Temperature conditions. Microclimatic conditions in hospitals Temperature in the ward of the children's department

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Personal hygiene of the patient

Hospital sanitary regime

Maintaining required sanitary regime V hospital premises plays a huge role in the work of a hospital, the organization of the treatment process and patient care, as well as in the prevention of many diseases. Violations of the requirements and rules of the sanitary regime leads to contamination of premises, the proliferation of pathogenic microorganisms, the spread various insects. Thus, poor ventilation of wards leads to an increase in the level of bacterial contamination of the air, and the preservation of food residues in the buffet and untimely removal food waste promote the appearance of cockroaches. Poor care behind soft equipment, furniture, mattresses, cracks in walls and baseboards contribute to the spread of bed bugs, and untimely removal of garbage from the hospital premises causes the spread of flies. Storage violations food products in the catering unit lead to the appearance of rodents.

Failure to comply with the sanitary regime increases the risk of the spread of nosocomial infections - infectious diseases that occur in patients in hospitals or in medical workers involved in the treatment and care of patients as a result of violations of the rules of asepsis and antisepsis, i.e. measures aimed at combating pathogens of various infections. Among these diseases spreading in hospital conditions, include influenza, infectious (serum) hepatitis B, infection of which occurs due to poor sterilization of syringes and needles, and in children's departments - measles, scarlet fever, chicken pox, etc.

When organizing a sanitary regime in a hospital, significant requirements are placed on lighting, ventilation and heating, i.e., the creation of a certain microclimate in hospital premises.

Equal importance should be given to the lighting of the chambers. It must be remembered that direct sunlight has a bactericidal effect, that is, it helps reduce the level of bacterial air pollution. At the same time, it is necessary that the lighting be of sufficient intensity, uniform, and biologically complete in its spectrum. For these reasons, for example, ward windows are usually oriented to the south and southeast, and operating room windows to the north. For best use daylighting It is advisable to place the beds in the wards parallel to the wall with windows. To avoid the blinding effect of direct sunlight and overheating of the rooms, windows must be equipped with visors, curtains or have blinds.

When organizing artificial lighting take into account that fluorescent lamps provide the patient with greater comfort than conventional incandescent lamps. Some departments (operating rooms, maternity units, etc.) also provide emergency lighting.

A prerequisite for maintaining a sanitary regime in hospitals is adequate ventilation, i.e. removing polluted air from the premises and replacing it clean air. Natural ventilation is achieved by regularly opening windows or transoms. Systematic failure to ventilate rooms leads to air stagnation and a significant increase in bacterial contamination, which facilitates the spread of nosocomial infections. In a number of rooms, for example in operating rooms, they use automatic maintenance of cleanliness, composition, humidity and air speed using air conditioners.

When organizing heating in hospitals, they proceed from the fact that for a person optimal temperature in the premises amounts to winter time+20 °C, and in summer time+23-24 °C. The hygienic requirement is best met by radiant heating (with heated surfaces located in the walls, floor, ceiling), which prevents a significant difference between the temperature of the heat source and the temperature of the human body.

Maintaining a sanitary regime involves regular thorough cleaning of the premises and territory of the hospital. Garbage from buildings and compartments is taken out into metal bins with tight-fitting lids and removed in a timely manner.

Cleaning hospital premises must be wet, since washing reduces microbial contamination of the premises and surfaces of objects.

Disinfection can be achieved different ways. Thus, boiling is widely used to disinfect dishes, linen, and patient care items. Ultraviolet radiation Mercury-quartz and mercury-uviol lamps are used for air disinfection in wards, treatment rooms, and operating rooms.

For disinfection, chlorine-containing compounds are most often used ( bleach, chloramine, calcium, sodium and lithium hypochlorite, etc.). The antimicrobial properties of chlorine preparations are associated with the action of hypochlorous acid, which is released when chlorine and its compounds are dissolved in water.

A bleach solution is prepared according to certain rules. 1 kg of dry bleach is diluted in 10 liters of water, thereby obtaining the so-called 10% bleach-lime milk, which is left in a special room in a dark container for 1 day. Then the clarified bleach solution is poured into an appropriate dark glass container, the date of preparation is marked and the container is stored in a darkened room, since active chlorine is quickly destroyed in the light. In the future for wet cleaning use a 0.5% clarified bleach solution, for which, for example, take 9.5 liters of water and 0.5 liters of a 10% bleach solution. Chloramine solution is most often used in the form of a 0.2-3% solution (mostly 1%).

But such products are almost a thing of the past, and only a chronic lack of funding does not allow us to completely switch to new generation disinfectants, which are less toxic, more effectively destroy microorganisms, and are much more convenient to use. Modern means disinfection is differentiated - for, for the treatment of instruments, for the treatment of premises and for the treatment of linen and secretions of patients.

Wet cleaning of hospital premises is carried out daily. In wards, corridors and offices - in the morning, after patients get up. During cleaning, pay attention to the sanitary condition of the bedside tables and bedside tables, where it is not allowed to store perishable foods that can cause food poisoning.

Furniture, window sills, doors and door handles, and also (last) wipe the floor with a damp cloth. Wet cleaning must be completed by ventilating the rooms, since the walking of patients and medical staff and the changing of beds are accompanied by an increase in bacterial air pollution.

To maintain cleanliness in the rooms, wet cleaning is repeated as necessary during the day, as well as before bedtime.

Wet cleaning of dining rooms and pantries is carried out after each meal. Food waste is collected in closed buckets or bins with lids and taken out.

It is very important to follow the rules for washing dishes. The operation includes washing dishes twice hot water using soda, mustard or other detergents, subsequent disinfection with a 0.2% clarified bleach solution and rinsing.

Particularly strict requirements are imposed on the personal hygiene of kitchen and buffet workers, their regular and timely medical examination and bacteriological examination.

Wet cleaning of bathrooms (bathtubs, sinks, toilets) is carried out several times a day as they become dirty. To clean toilets, use a 0.5% clarified solution of bleach. Baths are washed after each patient with warm water and soap, and then rinsed with a 0.5% solution of bleach or 1-2% solution of chloramine.

General cleaning of all premises, including washing the floor, sweeping walls and ceilings, is carried out at least once a week. The equipment used in this case (mops, buckets, etc.) must be appropriately marked (for example, for washing the toilet, for washing corridors, etc.).

If bedbugs or cockroaches are found in hospital premises, measures are taken to destroy them (disinsection). A set of special measures (deratization) is also carried out when rodents are identified. Since disinsection and deratization involve the use of toxic substances, these activities are carried out by staff members of sanitary and epidemiological stations (SES).

Preventing the spread of flies, bedbugs, cockroaches and rodents in hospitals consists of maintaining cleanliness in the premises, timely removal of garbage and food waste, carefully sealing cracks in the walls, and storing food products in places inaccessible to rodents.

Note that maintaining the necessary sanitary condition in hospitals involves not only strict implementation medical personnel and sick sanitary standards and wet cleaning mode various rooms, but also compliance by medical personnel and patients with personal hygiene rules.

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Organization of the work of the therapeutic departmentPersonal hygiene of the patient

table 2

Air temperature is essentially the most important microclimate factor that determines the thermal state of the body. The recommended optimal air temperature depends on the season of the year. Thus, in summer the thermal comfort zone shifts towards higher air temperatures than in winter. This is due to the seasonal restructuring of some body functions, including thermoregulatory ones. It is generally accepted to normalize the air temperature in enclosed spaces for the winter period of the year. The most favorable air temperature in residential premises for a person at rest and dressed in ordinary home clothes is 18-20 0 C with optimal humidity (40-60%) and air mobility (0.2-0.3 m/sec) . Air temperatures above 24-25 0 C, and below 14-15 0 C are considered unfavorable, capable of disturbing the thermal balance of the body and causing the development of various diseases. It is generally accepted that the optimal air temperature in the wards of medical institutions should be slightly higher than in residential premises. Since in many pathological conditions the heat exchange of the body with the environment changes to varying degrees, the microclimate standards of the wards and other functional departments of the hospital should take into account the characteristics of the patient’s heat exchange, the characteristics and stage of the pathological process, the patient’s age, time of day, season of the year, and climate of the area. For patients, the optimal air temperature parameters shift: during the day - often towards higher temperatures and at night - towards lower temperatures, due to changes in their heat exchange, imperfect skin-vascular reactions and a decrease in the regulatory role of the limbs in heat exchange. Optimal air temperatures in specialized wards must be differentiated depending on the purpose of the ward and the age of the patients, as well as the characteristics of the form and stage of the disease, which have a primary impact on heat exchange and thermoregulation of the body. When studying the thermal state of a patient, the pathological background of the thermoregulatory reaction should be taken into account, excluding the effect of medications that affect thermoregulation. Optimization of microclimatic conditions in hospital premises plays a significant role in the complex of factors that normalize homeostasis and contributes to favorable treatment, course and outcome of the disease. The optimal air temperature in the wards of a cardiology hospital during the day should be 21-24 0 C, adhering to the lower limit for middle-aged patients light forms illnesses in the summer and the lower limit - for elderly patients of moderate severity during the heating season. At night, for all these patients, the optimal air temperature will be 17-18 0 C. The optimal air temperature in the wards for the pulmonology department should be considered 21-22 0 C during the day and 16-17 0 C at night. For patients in the wards of the burn center , the optimal air temperature is in the range of 24-26 0 C, if the effect of radiant heating on the body surface is excluded. For feverish patients, the optimal air temperature is determined to be 22-23 0 C (daytime) and 17-18 0 C (at night). For other patients in whom thermal metabolism is not impaired, the optimal air temperature is taken to be the same as for cardiac patients. Thus, there is no single optimal air temperature for different patients. The desire to establish an individual optimal air temperature based on the body’s heat exchange is justified. To some extent, it is possible to improve microclimatic conditions to optimal ones by selecting clothes and thus creating the desired microclimate of the under-clothing space. Instruments: depending on the design and device, thermometers are divided into alcohol, mercury, electric, etc. In addition, thermometers are divided into household, aspiration (dry thermometer of the Assmann aspiration psychrometer), minimum and maximum. According to their purpose, thermometers are divided into wall, water, soil, chemical, technical, medical, etc.

2.1.1.1. Rules for measuring air temperature

Measuring air temperature in enclosed spaces, schools, apartments, children's rooms, medical institutions, industrial premises, etc. is carried out in compliance with the following rules: when measuring air temperature, it is necessary to protect the thermometer from the effects of radiant energy from stoves, lamps and other open energy sources. In residential premises, air temperature is measured at a distance of 1.5 m from the floor (breathing height) in the center of the room. For more accurate measurements, thermometers are simultaneously installed in the center of the room, outside and inner corners at a distance of 0.2 m from the walls. In medical institutions, air temperature is additionally measured at a height of 0.7 m from the floor (breathing zone of bed patients). Temperature differences are determined and evaluated vertically and horizontally. To determine vertical temperature differences, thermometers are installed in the center and at the mentioned corners of the room at a height of 0.2; 0.7; 1.5 m from the floor. To determine the horizontal temperature difference, the difference between the maximum and minimum temperature separately for each level (0.2; 0.7; 1.5 m) in all measured areas of the room. The daily temperature difference in the wards is measured using maximum and minimum thermometers, which are installed in the rooms at a level (0.7 and 1.5 m from the floor. To measure the temperature of walls (enclosing surfaces) at a height of 1.5 m from the floor, a wall thermometer is used , the reservoir of which is glued to the wall with plasticine, or an electric thermometer is used. Temperature readings during measurements are taken 5-10 minutes after the start of the measurement. The dynamics of recording the air temperature in the examined room over a certain period of time (day, week) is carried out with a thermograph.

What are the requirements for artificial lighting??
Electric lighting used in the evening and at night should not be too bright. At the same time, in doctors’ offices, laboratories, treatment rooms, especially in operating rooms and dressing rooms, the lighting, on the contrary, should be very powerful. In operating rooms and dressing rooms, special shadowless lighting systems are used.

What should the air temperature be in the hospital premises?
In the wards, the air temperature should be +20 "C, in dressing rooms and bathrooms - +22-25" C, in operating rooms and labor rooms - +25 "C. The temperature in the room should be uniform.

What is the hygienic air standard in a hospital per patient?
The composition of the air in the room where people are is constantly changing. Dust in the indoor air plays a large role in the spread of germs and viruses and thereby contributes to the occurrence of diseases such as influenza, catarrh of the upper respiratory tract, measles, scarlet fever, etc.
The hygienic standard of air in a hospital room per patient is 27-30 m3, and this air must be replaced with fresh air every hour. Replacement of indoor air with outdoor clean air is carried out using natural and artificial ventilation.

How is the ventilation of rooms in a hospital carried out?
Ventilation of hospital premises through vents and transoms cannot be regulated and depends on climatic and meteorological conditions. In hospitals, it is necessary to install artificial supply and exhaust ventilation to purify the air, warm it or cool it. Operating rooms, boxes, isolators must have independent supply and exhaust systems. Installed for each room hygiene standards exchange of air in the supply and exhaust.

What are the care items in the hospital?
Care items include sippy cups, heating pads, ice packs, glass, enamel and rubber Esmarch mugs, bedpans, urinals, beakers, thermometers for measuring body temperature, water and air, rubber cushions, mattresses for the prevention of bedsores, headrests, benches for legs, etc. All these items must be in places specially designated for them.

How are patient care items sterilized and disinfected?
Before serving to the patient, vessels and urinals are rinsed with hot water to keep them warm. After use, they are washed with soap or powder ("Lotus", "Hygiene", etc.) and disinfected with a 0.5% bleach solution or 1% chloramine solution. Used enema tips should be kept in special glass jars labeled "dirty", and clean ones - in sterilizers, where they are boiled after washing with soap. In infectious diseases departments, each patient has his own care items until discharge from the hospital.

What are hospital supplies?
Hospital equipment includes beds, bedside tables, stretchers, chairs, trestle beds, and cabinets. The host sister is responsible for the safety of hospital equipment. Sanitary condition equipment is provided by a nurse, and nurse controls her work.

The microclimate of the premises of medical institutions is determined by a combination of temperature, humidity, air mobility, the temperature of surrounding surfaces and their thermal radiation. Microclimate parameters determine the heat exchange of the human body and have a significant impact on the functional state of various body systems, well-being, performance and health.
High temperatures have a negative impact on human health. Working in conditions high temperature accompanied by intense sweating, which leads to dehydration of the body, loss of mineral salts, causes persistent changes in the activity of the cardiovascular system, weakened attention, slow reactions, etc.
When exposed to the human body negative temperatures There is a narrowing of the blood vessels in the fingers and toes, and the metabolism changes. Prolonged exposure to these temperatures leads to persistent diseases of internal organs.
Microclimate parameters depend on heat physical features technological processes, climate, season of the year, heating and ventilation conditions in healthcare institutions.
The fight against the unfavorable influence of the industrial microclimate is carried out using technological, sanitary and technical and medical and preventive measures.
Technological measures include: replacement of old and introduction of new technological processes and equipment, automation and mechanization of processes, remote control.
Sanitary and technical measures are aimed at localizing heat emissions and thermal insulation, i.e. sealing equipment, installing ventilation systems, using protective equipment, etc.
Medical and preventive measures include: organizing a rational work and rest regime, undergoing medical examinations, etc.
Requirements for heating, ventilation, microclimate and air environment of premises are established by the Sanitary and Epidemiological Rules and Standards SanPiN 2.1.3.1375-03 “ Hygienic requirements to the placement, arrangement, equipment and operation of hospitals, maternity hospitals and other medical hospitals.”
Heating, ventilation and air conditioning systems must provide optimal conditions microclimate and air environment premises of medical institutions.
Parameters of the design temperature, air exchange rate, categories for cleanliness of the premises of medical institutions, incl. in day hospitals, are given in Appendix No. 5 to SanPiN 2.1.3.1375-03.
Heating devices must have smooth surface allowing easy cleaning, they should be placed near external walls, under windows, without fences. It is not allowed to place heating devices in rooms near interior walls.
In operating rooms, preoperative, intensive care rooms, anesthesia, labor and delivery rooms, electric lighting and premises of psychiatric departments, as well as in intensive care wards and postoperative wards, heating devices with a smooth surface, resistant to daily exposure to cleaning and disinfecting solutions, eliminating adsorption should be used as heating devices dust and accumulation of microorganisms.

When installing fences heating devices in administrative and utility rooms, in children's hospitals, material is used that is approved for use in in the prescribed manner. At the same time, free access must be provided for routine operation and cleaning of heating devices.
Water with a maximum temperature of heating devices 85° C. The use of other liquids and solutions (antifreeze, etc.) as a coolant in heating systems of medical institutions is not allowed.
Buildings of medical institutions must be equipped with supply systems exhaust ventilation with mechanical urge and natural exhaust without mechanical urge.
In infectious diseases departments, including tuberculosis departments, mechanical exhaust ventilation is arranged through individual channels in each box and half-box, which must be equipped with air disinfection devices.
In the absence of infectious diseases departments supply and exhaust ventilation with mechanical motivation, natural ventilation must be equipped with the obligatory equipping of each box and half-box with a recirculation-type air disinfection device, ensuring an efficiency of inactivation of microorganisms and viruses of at least 95%.
Design and operation ventilation systems should prevent the flow of air masses from “dirty” areas to “clean” rooms.
The premises of medical institutions, except for operating rooms, in addition to supply and exhaust ventilation with mechanical impulse, are equipped natural ventilation(window windows, folding transoms, etc.), equipped with a fixation system.
Outdoor air intake for ventilation and air conditioning systems is carried out from a clean area at a height of at least 2 m from the ground surface. Outside air, supplied by air supply units, must be cleaned with coarse and fine structure filters in accordance with the current regulatory documentation.
The air supplied to operating rooms, anesthesia rooms, maternity rooms, resuscitation rooms, postoperative wards, intensive care wards, as well as wards for patients with skin burns, AIDS patients and other similar medical premises must be treated with air disinfection devices that ensure the effectiveness of inactivation of microorganisms and viruses located in the treated air at least 95% (filters high efficiency H11-H14).
Operating rooms, intensive care wards, resuscitation rooms, labor and delivery rooms, treatment rooms and other rooms in which the release into the air is accompanied by harmful substances, must be equipped with local suction or fume hoods.
Content medicines in the air of operating rooms, maternity wards, intensive care wards, resuscitation rooms, treatment rooms, dressing rooms and other similar rooms of medical institutions should not exceed the maximum permissible concentrations given in Appendix No. 6 to SanPiN 2.1.3.1375-03.
Levels of bacterial contamination of the indoor air, depending on their functional purpose and cleanliness class, should not exceed the permissible limits given in Appendix No. 7 to SanPiN 2.1.3.1375-03.
Air conditioning should be provided in operating rooms, anesthesia, delivery, postoperative wards, intensive care wards, oncohematological patients, patients with AIDS, patients with skin burns, intensive care units, as well as in wards for newborns, infants, premature babies, injured children and other similar medical premises. In wards that are fully equipped with incubators, air conditioning is not provided.
Air ducts of supply ventilation (air conditioning) systems after high efficiency filters (H11-H14) are made of stainless steel.
The use of split systems is allowed in the presence of high efficiency filters (H11-H14) only if the rules of routine maintenance are observed. Split systems installed in an institution must have a positive sanitary and epidemiological certificate issued in the prescribed manner.
The air exchange rate is selected based on calculations to ensure a given purity and maintain the gas composition of the air. Relative humidity air should be no more than 60%, air movement speed should be no more than 0.15 m/sec.
Air ducts, air distribution and air intake grilles, ventilation chambers, ventilation units and other devices must be kept clean and must not have mechanical damage, traces of corrosion, leakage.
Fans and electric motors should not create extraneous noise.
At least once a month, the degree of contamination of filters and the efficiency of air disinfection devices should be monitored. Filters should be replaced as they become dirty, but no less frequently than recommended by the manufacturer.
General supply and exhaust and local exhaust units should be turned on 5 minutes before the start of work and turned off 5 minutes after the end of work.
In operating rooms and preoperative rooms, supply ventilation systems are first turned on, then exhaust, or simultaneously supply and exhaust.
In all rooms, air is supplied to the upper zone of the room. Air is supplied to sterile rooms using laminar or slightly turbulent jets (air speed< = 0,15 м/сек).
Air supply and exhaust ventilation (air conditioning) ducts must have inner surface, excluding the removal of particles of air duct material or protective coating into the premises. The inner coating must be non-absorbent.
To accommodate the equipment of ventilation systems, special rooms should be allocated, separate for supply and exhaust systems and not vertically or horizontally adjacent to doctors’ offices, operating rooms, wards and other premises where people permanently reside.
In rooms for exhaust systems, exhaust ventilation with a single air exchange per hour should be provided, and for supply systems - supply ventilation with a double air exchange.
Ventilation equipment rooms should be used only for their intended purpose.
In rooms subject to aseptic conditions, hidden installation of air ducts, pipelines, and fittings is provided. In other rooms it is possible to place air ducts in closed boxes.
Natural exhaust ventilation is allowed for detached buildings with a height of no more than 3 floors (in emergency departments, ward buildings, hydrotherapy departments, infectious diseases buildings and departments). Wherein forced ventilation is provided with mechanical drive and air supply into the corridor.
Exhaust ventilation with mechanical drive without an organized inflow device is provided from the following premises: autoclaves, sinks, showers, latrines, sanitary rooms, rooms for dirty linen, temporary storage of waste and storage rooms for disinfectants.
Air exchange in wards and departments should be organized in such a way as to limit as much as possible the flow of air between ward departments, between wards, and between adjacent floors.
Quantity supply air per room should be 80 m 3 /hour per 1 patient.
To create an isolated air regime in the rooms, they should be designed with an airlock connected to the bathroom, with a predominance of exhaust in the latter.
At the entrance to the department there must be a gateway equipped with an exhaust ventilation device with an independent channel (from each gateway).
To eliminate the possibility of contaminated air entering from the staircase and elevator halls into the ward departments, it is advisable to construct a transition zone between them with provision of air pressure in it.
Architectural and planning solutions and hospital air exchange systems must prevent the transfer of infections from ward departments and other premises to the operating unit and other premises that require special air purity.
To exclude the possibility of air masses entering from the ward departments, staircase-elevator halls and other rooms into the operating unit, it is necessary to install a pressurized airlock between these rooms and the operating unit.
Movement air flow should be provided from the operating rooms to the adjacent rooms (preoperative, anesthesia, etc.), and from these rooms to the corridor. Exhaust ventilation is required in corridors.
The amount of air removed from the lower zone of the operating rooms should be 60%, from the upper zone - 40%. Fresh air is supplied through the upper zone, and the inflow should prevail over the exhaust.
It is necessary to provide separate (isolated) ventilation and air conditioning systems for clean and purulent operating rooms, maternity units, intensive care, oncohematology, burn departments, dressing rooms, separate ward sections, X-ray and other special rooms.
Preventive inspection and repair of ventilation and air conditioning systems must be carried out according to the approved schedule, at least 2 times a year. Elimination of current malfunctions and defects must be carried out immediately.
The administration of the medical institution organizes control over microclimate parameters and air pollution by chemicals, the operation of ventilation systems and the frequency of air exchange in the following premises:
- in the main functional rooms operating rooms, postoperative, maternity, intensive care wards, oncohematology, burn departments, medical and technical departments, rooms for storing potent and toxic substances, pharmaceutical warehouses, premises for the preparation of medicines, laboratories, the department of therapeutic dentistry, special rooms of radiology departments and other premises, in offices, using chemical and other substances and compounds that can have harmful effects for human health - once every 3 months;
- infectious, incl. tuberculosis hospitals (departments), bacteriological, virus laboratories, X-ray rooms - once every 6 months; - in other premises - once every 12 months.
To disinfect the air and surfaces of premises in medical institutions, ultraviolet bactericidal radiation must be used using bactericidal irradiators approved for use in the prescribed manner.
Methods for using ultraviolet bactericidal radiation, operating rules and safety of bactericidal installations (irradiators) must comply with hygienic requirements and instructions for the use of ultraviolet rays.
The microclimate is assessed based on measurements of its parameters (temperature, air humidity, air speed, thermal radiation) at all places where the employee stays during the shift.

Resolution of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 N 58
"On approval of SanPiN 2.1.3.2630-10 "Sanitary and epidemiological requirements for organizations engaged in medical activities"

With changes and additions from:

3. From the moment the sanitary and epidemiological rules and regulations SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities” are put into effect, SanPiN 2.1.3.1375-03 “Hygienic requirements for placement, arrangement, equipment and operation of hospitals, maternity hospitals and other medical hospitals", approved by the resolution of the Chief State Sanitary Doctor Russian Federation dated 06.06.2003 N 124 (registered with the Ministry of Justice of Russia on 06.18.2003, registration N 4709); SanPiN 2.1.3.2195-07, amendment No. 1 to SanPiN 2.1.3.1375-03, approved by Decree of the Chief State Sanitary Doctor of the Russian Federation dated April 25, 2007 No. 19 (registered with the Ministry of Justice of Russia on June 5, 2007, registration No. 9597); SP 3.1.2485-09 "Prevention of nosocomial infections in surgical hospitals (departments) medical organizations", Addendum No. 1 to SanPiN 2.1.3.1375-03, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated 02/13/2009 No. 9 (registered with the Ministry of Justice of Russia on March 20, 2009, registration No. 13548); SanPiN 2.1.3.2524-09 "Sanitary hygienic requirements for dental medical organizations", change No. 2 to SanPiN 2.1.3.1375-03, approved by Decree of the Chief State Sanitary Doctor of the Russian Federation dated July 7, 2009 No. 48 (registered with the Ministry of Justice of Russia on August 20, 2009, registration No. 14581); SanPiN 3.5.2528-09 "Organization of disinfection and sterilization measures in medical and preventive organizations", addendum No. 2 to SanPiN 2.1.3.1375-03, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated 08/06/2009 N 51 (registered with the Ministry of Justice of Russia on 08/26/2009, registration No. 14624); SanPiN 2.1.3.2576-10 amendment No. 3 to SanPiN 2.1.3.1375-03, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated 03/04/2010 No. 18 (registered with the Ministry of Justice of Russia on 04/27/2010, registration No. 17017).

Registration N 18094

Sanitary and epidemiological requirements for entrepreneurs and organizations engaged in medical activities have been determined (SanPiN 2.1.3.2630-10).

They replace SanPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals” (including additions and changes).

It has been established where treatment and prevention organizations (HPOs) should be located. Thus, psychiatric and infectious diseases hospitals are located at a distance of at least 100 m from residential buildings (previously - at least 500 m). In residential buildings, medical facilities for providing assistance to persons with alcohol or drug addiction, microbiological laboratories, and magnetic resonance imaging departments cannot be located.

Requirements for buildings, structures and premises have been established, interior decoration, water supply and sewerage, heating, ventilation, lighting, inventory and equipment.

It is recommended to ventilate the rooms at least 4 times a day for 15 minutes. They should also have cabinets to store patients' belongings. Window glass need to be washed at least 2 times a year. Previously - at least once a month from the inside and once every 3 months from the outside (spring, summer, autumn).

For cleaning, it is allowed to hire professional cleaning companies working around the clock. The exception is class A premises.

The rules of personal hygiene, as well as the organization of nutrition for patients, have been determined.

It has been established how preventive, anti-epidemic, disinfection and sterilization measures are carried out. Requirements for working conditions of medical staff, etc. have been established.