issued on the day of discharge from hospitalisation - if it lasts at least 7 days, it cannot be issued retrospectively.
Nursing staff
The patient has the right to know the name of his/her attending physician and other members of the healthcare team.
All NH staff are visibly identified with a card showing their name, surname, title and function.
Teaching and training of medical students and medical school students takes place within the hospital. Teachers and students are part of the medical team, participating in the diagnosis and treatment of patients under the supervision of fully qualified medical staff. The patient has the right to be informed of this fact and to refuse the presence of these persons at any time. This is recorded in the informed consent to hospitalisation (part of the patient's medical record).
Diagnostic and therapeutic plan
Each patient is treated individually in the provision of healthcare on the basis of an individual treatment plan.
The diagnostic and therapeutic plan is determined by the physician in collaboration with the patient and other members of the healthcare team, based on the patient's current health problem and pre-existing condition, in a logical and time sequence, based on recommended medical and nursing procedures, with the support of modern technology.
The treatment pathway includes diagnostic assessment, treatment design, treatment regimen and discharge planning.
The patient is obliged to comply with this regimen and to truthfully inform the medical staff of the development of his/her condition.
The patient has the right to ask the attending physician at any time for information about his/her state of health, the course of treatment, the results of individual examinations and the planned course of treatment.
The patient shall be entitled to request the opinion of another physician under the conditions laid down by law.
It is the duty of the medical staff to verify the patient's identity before each diagnostic and therapeutic procedure by asking for the patient's name, surname, date of birth and checking the accuracy of the data on the identification bracelet.
Patient's personal belongings
The patient comes to the hospital with only personal clothing and items required for hospitalization (safe slippers, pyjamas, dressing gown, items for personal hygiene - towel, soap, toothbrush and toothpaste, washcloth, comb, shaving, etc.).
On admission to the hospital, the patient shall place his/her belongings in a designated place designated by the nursing staff of the relevant department.
During hospitalisation, the patient shall have a designated area for civilian personal clothing, shoes and a bedside table.
It is not advisable to carry large amounts of money or valuable items (jewellery, watches, glasses, valuables, etc.) on admission. If this is the case, valuables and larger sums of money can be stored against the receipt in the hospital safe. Only in this case can the patient claim any losses against the hospital. If this is not done, the NH is not liable.
These items/cash will be returned against the same receipt on discharge from hospital.
Mobile phone, laptop and other small electrical appliances are allowed to be used during the hospitalisation with the following restrictions: medical staff visits, examinations, medical procedures.
The use of a mobile phone is allowed as long as its use does not disturb other patients and healthcare professionals in the performance of their duties.
The patient may use other electrical devices only with the consent of the attending staff.
It is strictly forbidden to bring weapons, ammunition, long-bladed knives, explosives or other dangerous objects into the NH.
Drugs brought in
If the patient brings chronic medication to the hospital, he/she is obliged to inform the nursing staff of this fact.
On admission to the ward, the patient shall hand over the medicines to the medical staff, who shall register them and store them in a safe place.
The patient must not take any medication brought in during the hospitalisation without the knowledge and advice of the physician.
If a chronic medication is prescribed and a medication from that medication is not available in the NH, the patient may be given the medication brought in from the original, non-expired package for as long as necessary.
At the end of the hospitalization, the stored medication is returned to the patient.
Daily regimen
- The patient has the right to privacy.
- The daily routine, including rounds, depends on the operating conditions of each ward and is determined by its house rules.
- The daily routine of the ward is communicated to the patient on admission and the patient is obliged to follow it.
- The patient shall be respectful of other patients and their rights throughout the hospitalization, shall not interfere with the treatment regimen of other patients and shall allow the medical staff to perform their duties.
- The patient is obliged to behave courteously towards the healthcare staff and respect their instructions.
- If the patient has consented to the provision of medical services, deliberately and consistently fails to comply with the proposed individual diagnostic and treatment plan, severely restricts the rights of other patients, or fails to comply with the Internal Regulations of NH Hospital a.s. - Hospital Hořovice and his/her behaviour is not caused by a medical condition and is not life-threatening, NH may prematurely terminate the care of such patient.
- The patient is obliged to keep the rooms and all areas of the NH clean and tidy.
- The patient is obliged to be respectful of the hospital's facilities and not to destroy them.
- Financial compensation is required for any damage caused by the patient to NH property.
- It is forbidden to make audiovisual recordings of other persons during hospitalization without their consent.
Familiarisation with the operation of the ward
Each patient is obliged to familiarize himself/herself with selected documents of the department/NH (Internal Regulations of NH Hospital a.s. - Hospital Hořovice, Home Rules of the department, Fire Alarm Directive, Patients' Rights) upon arrival to the hospital.
Fire alarm directives with marked escape routes are placed visibly on the walls of each workplace.
The patient has the right to familiarise himself with the spatial layout of the ward in which he is admitted.
Hygiene and epidemiological regime
The patient shall be placed in a ward room according to the physician's surgery.
The patient shall comply with the hygiene and epidemiological measures as instructed by the medical staff.
The medical staff is obliged to comply with the hygiene and epidemiological regime according to the attending physician's order.
Disinfectants for hygienic hand disinfection shall be available to the patient.
The patient has the right to change bed linen at least once every 7 days, when soiled and further according to the specifics of each ward.
It is forbidden to bring flowers into the hospital and to place them in the ward areas.
The patient's escort is prohibited from entering strictly aseptic areas of the hospital (central operating theatres, operating theatre of the obstetric ward, operating theatres).
Handling of waste
Waste is sorted in NH according to the legislative requirements of the Czech Republic.
In connection with the hospitalization of a patient, the most frequently generated waste is municipal waste, hazardous waste, packaging material - plastics, glass.
In the rooms of standard wards there are bins for municipal waste, which are marked with the NH label with the waste code 20 03 01.
In ICU/resuscitation rooms, waste bins are labelled NH with the hazardous waste code 18 01 03.
Plastic packaging is disposed of outside the municipal waste stream in separate containers (yellow bags), labelled with the NH waste code 15 01 02.
Glass waste is handed over by the patient to the staff of the unit, who subsequently dispose of it under the code 15 01 07.
Catering
Meals and diet are determined by the attending physician in the practice.
Unless otherwise specified by the attending physician, it shall be served 3 times/24 hours at times according to the house rules of each department.
Meals are served by a tablet system.
A table and chairs are available in patients' rooms for mobile patients to eat.
For non-ambulatory patients, food is delivered to the bedside.
In justified cases, the patient is provided with a consultation of a nutritional therapist.
Patients may consume their own/bring their own food and drinks only with the approval of the medical staff.
Patients have a refrigerator at each unit for storing their own food and drinks.
Food and drink intended for storage in this refrigerator shall be labelled with the patient's identification (name, surname, date of birth).
Food is regularly checked by staff and the hospital reserves the right to dispose of expired and unlabelled food.
Visit
Patients have the right to receive unlimited visits, taking into account their health condition, the running of the facility and fellow patients.
The terms and conditions of visits to each department are set out in the departmental house rules and vary according to the needs and specifics of each department.
The hospital is entitled to temporarily restrict/prohibit patient visits for serious reasons (epidemiological situations).
Visits to the AICU and intensive care beds are not appropriate for children.
Visits
If the patient is allowed to go out, he/she uses civilian shoes.
The patient must inform the nurse before leaving the unit.
It is not allowed to leave the hospital premises during walks.
Spiritual and spiritual services
In the provision of health care, hospital staff respect the value system of patients.
Issues of a patient's spiritual and pastoral needs are primarily evaluated upon admission to the hospital.
The patient has the right to express his/her request to have these needs met at any time during the hospitalization.
The medical staff will facilitate these services if requested.
Addictive substances
The use of alcohol and other addictive substances is prohibited during hospitalisation.
The patient is obliged to undergo, at the physician's discretion, in justified cases, a test to prove whether or not he/she is under the influence of alcohol or other addictive substances.
Smoking is prohibited in all NH buildings/premises.
Violations of these prohibitions may result in consequences.
Opinions and comments
Patients can give their views and comments on their stay in the hospital using the forms provided for this purpose.
Forms are located next to the mailboxes, at the entrance of each unit or upon request from the medical staff.
Completed forms are dropped into the freely accessible boxes located at the entrance of each unit.
Expression of dissatisfaction
- The patient has the right to express his/her satisfaction/dissatisfaction w/the course of his/her hospitalization.
- The patient may express his/her views verbally or in writing by means of a satisfaction questionnaire, which is placed at the entrances of each inpatient unit and in the outpatient areas of the hospital.
- Many comments or dissatisfaction often arise from misunderstanding or misinterpretation of the situation and can be resolved by immediate joint discussion.
Complaints
In the event of serious doubts about the course of hospitalisation, the treatment regimen or the quality of the health services provided, the patient has the right to express his/her reservations.
The form of complaint may be oral or written.
The patient may contact any member of the healthcare team, who is obliged to inform the management of the unit and the Quality of Care Department immediately.
The procedure for making a complaint is set out on the hospital's website.
Superior accommodation
NH offers the possibility of accommodation in superior rooms.
Charges for superior rooms are not covered by public health insurance and can be used at an additional cost according to the current price list published on the hospital's website or available on request from the medical staff.
The possibility of accommodation in superior rooms is limited by their capacity.
Hospitalization of accompanying persons
Co-hospitalisation of accompanying persons shall be decided by the chief physician on the basis of the patient's medical condition, taking into account the capacity and operational possibilities of the unit.
The hospital shall have the right to limit the presence of the escort in cases where the escort shows signs of infectious disease or intoxication or if the escort is aggressive or violent.
Accompanying a child during hospitalisation
The child shall have the right to the continuous presence of a legal deputy, another person close to him or her or a person designated by him or her, during the provision of health services.
The decision to admit a child's companion to a bed shall be taken by a physician on the basis of the availability of beds. In the case of full occupancy of the ward by pediatric patients, the escort shall not be entitled to a bed.
Hospitalisation of the escort in the standard ward and ICU is covered by the patient's health insurance for children under 6 years of age.
In the case of children over 6 years of age, the stay of the escort in the ward is not covered by the health insurance and does not give rise to a claim for incapacity for work; however, it is possible to hospitalize the child's escort at the child's own expense (see the price list of services and procedures).
The escort is admitted for hospitalisation in view of the child's needs and therefore takes care of the child within the scope of care as instructed by the attending staff.
The accompanying person shall inform the health professionals when he/she plans to be present with the child and when not.
In cases where the presence of only one deputy is objectively possible, the primary criterion shall be the child's wishes. If the child is unable to express his or her will on this issue, it is up to the parents to find a consensus on this issue.
A child of adequate volitional and intellectual maturity has the right to express his or her wish that a particular deputy or a person close to him or her not be present.
A chaperone may accompany the child to the operating room handover area and may be present in the recovery room thereafter. For operational hygiene reasons, the accompanying person is not allowed in the operating theatre itself.
Presence of a dog with special training
A patient with a sensory or physical disability who uses a guide or assistance dog has the right, in view of his/her current state of health, to be accompanied and to have the dog present in the healthcare facility, subject to the conditions set out below:
- the patient is able to provide routine care for the dog himself or herself or through another person;
- the ward concerned has a suitable space to accommodate such a dog with the patient;
- the presence of the dog is possible only with the agreement of the chief physician of the concerned department, taking into account all the circumstances, in particular the hygiene conditions and the rights of other patients;
- the patient/accompanying person must produce the dog's vaccination certificate with valid vaccinations required by law.
The presence of a dog is prohibited in the Central Operating Rooms, Delivery Rooms, Neonatal Ward, AICU and ICU.
Discharge of the patient from hospitalization
The patient has the right to be informed about the planned discharge from hospitalisation.
On discharge, the patient shall be informed by the attending physician of the course of treatment to date and of the further planned course of treatment.
On discharge from hospital, the patient shall be provided with a provisional/final discharge report and prescribed medicines for the period necessary (3 days).
Within three days of discharge from hospital, the patient must see his/her physician and present the discharge report to consult on further treatment.
After the end of the hospitalisation, the patient is obliged to pay all charges for health services provided that are not covered by health insurance.
Ambulance transport for patients who are unable to transport themselves to their place of residence or other designated place shall be decided by the attending physician at the time of discharge.
Self-paying patient
A patient has the right to be informed in advance of the cost of health services not or partially covered by public health insurance and the method of payment for them, if his/her health condition so permits.
If a self-paying patient is admitted for a planned hospitalisation in NH, the referring physician is obliged to inform the insurance department of this fact, which will prepare a preliminary financial calculation for the self-paying patient for this hospitalisation on the basis of the list of planned procedures. The patient shall confirm his/her agreement with this preliminary financial calculation by signing the agreement.
The patient shall be obliged to reimburse the provider for the cost of health services not or partially covered by public health insurance or other sources which have been provided with his/her consent.
The amount of payment for the provision of a health service is set at CZK 3 / 1 point (the amount of points for individual health procedures is determined by the List of Health Procedures with point values).
Regulatory fees
The patient pays only the regulatory fee, if set.
Social services
NH provides the services of a social worker.
Services offered:
- Socio-legal counseling,
- social investigations for socially at-risk patients, for patients without their own social background, for non-resident patients,
- cooperation in the provision of field social services such as home care and personal assistance,
- cooperation and provision of social services, such as a home for the elderly, a hospital for the long-term sick, a nursing home, a children's home, a hospice, etc,
- information service for people with disabilities.
Inspection of medical records kept on the patient, taking extracts and copies
The medical records kept on the patient are the property of the health service provider.
Access to the medical records, making extracts and copies is possible on the basis of a request submitted to the Care Quality Department and payment of a fee according to the currently valid "Price list for administrative tasks". The application form is freely available for download on the website of NH Hospital a.s., as well as on request from the medical staff of the department and the Quality of Care Department.
Closed medical records
The closed medical records (post inpatient/outpatient treatment) may be inspected, copied and abstracted:
The patient on the basis of an identity check.
- The legal guardian of a minor on the basis of checking the identity of the legal guardian and the birth certificate of the minor. In the case of minor children of divorced parents or parents not living in the same household, both parents have the right to information unless a final court order limiting or terminating parental rights has been documented.
- The guardian to whom the patient has been entrusted by court order, based on a check of the guardian's identity and the court's decision.
- A person designated by the patient on the basis of a certified power of attorney relating to the current application, within a well-defined scope, which shall cease upon the death of the patient, unless the wording of the power of attorney indicates otherwise.
- In the case of a deceased patient, the person close to the patient, unless excluded under Act 372/2011 Coll.
Open medical records
The patient has the right to inspect, make copies of and take extracts from open medical records (during hospitalisation/outpatient treatment):
- The patient on the basis of an identity check.
- The legal deputy of a minor on the basis of checking the identity of the legal deputy and the birth certificate of the minor. In the case of minor children of divorced parents or parents not living in the same household, both parents have the right to information unless a final court order limiting or terminating parental rights has been documented.
- The guardian to whom the patient has been entrusted by court order, based on a check of the guardian's identity and the court's decision.
- The person designated and named by the patient in the informed consent for hospitalisation, based on verification of the identity of the designated person.
Previously expressed wishes
The patient may, in the event that he or she becomes in a state of health in which he or she is unable to consent or object to the provision of health care services and the manner in which they are provided, express such consent or objection in advance.
The previously expressed wish shall be in writing with a certified signature and written instructions on the consequences of such a decision by the registering general practitioner and the specialist physician to whom the previously expressed wish relates.
A patient may also make an expressed wish on admission to or during hospitalization and such previously expressed wish relates to the current hospitalization, for the provision of health care services by that provider after signature by the patient, the physician, and a witness.
The previously expressed wishes are not applicable to minors and persons with diminished capacity.
Validity: from 1 September 2023
Basic patient rights
Health services may be provided to a patient only with his/her free and informed consent, unless otherwise provided by Act No 372/2011 Coll. on Health Services and Conditions of their Provision.
The patient has the right to the provision of health services at an appropriate professional level.
In addition, when providing health services, the patient has the right to:
- respect, dignified treatment, consideration and respect and privacy,
- choice of health service provider,
- to request the consultative services of another provider ('second opinion'),
- to be familiar with the 'internal rules' and other regulations relating to the health service provision regime,
- the continuous presence of a legal deputy, foster parent or person entrusted with the patient's care; the continuous presence of a guardian in the case of a patient with limited capacity; the presence of a relative or a person designated by the patient,
- to be informed of the cost of services not or partially covered by public health insurance and of the method of payment, if his/her state of health so permits,
- to know the name, where appropriate, of all staff directly involved in the provision of health services,
- refuse the presence of persons not directly involved in the provision of health services, including students,
- to receive visitors in accordance with his/her state of health, in accordance with the internal rules and with respect for the privacy and rights of other patients,
- to receive spiritual care,
- to the provision of health services in the least restrictive environment while ensuring the quality and safety of the services provided,
- to receive information about other services and possible social services that may lead to the improvement of his/her current or future health status.
Patient's responsibilities
The patient (legal deputy, guardian) is obliged to
- The patient (legal deputy, guardian) is obliged to
- comply with the proposed individual treatment procedure if he/she has consented to the provision of health services,
- follow the internal rules,
- pay the cost of the health services provided to him/her, not covered or partially covered by public health insurance or other sources, which were provided with his/her consent,
- truthfully inform the treating health care professional about the current state of health, including information about infectious diseases, health services provided by other providers, use of medicines, including substance abuse, and other facts relevant to the provision of health care services,
- not consume alcohol or other addictive substances during hospitalization and, at the discretion of the attending physician, undergo testing to determine whether or not he or she is under the influence of alcohol or other addictive substances, if warranted.
Proof of identity
The patient, the patient's legal deputy or guardian, a close relative or a person in the same household shall be obliged to provide proof of identity by means of an identity card at the request of a healthcare professional. A person who claims the right to health information shall also be obliged to provide proof of identity. If the patient, legal deputy or guardian refuses to provide proof of identity, the hospital may refuse to provide the requested assistance or health service, unless the patient is a patient in need of emergency care.
The Code of Conduct for Patients' Rights was developed in relation to the Charter of Fundamental Rights and Freedoms. Patients' Rights were promulgated by the Central Ethics Committee of the Ministry of Health of the Czech Republic on 25 February 1992.
