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Hygienic requirements for the lay-out
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HYGIENIC REQUIREMENTS FOR THE LAY-OUT
OF THE HOSPITAL SITE.
Area of hospital site.
The sizes of the ground areas for hospitals of all types are regulated by Sanitary norms and depend on capacity of hospital: at capacity hospital up to 50 cots (beds) - 300 m2 for 1 cot, up to 100 cots - 200 m2, from 200 up to 400 cots - 140-100 m2, from 400 up to 800 cots - 100 - 80 m2, from 800 up to 1000 cots - 80 - 60 m2.
For the specialized hospitals in suburb the area is increased: for infectious and oncological hospitals on 15 %, for phtysiatric and psychiatric - on 25 %, for pediatric on 40 %. The area site of maternity hospital makes 0, 7 from norms for usual hospital.
The hospital site should be the rectangular form with a ratio of the sides as 1: 2 or 3: 4 for convenience functional zones.
Density building of site of hospital should not exceed 15 %. Green plantings should occupy not less than 60 % of the area of a site. On perimeter the protective green strip not less than 15 meters is arranged.
Functional zones on hospital site:
1. Zone medical buildings (infectious and not infectious). Infectious branch place in depth of a site.
2. Gardening zone - includes green plantings on perimeter of a site, between buildings.
3. Zone pathological anatomical branch should settle down outside of it visibility from windows of medical cases.
4. Zone polyclinic. The polyclinic should be placed on distance 30-50 m from medical cases and have a separate entrance on a hospital site, or to be closer to a main entrance on a hospital site (prevention intrahospital infections from visitors of the polyclinic).
5. Economic zone settles on distance 30-40 meters from other zones. Here place the central boiler-house, laundry with desinfection chamber, warehouse premises, garage, kitchen.
SYSTEMS OF HOSPITAL CONSTRUCTION.
Historical types construction hospitals:
In 17-18 centuries - barracks type (one big room for all patients), then - corridor-barracks type - the big wards left in a corridor - conditions for patients and the personnel were very bad.
Hutment type. For the first time in the world was applied by N. I. Pirogov in Crimea in 1855-1856 during Russia-Gngland-France-Turkey war. Patients after operations were short time in one wooden barrack, then them translated in other barrack, and old barrack burnt. It made possible to lower amount of postoperative infectious complications.
Pavilion type - in 19 century - the beginning 20 century. It is construction separate premises for wards in park, with good airing, illumination.
Modern types construction hospitals
(in XX – XXI century):
1. Decentralized system is characterized by presence several, usually one - two floor buildings, each of which is used for branch of one type (surgical, therapeutic etc. ). In separate buildings of hospital placed diagnostic, economic and auxiliary services, management of hospital, polyclinic.
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Positive sides of it system – good conditions for prevention intrahospital infections (isolation each branch of hospital in separate building), it is easy for the patients to use hospital garden, to be at open air at good weather, to have daily doze of UV irradiation.
Lacks of it system – it is need very big area of hospital site, very expensive building many 1-floor buildings, it is difficulties for the personnel and patients at transportation to different diagnostic departments (especially at bad weather), to supply branches by medicaments, food, etc.
This system is now applied at construction sanatoriums and for building hospitals in mountain districts.
2. Centralized system is characterized accommodation all medical branches, polyclinics, pathological anatomical and economic branches in one multi-storey building. For example, for 900 - cot hospital needs 15-floor building. The advantages and lacks of it system – on the contrary as at desentralized system (for example, in such hospitals it is high level of intrahospital infections and it is very difficult to struggle with it in this system of hospital building)
3. Mixed system hospital building is characterized by the tendency to reduction amount of medical buildings up to 2-4, centralization hospital treatment-diagnostic and auxiliary services. Infectious, children's, radiological branches and polyclinic are placed in separate buildings. So, at hospital site there are some small-floor and multi-floor buildings.
4. Centralized - block system in modern conditions is the most appropriate for large hospitals. Basic sign of centralized - block system is division all premises of hospital complex into two groups for best maintenance treatment-quarding mode in hospital: 1) The first group of premises - for long-term, stable operation – treatment buildings with ward sections of any structure. 2. The second group of premises which functional purpose demands regular updating of the equipment, reconstruction or repair (which realization should not stop work of hospital complex as a whole) – operational block, premises for functional diagnostics, diagnostic laboratories, physiotherapeutic branches, polyclinic, etc.
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