Application of Clean Technology in the Medical Environment
2024.06.25
Clean technology, also known as cleanroom technology. In addition to meeting the conventional requirements of temperature and humidity in air-conditioned rooms, through various facilities and strict management in engineering technology, the content of microparticles, air flow, pressure, etc. in the room are also controlled within a certain range. Such a room is called a cleanroom. With the development of the medical and health care industry and high technology, the application of clean technology in the medical environment is more extensive, and the technical requirements for itself are also higher. The cleanrooms applied in medical care are mainly divided into three categories: clean operating rooms, clean care wards and clean laboratories.
1、 Clean Operating Rooms
The clean operating room takes indoor microorganisms as the control target. Operating parameters and classification indicators, and air cleanliness are necessary guarantee conditions. Clean operating rooms are classified into grades according to cleanliness:
1. Special clean operating room: The cleanliness of the operating area is grade 100, and the surrounding area is grade 1,000. It is suitable for aseptic operations such as burns, joint replacement, organ transplantation, neurosurgery, ophthalmology, plastic surgery and cardiac surgery;
2. Clean operating room: The cleanliness of the operating area is grade 1,000, and the surrounding area is grade 10,000. It is suitable for aseptic operations such as thoracic surgery, plastic surgery, urology, hepatobiliary and pancreatic surgery, orthopedic surgery and egg retrieval;
3. General clean operating room: The cleanliness of the operating area is grade 10,000, and the surrounding area is grade 100,000. It is suitable for operations such as general surgery, dermatology and abdominal surgery;
4. Quasi-clean operating room: The air cleanliness is grade 100,000, and it is suitable for operations such as obstetrics and anorectal surgery.
In addition to the cleanliness level and bacterial concentration of the rooms in the clean operating department should comply with the corresponding levels, the relevant technical parameters should also comply with the relevant regulations. See the main technical parameter table of each level of rooms in the clean operating department.
The planar layout of the clean operating department should be divided into two parts, the clean area and the non-clean area, according to the general requirements. The operating rooms and the functional rooms directly serving the operating rooms should be located in the clean area. When people and objects pass through different cleanliness areas within the operating department, air locks, buffer rooms or transfer windows should be set. Generally, the operating rooms are located in the core part. The internal plane and channel form should conform to the principles of functional process simplicity and clear separation of cleanliness and dirtiness.
2、Clean Care Wards
Clean care wards are divided into isolation wards and intensive care wards. Isolation wards are divided into four grades of P1, P2, P3 and P4 according to the biological hazard degree. The P1 ward is basically the same as the ordinary ward, and outsiders are not particularly prohibited from entering and leaving; the P2 ward is stricter than the P1 ward, and outsiders are generally prohibited from entering and leaving; the P3 ward is isolated from the outside by a heavy door or buffer room, and the room is negative pressure inside; the P4 ward is isolated from the outside by an isolation area, and the indoor negative pressure is constant at 30Pa. Medical staff wear protective clothing to prevent infection. Intensive care wards include ICU (intensive care unit), CCU (cardiovascular patient care unit), NICU (premature infant care unit), leukemia wards, etc. The room temperature of the leukemia ward is 242, the wind speed is 0.15-0.3/m/s, the relative humidity is below 60%, the cleanliness is grade 100. At the same time, the cleanest air sent in should first reach the patient's head, so that the mouth and nose breathing area is on the air supply side, and horizontal flow is better. The measurement of bacterial concentration in the burn ward shows that vertical laminar flow has obvious superiority for open treatment. The laminar flow speed is 0.2m/s, the temperature is 28-34, and the cleanliness is grade 1,000. Respiratory organ wards are rare in China. This kind of ward has strict requirements on indoor temperature and humidity. The temperature is controlled within 23-30, and the relative humidity is 40-60%. Each ward can be adjusted according to the patient's own condition. The cleanliness is controlled between grade 10 and 10,000. The noise is less than 45dB(A). Personnel entering the ward should undergo personal purification such as changing clothes and air showers, and the ward maintains positive pressure.
3、Clean Laboratories
Clean laboratories are divided into ordinary clean laboratories and biosafety laboratories. The experiments conducted in ordinary clean laboratories are not contagious, but the environment is required not to adversely affect the experiment itself. Therefore, no protective facilities are set up in the laboratory, but the cleanliness must meet the experimental requirements. Biosafety laboratories are those with first-level protective facilities and can achieve second-level protection for biological experiments. Scientific experiments in the fields of microbiology, biomedicine, functional experiments and gene recombination all require biosafety laboratories. The core of the biosafety laboratory is safety, and it is divided into four grades of P1, P2, P3 and P4 according to the degree of biological danger. P1 laboratories are suitable for very familiar pathogens that do not often cause diseases in healthy adults and pose little danger to laboratory personnel and the environment. In the experiment, the door should be closed and operated according to ordinary microbiological experiments; P2 laboratories are suitable for pathogens with moderate potential dangers to humans and the environment. Entry to the experimental area is restricted. Experiments that may generate aerosols should be carried out in a class II biosafety cabinet, and a high-pressure sterilizer should be prepared at the same time; P3 laboratories are used in clinical, diagnostic, teaching, or production facilities. Work on endogenous and exogenous pathogens is carried out at this level. If exposed and inhaled, this pathogen will cause serious and possibly fatal diseases. The laboratory is equipped with a double-door or air lock room and an externally isolated experimental area. Non-local staff are prohibited from entering. The laboratory is fully negative pressure. Experiments are carried out using a class II biosafety cabinet, and the indoor air is filtered and discharged outdoors through a high-efficiency filter; P4 laboratories have stricter requirements than P3 laboratories. Some dangerous exogenous pathogens have a high individual risk of laboratory infection and life-threatening diseases caused by aerosol transmission. Relevant work should be carried out in P4 laboratories. The structure of the isolation area and the external partition in an independent building is adopted. The indoor negative pressure is maintained. Experiments are carried out using a class III biosafety cabinet. An air partition device and a shower room are set up. Operating staff should wear protective clothing. Non-local staff are prohibited from entering. The core of biosafety laboratory design is dynamic isolation. Exhaust air measures are the focus, emphasizing on-site disinfection, paying attention to the separation of cleanliness and dirtiness, preventing accidental spread, and requiring moderate cleanliness.
The construction of cleanroom purification devices in hospitals in China is currently in the promotion stage. In recent years, major hospitals in major cities have successively built new and renovated cleanrooms, added or transformed the original cleanroom systems. This reflects the economic development, technological progress and improvement of the medical and health care level in China. Building new and renovating cleanrooms to reduce the infection rate and improve the therapeutic effect is a very prudent task. Starting from the current technical and economic level, the implementation conditions have been available, but it should be carried out successively under the overall planning of the local health authorities. At the same time, it should be noted that in recent years, in the new construction or expansion projects of hospital cleanrooms, some units and relevant departments often only focus on whether the cleanroom has been installed as the only concern, ignoring the quality problem of the cleanroom device. Hospital cleanrooms are different from electronic clean workshops and pharmaceutical clean workshops. They have higher cleanliness requirements. If the cleanroom device fails to meet the required cleanliness requirements, causing cross-infection within the hospital will endanger patients and medical staff. Therefore, professional construction units of hospital clean technology engineering should be invited to design and construct the hospital cleanrooms to ensure the high quality of each cleanroom.
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