The hospital medical treatment profession is a very huge and the special profession, especially the hospital operating room also is very high to the air cleanliness request. Typically, the minimum requirements for hospital air in a qualified hospital operating room decontamination project or medical cleanroom are combined with a 30% efficiency prefilter and a 90% efficiency subhigh efficiency filter. High efficiency filters are not required in general, but are required in special circumstances such as isolation rooms, specific test and care areas.
Types and grades of Clean Operating Theatres Reference:
Hospital operating room name, type, cleanliness, special sterile operating room I 100 class (local laminar flow) sterile operating room II 1000 x 10000 Class General Operating Room III class 100000 class sterile operating room IV general not required or & GT; 1000000 Class Toxic Operating Room v no required, surgical Zone III 100000 other rooms 100,000 -- 100,000
The clean room of the hospital system was first used in the operating room, which we now call the clean room of the hospital. At first it was only widely used in orthopaedic surgery because it takes a long time and tends to cause infections. The ideal level of control is to use a level 100 air cleanliness near the operating table. It is generally recommended to use a top HEPA system that covers an area of at least 3m 3m to include operating tables and people
Other areas where medical clean rooms have been used include delivery rooms, nurseries, burn rooms, and cardiac care units. One of the latest advances is the use of dental surgical cleanrooms, which reduce the risk of infection among medical personnel during long-term operations. As one of the important functional areas of hospital, the engineering quality of clean room has a direct impact on the use of hospital and the treatment of patients. In order to improve the engineering quality of hospital clean room, attention must be paid to design, construction and maintenance. The most widely used clean operating room in hospital is the modern operating room which uses air cleaning technology to replace the traditional ultraviolet radiation to control the pollution in the whole process. In a clean operating room, infection rates can be reduced by more than 10 times, allowing patients to use fewer or no antibiotics that can damage their immune systems. Both clean and sterile is the characteristic of clean operating room. The clean room of the hospital includes operating room, obstetrics, Nicu, ICU, intensive-care unit, Burn Ward and autopsy room, clean lab, artificial dialysis room, specimen room, etc. , there is a direct and important relationship between engineering quality and medical quality.
First, design, China's "clean room construction and Acceptance Code" (hereinafter referred to as "the code") stressed that fresh air must follow the principle of three-stage filtration. This is because compared with the air-conditioning system, fresh air purification system dust load ratio of up to 90% , therefore, in order to operate quality must emphasize fresh air three-stage filtration. Now the hospital clean operation department's Standard and the standard have taken this as the stipulation. In addition, return air must have a filter, can put the best effect. Only when designers understand the requirements of the "standard" can the clean room meet the functional requirements of the hospital to the greatest extent. To ensure the engineering quality of clean room, the designer must make careful investigation and investigation on the construction site of clean room in hospital, otherwise, the quality of clean room engineering will be greatly compromised. Such as in a hospital clean room to do the concentration of dust detection, suddenly found that the concentration of dust rose rapidly in general, beyond the standard serious. Engineers first thought of the filter air leakage, after inspection, although found that there is leakage, but not the same amount of dust detected. Judging from experience, this is an improper design of the fresh air vent. As the new air vent is located on the top of the 5-storey building, there is a refuse collection station directly below it, and this refuse collection station has the habit of regularly burning refuse, a lot of the dust is from the fresh air below the smoke. Such a position of fresh air outlet will inevitably bring about the result that endangers the indoor cleanliness. No matter how the later construction quality is, the engineering quality of the clean room is also difficult to meet the requirements, in fact, this is contrary to the general requirement in the "code" that newly-built clean operating rooms should be kept away from pollution sources. Design is the foundation of clean room engineering quality. The design of clean room engineering in hospital is by no means a closed door system, therefore the design is the cleanroom project quality first safeguard.
2. CONSTRUCTION, clean room construction quality control can be divided into three stages: preparation stage, construction stage and acceptance stage. Key Points of quality control in the preparation phase 1. It is an important technical link to ensure the construction quality of clean rooms to do a good job of drawing conference review and technical disclosure, fully understand the design intention, and do a good job of drawing conference review and technical disclosure, in order to guarantee the clean room construction quality to lay the solid foundation.
There will be a variety of contradictions in construction, which requires the construction side and the design, construction side cooperation, to ensure the construction quality of the clean room under the premise of reasonable changes. If during an inspection of the renovation and expansion project of a clean room, it was found that the originally designed air duct size could not be constructed at all in the ceiling floor of the main building, where the height of the main building was restricted, after coordination between the constructors, the designers and the constructors, on the premise of not affecting the project quality, the size of air duct is changed from square to flat, which not only meets the requirement of air volume, but also ensures the requirement of construction ceiling height.
2. Strictly control the quality of materials and equipment, clean room materials and equipment are mainly all kinds of decorative materials and air-conditioning equipment materials. Decoration materials shall be inspected and verified strictly in accordance with relevant national engineering technical standards, construction quality acceptance codes and design documents. Clean Room should use no dust, no dust, corrosion, moisture and mildew, easy to clean and fire-resistant materials, can not use wood and gypsum board for surface decoration materials. Air Conditioning insulation materials must also meet the relevant provisions of the state to achieve corrosion resistance, no dust, no attached dust and fire and other requirements.
Key Points of project quality control 1. Select the construction team after professional training, clean room construction involves decoration, HVAC, electrical and medical gases and other professional, construction personnel should have a comprehensive understanding of clean room construction specifications, construction technology, construction quality, otherwise, it is difficult to guarantee the construction quality.
2. The key point of sealing control in clean room is the quality of sealing construction of enclosure structure. For example, sealing glue should be spread evenly between plate and plate to prevent air leakage In the clean room, the socket, switch, smoke detector, lighting box, medical lamp belt, viewing lamp and so on installed on the wall and wall need to be sealed with sealant, in addition, reliable and effective sealing measures must be adopted between all kinds of pipes and boxes in the appliance cabinets. 3. The quality control of the return air duct and the sealing of the return air system duct are to prevent the unclean air from entering the air duct and prevent the polluted air from penetrating out of the air duct, thus, the utility model can satisfy the cleanness of the clean room and prolong the use time of the high-efficiency filter. During the construction, we should control the pipeline processing, the pipeline construction and the installation quality of the equipment
The cleaning of air duct equipment and the sealing measures during pipeline processing should be emphasized. The pipe shall be made of high quality galvanized steel plate to meet the requirements of flatness, smoothness, firmness and corrosion resistance; the Muffler shall be filled with sound-absorbing materials that do not produce dust, drop slag (fiber) , absorb moisture and do not pollute, and shall not be made of loose materials, fiber material should be felt material, coated to prevent fiber penetration of the package material. Foam plastic and centrifugal glass wool should not be used. Before Making Air Duct, use neutral detergent to remove oil stain, prevent scratch in making process. After making, wipe the inner surface with white silk cloth without any oil stain and grey stain. After the duct section has been processed and cleaned, protect both ends of the duct with plastic film and then install it on site. All duct fittings and equipment must be cleaned before installation. Otherwise, the duct can not be installed.
In the process of piping connection and equipment installation, the sealing measures should be taken to avoid secondary pollution. Because the hose and the flexible joint have the problem of dust retention, the flexible joint can be used in the connection between the purified piping and the power equipment, but it is not suitable to be used in the piping. Secondly, the control of secondary microbial pollution is more significant than secondary pollution, but also easier to be ignored. The secondary microorganism pollution is contained in the secondary dust pollution, mainly in the air conditioning treatment equipment. Bacteria and dust particles accumulated during the operation of an air-conditioning unit. During the shutdown period, the environment of high temperature and humidity and the nutrients provided by dust particles provide the most favourable conditions for the growth of microorganisms. The newly propagated microorganisms and their release of harmful odor gases and a large number of harmful metabolites, corpses and debris -- much of which can not be blocked by high efficiency filters -- thus constitute microbial secondary pollution. The fact tells us that soft joints are also an important source of microbial secondary pollution. This is because soft joints usually do not keep warm, condensation occurs here. For the medical clean room, even a small number of soft joints must be taken double-layer or insulation soft joint measures. Finally, all joints of the combined air-conditioning unit should be sealed, and water seal should be installed on the condensate drain pipe of the surface cooler to ensure that the air conditioner is airtight.
(3) key points of quality control in the acceptance phase, and the commissioning of the cleaning air conditioning system is an important work in the acceptance phase of the project. Through debugging, some defects in construction can be found and repaired in time. Debugging is also an important verification process for design drawings. Clean Room and air conditioning return air duct should be installed before the high-efficiency filter to meet the cleaning requirements, clean air conditioning system must be continuously air blowing for more than 12 hours, after air blowing, clean and scrub the air duct and air conditioning unit.
Upon completion of the project, the construction unit shall organize the medical department, the relevant departments that use the clean room, the design unit and the construction unit to carry out strict quality acceptance of the clean room in accordance with the engineering design document, the building technical code for Clean Operation Department of Hospitals (Gb50233-2002) , the construction acceptance code for ventilation and air conditioning engineering (GB50243-2002) and the construction and acceptance code for clean room (JGJ71-90) , a qualified third-party testing unit shall be commissioned to check the cleanliness of the clean room against the design documents and relevant standards and norms
Third, maintenance, in the process of ensuring the quality of hospital operating room purification project also plays an important role. Some information shows that a staff member in a hospital's clean room suddenly fainted. On the one hand, it was checked that the fresh air heater had not been filtered effectively. The relevant parts of the pipeline were seriously blocked. Due to lack of maintenance, there was no fresh air to breathe in, plus a part of the air conditioning box fan off belt, the total air volume is small, resulting in the clean room is relatively closed, physical weak people in the long-term lack of oxygen in the room will faint.
For example, a hospital clean operating room one day suddenly found that a point bacteria concentration increased, only to stop the operation to be examined. It turns out there's a visible leak in the filter above a certain point. Technicians believe the flaw was already there. The problem is usually on the filter did not check the leak system, if often open the orifice check, this problem is not difficult to find. Through the above discussion, we see that design, construction and maintenance is to ensure the quality of hospital clean room project trinity, one can not be dispensed with. We can only guarantee the functional rationality of the clean room drawing in the design, ensure the quality process control of the clean room strictly according to the drawing in the construction, and pay attention to the regular inspection and maintenance of the clean room engineering in the peacetime, in order to ensure the engineering quality of clean room from the angle of total quality control.
Negative pressure operating room solution, for patients with infectious diseases, we should establish a negative pressure clean operating room. METHODS: the Air volume should be adjusted by adding exhaust fan to change the positive pressure into negative pressure in the clean operating room. Results: The negative pressure difference was used to control the airflow, absorb the harmful gas and clean the indoor air. CONCLUSION: Negative Pressure Operating Room can control and solve the problem of air pollution in operating room. A negative-pressure operating room usually includes a ventilation system to allow air to flow from the corridor or any adjacent area into the negative-pressure operating room, while ensuring that contaminated air can not escape from the negative-pressure operating room, to other areas of hospitals and health facilities.
Under natural conditions, air flows from a high-pressure zone to a low-pressure zone. If the operating room is under negative pressure, the outside air will continue to flow under the door into the room, at the same time to prevent the growth of gas pollution particles escape into the outer corridor. A common example of a negative pressure chamber is a bathroom with an exhaust fan. After the negative pressure condition is formed, close the bathroom door and the fan will prevent the unpleasant smell and moisture from escaping from the bathroom. To create a negative pressure state can be achieved by balancing the ventilation system of the room so that more air is automatically emitted than automatically provided. This results in uneven ventilation, with the room's ventilation system constantly replenishing by drawing in air from outside the room. In a carefully designed negative-pressure chamber, air flows through a gap (usually about half an inch high) just below the door. In addition to this gap, the negative pressure chamber should be sealed as far as possible to prevent air from entering through various other cracks and gaps such as those around the windows, wall lighting and sockets. Even if the room has achieved negative pressure conditions, the air leakage into these areas may still offset or eliminate the negative pressure state of the room.
The minimum pressure difference required to achieve and maintain room negative pressure so that air flows into the room is very small (0.001 inch of the water gauge) . The actual realized negative pressure value depends on the difference between air consumption and supply in the ventilation system and the structure and size of the room, including air flow paths and flow openings. If the room is well sealed, it is easy to achieve a negative pressure above the 0.001-inch gauge. But if the room is poorly sealed, as is the case in many health facilities (especially older ones) , a larger negative pressure value may require a difference in emissions/supply greater than the ventilation system capacity.
To achieve a negative pressure environment with a well-functioning ventilation system, first adjust the air flow supply and emissions of the room to achieve 10% higher than the supply or 50 cubic feet per minute (depending on the higher value) . In most cases, this standard will achieve a negative pressure value of at least 0.001 inch. If the negative pressure of the 0.001-inch water gauge can not be achieved by increasing the flow differential (within the ventilation system) , the room should be carefully checked for cracks (such as door cracks, window cracks, plumbing and various embedded wall devices, etc.) , and then take remedial measures to seal these cracks.
The negative pressure in a room can be changed by changing the ventilation system to work or by opening and closing doors, hallways, or windows. If an operating structure is in place, ensure that all doors and windows in the negative pressure chamber and other areas (such as corridor doors that affect air pressure) are properly closed, except where personnel are required to enter or leave the room or area.
Smoke test a smoke test is a simple procedure used to determine whether a room is under negative pressure. Place a fire hose under the door of the negative-pressure chamber about 2 inches from the door. Squeeze the bulb gently to allow the tube to produce a small amount of smoke. Hand-held fire hose, parallel to the door, slowly exhaust smoke from the pipe, to ensure that the smoke exhaust speed is lower than the speed of air. If the room is already under negative pressure, smoke will flow under the door into the room. If the room is in a non-negative pressure condition, the smoke will blow out of the door or remain stationary. The test must be carried out while the door remains closed and all the windows in the room must be closed. If the air purifier of the room is already in operation (including fume hoods or Biosafety cabinet) , it must remain in operation. If the room has a reception room, the differential pressure from the corridor to the reception room and from the reception room to the room should be tested.
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