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 PUT 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 units (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 switchboards, 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 rooms, emergency rooms, emergency medical care substations and other services under the windows of the wards, to which vehicles must be accessible, is not allowed.

24. In the buildings of emergency medical services 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 require installation 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, resuscitation, 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-leaf 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 diagnostics, 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 receiving 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

MGSN 4.12-97
TSN 31-313-98 Moscow*
_____________
*See Notes label

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 by: Moskomarkhitektura, MNIIP of cultural, recreational, sports and healthcare facilities.

3. PREPARED FOR APPROVAL AND PUBLISHING 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.

AMENDED Change No. 1, approved by Moscow government decree No. 570 dated July 25, 2000, entered into force on July 25, 2000 and published in the official publication

Change No. 1 was made by the legal bureau "Code" according to the text of the official publication

1. AREA OF APPLICATION

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 must be observed, as well as the provisions of the Guidelines for the design of healthcare institutions to MGSN 4.12-97 and SNiP 2.08 .02-89 * and other recommendations and manuals, Manuals on the design of healthcare institutions (to SNiP 2.08.02-89 *) 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 the Design Guide for Healthcare Facilities, with the exception of the provisions given in the new edition or containing an addition or clarification.

(Changed edition, Amendment No. 1).

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. REGULATORY REFERENCES

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 11-01-95 "Instructions on the procedure for development, coordination, approval and composition of design documentation for the construction of enterprises, buildings and structures."

2.7. SP 11-101-95 "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 fire detection installations."
________________
* NPB 110-03 applies on the territory of the Russian Federation. Here and further. - Database manufacturer's note.

2.10. MGSN 1.01-94* "Temporary norms and rules for the design, planning and development of Moscow."
____________
*Probably an original error. You should read MGSN 1.01-97 **. Here and further. - Database manufacturer's note.

** MGSN 1.01-99 is valid. Here and further in the text. - Database manufacturer's note.

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."
________________
*SaNPiN 2.1.3.1375-03 is in force on the territory of the Russian Federation, hereinafter in the text. - Database manufacturer's note.

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.

2.17. SNiP 21-01-97 "Fire safety of buildings and structures."

(Introduced additionally. Amendment No. 1).

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. Treatment and prevention 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 treatment and preventive 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
Others
b) for children:
Infectious boxed
Infectious semi-boxes for 1 bed
Others

3.8. Fire safety requirements for buildings of medical institutions and pharmacies should be taken in accordance with the requirements of these Standards, including the mandatory Appendix 3, SNiP 2.01.02-85 *, SNiP 21-01-97, SNiP 2.08.02-89 * and others current norms and regulations.

(Changed edition, Amendment No. 1).

4. REQUIREMENTS FOR LOCATION, SITE AND TERRITORY

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 rooms 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 the 1st type 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)
1. Inpatient institutions for adults:
Infectious diseases, tuberculosis and oncology hospitals, oncology hospitals and anti-tuberculosis dispensaries
Rehabilitation hospitals, medical and physical training clinics
Hospices
Maternity hospitals
Other types of hospitals and hospitals, dispensaries
2. Inpatient institutions for the child population:
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 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.

(Changed edition, Amendment No. 1).

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 as follows:

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 areas of crowded urban development, 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 incineration furnace 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 care 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 hospital institutions 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 radiation 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
Others
Postoperative
Psychiatric and drug treatment
General type in wards with 2 beds
General type wards do not have 3-4 beds
Insulin and surveillance
Medical and social
For hospices
For nursing homes (departments)
Others
In wards with 2 beds
In wards with 3-4 beds
2. Ward departments for children under 7 years of age:
Infectious and tuberculous
Rehabilitation treatment, neurosurgical, orthopedic-traumatological, burn
Intensive care:
Burns
Others
Postoperative
Psychiatric:
General type
Supervisors
Others
3. Ward departments for newborns and premature babies:
For 1 bed
For 1 incubator

(Changed edition, Amendment No. 1).

5.6. Wards for adults and children over 7 years old, as well as wards where children stay with their mothers, should be designed with an airlock and a bathroom (restroom, washbasin, shower).

(Changed edition, Amendment No. 1).

*5.7. The area of ​​wards where children and mothers stay together (excluding the area of ​​locks and bathrooms) should be taken according to Table 4.

Table 4

Room capacity	Area of ​​the chambers, m
	24-hour stay mothers	daytime residence mothers
1 cot and 1 bunk (1 place)
2 cots and 2 bunks (2 places)

(Changed edition, Amendment No. 1).

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 operating conditions.

*5.10. In cardiology departments for patients with myocardial infarction, neurological departments for patients with acute cerebrovascular accidents, burns and toxicology departments, intensive care units with a capacity of at least 6 beds should be provided.

According to the design assignment, intensive care units can be provided in the structure of ward departments of other profiles.

(Changed edition, Amendment No. 1).

*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.

The approximate composition and area of ​​premises of self-supporting industrial pharmacies are given in recommended Appendix 6, for self-supporting non-industrial 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 of 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.

*5.18. The adult department and the children's department of an outpatient clinic, when located in the same building, must have separate external entrances and not communicate with each other; treatment, treatment and diagnostic rooms (departments) should be provided separately for adults and children. It is allowed to design a general clinical diagnostic laboratory, a centralized sterilization laboratory, and a dental laboratory with separate access to them.

(Introduced additionally. Amendment No. 1).

6. REQUIREMENTS FOR ENGINEERING EQUIPMENT

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.

Appendix 1 (recommended). TYPOLOGICAL NOMENCLATURE OF TREATMENT AND PREVENTIVE INSTITUTIONS AND TYPOLOGICAL STANDARD-CALCULATION INDICATORS OF NEED FOR TREATMENT AND PREVENTIVE INSTITUTIONS IN MOSCOW

TYPOLOGICAL NOMENCLATURE OF TREATMENT AND PREVENTIVE INSTITUTIONS AND TYPOLOGICAL STANDARD-CALCULATION INDICATORS OF THE NEED FOR
TREATMENT AND PREVENTIVE INSTITUTIONS IN MOSCOW

Typological nomenclature of medical and preventive institutions	Typological standard-calculation indicator
1. Inpatient institutions for adults:	beds per 10 thousand adult population
Multidisciplinary hospital
Eye Hospital
Oncology hospital (oncology dispensary inpatient unit)
Infectious diseases hospital
Tuberculosis hospital (inpatient tuberculosis dispensary)
Dermatovenerological hospital (inpatient dermatovenerological dispensary)
Psychiatric hospital (inpatient psychoneurological dispensary)
Narcological hospital (inpatient drug treatment clinic)
Orthopedic and traumatological rehabilitation hospital (inpatient medical and physical education dispensary)
Neurological Rehabilitation Hospital
Aftercare hospital
Nursing home
Hospice
Maternity hospital	An error has occurred Payment was not completed due to a technical error, funds from your account were not written off. Try waiting a few minutes and repeating the payment again.

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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 (rooms) of functional diagnostics, endoscopic departments (rooms), 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 to MGSN 4.12-97, you should also be guided by the Manual on 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 unit 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 endoscopic department (office) is a structural unit 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 the 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 dimensions 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 airlock 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 imaging, 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, 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, viewing 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. Ultrasound diagnostic rooms may be included in radiology departments.

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 division 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 inhalation anesthesia machine
	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 trolley
	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