Mainly transform hotels, schools, etc. into temporary special places for medical observation of close contacts.
Technical requirements for health protection in temporary special places for medical observation and treatment during the COVID-19 epidemic
1 Scope
This standard specifies the medical observation and treatment during the COVID-19 epidemic General requirements, disinfection measures, personal protection and hygiene management for temporary special places.
This standard applies to the renovation of indoor stadiums, exhibition halls, hotels, schools, etc. as temporary special places for the treatment of mild COVID-19 patients, isolation of suspected patients, and medical observation of close contacts during the COVID-19 epidemic.
2 Normative reference documents
The following documents are essential for the application of this document. For all dated referenced documents, only the dated version applies to this document. For undated referenced documents, only the latest version (including all amendments) applies to this document.
GB5749 Hygiene Standards for Drinking Water
GB18466 Water Pollutant Discharge Standards for Medical Institutions
GB19193 General Principles for Disinfection of Epidemic Foci
GB50849 Infectious Diseases Specifications for Architectural Design of Hospitals
WS/T311 Technical Specifications for Hospital Isolation
WS/T396 Specifications for Cleaning and Disinfection of Centralized Air Conditioning and Ventilation Systems in Public Places
Medical Waste Management Regulations
Measures for the Management of Medical Waste in Medical and Health Institutions Formerly Ministry of Health
Technical Guidelines for Hospital Wastewater Treatment Formerly State Environmental Protection Administration
3 Terms and Definitions
The following terms and definitions apply to this document.
3.1
Temporary special places
During the COVID-19 epidemic, they were transformed into temporary places for the treatment of mild patients, isolation of suspected patients, and medical observation of close contacts. place.
3.2
Contaminated area
The area where mild patients and suspected patients receive diagnosis and treatment, as well as areas contaminated by their blood, body fluids, secretions, excretions, etc. Temporary storage and processing places for items, including wards, disposal rooms, sewage rooms, and patient admission and admission processing rooms.
3.3
Semi-contaminated area
It is located between the clean area and the contaminated area and may be contaminated by the patient's blood, body fluids or pathogenic microorganisms. Areas include medical staff offices, treatment rooms, nurse stations, inner corridors, patient items and medical device processing rooms, etc.
3.4 Clean area clean area
Areas that are not easily contaminated by patients’ blood, body fluids and pathogenic microorganisms and are prohibited for patients with infectious diseases, including duty rooms, bathrooms, toilets, storage rooms for medical staff Things etc.
3.5 two passages
Contaminated passage and clean passage. Contaminated channels include access and transfer channels for mild patients, suspected patients, close contacts, etc. Clean channels include access channels for healthy medical care and staff.
4 Temporary special places for the treatment of mild COVID-19 patients
4.1 General requirements
4.1.1 Venue selection requirements
4.1.1.1 Mainly renovate indoor sports venues, exhibition halls, etc. as temporary treatment venues for receiving mild COVID-19 patients (such as makeshift hospitals, etc.).
4.1.1.2 The site selection should try to avoid high-density residential areas, kindergartens, schools and other crowded activity areas.
4.1.1.3 A green isolation and sanitary distance of at least 20m should be set between the site and surrounding buildings. When greening conditions are not available, the isolation and sanitary distance should not be less than 30m.
4.1.1.4 Set up obvious danger signs around the perimeter of the site.
4.1.2 Building requirements
4.1.2.1 The building of the site should have an appropriate orientation and meet basic requirements such as safety, lighting, sunshine, ventilation, and fire protection.
4.1.2.2 Underground spaces should not be transformed into such temporary special places.
4.1.3 Functional zoning
4.1.3.1 The overall site is operated and used according to the "contaminated area, semi-contaminated area, clean area" and "contaminated channel, clean channel". The two channels" should be completely separated.
4.1.3.2 Each partition should be physically isolated and clearly marked.
4.1.3.3 Set up a buffer room between the contaminated area and the semi-contaminated area.
4.1.3.4 The bed area should be divided into bed areas and male and female areas. The number of hospital beds in each area should not exceed 50, and the intervals between beds should be more than 1.2m. Each bed should be equipped with bedding, bedside table, storage box, trash can and other necessary personal items.
4.1.4 Water supply
Each bed area should have a separate drinking water supply point and provide tap water and boiled water. The quality of drinking water should meet the requirements of GB5749.
4.1.5 Ventilation
4.1.5.1 A mechanical ventilation system should be installed in the place. The mechanical ventilation and exhaust systems in contaminated areas, semi-contaminated areas, and clean areas of the site should be set up independently according to the area to ensure ventilation in the site.
4.1.5.2 Clean air should first pass through the clean area and then flow to the semi-polluted area and contaminated area.
4.1.5.3 Small spaces such as cleaning areas should adopt natural ventilation or mechanical ventilation.
4.1.5.4 Natural ventilation should be used in polluted and semi-polluted areas; when mechanical exhaust ventilation is used in contaminated areas, the exhaust air volume should be at least 10 times greater than the air supply volume.
4.1.5.5 If a centralized air conditioning system is used in a polluted area, the full air conditioning system should be operated at the maximum fresh air volume and the return air should be turned down as much as possible.
4.1.5.6 Clean, disinfect or replace operating equipment and components such as cooling towers, air handling units, air supply vents, and condensate water pans of the centralized air-conditioning system every week. Cleaning and disinfection technical requirements shall be implemented in accordance with WS/T396.
4.1.6 Sewage treatment
4.1.6.1 The drainage pipe should be sealed; the drainage pipe should be well ventilated around it and should not be connected to the exhaust duct of the air conditioning ventilation system. Drainage requirements shall be implemented in accordance with GB50849.
4.1.6.2 Sewage and wastewater in each district should be collected separately and disinfected and biochemically treated. Sewage treatment shall be carried out in accordance with GB19193 and "Technical Guidelines for Hospital Wastewater Treatment", and the treated water quality shall comply with the requirements of GB18466.
4.1.6.3 Wastewater from temporarily installed bathing rooms and toilets cannot be discharged directly, and must be collected separately with the sewage and wastewater in each district for treatment.
4.1.7 Toilet hygiene
4.1.7.1 When patients use temporary toilets, they should use dedicated channels; foam-blocked mobile toilets are preferred. Men's restrooms are equipped with one squatting space for every 20 people, and women's restrooms are equipped with one squatting space for every 10 people. If necessary, the number should be increased based on the actual needs of patients. The location of temporary toilets should be downwind of the site and more than 200m away from the dining area and water supply point.
4.1.7.2 Patient feces and other excreta in temporary toilets need to be disinfected or treated in a centralized manner. Arrange special personnel for disinfection twice a day. Arrange special feces cleaning and transportation machinery and equipment to promptly remove processed feces.
4.1.7.3 Fixed toilets inside and outside the site are only for use by medical staff.
4.1.7.4 Feces in toilets must be strictly managed in accordance with the requirements of infectious disease hospitals, and direct discharge is strictly prohibited. Collect excrement in special containers and disinfect it before discharging it. The disinfection method shall be implemented in accordance with GB19193.
4.1.7.5 Hand-washing facilities should be provided in the toilet, equipped with optional hand sanitizer (or soap), quick-drying hand disinfectant, non-contact dryer, etc. Post a diagram of the "Six Steps to Hand Washing" near the sink.
4.1.8 Garbage disposal
4.1.8.1 Domestic garbage in the clean area is placed in special trash cans, and each ward unit is equipped with special garbage covered with medical waste garbage bags and stamped bucket. Garbage should be cleared daily or promptly.
4.1.8.2 The disposal of medical waste should comply with the provisions of the "Medical Waste Management Regulations" and the "Medical Waste Management Measures of Medical and Health Institutions".
4.2 Disinfection measures
4.2.1 Disinfection of object surfaces
Disinfection of surfaces of diagnostic and treatment facilities and equipment, as well as bed rails, bedside tables, office tables and chairs, and office ** *If there are visible contaminants such as door handles, the contaminants should be completely removed before disinfection. When there are no visible pollutants, use a chlorine-containing disinfectant with an effective chlorine content of 1,000 mg/L or a chlorine dioxide disinfectant with an effective chlorine content of 500 mg/L to spray, wipe or soak for disinfection. Rinse with clean water after 30 minutes.
4.2.2 Disinfection of dining (drinking) utensils
After removing food residues from the dining (drinking) utensils, boil them for 30 minutes for disinfection, or soak them in chlorine-containing disinfectant with an effective chlorine content of 500 mg/L. After 30 minutes, rinse with clean water.
4.2.3 Disinfection of contaminants (patient blood, secretions and vomitus)
4.2.3.1 A small amount of contaminants can be removed with disposable absorbent materials (such as gauze, rags, etc.) Carefully remove chlorine-containing disinfectant with an effective chlorine content of 5,000 mg/L to 10,000 mg/L (or disinfectant wipes/dry wipes that can achieve high-level disinfection).
4.2.3.2 A large amount of pollutants should be completely covered with disinfectant powder or bleaching powder containing water-absorbing ingredients, or completely covered with disposable water-absorbing materials and then used with a sufficient amount of effective chlorine containing 5000mg/L ~ 10000mg/L. Pour chlorine disinfectant on the water-absorbent material and let it act for more than 30 minutes (or use a disinfectant dry towel that can achieve high-level disinfection), and then remove it carefully. Avoid contact with pollutants during the cleaning process, and the cleaned pollutants will be centrally disposed of as medical waste.
4.2.3.3 The patient's secretions, vomitus, etc. are collected in special containers and soaked and disinfected for 2 hours with chlorine-containing disinfectant with an effective chlorine content of 20,000 mg/L according to the ratio of substances to drugs: 1:2.
4.2.3.4 After removing pollutants, the contaminated environment or object surfaces should be disinfected. Containers holding pollutants can be soaked and disinfected in chlorine-containing disinfectant with an effective chlorine content of 5000 mg/L for 30 minutes, and then cleaned.
4.2.4 Disinfection of skin and mucous membranes
When the skin is contaminated by pollutants, the pollutants should be removed immediately, and then use disposable absorbent materials to soak in 0.5 iodine volts or 3 hydrogen peroxide Wipe with disinfectant for more than 3 minutes, then clean with clean water; the mucosa should be rinsed and disinfected with a large amount of physiological saline or 0.05 iodophor.
4.2.5 Hand hygiene
All personnel involved in on-site work should strengthen hand hygiene measures. You can choose alcohol-containing quick-drying hand disinfectant or alcohol-based quick-drying hand disinfectant, or directly use 75 ethanol for wiping and disinfection. Those who are allergic to alcohol can choose effective non-alcoholic hand disinfectants such as quaternary ammonium salts. Under special conditions, you can also use 3 hydrogen peroxide disinfectant, 0.5 iodophor or 0.05 chlorine-containing disinfectant to wipe or soak your hands, and extend the disinfection time appropriately. If there are visible contaminants, you should first use hand sanitizer to wash your hands under running water, and then disinfect according to the above method.
4.2.6 Terminal disinfection
After the temporary special place is terminated, the items and environment in the place should be terminally disinfected. The specific requirements shall be implemented in accordance with GB19193.
4.3 Personal protection
4.3.1 Equipped with protective equipment and facilities
Temporary special places should be equipped with masks, Gloves, protective clothing, protective masks or goggles, hand disinfectants and first aid supplies, etc., and set up places and facilities for putting on and taking off protective clothing.
4.3.2 Staff protection
4.3.2.1 When working on the job, medical staff should wear work clothes, disposable work caps, disposable gloves, protective clothing, and medical protective masks , medical protective masks or goggles, shoe covers, etc.
4.3.2.2 Cleaning, disinfection, security and other categories of staff should wear work clothes, disposable work caps, disposable gloves, protective clothing, medical protective masks or powered air filters when working in temporary special places Respirator, protective visor or goggles, work shoes or rubber boots, waterproof boot covers, etc.
4.3.2.3 During work, personal conversations should be reduced, gatherings should be avoided, and hand hygiene should be performed well.
4.3.3 Patient protection
Wear a mask, avoid close contact, and perform good hand hygiene.
4.4 Sanitation management
4.4.1 Strengthen environmental sanitation
The internal and external environment of temporary special places should be kept clean and free of mosquitoes, flies, cockroaches, rats, etc. Breed.
4.4.2 Maintain hygiene in the canteen
Carry out routine cleaning of the operating table, surfaces of various objects and floors every day, and use chlorine-containing disinfectant with an effective chlorine content of 500mg/L or other effective Disinfectant for disinfection. Disposable tableware should be used to serve meals and cold dishes should be avoided.
4.4.3 Anti-slip flooring
Anti-slip measures need to be taken in temporary special places; if the floors in corridors, toilets, bathing rooms, washrooms and other areas of the place are not treated with anti-slip treatment, temporary paving should be carried out. Non-slip floor mats.
5 Temporary special places for isolation of suspected COVID-19 patients
5.1 General requirements
5.1.1 Site selection requirements
Mainly transform community health Service centers, township health centers, etc. are used as isolation places to receive suspected patients with new coronavirus pneumonia.
For site selection requirements, please refer to 4.1.1.2.
5.1.2 Functional zoning
5.1.2.1 The place is divided into "polluted area, semi-polluted area, clean area" and "contaminated channel, clean channel", and is operated and used in different areas.
5.1.2.2 Set up a buffer room between the contaminated area and the semi-contaminated area. The setting requirements shall be implemented in accordance with WS/T311.
5.1.2.3 Suspected patients need to be isolated in a single room and are not allowed to leave the room without permission during the isolation period.
5.1.3 Ventilation
5.1.3.1 Windows should be opened regularly for ventilation to enhance air circulation, and timely adjustments should be made according to weather conditions; or exhaust equipment should be installed to enhance ventilation. Install a circulating air air sterilizer when possible.
5.1.3.2 When using an air conditioning system, a split air conditioner should be selected. When using a split air conditioner, windows should be opened for ventilation at intervals (more than 30 minutes for ventilation), and the bathroom exhaust fan in the room should be turned on at all times.
5.1.4 Sewage and feces treatment
There should be an independent septic tank. Sewage should be disinfected before entering the municipal drainage pipe network. Regularly add chlorine-containing disinfectants and ensure that after 1.5 hours of disinfection, the total residual chlorine reaches 10mg/L. The sewage after disinfection should meet the requirements of GB18466.
If there is no independent septic tank, use a special container to collect excrement, disinfect it before discharging it. The disinfection method shall be implemented in accordance with GB19193.
5.1.5 Garbage disposal
Domestic garbage of suspected patients should be collected uniformly and treated as medical waste. The disposal of medical waste should comply with the requirements of the "Medical Waste Management Regulations" and the "Measures for the Management of Medical Waste in Medical and Health Institutions". It should be packaged in a double-layered yellow medical waste collection bag and then disposed according to the process.
5.1.6 Hand-washing facilities
Hand-washing facilities should be set up in public areas and patient rooms, equipped with hand sanitizer (or soap), quick-drying hand disinfectant, and non-contact hand sanitizer. Dryer, etc. Post a diagram of the "Six Steps to Hand Washing" near the sink.
5.2 Disinfection measures
Places should strengthen cleaning and disinfection, including surfaces such as countertops, floors, door handles, as well as hands, skin, mucous membranes, etc. Please refer to 4.2 for specific disinfection methods.
When the suspected patient who is isolated in the room is replaced, the items and environment in the room should be terminally disinfected in accordance with GB19193.
5.3 Personal protection
5.3.1 Equipped with protective equipment and facilities
Temporary special places should be equipped with masks, Protective clothing, gloves, protective masks or goggles, hand disinfectants and first aid supplies, etc. Set up places and facilities for putting on and taking off protective clothing.
5.3.2 Staff protection
For personal protection of site staff, please refer to 4.3.2.
5.3.3 Protection of suspected patients
Wear masks, narrow the scope of activities, reduce contact with public items and facilities, and strengthen hand hygiene.
6 Temporary special places for medical observation of close contacts
6.1 General requirements
6.1.1 Site selection requirements
6.1.1.1 Main Renovate hotels, schools, etc. as temporary special places for medical observation of close contacts.
6.1.1.2 The place should be a multi-story single-family building.
6.1.1.3 A green isolation and sanitary distance of at least 20m should be set between the site selection and other adjacent buildings; adjacent buildings should not include densely populated areas and crowded places (such as residential areas, commercial centers, primary and secondary schools, and children and Places where the elderly gather); give priority to suburban hotels, schools, etc.
6.1.2 Construction requirements
Refer to 4.1.2.
6.1.3 Functional zoning
6.1.3.1 The medical observation area for close contacts should be separated from the staff working area, and the passage for close contacts should be separated from the passage for staff and divided into zones. Run using.
6.1.3.2 Each partition should be physically isolated and clearly marked.
6.1.4 Water supply
Drinking water quality should meet the requirements of GB5749.
6.1.5 Sewage and wastewater treatment
6.1.5.1 There should be a water trap under the basin in the guest room, and the bathroom floor drain should have a water seal.
6.1.5.2 The condensate water from split air conditioners should be collected centrally or drained to the bathroom floor drain.
6.1.5.3 Independent septic tanks and sewage discharge tanks should be set up; before sewage enters the municipal drainage pipe network, it should be treated according to 5.1.4. Disinfected sewage should comply with the requirements of GB18466.
6.1.6 Ventilation
6.1.6.1 Windows should be opened regularly for ventilation, and timely adjustments should be made according to weather conditions; or mechanical exhaust equipment should be installed to enhance air circulation.
6.1.6.2 When using an air conditioning system, a split air conditioner should be selected. Before using the split air conditioner, you should open the windows for ventilation for 30 minutes, then turn on the air conditioner, adjust the maximum air volume and run for more than 10 minutes before closing the doors and windows; after the split air conditioner is shut down, open the windows for ventilation. On the premise that the indoor temperature is suitable, the windows should not be completely closed when the air conditioner is running.
6.1.7 Garbage disposal
6.1.7.1 Domestic waste from close contacts should be collected uniformly and treated as domestic waste. When a close contact becomes a suspected patient or is diagnosed, the domestic waste generated by them shall be treated as medical waste.
6.1.7.2 The disposal of medical waste should comply with the provisions of the "Medical Waste Management Regulations" and the "Medical Waste Management Measures of Medical and Health Institutions".
6.1.8 Hand washing facilities
Refer to 5.1.6.
6.2 Disinfection measures
6.2.1 Disinfection of object surfaces
Guest rooms should be cleaned and disinfected by close contacts themselves. For high-touch surfaces (such as tabletops, bedside tables, furniture, door handles, etc.), regularly spray or wipe with chlorine-containing disinfectant with an effective chlorine content of 500mg/L or other effective disinfectants.
Public areas and external environments should be cleaned and disinfected by staff.
For high-touch surfaces (such as elevator buttons, handrails, door handles, etc.) and public bathrooms, wipe them regularly with chlorine-containing disinfectant with an effective chlorine content of 500 mg/L or other effective disinfectants.
6.2.2 Disinfection of dining (drinking) utensils
Refer to 4.2.2.
6.2.3 Hand hygiene
Refer to 4.2.5.
6.2.4 Terminal Disinfection
When a close contact is diagnosed with the new coronavirus and leaves the medical observation site, professionals will perform terminal disinfection on the items and environment in the site in accordance with GB19193. Not disinfected.
6.3 Personal protection
6.3.1 Staff protection
6.3.1.1 Medical staff when conducting sample collection, epidemiological investigation, psychological comfort, etc. When working, refer to 4.3.2.1 for protection.
6.3.1.2 Room service staff should wear work clothes, medical protective masks and disposable gloves while on duty, and wear protective masks or goggles when necessary. Work clothes should be kept clean and washed regularly. When symptoms such as fever and cough occur, you must promptly go to a designated hospital for medical treatment according to regulations. You should wear a mask on the way to the hospital and at all times in the hospital.
6.3.1.3 Reduce personal conversations during work, avoid gatherings, and perform good hand hygiene.
6.3.2 Protection of close contacts
Mainly move around in isolation rooms and strengthen hand hygiene. Wear a mask when passing through public areas and avoid contact with public items and facilities outside the room.
6.4 Hygiene Management
6.4.1 There should be no traces of phlegm in the public areas of the premises, no debris in the corridors, no sanitary dead corners, and no dust on the stair handrails.
6.4.2 The ground outside the site is free of phlegm, dirt, stagnant water, etc.; garbage is cleaned up in a timely manner and there is no exposed garbage; the trash cans are clean and tidy.
6.4.3 Close contacts should be isolated in a single room and are not allowed to leave the room without permission during the isolation period.
6.4.4 Conduct body temperature measurement and health monitoring of staff every day, and keep records. It is strictly forbidden to work while sick. If a staff member has a suspected patient at home, they should be quarantined in accordance with relevant regulations and are strictly prohibited from working.
6.4.5 Restaurant employees should eat at staggered times and dine alone. During the epidemic, the restaurant should be completely isolated from the kitchen and the air in the restaurant should be prevented from flowing to the kitchen.
6.4.6 Close contacts should implement a meal delivery system, with service staff delivering meals to the door of the isolation room.
6.5 Others
6.5.1 The existing soft fabrics on the ground in the venue, such as carpets, should be removed; or disposable floor mats should be laid.
6.5.2 First aid personnel, equipment and facilities should be equipped on the premises.
Legal basis:
According to the "Notice on Issuing the Medical Treatment Plan for the Autumn and Winter COVID-19 Epidemic" Attachment 3 Guidelines for the Prevention and Control of the COVID-19 Epidemic in Medical Institutions
5. Guidelines for COVID-19 Prevention and Control in Key Departments
(12) Guidelines for COVID-19 Prevention and Control in Blood Purification Centers (Departments) 4. Disinfection, Isolation and Medical Waste Management
(2) Surface disinfection of environmental objects: There are no visible pollutants on the surfaces of hemodialysis machines, treatment vehicles, etc.: spray, wipe or soak with 500mg/L chlorine-containing disinfectant or a disinfectant with the same microbial killing effect Disinfect and wipe clean with clean water after 30 minutes. Surfaces of medical devices, objects, and hemodialysis machines contaminated by contaminants such as patient blood, body fluids, secretions, etc.: The contaminants should be removed with disposable absorbent materials first, and then 1000 mg/L chlorine-containing disinfectant or 500 mg/L chlorine-containing disinfectant should be used. Wipe and disinfect with chlorine oxide disinfectant, etc. for 30 minutes; or use disinfection items with adsorption disinfection that can be completed in one go.