Transcript 04. Hygienic requirements for health

Hygienic requirements for
health-care institutions,
including dental
profile.Occupational dentists,
dental technicians. Biosafety
and bioethics work dentists
A hospital
is an institution for
health care providing
patient treatment by
specialised staff and
equipment, and often
but
not
always
providing for longerterm 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
Systems of hospital site development
are:
decentralized (pavilion),
centralized,
mixed,
centralized-blocked – the best system of
hospital
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 is the difficulty during the usage of
the diagnostic, physiotherapeutic measures or
their doubling, which increases the capital
expenditure.
Centralized system
 all departments
are situated in
one
(semidetached)
building;



The drawback of the centralized system is
the difficulty of nosocomial 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.
Surgical department
The operating block of a surgical department
should be situated in the blind-ended
projection or in the separate outhouse of the
hospital
In the operating block
there should be
following rooms: the
operating room – 30
m2 (on the basis of 3050 surgical beds in the
department; for the
complex operations –
40-45 m2)
Hygienic
requirements
concerning of the
hospital 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.
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 air-conditioners.
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.
DENTISTRY
DENTISTRY Cabinets
Digital ortopantomograph
utilized for the receipt of panoramic picture of teeth, necessity in
surgical dentistry
for the exposure of breaks, cysts, tumors, for the estimation of
the state of bone
PLAN OF THE DENTRISTRY CLINIC
Hospitalism Be are what physical, psychical, infectious
disorders of health of man, conditioned the features of medical
service.
Hospitalism
Physical
Psychical
Hospital
infection
Accident
Hospital cultures are
adapted
sporadic
endemic
Hospital cultures
are un adapted
epidemic
Intrhospital (nosocomial,
hospital) infection

any clinically recognized disease of
microbial etiology is related to the stay,
treatment, inspection or appeal of man for
medical help in hospital.
Exciters of intrahospital (nosocomial, hospital)
infections
Staphylococcuss,
streptococci, blue pear
stick, proteus, collibacillus,
salmonella, enterobacteria,
enterococcus and other de
bane ease pathogenic
microorganisms.
 And also viruses of flu,
adenoviruss, rotaviruss,
enteroviruss, exciters of
viral hepatitis et al

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 gramnegative bacteria, in
particular blue pear
in urology separations is a
coli bacillus, enterococcus
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
ambustial
separations.
 in separations
new-born find
staphylococcus,
enterococcuss.

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 sanitaryhygienic requirements in relation to apartments,
personal hygiene it is necessary to conduct:
-
timely exposure and
sanation 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;
control after patients with an
exposure in them of
pediculosis and them
 Pediculosis treatments (order
¹ 410), teniosis, infectious
diseases, to hepatitis and
others like that;


- safety measures at AIDS and disease
mode (order ¹ 486), measures of
infection (order ¹ 120);
 - observance of rules of asepsis and
antiseptic;
Prophylaxis of in-hospital infections
Tekhnichni
measures
Sanitary
disease
measures
Dezinfekciynosterilizaciyni
measures
IMMUNISATION
Ekstrenna
Architectonically
plan measures
Specific prophylaxis
Planned
Heterospecific prophylaxis
Architectonically plan measures
A rational location of
separations is on floors
Isolation of sections,
chambers, operating
blocks but other
Observance of streams
sick, personnel
Zonuvannya of
territory
Technical measures
Ventilation: (reveal, drawing, mixed, кондиціювання,
equipments of ламінарні and others like that)
Sanitary disease measures
Sanitary
educational work
is among a
personnel and
patients
Control is after the
sanitary state and
mode of
permanent
An exposure of
transmitters is
among a personnel
and patients
establishments
Control is after the bacterial semi nation of in-hospital
environment
Disinfection-sterilization measures
Tooling
Use
chemical facilities
Use
д
physical methods