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Hygiene of medical establishments, their planning and equipment. Modern problems in hospital building. Hygienic measures of optimization terms of stay patients in medical establishments. Prophylaxis of hospital infections. Hygiene of labor doctors and different specialties. A hospital is an institution for health care providing patient treatment by specialised staff and equipment. But not always providing for longer-term patient stays. The site land area depends on the power, specialization and system of the hospital group of buildings site development Number of beds Area norm per 1 bed, m2 Number of beds Area norm per 1 bed, m2 up to 50 300 > 400 to 800 100-80 > 50 to 100 300-200 80-60 > 100 to 200 200-140 > 800 to 1 000 > 1 000 >200 to 400 140-100 60 Decentralized (pavilion) type of hospital each department is situated in the separate building; The positive feature of the decentralized system is the possibility of patients to stay more outdoors; The drawback of the centralized system is the difficulty of nosocomial (intrahospital)infections prevention, Decreased time or impossibility of the patients to stay outdoors. Noise Centralized-blocked system of hospital Such version ensures both centralization of medical processes and using of equipment and realization of a principle of isolation of separate medical departments. The hospital site housing density depending on the amount of beds should not exceed 10 – 15 %. Up to 60 – 65 % of the area should be occupied by all kinds of green area; 20 – 25 % - a household zone, passages and passageways. The size of the landscape zone should be not less than 25 m2 per one bed. Hospital consist from next department: 1. Reception department; 2. Treatment and surgery department, genecology , children, infection, emergency, radiology department and other 3) Policlinic ; The building of the policlinic must be location on distance 30—50 m from hospital. Entrance must be separate. 4) Treat mentally and diagnostically departments with department functionally diagnostic, x-ray diagnostic, physiotherapy and rehabilitation department; 5) Pathological department; 6) Sterilization department and garage and other 7) Administration department, library, addition department and economical department. Isolator consist of ward, lock, tambours and restroom. Square of box is 22 m2. Surgical department Children’s departments Each hospital department is intended for patients with similar diseases. It should include: ward sections for 30 beds, with 6 wards for 4 beds with the area of 7 m2 per bed, 2 wards for 2 beds with the area of 7 m2 per bed wards 2 wards for 1 bed with the area of 9-12 m2 for severe somatic and infectious patients, with the cubic capacity of 20-25 m3 for each patient and the ventilation volume – 40-45 m3/hour. There can be two types of the corridor: a side one with windows facing towards the Northern points, or a central – with light gaps (halls). The nurse workplace is located in the corridor in order to supply a good review of the wards. Natural ward lighting should provide the daylight coefficient (DC) of not less than 1%, the lighting coefficient (LC) 1:5 – 1:6; in the procedure, manipulating, dressing and operating – DC respectively is 1.5 – 2 %, LC – 1:3 – 1:5. The wards ventilation should be achieved by means of exhaust ventilation ducts, presence of window leaves and windows which can be opened; the modern hospitals should be equipped with airconditioners. The treatment protective mode of permanent establishment includes the followings elements: providing of the mode is a thrift of psyche of patient; adherence of rules of internal order of day; providing of the mode rational physical (motive) to activity. Hospitalism Be are what physical, psychical, infectious disorders of health of man, conditioned the features of medical service. Hospitalism Physical Accident Psychical Hospital infection Hospital cultures are adapted sporadic Accident Hospital cultures are no adapted endemic epidemic Exciters of intrahospital (nosocomial, hospital) infections Staphylococcus, streptococci, blue pear stick, coli bacillus, salmonella, enter bacteria, enter cocas and other de bane ease pathogenic microorganisms. And also viruses of flu, adenovirus, enter virus, exciters of viral hepatitis ESCHERICHIA COLI Distribution of certain exciter in development of infection can be related to the type of medical establishment In permanent establishments of general surgical type are gram-negative bacteria, in particular blue pear in urology separations is a coli bacillus, enter cocas and others like that. ESCHERICHIA COLI Distribution of certain exciter in development of infection can be related to the type of medical establishment Blue pear sticks prevail in separations. in separations newborn find staphylococcus, enter cocas. STAPHYLOCOCCUS AUREUS Sources of infection: patients personnel visitors apparatus instruments linen et cetera Patients can be infected pathogenic factors both from an external environment and own in the case of hyposthenic immunity Ways of transfer of intrahospital infections PATIENT Objects materials animals and others like that Personnel visitors patients Except for control after the observance of sanitary-hygienic requirements in relation to apartments, personal hygiene it is necessary to conduct: - timely exposure and sanitation of transmitters of pathogenic staphylococcus: one time in a quarter obligatory inspection of employees on the transmitter of pathogenic staphylococcus for the medical staff of surgical separations and maternity hospital, and at origin of infection – on the measure of necessity; - safety measures at AIDS and disease mode, measures of infection; - observance of rules of asepsis and antiseptic; Prophylaxis of in-hospital infections Technical measures Sanitary disease measures Disinfection and sterilization IMMUNISATION Emergency Architectonically plan measures Specific prophylaxis Planned Un specific prophylaxis Measures of architectural plan A rational location of separations is on floors Isolation of sections, chambers, operating blocks but other Observance of streams sick, personnel Zoning of territory Technical measures Ventilation: (reveal, drawing, mixed, condition) Sanitary disease measures Sanitary educational work is among a personnel and patients Control is after the sanitary state and mode of permanent establishments An exposure of transmitters is among a personnel and patients Control is after the bacterial semi nation of in-hospital environment Disinfection and sterilization measures Tooling Use chemical facilities Use physical methods д