Hospital disinfection supply room is a special place for supplying sterile instruments and dressings in the whole hospital. Some people compare it to the heart of the hospital and the core of the hospital. Its function directly affects the medical quality and reputation of the hospital. Especially at present, with the rapid development of health care in China, the construction of disinfection supply system should also be in line with that of the hospital. In recent years, with the extensive use of disposable sterile goods and the diversification of goods management, how to make the management of disinfection supply system more effective towards standardization, standardization, systematization and rationalization has become an urgent problem to be solved. This paper briefly describes the scheme of disinfection supply room of Zhongshan Ophthalmological Center in Guangdong Province, which has participated in the bidding.
1. Design basis of disinfection supply room
The design is based on the relevant requirements of the "Standards for Examination and Acceptance of Disinfection Supply Room (Center) of Guangdong Medical and Health Institutions" issued by the Ministry of Health and the specific requirements of hospitals. It also collects the relevant information of many disinfection supply rooms at home and abroad, and draws on the management and construction mode of advanced disinfection supply rooms at home and abroad, and designs a suitable one for Sun Yat-sen University. The best plan of disinfection supply room in Zhongshan Ophthalmological Center.
The disinfection supply room should be located as close as possible to the adjacent floor of the operating Department building to facilitate the delivery of articles to the clinic; the surrounding environment should be free of pollution sources, which is conducive to the transport of contaminants, cleaning and sterile articles by staff.
2. Plane layout and overall decoration
The layout of the working area of the disinfection supply room is mandatory and reasonable according to the working process from "dirty" to "clean", i.e. recycling of articles, initial elimination of classified immersion, ultrasonic washing, machine washing, drying, inspection and equipment packaging, high pressure steam sterilization, inspection, storage of sterile articles, loading of articles and distribution of articles. 。 Two adjacent processes are located in two adjacent rooms. According to the requirements of cleanliness, they are divided into contaminated area, clean area, aseptic area, buffer area and general living and working area. To each district, it is necessary to go through buffer rooms and adopt compulsory channels to separate the flow of people and logistics, so as not to cross and retrograde as far as possible.
2.1 Pollution Zone
The polluted area is a slightly negative pressure area. Cleaning and disinfection room is mainly responsible for receiving and washing items. On the west side and South side, there are multi-functional cleaning troughs, stainless steel water troughs and stainless steel workbenches; on the East side, there are two double door automatic cleaning machines and two stainless steel transfer windows; only through the internal corridor, can staff enter the cleaning area after changing clothes and shoes, which reduces staff's cross-area walking and prevents cross-section communication. Cross infection.
2.2 Clean Area

The clean area is a micro-positive pressure area, and the cleanliness is relatively higher than that of the polluted area. According to the standard, referring to the layout design of advanced disinfection supply rooms at home and abroad, under the condition of high cleanliness control, the packing room and sterilizing furnace area are integrated into a whole, which makes the space not only smooth, but also conducive to work. There is a separate dressing baling table on the left and an independent equipment baling table on the right. The articles delivered from the cleaning room are packed in the packing room and packed with appliances, then pushed into the sterilizing furnace by a special sterilizing vehicle. After sterilizing for a specified time, the articles are received by the special sterilizing vehicle and placed on the sterile rack. Two imported double-door sterilizing furnaces are installed adjacent to the sterile zone to serve as a barrier to closely separate the clean zone from the sterile zone. Reserve certain maintenance space and compressed air unit position in sterilization zone.

2.3 aseptic zone
The aseptic zone is responsible for the storage and distribution of aseptic items. There are stainless steel storage racks and stainless steel equipment cabinets, which can store sterilized articles. There are stainless steel transfer windows in the delivery and parking rooms of aseptic goods storage rooms. The height of the transfer windows is about 80 to 90 cm from the ground. The size of the stainless steel transfer windows is 60 cm x 60 cm x 40 cm, so that the staff do not have to bend down when they take the goods, and transfer them directly by basket translation, which reduces the labor intensity of the staff and improves the work efficiency. Because of the high requirement for air cleanliness in aseptic zone, it is located in the corner of the workshop during the new construction process, which can be completely closed and can control the access of unrelated personnel. In order to prevent the pollution of aseptic zone in other areas, the aseptic zone is kept at 10-15 Pa positive pressure by increasing the amount of clean air supplied to the aseptic zone. The grade is 10,000, which prevents air from entering sterile zone in other areas.
2.4 General Region
Including men and women's bathroom, dressing room, conference room, head nurse's office, disinfector's room, quality control room and pure water room. In addition, there is a room for cleaning and opening the storage of the up and down delivery vehicles so as to collect sterile items. The decoration of this area is similar to that of the cleaning area, except that the floor and wall of the cleaning room are the same as that of the cleaning and disinfection room. The indoor use of patio split air conditioning, easy to open and close.
3. Organizational management
The main function and scale of the supply system in the disinfection supply room depend on the way of cleaning and disinfection of articles and the performance of sterilization equipment. Then the reasonable layout is optimized. In addition, the advanced equipment and environment are carefully managed, the quality of personnel management and the implementation of relevant rules and regulations are strengthened, so that the disinfection supply room can be promoted by the hospital. For high quality and satisfactory sterile articles.
3.1 Material Management
In order to meet the needs of modern management, the disinfection supply room should adopt local computer network management, each district has a computer. From the receipt and distribution of items, the monitoring and processing of expired items to warehouse management and daily statistics, computerized management should be implemented to achieve rapid and accurate, improve work efficiency, so as to make the material management of disinfection supply room step up to a new level.
3.2 Information Management
In order to meet the needs of modern management, an internal intelligent system is set up in the sterilization supply room, which can complete the broadcast function of group call and special call in the area, so as to facilitate the internal connection; it can also access the external line to facilitate the necessary connection between the sterilization supply room and the various departments of the hospital; besides, it can also play the background in peacetime. Music in order to ease the staff's tense working conditions.
4 Basic Equipment and Configuration Requirements
4.1 Equipments and Configuration in Polluted Areas
Manual cleaning pool, special contagious articles cleaning pool, high pressure water gun, needle cleaning machine, ultrasonic cleaning machine, pollutant classification table, sewage recovery vehicle, glove cleaning, dryer, conditional cleaning disinfection machine. There are detergents, pyrogens, enzymes and other detergents and storage equipment.
4.2 Cleaning area equipment and disposition power steam sterilizer, cleaning goods loader, equipment packaging desk, dressing packaging desk, dressing rack cabinet, glove packaging equipment, goods transfer vehicle, etc. Conditionally equipped with low temperature gas sterilizer and dry heat sterilizer.
4.3 Equipment and Configuration of Aseptic Storage Area
Sterilized goods unloading truck, sterile goods storage rack, sterile goods delivery truck, air replacement facilities, conditional installation of air purification devices. Air shower equipment is provided conditionally in the buffer room (area) of the entrance and exit. Each district has perfect air disinfection facilities and personal protective equipment, such as personal protective glasses, waterproof apron, waterproof shoes, rubber gloves, etc. Hand washing equipment in contaminated or clean areas and buffer rooms in aseptic areas shall be mobile water. Switches shall be elbow-type, pedal-type or induction-type, with hand washing liquid and dry hand equipment.
5. Problems needing attention in construction
(1) The design of disinfection supply room (center) should conform to the relevant national disinfection and isolation regulations and standards, and the building area should be in line with the size of the hospital. The ratio of bed to building area is 1:0.7-0.9 M2 (refer to the construction standard of general hospital [1996] 547). The minimum floor area of a hospital under 100 beds is 70M2.
(2) The building location is reasonable, not in the basement. The supply room should be close to the inpatient department, outpatient department and operating room, with clean surroundings and no pollution sources. It should avoid garbage disposal stations, canteens, laundries, traffic routes and other places to form relatively independent areas.
(3) Strictly dividing areas: 1. The supply rooms should be divided into contaminated areas, clean areas, storage areas of aseptic articles and living areas. Each area must be separated, separated by actual barriers, with its own equipment configuration, working scope and functions; the flow of people and air between contaminated areas, clean areas and storage areas of aseptic articles should be from clean to dirty, and the logistics should be from clean to dirty. Dirty to clean, one-way process settings, mandatory passage must not cross and retrograde. (2) The contaminated area is the area where medical equipment and articles contaminated by pathogenic microorganisms are handled. It is necessary to set up the receiving and classifying area, the cleaning area, the transfer window for delivering clean articles, and the area of the washing and recycling vehicle, etc. The operation area is divided according to the order of decreasing contamination. Buffer zones should be set up between polluted areas and clean areas. 3. Architectural design should be carried out according to the allocation of basic equipment in the three zones, such as cleaning and disinfection equipment, sterilization equipment, transportation equipment, assembly desk, storage equipment and special delivery elevator, and functional areas. (4) Buffer rooms (zones) are set up at the entrances and exits of workers in contaminated and sterile areas. The area of buffer rooms is not less than 3M2, and there are hand washing and changing equipment. The centralized management mode of disinfection supply center and operating room have special access.
(4) Equipment and articles in the three districts are managed separately. Pollutants, clean goods and sterile articles are strictly divided. Fixed facilities and equipment are used for treatment in the corresponding districts.
(5) The total steam pressure in the chamber is not less than 4kg/cm2. After decompression, the steam pressure in the furnace is 2.5kg/cm2. A separate steam pipeline is set up.
(6) Establish 220-volt and 380-volt two-way power supply and set up independent equipment power supply box.
(7) The normal water in disinfection supply center (room) meets the hygienic standard of drinking water, and the water pressure is not less than 1.5 kg. Guarantee hot water supply, water filtration and deionization, distilled water supply.
(8) Indoor ventilation and lighting are good, and the air cleanliness of each area should meet the environmental classification and standards stipulated in the "Hospital Hygiene Standards" GB15982-1995: sterile goods storage area should be classified according to Class II standard, bacterial colonies should be less than 200 cfu/m3; clean area should be classified according to Class III standard, bacterial colonies should be less than 500 cfu/m3; polluted area should be classified according to Class IV standard. If the air purification system is set up, the air purification pressure in aseptic area is 10-15 Pa, the air purification pressure in clean area is 5-10 Pa, and that in polluted area is 5-0 Pa. If the air purification system is not set up conditionally, there must be air-conditioning ventilation and air disinfection facilities with ventilation capacity of 8 times/m2/h. An independent ventilation system must be established in the cryogenic sterilization room.
(9) Building materials should meet the requirements of easy cleaning and corrosion resistance. There are no cracks in indoor walls and ceilings, and no pellets falling off. The ground is smooth, skid-proof, wear-resistant and easy to clean. Floor leakage must be encapsulated and sealed at the lower part of the drainage outlet. There is no floor leakage in the sterile storage room. The sewage discharge pipeline is connected with the hospital sewage treatment system.
6 Concluding remarks
The rationalization of the building layout of the disinfection supply room is an important part of the quality of disinfection supply in hospitals. It promotes the standardization, modernization, scientificalization and professional management of the disinfection supply room. It is also an important measure to reduce nosocomial infection. It is also an important guarantee for the quality of hospital medical care and modernization of construction. The strong supplement of the hospital calls for close cooperation between other departments of the hospital and the disinfection supply room to provide a highly reliable working environment for the disinfection supply room.
Reference:
[1] Technical Specification for Construction of Hospital Clean Surgery Department
[2] Code for Design of Clean Workshops
[3] Technical Specification for Biosafety Laboratory Construction
[4] Air Conditioning Design Manual
[5] Ministry of Health "Acceptance Standard for Hospital Sterilization Supply Room" (88) No. 6 of Medical Number
[6] Inspection and acceptance criteria for disinfection supply room (center) of medical and health institutions in Guangdong Province
Reprinted from https://www.xzbu.com/1/view-4975242.htm
Established in August 2010, Shandong Aide Purification Engineering Co., Ltd. has devoted ten years to the construction of special departments in hospitals. It is a laminar operation room purification, clean operation room decoration, ICU ward construction, neonatal NICU construction, CCU ward, hospital laboratory, central supply room decoration, laminar flow ward construction, venous configuration center design. Construction of professional enterprises. The main target of service is large, medium and small hospitals with professional contracting qualifications related to purification projects. There are many cases in the industry. Welcome new and old customers to consult. To learn more about the medical purification industry, please pay attention to the Wechat Public Number: Aide-188