Thông tư 18/2013/TT-BYT quy định vị trí, thiết kế, điều kiện cơ sở vật chất, kỹ thuật, thiết bị của các cơ sở khám, chữa bệnh truyền nhiễm do Bộ trưởng Bộ Y tế ban hành

CIRCULAR

PRESCRIBING LOCATION, DESIGN, FACILITY, TECHNICAL AND EQUIPMENT REQUIREMENTS OF INFECTIOUS DISEASE EXAMINATION AND TREATMENT ESTABLISHMENTS

Pursuant to clause 3 Article 17 and clause 3 Article 57 of the Law on Prevention and Control of Infectious Diseases dated November 21, 2007;

Pursuant to the Government's Decree No. 63/2012/ND-CP dated August 31, 2012, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

Upon the request of Department of Health Equipment and Works, affiliated to the Ministry of Health;

The Minister of Health hereby promulgates the Circular prescribing location, design, facility, technical and equipment requirements of infectious disease examination and treatment establishments.

Article 1. Location and site plan

1. Hospitals

a) Land areas for construction of hospitals must have transport advantages, be located at an environmentally safe distance from residential areas and nature reserves in accordance with regulations in force;

b) Construction sites must have advantages in infrastructure systems and environmental hygiene;

c) Land areas for construction of infectious disease hospitals must conform to hospital design standards under which they must have capacity from at least 50m2/bed to 100m2/bed, have proper geometrical dimensions and must have spaces intended for the following construction works: Outpatient block, medical technique – subclinical – functional assessment block, inpatient block, management or administration function and general service block, engineering – logistics block and other auxiliary construction works.

d) Hospital construction site plan must be developed according to the one-way principle with outpatient and inpatient areas which are arranged to ensure the safe isolation distance and the restriction on internal intersections;

dd) Construction area accounts for 35% of the area of the entire site at maximum;

e) There must be the waste treatment system conforming to prescribed standards in the general site plan;

g) Land areas for cultivation of shade producing plants and for isolation from the outside environment must account for 35% - 40% of the area of the entire site;

h) Each hospital must have entrance/exit doors and perimeter walls to separate the hospital from the outside and ensure its safety.

2. With respect to infection departments and other healthcare facilities providing infectious disease examination and treatment services.

a) Infection departments inside hospitals must be built at separate areas;

b) Construction sites must have advantages in transport, infrastructure and environmental hygiene systems;

c) They must be placed at the end of the main wind flow direction and must maintain isolation from other surrounding construction works.

Article 2. General design, facility and technical requirements

1. Spatial arrangement solutions of infectious disease examination and treatment establishments must ensure conformity to the following requirements:

a) Meet requirements concerning functions, medical practice characteristics and modernity;

b) Architectural, engineering solutions and equipment must be kept isolated and ensure occupational safety (e.g. air ventilation, illumination, fire fighting and prevention);

c) Buildings intended for construction of working offices of the Director, Vice Director, Head of a division or a department, and buildings intended for general administration affairs, shall be placed at separate areas;

d) Each medical department must spare a room for its head and another room accommodating all its staff, is equipped with working desks, file storage cabinets and other common equipment suitable for management and administration tasks;

dd) Surgical wards, medical equipment and accessory sterilization sites must line up following a direction;

e) Test laboratories must ensure conformity with the following requirements:

- They must be arranged in a closed state in order to ensure fulfillment of environmental hygiene requirements, infection prevention and control as well as none of adverse impacts on test results.

- They must be arranged to ensure conformance to grade-specific microclimate requirements.

g) Inpatient sites must be designed with movable partition boards dividing each site into many sections in the same original unit for the purpose of ensuring isolation at each grade where necessary;

h) Each infectious disease examination and treatment must have a technical site intended for provision of services and a training site intended for providing training for staff of lower-level healthcare establishments;

i) Potable water, wastewater and emission treatment systems must be available.

2. Room height:

a) Working rooms inside main construction works must be at least 3.30 m in height (working height);

b) Ancillary and satellite rooms must be at least 2.80 m in height.

3. Corridor width:

a) Main corridor must be at least 2.40 m in width.

b) Minor corridor must be at least 1.50 m in width.

4. Entrance/exit door:

a) Entrance/exit door must be at least 2.10 m in height.

b) Entrance/exit door width:

Double-panel door must be at least 1.20 m in width.

Single-panel door must be at least 0.80 m in width.

5. Staircases:

a) The angle of slope of each staircase must be 30° at maximum.

b) Each staircase must be at least 1.60 m in width.

c) Landings must be at least 2.00 m in width.

6. Lighting and air ventilation:

a) Rooms inside administrative areas, departments, medical wards and auxiliary areas must be given priority in allowing natural and direct light and air ventilation to get inside. With respect to surgical, medical operation and testing rooms, lighting, temperature, humidity and air ventilation can be manually adjusted, depending on different demands;

b) The dimensions of windows providing illumination for rooms shall be regulated in the following chart;

Chart of dimensions of windows supplying natural light

Article 3. Technical requirements

1. Test rooms must ensure conformance to biosafety requirements at proper grades.

With respect to test laboratories intended for performing HIV tests, requirements concerning regulations on quality assurance for HIV tests must be additionally fulfilled.

2. Disinfection cabins (hot laminar air flow chambers) of test laboratories must meet clean room requirements as follows:

3. Fire safety requirements shall conform to the National technical regulation “Fire protection distance between premises and works” with the code QCVN 06:2010/BXD.

4. The maximum distance between the entrance/exit door of each room and the nearest emergency exit shall be regulated in the following chart.

Chart of distances from rooms to the nearest emergency exit

5. Technical infrastructure:

a) Power supply:

- Infectious disease examination and treatment establishments must be provided with around-the-clock electricity for use in lights and medical equipment.

- Power supply systems of infectious disease examination and treatment establishments must meet the following requirements:

+ Lighting power supply systems must be independent from dynamic power supply system;

+ Safe earthing systems must be available.

b) Water supply:

- Infectious disease examination and treatment establishments must have systems continuously supplying clean water all day from the tap water source or basins storing water which is processed in conformity with applicable hygiene and quality standards.

- Each establishment must have the sterilized water supply system for surgical, medical operation rooms and for tests performed inside laboratories.

- Each establishment must have basins to retain water for domestic and provisional uses.

c) Water drainage:

- Infectious disease examination and treatment establishments must separate the surface water from the wastewater drainage systems.

d) Wastewater:

- Infectious disease examination and treatment establishments must keep wastewater treatment systems available for use. Wastewater must meet class-A wastewater standard (equivalent to level I in the Vietnamese Standard TCVN 7382-2004 regarding Water quality – Hospital wastewater – Discharge standard and column A in the National technical regulation QCVN 28: 2010 regarding medical wastewater). Sewage from laboratories and restrooms must be separately collected and treated before being released into the concentrated wastewater treatment system.

- Technical operation rooms must have systems intended for collecting dirty water on the floor after cleaning.

dd) Solid wastes:

- Medical wastes must be classified, collected, retained and transported to the waste treatment division of each establishment or the public area in conformity with applicable regulations on medical waste management.

- Domestic wastes must be collected in a concentrated manner before being transported for disposal under regulations in force.

e) Gas emissions:

- Test laboratories must have systems collecting and disposing of gas emissions from HOT cabinets

- Biochemical rooms must have air collection and treatment systems.

g) Requirements concerning configuration and completion of construction works:

- Configuration and completion of construction works:

+ Items of projects for construction of infectious disease examination and treatment establishments must have rigid structures which are easily built or installed and are connected with available local conditions.

+ Items of projects for construction of infectious disease examination and treatment establishments must be completely built with a full number of interior or exterior furniture in conformity with existing construction standards and particular requirements of specialized divisions.

- Walls:

+ Inner walls must be covered with erasable paints and outer walls must be covered waterproof paints.

+ Inner walls of technical operation rooms, laboratories, medical instrument disinfection or sterilization sites and restrooms must be painted or covered with acid, solvent-tolerant and easily disinfected tiles.

- Floor:

+ Floor must be covered with ceramic, granite and anti-slippery tiles.

+ The floor of the technical room and the testing laboratory site must be made from sizable materials with less than cracks. Intersection lines between two walls must be roundly beveled to prevent stains and dusts.

- Ceilings:

+ Ceilings must be flat with smooth edges and limited cracks to meet hygiene, thermal insulation, soundproofing and waterproof requirements.

+ Ceilings must be white-painted.

- Windows:

+ All windows must be protected with metal frames, grills and anti-insect nets.

+ The outer layers or window panels or louvered windows must be made of wood, metal or steel cord reinforced plastic. The inner layers of windows must be made of glass to let natural light and air get inside and prevent cold winds.

- Entrance/exit doors:

+ Entrance/exit doors must have frames to ensure rigidity and safety.

+ Entrance/exit doors must be made from wood, metal or steel reinforced plastic and glass.

Article 4. Dimensional and design standards

1. Dimensional standards shall conform to Vietnam's construction standard TCXDVN 365-2007 – General hospitals – Design guidelines and comply with relevant National technical regulations.

2. Standard 52 TCN – CTYT 0040: 2005: Standard of designing image diagnosis departments of general hospitals – Industrial standard.

3. Standard 52 TCN – CTYT 0039: 2005: Standard of designing emergency, intensive care and poison control departments of general hospitals – Industrial standard.

4. Standard 52 TCN – CTYT 0038: 2005: Standard of designing surgical departments of general hospitals – Industrial standard.

5. Standard 52 TCN – CTYT 0037: 2005: Standard of designing laboratory departments of general hospitals – Industrial standard.

6. The area of an outpatient site of an infectious disease hospital shall be calculated according to the Standard TCXDVN 365-2007 – General hospitals – Design instructions, and shall be multiplied with the coefficient ranging from 1.2 to 1.5 to determine the area of the standby site in case of an epidemic disaster. Article 5. Medical equipment requirements

Article 5. Medical equipment requirements

Medical equipment of infectious disease examination and treatment establishments shall be specified in the List of standards of medical equipment of province- or district-level general hospitals, general clinics, commune-level healthcare stations and village-level medical bags, which is appended to the Decision No. 437/QD-BYT dated February 20, 2002 of the Minister of Health. In particular,

1) Ventilators must be equipped with disinfection devices at the outlets.

2) Inpatient rooms must have ozone generators or disinfection equipment.

Article 6. Entry into force

This Circular shall take effect on August 15, 2013.

Article 7. Implementary responsibilities

The Chief of the Ministry’s Office, the Director of Department of Health Equipment and Works, the Directors or General Directors of Departments, Administrations or Directorates of the Ministry of Health, the Heads of affiliates of the Ministry, the Directors of Departments of Health in provinces or centrally-affiliated cities, and the Heads of healthcare units of Ministries and sectoral administrations, shall be responsible for implementing this Circular.

In the course of implementation, if there is any difficulty or problem arising, entities and persons should inform the Ministry of Health (Department of Health Equipment and Works) for its guidance, review and decision./.

---------------

This document is handled by Luật Dương Gia. Document reference purposes only. Any comments, please send to email: dichvu@luatduonggia.vn