Tasks of healthcare facilities and treatment-and-protective regimen
Medical organizations include hospitals, polyclinics, dispensaries, maternity hospitals, paramedic-midwife stations (feldsher-midwife stations), sanatoriums, and sanitary-antiepidemic stations (e.g., Rospotrebnadzor institutions). Their main task is to reduce population morbidity and provide highly qualified care based on the latest scientific achievements.
To achieve this, inpatient facilities organize a treatment-and-protective regimen. It addresses four key tasks:
- Ensures maximum physical and mental rest for the patient.
- Prevents the transmission of healthcare-associated infections (HAIs).
- Facilitates the work of the staff and patient care.
- Serves as a "hygiene skills school" for patients.
It is important to remember that a hospital is also a work environment where doctors and engineers are exposed to specific occupational factors from various medical equipment.
Placement of healthcare facilities and urban development
Hospitals and polyclinics are integrated into the structure of the residential area. The primary unit here is the microdistrict, where daily-demand infrastructure is located. Large, periodically used facilities (hospitals, antenatal clinics) serve a residential district, which combines 3–5 microdistricts. This decentralization spares people long trips to the city center.
The type of block development is of immense hygienic importance as it determines the microclimate:
- Free-standing development: the optimal modern option. Buildings are arranged to provide the best insolation and cross-ventilation.
- Closed (continuous) development: well-type yards. It is unacceptable today because it deprives rooms of sunlight and normal air exchange. Historically used to maximize the use of expensive land in city centers.
- Row development: one of the options for grouping buildings.
Admissions department and patient hygiene
A patient's journey in a surgical hospital begins in the admissions department. Here, the doctor conducts an examination, makes an admission diagnosis, and decides on hospitalization. During planned hospitalization, contraindications are identified (fever, contact with infectious patients); during emergency hospitalization, first aid is provided. The nurse fills out the medical record, measures the temperature, and checks the patient for pediculosis.
Sanitary and hygienic treatment includes a shower or therapeutic bath and a change of clothes. If lice are found, the hair is cut, a 50% soap-solvent paste is applied, and the clothes are sent for disinsection. Transportation to the ward depends on the severity of the condition: on foot, in a wheelchair, or on a stretcher.
Strict rules are observed within the department itself:
- Personal clothing is handed over to storage or to relatives.
- The department provides dishware and care items (bedpan, drinking bowl). Patients may bring a toothbrush, soap, razor, spoon, and cup.
- Scheduled bathing takes place at least once every 7 days.
- Bedridden patients are washed and wiped down after every meal and as they become soiled.
- Patients' hair is periodically cut and shaved.
Prevention of healthcare-associated infections
According to the definition of the WHO Regional Office for Europe (1979), a healthcare-associated infection (hospital, nosocomial, cross-infection) is any clinically recognizable infectious disease that affects a patient when seeking medical care at a healthcare facility, or a staff member while performing professional duties.
HAIs are classified as such regardless of when symptoms appear: right in the ward or after discharge home.
Infection can enter the hospital in two ways, creating a hidden epidemiological threat:
- Hospitalization of a person who is in the incubation period of an infectious disease.
- Introduction of pathogens by medical staff who are asymptomatic carriers.
To memorize the tasks of the treatment-and-protective regimen, use the acronym POPSh: Pakoy (Rest — physical and mental), Oblegchenie (Facilitation of care), Profilaktika (Prevention of HAIs), Shkola (Hygiene school).
Class and exam questions
Is an infection considered healthcare-associated if a patient falls ill a week after discharge?
Yes, if the infection resulted from a hospital stay or a polyclinic visit. The time of symptom onset does not matter.
How often should bedridden patients be washed in the department?
Scheduled bathing is carried out at least once every 7 days. However, bedridden patients must be wiped down and washed after every meal and as the body becomes soiled.
Why are hospitals with closed well-type yards no longer built?
Closed development deprives wards of sufficient insolation (sunlight) and prevents normal ventilation of the area, which is critically important for infection prevention.
What else to study on this topic
- Features of the layout and zoning of surgical departments
- Specifics of work and the hygienic regime in infectious disease hospitals
- Occupational hazards in the work of medical personnel
- Methods of disinfection and sterilization of medical instruments
- Organization of catering and control over the hospital catering unit
Master the entire topic in the "Hygiene" course
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- Complete study guide on "Hygiene of healthcare facilities" and 530 more pages of the subject
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Other topics in the section "Chapter 8. Hygiene of Healthcare Facilities"
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.