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Sanitary Regimen of Maternity Home
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Premises of maternity home should be kept ideally clean. Not less than once a year decoration should be made. Wet cleaning and aeration should be done in all wards, corridors, sanitary premises twice a day.
Postnatal wards are occupied according to the cyclic principle: each ward is occupied by mothers not longer than 2 days.
Systematic bacteriologic research of air in delivery room and nurseries is made. Cleansing is made every 7-10 days in a delivery room, prenatal ward, children’ and mothers’ wards. Wards are emptied in turn, during a day they are ventilated, then oil-painted floors, windows and walls are washed with soup and chloramine solution. Beds are covered with clean mattresses, linen, and blankets; premises are rayed with mercury quartz lamp in order to disinfect things which are in contact with puerperas, newborns.
During delivery a bed is covered with clean linen. In postnatal wards the following sanitization is made. After discharging mother her bed is washed, mattress, pillow and blanket are autoclaved.
Used linen and underwear, dirty towels and napkins are collected in special boxes located in a room designed for dirty linen and are taken to laundry as soon as possible. Linen from maternity home is washed separately from that of other medical institutions that is of great importance as to prevention of infection. Linen is washed and then autoclaved. Clean linen is kept in special cupboards, sterile — in special sterilizer boxes (drums). Linen and underwear are changed according to necessity; swaddling bands are changed not less than twice a day. Cloths which are placed under swaddling bands are changed and washed 2-3 times a day. They are washed with warm water and soap and brush, rinsed with disinfective chloramine solution, then dried and kept in a sterile bag.
Sterilization of bedpans is of great significance in respect of prevention of puerperal diseases. Each puerpera or mother uses an individual sterile bedpan. Before usage bedpans are washed with water, boiled in a special tank for 10-15 minutes, and kept in special bags or canister. Applied bedpans are washed with water after each use, rinsed with chloramine solution and placed on a rack under the bed. Cleaning puerperas is done according to the rules preventing infection penetration to genitourinary tract.
Twice a year prophylactic cleaning of all obstetric departments is done. At appointed by City Health Department time the scheduled and urgent reception for delivery and treatment is stopped. All pregnant and puerperas are discharged from the in-patient department. If it is impossible, they are transferred to other obstetric departments. After discharging all the patients a necessary decoration of premises is made during 2 weeks. Then a scheduled sanitary disinfection of all premises and household equipment with disinfectants and generalized cleaning are made. After the completion of a scheduled sanitization by a sanitary epidemiologic station specialists take samples of wash-outs from premises, sterile instruments, disinfected soft materials, etc. Admission of patients for treatment and delivery begins after receiving the results of tests and permission of head physician of sanitary epidemiologic station.
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Timely isolation of ill puerperas is of great significance. On occurrence of purulent discharges, high temperature, and other signs of infection (furunculosis, influenza, etc. ), they are transferred to the second obstetric department and in small maternity homes — to isolated ward.
If endometritis occurs in a puerpera, an urgent notification is sent to a sanitary epidemiologic station. She is isolated in an isolation ward of the observation department and her child is transferred to the second children’s department. If the second case of endometritis occurs, the maternity home closes for extraordinary disinfection for 10-14 days. Availability for service is determined according to results of bacteriologic test which is carried out by specialists of sanitary-epidemiologic station.
Apart from all above-mentioned measures, elucidation of antiseptic and aseptic rules to mothers and puerperas for the proper course of puerperal period and health of a newborn is of great importance.
Self Test
1. Antiseptics is
A. a wound disinfection.
B. prophylaxis of infection in a wound.
C. suture material sterilization.
D. treatment of septic processes in a wound with antibiotics.
2. Aseptics is
A. a prophylactic destruction of bacteria and prevention of their penetration into the wound.
B. a wound disinfection.
C. treatment of septic process in a wound with antibiotics.
D. management of wound with antiseptics.
3. The following substances refer to antiseptics, apart from
A. ethyl alcohol.
B. alcoholic iodine solution.
C. permanganate potassium.
D. gelatinol.
4. Which of the following is not an indication for hospitalization to observation obstetric department?
A. body temperature over 37. 5º C
B. IV degree of vagina discharge purity
C. a long waterless period
D. diabetes of pregnants
5. Indications for hospitalization to observation department are:
A. diabetes of pregnants
B. pustular colpitis
C. anemia of pregnancy
D. premature birth threat
6. Planned prophylactic disinfection of obstetric in-patient department is carried out:
A. twice a year
B. once a year
C. three times a year
D. in case of epidemics at the in-patient department
7. The postnatal wards are occupied by puerperal:
A. according to their admission
B. for not more than 2 days
C. for not more than 3 days
D. for not more than a day
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