The same is true of the medical department, the supply department and the management department, as well as the general hospital, whose composition is shown in figure 1. The general layout principle is to give priority to the medical part, so that all parts are convenient to contact and do not interfere with each other. General hospitals have three basic layout forms: decentralized, centralized and semi-centralized. Decentralization means that all departments are located in independent buildings, which is convenient for ventilation and lighting, but the connection is not tight, occupying more land and long pipelines; Centralization is to integrate outpatient service, medical treatment, hospitalization, supply and management into a whole building, which is convenient to contact, saves land and has few pipelines, but the project is more complicated; Semi-centralization means that outpatient service, medical treatment and hospitalization are centralized, and supply and management are separated.
The medical part includes outpatient department, inpatient department, emergency department, key treatment and nursing unit, operation department, radiology department, physiotherapy department, pharmacy department, central disinfection and supply department, laboratory department, functional diagnosis room and blood bank. Hospitals with teaching requirements also have rooms for scientific research and clinical teaching.
outpatient department
The outpatient department consists of public part, diagnosis and treatment part and consulting room of each department. The combination of various parts of the clinic is arranged according to the diagnosis and treatment procedures. Generally, the public part is the transportation hub, and the diagnosis and treatment part and consultation rooms of various departments are arranged around it to shorten the treatment route, facilitate disinfection and reduce infection. Its combination forms are single hall type, divided hall type and condensing film type.
(1) public parts. Including the hall, waiting room, registration room, medical record room, medicine collection and charging room, stairs, elevators, toilets, etc. The layout of the waiting room includes corridor waiting, corridor room waiting and corridor room secondary waiting. The waiting room requires good lighting, ventilation and clean environment, and attention should be paid to avoiding cross-infection of patients in other departments.
② Diagnosis and treatment. Including laboratory, radiology, physiotherapy, injection and dressing room, as well as Chinese and western pharmacies, these departments usually serve the inpatient department.
(3) consulting rooms of various departments. Including internal medicine, surgery, obstetrics and gynecology, pediatrics, facial features, dermatology and traditional Chinese medicine. Large general hospitals have detailed departments, such as thoracic surgery, brain surgery, bone surgery, trauma surgery and so on. Obstetrics and gynecology should be strictly divided into gynecology and obstetrics. Obstetric examination room and birth control operating room should be set up with independent entrances and exits. Pediatrics should have a separate entrance and exit, and a pre-diagnosis and identification room should be set at the entrance and exit to treat patients separately, so that sick children can be separated from adult patients and infectious children can be separated from non-infectious children. Chinese medicine includes internal medicine, surgery, pediatrics, gynecology, ophthalmology, traumatology, hemorrhoids, massage and acupuncture.
inpatient department
The scale of the inpatient department is expressed by the number of patient beds, which is determined according to the population of the service area, the nature of the hospital and the technical strength. The inpatient department is mainly composed of admission management department and ward.
(1) Admissions Management Department. Comprises a consulting room, an admission sanitary treatment room and an admission place.
② Ward. It is the main body of the inpatient department, and its basic unit is the nursing unit. The capacity of adult patient intensive care unit is generally 30 ~ 50 beds; Pediatrics, infectious diseases and other nursing units are generally 20 ~ 25 beds. The nursing unit mainly consists of three parts: ward, nurse station and auxiliary room. The combined layout forms of nursing units are: strip-shaped units in the middle corridor, in which the ward is located in the south of the middle corridor, and the auxiliary rooms such as the nurse station are located in the north of the middle corridor, which can be naturally lit and ventilated; A rectangular unit with two corridors, in which a nursing station and other auxiliary rooms are located in the middle of the two corridors, surrounded by sick rooms, so the nursing distance is short, but some rooms in the middle must be equipped with air conditioning and artificial lighting; The auxiliary rooms such as radial nursing unit and nurse station in the circular corridor are located in the middle, and the wards are located around, which has the same characteristics as the rectangular unit with double corridors; The nursing unit of the open nurse station divides a nursing unit into 3 ~ 4 small units, and the auxiliary rooms except the nurse station are located at the joint of several small units. The nurse station is completely in the center of the small unit, with the shortest distance from each ward. General wards are divided into large, medium and small wards according to the number of beds, with 4-8 beds, 3-6 beds and 1-2 beds.
The key treatment and nursing unit is called ICU internationally, which is an advanced symbol of medical treatment today and a new trend of hospital development. The key treatment and nursing unit aims at continuous observation, treatment and nursing of patients, so that critically ill patients can get out of danger as soon as possible. Therefore, its layout is centered on the open nurse station, with wards around it, forming a clean closed space-clean area; Auxiliary rooms such as internal management and equipment of the unit are clean areas; The part of the family waiting outside the unit is the polluted area. The nurse station adopts electronic monitoring system to observe patients, which can continuously observe and record various pathological indexes of patients for 24 hours, and can automatically give an alarm for timely rescue and treatment. The bedside wall of all beds should be equipped with medical pipes, electric plugs and various rescue equipment. ICU also has nurses' operating room, examination room, instrument room and washing room.
emergency department
According to the size of the hospital. The emergency department of large hospitals includes emergency room, observation room and rescue room. The entrance and exit of the emergency room should be obviously easy to find, and there should be a special registration room, a medicine taking room and a waiting area for stretchers, carts and escorts. The emergency department works around the clock, and it should be able to form its own independent system after the outpatient clinic closes at night. Most emergency patients need surgery, so the emergency department should be close to the inpatient department and operating room.
The operating department is equipped with operating room, hand washing room, disinfection room, instrument room, packaging room, dressing storage room, washing room, plaster room, duty room, office, dressing room and bathroom.
Surgical activities are generally divided into three streamline lines: patient streamline, medical staff streamline and medical equipment streamline. In order to prevent infection, the operation part has three areas: sterile area, including operating room and hand washing room; Disinfection area, including endoscope room, plaster room, washing room, dressing room, instrument room, duty room and office; Non-sterile area, including the front and entrance of staff locker room.
The core of the operating department is the operating room, which is divided into sterile operating room, ordinary operating room and polluted operating room. Aseptic operating room requires air purification facilities, control the minimum bacterial quantity, and pollute the operating room with bacterial diseases for operation.
Radiology is divided into two parts: diagnosis and treatment. The diagnosis part consists of fluoroscopy room, filming room, darkroom, film storage room and film viewing room. The treatment part consists of shallow line treatment room and deep line treatment room. Radiology treatment room should be protected separately from other departments.
The permanent physiotherapy rooms of physiotherapy department include electrotherapy room, phototherapy room, sound therapy room, damp-heat treatment (water, steam, wax) room, etc. The treatment rooms of acupuncture, massage and cupping in traditional Chinese medicine are either located in Chinese medicine department or physical therapy department. The electrotherapy room should use wooden floors. The phototherapy room needs good ventilation.
Pharmacy general hospitals in China are usually divided into western pharmacies and traditional Chinese pharmacies.
① Western pharmacy. The main rooms of western pharmacy are dispensing room, sub-packaging room, preparation room, dispensing room, washing room, disinfection room and warehouse. The above rooms should be arranged together, and the rooms should be well ventilated to avoid direct sunlight.
② Chinese medicine. The room of the finished medicine part of the Chinese pharmacy is the same as that of the western pharmacy, but the crude drug part is different. If the medicine is distributed by a medicine dispenser, the medicine dispenser should be installed upstairs and distributed below. The crude drug storehouse should be connected with the dispensing room on the floor, and the finished drug storehouse should be similar to the dispensing room of traditional Chinese medicine. The traditional Chinese medicine dispensing room without dispensing machine should be connected with the raw material medicine library and the finished traditional Chinese medicine library.
The central disinfection supply room is a place for centralized disinfection in hospitals, and its location should be convenient to contact with outpatient departments, inpatient departments and various clinics. The indoor clearance of disinfection room should be high to exclude hot air. In the disinfection room, in addition to placing the disinfection cabinet, we should also consider the room for maneuver of the operator's delivery vehicle.
Laboratories and functional diagnosis rooms are places for physiological or pathological analysis and testing of patients' blood, body fluids, excreta and human tissue samples. Relatively perfect laboratories include routine laboratories, biochemical laboratories, bacterial laboratories, serum laboratories and pathological tissue slicing laboratories. Functional diagnosis room generally includes ECG description, basic metabolism measurement and ultrasound examination. Conventional laboratories should be sunny and require uniform indoor light. Biological laboratory needs good ventilation and toxic gas exhaust cabinet. Bacteria laboratories and serum laboratories require that walls, floors and ceilings be easily disinfected. The functional diagnosis room adopts insulated floor. The ECG examination room should be vibration-proof, away from high-voltage lines and electrical appliances, and take electromagnetic shielding measures to eliminate the interference of other radio waves.
A blood bank generally consists of a blood collection room, a blood supply room, a blood donor lounge, a blood storage room, a blood preparation room and a washing and disinfection room.
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