Substantiation of the sanitary-epidemiological component to the new edition of the state-building norms of Ukraine “Health care institutions” concerning designing of psychiatric hospitals, taking into account the international experience

Abstract

Annotation. The aim of the work was to evaluate the design decisions of new psychiatric health care facilities in Ukraine and their comparative characteristics with EU institutions. An analysis of the requirements for the design of domestic new psychiatric wards, day hospitals in outpatient psychiatric wards in general hospitals according to paragraph 8.2.15 SBN B.2.2-10: 2019. State building codes of Ukraine “Buildings and structures. Healthcare facilities” (draft, final version) and European facilities of the same type based on the study of literature data. The method of theoretical analysis is used. It was found that conditions of the location of inpatient departments, their zoning, composition, and area of premises, requirements to ensure a safe stay of patients in wards, toilets, and bathrooms are regulating in the new SBN B.2.2-10: 2019. This essentially repeats the sanitary and hygienic requirements of the previous document SBN B .2.2-10: 2001 “Healthcare facilities”, ie no changes are aiming at creating an ecological environment and comfortable conditions for patients and medical staff of psychiatric healthcare facilities. In this normative document, there is no clear understanding of the location of medical facilities and the next post of a nurse in inpatient departments of psychiatric hospitals; there is no area for a private stay of patients with mental disorders in the middle of the department and outside it; the regulations of life support systems for nurses and patients in the inpatient department (lighting, noise, air exchange, etc.) of psychiatric hospitals are not standardized. In European psychiatric clinics, the “therapeutic environment” provides for the presence of single and double wards (coincides with domestic building codes); area of 37.7 m2 per patient under foreign law, while the project DBN B.2.2-10: 2019 – the zone per patient is 12 m2, which is three times less; separate bathrooms and toilets, common areas, individual access to the garden, where the conditions of privacy of patients are creating (not provided by Ukrainian regulations); location of most patient rooms around the central work area for medical staff (according to national legislation – a corridor-type system); creation of visual supervision over the doors of bedrooms, showers, toilets, kitchens, garden gazebos, as well as the selection of colours for painting the walls of wards and corridors of offices (not provided by Ukrainian regulations). To create a proper “therapeutic/healing environment” in new domestic mental health facilities (psychiatric wards, day hospitals in outpatient psychiatric wards in general hospitals, mental health centres), it is necessary to implement European requirements in the design of these facilities with the involvement of multidisciplinary groups: from architects to nurses, from construction contractors to patients and supplement SBN B.2.2-10: 2019 “Buildings and structures. Health Facilities” is a guide to designing psychiatric health facilities.

The Importance of Controlling and Preventing Infectious Diseases Associated With the Provision of Medical Care

“…В приміщеннях лікарень (в палатах, кабінетах лікарів, обідніх залах та інших приміщеннях) однією із найважливіших санітарно-гігієнічних вимог є створення тиші, тобто сила шуму в цих приміщеннях не повинна перевищувати 30 дБ [13,14]…”