NABH Questions Assessors Ask Staff, with Model Answers

How assessors question staff

NABH assessors do not only read policies; they test whether the policies are followed. They follow patients through the hospital and stop to ask the people they meet: the ward nurse, the resident, the pharmacist, the housekeeper, the security guard and the laboratory technician, including outsourced staff. Questions are usually open ("What do you do if…?") and often end with "Show me": the crash cart, the spill kit, the incident form, the high-alert medicine shelf.

A good answer says what you do and where the written guidance is kept. The model answers below follow the NABH 6th Edition standards; replace any detail with what your own policy says, because assessors compare what staff say with your documents.

Questions every staff member should be ready for

How do you identify a patient? With at least two identifiers, usually the full name and the unique hospital ID, checked before giving medicines, blood or treatment, before taking samples or doing procedures, and when handing over reports. Never the bed number. This is a Core element (COP.1.b).

What rights does a patient have here? Respect for beliefs and privacy, confidentiality, protection from abuse, information about the treating doctor, diagnosis, care plan and expected cost, informed consent, the right to refuse treatment or seek another opinion, access to their records, and the right to complain. The rights and responsibilities are documented and displayed (PRE.1 and PRE.2).

What do you do if a patient or relative complains? Listen without arguing, try to solve it on the spot if it is within my role, and tell the in-charge. The complaint is registered through the hospital's grievance procedure and answered within the defined time (PRE.7).

What will you do if you see a fire? Follow RACE: rescue anyone in immediate danger, raise the alarm and call the fire code, contain the fire by closing doors, then extinguish it if it is small and safe to do so, or evacuate. Use an extinguisher with PASS: pull the pin, aim at the base, squeeze, sweep. Do not use lifts, and know your nearest exit and assembly point (FMS.7, HRM.6.f).

What are the emergency codes here? Each hospital defines its own codes, and staff must know them and the number to dial. Common examples are code blue for cardiac arrest, code red for fire and code pink for infant or child abduction. NABH requires plans for both fire and non-fire emergencies, and mock drills at least twice a year (FMS.7.a, FMS.7.b, FMS.7.d).

What is your role in a disaster or mass casualty event? Report to my designated place and do the role the disaster plan gives my department. Training on the disaster plan is a Core element (HRM.6.e), and the plan is tested at least twice a year (COP.4.d).

When do you clean your hands, and for how long? At the WHO's five moments: before touching a patient, before a clean or aseptic procedure, after a body fluid exposure risk, after touching a patient, and after touching the patient's surroundings. An alcohol hand rub takes 20 to 30 seconds; washing with soap and water takes 40 to 60 seconds.

How do you segregate biomedical waste? At the point of generation, by the four colours of the Bio-Medical Waste Management Rules, 2016: yellow for anatomical and soiled waste, expired or discarded medicines and chemical waste; red for contaminated recyclable plastics such as tubing, IV sets, catheters, urine bags and gloves; white translucent puncture-proof containers for sharps; and blue-marked boxes for glassware such as vials and ampoules, and metal implants. Needles are never recapped.

What do you do after a needle-stick injury? Wash the site straight away with soap and running water without scrubbing, report to the in-charge at once, and go for a risk assessment as the needle-stick policy says. If HIV post-exposure prophylaxis is advised it should start as early as possible; started after 72 hours it is not recommended. The injury is recorded and followed up.

What do you do with a blood spill? Use the spill kit as the infection control policy says: protect yourself, contain and absorb the spill, disinfect with the approved disinfectant, discard the waste in the right colour bag and wash your hands.

What is an incident, and how do you report it? Any event during care that is inconsistent with the expected outcome or routine operations, from a near miss that caused no harm to a sentinel event, meaning death or serious harm caused by the care rather than the illness. I report it on the incident form or system within the defined time, and reporting is not for blame (PSQ.7).

What quality indicators does your department track? Name two or three of your department's indicators and the latest trend, for example hand hygiene compliance or medication errors. Our NABH quality indicators list has the full set.

What is the hospital's mission? Say it in your own words. Vision, mission and values are part of induction training (HRM.3.b).

Questions for nurses

Which medicines are high-alert here, and how are they stored? The ones on the hospital's high-alert list, such as concentrated electrolytes, insulin, heparin and narcotics. They are stored apart and labelled, and look-alike, sound-alike medicines and different strengths of the same medicine are kept physically separate (MOM.3.c and MOM.3.e, both Core).

What do you check before giving a medicine? The right patient with two identifiers, the right medicine, dose, route and time against the written order, and the medicine itself: label, expiry and appearance. Then I document it (MOM.7.d, Core).

How do you take a verbal order? Only when the policy allows it, such as an emergency. I write it down, read it back to the doctor and get it countersigned within the time the policy sets (MOM.4.f, Core).

What do you do if a patient has an adverse drug reaction? Stop the medicine if it is safe to do so, inform the doctor, treat as ordered, and report the reaction (MOM.8.c, Core).

How do you assess the risk of falls, pressure ulcers and DVT? With the hospital's risk scores at admission and on reassessment, then the prevention measures the score calls for, such as side rails and assisted walking, position changes, or DVT prophylaxis as ordered. All four high-risk elements in COP.16 are Core.

When can a patient be restrained? Only as the restraint policy allows, usually on a doctor's order and with the family informed. The patient is monitored and reassessed at the intervals the policy sets, and everything is documented (COP.16.e).

What do you do before and during a blood transfusion? Check that consent is signed (PRE.2.g, Core), verify the patient and the blood bag at the bedside as the policy says, monitor for reactions, and complete the post-transfusion form (COP.8).

Where is the crash cart, and how is it checked? Say where it is, that its contents follow the standard hospital list, and how often it is checked and restocked after use (COP.5.c, MOM.3.g).

What else is checked at admission? Pain screening (COP.17.b), nutritional risk screening (COP.19.a), and early warning signs of deterioration, which trigger a prompt response (AAC.5.e).

Questions for doctors

Who takes informed consent, and what does it cover? The person performing the procedure (PRE.4.e, Core). It covers the procedure, its risks, benefits and alternatives, and who will perform it, in a language the patient understands (PRE.4.c, Core).

What is done before and during anaesthesia? A pre-anaesthesia assessment that leads to a documented anaesthesia plan (COP.13.b, Core) and a pre-induction assessment. During anaesthesia, temperature, heart rate, cardiac rhythm, respiratory rate, blood pressure, oxygen saturation and end-tidal CO2 are recorded (COP.13.e, Core).

How do you prevent wrong-site surgery? By marking the site, verifying the patient and procedure, and doing a time-out before the incision (COP.14.d, Core). The operative note is written before the patient leaves recovery (COP.14.e).

What are you privileged to do here? Name your privileges as granted by the credentialing committee; you should work within them (HRM.11).

How are critical results handled? The laboratory and imaging staff report them to the person concerned at once (AAC.6.g and AAC.8.f), and I act on them and document it.

What must a discharge summary contain? Standard content including follow-up advice, medicines and other instructions in plain language, and when and how to get urgent care (AAC.13). Every entry in the record is signed, dated and timed, and only approved abbreviations are used (IMS.3).

Questions for support departments

Housekeeping: waste segregation by colour, spill management, the cleaning schedule for their area, the right dilution of disinfectants, protective equipment and hand hygiene.

Security: the fire response and emergency codes, visitor control and restricted areas (FMS.3.a), measures against child and newborn abduction (COP.11.f), and handling workplace violence (HRM.9.d, Core).

Pharmacy: the formulary (MOM.2.a, Core), storage temperatures and cold chain records (MOM.3.a, Core), look-alike, sound-alike storage, near-expiry and recall procedures, and the narcotics register (MOM.9).

Laboratory: sample labelling with two identifiers, sample rejection criteria, critical value reporting (AAC.6.g), and internal quality control.

Maintenance and biomedical engineering: preventive maintenance and calibration schedules (FMS.4 and FMS.5), backup power and water tests (FMS.2.f), and the alternate medical gas supply (FMS.6.d, Core).

Questions for managers and the quality team

Expect questions on the quality and patient safety programmes, which indicators you monitor and how the data is verified (PSQ.3), your latest improvement project and clinical audit (PSQ.4 and PSQ.5), committee minutes, monthly facility rounds (FMS.1.c), drill reports (FMS.7.d), statutory licences (ROM.4.b, Core) and credentialing records (HRM.11 to HRM.13). Our chapter guides explain each area: PSQ, FMS, ROM and HRM.

How to prepare your staff

1. Teach your own policies first, then these questions. A generic answer that contradicts your SOP counts against you.
2. Make a one-page question sheet for each department and use it in ten-minute huddles.
3. Practise "show me": the spill kit, the crash cart, the incident form, the fire exit.
4. Run a mock assessment in which someone from outside asks the questions, including to night staff and contract workers.
5. Keep training records current, because assessors check them too (HRM).

Our staff training service runs department-wise NABH training and mock assessments, and the NABH documents checklist lists the policies these answers come from.