Mgsn 4.12 97 medical and preventive institutions. Departments of Anesthesiology and Reanimation
MOSCOW GOVERNMENT
MOSKOMARCHITECTURE
ALLOWANCE
K MGSN 4.12-97
TREATMENT AND PREVENTIVE INSTITUTIONS
ISSUE 1
GENERAL PROVISIONS. STATIONARY INSTITUTIONS:
BASIC PROVISIONS. ADMISSION DEPARTMENTS
1998
PREFACE
1. DEVELOPED by MNIIP for cultural, recreational, sports and healthcare facilities (architects Yu.V. Sorokina, G.I. Rabinovich, doctors G.N. Ilnitskaya, S.L. Polishkis) with the participation of the State Sanitary and Epidemiological Supervision Center in Moscow (doctors I .A. Khrapunov, L.I. Fedorova).
2. PREPARED for approval and publication by the Department of Advanced Design and Standards of the Moscow Architecture Committee (architect L.A. Shalov, engineer Yu.B. Shchipanov).
3. AGREED BY the Center for State Sanitary and Epidemiological Surveillance in Moscow, the Moscow Health Committee and the Moscow City Committee for Architecture and Civil Engineering.
4. APPROVED AND ENTERED INTO EFFECT by Directive of the Moscow Committee for Architecture and Architecture dated September 29, 1998 No. 32.
INTRODUCTION
This Manual is being developed to develop the current MGSN 4.12-97 “Medical and preventive institutions”.
The Manual outlines the fundamental provisions and specific features of the formation of a network of healthcare facilities in Moscow, detailed provisions of volumetric-spatial, architectural, planning and functional solutions of various types of healthcare facilities, their engineering equipment, as well as the necessary reference materials, calculations, recommended compositions and areas of premises, functional diagrams of health care facilities of their divisions (departments) and individual premises.
The manual consists of 7 sections and 9 issues:
3. Estimated indicators of the capacity of treatment and preventive institutions are: for inpatient institutions - the number of beds; for outpatient clinics, including dispensaries without hospitals - the number of visits per shift; for medical and preventive institutions, the structure of which includes a hospital and a clinic - the number of beds and the number of visits per shift; for stations (substations, departments) of ambulance and emergency medical care - the number of visits per year.
4. The design capacity of hospitals, maternity hospitals, and dispensary hospitals is determined by the design assignment.
The bed capacity of ward departments should be taken in accordance with the requirements of MGSN 4.12-97.
5. The design capacity of outpatient clinics, including dispensaries without hospitals, is determined by the design assignment and is calculated as the sum of the capacity of all designed medical appointment rooms per shift, with the exception of functional, ultrasound, endoscopic and radiology diagnostic rooms.
The capacity of doctor's offices per shift was determined based on the capacity of the offices per 1 hour of doctors' work and the duration of a doctor's appointment in the office during one shift, excluding the time spent on home visits.
The capacity of doctor's offices for 1 hour of doctors' work is given in the Appendix.
6. Medical and preventive institutions should be located, as a rule, in a residential area on land plots with the most favorable sanitary and hygienic conditions, in accordance with the approved master plan and detailed planning projects, taking into account the administrative-territorial division of Moscow.
Psychiatric, psychoneurological and narcological hospitals, hospitals for rehabilitation and after-care, tuberculosis hospitals, hospices, nursing homes can also be located in green or suburban areas.
7. The dimensions of land plots of medical institutions should be taken according to MGSN 4.12-97.
8. On the land plots of hospitals, maternity hospitals, dispensaries with hospitals, as a rule, the following zones are distinguished:
Medical buildings for non-infectious patients, maternity hospitals (obstetric departments;
Medical buildings for infectious patients;
Psychosomatic corps;
Pediatric buildings;
Tuberculosis buildings;
Dermatovenerological buildings;
Radiological buildings;
Gardening;
Clinics, antenatal clinics;
Pathoanatomical building;
Economic;
Wastewater disinfection zones;
Water intake area.
Located on the land plot of the hospital complex, the separate buildings of the infectious diseases building and emergency medical care substation are isolated from the hospital territory with convenient access for visitors of their own and hospital staff.
9. In front of the main entrances to hospitals, clinics, dispensaries and maternity hospitals, areas for visitors should be provided at the rate of 0.2 m2 per bed or one visit per shift, but not less than 50 m2.
At the entrances to children's outpatient clinics and distribution points of dairy kitchens, areas with canopies for baby strollers with an area of at least 20 m 2 should be provided.
10. Before entering the territory of stationary institutions, parking areas for vehicles of institutions, employees and visitors should be designed.
According to the assignment for designing a parking lot for vehicles, institutions and employees can be designed on the territory of inpatient institutions, while the size of the land plot of the inpatient institution increases accordingly by the size of the land plot of the parking lot for vehicles.
The dimensions of land plots for parking lots for vehicles and the distance between parking lots for vehicles and ward buildings should be taken in accordance with the requirements of SNiP 2.07.01-89 *, MGSN 1.01-97, Part 1 and MGSN 1.01-98, Part 2.
11. The area of green spaces and lawns should, as a rule, be no less than 60% of the area of hospices, rehabilitation and aftercare hospitals, and no less than 50% for other hospitals and dispensaries with inpatients.
When constructing new stationary institutions on newly developed sites in areas of crowded urban development, it is allowed to reduce the area of green spaces and lawns in agreement with the city and territorial State Sanitary and Epidemiological Supervision Centers.
12. The dimensions of the garden and park area of a hospital, maternity hospital and dispensary with a hospital are recommended to be taken at the rate of at least 25 m 2 per bed, and when constructing these institutions on newly developed sites in areas of crowded urban development - at least 20 m2 per bed.
When designing the garden and park area of the territories of hospices, rehabilitation and aftercare hospitals, one should strive to achieve the effects of a natural and picturesque landscape. On the territory of these institutions, landscape architecture should be used to provide comfortable rest areas and walking routes for patients using a variety of small architectural forms: gazebos, fountains, small ponds, lamps, benches, etc. Walking routes should be designed taking into account the use of strollers.
13. Facilities and sites for climatotherapy, occupational therapy and physical education should be provided in accordance with the design assignment.
Open facilities for physical culture must be at least 25 m2 away from buildings with wards.
14. Along the development-free perimeter of areas of hospitals, dispensaries with hospitals and maternity hospitals, strips of green space should be provided with a width of at least 5 m.
Around the radiological and infectious diseases buildings, as well as along the X-ray rooms located on the ground floor, strips of plantings of impenetrable bushes should be provided.
15. Areas of inpatient facilities must be fenced. The height of fencing in areas of psychiatric hospitals must be at least 2.5 m, for other hospitals - 1.6 m.
16. The height of the premises of medical institutions from floor to ceiling should be at least 3 m.
The height of radiation therapy rooms, operating rooms in operating rooms of hospitals and X-ray rooms with non-standard equipment is set depending on the dimensions of the equipment, taking into account special requirements both for the installation of equipment and for work in a given room.
The height of the halls of therapeutic swimming pools with a number of patients of 10 or more is accepted to be at least 4.2 m.
17. The width of corridors of medical institutions, including corridors used as a waiting room for visitors, should be taken according to the mandatory Appendix 3 of MGSN 4.12-97
18. The width of the premises must be at least:
Small operating rooms, dressing rooms, treatment rooms with a urological chair, gynecological, urological, orthopedic rooms - 3.2 m;
Procedural X-ray fluorography and X-ray therapy rooms - 4 m;
Operating rooms, intensive care and delivery rooms - 5 m;
Procedural X-ray diagnostic rooms, external and intracavitary radiation therapy rooms are installed depending on the size of the equipment and the required width of passages, but not less than 5 m;
19. The depth of premises (except for wards) should be determined taking into account medical and technological requirements, the size of the equipment used, the number and area of window openings.
The depth of the chambers with natural light on one side should be no more than 6 m.
The ratio of depth to width of wards and other rooms for medical and diagnostic purposes should be no more than 2.
20. In the basement and ground floors of medical institutions, only those premises that are provided for in Appendix 4 * SNiP 2.08.02-89 * should be placed.
21. Rooms for ventilation equipment, heating units, refrigerated chambers with machine rooms, electrical panels, engine rooms and elevator and lift shafts and other rooms that are a source of noise and vibration, as well as autoclaves and disinfection chambers are not allowed to be located adjacent to wards, treatment and treatment rooms , as well as above and below them.
22. When ward, intensive care and maternity departments, operating units are located on the top floors of buildings, an attic or technical floor should be provided above them.
23. Placement of emergency departments, emergency rooms, emergency medical care substations and other services under the windows of the wards, to which vehicles must have access, is not allowed.
24. In the buildings of emergency medical service substations it is allowed to place underground garages for emergency medical vehicles.
25. The dimensions of restroom cabins for patients must be at least 1.6´ 1.1 m with mandatory door opening outwards.
The dimensions of restroom cabins for patients in traumatological, orthopedic, neurological, neurosurgical departments, hospices, nursing homes (departments), as well as for patients using wheelchairs when moving, must be at least 1.65 m wide and at least 1 m deep. 8 m.
26. The installation of washbasins should be provided in the wards of ward departments for adults and children (with the exception of wards with a lock and a bathroom and wards of psychiatric and narcological departments), in doctors’ offices of inpatient and outpatient clinics, as well as in all offices and premises whose operation According to sanitary and hygienic standards and regulations, they must be installed with hot and cold water supply.
27. The width of the doorway should be no less than:
In wards, isolation wards, vestibules and airlocks of boxes, semi-boxes, prenatal, birth, procedural, dressing rooms, operating rooms, intensive care, anesthesia, as well as in bathrooms, restrooms for patients and enema hospitals (departments) for rehabilitation treatment, hospices and nursing homes - 1.1 m;
In doctors' offices, in laboratory rooms, in restrooms for patients in ward departments, enema rooms and other rooms - 0.9 m;
In procedural X-ray diagnostic rooms, radiation therapy and radioisotope diagnostic rooms with large-sized equipment and on patient evacuation routes - 1.2 m (with the installation of a double door);
In barozals - 1.4 m (with the installation of a double-leaf door).
28. The premises of medical institutions must have natural light.
The coefficient of natural light in the premises should be taken according to table 2 of MGSN 2.06-97.
With second-light lighting or without natural lighting, it is allowed to design only those rooms that are provided for by SNiP 2.08.02-89 * and MGSN 4.12-97.
Insolation and sun protection of buildings of medical institutions must comply with the requirements of MGSN 2.05-97.
CHAPTER II. RESIDENTIAL INSTITUTIONS
1. Basic provisions
1.1. Inpatient institutions are medical and preventive institutions (hospitals, maternity hospitals) designed to provide medical care to the population under the conditions of their round-the-clock stay in these institutions under the supervision of medical personnel.
Hospital is a structural unit of a medical institution (medical unit, dispensary, hospice, perinatal center, etc.), intended to provide inpatient care to the population.
The structure of an inpatient facility may include clinics, antenatal clinics, and diagnostic centers.
1.2. The capacity and structure of inpatient facilities is determined by the design assignment, taking into account the needs of the population served for inpatient care.
1.3. Hospitals (hospitals) designed to provide inpatient care in various fields are multidisciplinary.
Hospitals designed to provide inpatient care for a specific profile are specialized.
Maternity hospitals are specialized inpatient institutions that provide medical care to pregnant women, women in labor, postpartum women, newborns, and gynecological patients (if there is a gynecological department in the structure of the maternity hospital).
1.4. The hospitals include the following structural divisions:
Reception departments;
Ward departments, including radiological departments;
Operating units;
Reanimation and intensive care units;
Anesthesiology departments (can be combined with intensive care units or an operating room);
Hemodialysis departments;
Detoxification departments;
Hyperbaric oxygenation departments;
Lithotripsy departments;
Blood transfusion departments (rooms);
Departments of physiotherapy and physical therapy, occupational therapy departments;
Diagnostic departments - clinical diagnostic laboratories, departments of functional, endoscopic, radiation diagnostics (x-ray, radioisotope, ultrasound), pathology departments;
Auxiliary departments - hospital pharmacies, centralized sterilization departments, disinfection departments, laundries, food preparation services;
Service premises;
Premises of clinical departments (for clinical hospitals).
1.5. The structure of the maternity hospital includes:
Reception department;
Maternity physiological department;
Postpartum physiological department;
Observation department;
Department of Pathology of Pregnant Women;
Diagnostic, specialized and auxiliary departments (offices);
Service and utility premises.
The structure of the maternity hospital may include premises of clinical departments.
1.6. The name of the inpatient facility is determined by the city (district) health authority, taking into account the current Nomenclature of health care institutions (Order of the Ministry of Health of the Russian Federation dated 04/09/98 No. 110).
1.7. New construction and reconstruction of inpatient institutions must be carried out in accordance with the territorial and sectoral scheme for the development and reconstruction of the network of these institutions.
2. Reception department
2.1. Main tasks and functions of the reception department:
Reception, registration and medical triage of patients entering the emergency department;
Establishing a preliminary medical diagnosis based on examination, diagnostic studies and, if necessary, the conclusion of medical consultants;
Organization of dynamic monitoring of patients with unclear and questionable diagnoses in diagnostic wards or isolation and diagnostic boxes;
Deciding on the need for inpatient or outpatient treatment;
Providing necessary medical care;
Carrying out, if necessary, sanitary treatment of patients hospitalized in non-infectious departments;
Providing measures to prevent the introduction and spread of infectious diseases among patients and staff;
Organization of transfer of patients in need of treatment in other inpatient facilities.
2.2. It is recommended that centralized emergency departments be located in the hospital building with the largest number of beds.
Reception departments for children's, obstetric, infectious diseases, dermatovenerological, tuberculosis, psychiatric (psychosomatic) departments must be autonomous.
2.3. Patients are admitted to the emergency department by emergency medical care, as planned and independently (“by gravity”).
It is recommended to allocate the premises of the emergency department intended for the reception of planned patients into a separate group. This group may include a lobby-waiting room for registration and paperwork, examination rooms, a changing room, and a sanitary inspection room for patients admitted in “questionable” sanitary condition.
2.4. The estimated number of patients admitted to the emergency departments of various types of inpatient facilities during the day should be taken depending on the number of beds and their profile:
12% - in maternity hospitals;
10% - in multidisciplinary hospitals for adults, gastroenterological, urological, ophthalmological, oncology hospitals and medical and social care hospitals (hospices, nursing homes);
5% - in dermatovenerological and psychoneurological hospitals (departments) for adults and children;
2.5% - in children's psychiatric hospitals and children's rehabilitation hospitals;
2% - in rehabilitation and after-care hospitals, psychiatric and drug treatment hospitals for adults;
1.5% - in tuberculosis hospitals for adults;
1% - in children's tuberculosis hospitals (departments).
2.5. In the emergency departments of non-infectious inpatient institutions for adults, examination rooms (examination rooms) should be provided.
The examination room (examination room) is intended for examination, examination, establishment of a preliminary diagnosis and, if necessary, provision of emergency medical care to patients admitted to the departments of therapeutic (general therapy, cardiology, pulmonology, etc.), surgical (pure surgery, purulent surgery, urology, etc.) and specialized (otolaryngology, ophthalmology, oncology, etc.) profiles. The dimensions of the examination room must ensure the free entry of the gurney. The viewing room can be designed to accommodate one or more couches. Each couch must be approached by medical personnel from at least three sides.
The number of examination rooms should be taken based on:
1 examination room for 150 beds - in multidisciplinary hospitals accepting emergency patients;
1 examination room for 600 beds in psychiatric and drug treatment hospitals; rehabilitation hospitals;
1 examination room for 250 beds - in other types of non-infectious hospitals for adults.
The purpose of examination rooms, including specialized ones (gynecological proctology, urology, etc.), is determined by the profiles of the ward departments and the design assignment.
In maternity hospitals, the following should be provided: 1 examination room for the physiological department and the department of pathology of pregnant women; 1 examination room for the observation department; 1 examination room for the gynecological department.
In dermatovenerological hospitals (departments) the following should be provided: 1 examination room with a gynecological chair; 1 examination room without a gynecological chair; reception and examination box for infectious patients.
2.6. The number of sanitary inspection rooms is set at the rate of one sanitary inspection room per 2 inspection rooms. In addition, for the reception of planned patients, a changing room should be provided (without installing a bathtub and shower).
The sanitary port is intended for hygienic treatment of hospitalized patients. The dimensions of the room where the bathtub is installed should allow a gurney to be easily brought in, conveniently transported to the bathtub, and personnel to move freely around the bathtub.
2.7. In children's hospitals of all types, as well as in infectious diseases hospitals (departments) for receiving adults and children, reception and examination boxes and isolation and diagnostic boxes should be provided.
The reception and examination box is the main element of the emergency departments of children's and infectious diseases hospitals. It is intended for individual admission of patients, which eliminates contact between incoming patients and helps protect them from secondary infection. The reception and examination box includes the following mandatory premises: entrance (external) vestibule, examination room, bathroom, antechamber (gateway between the corridor of the reception department and the examination room). The preboxing device provides the necessary sanitary, hygienic and anti-epidemic regime, both in the examination room and in the hospital corridor. In the pre-boxing room, the staff puts on special clothing and sanitizes and disinfects their hands.
In the reception and examination boxes of children's hospitals, children of all ages (from 0 to 14 years old) with diseases of any medical profile are admitted, therefore each reception and examination box must be universal and have an appropriate set of furniture and equipment, including a couch, changing table and scales.
The versatility of the reception and examination boxes provides the ability to maneuver them with uneven admission of patients of different ages.
Isolation and diagnostic box is intended for isolation of patients with unclear diagnoses or mixed infections, as well as patients who were in contact with infectious patients. An isolation and diagnostic box (similar to a Meltzer box) is characterized by the presence of two entrances: one for the patient to enter from the street through the vestibule, the second for personnel to enter from the hospital corridor through the antechamber. The isolation and diagnostic box consists of the following mandatory rooms: entrance (external) vestibule, bathroom (with bathtub, shower, toilet and washbasin), ward, pre-box.
Functional and planning diagrams of examination rooms, reception and examination and isolation and diagnostic boxes are given in the Appendix.
2.8. In children's multidisciplinary hospitals and other types of children's non-infectious hospitals, the number of reception and examination boxes should be determined depending on the number of therapeutic and surgical beds:
2% - from the number of therapeutic beds;
4% - from the number of surgical beds.
The number of isolation and diagnostic units in these hospitals should be 5% of the total number of beds in the hospital.
2.9. In infectious diseases hospitals (departments) for adults and children, the number of reception and examination boxes must correspond to the number of main types of infections present in the hospital and be at least 3% of the number of infectious disease beds in the hospital (department).
The number of isolation and diagnostic boxes in the emergency departments of infectious diseases hospitals (departments) for adults should be at least 4% of the number of beds in the infectious diseases hospital (department).
The number of isolation and diagnostic boxes in the emergency departments of children's infectious diseases hospitals (departments) should be at least 5% of the number of infectious disease beds in the hospital (department).
If in an infectious diseases hospital (department) all 100% of the beds are located in boxes, the emergency department, as a functional unit of the hospital, can be excluded.
In the emergency departments of infectious diseases hospitals for adults and children, as well as children's hospitals, the design specifications provide for specialized boxes (X-ray, operating room, intensive care unit).
If the structure of an infectious diseases hospital contains, in addition to boxed, semi-boxed and ward departments, entrances, staircases and elevators must be separate for the admission and discharge of patients.
When designing admission and discharge departments in infectious diseases hospitals (departments), it should be taken into account that sanitary treatment and discharge of patients occurs in ward, boxed or semi-boxed sections where patients are being treated. The admission department of an infectious diseases hospital (department) must be isolated from all other departments of the hospital (department premises) by organizing sanitary checkpoints for staff and by architectural and planning means.
The control room of the admission department of an infectious diseases hospital must have an external exit.
At the reception departments of infectious diseases hospitals, premises should be allocated for sanitary treatment of vehicles in which a patient suspected of having an infectious disease was delivered. For this purpose, a room for storing disinfectants, a room for duty disinfectors and a box for processing vehicles should be provided.
2.10. When designing emergency departments of maternity hospitals or obstetric departments on the territory of multidisciplinary and other hospitals, examination rooms and sanitary treatment rooms for women in labor and pregnant women should be provided common to the physiological department and the department of pathology of pregnant women. The observation department and the gynecological department (if located in the building of the maternity hospital) must have their own (separate) examination and sanitary inspection rooms.
The premises of the emergency department of a maternity hospital (obstetric department) should include a filter designed for examining women in labor and pregnant women, after which they are divided into two isolated streams and sent: one stream - to the obstetric physiological department and the department of pathology of pregnant women, the second stream - to the observation room department. Each stream is provided with an examination room with a gynecological chair and a sanitary treatment room. The paths of movement of patients in these departments, including staircases and elevators, must be strictly isolated from each other.
As part of the admission department, according to the design assignment, a birth box for the observation department may be provided.
2.11. The reception department should be located on the first or (if there is a ramp for ambulances) second floors, in an isolated part of the building, if possible, near the main entrance to the hospital site.
For the access of ambulances to the reception department, a canopy for parking 1-2 cars and a heated vestibule should be provided. The entrance of ambulance transport should not be under the windows of the wards.
2.12. The following functional groups of premises can be distinguished as part of the admission department: a lobby group, premises for examination, sorting and sanitary treatment of patients, a group of treatment and diagnostic premises, premises for temporary isolation and observation of patients, service and amenity premises.
A diagram of the interconnection of the main premises of the reception departments of non-infectious hospitals for adults is given in the Appendix, a diagram of the interconnection of the main premises of the reception departments of children's non-infectious hospitals is given in the Appendix.
2.13. The composition of the premises of the emergency department and their number, the presence in its structure of diagnostic beds, treatment and diagnostic rooms, specialized boxes, the ratio of the number of examination rooms for receiving planned and emergency patients is determined in each specific case by a design assignment, taking into account the type and capacity of the hospital, the profile of the ward departments and their bed capacity, the intensity of the treatment process in the hospital, as well as the volume of medical care provided to the sick and injured in the emergency department.
2.14. It is recommended to take the area of the reception departments according to the table. , , , specialized boxes - according to table. ; checkout premises - according to table. .
| Name of premises | Area, m2 |
|
| Lobby-waiting room for scheduled patients * | 1.2 m2 per patient, but not less than 12 m2 |
|
| Bathroom with airlock in the lobby | ||
| Security room | ||
| Information | ||
| Control room | ||
| Room for registration and paperwork of planned patients | ||
| Examination rooms for receiving scheduled patients: | ||
| Examination room for receiving therapeutic patients with 1 couch | ||
| Examination room for receiving surgical patients with 1 couch | ||
| Changing room for scheduled patients | ||
| Sanitary checkpoint for planned patients in “questionable” sanitary condition | ||
| Entrance vestibule for ambulances for 2 vehicles | ||
| Storage room for gurneys and wheelchairs | 2 m2 per 1 gurney, but not less than 12 m2 |
|
| Waiting room for accompanying persons with bathroom | ||
| Room for registration and paperwork of emergency patients | ||
| Examination rooms for receiving emergency patients: | ||
| Viewing room for 1 couch | ||
| Viewing room for 2 couches | ||
| Viewing room for 3 couches | ||
| Specialized viewing room | ||
| Specialized examination room for 3 couches | ||
| Sanitary passage for emergency patients with a bathroom | ||
| Filter for the reception of women in labor and pregnant women (in the emergency departments of maternity hospitals and obstetric departments) | ||
| Room for sanitary treatment of women in labor and pregnant women (in the emergency departments of maternity hospitals and obstetric departments) | ||
| Isolation and diagnostic box for 1 bed | ||
| Ward for 1 bed with airlock and bathroom ** | ||
| Ward for 2 beds with airlock and bathroom ** | ||
| Enema machine with sluice | ||
| Shock ward (resuscitation room) | ||
| Pantry | ||
| Premises for: | ||
| Washing and disinfecting vessels, washing and drying oilcloths | ||
| Storage of cleaning items | ||
| Temporary storage room for dirty linen | ||
| Procedural | ||
| Dressing room | ||
| Dressing purulent | ||
| Operating room for urgent operations: | ||
| operating room | ||
| Preoperative room with storage space for infusion solutions | ||
| Sterilization | ||
| Storage room for plaster and plaster bandages | ||
| Small operating room with airlock | ||
| Laboratory assistant | ||
| Washing-centrifuge | ||
| Material | ||
| Laboratory assistant's room | ||
| Endoscopy room | ||
| Doctor's office | ||
| Procedural | ||
| Washing | ||
| X-ray room: | ||
| Treatment room with imaging table, imaging stand and imaging stand | ||
| Treatment room with a rotating tripod table, an image stand, an image stand and a doctor’s work table | ||
| Same with X-ray image intensifier | ||
| Control room | ||
| Photo lab | ||
| Doctor's office | ||
| Electrocardiography room | ||
| Doctors' office on duty | 4 m2 per doctor on duty, but not less than 10 m2 |
|
| Drivers room | ||
| 0.3 m2 per patient, but not less than 8 m2 |
||
| *Calculation is made on 60% of simultaneously waiting planned patients. ** The number of diagnostic beds can be 0.5 - 1.5% of the total bed capacity of the hospital. |
||
| Name of premises | Area, m2 |
|
| Lobby-waiting area for patients admitted by gravity | 1.5 m2 per patient, but not less than 12 m2 |
|
| Bathroom with a lock in the waiting room | ||
| Filter box for examining children admitted by gravity | ||
| Control room with separate entrance and external vestibule | ||
| Room for registration of incoming patients | ||
| Information | ||
| Reception and viewing box | ||
| Charge nurse post | ||
| Isolation and diagnostic box | ||
| Pantry | ||
| Procedural | ||
| Dressing room | ||
| Dressing purulent | ||
| Plaster dressing room with storage room for plaster and plaster bandages | ||
| Small operating room with airlock | ||
| Urgent testing laboratory (may be common to the emergency department and intensive care unit): | ||
| - laboratory assistant | ||
| Washing-centrifuge | ||
| Material | ||
| Laboratory assistant's room | ||
| Endoscopy room: | ||
| Doctor's office | ||
| Procedural | ||
| Washing | ||
| X-ray room | ||
| Sanitary checkpoint for patients | ||
| Storage room for portable equipment | ||
| Room for temporary storage of patients' belongings | 0.3 m2 per patient, but not less than 6 m2 |
|
| Storage space for gurneys | ||
| Premises for: | ||
| Washing and disinfecting pots, vessels, washing and drying oilcloths | ||
| Storage of cleaning items | ||
| Temporary storage of dirty laundry | ||
| Storing disinfectants and preparing disinfectants | ||
| Office of the head of the department | ||
| Doctor's office | ||
| Head nurse's room | ||
| The hostess's room with a storage room for clean linen | ||
| Nursing staff room | ||
| Junior medical staff room | ||
| Bathroom with a lock for staff | ||
| Sanitary pass for personnel: | ||
| Dressing room for home and work clothes (the number of closets should be taken equal to 100% of the staff list) | 0.55 m2 per 1 cabinet |
|
| Smothered |
| Name of premises | Area, m2 |
|
| Control room with separate external entrance and vestibule | ||
| Reception and viewing box: | ||
| In infectious diseases hospitals (departments) for children | ||
| Isolation and diagnostic box: | ||
| In infectious diseases hospitals (departments) for adults | ||
| In children's infectious diseases hospitals (departments) | ||
| Isolation and diagnostic box for mother and child staying together | ||
| Pantry | ||
| Room for washing and sterilizing tableware (with a separate external entrance) | ||
| Kitchen utensil washing area | ||
| Charge nurse post | ||
| Doctor's office | ||
| Procedural-preparatory | ||
| Urgent analysis laboratory | ||
| Storage room for portable equipment | ||
| Room for temporary storage of infected linen and bedding (with a separate external entrance) | ||
| Office of the head of the department | ||
| Head nurse's room | ||
| The hostess's room with a storage room for clean linen | ||
| Staff room | ||
| Sanitary pass for personnel. | ||
| Dressing room for isolated storage of home and work clothes (the number of closets for storing home and work clothes should be taken equal to 100% of the staff) | 0.4 m2 per 1 closet for storing home clothes 0.4 m2 per 1 closet for storing work clothes |
|
| Shower room (the number of shower cabins should be taken at the rate of 1 shower cabin for 10 people) | 3 m 2 per 1 cabin |
|
| Staff room | ||
| Bathroom with a lock for staff | ||
| Room for storing cleaning items | ||
| Room for storage and dilution of disinfectants | ||
| Room for duty disinfectors for processing vehicles (with a separate external entrance) | ||
| Box for transport processing |
| Name of premises | Area, m2 |
|
| X-ray box: | ||
| Waiting room with external entrance | ||
| Waiting room bathroom | ||
| Procedural | ||
| Control room | ||
| Photo lab | ||
| Doctor's office | ||
| Barium preparation cabin | ||
| Operating box: | ||
| External vestibule at the entrance to the box | ||
| Internal airlock at the entrance to the box from the department | ||
| Waiting room with external entrance | ||
| Waiting room bathroom | ||
| Preoperative | ||
| Sterilization | ||
| operating room | ||
| Dressing room | ||
| Sanitary checkpoint for staff | ||
| Resuscitation box: | ||
| External vestibule at the entrance to the box | ||
| Internal airlock at the entrance to the box from the department | ||
| Pre-resuscitation | ||
| Reanimation room | ||
| Intensive care ward for 1 bed with nurse's station, drain and airlock | ||
| Birth box: | ||
| External vestibule at the entrance to the box | ||
| Internal airlock at the entrance to the box from the department | ||
| Room for sanitary treatment of women in labor | ||
| Maternity room for 1 bed with toilet for a newborn | ||
| Preparatory staff with shower |
| Name of premises | Area, m2 |
|
| Multidisciplinary and specialized non-infectious hospitals |
||
| Waiting room | ||
| Room for putting on outerwear and shoes | ||
| Maternity hospitals and obstetric departments |
||
| Waiting room | ||
| Check out premises: | ||
| From the physiological department and the department of pathology of pregnant women | ||
| From the observation department | ||
| From the gynecological department | ||
| Infectious diseases hospitals (departments) |
||
| Waiting room | ||
| Extract room from departments consisting of semi-boxes (with shower)** | ||
| Room for discharge from departments consisting of wards (with shower)** | ||
| * Located in a group of service and household premises next to the room for storing outer clothing for patients. ** Placed in section |
||
APPENDIX 1
Layout of the network of health care facilities in Moscow by territorial planning levels
| 1st level 5 thousand population |
| Outpatient clinic of a general practitioner (family doctor) |
| 2nd level 50 - 80 thousand population |
| Territorial clinic for adults Territorial clinic for children Women's consultation |
| 3rd level 200 - 250 thousand population |
| Consultative and diagnostic center for adults Dental clinic Children's dental clinic Medical and physical education clinic Polyclinic for rehabilitation treatment Dermatovenerologic dispensary Multidisciplinary hospital Maternity hospital Nursing home |
| 4th level 800 - 1200 thousand population |
| Consultative and diagnostic center for children Anti-tuberculosis dispensary Narcological clinic Psychoneurological dispensary Tuberculosis hospital Narcological hospital Psychiatric hospital Aftercare hospital Children's Multidisciplinary Hospital |
| Level 5 8500 thousand population |
| Cardiology clinic Mammology dispensary Oncological clinic Endocrinological dispensary Family Planning and Reproduction Center Gastroenterology Hospital Urological hospital Eye Hospital Cancer hospital Infectious diseases hospital Skin and Venereal Diseases Hospital Psychoneurological hospital Orthopedic and traumatological rehabilitation hospital Neurological Rehabilitation Hospital Children's Surgical Hospital Children's Infectious Diseases Hospital Children's Orthopedic and Traumatology Hospital Children's Psychiatric Hospital Children's Psychoneurological Hospital Children's Tuberculosis Hospital Children's Dermatovenerological Hospital Children's Hospital for Rehabilitation Treatment |
APPENDIX 2
Throughput of doctor's offices per 1 hour of doctors' work
| Doctor's job title | Number of visits per 1 hour of doctors’ work |
||
| Adult population | Child population |
||
| I. At appointments in city, territorial and dental clinics for adults and children, antenatal clinics, dispensaries and medical units: |
|||
| Obstetrician-gynecologist | |||
| Allergist-immunologist | |||
| Gastroenterologist | |||
| Hematologist | |||
| Dermatovenerologist | |||
| Diabetologist | |||
| Doctor at acupuncture office | |||
| Infectious disease specialist | |||
| Cardiologist | |||
| Cardiorheumatologist | |||
| Physician for supervision of those involved in physical education and sports | |||
| Physiotherapy doctor | |||
| Doctor at chiropractic office | |||
| Neuropathologist | |||
| Nephrologist | |||
| Otolaryngologist | |||
| Ophthalmologist | |||
| Proctologist (coloproctologist) | |||
| Psychiatrist | |||
| Psychiatrist-narcologist | |||
| Neuropsychiatrist | |||
| Psychotherapist: | |||
| In the individual psychotherapy room | |||
| In the group psychotherapy room | |||
| Pulmonologist | |||
| Rheumatologist | |||
| Sex therapist | |||
| Dentist: | |||
| Dentist-therapist | |||
| Dentist-prosthetist, orthopedic dentist | |||
| Dental surgeon | |||
| Therapist | |||
| Teenage therapist | |||
| Traumatologist-orthopedist | |||
| Physiotherapist | |||
| Phthisiatrician | |||
| Endocrinologist | |||
| II. At appointments in advisory clinics, multidisciplinary and specialized advisory and diagnostic centers | 616 ´ 420 ´ 805 |
||
| Mobile manipulation table | 922 ´ 432 ´ 897 |
||
| Medical cabinet | 630´460´1850 |
||
| Gynecological chair | 1655 ´ 950 ´ 1600 |
||
| Folding dressing table | 1900 ´ 600 ´ 1640 |
||
| Mobile lamp | 550 ´ 300 ´ 1900 |
||
| Bactericidal irradiator | 575 ´ 150 ´ 215 |
||
| 450 ´ 400 ´ 800 |
|||
| Pedal bucket | 270´ 270´ 360 |
||
| Wash basin | 600´500´780 |
||
| 450 ´ 670 ´ 730 |
|||
| Wall hanger | 700 ´ 150 ´ 100 |
||
| 390´760 |
|||
| Changing table | 680 ´ 655 ´ 900 |
||
| Table for baby scales | 519 ´ 400 ´ 805 |
||
| Pot cabinet | 1345 ´ 275 ´ 1500 |
||
| Surgical washbasin | 650 ´ 590 ´ 850 |
||
| Functional bed | 2010 ´ 900 ´ 1000 |
||
| Bedside table | 475 ´ 400 ´ 740 |
||
| Ward table | 850 ´ 630 ´ 740 |
||
| 1800´750´622 |
|||
| Table for portable equipment | 640 ´ 800 ´ 800 |
||
| 1600 ´ 1700 |
|||
| Stand for sterilization boxes | 600 ´ 1104 |
||
| Stand for basins | 520´480´760 |
||
| mother and child. Area - 27.8 m2 | |||
Download document
MOSCOW GOVERNMENT
MOSKOMARCHITECTURE
ALLOWANCE
to MGSN 4.12-97
TREATMENT AND PREVENTIVE
INSTITUTIONS
SECTION III
1. DEVELOPED: State Unitary Enterprise MNIIP "Mosproekt - 4" (architect Sorokina Yu.V., engineer Demina E.S.), with the participation of:
Department of Health of the City of Moscow (Chief specialist in functional diagnostics Sakhno Yu.F.; Chief specialist in endoscopy Sotnikov V.N., Chief specialist in radiation diagnostics Director of the Scientific and Practical Center MP Varshavsky Yu.V.);
Employees of the SPC MP (deputy director, candidate of medical sciences Gureev G.T., head of the organizational and methodological department Zhavoronkova Z.V., head of the department of technical X-ray radiological control Berdyakov G.I.);
Head of the Department of Radiation Diagnostics of the Clinical Oncology Dispensary, Candidate of Medical Sciences, Associate Professor. Sologubova G.F.
2. PREPARED for approval and publication by the Department of Advanced Design, Standards and Coordination of Design and Survey Works of the Moscow Committee for Architecture.
3. AGREED: Department of Health of the City of Moscow and Moskomarkhitektura.
4. APPROVED AND PUT INTO EFFECT By order of the Moscow Committee for Architecture and Architecture of February 26, 2006 No. 38.
|
Scope of application. 1 1. Department (office) of functional diagnostics. 3 2. Endoscopy departments (rooms) 4 3. Department (department) of radiation diagnostics. 6 3.1. X-ray department. 6 3.2. Department of X-ray computed tomography (RT) 11 3.3. Magnetic resonance imaging room. 12 3.4. Department (laboratory) of radionuclide diagnostics. 12 Appendix 1. Approximate dimensional diagrams of the main premises of the functional diagnostics department with the necessary equipment and furniture.. 15 Appendix 2. Approximate dimensional diagrams of the main premises of the endoscopy department with the necessary equipment and furniture.. 19 Appendix 3. Approximate dimensional diagrams of the main premises of the radiology department with the necessary equipment and furniture.. 21 Appendix 4. Approximate overall diagram of a computed tomography room with the necessary equipment and furniture.. 28 Appendix 5. Approximate overall diagram of a magnetic resonance imaging room with the necessary equipment and furniture.. 29 Appendix 6. Approximate overall diagram of the scanning room with the necessary equipment and furniture.. 30 |
INTRODUCTION
The manual was developed to develop the existing MGSN 4.12-97 “Medical and preventive institutions”.
Section V - Outpatient clinics (Issue 7);
Section VI - Service and utility premises. Ambulance and emergency medical care substations. Dairy kitchens and distribution points of dairy kitchens (Issue 8);
Section VII - Engineering Equipment (Issue 9).
This Issue 5 of the Manual sets out the basic provisions and specific requirements for the design of departments (offices) of functional diagnostics, endoscopic departments (offices), departments (departments) of radiation diagnostics (radiology, computed tomography, magnetic resonance imaging, radionuclide diagnostic laboratories), as well as recommended compositions and areas of premises and approximate dimensional diagrams with a set of necessary technological equipment.
The manual is intended for designers, as well as for healthcare organizers working in the field of planning and design of medical institutions.
AREA OF APPLICATION
1. This edition of the Manual applies to the design of departments (offices) of functional diagnostics, endoscopic departments (offices), departments of radiation diagnostics (x-ray diagnostics, magnetic resonance imaging, radioisotope diagnostic laboratories) of new and reconstructed medical institutions, regardless of their organizational and legal forms and forms of ownership.
2. When designing medical institutions, one should be guided by the requirements of SNiP 2.08.02-89*, MGSN 4.12-97, MGSN 4.01-94, and other regulatory documents in construction in force in Moscow, and also take into account the provisions of issues 1, 2, 3, 4 Manuals for MGSN 4.12-97 and this issue.
Until the release of subsequent editions of the Manual for MGSN 4.12-97, you should also be guided by the Manual for the design of healthcare institutions (to SNiP 2.08.02-89 *) in terms of departments, divisions and institutions not included in issues 1, 2, 3, 4 and 5 of this Manual .
1. DEPARTMENT (OFFICE) OF FUNCTIONAL DIAGNOSTICS
1.1. The department (office) of functional diagnostics is a structural subdivision of a medical and preventive institution (inpatient or outpatient).
The main objectives of the department are to carry out research using special biophysical methods and means for the purpose of physiological assessment of the state of organs, systems and the body as a whole of healthy and sick people, as well as drawing up a qualified conclusion based on the results of these studies by a specialist doctor.
1.2. In outpatient clinics, studies are carried out both directly in the department in specially equipped rooms, and at home.
In inpatient institutions, studies are carried out both directly in the department in specially equipped rooms, and in other departments (reception, ward) in cases where the patient is not transportable. In this regard, and also due to the fact that examinations of the patient are carried out repeatedly during his stay in the hospital, functional diagnostic departments should have convenient and, if possible, short connections with the emergency department and ward departments.
In the offices of the functional diagnostics department of a hospital, it should be possible to transport a patient on a gurney.
1.3. The couch on which the study is being conducted must be approached from three sides. All devices, as well as couches in the department, must be grounded.
1.4. All working rooms (rooms in which research is carried out) of the department must be located outside the zone of influence of electromagnetic fields, away from x-ray diagnostic rooms and electrophototherapy rooms, due to the fact that research is carried out using highly sensitive electronic equipment. When designing these premises, the following requirements should be taken into account: the need to eliminate vibration interference, increased requirements for noise protection, as well as the installation of electrical screens with grounding.
1.5. Approximate dimensional diagrams of the main premises of the functional diagnostics department with the necessary equipment and furniture are given in Appendix 1.
1.6. The composition and area of the premises of functional diagnostic departments is determined by the design assignment. The set of premises for hospitals depends on the profile of ward departments, for consultative and diagnostic centers - on the specialization of doctor's offices.
Table 1
|
№№ |
Name of premises |
Area, m2 |
|
Electrocardiography room: |
||
|
Diagnostic room |
||
|
Doctor's office for ECG interpretation |
||
|
Changing room 1) |
||
|
Electro/echoencephalography room: |
||
|
Diagnostic room |
||
|
Screened cabin |
||
|
Changing room 1) |
||
|
Echoencephalography room: |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Study room for external respiration function |
||
|
Phonocardiography room: |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Polycardiography room |
||
|
Load testing room: |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Study room for regional circulatory disorders: |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Rheoencephalography room |
||
|
Room of rheography, oscillography, plethysmography |
||
|
Echocardiography room: |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Holter monitoring room |
||
|
Electromyography room |
||
|
Ultrasound room (abdominal studies): |
||
|
Diagnostic room |
||
|
Changing room 1) |
||
|
Room for functional studies of the stomach |
||
|
Ultrasound room for puncture biopsy |
||
|
Thermal imaging room: |
||
|
Diagnostic room |
||
|
Changing cabin |
||
|
Air conditioner room |
||
|
Photo lab |
||
|
Liquid nitrogen storage room |
||
|
Doctor's office |
||
|
Long-term ECG monitoring room |
||
|
Room for reception, registration and interpretation of ECG by telephone |
||
|
Room for learning new techniques |
||
|
Photo lab |
||
|
Head nurse's room |
||
|
Staff room |
||
|
Storage room for portable equipment |
||
|
Expected 2) |
||
|
Staff room |
||
|
Bathroom with a lock for patients |
||
|
Bathroom with a lock for staff |
||
|
2) The expected area is provided at the rate of 4.8 m 2 per 1 diagnostic room. |
||
2. ENDOSCOPIC DEPARTMENTS (ROOMS)
2.1. The endoscopy department (office) is a structural subdivision of a medical institution (inpatient or outpatient).
2.2. The main objective of the department is the use of endoscopic methods for the early diagnosis and treatment of diseases of the gastrointestinal tract, upper respiratory tract and bronchopulmonary apparatus, abdominal organs, gynecological and urological diseases.
2.3. The endoscopy department of a hospital should be planned close to the ward departments and have a separate entrance. The set of department rooms must correspond to the specialization of the ward departments of the hospital.
2.4. With a narrow specialization of the hospital, the endoscopy department (rooms) can be located directly in the ward department (departments), while remaining an independent structural unit.
2.5 The endoscopy department (rooms) can be located in a separate medical and diagnostic building, connected to the ward departments by a passage.
2.6. In hospitals operating in the emergency medical care system, it is necessary to provide for convenient communication between the endoscopy department (rooms) and the emergency department, surgical departments and the department of anesthesiology and intensive care.
2.7. When designing an endoscopy department (rooms) as part of a hospital facility, it is necessary to provide for the possibility of transporting patients on gurneys.
2.8. In the system of outpatient clinics, full-fledged endoscopy departments are designed as part of Consultative and Diagnostic Centers.
Regional clinics may have separate endoscopy rooms.
In both cases, the structure and set of offices depends on the profiles of medical offices and are determined by the design assignment.
2.9. In outpatient clinics, an endoscopic operating room is not provided.
2.10. In endoscopic operating rooms, it is necessary to have special devices designed to lift endoscopic equipment during cleaning.
2.11. When designing the department, it is necessary to take into account that for a number of endoscopic examinations, X-ray control is required (in accordance with the requirements of SanPiN 2.6.1.1192-03).
2.12. Approximate outline diagrams of the main premises of the endoscopy department with the necessary equipment and furniture are given in Appendix 2.
Table 2
|
№№ |
Name of premises |
Area, m2 |
|
Gastroscopy room: |
||
|
Doctor's office |
||
|
Procedural |
||
|
Preparatory 1) |
||
|
Sigmoidoscopy room (colonoscopy, cystoscopy): |
||
|
Doctor's office |
||
|
Treatment room with drain (18 + 2) |
||
|
Changing room 1) |
||
|
Endoscopy room: 2) |
||
|
Small operating room |
||
|
Preoperative |
||
|
Ultrasonography room: |
||
|
Operating room 3) with gateway (36 + 2) |
||
|
Preoperative |
||
|
Operating sigmoidoscopy, colonoscopy, cystoscopy, hysteroscopy: 4) |
||
|
Operating room with airlock and drain (36 + 2 + 2) |
||
|
Preoperative |
||
|
Sick rest room |
||
|
Bathroom for patients |
||
|
Operating laparoscopy, gastroscopy and bronchoscopy: 4) |
||
|
operating room |
||
|
Preoperative |
||
|
Gateway at the entrance to the operating room |
||
|
Sick rest room |
4 m2 per 1 bed, but not less than 8 m2 |
|
|
Washing and disinfection of endoscopic equipment (consists of “clean” and “dirty” zones) |
||
|
Equipment storage room |
||
|
Photo lab |
||
|
Office of the head of the department 5) |
||
|
Head nurse's room with utility room (10 + 8) |
||
|
Staff room |
||
|
Staff room 5) |
||
|
Room for conferences and meetings 6) |
||
|
Expected 7) |
||
|
Cleaning equipment storage room |
||
|
Bathroom with lock for staff (3 + 3) |
||
|
Bathroom with airlock for patients (3 + 3) |
||
|
1) For outpatient clinics. |
||
|
2) Intended to provide emergency endoscopic care in emergency departments of emergency hospitals. |
||
|
3) Provide protective equipment in accordance with the Hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations. |
||
|
4) For hospital use only. |
||
|
5) If the department has at least 4 diagnostic rooms. |
||
|
6) If the department has at least 6 diagnostic rooms. |
||
|
7) The expected area is provided at the rate of 4.8 m2 per 1 diagnostic room. |
||
3. DEPARTMENT (DEPARTMENT) OF RADIOLOGY DIAGNOSTICS
The department (department) of radiation diagnostics is organized on the basis of treatment and preventive institutions, clinics of medical and research institutes and is their structural unit.
The department (department) of radiation diagnostics includes departments, offices and laboratories for X-ray, angiography, X-ray tomography, magnetic resonance, radioisotope, ultrasound and other types of diagnostics, depending on the profiles of ward departments and medical reception rooms of medical institutions.
The placement of X-ray rooms and premises related to work with radioactive substances is carried out in accordance with the hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations, as well as other applicable regulatory documents.
Procedural X-ray rooms, rooms and premises of the radiology department, in which there are sources of ionizing radiation, rooms of radioisotope diagnostic laboratories, where work of classes 1 and 2 is carried out, is not allowed to be placed adjacent (horizontally and vertically) to the wards of pregnant women and children.
3.1. X-ray department
3.1.1. The X-ray department is an independent division of a medical institution (inpatient or outpatient), or is part of the department (department) of radiation diagnostics.
3.1.2. The placement of X-ray departments (rooms) in residential buildings and children's institutions (nurseries, kindergartens, schools) is prohibited. In some cases, in agreement with the sanitary and epidemiological service authorities, it is allowed to place radiology departments (rooms) in a separate extension to a residential building, as well as in the basement floors.
3.1.3. It is permitted to place X-ray dental rooms in residential buildings, provided they are equipped with dental devices that work with highly sensitive image receivers, or with digital image processing, the workload of which does not exceed the standard (SanPiN 2.6.1.1192-03).
3.1.4. Stationary radiation protection means of the X-ray treatment room (walls, floor, ceiling, protective doors, shutters, observation windows, etc.) must ensure attenuation of X-ray radiation to a level at which the main dose limit (PD) for the corresponding categories of exposed persons will not be exceeded ( SanPiN 2.6.1.1192-03).
3.1.5. In united treatment and preventive institutions (a hospital with an outpatient department, or a consultative and diagnostic center), the radiology department should be centralized and serve both inpatient and outpatient patients, with the exception of cases where the hospital structure has infectious, tuberculosis , obstetric and pediatric departments. The presence of X-ray rooms in these departments is provided for in the design assignment.
3.1.6. Entrances to the radiology department for inpatients and for visitors to the outpatient department should be separate.
The placement of the department in the planning structure of the medical institution should provide for convenient and short connections with the ward departments and the outpatient department.
The X-ray department should not be walk-in.
3.1.7. The number of X-ray rooms for general examinations in inpatient health care facilities is determined by the design assignment (at the rate of 1 room for universal X-ray machines for 200 beds). Additionally, an X-ray room is provided at the emergency department. In territorial clinics - one office for 400 visits per shift (excluding the X-ray fluorography room), in consultative and diagnostic centers - one office for 250 visits per shift.
3.1.8. The X-ray operating unit (room) is organized as part of the department (department) of radiology diagnostics of a multidisciplinary hospital, which includes thoracic, abdominal, urological, vascular and other surgical departments, or a diagnostic center in the presence of appropriate conditions (hospital, intensive care unit, etc. .)
3.1.9. In inpatient and outpatient clinics that include a traumatology and orthopedic (traumatology) department (office), an additional x-ray room is provided.
3.1.10. It is allowed to provide only artificial lighting in the X-ray room.
3.1.11. The X-ray room for general examinations includes a treatment room, control room and darkroom.
3.1.12. The area of the treatment room can be adjusted in accordance with the technological design approved in accordance with the established procedure, taking into account the following requirements:
The distance to the personnel workplace behind a small protective screen to the walls of the room is at least 1.5 m;
The distance from the personnel workplace behind a large protective screen to the walls of the room is at least 0.6 m;
The distance from the rotating tripod table or from the imaging table to the walls of the room is at least 1.5 m;
The distance from the photo stand to the nearest wall is at least 0.1 m;
The distance from the X-ray tube to the viewing window is at least 2 m (for mammography and dental devices - at least 1 m);
The width of the technological passage for personnel between the tripods is at least 0.8 m;
The area where the gurney is placed for the patient is at least 1.5×2 m;
Additional area if there is a technological need to bring a gurney into the treatment room: 6 m2.
3.1.13. In the treatment room of the X-ray room for general research, it is allowed to additionally install a small-sized X-ray machine with a voltage of up to 60 kW for dental photographs and mammography.
3.1.14. The doctor's office should not be located in close proximity to the treatment room.
3.1.15. The photo lab can be common to two offices or be attached to one office. The entrance to the darkroom should be provided directly from the treatment rooms.
3.1.16. A darkroom can consist of one room - a “dark room”. When the laboratory is equipped with a developing machine and there is a large volume of work, an additional “light” room should be provided for sorting, marking and trimming dry photographs.
3.1.17. The archive of radiation diagnostics materials is an integral part of the department (department) of radiation diagnostics. Depending on the type of storage medium, the archive allocates rooms for storing film materials, magnetic materials, and paper media.
The archive is divided into three parts:
Operative (images of patients examined during the year);
Basic (with a shelf life of radiographs of more than a year);
Educational and scientific archive.
The premises of the operational and scientific-educational archive are located directly in the radiology department.
The main archive may be located outside the radiology department in medical and auxiliary buildings. The archive room must be dry, protected from direct sunlight, it can be located in the basement without windows; if there are windows, they are screened with protective curtains or blinds.
3.1.17. Radiology departments may include ultrasound diagnostic rooms.
3.1.18. Approximate dimensional diagrams of the main premises of the radiology department with the necessary equipment and furniture are given in Appendix 3.
The recommended area of premises can be reduced, and the set of premises can be changed according to the design specifications of the equipment manufacturer. At the same time, the organization of work must ensure general hygiene requirements.
Table 3.1.
|
№№ |
Name of premises |
Area, m2 |
|
Fluorography room for mass research: |
||
|
Procedural |
||
|
Changing cabin |
||
|
Expected |
||
|
Photo lab 1) |
||
|
Staff room |
||
|
X-ray room with universal X-ray machine |
||
|
Procedural |
||
|
Control room |
||
|
Changing room 2) |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Bathroom |
||
|
X-ray room for general research with 3 workstations |
||
|
Procedural |
||
|
Control room |
||
|
Changing room 2) |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Bathroom |
||
|
X-ray room for radiography and/or tomography 3) |
||
|
Procedural |
||
|
Control room |
||
|
Changing room 2) |
||
|
Photo lab 1) |
||
|
Staff room |
||
|
X-ray mammography room: |
||
|
Procedural |
||
|
Small operating room for ductography and punctures under ultrasound control |
||
|
Changing room 2) |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
X-ray urology room: |
||
|
Procedural (with drain) |
||
|
Control room |
||
|
Photo lab 1) |
||
|
Changing cabin with daybed 2) |
||
|
Doctor's office |
||
|
X-ray diagnostic box with a universal X-ray apparatus for infectious diseases departments: |
||
|
Gateway at the entrance to the box |
||
|
Waiting room with bathroom (6 + 3) |
||
|
Procedural |
||
|
Control room |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Staff bathroom |
||
|
Tonometry room (radiation therapy planning): |
||
|
Procedural |
||
|
Control room |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Ultrasound room |
||
|
Rooms for X-ray dental examinations 4): |
||
|
X-ray diagnostic room for dental diseases using radiography with a dental apparatus working with a digital image receiver: |
||
|
Procedural |
||
|
Control room |
||
|
X-ray room for diagnosing dental diseases using radiography with a dental apparatus working with ordinary film without an intensifying screen: |
||
|
Procedural |
||
|
Control room |
||
|
Photo lab |
||
|
X-ray diagnostic room using panoramic radiography or panoramic tomography with an orthopantomograph: |
||
|
Procedural |
||
|
Control room 5) |
||
|
Photo laboratory 1) |
||
|
X-ray operating unit: |
||
|
Diagnostic unit for heart and vascular diseases: |
||
|
X-ray operating room with biplanar angiograph |
||
|
Control room |
||
|
Preoperative |
||
|
Sterilization 2) |
||
|
Room for temporary stay of the patient after the study 2) |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Diagnostic unit for lung and mediastinal diseases: |
||
|
X-ray operating room with a general-purpose single-plane angiograph |
||
|
Control room |
||
|
Preoperative |
||
|
Sterilization 2) |
||
|
Cytological diagnostic room 2) |
||
|
Photo lab 1) |
||
|
Image review room 2) |
||
|
Doctor's office |
||
|
Nurses room |
||
|
Storage room for dirty linen 2) |
||
|
Diagnostic unit for diseases of the urogenital system: |
||
|
X-ray operating room |
||
|
Control room |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Bathroom for patients |
||
|
RKT office 8) |
||
|
Procedural |
||
|
Control room |
||
|
Generator/computer room |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Changing cabin |
||
|
Image review room 2) |
||
|
Contrast preparation room |
||
|
Common areas of the department |
||
|
Office of the head of the department |
||
|
Professor's office |
||
|
Assistants' room |
||
|
Study room |
||
|
Staff room |
||
|
Expected 6) |
||
|
Material with a compartment for temporary storage of X-ray film stock (no more than 100 kg) |
||
|
Spare parts storeroom 7) |
||
|
Pantry of cleaning supplies |
||
|
Operational and educational-scientific archive premises |
||
|
Main archive premises (long-term storage of images) |
||
|
Staff personal hygiene room |
||
|
Bathroom with airlock (3 + 3)?2 |
||
|
Computer |
||
|
Engineers' room |
||
|
1) When using devices for digital radiography and fluorography, |
||
|
3) If there is a trauma department and emergency rooms. |
||
|
4) When installing more than one X-ray detailed device in a treatment room, the area of the room must be increased depending on the type of device, but not less than 4 m2 for each additional device. |
||
|
5) May be absent when using devices equipped with means of protecting personnel workplaces (protective booths, protective barriers, etc.). |
||
|
6) The expected area is provided at the rate of 4.8 m2 per 1 diagnostic room, but not less than 10 m2 |
||
|
7) If the number of devices is more than 2, increase the area by 2 m2 for each device. |
||
|
8) If there are two or more offices, an independent department is formed. |
||
3.2. Department of X-ray computed tomography (XCT)
3.2.1. The X-ray computed tomography department is an independent department of a medical institution (inpatient or outpatient), or is part of the department (department) of radiation diagnostics.
3.2.2. The area of the premises of the X-ray computed tomography room is specified by the manufacturer of the computed tomography scanner in the form of a design proposal, which is taken into account when creating the technological design of the room, but does not replace it.
3.2.3. An approximate overall diagram of a computed tomography room is given in Appendix 4.
Table 3.2.
|
№№ |
Name of premises |
Area, m2 |
|
RKT office |
||
|
Procedural |
||
|
Control room |
||
|
Generator/computer room |
||
|
Photo lab 1) |
||
|
Doctor's office |
||
|
Changing cabin |
||
|
Image review room 2) |
||
|
Contrast preparation room |
||
|
Common areas of the department |
||
|
Office of the head of the department |
||
|
Staff room |
||
|
Expected 3) |
||
|
Material |
||
|
Spare parts storeroom 4) |
||
|
Pantry of cleaning supplies |
||
|
Staff personal hygiene room |
||
|
Bathroom with airlock (3 + 3) ? 2 |
||
|
Engineers' room |
||
|
1) When using devices for digital radiography, there may not be any |
||
|
2) May not be included in the design assignment. |
||
|
3) The expected area is provided at the rate of 4.8 m2 per 1 diagnostic room, but not less than 10 m2 |
||
|
4) If the number of devices is more than 2, increase the area by 2 m2 for each device. |
||
3.3. Magnetic resonance imaging room
3.3.1. The magnetic resonance imaging (MRI) room is part of the radiology department (department) of a medical institution.
3.3.2. When placing the MRI room, the heavy weight of the MRI scanner should be taken into account (the load-bearing capacity of the floor is calculated in accordance with the load from the installation).
3.3.3. Patients with pacemakers and other types of implanted electronic stimulators are not allowed to be in the magnetic induction zone up to 0.5 milli Tesla (mT). The magnetic induction zone (more than 0.5 mT) must be marked with warning signals in accordance with current regulations, and entry into it must be constantly monitored.
3.3.4. The MRI room includes: scanning room (RF cabin), control room, technical room, undressing cabin.
3.3.5. The area of the MRI room is determined based on the recommendations of the equipment manufacturer and is agreed upon with the State Sanitary and Epidemiological Supervision Service in the prescribed manner.
3.3.6. An approximate outline diagram of the magnetic resonance imaging room is given in Appendix 5.
Table 3.3.1.
|
№№ |
Name of premises |
Area, m2 |
|
Magnetic resonance imaging room: |
||
|
Treatment room (RF cabin) |
||
|
Control room |
||
|
Preparatory |
||
|
Technical room |
||
|
Changing cabin |
||
|
Research Processing Room |
||
|
Doctor's office |
||
|
Bathroom for patients |
||
|
Office of the head of the department |
||
|
Staff room |
||
|
Engineers' room |
||
|
Material |
||
|
Spare parts storeroom 1) |
||
|
Expected 2) |
||
|
Pantry of cleaning supplies |
||
|
Staff personal hygiene room |
||
|
Bathroom with airlock (3 + 3)?2 |
||
|
1) If the number of devices is more than 2, increase the area by 2 m2 for each device. |
||
|
2) The waiting area is provided at the rate of 4.8 m2 per diagnostic room, but not less than 10 m2 |
||
3.4. Department (laboratory) of radionuclide diagnostics
3.4.1. The department (laboratory) of radionuclide diagnostics is an independent division of an inpatient treatment and preventive institution, or is part of the department (department) of radiation diagnostics.
The department (laboratory) of radionuclide diagnostics should not be located in residential buildings and children's institutions.
3.4.2. Premises for radiological research must be protected by adjacent premises containing sources of ionizing radiation (calculated dose rate - 0.03 mrem/hour).
3.4.3. Entrances to the department (laboratory) of radionuclide diagnostics for inpatient and outpatient department patients must be separate.
3.4.4. The department (laboratory) of radionuclide diagnostics should not be walk-through.
3.4.5. When receiving radioactive sources and disposing of radioactive waste maintained to a specified level of activity, it is necessary to provide a separate external entrance.
3.4.6. The IN VITRO radiodiagnostic research unit with radioisotope support rooms can be provided outside the radionuclide diagnostics department (laboratory).
3.4.7. The treatment room with a generator of short-lived isotopes should be close to the premises for the gamma camera.
3.4.8. Premises where open radioactive sources are used for diagnostic purposes based on activity in the workplace, as a rule, belong to premises for class III work, with the exception of premises intended for storing radioactive substances and their packaging, which are arranged in class II. In class II, premises are also arranged in which methods are used that require increased activity of radiopharmaceuticals (in accordance with the initial design data and sanitary rules).
3.4.9. Class III work premises intended directly for diagnostic research, in order to avoid obtaining distorted data caused by the influence of extraneous radioactive sources on radiometric equipment, must be as far as possible from the premises where radioactive substances are stored (storage) and where work is carried out with them in quantities exceeding the minimum significant activity (not requiring registration with sanitary authorities). In rooms for class III work, supply and exhaust ventilation must be provided with 4-fold air exchange during exhaust and 3-fold in inflow. Premises for each class of work must be concentrated in one part of the building.
3.4.10. An approximate overall diagram of the scanning room with the necessary equipment and furniture is given in Appendix 6.
Table 3.4.1.
|
№№ |
Name of premises |
Area, m2 |
|
Radioisotope supply unit: |
||
|
Room for receiving radiopharmaceuticals |
||
|
Radiopharmaceutical storage facility |
||
|
Packing of radiopharmaceuticals |
||
|
Sanitary radiation gateway of the radioisotope supply unit |
||
|
Radioactive waste storage room |
||
|
Block of radiodiagnostic studies "IN VIVO": |
||
|
Procedural unit for intravenous administration of radiopharmaceuticals with a short-range isotope generator |
||
|
Procedural for oral administration of radiopharmaceuticals |
||
|
Procedural scintigraphy (with gamma camera) |
||
|
Console scintigraphy |
||
|
Computer |
||
|
Photo lab |
||
|
Scan room |
||
|
Radiometry room (renography, radiocirculography, radiocardiography, etc.) |
||
|
Room for radiometry of biological media |
||
|
Observation room |
||
|
Expected |
4.8 m2 per diagnostic room, but not less than 10 m2 |
|
|
Radiodiagnostic research unit "IN VITRO": |
||
|
Radiochemical |
18 m2 for 2 workplaces; for each additional area should be increased by 6 m2 |
|
|
Radiometric |
12 m 2 for 1 automatic counter; for each additional area it should be increased by 6 m2 |
|
|
Centrifugal |
||
|
Storage-cryogenic |
10 m2 for 2 low-temperature cabinets; for each additional area it should be increased by 4 m2 |
|
|
Laboratory assistant |
||
|
Procedure room for taking blood samples |
||
|
Expected |
||
|
Doctor's office |
||
|
General premises of the department (laboratory) of radionuclide diagnostics |
||
|
Doctors room |
10 m2 for 2 doctors, for each doctor in excess of 2 the area should be increased by 4 m |
|
|
Office of the head of the department |
||
|
Staff bathroom |
||
|
Bathroom for patients |
||
|
Head nurse's room with material |
||
|
Room for engineering and technical personnel with a workshop for repairing and setting up equipment |
||
|
Pantry for cleaning supplies (for common areas) |
||
|
Storeroom for spare parts and consumables |
||
|
Personnel personal hygiene cabin |
||
|
Staff room |
3.25 m2 per person, but not less than 10 m2 |
4. REGULATORY REFERENCES
4.1 SNiP 2.08.02-89* “Public buildings and structures.”
4.2 SNiP 2.04.05-91* “Heating, ventilation and air conditioning.”
4.3 SanPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals.”
4.4 MGSN 4.12-97 “Treatment and preventive institutions.”
4.5 Issues 1, 2, 3 and 4 of the Manual for MGSN 4.12-97.
4.6 MGSN 2.01-99 “Energy saving in buildings. Standards for thermal protection and heat and water power supply.”
4.7 Sanitary rules and regulations SanPiN 2.6.1.1192-03 “Hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations.”
4.8 Sanitary and epidemiological rules SP 3.1.1275-03 “Prevention of infectious diseases during endoscopic manipulations.”
Appendix 1
Approximate dimensional diagrams of the main premises of the department of functional diagnostics with the necessary equipment and furniture
Explication of equipment
|
№№ |
Equipment name |
Dimensions, mm |
|
Doctor's desk |
||
|
Computer desk |
||
|
Printer cart |
||
|
Working chair |
||
|
Examination couch |
||
|
Semi-soft chair |
||
|
Four-leaf screen |
||
|
Table for pneumotachometer with computer and printer |
||
|
Doctor's workplace with computer electroencephalograph |
||
|
Veloergotest |
||
|
Multichannel electrocardiograph |
||
|
Single door medical cabinet |
||
|
Filing cabinet |
||
|
Pedal bucket |
||
Figure 1.1. Study room for regional circulatory disorders
Rice. 1.2. Study room for external respiration functions
Rice. 1.3. A. Electrocardiography room with physical activity
B. Room for ECG interpretation
Rice. 1.4. Electro/echoencephalography room
Appendix 2
Approximate dimensional diagrams of the main premises of the endoscopy department with the necessary equipment and furniture
Explication of equipment
|
№№ |
Equipment name |
Dimensions, mm |
|
Doctor's desk |
||
|
Computer desk |
||
|
Printer cart |
||
|
Table-bedside table for equipment with hinged doors |
||
|
Examination couch |
||
|
Screw chair |
D = 320; H = 400/545 |
|
|
Semi-soft chair |
||
|
Four-leaf screen |
||
|
Ceiling bactericidal irradiator |
||
|
Double-leaf medical cabinet |
||
|
Long-term infusion stand |
||
|
General purpose X-ray viewer |
||
|
Dressing table |
||
|
Stand for sterile boxes |
||
|
Stand for basins |
||
|
Intermittent flow inhalational anesthesia apparatus |
||
|
Gynecological chair with hydraulic drive |
||
|
Universal operating table |
||
|
Ceiling lamp 6 reflector |
||
|
Mobile 4-reflector lamp |
||
|
Device for high-frequency electrosurgery |
||
|
Anesthesiologist's table |
||
|
Tool table |
||
|
Medical surgical table |
||
|
Surgical washbasin |
||
|
Rectangular porcelain washbasin with backrest |
||
|
Hospital drain (viduar) |
||
|
Rectangular ceramic washbasin |
||
|
Household refrigerator |
||
|
Pedal bucket |
Rice. 2.1. Sigmoidoscopy room
Rice. 2.2. Endoscopic operating room
Appendix 3
Approximate dimensional diagrams of the main premises of the radiology department with the necessary equipment and furniture
Explication of equipment
|
№№ |
Equipment name |
Dimensions, mm |
|
Rotating tripod table with emitter (without grille) |
||
|
Photo tripod with emitter |
||
|
Picture table horizontal |
||
|
Tomography attachment drive |
||
|
Control panel for tomography attachments |
||
|
Rotating tripod table with column for images and tomography |
||
|
Picture rack |
||
|
Stationary dental x-ray device |
L = 1530, H = 560 |
|
|
Panoramic tomography device |
||
|
Electrical cabinet |
||
|
Panoramic tomography device control panel |
||
|
Power supply unit |
||
|
Video monitoring device |
||
|
Low-voltage power supply rack |
||
|
Power supply control panel |
||
|
Low-voltage power supply cabinet |
||
|
Medium Frequency X-ray Feeder |
||
|
Manual control panel with attachment |
||
|
Support stand with tube |
||
|
Patient lift with drive and footrest |
||
|
Floor-standing tripod with emitter |
||
|
Digital CCD camera |
||
|
Device for preparing radiopaque suspension |
||
|
Scanner for digitizing X-ray film |
||
|
Wall-mounted X-ray viewer |
||
|
X-ray laboratory technician's workstation |
||
|
X-ray unit for angiocardiography |
||
|
27a Ceiling tripod with URI |
||
|
27b Digital display |
||
|
27v Control panel |
||
|
27g Angiography table |
||
|
27d Ceiling system with two monitors |
||
|
27e Injector |
||
|
Upper protective screen with operating lamp on rails |
||
|
Remote video monitoring device |
||
|
Cardiac catheterization registration station |
||
|
Station for archiving and reproducing cardiac images |
||
|
Cabinet for equipment |
||
|
Automated radiologist workstation (AWS) |
||
|
Generator power supply |
||
|
Automatic developing machine (thermostat tank) |
||
|
Wash tank |
||
|
Non-actinic lantern |
||
|
General purpose X-ray viewer |
||
|
Electric drying cabinet for X-ray films |
||
|
Cassette holder for storing cassettes with X-ray films |
||
|
Tool rack |
||
|
Dental chair |
||
|
Examination couch |
||
|
Doctor's desk |
||
|
Operator desk |
||
|
Chemical laboratory table |
||
|
Screw chair |
D = 320, H = 430/545 |
|
|
Large protective screen |
||
|
Small protective screen |
||
|
X-ray protective viewing window |
||
|
Enameled steel sink with voluminous back |
||
|
Rectangular porcelain washbasin with backrest |
||
B. Photo lab D. Bathroom
Rice. 3.1. X-ray room with universal X-ray machine
A. Control room B. Treatment room
B. Photo lab D. Bathroom
Rice. 3.2. X-ray room for general research with 3 workstations
A. Control room
B. Photo laboratory
B. Procedural
G. Bathroom
Rice. 3.3. X-ray room for general examinations with increased throughput
A. Procedural
B. Photo laboratory
Rice. 3.4. X-ray room for diagnosing dental diseases using radiography with a dental apparatus
A. Procedural
B. Control room
B. Photo laboratory
Rice. 3.5. X-ray diagnostic room using panoramic radiography or panoramic tomography
A. Procedural
B. Control room
Rice. 3.6. Diagnostic unit for heart and vascular diseases
Rice. 3.7. Fragment of the planning solution for the radiology department
Rice. 3.8. Fragment of the planning solution for the radiology department
Appendix 4
Approximate overall diagram of a computed tomography room with the necessary equipment and furniture
Explication of equipment
|
№№ |
Equipment name |
Dimensions, mm |
|
Patient table |
||
|
Power connection cabinet |
||
|
Monitor Cart |
||
|
Injection system |
||
|
Distribution cabinet |
||
|
Control panel with container (image system) |
||
|
Management Console |
||
|
Image processing system with container |
||
|
Demonstration X-ray viewer |
||
|
Doctor's desk |
||
|
Operator desk |
||
|
X-ray protective viewing window |
||
|
Wall-mounted bactericidal irradiator |
||
|
Examination couch |
||
|
Rectangular porcelain washbasin with backrest |
Rice. 4.1. X-ray diagnostic room using radiography and/or tomography
Appendix 5
Approximate overall diagram of a magnetic resonance imaging room with the necessary equipment and furniture
Explication of equipment
|
№№ |
Equipment name |
Dimensions, mm |
|
Magnet OR70 (variable induction 1.5 T) |
||
|
Patient table |
||
|
RF filter |
||
|
Magnet stop panel |
||
|
Reel trolley |
||
|
Electronics cabinet |
||
|
Cooling cabinet |
||
|
Water connection block |
||
|
Computer image |
||
|
Operator desk |
||
|
MRC central computer |
||
|
Control and alarm panel |
||
|
Doctor's desk |
||
|
Central computer MRSC |
||
|
Transformer |
||
|
Uninterruptible power supply |
||
|
Cabinet with batteries for 10 minutes |
||
|
Injector for MP |
||
|
Network distributor |
||
|
Air conditioning system |
||
|
Wash basin |
||
|
Protective viewing window |
Rice. 5.1. Approximate overall diagram of a magnetic resonance imaging room
Appendix 6
Approximate overall diagram of a scanning room with the necessary equipment and furniture
Equipment explanations
Section II
INPATIENTS
Operating blocks.
Department of Anesthesiology and Reanimation.
Hemodialysis and detoxification departments.
Department of industrial transfusiology.
Hyperbaric oxygenation departments.
PREFACE
1. DEVELOPED: State Unitary Enterprise MNIIP "Mosproekt-4" (architects Yu.V. Sorokina, G.I. Rabinovich, doctor G.N. Ilnitskaya, engineer E.S. Demina) with the participation of the State Sanitary and Epidemiological Supervision Center in Moscow (candidate. med. sciences I.A. Khrapunov).
2. PREPARED for approval and publication by the Department of Advanced Design and Standards of the Moscow Architecture Committee (architect L.A. Shalov, engineer Yu.B. Shchipanov).
3. AGREED BY: the Center for State Sanitary and Epidemiological Surveillance in Moscow, the Moscow Health Committee and the Moscow Architecture Committee.
4. APPROVED AND PUT INTO EFFECT by Directive of the Moscow Committee for Architecture and Architecture dated January 29, 2003 No. 5.
INTRODUCTION
INTRODUCTION
This Issue of the Manual for MGSN 4.12-97 “Treatment and preventive institutions” was developed to develop the indicated MGSN in terms of hospitals.
This Issue sets out the main provisions and specific features, including recommended compositions and areas of premises, planning schemes with a set of necessary technological equipment, requirements for engineering equipment for operating units, departments of anesthesiology and intensive care, hemodialysis, detoxification, industrial transfusiology and hyperbaric oxygenation .
The manual as a whole consists of 7 sections and 9 issues:
Section I - General Provisions (Issue 1);
Section II - Hospitals (Issues 2, 3);
Section III - Diagnostic departments (Issues 4, 5);
Section IV - Specialized and Auxiliary Branches (Issue 6);
Section V - Outpatient clinics (Issue 7);
Section VI - Service and utility premises. Ambulance and emergency medical care substations. Dairy kitchens and distribution points of dairy kitchens (Issue 8);
Section VII - Engineering Equipment (Issue 9).
The manual is intended for designers, as well as for healthcare organizers working in the field of planning and design of medical institutions.
AREA OF APPLICATION
1. This edition of the Manual applies to the design of operating units, anesthesiology and resuscitation departments, hemodialysis and detoxification departments, industrial transfusiology departments (rooms), hyperbaric oxygenation departments of new and reconstructed medical institutions, regardless of their organizational and legal form and forms of ownership.
2. When designing medical institutions, one should be guided by the requirements of SNiP 2.08.02-89 *, MGSN 4.12-97, MGSN 4.01-94, other regulatory documents in construction in force in Moscow, and also take into account the provisions of issues 1 and 2 of the Manual to MGSN 4.12-97 and this issue.
When designing medical institutions, before the release of subsequent issues, one should also be guided by the Manual on the design of healthcare institutions (to SNiP 2.08.02-89 *) in terms of sections not included in issues 1 and 3 of the Manual to MGSN 4.12-97.
1. OPERATING UNITS
1.1. The operating unit is a separate structural department of a hospital (hospital, clinic, maternity hospital, etc.) and is intended for performing surgical operations. The operating unit consists of operating rooms and a complex of auxiliary rooms.
1.2. Operating units are located separately from other departments of the hospital and are connected by convenient communications with postoperative wards, the department of anesthesiology and intensive care, surgical ward departments and other departments of the hospital that are functionally connected with them.
The placement of operating units can be centralized, decentralized or mixed. As a rule, decentralized operating units are located in specialized ward departments in isolated compartments. They can be provided in the departments of gynecology, urology, otolaryngology, ophthalmology, and purulent surgery.
In the emergency departments of hospitals receiving urgent patients, an emergency operating unit for urgent operations should be allocated.
The use of one or another layout of the operating unit depends on the capacity and structure of the ward departments of the hospital, however, centralized operating units are more economical, create the possibility of using medical equipment and engineering equipment of a higher level, and also make it possible to reduce the area of auxiliary premises per operating room.
1.3. Centralized operating units consist of aseptic and septic departments. These departments must be isolated from each other, each of them has its own auxiliary and service premises. Common to them may be (depending on capacity) the office of the head of the department, the room of the head nurse, the housewife, an express laboratory, and storage rooms.
Operating units consisting only of a septic department can be organized if there are purulent surgery departments in the hospital structure, as well as otolaryngological, urological, gynecological and other departments intended for the treatment of patients with purulent pathology, and located at these departments.
1.4. The number of operating rooms in the operating block should be taken at the rate of 1 operating room for every 25-30 surgical beds. The number of operating rooms for urgent operations in the emergency department is determined by the design assignment. It is advisable to locate emergency operating rooms on the ground floor in close proximity to the intensive care unit and diagnostic services.
The number of operating rooms depends on the bed capacity and structure of the hospital, the number, size and profile of surgical departments, surgical activity, complexity and duration of operations, the number of operating days per week and other factors.
1.5. In a centralized operating unit of multidisciplinary hospitals, consisting of septic and aseptic departments, the approximate ratio of septic and aseptic operating rooms is 1:3, but not less than one septic operating room per operating unit.
In each specific case, the number of operating rooms is determined by the design assignment.
1.6. Operating rooms should be designed for 1 operating table.
1.7. The surfaces of walls, floors and ceilings in operating rooms should be as smooth as possible, with rounded corners to ensure ease of cleaning and disinfection. The walls of operating rooms can be covered with special paints, lined with glazed tiles or special metal panels with enamel coating, etc. In the case of using glazed tiles, all seams must be carefully rubbed into the plane of the tile surface and painted with enamel.
The walls of operating rooms with laser coagulation devices must be matted.
Light green wall color is considered the most comfortable for operating rooms.
The floor in operating rooms must completely absorb static electricity. The use of antistatic linoleum should be combined with gluing strips of copper foil and securing the linoleum along the entire contour of the operating room walls to grounded copper spikes.
1.8. Increased demands are placed on the microclimate of the operating unit, especially the operating room. This is due to the fact that during the operation the temperature and humidity of the air increases, it becomes polluted with narcotic gases and bacterial flora, and static electricity accumulates. Particularly dangerous is airborne infection, which is one of the main causes of purulent-inflammatory complications of the postoperative period.
The air temperature in the operating room should be within 22-23 °C without noticeable fluctuations at a relative humidity of 55-60% (SNiP 2.08.02-89 *).
A higher air temperature of up to 25-30 °C is necessary during operations on patients with thermal lesions, as well as during long-term operations on a widely opened abdominal or pleural cavity.
The constancy of the required parameters of temperature and air humidity, as well as its quality, is ensured by the air conditioning system.
1.9. Ventilation and air conditioning of operating units is designed in accordance with the requirements of SNiP 2.04.05-91 * and SNiP 2.08.02-89 *. The most preferred system that ensures maximum sterility is considered to be a device that cuts off the laminar flow of conditioned air above the operating table area.
1.10. Depending on the characteristics of surgical interventions, as well as on the number, specificity and dimensions of the equipment used, the following types of operating rooms are distinguished:
- general surgical profile;
- for carrying out orthopedic, traumatological, neurosurgical operations, as well as operations using laser equipment;
- for performing operations on the heart and blood vessels.
1.11. To monitor the progress of operations (primarily in clinical hospitals), special television equipment can be used, including recording the progress of operations.
1.12. The location and interconnection of the operating rooms is determined by aseptic requirements. In this regard, the architectural and planning solution should be based on the division of operating blocks into non-passable aseptic and septic compartments, as well as rational zoning of the internal space in accordance with the functional division of the premises into the following zones:
- the first one is sterile
- second - strict regime
- third - limited mode
- fourth - general hospital regime.
The first, sterile zone includes the operating rooms themselves and the sterilization rooms directly adjacent to them. If there are no sterilization rooms directly adjacent to the operating rooms, and there is a special corridor through which sterile materials are transferred to the operating rooms, this corridor is included in the sterile zone.
The second zone (strict security) includes preoperative, anesthesia, and artificial blood circulation apparatus (ACB) rooms. This group of rooms is an air buffer between the first and third zones.
The third zone (limited regime) includes rooms for preparing and washing instruments and equipment, disinfection of anesthesia and respiratory equipment, protocol rooms, rooms for surgeons, anesthesiologists, nurse anesthetists, rooms for junior medical staff, storage rooms for blood, suture material, mobile X-ray apparatus, clean part of the sanitary inspection room.
In the fourth zone (general hospital regime) there are rooms, the entrance to which, according to the conditions of the sanitary and hygienic regime of work in them, is not associated with passing a sanitary checkpoint: the office of the head of the operating unit, the room of the senior operating room nurse with material, an expert laboratory, storage rooms, a bathroom, a personal hygiene room personnel, entrance part of the sanitary inspection room.
All medical personnel, entering the operating room, change into operating clothes, shoe covers and caps. Operating room personnel wear masks and gloves in the preoperative room.
1.13. The number of beds in postoperative wards should be provided at the rate of two beds per operating room. These beds are located, as a rule, as part of the anesthesiology and intensive care department and are taken into account in their bed capacity. It is also possible to place postoperative beds in an isolated compartment at the operating unit or as part of surgical departments of the corresponding profile, subject to the conditions for the necessary isolation of postoperative wards from the rest of the department.
1.14. The composition of the operating rooms depends on the type and capacity of the hospital facility, the size and profile of the ward departments, the degree of complexity of the surgical interventions performed and the equipment used, and in each specific case is determined by the design assignment.
1.15. Approximate diagrams of the main premises of the operating units with the necessary equipment and furniture are given in Appendix 1.
The recommended minimum area for operating rooms is shown in Table 1.
Table 1
|
Name of premises |
Area, m |
|
|
Operating rooms: |
||
|
General surgery (including endoscopic and laparoscopic operating rooms) |
||
|
For orthopedic, traumatological and neurosurgical operations |
||
|
For operations on the heart and blood vessels |
||
|
Preoperative: |
||
|
For one general surgical operating room |
||
|
For two general surgical operating rooms |
||
|
For one specialized operating room |
||
|
Anesthesia |
||
|
Hypothermia room |
||
|
Sterilization room for emergency sterilization: |
||
|
For one operating room |
||
|
For two or more operating rooms |
||
|
Instrumental-material |
4 for each operating room, |
|
|
Storage area for sterile material |
||
|
Storage room for suture material |
||
|
Tool disassembly and washing room |
10 for 4 operating rooms +2 for each operating room over 4 |
|
|
Placement of the heart-lung machine: |
||
|
Washing |
||
|
Assembly |
||
|
Storing the sterile apparatus |
||
|
Washing anesthesia-respiratory equipment |
||
|
Disinfection of anesthesia and respiratory equipment |
||
|
Room for storing and preparing blood for transfusion |
||
|
Storage room for a mobile X-ray unit |
||
|
Copier room |
||
|
Storage room for portable equipment |
||
|
Storeroom for anesthesia and respiratory equipment |
||
|
Protocol |
||
|
Surgeons' office |
||
|
Office of anesthesiologists |
||
|
Nurses operating room |
||
|
Nurse anesthetist room |
||
|
Junior medical staff room |
||
|
Room for psychological and psycho-emotional relief |
||
|
Urgent analysis laboratory |
||
|
Manager's office |
||
|
The room of the senior operating nurse with a storage room for alcohol, medications, etc. |
||
|
The hostess's room with a storage room for clean linen |
||
|
Room for dismantling and temporary storage of dirty linen and waste during operations |
||
|
Pantry for cleaning items with drying, drain and tap |
||
|
Room for preparing disinfectants and storing disinfectants |
||
|
Plaster room with storage room for plaster and plaster bandages |
||
|
Sanitary pass for personnel: |
||
|
Compartment for storing work (hospital) clothing, equipped with individual lockers |
0.4 per 1 cabinet, |
|
|
Shower room |
2 per cabin |
|
|
Compartment for storing sterile clothing (surgical suit) equipped with individual lockers |
0.4 per 1 cabinet, |
|
|
Staff restroom |
||
|
Personnel personal hygiene cabin |
||
|
Gateway at entrance: |
||
|
To the septic department |
||
|
To the aseptic department |
||
|
Directly blocked with operating rooms. Provided if there are more than 4 operating rooms. |
||
2. DEPARTMENTS OF ANESTHESIOLOGY AND RESUSCITATION
2.1. Departments of anesthesiology and intensive care are organized as part of a hospital (hospital, clinic, maternity hospital) and are its structural divisions.
2.2. The main tasks of the departments are:
- implementation of a set of measures for the preparation and conduct of general anesthesia (anesthesia) and regional anesthesia during operations, childbirth, diagnostic and therapeutic procedures; monitoring the condition of patients in the postoperative period;
- implementation of a set of measures to restore and maintain impaired functions of vital organs resulting from illness, injury, surgery and other reasons until their activity stabilizes (acute cardiovascular failure, traumatic shock, cardiogenic shock, acute respiratory disorders, severe poisoning and others dysfunctions of vital organs and systems).
2.3. As part of a medical institution, anesthesiology and intensive care departments can be represented by one or more divisions, taking into account the main tasks and characteristics of the work.
2.4. For sick and injured people delivered to the hospital by ambulance or other transport, intensive care units are organized, designed to carry out resuscitation measures (including emergency) in acute terminal conditions (traumatic shock, blood loss, acute respiratory and heart failure, etc. .) It is recommended that these departments be located on the 1st floor with a convenient and short internal connection to the reception department. The shortest route from the ambulance to the intensive care unit must be ensured with a minimum number of turns and obstacles.
2.5. The total number of beds in anesthesiology and intensive care departments is determined by the design assignment and depends on the location of the hospital in the city, the number of incoming patients and injured people, the length of their stay, as well as the bed capacity of the hospital and the profiles of the ward departments. It must be taken into account that 20-25% of beds should be “reserve”, ready to accept new patients at any time.
2.6. To provide resuscitation care and intensive therapy for cardiological, neurological, burn, and toxicological patients, intensive care units with at least 6 beds must be provided directly as part of the ward departments of the corresponding profile. The beds in these blocks are part of the intensive care unit.
2.7. Intensive care units can be provided in the structure of ward departments of other profiles. The set of premises in intensive care units, organized as part of ward departments, is determined by the design assignment.
2.8. The departments of anesthesiology and intensive care can accommodate postoperative wards for monitoring by anesthesiologists and resuscitators of the condition of patients in the postoperative period until their functions of vital organs are stabilized. The number of beds in postoperative wards is determined at the rate of 2 beds per 1 operating room. As part of the department, the postoperative wards are located compactly, in a separate block.
2.9. For infectious patients requiring resuscitation and intensive care, boxed intensive care units should be provided in infectious disease buildings. The number of beds in them is determined by the design assignment, depending on the amount of work. The recommended number of beds is from 6 to 12.
2.10. Intensive care wards for pregnant women and postpartum women, as well as newborns in need of resuscitation and intensive care, are located as part of maternity hospitals (obstetric buildings). The recommended capacity of these wards is 3-6 beds.
2.11. Intensive care ward beds are not included in the calculated number of beds and are not taken into account in the total bed capacity of the medical institution.
2.12. It is recommended to set the number of beds in the departments of anesthesiology, resuscitation and intensive care to a multiple of three, since one round-the-clock nursing post, according to current staffing standards and based on the practice of organizing and functioning of these departments, should serve three beds.
2.13. The functional bed on which the patient is located must be approached from three sides. Beds should be easy to move on wheels and have braking devices. It is necessary that the bed can be given the height (60-90 cm) and position required for a particular patient (head raised, lower limbs raised, knees bent, etc.).
2.14. In intensive care wards, the area per bed for patients with injuries and burns should be at least 18 m2, for postoperative patients - at least 13 m2, for all other patients - at least 15 m2 (Appendix 2, Fig. 2.2.). The indicated areas are provided taking into account the high saturation of each ward with diagnostic and therapeutic equipment, the number of medical personnel, as well as the need for strict compliance with the sanitary and hygienic regime.
2.15. In the premises of anesthesiology and intensive care departments, to prevent the spread of nosocomial infections and strictly adhere to aseptic requirements, excess pressure must be maintained by installing pressurized airlocks at the entrances to the departments.
2.16. For infected patients, anesthesiology and intensive care departments should provide boxed wards and isolation wards.
2.17. At the entrance to the departments, a sanitary checkpoint should be provided for personnel. At the entrances to departments, including from stairs, elevators and lifts, airlocks with air pressure should be provided.
2.18. For the uninterrupted operation of artificial respiration devices and other vital equipment, it is necessary to provide an emergency power supply system.
2.19. In intensive care, anesthesiology and resuscitation rooms, the floor covering must be antistatic, with grounding along the entire contour of the walls.
2.20. In intensive care wards, resuscitation rooms and postoperative wards, the estimated air temperature should be 22 ° C with a relative humidity of 55-60% (SNiP 2.08.02-89 *).
2.21. Intensive care wards, resuscitation rooms, and postoperative wards must be provided with a centralized supply of oxygen, nitrous oxide, vacuum and compressed air.
2.22. The composition of the premises of the anesthesiology and intensive care departments and their number is determined by the design assignment, taking into account the type and capacity of the medical institution, its location in the city, the profile of the ward departments and their bed capacity, as well as the volume of medical care provided to the sick and injured in this department.
2.23. Approximate diagrams of the main premises of the anesthesiology and intensive care departments with the necessary equipment and furniture are given in Appendix 2.
The recommended minimum area of premises for anesthesiology and intensive care departments is shown in Table 2.
Table 2
|
Name of premises |
Area, m |
|
|
Lobby-distribution |
||
|
Storage room for gurneys and stretcher exchange stock |
2 per bed in the department, but not less than 12 |
|
|
Expected |
||
|
Room for temporary storage of patients' belongings |
||
|
Pre-resuscitation |
||
|
Reanimation room |
||
|
Reanimation room at the emergency department |
||
|
Intensive care ward: |
||
|
General purpose |
15 per bed |
|
|
For trauma and burn patients (with a 3 m airlock for each room) |
18 per bed |
|
|
Postoperative ward |
13 per bed |
|
|
Room (post) for a nurse on duty (one for three intensive care beds) |
||
|
Insulator: |
||
|
Ward |
||
|
Sanitary room* |
||
|
Compartment for washing and disinfecting vessels, washing and drying oilcloths |
||
|
Compartment for sorting and temporary storage of dirty linen |
||
|
Storage compartment for cleaning items (with ladder, tap and drying) and storage of disinfectants |
||
|
Pantry |
||
|
Room for anesthesiologists and resuscitators on duty |
||
|
Procedural-preparatory |
||
|
Dressing room with bath and lift for burn patients |
||
|
Room for aerotherapeutic treatment of burn patients |
||
|
Treatment room for 1 bed with airlock |
||
|
Compressor room |
||
|
Hemosorption rooms: |
||
|
Procedural |
||
|
Patient preparation room An error has occurred Payment was not completed due to a technical error, funds from your account |
MGSN 4.12-97
SYSTEM OF REGULATIVE DOCUMENTS IN CONSTRUCTION
MOSCOW CITY BUILDING STANDARDS
TREATMENT AND PREVENTIVE INSTITUTIONS
Date of introduction 1997-07-01
1. DEVELOPED BY: MNIIP of cultural, recreational, sports and healthcare facilities of the Moscow Committee for Architecture (architects Yu.V. Sorokina, G.I. Rabinovich, doctors G.N. Ilnitskaya, S.A. Polishkis) with the participation of the Center for State Sanitary and Epidemiological Supervision in Moscow ( doctors I.A. Khrapunova, L.I. Fedorova, S.I. Matveev).
2. INTRODUCED: Moskomarkhitektura, MNIIP of cultural, recreational, sports and healthcare facilities.
3. PREPARED FOR APPROVAL AND PUBLICATION by the Department of Advanced Design and Standards of the Moscow Architecture Committee (architect L.A. Shalov, engineer Yu.B. Shchipanov).
4. AGREED BY: the Center for State Sanitary and Epidemiological Surveillance in Moscow, the Moscow Health Committee, the State Police Department of the Moscow City Internal Affairs Directorate, Moskompriroda, Moskomarkhitektura, Mosgosexpertiza.
5. ADOPTED AND ENTERED INTO EFFECT by Resolution of the Moscow Government of June 10, 1997 N 435.
1. AREA OF APPLICATION
1.1. These Standards have been developed in accordance with the requirements of SNiP 10-01-94 for Moscow as an addition and clarification to the regulatory documents in construction in force in the territory of Moscow, and apply to the design of new and reconstructed medical institutions and pharmacies, regardless of their organizational and legal form and forms of ownership.
1.2. When designing medical institutions and pharmacies, the requirements of SNiP 2.08.02-89*, MGSN 4.01-94, other current regulatory documents in construction and these Standards, as well as the provisions of the Manual for the design of healthcare institutions (to SNiP 2.08.02-89) must be observed *) and other recommendations and manuals on the design of medical institutions in Moscow.
Note. These standards do not duplicate the requirements of regulatory
documents in construction and manuals for designing institutions
health care, with the exception of the provisions contained in the new
edition or containing an addition or clarification.
1.3. These Standards establish the basic provisions and requirements for the location, site, territory, architectural and planning solutions and engineering equipment of medical institutions and pharmacies.
1.4. These Standards contain mandatory, recommended and reference provisions for the design of medical institutions and pharmacies.
The provisions of these Standards, indicated by the sign “*”, are mandatory.
2.1. SNiP 10-01-94 "System of regulatory documents in construction. Basic provisions."
2.2. SNiP 2.08.02-89* "Public buildings and structures".
2.3. SNiP 2.07.01-89* "Urban planning. Planning and development of urban and rural settlements."
2.4. SNiP 2.01.02-85* "Fire safety standards".
2.5. SNiP III-10-75 "Territory improvement".
2.6. SNiP II-01-95 "Instructions on the procedure for development, coordination, approval and composition of design documentation for the construction of enterprises, buildings and structures."
2.7. SP II-101-95 "The procedure for the development, coordination, approval and composition of justifications for investments in the construction of enterprises, buildings and structures."
2.8. VSN 62-91* "Designing a living environment taking into account the needs of people with disabilities and low-mobility groups of the population."
2.9. NPB 110-96 "List of buildings, structures, premises and equipment subject to protection by automatic fire extinguishing and detection systems."
2.10. MGSN 1.01-94 "Temporary norms and rules for the design, planning and development of Moscow."
2.11. MGSN 2.01-94 "Energy saving in buildings. Standards for thermal protection and heat and water power supply."
2.12. MGSN 4.01-94 "Hospices".
2.13. A manual for the design of healthcare institutions (to SNiP 2.08.02-89*).
2.14. SanPiN 5179-90 "Sanitary rules for the design, equipment and operation of hospitals, maternity hospitals and other medical hospitals."
2.15. "Temporary sanitary rules for the establishment, equipment and operation of general self-supporting pharmacies, warehouses for small wholesale trade of pharmaceutical products." Center for State Sanitary and Epidemiological Surveillance in Moscow No. 4-96 dated June 25, 1996
2.16. "Temporary rules for environmental protection from production and consumption waste in the Russian Federation." Ministry of Environment Protection and Natural Resources of the Russian Federation, 1994.
3. BASIC PROVISIONS
3.1. The network of medical and preventive institutions in Moscow includes hospital and outpatient clinics for adults and children, dispensaries, maternal and child health institutions, ambulance and emergency medical care stations with substations.
3.2. Medical and preventive institutions and their departments, which are used for teaching or scientific purposes by medical universities or research institutes, are clinical.
Treatment and preventive institutions that are part of medical universities and research institutions or subordinate to them are clinics.
3.3. For planning and design purposes, health care facilities are grouped by type.
The type of medical and preventive institution represents a unified name of institutions that are homogeneous or similar in purpose and functional structure, having common principles and medical and technological design features.
The type of treatment and preventive institution can be represented by one institution.
The totality of types of treatment and preventive institutions constitutes the Typological Nomenclature. The typological nomenclature of treatment and preventive institutions is given in the recommended Appendix 1.
3.4. Calculation of the need for medical institutions should be carried out on the basis of typological normative indicators, taking into account the size of the population living in the service area.
Typological normative and calculated indicators of the need for medical and preventive institutions in Moscow are given in the recommended Appendix 1.
3.5. New construction and reconstruction of medical institutions must be carried out in accordance with the territorial-sectoral scheme for the development and reconstruction of the network of these institutions.
The approximate capacity of medical institutions for new construction is given in recommended Appendix 2.
*3.6. When reconstructing medical buildings of hospitals, the bed capacity of ward departments should be no more than 60 beds in ward departments for adults and no more than 40 beds in ward departments for children.
3.7. When designing new inpatient facilities, the bed capacity of ward departments is recommended to be taken according to Table 1.
Table 1
Ward departments |
Capacity, beds (no more) |
a) for adults: |
|
Obstetric physiological |
|
Infectious and tuberculosis from semi-boxes with 1-2 beds |
|
Infectious and obstetric boxed |
|
Obstetric observational, medical and social for hospices, helminthological, pregnancy pathologies and gynecological for sexually transmitted patients |
|
|
|
|
b) for children: |
|
Infectious boxed |
|
Infectious semi-boxes for 1 bed |
|
|
|
3.8. Fire safety requirements for buildings of medical institutions and pharmacies should be taken in accordance with the requirements of these Standards, SNiP 2.01.02-85*, SNiP 2.08.02-89*, other current norms and regulations and mandatory Appendix 3.
4.1. The placement of medical institutions and pharmacies, landscaping of their territories, construction and sanitary and hygienic requirements for the site and territory should be taken in accordance with the Manual for the design of healthcare institutions (to SNiP 2.08.02-89*), SNiP 2.07.01-89* , SNiP III-10-75, MGSN 4.01-94, MGSN 1.01-94, SanPiN 5179-90, Temporary Sanitary Rules 4-96 and the requirements of this section.
4.2. Medical and preventive institutions and pharmacies should be located in accordance with the approved master plan and detailed planning projects, taking into account the administrative and territorial division of Moscow.
*4.3. In residential buildings, as well as in public buildings for non-medical purposes, it is not allowed to place:
X-ray and other medical or diagnostic equipment and installations that are a source of ionizing radiation;
Magnetic resonance imaging departments (rooms);
Dental, clinical diagnostic and bacteriological laboratories;
Hospitals, including dispensary hospitals, day hospitals and private clinic hospitals;
Dispensaries without hospitals of all types, emergency rooms, ambulance substations;
Dermatovenerological, psychiatric, infectious diseases and phthisiatric medical offices, including offices of doctors engaged in private practice in these specialties.
4.4. It is allowed to place in residential and public buildings, as well as in extensions to them, antenatal clinics, dental clinics, offices of general practitioners (family doctors) and other medical offices, including offices of private practicing doctors, subject to the requirements of clause 4.3. of these Standards, as well as dispensing points of dairy kitchens and general self-supporting pharmacies.
It is allowed to place X-ray dental offices of dental clinics built into residential buildings if the vertically and horizontally adjacent rooms are not residential.
In agreement with the Center for State Sanitary and Epidemiological Surveillance in Moscow, it is allowed to locate x-ray departments (rooms) in an extension to a residential or public building for non-medical purposes.
*4.5. Premises of antenatal clinics, dental clinics, offices of general practitioners (family doctors), dispensing points of dairy kitchens and self-supporting general pharmacies, when located in buildings for other purposes, must be separated from other premises by blind fire walls of type 1 and have independent exits to the outside. .
4.6. Offices of general practitioners (family doctors) and distribution points of dairy kitchens, when located in residential and public buildings, are recommended to be located on the ground floor of the building.
4.7. Maternity clinics and dental clinics, when located in residential and public buildings, can be located on the first and second floors of the building.
4.8. Self-supporting pharmacies can be located in separate buildings, on the ground floor of residential and public buildings, in extensions to residential and public buildings.
*4.9. The sizes of land plots of inpatient institutions within the city limits should be taken according to Table 2.
Table 2
Types of inpatient facilities |
Dimensions of land plots, sq.m per 1 bed (not less) |
|
|
|
Infectious diseases, tuberculosis and oncology hospitals, oncology hospitals and anti-tuberculosis dispensaries |
|
Rehabilitation hospitals, medical and physical training clinics |
|
|
|
|
Maternity hospitals |
|
Other types of hospitals and hospitals, dispensaries |
|
|
|
|
Children's infectious diseases and tuberculosis hospitals |
|
Children's rehabilitation hospitals |
|
Other types of hospitals |
|
Notes 1. When constructing new medical buildings on the territory of existing hospitals, leading to an increase in the capacity of the hospital, it is allowed to reduce the specific indicators of the land plot (sq.m per 1 bed), but not more than by 20%. 2. When constructing new inpatient institutions on newly developed sites in areas of crowded urban development, it is allowed to reduce the specific indicators of land plots (sq.m per 1 bed), but not more than 20-25%, taking into account specific urban planning factors. |
|
4.10. The size of land plots of clinics, consultative and diagnostic centers and dispensaries without hospitals should be taken depending on the volumetric composition solution and the building area, taking into account access and pedestrian routes at the rate of 0.1 hectares per 100 visits per shift, but not less than 0.5 ha per 1 object.
*4.11. The dimensions of land plots of medical institutions, the structure of which includes a hospital and a clinic (outpatient department of a dispensary, antenatal clinic, consultative and diagnostic center, territorial clinic, etc.), should be taken as follows:
when a hospital and a clinic are located in the same building - according to Table 2 of these Standards;
when the clinic is located in a separate building on the territory of a stationary institution - at the rate of 0.1 hectares per 100 visits per shift, but not less than 0.3 hectares per 1 facility.
4.12. The dimensions of land plots for ambulance substations and pharmacies should be taken in accordance with MGSN 1.01-94.
*4.13. On the territory of a stationary institution, the distance between buildings should be taken as follows:
between the walls of buildings with chamber windows - 2.5 times the height of the opposing building, but not less than 24 m;
between the radiological building and other buildings - at least 25 m;
between the vivarium building and the ward buildings - at least 50 m.
*4.14. The minimum distance from buildings of medical institutions to residential buildings should be taken:
for buildings of hospitals and dispensaries with ward departments, maternity hospitals, radiology buildings, garages and summer parking for ambulance substations - 30 m;
for buildings of outpatient clinics, dispensaries without hospitals and medical and diagnostic buildings - 15 m.
4.15. The distance between buildings of medical institutions and red building lines should, as a rule, be at least 30 m - for buildings of hospitals and dispensaries with ward departments and maternity hospitals and at least 15 m - for buildings of outpatient clinics, dispensaries without hospitals and diagnostic and treatment buildings.
When constructing new medical and preventive institutions on newly developed sites in crowded urban areas, as well as new medical and treatment and diagnostic buildings on the territory of existing hospitals, it is allowed to reduce this distance, up to the red building line.
4.16. The distance between the waste incinerator to the medical buildings with wards or residential buildings depends on the design and power of the furnace, the amount of harmful emissions into the atmosphere and the direction of the prevailing winds and is agreed upon in each specific case, as part of the initial permitting documentation, with the State Sanitary and Epidemiological Supervision Center in the city. Moscow and Moskompriroda, in accordance with the requirements of SP 11-101-95 and SNiP 11-01-95.
The need for a waste incinerator is justified by the capacity of the treatment facility and the volume of waste generated.
*4.17. The distance from the building of the forensic medical examination bureau to residential and public buildings must be at least 50 m.
*4.18. The distance from the vivarium building to residential and public buildings must be at least 100 m.
*4.19. On the hospital's land plot, separate access roads should be provided to the medical buildings for infectious patients, to the medical buildings for non-infectious patients, to the emergency medical substation (if located on the hospital's land), to the pathological-anatomical building and to the economic zone. Access roads to the pathological-anatomical building and to the economic zone can be combined.
The pathological-anatomical building, the passages to it and the parking of funeral cars should not be visible from the windows of the wards.
4.20. In the garden and park area of children's hospitals, playgrounds should be provided, separated by green plantings. The number and area of playgrounds are determined by the design assignment, the number of ward departments and the set of age groups.
4.21. Only functionally related buildings and structures should be placed on the land plots of medical institutions.
On the territory of clinics of republican significance and hospitals, except for infectious diseases and tuberculosis, with appropriate justification according to the design assignment, the placement of small-capacity hotels for non-resident citizens arriving for consultations and relatives of hospitalized patients, as well as medical schools and colleges is allowed.
4.22. The food preparation service (food units) should be located, as a rule, in a separate building.
The catering units of medical and social care hospitals (hospices, nursing homes) should be designed in separate compartments of the buildings of these hospitals with separate service and utility entrances and technological connections with the wards.
When constructing new hospitals and maternity hospitals on newly developed sites in crowded urban areas, it is allowed to place catering units built-in or attached to medical and utility buildings, subject to the necessary engineering and technical solutions that ensure comfortable living conditions for patients and staff.
4.23. Storage of X-ray and fluorographic films should, as a rule, be provided in separate buildings of at least II degree of fire resistance.
Storage of X-ray and fluorographic films produced on a triacetate basis may be provided in the building of a medical institution, provided that the archive rooms of radiological diagnostic materials are separated from other rooms of the building by a blank fire wall of type 1.
4.24. In the economic zone of a medical institution, separate places should be provided for temporary storage of household and medical waste (separately).
Storage of household waste can be carried out at specially designated sites in standard containers. The volume and number of containers are determined by calculation based on the capacity of the medical institution.
The storage of medical waste before its removal or destruction should be carried out in specially equipped areas that exclude the possibility of flooding by storm drains. Storage of medical waste must be carried out in sealed containers (tanks) separately by type of waste in accordance with the “Permit for waste disposal on the territory of the enterprise” issued by Moskompriroda in accordance with the “Temporary Rules for Environmental Protection from Industrial and Consumption Waste in the Russian Federation”.
5. REQUIREMENTS FOR ARCHITECTURAL AND PLANNING SOLUTIONS
5.1. Buildings of medical and preventive institutions should, as a rule, be designed no higher than nine floors.
In case of urban planning justification, the number of storeys of a medical institution building can be more than nine floors in agreement with the territorial state fire service.
5.2. The structure and composition of the premises of medical institutions for new construction and reconstruction is determined by the design assignment, taking into account network indicators of the population's need for medical care.
5.3. When constructing new buildings or reconstructing existing buildings on the territory of existing medical institutions, it is necessary to provide for the comprehensive development of all medical, diagnostic and auxiliary services.
*5.4. The area of single-bed wards (excluding the area of locks and bathrooms) of nursing homes (departments) and hospices should be no less than 14 sq.m; in ward departments of rehabilitation treatment, neurosurgical, orthopedic-traumatology, burns, radiological and in wards for patients using wheelchairs - at least 12 sq.m; in ward departments of other profiles - at least 10 sq.m.
*5.5. The area of wards with 2 beds or more (excluding the area of airlocks and bathrooms) should be taken according to Table 3.
Table 3
Branch profile |
Area, sq.m. for 1 bed (at least) |
1. Ward departments for adults and children over 7 years old: |
|
Infectious and tuberculous |
|
Rehabilitation treatment, neurosurgical, orthopedic-traumatological, burn, radiological, for patients using wheelchairs |
|
Intensive care: |
|
Burns |
|
|
|
|
Postoperative |
|
Psychiatric and drug treatment |
|
General type |
|
Insulin and surveillance |
|
Medical and social |
|
For hospices |
|
For nursing homes (departments) |
|
|
|
|
2. Ward departments for children under 7 years of age: |
|
Infectious and tuberculous |
|
Rehabilitation treatment, neurosurgical, orthopedic-traumatological, burn |
|
Intensive care: |
|
Burns |
|
|
|
|
Postoperative |
|
Psychiatric: |
|
General type |
|
Supervisors |
|
|
|
|
3. Ward departments for newborns and premature babies: |
|
For 1 bed |
|
For 1 incubator |
|
5.6. Wards for adults and children over 7 years of age should be designed with an airlock and a bathroom (toilet, washbasin, shower).
*5.7. The area of wards for children when children stay together with their mothers should be increased based on each child's bed (crib) by 3 sq.m. for daytime and by 6 sq.m. for mothers staying around the clock.
24-hour stay of mothers should be provided, as a rule, in one- and two-bed wards for children.
5.8. The minimum area of premises of medical institutions (except for wards) should be taken in accordance with the Manual for the design of healthcare institutions (to SNiP 2.08.02-89*), MGSN 4.01-94 and the recommended Appendix 4.
5.9. The area of medical, diagnostic and auxiliary premises (offices) for the introduction of new methods of examination, diagnosis and treatment of patients not specified in the Manual for the design of healthcare institutions (to SNiP 2.08.02-89 *) and the recommended Appendix 4 of these Standards should be taken as specified for design, based on the functional purpose of the room (office), the dimensions of the devices and equipment used and other medical and technological requirements and conditions of their operation.
*5.10. In cardiology departments for patients with myocardial infarction and neurology departments for patients with acute cerebrovascular accidents, intensive care units with a capacity of no more than 6 beds should be provided.
According to the design assignment, intensive care units can be provided in the structure of ward departments for toxicology, burns and other profiles.
*5.11. The room for psychosocial counseling and voluntary HIV testing in clinics for adults and the room for anonymous examination and treatment of sexually transmitted diseases in dermatovenerological clinics must be isolated from other premises of the medical institution and have independent exits to the outside. The composition and area of these offices are determined by the design assignment.
5.12. The area of the public service hall and premises for the preparation of dosage forms of general self-supporting pharmacies should be taken based on the number of workplaces specified in the design assignment.
The list of jobs for general self-supporting pharmacies is given in reference Appendix 5.
Self-supporting industrial pharmacies are listed in recommended Appendix 6, self-supporting non-production pharmacies - in recommended Appendix 7.
*5.14. Magnetic resonance imaging treatment rooms should be designed without natural light.
5.15. In addition to SNiP 2.08.02-89* and SanPiN 5179-90, it is allowed to design control rooms (consoles) of X-ray diagnostic rooms, staff rooms of ward departments, cabins for preparing barium, rooms for storing blood and blood substitutes with second-light lighting or without natural lighting ( blood bank), rooms for storing narcotic drugs, rooms for expressing breast milk, material and instrumental materials, canteens for patients and other rooms, the operation of which is not associated with the constant presence of patients and staff, subject to the provision of standardized requirements for ventilation and artificial lighting .
5.16. The interior decoration of the premises of medical institutions and pharmacies must be made from materials approved by the authorities and institutions of the Department of State Sanitary and Epidemiological Surveillance of the Ministry of Health of the Russian Federation, and correspond to their functional purpose.
The sanitary and hygienic qualities of the interior decoration of the premises of medical institutions must comply with the requirements of SanPiN 5179-90, and the premises of general self-supporting pharmacies must comply with the requirements of Temporary Sanitary Rules 4-96 of the State Sanitary and Epidemiological Supervision Center in Moscow.
*5.17. The design and installation of aids and devices for patients (ramps, handrails, handles, levers, rods, etc.) must be carried out in accordance with the requirements of VSN 62-91 *, republican and city recommendations (manuals) on the design of the environment for people with physical limitations.
6.1. Engineering equipment of medical institutions and pharmacies (elevators and lifts, heating, ventilation, air conditioning, water supply, sewerage, gas supply, supply of medical gases, vacuum network and compressed air pipelines, electrical devices and artificial lighting, fire and security alarms) should be designed in accordance with the requirements of current regulatory documents in construction and the Manual for the design of healthcare institutions.
6.2. Hospice engineering equipment should be designed in accordance with the requirements of MGSN 4.01-94.
6.3. Thermal protection of buildings of medical institutions and pharmacies should be designed in accordance with the requirements of MGSN 2.01-94.
6.4. When using the latest medical and diagnostic equipment (devices, devices) that require special engineering support for premises, you should be guided by the requirements of technical passports and instructions for the installation and operation of this equipment.
TYPOLOGICAL NOMENCLATURE OF TREATMENT AND PREVENTIONAL
INSTITUTIONS AND TYPOLOGICAL STANDARDS AND CALCULATIONS
INDICATORS OF THE NEED FOR TREATMENT AND PREVENTION
MOSCOW INSTITUTIONS
Typological nomenclature of medical and preventive institutions |
Typological standard-calculation indicator |
1. Inpatient institutions for adults: |
beds per 10 thousand adult population |
Multidisciplinary hospital |
|
Gastroenterology Hospital |
|
Urological hospital |
|
Eye Hospital |
|
Oncology hospital (oncology dispensary inpatient unit) |
|
Infectious diseases hospital |
|
Tuberculosis hospital (inpatient tuberculosis dispensary) |
|
Dermatovenerological hospital (inpatient dermatovenerologic dispensary) |
|
Psychiatric hospital |
|
Psychoneurological hospital (inpatient psychoneurological dispensary) |
|
Narcological hospital (inpatient drug treatment clinic) |
|
Orthopedic and traumatological rehabilitation hospital (inpatient medical and physical education dispensary) |
|
|
|
|
Aftercare hospital |
|
Nursing home |
|
|
|
|
Maternity hospital |
|
2. Inpatient institutions for the child population: |
beds per 10 thousand child population |
Children's Multidisciplinary Hospital |
|
Children's Infectious Diseases Hospital |
|
Children's Surgical Hospital |
|
Children's Orthopedic and Traumatology Hospital |
|
|
|
|
Children's Psychiatric Hospital |
|
|
|
|
|
|
|
Children's Hospital for Rehabilitation Treatment |
|
3. Outpatient clinics for adults: |
visits per shift per 10 thousand adults |
|
|
|
Dental clinic |
|
Consultative and diagnostic center (clinic) |
|
Women's consultation |
|
4. Outpatient clinics for children |
visits per shift per 10 thousand child population |
|
|
|
|
|
|
Children's Consultative and Diagnostic Center (clinic) |
|
5. Specialized outpatient clinics: |
visits per shift per 10 thousand inhabitants |
Medical and physical education clinic (rehabilitation clinic) |
|
Cardiology clinic |
|
|
|
|
Mammology dispensary |
|
Narcological clinic |
|
Oncological clinic |
|
|
|
|
|
|
|
Endocrinological dispensary |
|
Family Planning and Reproduction Center |
needs development |
Note. Typological normative and calculated indicators are given only for treatment and preventive institutions of the system of city and district health authorities, excluding institutions of the Ministry of Health of the Russian Federation, the Academy of Medical Sciences, the Ministry of Railways and other ministries and departments. |
|
ESTIMATED CAPACITY OF TREATMENT AND PREVENTIVE INSTITUTIONS
FOR NEW CONSTRUCTION IN MOSCOW
Type name medical institution |
Power |
1. Inpatient institutions: |
|
Eye Hospital |
|
Cancer hospital |
|
Infectious diseases hospital |
|
Tuberculosis hospital |
|
Skin and Venereal Diseases Hospital |
|
Psychiatric hospital |
|
Narcological hospital |
|
Orthopedic and traumatological rehabilitation hospital |
|
Neurological Rehabilitation Hospital |
|
Nursing home |
|
|
|
|
Maternity hospital (general type, specialized) |
|
Children's Dermatovenerological Hospital |
|
Children's Psychoneurological Hospital |
|
Children's Tuberculosis Hospital |
|
2. Outpatient clinics: |
visits per shift |
Territorial clinic of a residential area |
|
Children's territorial clinic of a residential area |
|
Dental clinic |
|
Children's dental clinic |
|
Women's consultation |
|
Dermatovenerological dispensary |
|
Narcological clinic |
|
Oncological clinic |
|
Anti-tuberculosis dispensary |
|
Psychoneurological dispensary |
|
Note. The capacity of medical and preventive institutions not included in this appendix, as well as in-patient dispensaries, is determined by the design assignment |
|
Appendix 3
Mandatory
FIRE REQUIREMENTS
1. Buildings of medical institutions and pharmacies must, as a rule, have a fire resistance rating of at least II. Medical and preventive institutions without hospitals and pharmacies are allowed to be located in buildings of III degree of fire resistance, and they must be no more than 2 floors in height.
Medical buildings of psychiatric hospitals and psychoneurological dispensaries must have fire resistance grades I and II.
2. Basements under buildings should be designed as one-story. Communication between ground floors via common staircases and elevator shafts with basement and ground floors is not permitted.
It is allowed to connect the basement and ground floors with the first floor via a separate closed staircase with an entrance to it at the underground floor level through a vestibule. In hospital buildings, an air pressure of 20 Pa must be provided in the airlock in front of the entrance to the specified (technological) staircase.
3. The width of the corridors must be no less than:
In ward departments - 2.4 m;
In outpatient clinics, dispensaries without hospitals, antenatal clinics, laboratory departments - 2 m;
In hospitals for the rehabilitation treatment of neurological and orthopedic traumatology - 3.2 m;
In operating rooms, maternity and intensive care units - 2.8 m;
In warehouses and pharmacies - 1.8 m.
4. The width of corridors used for waiting areas for visitors should be no less than:
For one-sided cabinets - 2.8 m;
With double-sided cabinets - 3.2 m.
5. The corridors of ward departments should have natural light through windows at the ends of the corridors or light pockets. When lighting a corridor from the end, its length should not exceed 24 m, when lighting from two ends - 48 m. The distance between light pockets should not exceed 24 m, and between the first light pocket and the window at the end of the corridor - 36 m.
6. The width of landings and flights of evacuation staircases in ward buildings must be at least 1.35 m, external doors - not less than the width of flights of stairs.
7. In in-patient facilities of medical institutions, the distance from the doors of the most remote premises (with the exception of restrooms, washrooms, showers and other auxiliary premises) to the exit outside or to the staircase should be no more than:
35 m when rooms are located between stairwells;
15 m in case of exit from the premises into a dead-end corridor or hall.
8. The installation of open staircases in ward buildings at full height is not allowed. Open staircases from the lobby to the second floor are allowed, and the lobby should be separated from adjacent corridors by type 1 fire partitions.
9. Doors in partitions installed in the corridors of ward departments every 42 m must be equipped with automatic devices for closing them when fire alarm detectors are triggered.
10. The distance between the central point for storage and distribution of medical gases (oxygen) and other buildings must be at least 25 m. The buildings of the central point must be made of fire-resistant materials (brick, reinforced concrete) and have no window openings. If the number of cylinders is less than 10 (standard 40-liter, with a pressure of up to 150 atm.), they can be placed in fireproof cabinets near solid end walls with a fire resistance rating of at least 2.5 hours, or one-story extensions of fire resistance class I, II, with an exit directly outside.
11. Laying oxygen pipelines in basements and ground floors, staircases, under buildings and structures is not allowed.
Medical gas pipelines must be protected from mechanical damage, and their visibility must be ensured.
12. The placement of built-in and attached transformer substations in the buildings of medical institutions is not allowed.
13. Premises (storage rooms) for storing flammable and combustible liquids should be located, as a rule, in auxiliary buildings and structures of medical institutions, near external walls with window openings and provided with general supply and exhaust ventilation. Storage of flammable liquids and gases must be carried out in airtight containers to prevent evaporation of liquids.
14. In buildings of medical institutions with hospitals, the finishing (cladding) of walls and ceilings in common corridors, staircases, lobbies, halls, pedestrian tunnels must be made with non-combustible materials. To paint the walls and ceilings of these rooms, non-flammable (water-based, etc.) paints should be used.
15. Protection of the premises of medical institutions and pharmacies by automatic fire extinguishing installations and fire alarms must be provided in accordance with NPB 110-96.
16. In buildings of medical institutions with a height of 8 or more floors, one of the elevators must be designed to provide transportation for fire departments.
17. Around the buildings of medical institutions with hospitals, regardless of the number of floors, a circular passage for fire engines should be provided with a width of at least 3.5 m for buildings up to 5 floors inclusive and a width of at least 4.2 m for buildings with a height of 6-9 floors.
Entrances to buildings without ward departments should be designed on two longitudinal sides.
MINIMUM AREA OF PREMISES
TREATMENT AND PREVENTIVE INSTITUTIONS
(Supplement to the Design Guide
healthcare institutions to SNiP 2.08.02-89*)
Name of premises |
Area, sq.m |
1. Hospitals: |
|
1. Premises of the department of clinical ward department: |
|
Professor's office |
|
Associate Professor's office |
|
Room for assistants for 2 people |
|
Study room |
|
Student duty room |
|
Bathroom |
|
2. Specialized premises of hematology ward departments: |
|
Room for blood transfusion and plasmapheresis (with a gateway) |
|
Small operating room with preoperative room for puncture trepanobiopsy |
|
Isolation facility for patients with myelo- and immunosuppression (with a lock and drain) |
|
2. Outpatient clinics and dispensaries without hospitals: |
|
3. Office of a general practitioner (family doctor):* |
|
Expected |
|
Doctor's office (with gateway) |
|
Dressing room |
|
Procedural |
|
Small operating room with preoperative room |
|
Room for temporary stay of patients |
|
Physiotherapy room for 2 couches with space for processing pads |
|
Staff room |
|
Sanitary room |
|
Inventory storage room |
|
Bathrooms for patients and staff |
|
4. Office of a geriatrician at a territorial clinic with a file cabinet |
|
5. Office of an endocrinologist at a territorial clinic: |
|
Doctor's office |
|
Premises for storing and dispensing antidiabetic drugs |
|
6. Office of a sex therapist |
|
3. Specialized medical and treatment and diagnostic rooms: |
|
7. Manual therapy room |
|
8. Magnetic resonance imaging room: |
|
Procedural** |
|
Control room |
|
Machine room** |
|
Preparatory*** |
|
Photo lab |
|
Doctor's room |
|
Engineer's room |
|
9. Lithotripsy room: |
|
a) with an X-ray guidance system |
|
X-ray operating room** |
|
Control room** |
|
Preoperative |
|
Preparatory |
|
Sterilization*** |
|
Water preparation room**** |
|
Doctor's room |
|
b) with an ultrasonic guidance system |
|
operating room |
|
Preoperative |
|
Preparatory |
|
Doctor's room |
|
10. Laser therapy room** |
|
4. Service and utility premises: |
|
11. Epidemiologist’s office |
|
12. Office of the epidemiologist and assistant epidemiologist |
|
13. Insurance company representative's room |
|
14. Premises for automated collection, processing and storage of information for an insurance company |
4 per worker, but not less than 12 |
* for a general practitioner (family doctor) office located outside the clinic |
|
** area can be changed in accordance with the dimensions of the devices and equipment used |
|
*** provided according to the design specifications |
|
**** is provided according to the design assignment when using the method of immersing the patient in water; the area can be changed in accordance with the dimensions of the equipment used |
|
Appendix 5
Information
LIST OF JOBS IN SELF-SUPPORTING PHARMACIES
GENERAL TYPE
1. Self-supporting industrial pharmacy
Accepting prescriptions from the public for the production of dosage forms;
Dispensing medications manufactured in a pharmacy;
Information;
Implementation of optics;
2. Assistant:
Production of dosage forms for internal use;
Production of dosage forms for external use;
Packaging of medicines for internal use;
Packaging of medicines for external use;
Pharmacist-technologist;
Integrated production of dosage forms for healthcare facilities;
Packaging of medicines for healthcare facilities.
3. Analytical:
Quality control of manufactured medicines.
4. Procurement of concentrates and semi-finished products:
Production of concentrates and semi-finished products.
5. Washing and sterilization:
Processing of prescription glassware;
Processing of glassware for sterile dosage forms;
Sterilization of dishes.
6. Distillation:
7. Disinfection:
Processing of returnable dishes from healthcare facilities.
8. Unpacking:
Unpacking the goods.
9. Recipe and forwarding:
10. Assisting-aseptic:
Production of sterile medicines;
Packaging of manufactured medicines.
11. Sterilization:
Sterilization of dosage forms;
Sterilization of dosage forms for healthcare facilities.
12. Control and marking:
Registration of manufactured dosage forms for healthcare facilities.
1. Public service hall:
2. Assistant-analytical:
Production of dosage forms according to prescriptions;
Quality control of dosage forms.
3. Washing and sterilization:
Processing of prescription glassware.
4. Distillation:
Obtaining distilled water.
5. Unpacking area:
Unpacking the goods.
II. Self-supporting non-production pharmacy
a) with the largest number of jobs:
1. Public service hall:
Sales of finished medicines according to prescriptions;
Sales of finished medicines without a prescription;
Information;
Implementation of optics;
Sales of parapharmaceutical products.
2. Recipe-forwarding:
Acceptance of requirements (prescriptions) from health care facilities;
Completing and issuing orders from healthcare facilities.
b) with the smallest number of jobs:
1. Public service hall:
Sales of medicines and medical products.
APPROXIMATE COMPOSITION AND AREA OF PREMISES
SELF-SUPPORTING PRODUCTION PHARMACIES
Functional groups and |
|
|
||||||
list of premises |
Number of jobs |
Area, sq.m |
Number of jobs |
Area, sq.m |
||||
1. Public service hall: |
||||||||
|
|
|
|
|
|||||
|
|
|
|
|
|||||
|
|
|
|
|
|||||
Public service area |
|
|
|
|
||||
|
|
|
|
|
|||||
Production premises: |
||||||||
3. Assistant: |
||||||||
Excluding jobs for servicing attached health care facilities |
|
|
|
|
||||
Taking into account jobs for servicing attached health care facilities** |
|
|
|
|
||||
4. Analytical |
|
|
|
|
||||
5. Assistant-analytical |
|
|
|
|
||||
6. Procurement of concentrates and semi-finished products (with a gateway) |
|
|
|
|
||||
7. Washing and sterilization room (with an area for processing dishes of the aseptic block) |
|
|
|
|
||||
8. Distillation room (with an area for placing devices for producing water for injection) |
|
|
|
|
||||
9. Disinfection (with airlock)*** |
|
|
|
|
||||
10. Unpacking |
|
|
|
|
||||
11. Unpacking area |
|
|
|
|
||||
12. Prescription and forwarding** |
|
|
|
|
||||
Premises for the preparation of dosage forms under aseptic conditions****: |
||||||||
13. Assistant - aseptic (with airlock) |
|
|
|
|
||||
14. Sterilization of dosage forms: |
||||||||
Without taking into account the workplace for sterilization of dosage forms for healthcare facilities |
|
|
|
|
||||
Taking into account the workplace for sterilization of dosage forms for healthcare facilities** |
|
|
|
|
||||
15. Control and marking** |
|
|
|
|
||||
Storage premises: |
||||||||
16. Medicinal substances |
|
|
|
|
||||
17. Finished prescription drugs |
|
|
|
|
||||
18. Medicinal plant materials |
|
|
|
|
||||
19. Poisonous and narcotic drugs |
|
|
|
|
||||
20. Finished over-the-counter medicines |
|
|
|
|
||||
21. Medicinal substances, finished medicinal products, medicinal plant raw materials (instead of paragraphs 16,17,18,19, 20) |
|
|
|
|
||||
22. Medical products |
|
|
|
|
||||
23. Heat-labile drugs and substances |
determined in accordance with the dimensions of the equipment used |
|||||||
24. Disinfectants and acids |
|
|
|
|
||||
25. Flammable and combustible liquids |
|
|
|
|
||||
26. Auxiliary materials and glass containers |
|
|
|
|
||||
27. Parapharmaceutical products, |
|
|
|
|
||||
including: |
||||||||
|
|
|
|
|
|||||
Scented products (shampoos, soaps, creams, etc.) |
|
|
|
|
||||
|
|
|
|
|
|
||||
28. Glasses and other optical items |
|
|
|
|
||||
29. Premises for receiving and processing plant raw materials*****, |
|
|
|
|
||||
including: |
||||||||
Fresh raw materials reception room |
|
|
|
|
||||
Drying chamber (with warm airlock) |
|
|
|
|
||||
Room for processing and storing dried raw materials |
|
|
|
|
||||
Service premises: |
||||||||
30. Manager's office |
|
|
|
|
||||
31. Accounting (with archive) |
|
|
|
|
||||
32. Staff room |
|
|
|
|
||||
33. Dressing room for staff street clothes |
|
|
|
|
||||
34. Staff dressing room for work and home clothes |
|
|
|
|
||||
35. Pantry for storing household equipment and cleaning items |
|
|
|
|
||||
36. Bathroom (with airlock and washbasin in the airlock) |
|
|
|
|
||||
37. Shower |
|
|
|
|
||||
* For on-duty pharmacies |
||||||||
*** Provided for servicing attached health facilities for processing returnable glassware |
||||||||
**** Premises 13, 14, and 15 may have a common gateway, but not less than 6 sq.m. |
||||||||
***** Provided for by the design assignment when assigning the corresponding functions to the pharmacy in the form of a separate extension |
||||||||
APPROXIMATE COMPOSITION AND AREA OF PREMISES
SELF-SUPPORTING NON-PRODUCTION PHARMACIES
Functional groups and list of premises |
Pharmacy with the most jobs |
Pharmacy with the fewest jobs |
||||
Number of jobs |
Area, sq.m |
Number of jobs |
Area, sq.m |
|||
1. Public service hall: |
||||||
Area where workplaces are located for the sale of medicines and medical products |
|
|
|
|
||
Workplace area for the sale of optics |
|
|
|
|
||
Workplace area for selling parapharmaceutical products |
|
|
|
|
||
Public service area |
|
|
|
|
||
2. Room for serving the population at night* |
|
|
|
|
||
3. Recipe-forwarding** |
|
|
|
|
||
Storage premises: |
||||||
4. Finished prescription drugs |
|
|
|
|
||
5. Poisonous and narcotic drugs |
|
|
|
|
||
6. Finished over-the-counter medicines |
|
|
|
|
||
7. Finished medicinal products (instead of paragraphs 4, 5, 6) |
|
|
|
|
||
8. Medical products |
|
|
|
|
||
9. Heat-labile drugs |
determined according to dimensions equipment used |
|||||
10. Parapharmaceutical products, including: |
|
|
|
|
||
Mineral waters, diet food, juices, syrups, etc. |
|
|
|
|
||
Scented products (shampoos, soaps, creams, etc.) |
|
|
|
|
||
Sanitation and hygiene items |
|
|
|
|
||
11 Glasses and other optical items |
|
|
|
|
||
Service premises: |
||||||
12. Manager's office |
|
|
|
|
||
13. Accounting (with archive) |
|
|
|
|
||
14. Staff room |
|
|
|
|
||
15. Dressing room for staff street clothes |
|
|
|
|
||
16. Staff dressing room for work and home clothes |
|
|
|
|
||
17. Pantry for storing household equipment and cleaning items |
|
|
|
|
||
18. Bathroom (with airlock and washbasin in the airlock) |
|
|
|
|
||
19. Shower |
|
|
|
|
||
* For on-duty pharmacies |
||||||
** Provided for servicing attached health care facilities |
||||||
1. AREA OF APPLICATION
3. BASIC PROVISIONS
4. REQUIREMENTS FOR LOCATION, SITE AND TERRITORY
6. REQUIREMENTS FOR ENGINEERING EQUIPMENT
Appendix 3 (mandatory). FIRE REQUIREMENTS
Appendix 5 (for reference). LIST OF WORKPLACES IN GENERAL TYPE OF SELF-SUPPORTING PHARMACIES
