TIU CHUN NGNH Y T 52TCN CTYT 38: 2005 TIU CHUN THIT K - KHOA PHU THUT BNH VIN

N A KHOA 1. PHM VI P DNG 1.1. Tiu chun c p dng lp, thm nh d n u t xy dng cng trnh, thit k xy dng cng trnh, thit k xy dng ci to Khoa Phu thut ti bnh vin a khoa khu vc, bnh vin a khoa tnh v Trung ng trong phm vi c nc. 1.2. C th vn dng khi xy dng Khoa phu thut ti bnh vin ca cc B, ngnh, bnh vin tuyn huyn v bnh vin ngoi cng lp c iu chnh theo tng quy m c th. 2. TIU CHUN TRCH DN 2.1. Bnh vin a khoa - Yu cu thit k TCVN - 4470:1995. 2.2. Phng chy v cha chy cho nh v cng trnh cng cng - Yu cu thit k TCVN 2622:1995. 2.3. Chiu sng TCXD - 29:1991. t nhin trong cng trnh dn dng Tiu chun thit k

2.4. Chiu sng nhn to trong cng trnh dn dng TCXD -16: 1986. 2.5. Danh mc trang thit b y t bnh vin a khoa tuyn tnh ban hnh km theo Quyt nh 437/Q-BYT ngy 20/02/2002 ca B trng B Y t. 2.6. Quy ch bnh vin ban hnh km theo quyt nh 1895/1997/BYT-Q ngy 19/9/1997 ca B trng B Y t. 3. QUY NH CHUNG 3.1. Khoa Phu thut thuc khi k thut nghip v, gm h thng cc phng thc hin cc th thut, phu thut cha bnh. 3.2. Khoa Phu thut gm cc khng gian thc hin cc chc nng nhim v: - Thc hin cc k thut tin phu thut (thm khm, hi chn, tin m) i vi ngi bnh cn phu thut. - Thc hin cc phu thut cha bnh. - Thc hin cc k thut sau m (gii m, hi tnh) v chuyn ngi bnh ti cc khoa khc tip tc iu tr - Bo m an ton phu thut cho ngi bnh 3.3. Phi c khu vc nghin cu khoa hc, o to chuyn mn v ngoi khoa. 3.4. Khoa Phu thut c t chc theo quy m s ging lu (t 55 - 65 ging/phng m) s lng phng m quy nh trong Bng 1. - Quy m 1: Bnh vin a khoa quy m: - Quy m 2: Bnh vin a khoa quy m: - Quy m 3: Bnh vin a khoa quy m: Bng 1. S lng n v phng m STT Tn phng m Quy m 1 250 350 ging 1. 2. M tng hp M hu khun 01 01 Quy m 2 400 500 ging 01 01 Quy m 3 trn 550 ging 02 02 t 250 n 350 ging lu. t 400 n 500 ging lu. trn 550 ging lu.

3. 4. 5. 6.

M chn thng M cp cu M sn M chuyn khoa Cng

01

01 01

01 01 01 02 09

01

01 01

04

06

3.5. Khoa Phu thut c quy nh thit k t tiu chun bn vng theo cp ca c s y t, ph hp vi tiu chun TCVN - 4470: 1995. 3.6. Khoa Phu thut phi m bo iu kin v sinh mi trng, yu cu v khun cao nht trong bnh vin. 4. YU CU V DY CHUYN HOT NG 4.1. S dy chuyn cng nng:

4.2. Dy chuyn hot ng ca Khoa Phu thut phi m bo yu cu sch bn mt chiu, ring bit v c phn chia cp sch theo ba khu vc: 4.2.1. Khu vc v khun: khu vc c yu cu v mi trng sch v khun gm: - Cc phng m. - Hnh lang v khun. - Kho cung cp vt t tiu hao. 4.2.2. Khu vc sch: khu vc c yu cu v mi trng sch, v khun mc trung bnh, l phn chuyn tip gia khu vc v khun vi khu vc ph tr gm: - Tin m. - Hnh lang sch. - Phng kh khun (lau ra dng c, thit b). - K thut h tr (Thit b chuyn dng, chun b b bt). - Phng ngh gia ca m. - Phng ghi h s m. 4.2.3. Khu vc ph tr: gm cc b phn: - Tip nhn bnh nhn.

- Hi tnh. - Hnh chnh, giao ban o to. - Thay nhn vin, Khu v sinh (tm, ra ,thay qun o). - Phng trng khoa. - Phng bc s. - Phng y t, h l. - Snh n tip. - Ni i ca ngi nh. 5. YU CU V V TR XY DNG 5.1. S v tr khoa phu thut trong bnh vin a khoa.

5.2. t khu vc trung tm bnh vin, ni c cc iu kin mi trng v h tng k thut tt nht. 5.3. Gn khu chm sc tch cc, lin h thun tin vi khu iu tr ngoi khoa v cc khu xt nghim, chn on hnh nh. 5.4. t ti v tr cui hnh lang d dng kim sot c s ra vo, khng c giao thng qua li.

5.5. Thun tin cho vic lp t, vn hnh cc thit b; gn ngun cung cp dng c, vt t v khun v h thng k thut; in, nc, iu ho khng kh, kh y t. 6. YU CU V GII PHP THIT K 6.1. Kt cu: Kt cu cng trnh ca Khoa Phu thut phi m bo bn vng ( s dng khung b tng ct thp hoc khung kim loi). 6.2. T chc khng gian: gii php thit k t chc khng gian trong Khoa Phu thut phi m bo cc yu cu sau: - Khu vc v khun, khu sch v khu ph tr ring bit; dy chuyn hot ng hp l sch, bn mt chiu, phi m bo cc yu cu v phng sch, v khun. - Ph hp vi yu cu lp t v vn hnh cc thit b quy nh ti Danh mc trang thit b y t c ban hnh. 6.3. Cc yu cu v kch thc khng gian: 6.3.1. Cc phng chc nng: - Chiu cao khu v khun, khu sch (t sn ti trn) - Chiu cao khu ph tr (t sn ti trn) - Chiu cao tng k thut (t trn ti hn di kt cu dm sn) 6.3.2. Cu thang, ng dc(nu c): khng nh hn 1,8m. khng nh hn 2,4m. khng thp hn 2,0m. khng nh hn 1,1 x 1,4m. khng nh hn 1,1 x 2,3m. khng nh hn 2,1m. khng nh hn 2,7m. khng nh hn 3,0m. khng thp hn 2,5m. khng nh hn 0,9m. khng nh hn 1,2m. khng nh hn 1,6m. - Chiu rng bn thang (1 v) - Chiu rng chiu ngh - Chiu cao gia cc chiu ngh 6.3.3. Thang my: - Kch thc bung thang nhn vin - Kch thc bung thang bnh nhn 6.3.4. Hnh lang: - Chiu rng hnh lang bn: - Chiu rng hnh lang bn c di chuyn ging y: - Chiu rng hnh lang gia: - Chiu cao ca hnh lang 6.3.5. Ca: - Chiu rng ca i mt cnh: - Chiu rng ca i hai cnh: - Chiu rng ca chnh ca phng m: - Chiu cao khng thp hn 2,1m. 6.4. Yu cu din tch ca cc hng mc cng trnh: 6.4.1. Khu vc v khun: Din tch s dng cc phng chc nng khu v khun c quy nh trong bng 2 Bng 2. Tn phng Din tch/ Quy m (m2) Ghi ch khng thp hn 3,1m. khng thp hn 3,0m. khng nh hn 0,2m.

STT T 1. 2. 3. 4. 5. 6. 7. 8. 9. M tng hp M hu khun M chn thng

Quy m 1 250350ging 36 x 1ph 36 x 1ph

Quy m 2 400500ging 36 x 1ph 36 x 1ph 36 x 1ph

Quy m 3 trn 550ging 36 x 2ph 36 x 2ph 36 x 1ph 36 x 1ph 36 x 1ph 36 x 2ph 42 Khng nh hn - nt - nt - nt - nt - nt Kt hp hnh lang VT

36 x 1ph M cp cu M sn M chuyn khoa Ra tay v khun Cung cp vt t tiu hao Hng lang v khun 36 x 1ph 18 36 x 1ph 36 x 1ph 36 x 1ph 36

18 18 4 phng 198

36 36 6 phng 288

42 42 9 phng 450 Kt hp cung cp vt t tiu hao

Tng cng Cng din tch 6.4.2. Bng 3. Khu vc sch:

Din tch s dng cc phng chc nng khu sch c quy nh trong Bng 3.

Din tch/Quy m (m2) STT Tn phng Quy m 1 250 -350 ging Quy m 2 400 -500 ging Quy m 3 trn 550 ging Ti thiu 9 m2/g c th kt hp vi hng lang sch Khng nh hn C v sinh lin phng C th kt hp vi hnh Ghi ch

1.

P.Tin m (ly bng 50% s phng m)

18

27

45

2.

Hnh lang sch

24

36

48

3.

P. ngh gia ca m

18

24

24

4.

P. ghi h s m

12

Din tch/Quy m (m2) STT Tn phng Quy m 1 250 -350 ging Quy m 2 400 -500 ging Quy m 3 trn 550 ging lang sch 5. 6. 7. Phng kh khun Phng thi Kho thit b Tng cng 12 12 18 111 24 18 24 162 36 24 36 235 Khng nh hn - nt - nt Ghi ch

6.4.3. Bng 4.

Khu vc ph tr:

Din tch s dng phng chc nng khu ph tr c quy nh trong Bng 4

Din tch/ Quy m (m2) STT Tn phng Quy m 1 250 -350 ging 24 Quy m 2 400 -500 ging 36 Quy m 3 trn 550 ging 48 Ghi ch

1. 2. 3. 4. 5. 6. 7. 8.

Tip nhn B/N Hi tnh(ly bng 50% s phng m) Hnh chnh, trc Hi chn, o to Thay qun o, WC Trng khoa Bc s P. Y t, h l Tng cng

Khng nh hn Ti thiu 12 m2/g - nt - nt -

24 12 24 18 x 2ph 12 18 18 174

36 18 36 24 x 2ph 12 18 x 2ph 18 x 2ph 264

60 24 48 36 x 2ph 12 x 2ph 18 x 3ph 18 x 3ph 372

- nt - nt -

6.4.4. Din tch ca cc khu vc Khoa Phu thut theo tng quy m ca bnh vin a khoa cc tuyn; c quy nh trong Bng 5. Bng 5 STT Khu vc Quy m 1 250-350 ging Quy m 2 400-500 ging Quy m 3 trn 550

ging 1. 2. 3. Khu v khun Khu sch Khu ph tr 198 m2 111 m2 174 m2 483 m2 730 m2 288 m2 162 m2 264 m2 714 m2 1100 m2 450 m2 235 m2 372 m2 1057 m2 1600 m2

Din tch s dng Din tch sn Khoa Phu thut (*)

Ghi ch: (*) Din tch sn Khoa Phu thut c tnh vi h s k = 0,65 - 0,6. 7. YU CU V GII PHP K THUT 7.1. Chiu sng: 7.1.1. Khoa Phu thut phi m bo iu kin chiu sng theo yu cu cho tng khu vc. - Khu v khun: chiu sng nhn to. - Khu sch, khu vc ph tr: gii php chiu sng nhn to kt hp nh sng t nhin. 7.1.2. Yu cu v ri ti thiu ca nh sng c quy nh trong bng 6. Bng 6 Tn phng Snh i, tip nhn bnh nhn Phng v sinh, thay qun o Phng kh khun, cung cp v khun, k thut, hnh lang v khun Phng m Phng Tin m, hi tnh Phng ngh th gin, Phng hnh chnh, bc s trng khoa, giao ban, o to (b phn vn phng) Kho (dng c, thit b, vt phm y t v dc phm, bn) Hnh lang, li i ri ti thiu (lux) 140 140 300 700/300 500/250 140 Tnh ton i vi mt phng thng ng, cao trn 1,0m iu khin 2 mc sng Ca s cao trn 1,8m Ghi ch

140 100

Ch thch: ri ti thiu l lng nh sng ti thiu trn n v din tch (c tnh i vi mt phng ngang, cao trn 0,8m tnh t sn). 7.2. 7.2.1. Cc yu cu vi kh hu: m bo iu kin vi kh hu (nhit , m, p sut);

- Nhit : 21C 26C - m : 7.2.2. 60 % 70 % 15 20 ln/gi yu cu sch t mc Class 100 000. - S ln lun chuyn khng kh : Cc phng m v hnh lang v khun:

7.2.3. Bng 7

Cc yu cu vi kh hu c quy nh trong bng 7

Tn phng

Nhit ( C)

m (%)

S ln lun chuyn khng kh / gi

S lng ht bi 0,5 m trong 1m3 khng kh 3 x 106

Phng m, phng hi tnh, hnh lang v khun Tin m, hnh lang sch 7.3.

21 - 24 21 - 26

60 - 70 70

15 20 5 15

Yu cu v phng chy v cha chy:

7.3.1. Khoa Phu thut c thit k tun theo nhng quy nh trong Tiu chun TCVN - 2622 : 1995. 7.3.2. Khong cch ti a t ca i ca cc phng n li thot nn gn nht trong Khoa Phu thut c quy nh ti bng 8 Bng 8 Khong cch ti a cho php (m) Bc chu la T cc phng gia 2 li thot nn 30 30 T cc phng c li ra hnh lang ct 25 25

I II

Ch thch: i vi cc khng gian rng, hnh lang di tu theo yu cu b tr ca ngn la m bo an ton. 7.4. Cp in: 7.4.1. Khoa Phu thut phi c cp in, lin tc 24 h/ngy. Ngoi ngun thng xuyn phi c ngun d phng, t ng cp in sau 5 giy. 7.4.2. Ngoi ngun in 2 pha theo quy chun thng thng, c b tr thm ngun cp in 3 pha ti khu sch phng s dng cc thit b c bit. 7.4.3. H thng cp in ca Khoa Phu thut phi m bo cc yu cu: - H thng in chiu sng phi c lp vi h thng in ng lc cp cho cc thit b. - H thng chiu sng phi m bo yu cu v ri ti thiu ca nh sng (quy nh ti mc 7.1.2 - Bng 6). - Thit b s dng in phi c h thng tip a c lp cp II. - H thng dy dn v thit b kim sot, cung cp in phi m bo an ton v ph hp cc thng s k thut (cng sut, cht lng). 7.5. Cng ngh thng tin: C h thng kt ni thng tin lin lc trong cc b phn, gia cc khoa khc trong bnh vin v cc c s bn ngoi bng h thng in thoi tng i, truyn d liu v hnh nh, mng my tnh ni b. Ch thch: Trong cc phng m ty theo yu cu c h thng thng tin (truyn hnh nh, v s liu) lin lc vi bn ngoi v phng hnh chnh, o to phc v cng tc nghin cu khoa hc, ging dy. 7.6. Cp thot nc:

7.6.1. Nc cp: Khoa Phu thut phi c cp nc sch v khun y , lin tc trong ngy m bo yu cu hot ng chuyn mn. 7.6.2. Nc thi: Phi c h thng thu gom nc thi cc phng chuyn mn v nc thi sinh hot vo h thng x l nc thi chung ca bnh vin, m bo v sinh mi trng. 7.7. Cht thi rn: - Cht thi y t phi c, phn loi v chuyn ti b phn x l chung ca bnh vin tun th theo quy nh ca quy ch qun l cht thi y t. - Bnh phm sau phu thut nu cn s dng nghin cu khoa hc cn phi c bo qun ring trong iu kin thch hp. - Khu m phi c ng kt ni vi b phn chng nhim khun. 7.8. Yu cu cung cp kh y t: H thng kh y t phi c cp t h thng trung tm. S lng cc loi kh y t, s u cp c quy nh Bng 9 Bng 9. S u kh cp/ging, bn m STT Loi kh y t Tin m 1. 2. 3. (O2) trung tm Kh nn (AIR) trung tm Kh ht (VAC) trung tm 01 01 hi tnh 01 01 01 Phng m 02 02 02 p lc 4bar v 8bar Ch thch

Ch thch: Ty theo yu cu ca phng m m thit k h thng trung tm kh CO2 v N2O... 7.9. Yu cu hon thin cng trnh: 7.9.1. Nn sn: Nn sn ca Khoa Phu thut m bo phng, nhn, chu lc khng trn trt, chu c ho cht, chng thm, v d c ra v sinh. Gia cc khng gian khng chnh ct. Giao tuyn ca sn vi tng m bo d v sinh, chng ng v bm bi. 7.9.2. Tng: Tng ca Khoa Phu thut, s dng vt liu hon thin cht lng cao m bo b mt phng, nhn, chu nc, chng n mn ho cht, d v sinh t sn ti trn. Giao tuyn ca sn vi tng cong trn chng bm bi. Tng bn trong khu vc hnh lang phi gn thanh chng va p cao t 0,7m n 0,9m (tnh t sn). 7.9.3. Trn: Trn bn trong v hnh lang ca Khoa Phu thut sn mu trng, phi c b mt phng, nhn (khng bm bi) chng thm, khng khun, bo n v cch m tt. 7.9.4. Ca i: Ca ra vo c khun, cnh ca bng nha tng hp hoc kim loi kt hp vi knh trong hoc m. Ca c chuyn xe, ging y bn l m hai chiu hoc ng m t ng. Cc ca ra vo u phi c cht, kho an ton (cc bnh vin loi I nn c ca ng m t ng cc hnh lang).

7.9.5.

Ca s:

Ca s c khun, cnh ca bng nha tng hp hoc kim loi kt hp vi knh trong hoc m chiu sng t nhin. 7.9.6. Ca chuyn dng c (Passbox) Ca chuyn dng c cch sn ti thiu 0,9m m bo ngn cch khng kh sch lnh v chnh p gia cc khu vc. 7.9.7. Lp t thit b k thut: Lp t thit b k thut (t iu khin, n c phim, passbox dng c) phi m bo yu cu k m thut, hon thin khng khng kh bn, bi lt vo trong phng. 8. TNG HP CC YU CU K THUT Bng 10. - Phng m, - Hnh lang v khun, - Phng hi tnh 36m2/phng m - Phng Tin m, - Hnh lang sch - P. ngh th gin 6(9)m2/ngi (gi) Chng trn trt. m bo phng, nhn. khu t p bng gch men knh, hoc sn Epoxy - Ra dng c, - Thay nhn vin Khu ph tr - Hnh chnh

Phng chc nng

1. Din tch 2. Sn nh

Ph vt liu nhn to chng mi mn, chng nm mc, chng tnh in. S dng cc vt liu chu nc, cc cht ty khun, sn khng khun, c s dng ti trn.

3. Tng

4. Trn 5. Ca 6. Cng kt ni phng tin 7. Nhit 8. m khng kh 9. Lun chuyn khng kh /h 10. S lng u cp kh 11. nh sng

B mt phng, nhn; h thng chiu sng, phng - cha chy, cp khng kh sch v cc h thng my mc k thut. D cm nm, ng m nh nhng; ca c chuyn xe, ging y bn l m hai chiu. Ton b cc cng kt ni t cnh ging 21 24C 60% - 70% 15 - 20 ln/h 06 cho 3 loi ri 300-700 lux 10 /phng m loi 220V/10A (c tip a) 21 - 26C Khng ln hn 70% 5 - 15 ln/h 03 cho 3 loi ri 250-500 lux 4 / ging loi 220V/10A (c tip a) ri 100-140 lux 4 loi 220V/10A (c tip a) 2 /phng (c tip a) 21 - 26C

12. cm in

13. H thng cp in khn cp

Cung cp cho cc thit b y t v chiu sng, thi gian tr hon vn hnh khng qu 15 giy.

14. Cng sut cng kt ni 15. My s dng ngun in DC ng h,my gi o chiu

1200 w/ging My gi y t, my gi o chiu, u Tel 01 chu ra cho 1 phng

2,8 kW My gi o chiu, u Tel 01chu ra 10/ngi 01 vi sen 20 ngi

16. Cp nc

Nc v khun cp cho chu ra tay

02 chu ra cho bc s

17. Thot nc

H thng thu, thot nc thi ho cht v nc thi sinh hot c x l s b trc khi thot vo h thng x l nc thi chung ca bnh vin.

PH LC A (thng tin tham kho) MU THIT K NI DUNG: Mt ct, mt bng k thut phng m Mt ct, mt bng h thng kh sch Phng hi tnh

Phng m Mt ct

MT BNG

1. 2. 3. 4. 5. 6. 7. 8. 9.

Bn m n m Ming thu hi kh n c phim XQ cp kh y t T thuc, dng c thit yu T lnh, sy T dng c gy m, hi sc Bng iu khin

H THNG KH SCH PHNG M

MT CT

MT BNG

1. 2. 3. 4.

n m Ca cp kh sch n m Ming thu hi kh

PHNG HI TNH

1. 2. 3.

Ging bnh Vch ngn nh di ng Gi truyn dch

4. 5. 6.

Bn + ra tay Xe thu bn H thng cp kh in

PH LC B (thng tin tham kho) MU THIT K QUY M 1 : BNH VIN A KHOA ; 250 350 GING Dy chuyn cng ngh, S hot ng Mt bng Mt ct QUY M 2 : BNH VIN A KHOA ; 400 500 GING Dy chuyn cng ngh, S hot ng Mt bng Mt ct QUY M 3 BNH VIN A KHOA ; TRN 550 GING Mt bng s t chc

QUY M 1 (Bnh vin a khoa 250 n 350 ging) DY CHUYN CNG NGH

S HOT NG

MT BNG

GHI CH:

1. 2. 3. 4. 5. 6. 7. 8.

Snh Ni i ngi nh Hi tnh khun Tin m khun Chun b M hu khun Li vo nhn vin Trng khoa m m hu hu

9. 10. 11. 12. 13. 14. 15. 16.

Phng bc s Phng y t, h l Hnh chnh + hi chn + o to Tm, thay nhn vin Phng m v khun Hnh lang v khun Kho vt t tiu hao Hnh lang sch + tin m

17. 18. 19. 20. 21. 22. 23.

Tip nhn bnh nhn Kho thit b P.ngh th gin+ghi h s m Phng v sinh P. kh khun Hi tnh Phng thi

Quy m 1 (Bnh vin a khoa 250 n 350 ging) MT CT

QUY M 2 (Bnh vin a khoa 400 n 500 ging) DY CHUYN CNG NGH

S HOT NG

MT BNG

GHI CH: 1. 2. 3. 4. 5. 6. 7. 8. Snh Ni i ngi nh Hi tnh m hu khun Tin m m hu khun Chun b M hu khun Hnh lang v khun Trng khoa 9. 10. 11. 12. 13. 14. 15. 16. Phng bc s Phng y t, h l Hnh chnh+hi chn+o to Tm, thay nhn vin Kho thit b Phng m v khun Kho vt t tiu hao Hnh lang sch + Tin m 17. 18. 19. 20. 21. 22. Hi tnh Tip nhn bnh nhn P. kh khun P. ngh gia ca + ghi h s m Phng v sinh Phng thi

MT CT

QUY M 3 (Bnh vin a khoa trn 550 ging) MINH HO PHNG N B CC MT BNG