The generic physiological compartment predusmat Riva Xia also cabinet department head, ordinatorskuju room older midwife housewife sisters, Layout (14 m 2 ), a room for the collection, storage and pasteurisation grud- Nogo milk colonic enema et al.
Part II. Answer the following questions.
• The presence of a physiological birth department and an observational department, their isolation.
• Compliance of the set of premises and their areas with hygienic standards.
• Luminous coefficient in the wards (standard 1: 8-1: 10).
Part III. List the shortcomings discovered during the examination of the project and formulate a conclusion.
Surgery department
The main features of the design and construction of a surgical department of any type (general surgery or specialized) are as follows:
• the presence of two departments – “clean” and “purulent” (to reduce the risk of postoperative purulent-inflammatory complications);
• the presence of an operating unit (or an operating unit in large healthcare facilities);
• the presence of dressings in the ward section of the department;
• the presence of postoperative wards in the ward section.
Note. In the absence of departments for “clean” and “purulent” patients, the latter are placed in the wards farthest from the operating unit.
The relative position of the main rooms of the surgical department should include the approach of the wards, departments of non-estesiology, intensive care and intensive care, chronic hemodialysis to the operating unit, subject to all measures to isolate them from each other.
Purulent surgery departments are recommended to be located in separate buildings or blocks provided with their own staircase elevator communication center. If it is necessary to place purulent and clean compartments in one building, the latter should be a floor below.
Trauma departments are located in the lower floors of hospitals.
The main feature of the surgical departments is the operating unit (and in modern large hospitals – the operating department) – the most complex functional element of the hospital. In any surgical hospital, the availability of aseptic and septic operating units with strict zoning of the internal premises (sterile zone, strict regime zone, dirty zone) is provided. All of them must be impassable and placed in an isolated building, annex-block or isolated sections in the general building. When placing the operating unit outside other medical buildings, it is necessary to provide convenient insulated transitions connecting it with other medical diagnostic and clinical units. Surgical rooms for emergency surgery are located in the emergency rooms.
Entrances to the operating units for staff should be organized through sanitary inspection rooms, and for patients through locks. Sanitary inspection rooms for staff (male and female) should be designed each in three rooms. The first room is equipped with a shower, a bathroom and a dispenser with an antiseptic solution. In it, the staff preparing for operations takes off their overalls, in which they worked in the department, take a shower and perform hygienic processing of hands. In the second room, the staff puts on clean surgical suits, arranged in cells in size, special shoes, shoe covers and leaves the sanitary inspection room in the preoperative room, where hands are treated, sterile gowns, masks, and hats are put on. After the operations, the staff returns from the operating room to the third room, in which containers for collecting used clothes are installed (robes, surgical suits, masks, hats, boot covers). Then the staff returns to the first room, where it takes a shower if necessary, puts on overalls for work in the department and leaves the operblok. Showers are installed at the rate of 1 cabin for 2-4 operating rooms.
Streams in the operating unit should be divided into: • “sterile” – the passage of surgeons, operating sisters; • “clean” – passage of anesthetists, junior and technical
sky staff for the delivery of patients, clean linen, medicines;
• “dirty” – for the disposal of waste, used laundry, dressings, etc.
Streams are provided by separate elevators and should not intersect.
To exclude the possibility of air masses coming from the wards, staircase elevators and other rooms to the operating unit, a device must be installed between these rooms and the operating unit of the airlock with air pressure.
The operating unit includes: operating room, preoperative room, anesthesia, equipment room and other premises.
Note. Existing SanPiNs have removed sterilization from the operating unit. The sterilization process should be carried out in central sterilization departments (CCO).
Operating blocks should be placed no lower than the second floor, and with a vertical sectional layout, the septic tanks should be above the aseptic ones.
The number of operating rooms is determined at the rate of 1 operating table for 30 surgical beds. Area ope- ration obshchehirurgicheskogo profile – 36 m 2 , for ortopedo- trauma and neurosurgical operations – 42 m 2 to operations on the heart and blood vessels – 48 m 2 . The height of the operating rooms should be at least 3.5 m, the width should be at least 5 m. The width of the corridors in the operating unit should be at least 2.8 m.
Windows of the operating room should be oriented to the northern rumbas; light coefficient 1: 3-1: 4. Windowless operating rooms, used in a number of countries to protect against dust and noise, cause personnel fatigue and poor health.
Operating room doors should close tightly, open outwards; the best option is the doors automatically sliding in the frontal plane when a person approaches them.
Operating rooms intended for demonstration must have viewing galleries, domes or television installations. Preoperative is intended for the last preparation of the surgeon and other medical personnel for the operation.
Anesthesia – a room for the last preparation of the patient for surgery.
Chambers for postoperative stay of patients are located in close proximity to the operating unit. The number of beds in these rooms is set at the rate of 2 beds per 1 operating room. In the presence of departments of anesthesiology and intensive care, postoperative beds are not provided. The area in the postoperative wards is 13 m 2 per bed.
In postoperative wards, there is a post of a nurse on duty (6 m 2 ), a room for washing and sterilizing ships (8 m 2 ), for storing cleaning items (4 m 2 ) and dirty linen (4 m 2 ).
The composition of the main rooms of the surgical department and the operating unit is given in the assignment for students on the project expertise.