The main transformation of hotels, schools, etc. as receiving close contacts of medical observation temporary special places.
The new crown pneumonia epidemic during medical observation and treatment of temporary special places of health protection technical requirements
1 Scope
This standard specifies the new crown pneumonia epidemic during medical observation and treatment of temporary special places of general requirements, disinfection measures, personal protection and health management.
This standard applies to the new crown pneumonia epidemic, indoor stadiums, exhibition halls, hotels, schools and other transformations as the new crown pneumonia treatment of mildly ill patients, suspected patient isolation, close contacts of medical observation and other temporary special places.
2 Normative references
The following documents are essential to the application of this document. Where cited documents are dated, only the dated version applies to this document. Where a cited document is not dated, only the latest version (including all change orders) applies to this document.
GB 5749 Hygienic Standard for Drinking Water
GB 18466 Standard for Discharge of Water Pollutants in Medical Institutions
GB 19193 General Principles for Disinfection of Sources of Epidemics
GB 50849 Architectural Design Specification for Infectious Disease Hospitals
WS/T 311 Technical Specification for Hospital Isolation
WS/T 396 Specification for Cleaning and Disinfection of Centralized Air-conditioning and Ventilation Systems in Public *** Places
Medical Waste Management Regulations
Methods for the Management of Medical Wastes in Healthcare Institutions Former Ministry of Health
Technical Guidelines for Hospital Wastewater Treatment Former State Environmental Protection Administration
3 Terminology and Definitions
The following terminology and definitions are applicable to this document.
3.1
Temporary special places temporary special places
Temporary places that are transformed to be used as treatment for mildly ill patients, isolation of suspected patients, and medical observation of close contacts during the New Crown Pneumonia epidemic.
3.2
Contaminated area
The area where mildly ill patients and suspected patients receive medical treatment, as well as the temporary storage place for items contaminated by their blood, body fluids, secretions, excretions, etc., and the place for item disposal, including wards, disposal rooms, soiled rooms, and rooms for handling the entry and exit of patients from and to the hospital.
3.3
Semi-contaminated area semi-contaminated area
Located between the clean area and the contaminated area, there may be contaminated by the patient's blood, body fluids or pathogenic microorganisms and other areas, including the medical staff office, treatment rooms, nurses' stations, internal corridors, patient use of the goods and medical equipment processing room.
3.4 clean area clean area
It is not easy to be contaminated by patients' blood, body fluids and pathogenic microorganisms, as well as infectious disease patients are prohibited from entering the area, including the medical staff's duty room, bathrooms, toilets, storage rooms and so on.
3.5 Two passages two passages
Pollution passages and clean passages. Contaminated passages include patients with minor illnesses, suspected patients, close contacts in and out of the transportation channel, etc., and clean passages include healthy health care and staff in and out of the channel, etc.
4 new passages.
4 temporary special places for the treatment of new crown pneumonia patients with mild symptoms
4.1 General requirements
4.1.1 Place selection requirements
4.1.1.1 The main transformation of indoor stadiums, exhibition halls, etc. as a temporary place to receive the new crown pneumonia patients with mild symptoms of the treatment (such as the Square Cabin Hospital, etc.).
4.1.1.2 The sites of the venues should try to avoid high-density residential areas, kindergartens, schools and other areas of intensive crowd activity.
4.1.1.3 places and neighboring buildings should be set at least 20 m green isolation health spacing. When there is no green conditions, the isolation of health spacing should be no less than 30 m.
4.1.1.4 In the periphery of the premises to set up obvious danger signs.
4.1.2 Building requirements
4.1.2.1 The premises building should be suitable orientation, and meet the basic requirements of safety, lighting, sunlight, ventilation, fire and other requirements.
4.1.2.2 Underground space should not be converted into such temporary special places.
4.1.3 Functional partitioning
4.1.3.1 The overall premises are partitioned for operation and use in accordance with "polluted area, semi-polluted area, clean area" and "polluted channel, clean channel". The "two channels" should be completely separated.
4.1.3.2 Each partition should be physically separated and clearly labeled.
4.1.3.3 buffer room between the contaminated area and semi-contaminated area.
4.1.3.4 Bed areas should be well partitioned into beds and men and women. The number of beds set up in each area should not be greater than 50, the interval between beds 1.2 m or more. Each bed should be equipped with bedding, bedside tables, storage boxes, trash cans and other necessary personal necessities.
4.1.4 Water supply
Each bed area should set up a separate drinking water supply point, and provide tap water and boiled water. The quality of drinking water for life should meet the requirements of GB5749.
4.1.5 Ventilation
4.1.5.1 Mechanical ventilation system should be set up in the premises. Polluted areas, semi-polluted areas, clean areas within the premises of the mechanical air supply and exhaust system should be set up independently according to the region, to ensure that the ventilation and air exchange within the premises.
4.1.5.2 Clean air should first pass through the clean area, and then flow to the semi-polluted area, polluted area.
4.1.5.3 Clean areas and other small spaces using natural ventilation or mechanical ventilation.
4.1.5.4 Polluted areas and semi-polluted areas should be natural ventilation; polluted areas using mechanical exhaust ventilation, the exhaust air volume should be more than the supply air volume of at least 10 %.
4.1.5.5 If a centralized air-conditioning system is used in a contaminated area, the whole-air air-conditioning system shall be operated with the maximum amount of fresh air and the return air shall be turned off as little as possible.
4.1.5.6 Weekly cleaning, disinfection or replacement of equipment and parts of the centralized air-conditioning system, such as cooling towers, air-handling units, air supply outlets, condensate pans and other operating equipment. Cleaning and disinfection technical requirements, etc. with reference to WS/T 396.
4.1.6 Sewage treatment
4.1.6.1 Drainage pipe should be sealed; drainage vent pipe should be well ventilated around, shall not be accessed to the air conditioning ventilation system of the exhaust duct. Drainage requirements refer to GB 50849.
4.1.6.2 Sewage and wastewater in each area should be collected separately and disinfected and biochemical treatment. Sewage treatment shall be implemented with reference to GB 19193 and Hospital Sewage Treatment Technical Guidelines, and the treated water quality shall meet the requirements of GB 18466.
4.1.6.3 Wastewater from temporarily set up bathing rooms and lavatories can not be directly discharged, and sewage and wastewater are collected separately with each area and treated.
4.1.7 Toilet hygiene
4.1.7.1 When patients use temporary toilets, they should take the special channel; priority is given to the use of foam-sealed mobile toilets. Men's toilet according to every 20 people with a squat, women's toilet according to every 10 people with a squat, if necessary, should be based on the actual needs of patients to increase. Temporary toilets should be located downwind of the premises and more than 200 m away from the dining area and water supply points.
4.1.7.2 Patients' feces and other excreta in the temporary toilets need to be disinfected with medicine or centralized harmless treatment. Arrange for special personnel to disinfect twice a day. Arrange special feces removal machinery and equipment to remove the treated feces in a timely manner.
4.1.7.3 The fixed toilets inside and outside the premises are for the use of medical staff only.
4.1.7.4 Toilet feces are to be strictly managed in accordance with the requirements of infectious disease hospitals, and are strictly prohibited from being directly discharged outside. Special containers are used to collect excreta, which are disinfected and treated before being discharged, and the disinfection method is carried out with reference to GB19193.
4.1.7.5 Toilets should be equipped with hand-washing facilities, optional hand sanitizer (or soap), quick-drying hand sanitizer, non-contact dryer and so on. In the hand-washing sink near the posting of the "six-step washing method" step by step chart.
4.1.8 Garbage disposal
4.1.8.1 Cleaning area living garbage placed in a special garbage cans, each ward unit is equipped with a set of medical waste garbage bags and cover the special garbage cans. Garbage should be cleaned up daily or in a timely manner.
4.1.8.2 Disposal of medical waste should be in accordance with the "Medical Waste Management Regulations" and "Measures for the Management of Medical Waste in Healthcare Institutions".
4.2 Disinfection measures
4.2.1 Object surface disinfection
The surface of diagnostic and treatment facilities and equipment, as well as bed rails, headboards, public **** tables and chairs, public **** door knobs, etc. when there are contaminants visible to the naked eye, the contaminants should be completely removed before disinfection. No visible pollutants, with effective chlorine 1000mg / L of chlorine disinfectant or 500mg / L of chlorine dioxide disinfectant for spraying, wiping or soaking disinfection, the role of 30min after rinsing with water.
4.2.2 Meal (drinking) utensils disinfection
Meal (drinking) utensils to remove food debris, boiling disinfection for 30 minutes, can also be used 500 mg/L chlorine disinfectant solution soaked for 30 minutes, and then washed with water.
4.2.3 Disinfection of contaminants (patients' blood, secretions and vomit)
4.2.3.1 A small amount of contaminants can be carefully removed by dipping disposable absorbent materials (e.g., gauze, wipes, etc.) in chlorine disinfectant with effective chlorine of 5000 mg/L to 10000 mg/L (or disinfectant wipes/dry towels that can achieve a high level of disinfection).
4.2.3.2 A large number of contaminants should be completely covered with disinfectant powder or bleach containing absorbent ingredients, or completely covered with disposable absorbent material and then poured with sufficient amount of chlorine 5000 mg/L to 10000 mg/L chlorine-containing disinfectant on the absorbent material for more than 30 min (or disinfectant wipes/dry towels that can achieve a high level of disinfection), and then carefully removed. Avoid contact with contaminants during the removal process, and dispose of the cleaned contaminants centrally as medical waste.
4.2.3.3 Patients' secretions, vomit, etc. are collected in special containers, and disinfected with chlorine disinfectant with effective chlorine 20,000 mg/L, and soaked for 2 h according to the ratio of material and medicine 1:2.
4.2.3.4 After removing the pollutants, the contaminated environment or the surface of the object should be disinfected. Containers holding pollutants can be disinfected by immersion in chlorine disinfectant solution with effective chlorine 5000 mg/L for 30 min, and then cleaned.
4.2.4 Skin, mucous membrane disinfection
Skin contaminated by pollutants, should immediately remove the pollutants, and then use disposable absorbent material dipped in 0.5 % iodine povidone or 3% hydrogen peroxide disinfectant wipe disinfection for more than 3 minutes, use water to wash; mucous membranes should be a large number of physiological saline rinse or 0.05 % iodine povidone rinse disinfection.
4.2.5 Hand hygiene
People involved in site work should strengthen hand hygiene measures. Alcohol-containing quick-drying hand sanitizers or alcohol compounded quick-drying hand sanitizers can be used, or 75% ethanol can be used directly for wipe disinfection. For those who are allergic to alcohols, effective non-alcoholic hand sanitizers such as quaternary ammonium salts can be chosen. Under special conditions, 3 % hydrogen peroxide disinfectant, 0.5 % iodophor or 0.05 % chlorine disinfectant can also be used to wipe or soak the hands, and appropriately extend the disinfection effect time. When there are contaminants visible to the naked eye, you should first use hand sanitizer to wash your hands under running water, and then disinfect them as described above.
4.2.6 Terminal disinfection
Temporary special places after the termination of the use of the place, the place of goods and the environment should be the final disinfection, the specific requirements refer to GB 19193 implementation.
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 face screen or goggles, hand sanitizers, as well as first-aid supplies for medical, cleaning, disinfection, security and other staff, and set up a place to put on and take off protective clothing and facilities.
4.3.2 Staff protection
4.3.2.1 Medical and nursing staff should wear overalls, disposable caps, disposable gloves, protective clothing, medical protective masks, medical protective face screen or goggles, and shoe covers, etc., when working on duty.
4.3.2.2 Cleaning, disinfection, security and other categories of staff working in temporary special places, should wear overalls, disposable caps, disposable gloves, protective clothing, medical protective masks or power supply air-filtering respirator, protective face screen or goggles, work shoes or rubber boots, waterproof booties, etc..
4.3.2.3 During the work period should reduce the personnel conversation, avoid gathering, good hand hygiene.
4.3.3 Patient protection
Should wear a mask, avoid close contact, good hand hygiene.
4.4 Hygiene management
4.4.1 Strengthen environmental hygiene
Should keep the internal and external environment of the temporary special place clean and free from mosquitoes, flies, cockroaches, rodents and other breeding.
4.4.2 Maintaining canteen hygiene
The operating table, various object surfaces and the ground are routinely cleaned daily and disinfected with chlorine disinfectant solution with effective chlorine 500 mg/L or other effective disinfectants. Disposable tableware should be used to serve meals and avoid serving cold dishes.
4.4.3 Anti-skid floor
The anti-skid measures need to be taken in the temporary special places; if the corridors, toilets, bathrooms, washrooms and other areas of the floor in the premises are not treated as anti-skid, temporary anti-skid mats should be laid.
5 new crown pneumonia suspected patients isolation temporary special places
5.1 General requirements
5.1.1 place selection requirements
Mainly transform the community health service centers, township health centers, etc., as the reception of new crown pneumonia suspected patients isolation places.
Site selection requirements refer to 4.1.1.2.
5.1.2 Functional partitioning
5.1.2.1 The site is divided into "contaminated area, semi-contaminated area, clean area" and "contaminated channel, clean channel". Division, and zoning operation and use.
5.1.2.2 buffer room set up between the contaminated area and semi-contaminated area, set up requirements with reference to WS/T 311 implementation.
5.1.2.3 Suspected patients need to be isolated in a single room, isolation period without permission shall not leave the room.
5.1.3 Ventilation
5.1.3.1 Ventilation should be opened regularly to strengthen air circulation, and adjusted according to the weather conditions at the right time; or install exhaust equipment to strengthen the exhaust. Install circulating wind air sterilizers when available.
5.1.3.2 When using an air-conditioning system, split-type air-conditioners should be selected. When using split-type air conditioning, windows should be opened at intervals to ventilate the room (ventilated for more than 30 min), and the exhaust fan of the bathroom in the room is always on.
5.1.4 Sewage and feces treatment
There should be an independent septic tank. Sewage should be disinfected before entering the municipal drainage network. Regularly put chlorine-containing disinfectant and ensure that the total residual chlorine reaches 10 mg/L after disinfection for 1.5 h. The disinfected sewage should meet the requirements of GB 18466.
If there is no independent septic tank, special containers are used to collect excreta, and then discharged after disinfection treatment, and the disinfection method refers to GB 19193.
5.1.5 Disposal of garbage
Life garbage of suspected patients should be collected uniformly and treated as medical waste. Disposal of medical waste should follow the "Regulations on the Management of Medical Waste" and "Measures for the Management of Medical Waste in Healthcare Institutions" requirements, the use of double yellow medical waste collection bags standardized encapsulation and then disposed of according to the process.
5.1.6 Hand washing facilities
Place of public **** area and patient rooms should be set up hand washing facilities, optional hand sanitizer (or soap), quick-drying hand sanitizer, non-contact dryer. In the hand-washing pool near the posting of "six-step washing method" step by step chart.
5.2 Disinfection measures
The premises should be strengthened to clean and disinfect, including countertops, floors, door knobs and other surfaces, as well as hands, skin, mucous membranes, etc., the specific disinfection methods refer to 4.2.
When the suspected patients in the room being quarantined are changed, the items in the room and the environment should be referred to the GB 19193 implementation of the final disinfection.
5.3 Personal protection
5.3.1 Equipped with protective supplies and facilities
Temporary special places should be equipped with masks, protective clothing, gloves, protective face screen or goggles, hand disinfectant and first aid supplies for staff of medical care, cleaning, disinfection and security. Set up places and facilities for wearing and taking off protective clothing.
5.3.2 Staff protection
Place staff personal protection refer to 4.3.2.
5.3.3 Suspected patient protection
Suspected patients should wear masks, reduce the scope of activities, reduce contact with the public **** items and facilities, and strengthen hand hygiene.
6 Close Contacts Medical Observation Temporary Special Places
6.1 General Requirements
6.1.1 Place Selection Requirements
6.1.1.1 The main transformation of hotels, schools, etc. as the reception of close contacts medical observation temporary special places.
6.1.1.2 The place should be a multi-story single building.
6.1.1.3 site and other neighboring buildings should be set up at least 20m green isolation health spacing; neighboring buildings should not include densely populated areas and crowded places (such as residential areas, commercial centers, primary and secondary schools, as well as young children and the elderly gathered in the place); preferred suburban hotels, schools and so on.
6.1.2 Building requirements
Refer to 4.1.2.
6.1.3 Functional zoning
6.1.3.1 Should separate the close contact medical observation area from the staff work area, and separate the close contact channel from the staff channel, and zoned for operational use.
6.1.3.2 Each partition should be physically isolated and clearly labeled.
6.1.4 Water supply
Living drinking water quality should meet the requirements of GB 5749.
6.1.5 Sewage and wastewater treatment
6.1.5.1 There should be a water storage bend under the guest room basin, and the floor drain in the bathroom should have a water seal.
6.1.5.2 Condensate from split air-conditioners should be centrally collected or discharged to the bathroom floor drain.
6.1.5.3 Independent septic tanks and sewage drainage tanks shall be set up; sewage shall be treated with reference to 5.1.4 before entering the municipal drainage network. Sewage after disinfection should meet the requirements of GB18466.
6.1.6 Ventilation
6.1.6.1 Ventilation shall be carried out by opening the windows regularly and adjusting them according to the weather conditions at the right time; or installing mechanical ventilating equipment to strengthen air circulation.
6.1.6.2 When using an air-conditioning system, split-type air-conditioners should be selected. Before using split-type air-conditioning, windows should be opened for 30 min to ventilate the room before turning on the air-conditioning, and the air-conditioning should be adjusted to run at the maximum airflow for more than 10 min before closing the doors and windows; after the split-type air-conditioning is turned off, open the windows to ventilate the room. Under the premise of meeting the appropriate indoor temperature, the air conditioning operation should keep the windows not completely closed.
6.1.7 Garbage disposal
6.1.7.1 The living garbage of close contacts should be collected uniformly and disposed of as living garbage. When close contacts are turned into suspected patients or after diagnosis, the domestic garbage generated by them is treated as medical waste.
6.1.7.2 Disposal of medical waste should be in accordance with the "Regulations on the Management of Medical Waste" and "Measures for the Management of Medical Waste in Healthcare Institutions".
6.1.8 Handwashing facilities
Refer to 5.1.6.
6.2 Disinfection measures
6.2.1 Disinfection of object surfaces
Rooms should be cleaned and disinfected by close contacts themselves. The surfaces of objects with high frequency contact (such as table tops, bedside cabinets, furniture, door handles, etc.) should be sprayed or wiped regularly with chlorine disinfectant with effective chlorine 500 mg/L or other effective disinfectants.
Public **** areas and external environment should be cleaned and disinfected by staff. For high-frequency contact with the surface of objects (such as elevator room buttons, handrails, door handles, etc.), public **** bathroom, with effective chlorine 500 mg / L of chlorine-containing disinfectant solution or other effective disinfectant for regular wiping.
6.2.2 Disinfection of food (drinking) utensils
Refer to 4.2.2.
6.2.3 Hand hygiene
Refer to 4.2.5.
6.2.4 Final disinfection
When close contacts are diagnosed as infected with the new coronavirus and leave the place of medical observation, the professional staff will carry out final disinfection of the items and environment in the place with reference to GB 19193 for final disinfection.
6.3 Personal protection
6.3.1 Staff protection
6.3.1.1 Medical and nursing staff should refer to 4.3.2.1 for protection when carrying out sample collection, epidemiological investigation, and psychological pacification.
6.3.1.2 Room service staff should wear overalls, medical protective masks and disposable gloves during work, and protective face screen or goggles when necessary. Work clothes should be kept clean and washed regularly. When a fever, cough and other symptoms, to go to the designated hospital in a timely manner in accordance with the provisions of the medical, to the hospital on the way and in the hospital should wear a mask throughout.
6.3.1.3 Reduce the number of people talking during work, avoid gathering, and do a good job of hand hygiene.
6.3.2 Close contact protection
Mainly in the isolation room, strengthen hand hygiene. Wear a mask when passing through the public **** area and avoid contact with public **** items and facilities outside the room.
6.4 Hygiene management
6.4.1 The public **** area in the premises should be free of sputum, no debris in the hallways, no hygiene dead ends, and no accumulation of dust on the stair handrails.
6.4.2 The ground outside the premises is free of sputum, dirt, water, etc.; timely cleanup of garbage, no exposed garbage; garbage cans are tidy.
6.4.3 Close contacts should be isolated in a single room, and not allowed to leave the room without permission during isolation.
6.4.4 Daily temperature measurement and health monitoring of staff, and make a record of it, is strictly prohibited to take the disease on duty. If there is a suspected patient in the staff's home, they should be isolated according to the relevant regulations and are strictly prohibited from going to work.
6.4.5 Restaurant staff should implement staggered meals, separate meals. During the epidemic, the restaurant should be completely partitioned from the kitchen, and should prevent the flow of air from the restaurant to the kitchen.
6.4.6 Close contacts should implement a meal delivery system, by the service staff to the door of the isolation room.
6.5 Other
6.5.1 Soft furnishing fabrics, such as carpets, should be removed from existing floors in the premises; or disposable mats should be laid.
6.5.2 First aiders, equipment and facilities should be available on the premises.