The operating room and the intensive care unit are the two core parts of the hospital. The intensive care unit that does not contain the general ward, mainly includes the intensive care unit (ICU) generally established in the hospital, and the ward for vulnerable patients with extremely low immunity (such as blood diseases, organs) Transplantation, immunodeficiency neonatal, burn patient wards) and air infectious isolation wards.

The SARS virus in 2003 and the new crown pneumonia in 2020 have made the significance of refuge in hospitals more prominent, and the clean construction of hospitals has become particularly important. As early as 2016, Jianbiao [2016] No. 248 approved the establishment of "Technical Standards for Hospital Clean Care and Isolation Units" (hereinafter referred to as "Technical Standards"), which includes ICU, burn wards, negative pressure isolation wards, and neonatal immunization The current status of defective wards or NICU and other related medical areas, and develop solutions for the problems encountered.

I. The origin of "Technical Standards"

The operating room and the intensive care unit are the two core parts of the hospital. The intensive care unit that does not contain the general ward, mainly includes the intensive care unit (ICU) generally established in the hospital, and the ward for vulnerable patients with extremely low immunity (such as blood diseases, organs) Transplantation, immunodeficiency neonatal, burn patient wards) and air infectious isolation wards.

Hospital clean care and isolation unit technical standards

Regarding the operating room, my country has already issued technical specifications for the clean operating department, and the general operating department standards are also reflected in the building design specifications for general hospitals. Regarding the intensive care unit, it is very simple in the general hospital building design code. The blood ward only has certain provisions in the YEB004-1997 "Technical Standards for the Construction of Clean Nursing Units in Military Hospitals". Air infectious isolation wards are also very simple in the building design specifications of infectious disease hospitals. Only the Beijing local standard "Basic Requirements for Construction and Configuration of Negative Pressure Isolation Wards" applies China’s own scientific research results, namely dynamic isolation concepts and measures, to correct The incomprehensive understanding of the popular high negative pressure, closed doors, and fresh air has given the technical standards for infectious isolation wards. Although most local designs refer to this standard, there is no national standard, which still brings inconvenience to designers.

As for the ICU, although it is commonly installed in hospitals, the means to control environmental pollution are very different. Those with centralized systems, those with self-circulation systems, and those with local equipment. There is no relatively uniform standard, and it is considered that serious cross-infection may occur. Because there is no complete design standard, serious accidents caused by improper use of air purification and disinfection equipment have occurred in some places.

As a result, designers and hospital construction parties called for the introduction of technical standards for the above-mentioned susceptible patient wards, air infectious isolation wards and ICUs to meet the needs of my country's medical development and lay a good foundation for the construction of a healthy China.

II. Class 3 wards in the "Technical Standards"

In the comprehensive standards of foreign hospitals or medical facilities, the regulations on ICU, wards for susceptible patients and air-borne infectious isolation wards are emphasized.

In the Japan Medical Welfare Equipment Association standard "Hospital Equipment Design" (2013 edition and previous editions), in addition to general wards and radiotherapy wards, three types of wards are mainly listed:

Infectious patient ward: mainly refers to the ward of easily infected patients such as hematopoietic stem cell transplantation.

Air infectious isolation ward: mainly refers to the ward for patients with air infections such as tuberculosis, chickenpox, measles, etc.

ICU: ICU for critically ill patients and patients in critical condition after surgery.

III. About the naming of "Technical Standards"

1. my country's relevant regulations on 3 types of wards

Hospital clean room construction

2. Ward category

It can be seen from the previous introduction that the three types of wards can be simplified into two types: whether it is a patient with extremely low immunity or a general severely ill patient, they are all weak against infection and need to avoid external infections, so they all need positive pressure isolation; air In the isolation ward for patients with infectious diseases, in order to prevent external transmission, they must be isolated by negative pressure.

The standards of Japan, the United States, and Germany generally use centralized air conditioning (a few local units + filters that can be used for heating and cooling) for the environmental control of all wards (not only intensive care units).

3. Requirements for the final filter

my country's GB 51039-2014 "General Hospital Building Design Code" stipulates that the final filter of clean rooms is:

Class I: High efficiency filter (my country's Class A high efficiency filter is approximately equivalent to foreign H12 filters, which is lower than foreign high efficiency filters that require the lowest level of H13);

Level Ⅱ: high efficiency or sub-high efficiency filter;

Grade Ⅲ: Sub-high efficiency filter;

Level IV: High and medium efficiency filter.

4. Microbial concentration requirements

China’s GB 15982–2012 "Hospital Disinfection and Hygiene Standards" stipulates: Class II environment is non-clean operating department (room), delivery room, blood disease ward, burn ward and other protective isolation wards, intensive care unit, neonatal room Wait. Only the concentration of sedimentation bacteria is required to reach the standard, that is, ≤4.0cfu/(dish·15min) (the plate is φ90, which is equivalent to 8cfu/(dish·30min)). The grade IV standard for clean rooms only specifies the concentration of sedimentation bacteria, that is, ≤6cfu/(φ90 dish·30min).

Wards that use high- and medium-efficiency filters as the final filter can reach the level IV clean room standard specified in GB 51039-2014 "General Hospital Building Design Code", so clean care can be emphasized for susceptible and intensive wards, which is contagious to the air Sexual isolation wards can emphasize isolation, but they all adopt air purification methods, and all can reach the standard of Class IV clean room.

The above-mentioned three types of wards are medical rooms that the technical standards attach importance to. The construction and use of such wards are not only the needs of the hospital, but also the needs of the majority of patients. Therefore, in the construction of the hospital, the relevant construction and technical standards should be strictly followed.