METHODICAL INSTRUCTION FOR STUDENTS OF THE 3 COURSE

MEDICAL FACULTY

LESSON # 12 (PRACTICAL 6 HOURS)

Theme:

1. Hospital hygiene. The hygienical estimation of placing and planning of separate structural subdivisions of hospital on materials of project. 6 hours.

Aim:

1. To acquaint with the stages of preliminary inspection, to learn how to read building drawings, to acquaint with the main building symbolic signs, to how to form a correct estimate of the general and situational building hospital plan.

2. To learn to estimate conformity of internal planning of hospitals to hygienic requirements.

3. To lean to assess the sanitary conditions of hospital (hospital buildings), to make conclusions as to the typical design of hospital, its adherence to the hygienic requirements, to reveal drawbacks and to make practical suggestions as to improving the design.

4. To be able to write the report of sanitary inspection of hospital or one of its separations.

PROFESSIONAL ORIENTATION OF STUDENTS

One of the most important parts of the preliminary sanitary inspection is the examination of the projects. Especially great significance has sanitary examination of hospital projects the aim of which is achieving of further improving of public medical service, ensuring of medical protection regimen, infection warning in hospitals.

Hygienic standards concerning planning creation and organization the work of medical-prophylactic establishments. The process of creation optimal hygienic conditions in medical-prophylactic establishments are defined by the peculiarities of planning and building on the plot regulation and inside planning of the buildings, their sanitary-technical improvements, and also sanitary condition during maintenance.

METHODOLOGY OF PRACTICAL CLASS (900-1200 hour).

I. Theme 1 Hospital hygiene. The hygienical estimation of placing and planning of separate structural subdivisions of hospital on materials of project..

1. Students to acquaint with main symbolic signs in building drawings.

2. To examine situational plan of locality, direction of dominant winds, level of isolation from residential areas, existence of enterprises which pollute air on the territory of a hospital with dust and gases, existence of noisy streets and roads, railroads, aerodromes.

3. To examine general plan of a hospital, to determine harmony of sizes with hygienic standards building and planting trees (green zone) percentage on the plot, approaches to separate blocks zoning of the plot, rational arrangement of hospital blocks managerial buildings on the plot and gaps between them.

4. Students reading of plans of the typical project to find out:

Composition of apartments on floors, their size (length, width, area for a 1 bed, height, cubic capacity for a 1 bed).

Accordance of the sizes of apartments to the hygienically requirements.

Presence of the functional grounded intercommunication between the separate apartments.

Orientation of wards and auxiliary apartments.

Possibility of ventilation in different apartments.

Presence of wave-drawing ventilation, its description.

Depth of the apartments, quantity of light road clearances (windows), light coefficient.

5. At subsequent consideration of plans of project to find out:

a. Ventilation system, if there is an independent exhaust-fan in surgical delivery suites and intensive care units;

b. Heating system, characteristics of heating appliances, their suitability to the purpose and size of premises;

c. Water supply-availability of hot and cold water in the wards, offices, bathrooms and other rooms;

d. The system of purification and disinfections of sewage; collecting, disposal and disinfections of solid wastes. To pay special attention to temporary storage , and disposal of radioactive wastes from radiological departments.

e. Characteristics of natural illumination: light coefficient, coefficient of the depth.

f. To assess the amount of artificial illumination, types of lamp;

6. To give the conclusion on the typical project of hospital, accordance of hygienic norms. To mark failing and dates concrete and grounded suggestions on the improvement of project.

7. Estimate working conditions of the medical personnel and a sanitary condition of hospital establishment (according to inspection of treatment-and-prophylactic establishment). To prepare the accurate report by results of sanitary inspection of hospital and operating conditions of the medical personnel in it.

INDIVIDUAL STUDENTS PROGRAM

 

I. Theme 1 Hospital hygiene. The hygienical estimation of placing and planning of separate structural subdivisions of hospital on materials of project.

Control questions:

1. Kinds of sanitary inspection .

2. Main stages of preliminary sanitary inspection (set aside a building plot, consideration of design documentation, building attendance).

3. Hospital building systems, their advantages and disadvantages.

4. Factors which influences the choosing a building plot for medical-prophylactic establishments.

5. Main materials for sanitary examination of designs for building hospitals (explanatory note, general plan, situational plan, plans of story and sketches of facade plan).

6. Sanitary examination of hospital building, the analysis of projects.

7. Establish and equipment of wards, ward sections, specialized departments.

8. Demands to air regimen and microclimate of wards.

9. Peculiarity of planning of children and infections department.

10. Principal hygienic demands to arrangement of operating block

11. Hygienic requirements to internal planning therapeutic, surgical, obstetrics and gynecologic, children's and infectious departments of hospital.

12. Hygienic requirements to a sanitary regimen of the basic departments and rooms in hospital.

SEMINAR DISCUSSION OF THEORETICAL ISSUES (1230  1400 hour).

Kinds of sanitary inspection .

2. Main stages of preliminary sanitary inspection (set aside a building plot, consideration of design documentation, building attendance).

3. Hospital building systems, their advantages and disadvantages.

4. Factors which influences the choosing a building plot for medical-prophylactic establishments.

5. Main materials for sanitary examination of designs for building hospitals (explanatory note, general plan, situational plan, plans of story and sketches of facade plan).

6. Sanitary examination of hospital building, the analysis of projects.

7. Establish and equipment of wards, ward sections, specialized departments.

8. Demands to air regimen and microclimate of wards.

9. Peculiarity of planning of children and infections department.

10. Principal hygienic demands to arrangement of operating block

11. Hygienic requirements to internal planning therapeutic, surgical, obstetrics and gynecologic, children's and infectious departments of hospital.

12. Hygienic requirements to a sanitary regimen of the basic departments and rooms in hospital.

TEST EVALUATION AND SITUATIONAL TASKS

 

TEST QUESTIONS:

1. Results of estimation of microclimate of ward of therapeutic departments are next: the middle temperature of air is 20 C, speed of air is 0,2 m/s, relative humidity of air is 48 %. Give hygienically estimation of ward`s microclimate.

A. comfortable microclimate;

B. uncomfortable microclimate of cooling type

C. uncomfortable microclimate of heating type

D. uncomfortablemicroclimate with the increased humidity of air

E. uncomfortable microclimate with the increased speed of air

2. Name groups of harmful and dangerous factors, which are not present in the work of doctors of various specializations:

. Physical

. Ethnogeny

. Chemical

D. Biological

E. Psychophysiological

3. The minimum quantity of entrances to hospital territory.

A. One.

B. Two.

C. Three.

D. Four.

E. Five

4. How many patients must be in the typical wards section?

A. 25

B. 35

C. 30

D. 15

E. 20

5. Among which one of the following pregnant women should not be received in observation department of the maternity home

A. acute respiratory disease

B. at absence of the medical documentation

C. skin diseases of infectious ethyology

D. long waterless interval

E. Fe-deficient anemia.

6. Isolator in infectious department has an area of 22 m2. What are the maximum number of beds in this ward?

A. 2

B. 4

C. 1

D. 3

E. 6

Situation task 1. City hospital consists of main block (surgical and therapeutic separations) and a few blocks for the infectious, maternity, child's separations. The therapeutic and surgical separation is divided into two ward sections, in each are 40 beds. There are 10 wards for 4 beds in every section. An area on one bed is 5,9 m2. Other separations are with one ward section on 36 beds.

To define the type of building of hospital and to give hygienically estimation planning. To indicate, which still indexes are needed for estimation of work conditions of medical personnel?

CORRECT ANSWERS OF TEST EVALUATIONS AND SITUATIONAL TASKS:

A;

E;

B;

C;

E;

A.

Answer on situation task:

 

Type of building of hospital is mixed. Ward sections have more of beds (it is recommended to 30, area for 1 bed insufficient (it is to be not less than 7 m2). For estimation of work conditions of medical personnel we need use the indexes of microclimate, chemical composition of air (possible maintenance of medical preparations in air), indexes of bacterial cleanness of air, coefficients of day lighting and artificial illumination, level of noise and others like that.

 

 Individual student work (1415-1500 hour)  are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions (the instructor has tests & situational tasks).

 

INITIAL LEVEL OF KNOWLEDGE AND SKILLS

are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions.

(the instructor has tests & situational tasks)

The student must know:

1. Kinds of sanitary inspection.

2. Preventive sanitary inspection of the patient care institutions project and building; its main stages. Constituents of the project.

3. Hygienic requirements concerning the location of the hospital within the settlement taking into account the adjacent objects and wind rose.

4. Hygienic requirements concerning the hospital area general plan, the territory functional zoning, accomplishment, density of housing and green area.

5. Modern systems of the hospitals site development, their comparative characteristics, influence on the exploitation and equipment conditions.

6. Hygienic significance of the hospital constructions and departments internal planning for the provision of the personnel labour and patient treatment hygienic conditions.

7. Hygienic requirements concerning the planning of the hospital admission departments; its significance for the exploitation regime and the hospital nosocomial infections prevention.

8. Hygienic requirements concerning the planning and the work regime of the therapeutic, surgical and infectious diseases departments.

9. Hygienic characteristics of the ward sections, the requirements for these sections rooms at different departments.

The student should how:

1.To estimate conformity of internal planning of hospitals to hygienic requirements.

2.Using the construction drawings of the situational and general layout to determine and assess the project patient care institutions location and territory zoning, taking into account objects, adjacent to the land parcel, wind rose, correspondence with the site development, percentage of green area and the constructions orientation

3.Using the constructions plans and slits to determine and assess the correspondence of the hospital premises area, cubic capacity and sanitary accomplishment to hygienic standards; their correspondence to the functional purpose.

REFERENCES:

Principal:

1.          Practical classes materials http://intranet.tdmu.edu.ua/data/kafedra/internal/hihiena/classes_stud/en/med/lik/ptn/hygiene%20and%20ecology/3/12.%20Hospital%20hygiene.htm

2.          Hygiene and human ecology. Manual for the students of higher medical institutions/ Under the general editorship of V.G. Bardov. K., 2009.  PP. 474-484. http://www.nmu.edu.ua/kaf55-8.php

3.          Datsenko I.I., Gabovich R.D. Preventive medicine. - K.: Health, 2004, pp. 558-575.

4.          Lecture on hygiene.

additional:

1.          Kozak D.V., Sopel O.N., Lototska O.V. General Hygiene and Ecology. Ternopil: TSMU, 2008. 248 p.

2.          Dacenko I.I., Denisuk O.B., Doloshickiy S.L. General hygiene: Manual for practical studies. -Lviv: Svit, 2001. - P. 344-357.

3.          A hand book of Preventive and Social Medicine. Yash Pal Bedi / Sixteenth Edition, 2003  361 p.

 

Methodical instruction has been worked out by: ass-prof. Sopel O.M.

Methodical instruction was discussed and adopted at the Department sitting

30 august 2011, Minute 1

Methodical instruction was adopted and reviewed at the Department sitting

28 august 2013, Minute 1