Maternity Hospital

8/16/2019 Maternity Hospital

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THE MOST POWERFUL

EMOTION IN LIFE MAYBE THE LOVE OF A MOTHERFOR HER CHILD.

'MOTHERHOOD: ALL LOVE BEGINSAND ENDSTHERE.' ~ ROBERT BROWNING

A MOTHER UNDERSTANDS WHAT A CHILD DOES

NOT SAY.- JEWISH PROVERB


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SYNOPSIS

A BIRTH PLACE

MATERNITYHOSPITAL

AFTAB ALAM

M.ARCH

II-SEM

F/O ARCHITECTURE AND EKISTICS

JAMIA MILLIA ISLAMIA

NEW DELHI


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Introduction

lady is not suffering from any diseases, its just a new phase in her life, her

transformation to motherhood .• Maternity service includes antenatal care, deliveryand post-natal care, before

and after child birth,• the patient should be attended to in the out-patient clinic and during labour

the patient is confined to bed in the nursing unit.•

It is recommended to place the in-patient unit close to the out-patient clinicmaking it easily accessible to the child bearing women.


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Aim :• To study and understand the functioning and designing of Maternity

Department.• Planning a maternity nursing home in respect of functional.• space, man-power, instruments and equipment, and management

requirements. Certain essential.• requirements for building, services and environment have also been included.• The hospital set-up should change. The lady should feel at home .


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1.2. Objective

•

To study the diseases and diagnostics procedures related toMaternity and its treatment.

• To study the functional spaces and equipment required forconsultation, treatment and other whole ancillary areas ofNeurology department.

• To study the technology used in consultant diagnostic &treatment and its special needs .

• In the healthcare industry, brands are chosen by patients ontrust. People consult their friends , colleagues and familymembers before choosing a particular doctor.


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MATERNITY NURSING HOME

Functionally the maternity nursing home shall havefour distinct sections:a) Out-patient and emergency services,b) Diagnostic and therapeutic services,c) In-patient nursing units (wards), and

d) Administrative, non-clinical and engineeringsupport services.


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FUNCTIONAL REQUIREMENTS

Out Patient and Emergency ServicesThese are needed to perform following chief functions,namely:

a) To diagnose and treat patients at an early stage,b) To follow up treatment after discharge from the maternity

nursing home, andc) To institute health education programme to educate thepublic in environmental hygiene


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DEPARTMENTS• Obstetric and Gynaecological Clinic• Family Welfare Clinic• Paediatric Clinic• General Purpose Clinic• Emergency Unit• Clinical laboratory• Injection room• Pharmacy (Dispensary)• Diagnostic and Therapeutic Services

PathologyBiochemistry laboratoryMicrobiology laboratory

• Ultrasound• Radiography room•

Consultation area• Obstetrical-cum-Surgical Suite


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Literature study

1. Introduction2. Departments3. Specialist Hospitals4. Early developments5. Surgeries6. Design considerations7. Benefits .

Case s tudy

1. Apollo Hospital2. Holy family Hospital3. Hindurao Hospital

Refrences

1. Journals2. Codes3. researches

METHODOLOGY


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THANK YOU


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1. FEATURES OF IPD

• The IPD forms 33%-50% of the structure of hospital construction and most

of the equipment and staffs are in this department with maximum amount

of patient care, training, medical teaching and research concentrated in

this department.• IPD is the area which gives maximum output of services and name and

fame to the hospital too.

• An inpatient is admitted to the hospital and stays overnight or for an

undetermined time, usually several days or weeks (though some cases,like coma patients, have been in hospitals for years.


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SPACE REQUIREMENT FOR WARDS

S No. Facilities Area (sq. m)1. Beds 7

1. Treatment room 12

1. Nursing station 15

1. Ward store 9

1. Sluice room 9

1. Clean utility /dirty

utility

18

1. Doctors duty room 18

Space Relationship


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1. B.AREA AND SPACE NORMS OF THE HOSPITAL:Land Area

(Desirable)Minimum Land area requirement are as follows:Upto 100 beds = 0.25 to 0.5 hectareUpto 101 to 200 beds = 0.5 hectare to 1 hectare500 beds and above = 6.5 hectare (4.5 hectare for hospital and 2

hectare for residential)

1. C.SIZE OF HOSPITAL AS PER NUMBER OF BEDS:a. General Hospital –80 to 85 sqm per bed to calculate total plinth area. (Desirable) .(Including waiting space, entrance hall, registration counter etc.)

Example: If in general hospital the no bed are = 100(say)Then total plinth area of the hospital = 100 x 80 = 8000 sm

Or = 100 x85 = 85000 smtb. Teaching Hospital –

100 to 110 sqm per bed to calculate total plinth area.


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C. Others Services And Area:(i) Operation Theatre:

a. One OT for every 50 general in-patient bedsb. One OT for every 25 surgical beds.(ii) ICU beds -5 to 10 % of total beds in hospital

Example: if in any hospital no of beds are = 200Then ICU beds = 5x 200/100 = 10 minimum

And = 10 x 200/100 = 20 maximum

(iii) Floor space for each ICU bed = 25 to 30 sq m (this includes support

services)

(iv) Floor space for Paediatric ICU beds = 10 to 12 sq m per bed

(v) Floor space for High Dependency Unit (HDU) = 20 to 24 sq m per bed

(vi) Floor space Hospital beds (General) = 15 to 18 sq m per bed

(vii) Beds space = 7 sq m per bed.

(viii) Minimum distance between centres of two beds = 2.4 m (minimum)

(ix) Clearance at foot end = 1.2 m (minimum)


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WARD UNIT DESIGN:Aim Should Be To Minimise The WorkflowSpaces:• nursing station,

• doctors’

• duty room,

• pantry,

• isolation room,

• treatment room,

• nursing store along with wards and toilets as per the norms.

• 1 nursing station will cater upto 40-45 beds(acute 50% + 50% chronic patient)

QUALITY PARAMETERS:• at least 2.5 metre between centres of two beds

• Bed side locker and stool for attendant

• Screen shall be available for privacy.

• Dirty utility room

• janitors rooms

•

ventilation (except isolation ward) and fans.


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PATIENT CONVENIENCES:


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EMERGENCY SERVICES:• 24 x 7 operational emergency

• distinct entry independent of OPD main entry

• easy ambulance approach• Signage of emergency

• triage, resuscitation and observation area.

• Separate provision for examination of rape/sexual assault victim

•

It should have mobile X-ray/ laboratory, side labs/plaster room/and minor OT facilities.• Separate emergency beds

• Duty rooms for Doctors/nurses/ paramedical staff and medico legal cases.

• separate waiting areas

• it should have ECG, Pulse Oxymeter, Cardiac Monitor with Defibrillator, Multiparameter

Monitor,

Ventilator also.

• Stretcher, wheelchair and trolley shall be available at the entrance of the emergency at

designated area.


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OPERATION THEATRE:

Location:• Free from noise and other disturbance

• free from contamination and possible cross infection

• maximum protection from solar radiation

ZONES:

1.Protective Zone2.Clean Zone3. Aspectic or Sterile Zone4. Disposal or Dirty Zone.

TRAFFIC FLOW:1.Patients2.Staff

3.supplies

TYPES OF ROOM :1.preparation room2.pre operative room3.post operative room4.scrub up

Services:hospitals suggest the minimum to desirableassured services in its three main departmentsaccording to the code :1.OPD2.Indoor3.Emergency


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Besides the basic services it should also cater for:

• New-born Care unit services(NCUS)• Post partum unit(birth of young)•

Post natal(after childbirth)• Family planning• Safe abortion• Immunization services• Psychiatric services(mental)• Physical Medicine•

Rehabilitation services(restore to health)• Accident• Trauma(distressing experience)• Dialysis services(purification of blood) and• Anti-retroviral therapy(HIV)

More than 300 bedded hospital it is desirable to provide super specialityservices and related diagnosis services.

It provides all basic speciality servicesIt should aim to provide super speciality services alsoThese hospitals should be ready for all epidemic and disastrous times.


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Beds Requirement in Different types of Hospitals


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INSIDE DESIGN CONDITIONS

Inside design conditions for air cooling and air handling shall be as under: -

Temperature

OT department 23-25 degree Celsius in Common OT, 15-20 degree Celsius in Cardiac OT2) ICU/CCU/PICU 23-25 degree Celsius

3) NICU 26-30 degree Celsius

4) Ward units 23-25 degree Celsius

AIR CHANGES IN DEPARTMENTSOperation theatre depttOT Room conducting specialised operation like cardiac-,Neuro-, and Transplant surgery 25 Air changes/hr2) General OT Room 20 Air changes/hrOther areas 10 Air changes/hr

4) ICU/CCU/NICU/PICU 12 Air changes/hr(Rooms to be A/C specified in respective tables)5) Ward units and deptts. not specified 6 Air changes/hr

HUMIDITYOT departments 40-60%ICU/CCU/NICU/PICU 40-60%

Ward units except burn centre/burn ward 40-60 %


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AS per IS 12443.2 Requirement of Hospitalsup to 100 beds


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G di f di i h i l


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Grading of district hospital:

Grade I: District hospitals norms for 500 beds

Grade II: District Hospital Norms for 400 beds

Grade III: District hospitals norms for 300 beds

Grade IV: District hospitals norms for 200 beds

Grade V: District hospitals norms for 100 beds.

district hospital should be able to serve 85-95% of the medical needs expected hospital

bed occupancy rate should be at least 80%.

Functions:• It provides effective, affordable health care services

• It covers both urban population (district head quarter town) and the rural population

in the district

• Function as a secondary level referral centre for the public health institutions below

the district level

• To provide technical and administrative support and education and training for

primary health care.


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Services:Administrative services:• (i) Finance• (ii) Medical records• (iii) Procurement• (iv) Personnel• (v) Housekeeping and Sanitation• (vi) Education and training• (vii) Inventory Management• (viii) Hospital Information System• (ix) Grievances redressal Services

General Specialties:General MedicineGeneral Surgery

Obstetric & Gynaecology ServicesFamily Planing services like Counseling,Tubectomy (Laparoscopic and Minilap),NSV, IUCD, OCPs, Condoms,ECPs, Follow up services


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Paediatrics including Neonatology and Immunization

• Emergency (Accident & other emergency)• Critical care/Intensive Care (ICU)• Anaesthesia• Ophthalmology• AnaesthesiaOphthalmology• Otorhinolaryngology (ENT)• Orthopaedics• Radiology including Imaging

• Radiology including Imaging• Psychiatry• Geriatric Services (10 bedded ward)• Health promotion and Counseling Services• Dental care• District Public Health Unit• DOT centre• AYUSH• Integrated Counseling and Testing Centre; STI Clinic; ART Centre.• Blood Bank• Disability Certification Services• Services under Other National Health Programmes


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Physical Facilities

Location: Away from parking and crowd area, adjacent to supportand diagnostic services, should be away from mortuary.

Circulation: Vertical or horizontal

Vertical circulation can be arranged with less space with central

vertical spine for lifts, conveyers and stairs and pipe lines. Reducespatient errors and cross infections.

Horizontal circulation: eliminates requirement of expensive verticaltransportation system. suitable for inpatient up to 300 bedstrengths.


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Primary accommodation :

Aim of ward design:

Obs/Gyne ward – Privacy

General ward :Healthy Environment

Pediatric/ psychiatric ward- Safety

Geriatric ward- Safety/ comfort

ICU- Nursing Care

OT-Infection control

Size of ward: depending upon type of patient , kind of nursing and manpower.

NHS,UK recommends 24 bed/ward

Traditionally it’s 10 beds/wardArea of ward :90 -110 sq.feet /bed (8-10 sq.meter)

Distance between center of two bed -2.25 meter,not less than 2 meter.

Distance between two bed -1.5 meter


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Width of corridor -2.7 meter

Distance between bed end and wall-0.25m

Distance between bed wall and bed nearest to side wall-0.5 meter.Ceiling Height: at least 3 meter.,Height of suspended ceiling fan –at least 2.6meter.

Windows: if only in one wall then it should be 20% of floor area, if multiplewindows then 15% of floor area.

Corridors: the width of corridor recommended is 2.4 m to faciliate movementof trolley, bed, stretchers

Door: should not be less than 1.2 meter wide and 2.25 m tall.

Bed side locker/cupboard-must

Chair sofa/sofa cum bed- for visitors

Other facilities-depending upon rooms(private/semiprivate/deluxe/semideluxe)

7 SQ MT AREA REQUIRED PER BED


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NURSE STATION:

should not be less than 60 sq. feet with nursing table ,sisters room and build in cupboard. with provision of large glass window for observation is possible.

Auxiliary Accomodation

Doctors room :120 sq ft

Nurse room :120 sq feet

Space for stretcher trolley 21 sq ft

Store room :200 sq ft

Clean utility room -90 sq ft

Sluice room -120 sq ft

Sanitary accomodation

Toilet with washroom/bathroom

Only shower

Dirty utility -120 sq mt

Janitors closet -Recommended- urinal (1 for 16 bed ) WC- (1 for 5 bed ) bathroom (1for 12 bed ) wash basin (1 for 10 bed )

Ancillary accommodationWard pantry -100 sq ft


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• Inpatient Department consists of a wards with Nursing Station, Beds, and allother facility & services necessary for good patient care.

• It is one of the important aspects of hospital as every ratios and calculation forhospital planning and designing process is based upon the no. of bed it consists.


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Function of Inpatient Department

To provide highest possible quality of medical and nursing care.

To make a provision of essential equipment, Drugs, and other material required for patientcare.

To provide comfortable and desirable environment to patient on temporary substitution ofhome.

To provide facilities for visitors.

To provide suitable atmosphere for highest possible degree of job satisfaction amonghealthcare personal and high level of patient satisfaction.

To provide opportunity for education, Training and research


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B.AREA AND SPACE NORMS OF THE HOSPITAL:

Land Area(Desirable)Minimum Land area requirement are as follows:Upto 100 beds = 0.25 to 0.5 hectareUpto 101 to 200 beds = 0.5 hectare to 1 hectare500 beds and above = 6.5 hectare (4.5 hectare for hospital and 2

hectare for residential)

C.SIZE OF HOSPITAL AS PER NUMBER OF BEDS:

a. General Hospital –80 to 85 sqm per bed to calculate total plinth area. (Desirable) .(Including waiting space, entrance hall, registration counter etc.)

Example: If in general hospital the no bed are = 100(say)Then total plinth area of the hospital = 100 x 80 = 8000 sm

Or = 100 x85 = 85000 smtb. Teaching Hospital –

100 to 110 sqm per bed to calculate total plinth area.


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C.OTHERS SERVICES AND AREA:(i) Operation Theatre:

a. One OT for every 50 general in-patient bedsb. One OT for every 25 surgical beds.

(ii) ICU beds -5 to 10 % of total beds in hospital

Example: if in any hospital no of beds are = 200Then ICU beds = 5x 200/100 = 10 minimum

And = 10 x 200/100 = 20 maximum

(iii) Floor space for each ICU bed = 25 to 30 sq m (this includes supporservices)

(iv) Floor space for Paediatric ICU beds = 10 to 12 sq m per bed(v) Floor space for High Dependency Unit (HDU) = 20 to 24 sq m per bed(vi) Floor space Hospital beds (General) = 15 to 18 sq m per bed

(vii) Beds space = 7 sq m per bed.(viii) Minimum distance between centres of two beds = 2.4 m(minimum)

(ix) Clearance at foot end = 1.2 m (minimum)


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THANK YOU

Maternity Hospital

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