Disinfection supply center construction management standard

Nature and tasks of the disinfection supply center (room)

1. Nature of the disinfection supply center (room)
The disinfection supply center (room) is the core department with the functions of cleaning, disinfection and sterilization in the disinfection and sterilization system of the hospital. It is the logistics center for the supply and turnover of sterile goods, and an important guarantee department for clinical medical services. Disinfection supply center has become an independent professional field, according to the theory, method and technology of disinfection, remove and kill pathogenic microorganisms, the quality of its work is closely related to the occurrence of hospital infection, directly affect the quality of medical care and patient safety.

2. Tasks of the disinfection supply Center (room)
① According to the needs of clinical departments, various treatment kits, instrument kits, cloth kits and dressings were prepared and sterilized for use in the whole hospital.
② In accordance with the relevant provisions of hospital infection management, establish and improve various systems, operating procedures, quality control measures to ensure the safety of clinical medical supplies.
③ Participate in the hospital management of some disposable sterile medical supplies.
The establishment of hospital computer network center system makes the supply process more convenient and material management more economic and scientific.
Continuously study and improve the work content and methods to ensure timely and effective supply of goods; Implement in-service personnel training to improve service quality.

Disinfection supply center (room) classification
1. Distributed Disinfection Supply Center (Room)
The distributed disinfection supply center (room) can be divided into the following two forms:
① The first form: The disinfection and sterilization work in the hospital is completed by the relatively independent disinfection supply center (room) and the operating room supply room.
Disinfection Supply Center (room) : Responsible for the handling and supply of reusable items in all clinical departments except the operating room.
Operating room supply room: responsible for the handling and supply of instruments and articles in the operating room.
② The second form: in addition to handling and supplying reusable items in clinical departments, it is also responsible for completing part of the steps of handling items in the operating room (such as sterilization).

2. Centralized Disinfection Supply Center (room)
All the items that need to be sterilized and sterilized in the hospital are centralized in the supply center for unified treatment. The whole process is standardized by professionals to reduce the spread of pollution, reduce the investment of personnel and equipment, and improve work efficiency. Facilitate the quality control and management of the whole hospital. It is the development trend of the management mode of the disinfection supply center (room) in international and domestic newly built hospitals, which is conducive to the safety of operation and economic rationality.

Design and layout requirements for disinfection supply centres (rooms)
1. Geographical location of the disinfection supply center (room)
The disinfection supply center (room) should be located close to the clinical department. Facilitate the supply and transportation of clinical items; Have better ventilation and lighting conditions; The surrounding environment is clean, no odor, no dust, no pollution sources (such as garbage concentration places, public toilets, coal piles, etc.).

2. Area index of disinfection supply center (room)
(1) Centralized disinfection and supply centers for hospitals with 200 to 800 beds, implementing the "General Hospital Construction Standards" implemented in 1996, namely: 200 beds Hospital disinfection and supply center (room) construction area of 229 square meters, 300 beds 327 square meters, 400 beds 398 square meters, 500 beds 474 square meters, 600 beds 578 square meters, 700 beds 655 square meters, 800 beds 709 square meters; The total building area of the distributed disinfection supply center (room) should be more than 5% higher than that of the centralized one.
② The building area of the centralized disinfection supply center of the 1000-bed hospital should not be less than 800 square meters.
③ The disinfection supply room of a 20-bed hospital should not be less than 40 square meters.
④ New disinfection supply center (room). It is advisable to determine the area of the disinfection supply center 'room' according to the number of beds planned for development; When the standard is accepted, the area index is calculated according to the number of beds immediately prepared.

3. Regional division of disinfection supply center (room)
According to the work flow, it is divided into three areas, namely, contaminated area, clean area and sterile area. These three zones must be clearly partitioned, and physical barriers such as equipment or walls can be separated between the zones. Clearly marked, no crossing.
① Contaminated areas: including the classification of reusable items, soaking, removing pyrogen, cleaning, recycling car washing and other areas.
② Cleaning area: including instrument packaging, preparation of Peng materials, storage of materials, receiving clinical departments (operating rooms) clean self-provided kits, quality monitoring and other areas.
(3) Aseptic area: including the storage and distribution of aseptic items and other areas, disposable aseptic items are stored in the aseptic area after being removed from the outer packaging; The release space outside the storage room and the drop off car storage space shall be managed according to the requirements of the cleaning area.
In order to make the flow of people walk reasonably and easy to manage, the disinfection supply center (room) should also reasonably arrange the office and living area of the staff. There are: dressing room, bathroom, head nurse's office, staff study room and rest room. This area belongs to the category of clean area, but must be separated from the operation area and become a relatively independent area.

Other building requirements for the disinfection supply center (room)
1. Suitable material selection. The ceiling should be smooth and seamless; Walls should be easy to clean and disinfect; The corner should be curved to reduce the dead Angle. The ground should be non-slip, easy to clean, and anti-corrosion. The clean area is resistant to washing and the polluted area is resistant to acid and alkali.
2. Good indoor lighting and ventilation design. For hospitals with more than 800 beds, central air conditioning systems and positive pressure air purification devices should be used in the aseptic room, so that the indoor temperature is maintained at 18 ~ 220 ° C and the humidity is 350% ~ 60%. Hospitals with more than 400 beds should gradually adopt central air conditioning systems and positive pressure air purification devices.
3. The delivery of sterile items should be completed through the delivery box (window) or buffer room (area). The fire-bacteria self-prepared package shall be taken from the disinfection supply center (room) of the department itself, and a connecting rod lock type closed transfer box may be used. In the disinfection supply center (room), the sterilized items shall be distributed through the buffer room (area), and the buffer room (area) shall be formed by two automatic control doors that cannot be opened at the same time.
4. The storage room of sterile items should use hollow glass Windows or double exterior Windows, and hospitals with more than 400 beds should be equipped with dehumidifiers.
5. The sterilization room should solve the problem of rapid discharge of hot steam.
6. Rodent prevention measures should be taken at the outlet of floor drains and sewers, and anti-overflow floor drains and sewers should be adopted.
7. In general. The disinfection center (room) of the hospital should be set up centrally. The disinfection supply center (room) shall have a special elevator or passageway for contaminated and sterile materials with key infection control departments such as the operating room. When the conditions are limited and need to be decomposed, the consent of the hospital approval authority must be obtained. Among them, the two working processes of "cleaning → fine washing → packaging" and "sterilization → storage → distribution" cannot be broken down.

Equipment configuration of disinfection supply center (room)
1. Basic equipment configuration of disinfection supply center (room)
In order to ensure the normal operation and working quality of the disinfection supply center (room), the following necessary conditions should be met:
Tap water, hot water, distilled water or soft water. Adequate supply of water, electricity and saturated steam.
② Cleaning device, flushing pool, if necessary, can be equipped with cotton balls, gauze and other dressing equipment.
③ Pressure steam sterilization, dry heat sterilizer.
④ Air disinfection equipment, sterile items storage cabinets and baskets, packaging tables, receiving and sending equipment, air conditioning cooling equipment.
⑤ Protective equipment, such as protective gloves, waterproof clothes and shoes, goggles.
All areas (except sterile areas) are equipped with hand-washing equipment for staff.
The sewage discharge pipe is connected with the sewage treatment room of the hospital.

2. Disinfection supply center (room) standard equipment configuration
Conditional hospital in addition to the basic equipment configuration, there should be the following equipment configuration:
① Automatic cleaning and disinfection machine, ultrasonic cleaning machine, catheter cleaning device, vehicle cleaning device.
② Gas sterilization equipment.
③ Air purification equipment, drying equipment, compressed air supply equipment.
(4) All areas (except sterile areas) are equipped with staff sensing or foot control switch hand-washing equipment.
(5) Sterilized articles quality monitoring equipment.
⑥ Computers manage equipment.

Organization management and operational requirements of disinfection supply center (room)
1. Organization and management of disinfection supply center (room)
① Organization and management system
The disinfection supply center (room) shall implement the head nurse responsibility system within the vertical management system of the Nursing Department, and the nursing Department shall be responsible for personnel, organization and quality management. The nosocomial infection management department implements business guidance and project monitoring of nosocomial infection.
② Staffing and structure
I. According to the different functions and tasks of the disinfection supply center (room), the ratio of staff to beds is about (1.5 ~ 3) : 100, of which personnel with nursing professional titles account for 30% ~ 50%.
Ii. The head nurse has the corresponding clinical work experience and should be trained in nursing management, disinfection supply center (room) business management knowledge.
Iii. Nursing staff should undergo corresponding theoretical and technical training.
ⅳ. Staff engaged in the operation of disinfection and sterilization equipment should hold the corresponding work certificate (such as pressure vessels, low-temperature sterilization equipment); In addition to the above-mentioned corresponding job certificates, disinfection personnel must also have a special training certificate (including theory and operation) of disinfection and sterilization knowledge at or above the provincial (city) level.

2. Disinfection supply center (room) personnel business management requirements
With the continuous development of science and technology, various high-cutting-edge precision instruments and equipment are used more and more widely in clinical departments. The complexity of the operation and the delicacy of the surgical instruments put forward more stringent business requirements for the personnel of the disinfection supply center (room). Hospital disinfection supply center (room) should have nursing business technical management procedures to ensure the professional level of staff. The specific management plan is as follows:
① Strictly implement the "disinfection technical Specifications", "Hospital infection management specifications", "Technical operation routine".
(2) Have learning plans and systems, carry out regular department business learning, and assess the business requirements of department staff according to their positions.
③ The departments have weekly work quality inspection, and the hospital nursing department and infection management department are responsible for supervising and guiding the quality management.
④ Participate in various theoretical and professional learning and assessment organized by the nursing department.
5. Carry out continuing education and implement the credit system.

Disinfection supply center (room) building area calculation formula
Disinfection supply center (room) construction area (m²)= (0.8 ~ 1.0) × number of beds +50m²
Note:
① When the relationship between daily emergency visits and actual number of beds in a general hospital is in line with the ratio of 3:1, the number of beds in the formula is equal to the actual bed sensitivity in the hospital.
(2) When the relationship between daily emergency visits and actual number of beds in general hospitals does not conform to the ratio of 3:1, the number of beds in the formula can be adjusted according to the following formula; The number of beds in specialized hospitals should be adjusted according to the following formula.
Number of beds (one bed) = actual number of beds /2+ daily average outpatient and emergency visits /6

The calculation formula derived from the above data can be used as another method of calculating the floor area of the disinfection supply center (room) :
Disinfection Supply Center (Room) Building area (m²)
=1.2× Number of beds +[(-11) ~ (+43)]m²

Estimation method of pressure steam sterilization equipment configuration in disinfection supply center (room)
1. The disinfection supply center (room) supplies supplies to all departments of the hospital
① Articles treated with pressure steam sterilization.
② Articles for low temperature gas sterilization.
③ Other sterilized items.
④ Disposable medical supplies.
⑤ Others.

2. Supply of items treated by pressure steam sterilization in the disinfection supply center (room)
Calculation reference factor:
① Outpatient department 0.4 L/person
② Ward department 4 liters/bed
③ Surgery department 150 liters/unit
④ Other departments (①+②+③)× 20% units: liters
⑤ The supply of articles required for pressure steam sterilization treatment in the hospital every day = ①+②+③+④ Unit: liters

3. Reference factor for normal operation of each pressure steam unit per day:
① The effective volume of each sterilizer (L) = the fixed volume of the sterilizer × (75% ~ 80%)
② Machine operation cycle: about 50 minutes from preparation to the end of work
③ Maximum number of operations: the daily working time is 7 hours, the number of continuous operation of the machine is 420 minutes ÷50 minutes =8.4 times ≈8 times
④ Actual number of runs: the maximum number of normal runs is 60% ~ 70%, that is, 8 times × (60% ~ 70%) =4.8 ~ 5.6 times = 5 ~ 6 times

4. The number of pressure steam sterilizers required by the disinfection supply center (room)

Example: The number of beds in a hospital is 1500, the daily number of operations in the hospital is 70, and the average daily outpatient volume of the hospital is 6000. Then:
① Disinfection supply center (room) daily supply of sterilized items for outpatient department = 0.4 liters/person-time × the average daily outpatient volume of the hospital 6000 people = 2400 liters
(2) Disinfection supply center (room) needs to supply sterilized items to ward departments per day =4 liters/bed × 1500 hospital beds = 6000 liters
(3) Sterilized items to be supplied by the disinfection supply center (room) to the operating department per day =150 liters/set × the number of operations in the hospital per day = 70 sets = 10,500 liters
④ The disinfection supply center (room) needs to supply sterilized items from other departments every day = (2400+6000+10500)×20%=3780 liters
⑤ The total amount of sterilized items required by the disinfection supply center (room) per day =2400+6000+10500+3780=22680 liters
⑥ If the fixed volume of each sterilizer is 1000 (liters), the effective volume of the sterilizer = 1000×80%=800 liters
⑦ The actual operation times of each sterilizer are 5 times per day
⑧ The number of sterilizers required by the disinfection supply center (room) =22680 liters ÷(800 liters ×5 times/day) =5.67 units ≈ 6 units