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Office of Acquisition and Materiel Management Distribution Programs Division Office of Construction Management Facilities Quality Office Standards Service
Foreword
The material contained in the Supply, Processing, and Distribution (SPD) Design Guide is the culmination of a partnering effort by the Department of Veterans Affairs Office of Acquisition and Materiel Management and the Facilities Quality Office. The goal of the Design Guide is to ensure the quality of VA facilities while controlling construction and operating costs. This document is intended to be used as a guide and a supplement to current technical manuals and other VA criteria in the planning of SPD facilities. The Design Guide is not to be used as a standard design, and use of this Design Guide does not limit the project Architects' and Engineers' responsibilities to develop a complete and accurate project design that best meets the users' needs and applicable code requirements.
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Foreword
Contents
Section 1 ............. Acknowledgments, Introduction, Abbreviations, and Legend of Symbols Section 2 ............. Narrative Section 3 ............. Relationship Diagrams and Generic Layout Section 4 ............. Design Guide Plates and Design Standards: General Rooms Section 5 ............. Design Guide Plates and Design Standards: Areas Specific to SPD Section 6 ............. Satellite Outpatient Clinic Section 7 ............. Miscellaneous
Contents
Contents - Section 1
Acknowledgments
Credit is due to the following individuals whose guidance, advice, and effort made this publication possible:
Joel Cadiz William H. Cable Mark G. Hall Debra Bonarti, Assoc. AIA Elizabeth Bunn, CIPE Sheila C. Jackman
Design Guide Developer, Standards Service Architect, Standards Service Architect, Standards Service Architect, Standards Service Engineering Technician, Standards Service Secretary, Standards Service
Dan Colagrande, RA Don Walden E.T. Minter Evaldo Guillama Barry Woods Dave Armstrong
Architecture Mechanical Engineering Plumbing and Sanitary Engineering Electrical Engineering Equipment Equipment
William Stewart
Page 1-1
Introduction
The SPD Design Guide is intended to be a graphic consolidation of existing Department of Veterans Affairs standards and criteria. It contains data from the following sources: The Design Guide for Supply, Processing, and Distribution was developed as a design tool to assist health care professionals in better understanding the choices that designers ask them to make, and to help designers understand the functional requirements necessary for proper operation of SPD. The guide plates contained in the SPD Design Guide are intended as illustrations of VA's space needs (e.g., furniture, equipment, personnel, etc.). They are not meant to limit design opportunities. This Design Guide is not intended to be project specific. While it does contain the majority of spaces that now are required in SPD, it is not possible to encompass all possible future requirements. Therefore, it is recommended that the project-specific space program be the starting point for an individual project design. In addition, it is important to note that the guide plates are a generic graphic representation only. Equipment manufacturers should be consulted for actual dimensions and utility requirements. Use of this Design Guide does not compromise the project Architects' and Engineers' responsibilities to develop a complete and accurate design that meets the user's needs and appropriate code requirements.
H-7610 Space Planning Criteria H-08-3 Construction Standards H-08-4 Standard Details H-08-13 Barrier-Free Design Handbook PG-7610 Equipment Guide List PG-08-1 Master Construction Specifications PG-08-6 List of Equipment Symbols PG-08-10 Design Manuals PG-08-14 Room Finish and Door Hardware Schedule Consensus information from SPD Chiefs of various VA Medical Centers. Distribution Programs Division
The Design Guide refers to the above mentioned sources when data is either too detailed or too broad to be included in this guide.
Page 1-3
Abbreviations
A.................... Amperes AC/HR ........... Air Changes Per Hour ADA............... Americans with Disabilities Act AFF ............... Above Finished Floor AI................... Acquisition and Installation A&MM............ Acquisition and Materiel Management AR ................. As Required AT.................. Acoustical Ceiling Tile C.................... Degrees Celcius CC ................. Contractor Furnished and Installed Construction Funds for Equipment and Installation CF ................. Construction Funds For VA Furnishing of Equipment and/or Installation CFM............... Cubic Feet per Minute CLG............... Ceiling CM................. Office of Construction Management CMU .............. Concrete Masonry Unit CP ................. Carpet (without cushion broadloom) CS ................. Construction Standard CT ................. Ceramic Tile DISC SW ....... Disconnect Switch EtO ................ Ethylene Oxide Gas EXH .............. Exhaust F .................... Degrees Fahrenheit FC ................. Foot-candle FD ................. Floor Drain FIXT .............. Fixture FLUOR .......... Fluorescent GFI................ Ground Fault Interrupter GWB ............. Gypsum Wallboard HAC .............. Housekeeping Aids Closet HVAC ............ Heating, Ventilation, and Air Conditioning HP................. Horsepower HR................. Hour ICU................ Intensive Care Unit KW ................ Kilowatt LB ................. Pound/Pounds LLTS ............. Lounge, Lockers, Toilets, and Showers MCS .............. Master Construction Specifications MTD .............. Mounted NA................. Not Procured with Activation Funds NFPA ............ National Fire Protection Association NSF............... Net Square Feet NSM .............. Net Square Meters OSD .............. Open Site Drain PCP .............. Portland Cement Plaster PH................. Phase PL ................. Plaster PREP ............ Preparation PSIG ............. Pounds per Square Inch Gauge QT................. Quarry Tile RB................. Resilient Base SC................. Special Coating (High Build Glazed Coating) SD................. Standard Detail SF ................. Square Feet, Square Foot
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Page 1-6
Section 2 Narrative
Page Narrative............................................ 2 - 1
Contents - Section 2
Narrative
Mission
Supply, Processing, and Distribution (SPD) is organizationally aligned under Acquisition and Materiel Management Service. The mission of SPD is to provide a steady flow of patient care supplies and equipment to points of need, and to return contaminated items to a central decontamination area. The accomplishment of this mission requires quick and efficient service to all departments dependent on SPD for indirect patient care. SPD is the first line of defense against harmful microorganisms. Contamination prevention is achieved by closely monitoring the following elements: of SPD, the Hospital Administrative Officer, and the VA Central Office during the design phases. In each instance, the reviews must thoroughly examine the plans. Planning changes and design errors must be addressed as early as possible to avoid costly change orders during construction.
Air Flow: To minimize microorganism movement from dirty to clean areas. In clean areas there is a positive air flow. Staff Flow: Personnel work either on the clean side or the dirty side of the SPD unit to avoid cross contamination. Work Flow: Refers to the movement of clean (sterile) supplies and the return of contaminated items for decontamination and sterilization.
Communication
The single most frequent source of user dissatisfaction during both the design and construction phases is failure of communication and interaction among parties with an interest in and responsibility for the project. The Office of Construction Management selects the architect/engineer (A/E) with VA medical center representation on the Selection Board. The A/E bases the design on VA criteria. Costs are fixed at the end of design development; therefore, extensive changes must be avoided beyond this point. Plans should be reviewed by the Chief of Acquisition and Materiel Management, the Chief
Trends In SPD
One trend impacting SPD is the increasing complexity of many surgical procedures such as laparoscopy, endoscopy, laser, micro vascular, and more complex surgeries. SPD's role has become more technical in nature, by the
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Architectural Aspects
Separation of soiled areas from sterile areas Restricted areas Containment area for EtO gas Heating, ventilation, and air conditioning (HVAC Systems) Room relationships (regarding function and staff utilization) Modularity of design/flexibility Interior surfaces and finishes
Location
Many architectural considerations play a role in deciding the ideal location for SPD. In order for SPD to provide fast and efficient service, it must be located in an area which will facilitate the delivery of supplies throughout the medical center in a minimum amount of time. In addition to issuing supplies and equipment, SPD receives soiled reusables back for reprocessing to complete the cycle. SPD accepts fresh supplies to store, issue, and inventory, as well as issue replacements for damaged, useless items. If SPD is not adjacent to the hospital warehouse and loading dock, a simplified route from these areas must be carefully planned. Easy accessibility to SPD is key and is determined by the materials handling system within the facility. Halls, ramps, and elevators of sufficient capacity need to accommodate carts used to distribute supplies. SPD should be located where some degree of high speed automation of delivery (direct line cart lift, conveyor, dumbwaiter, tube system) can be maintained where emergency situations most commonly occur (operating rooms, recovery, and intensive care units). It is important that SPD have two separate and dedicated cart lifts or dumbwaiters (one for soiled and one for clean) to transport patient care items.
Environmental Requirements
The processing of medical and surgical equipment, linens, and case carts requires
Sufficient amount of floor space for parking returned soiled carts adjacent to sorting work stations is important to achieve efficient work flow. Space for cart queuing is determined using verified workload figures. The cart and equipment wash area must be immediately adjacent and interconnected to the soiled receiving and decontamination area.
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Work stations and equipment for cleaning soiled items must be located in a manner to facilitate unidirectional flow of work towards the clean side of SPD. The decontamination area is totally separated from the clean area and its staff is confined to this space; therefore, the staff must be provided with its own lounge, lockers, toilets, and shower facilities (LLTS). Space for this function is determined by staffing and workload projections on a project by project basis. If an automatic cart wash is required, an additional 5 NSM (53.8 NSF) is required for the integrated drying chamber. In the Preparation, Assembly & Sterilization Area sufficient space must be provided in front of the sterilizers for loading and unloading the sterilizer carriages and for cooling after the sterilization cycle. The EtO sterilizers/aerators, should be in an enclosed room inside the Preparation, Assembly & Sterilization Area. Loading/unloading zone access to the sterilizers must be included in this room. SPD). The instruments are thoroughly inspected, assembled, packaged, and sterilized (using the appropriate sterilizer; either steam or EtO gas), and then stored in the Sterile/Nonsterile Storage Room adjacent to the Preparation, Assembly & Sterilization Area for future use. Refer to Section 3, Room Relationship Diagrams for examples of suggested room relationships, recognizing however, that the needs of individual healthcare facilities may determine deviations from the diagrams.
Clean Receiving and Breakout Area: This is where supplies enter the SPD from the clean side of the loading dock and are removed from their shipping containers prior to entry into the clean/sterile storage area. Bulk Storage Area: Incoming containers that remain sealed are stored temporarily in the Bulk Storage Area. Clean/Sterile Storage Area: Supplies are stored here prior to being delivered to users. These items consist of reusables and disposables, and may already be sterilized or awaiting sterilization. Receiving, Cleaning, and Decontamination Area: Contaminated reusable instruments and supplies are received, sorted, cleaned, decontaminated, and presterilized in this area. The room must be physically separated from the other SPD areas. This area should be provided with direct access to locker, lounge, toilet, and shower facilities where personnel assigned to this area can change clothing before entering/exiting. Manual Equipment Wash Area: Equipment and carts are decontaminated in the manual equipment wash area. Automatic Cart Wash Area: This area houses a cart washer that must have drying capabilities.
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Preparation, Assembly & Sterilization Area: Decontaminated, clean instruments and other reusable medical devices are inspected, assembled onto trays and sets, and wrapped or packaged for terminal sterilization. Linen Processing Area: Clean reusable linens are inspected, patched, folded, and assembled into packs. This area is to be provided only if the function is not delegated to Environmental Management Service, Laundry Division. Equipment Testing and Storage Area: Clean medical equipment is tested and stored here until issued. This area must be located so as not to interfere with the work flow traffic of the clean/sterile storage area. Dispatch Area: Control of receiving and issuing of supplies and equipment is maintained at the Dispatcher's Control Station. Volunteers Work Area and Technician Training Room: This dual purpose room serves as a working space for SPD volunteers, as well as a retraining area for SPD technicians, and new equipment demonstrations. Housekeeping Aids Closet: Cleaning supplies need to be maintained in dedicated closets; one for the decontamination area, and another for the clean areas. Administrative Area: This area contains office space for the Chief of SPD, supervisors, and clerical staff. specialists in order to accommodate sterilizing equipment specified for the project. Any request for deviation from HVAC design criteria must be approved by the VA and occur no later than the design development stage. The following represents the highlights of the mechanical system design for SPD. Refer to the VA HVAC Design Manual for further design requirements.
HVAC System
The entire SPD area should be under negative pressure with respect to adjoining areas. See the HVAC Design Manual for Hospital Projects for additional requirements. A dedicated 100% outside air handling unit with constant volume reheat should be provided for SPD to serve each of the following areas:
Soiled Receiving and Decontamination Room (Negative Air Pressure) Preparation, Assembly & Sterilization Area (Positive Air Pressure) EtO Gas Enclosure (Negative Air Pressure) Steam Sterilizer Enclosure (Negative Air Pressure) Preparation and Inspection of Surgical Linens and Packs (Positive Air Pressure) Sterile/Nonsterile Pressure) Storage (Positive Air
Separate dedicated exhaust systems should be provided for each of the following spaces:
EtO Sterilizers Cart and Manual Equipment Wash General Exhaust of entire SPD suite, including steam sterilizers.
Engineering Considerations
Mechanical (Heating, Ventilating, and Air Conditioning)
An adequate heating and ventilating and air conditioning (HVAC) system is a critical element in planning for SPD and requires careful evaluation. The mechanical engineer should coordinate with the architect and equipment
Since air is a very good carrier of contaminating agents, air in the Soiled Receiving and Decontamination unit should never mix with air in the Preparation and Inspection unit. It is imperative that the soiled areas have a negative air pressure and the clean areas have a positive air pressure. Conditioned air should be supplied to all SPD areas at a minimum rate of 10 air changes per hour (10 AC/HR).
Page 2-4
Lighting
Lighting in SPD is dependent on the functions associated with the various rooms. Lighting should be uniform, automatic, and individually controlled to ensure consistency. Task lighting is needed where specific tasks are performed. Separate switches should be used so that during off hours task lighting may be turned off. Furthermore, lights in the Preparation and Sterilization area and in the Soiled Receiving and Decontamination area should be recessed to facilitate cleaning. Light fixtures in the Auto Cart Wash and the Manual Equipment Wash should be waterproof, and surface mounted. Dust and moisture resistant fixtures must be used where humid conditions are present.
Utilities
When SPD is located on the ground floor, some experience problems with wet packs in their steam loads. It has been determined that this is due to steam pipes feeding from above the sterilizers. It is advisable that steam pipes should enter from below the sterilizer.
Electrical
SPD processes pumps, monitors, and other electronic devices that are used in patient care. These devices are rechargeable and must be calibrated in the Equipment Testing and Storage Area. A sufficient amount of power strips must be provided to handle the amount of electronic equipment brought down to SPD. Computer (ADP) outlets should be installed in the Administrative Offices, Computer Room, and the Dispatch Area for use of the computers. Refer to the VA Electrical Design Manual and H08-4, Vol. 4, for further information.
Page 2-5
Sanitation Equipment
Frequent and thorough cleaning of shelves and room surfaces is essential to prevent build up of dust and unwanted particles which may contaminate medical and surgical supplies. Room walls are manually scrubbed with either a detergent and/or disinfectant. Thus, to facilitate cleaning, walls are typically treated with a smooth finish. Floors in the Soiled Receiving and Decontamination room may be damp mopped or cleaned with an electric floor scrubber. In the Sterile/Nonsterile storage room however, cleaning with a damp mop will suffice. Generally, storage shelves in the Sterile/ Nonsterile storage room are kept 200 to 250 mm (8 to 10 inches) above the floor to facilitate cleaning. The Manual Equipment Wash Area, because of its function, is an enclosed room and accessible by a pair of swinging doors at either end. A high pressure sprayer is to be used in cleaning equipment in this area.
Page 2-6
Washer/Sterilizer
After the instruments have undergone ultrasonic cleaning, they are placed into the washer/sterilizer. The instruments are washed a second time before final sterilization. Again it should be noted that after the secondary wash cycle, the instruments are decontaminated, but not sterilized. It is at this point that the instruments can now be sterilized in the washer/ sterilizer. The difference between a washer/ sterilizer and a typical sterilizer is that the washer/ sterilizer is for decontaminating as well as terminal sterilization. The steam sterilizer is solely for terminal sterilization.
Sterilizers (Steam)
After surgical instruments and utensils are cleaned, either manually or through a sonic cleaner, they are decontaminated, but not sterile. Steam is often used as a sterilizing agent because it is the most effective and efficient way of sterilizing equipment.
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Page 2-8
Contents - Section 3
Contents - Section 4
Power
General Emergency 2000 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: YES Telephone Intercom YES -
Public Address -
VV CC
1 AR
Power
General Emergency 2000 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: YES Telephone Intercom YES -
Public Address -
VV CC
1 AR
Power
General Emergency 2000 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: YES Telephone Intercom YES -
Public Address -
VV CC
AR AR
ELECTRICAL
Lighting
General Special Notes: 30 FC - 2 W/SF -
Power
General Emergency 400 W -
COMMUNICATIONS
ADP Radio Notes: Telephone Intercom -
Public Address -
Equipment Guide List Lockers, Toilet, & Shower Room (Soiled Area)
SYMBOL AI A QUANTITY B C D LOCKERS, LOUNGE, TOILET AND SHOWER FACILITIES - MALE NOTE: CONTIGUOUS TO SOILED RECEIVING AND DECONTAMINATION AREA. T-B P-415 CC CC CC AR 1 1 2 2 2 2 1 1 LOCKER, STEEL, SLOPING TOP, 12"W X 21"D X 72"H (PG-08-1, MCS 10500; H-08-4, SD 61) LAVATORY, STRAIGHT BACK (PG-08-1, MCS 15450; H08-4, SD 53) MIRROR, 406 MM X 508 MM (16" X 20"), WITH INTEGRAL SHELF, OVER LAVATORY (PG-08-1, MCS 10800; H-08-4, SD 15) DISPENSER, SOAP, LIQUID, WALL MOUNTED DISPENSER, PAPER TOWEL AND DISPOSAL COMBINATION UNITS (PG-08-1, MCS 10800) RECEPTACLE, ELECTRICAL, DUPLEX, 120 VOLT, 20 AMP, WITH GROUND FAULT INTERRUPTER, ADJACENT TO LAVATORY (PG-08-1, MCS 16140; H-08-3, CS 801-3) WHEELCHAIR WATER CLOSETS WILL BE IN ACCORDANCE WITH THE APPROPRIATE SPACE PROGRAM, P-103 WILL BE USED FOR BOTH CONVENTIONAL AND WHEELCHAIR INSTALLATIONS. P-103 CC CC CC CC P-201 CC CC P-702 CC 1 1 1 1 1 1 1 WATER CLOSET, WALL HUNG (PG-08-1, MCS 15450; H08-4, SD 4) ENCLOSURE, TOILET, CEILING HUNG (PG-08-1, MCS 10162; H-08-3, CD 13; H-08-4, SD 12) BAR, GRAB FOR WATER CLOSET (PG-08-1, MCS 10800; H-08-4, SD 12, 14B & 14F) DISPENSER, TOILET TISSUE, DOUBLE ROLL (PG-08-1, MCS 10800; H-08-4, SD 12) URINAL, WALL HUNG (PG-08-1, MCS 15450; H-08-4, SD 4) STALL, SHOWER (PG-08-1, MCS 10170; H-08-4, SD 13A) SHOWER, BATH FIXTURE, WALL MOUNTED, CONCEALED SUPPLIES (PG-08-1, MCS 15450; H-08-4, SD 13A) ROD, CURTAIN, TUB OR SHOWER (PG-08-1, MCS 10800) DISH, SOAP, SURFACE MOUNTED (PG-08-1, MCS 10800) 2 2 1 HOOK, TOWEL (PG-08-1, MCS 10800) HOOK, CLOTHES (PG-08-1, MCS 10800) HAMPER, SOILED LINEN, WITH HINGED SELF CLOSING TOP, 20" DIA. RECEPTACLE, WASTE, WITH SWINGING TOP, 16" X 16" DESCRIPTION
VV CC CC
1 1 1
2 2 2
2 2 2
1 1 1
CC CC CC CC VV VV
1 1 1 1 1 1
Equipment Guide List Lockers, Toilet, & Shower Room (Soiled Area)
SYMBOL AI A QUANTITY B C D LOCKERS, LOUNGE, TOILET AND SHOWER FACILITIES FEMALE NOTE: CONTIGUOUS TO SOILED RECEIVING AND DECONTAMINATION AREA. T-B P-415 CC CC CC AR 1 1 2 2 2 2 1 1 LOCKER, STEEL, SLOPING TOP, 12"W X 21"D X 72"H (PG-08-1, MCS 10500; H-08-4, SD 61) LAVATORY, STRAIGHT BACK (PG-08-1, MCS 15450; H08-4, SD 53) MIRROR, 406 MM X 508 MM (16" X 20"), WITH INTEGRAL SHELF, OVER LAVATORY (PG-08-1, MCS 10800; H-08-4, SD 15) DISPENSER, SOAP, LIQUID, WALL MOUNTED DISPENSER, PAPER TOWEL AND DISPOSAL COMBINATION UNITS (PG-08-1, MCS 10800) RECEPTACLE, ELECTRICAL, DUPLEX, 120 VOLT, 20 AMP, WITH GROUND FAULT INTERRUPTER, ADJACENT TO LAVATORY (PG-08-1, MCS 16140; H-08-3, CS 801-3) WHEELCHAIR WATER CLOSETS WILL BE IN ACCORDANCE WITH THE APPROPRIATE SPACE PROGRAM, P-103 WILL BE USED FOR BOTH CONVENTIONAL AND WHEELCHAIR INSTALLATIONS. P-103 CC CC CC CC CC P-702 CC 1 1 1 1 1 1 WATER CLOSET, WALL HUNG (PG-08-1, MCS 15450; H08-4, SD 4) ENCLOSURE, TOILET, CEILING HUNG (PG-08-1, MCS 10162; H-08-3, CD 13; H-08-4, SD 12) BAR, GRAB FOR WATER CLOSET (PG-08-1, MCS 10800; H-08-4, SD 12, 14B & 14F) DISPENSER, TOILET TISSUE, DOUBLE ROLL (PG-08-1, MCS 10800; H-08-4, SD 12) STALL, SHOWER (PG-08-1, MCS 10170; H-08-4, SD 13A) SHOWER, BATH FIXTURE, WALL MOUNTED, CONCEALED SUPPLIES (PG-08-1, MCS 15450; H-08-4, SD 13A) ROD, CURTAIN, TUB OR SHOWER (PG-08-1, MCS 10800) DISH, SOAP, SURFACE MOUNTED (PG-08-1, MCS 10800) 2 2 1 HOOK, TOWEL (PG-08-1, MCS 10800) HOOK, CLOTHES (PG-08-1, MCS 10800) HAMPER, SOILED LINEN, WITH HINGED SELF CLOSING TOP, 20" DIA. RECEPTACLE, WASTE, WITH SWINGING TOP, 16" X 16" DESCRIPTION
VV CC CC
1 1 1
2 2 2
2 2 2
1 1 1
CC CC CC CC VV VV
1 1 1 1 1 1
ELECTRICAL
Lighting
General Special Notes: 30 FC - 2 W/SF -
Power
General Emergency 400 W -
COMMUNICATIONS
ADP Radio Notes: Telephone Intercom -
Public Address -
Equipment Guide List Lockers, Toilet, & Shower Room (Clean Area)
SYMBOL AI A QUANTITY B C D LOCKERS, LOUNGE, TOILET AND SHOWER FACILITIES FEMALE NOTE: CONTIGUOUS TO SOILED RECEIVING AND DECONTAMINATION AREA. T-B P-415 CC CC CC AR 1 1 2 2 2 2 1 1 LOCKER, STEEL, SLOPING TOP, 12"W X 21"D X 72"H (PG-08-1, MCS 10500; H-08-4, SD 61) LAVATORY, STRAIGHT BACK (PG-08-1, MCS 15450; H08-4, SD 53) MIRROR, 406 MM X 508 MM (16" X 20"), WITH INTEGRAL SHELF, OVER LAVATORY (PG-08-1, MCS 10800; H-08-4, SD 15) DISPENSER, SOAP, LIQUID, WALL MOUNTED DISPENSER, PAPER TOWEL AND DISPOSAL COMBINATION UNITS (PG-08-1, MCS 10800) RECEPTACLE, ELECTRICAL, DUPLEX, 120 VOLT, 20 AMP, WITH GROUND FAULT INTERRUPTER, ADJACENT TO LAVATORY (PG-08-1, MCS 16140; H-08-3, CS 801-3) WHEELCHAIR WATER CLOSETS WILL BE IN ACCORDANCE WITH THE APPROPRIATE SPACE PROGRAM, P-103 WILL BE USED FOR BOTH CONVENTIONAL AND WHEELCHAIR INSTALLATIONS. P-103 CC CC CC CC CC P-702 CC 1 1 1 1 1 1 WATER CLOSET, WALL HUNG (PG-08-1, MCS 15450; H08-4, SD 4) ENCLOSURE, TOILET, CEILING HUNG (PG-08-1, MCS 10162; H-08-3, CD 13; H-08-4, SD 12) BAR, GRAB FOR WATER CLOSET (PG-08-1, MCS 10800; H-08-4, SD 12, 14B & 14F) DISPENSER, TOILET TISSUE, DOUBLE ROLL (PG-08-1, MCS 10800; H-08-4, SD 12) STALL, SHOWER (PG-08-1, MCS 10170; H-08-4, SD 13A) SHOWER, BATH FIXTURE, WALL MOUNTED, CONCEALED SUPPLIES (PG-08-1, MCS 15450; H-08-4, SD 13A) ROD, CURTAIN, TUB OR SHOWER (PG-08-1, MCS 10800) DISH, SOAP, SURFACE MOUNTED (PG-08-1, MCS 10800) 2 2 1 HOOK, TOWEL (PG-08-1, MCS 10800) HOOK, CLOTHES (PG-08-1, MCS 10800) HAMPER, SOILED LINEN, WITH HINGED SELF CLOSING TOP, 20" DIA. RECEPTACLE, WASTE, WITH SWINGING TOP, 16" X 16" DESCRIPTION
VV CC CC
1 1 1
2 2 2
2 2 2
1 1 1
CC CC CC CC VV VV
1 1 1 1 1 1
ELECTRICAL
Lighting
General Special Notes: 30 FC - 2 W/SF -
Power
General Emergency 400 W -
COMMUNICATIONS
ADP Radio Notes: Telephone Intercom -
Public Address -
Equipment Guide List Lockers, Toilet, & Shower Room (Clean Area)
SYMBOL AI A QUANTITY B C D LOCKERS, LOUNGE, TOILET AND SHOWER FACILITIES - MALE NOTE: CONTIGUOUS TO SOILED RECEIVING AND DECONTAMINATION AREA. T-B P-415 CC CC CC AR 1 1 2 2 2 2 1 1 LOCKER, STEEL, SLOPING TOP, 12"W X 21"D X 72"H (PG-08-1, MCS 10500; H-08-4, SD 61) LAVATORY, STRAIGHT BACK (PG-08-1, MCS 15450; H08-4, SD 53) MIRROR, 406 MM X 508 MM (16" X 20"), WITH INTEGRAL SHELF, OVER LAVATORY (PG-08-1, MCS 10800; H-08-4, SD 15) DISPENSER, SOAP, LIQUID, WALL MOUNTED DISPENSER, PAPER TOWEL AND DISPOSAL COMBINATION UNITS (PG-08-1, MCS 10800) RECEPTACLE, ELECTRICAL, DUPLEX, 120 VOLT, 20 AMP, WITH GROUND FAULT INTERRUPTER, ADJACENT TO LAVATORY (PG-08-1, MCS 16140; H-08-3, CS 801-3) WHEELCHAIR WATER CLOSETS WILL BE IN ACCORDANCE WITH THE APPROPRIATE SPACE PROGRAM, P-103 WILL BE USED FOR BOTH CONVENTIONAL AND WHEELCHAIR INSTALLATIONS. P-103 CC CC CC CC P-201 CC CC P-702 CC 1 1 1 1 1 1 1 WATER CLOSET, WALL HUNG (PG-08-1, MCS 15450; H08-4, SD 4) ENCLOSURE, TOILET, CEILING HUNG (PG-08-1, MCS 10162; H-08-3, CD 13; H-08-4, SD 12) BAR, GRAB FOR WATER CLOSET (PG-08-1, MCS 10800; H-08-4, SD 12, 14B & 14F) DISPENSER, TOILET TISSUE, DOUBLE ROLL (PG-08-1, MCS 10800; H-08-4, SD 12) URINAL, WALL HUNG (PG-08-1, MCS 15450; H-08-4, SD 4) STALL, SHOWER (PG-08-1, MCS 10170; H-08-4, SD 13A) SHOWER, BATH FIXTURE, WALL MOUNTED, CONCEALED SUPPLIES (PG-08-1, MCS 15450; H-08-4, SD 13A) ROD, CURTAIN, TUB OR SHOWER (PG-08-1, MCS 10800) DISH, SOAP, SURFACE MOUNTED (PG-08-1, MCS 10800) 2 2 1 HOOK, TOWEL (PG-08-1, MCS 10800) HOOK, CLOTHES (PG-08-1, MCS 10800) HAMPER, SOILED LINEN, WITH HINGED SELF CLOSING TOP, 20" DIA. RECEPTACLE, WASTE, WITH SWINGING TOP, 16" X 16" DESCRIPTION
VV CC CC
1 1 1
2 2 2
2 2 2
1 1 1
CC CC CC CC VV VV
1 1 1 1 1 1
Section 5 Design Guide Plates and Data Sheets: Areas Specific to SPD
Guide Plate Series 5 - 1 .......Soiled Receiving & Decontamination Area Equipment & Utility Plan Design Standards Equipment Guide List 5 - 2 .......Preparation, Assembly & Sterilization Area Equipment & Utility Plan Design Standards Equipment Guide List 5 - 3 .......EtO Sterilizer/Aerator Room Equipment & Utility Plan Design Standards Equipment Guide List Guide Plate Series 5 - 4 ....... Manual Equipment Wash Area Equipment & Utility Plan Design Standards Equipment Guide List 5 - 5 ....... Equipment Storage & Testing Room Equipment & Utility Plan Design Standards Equipment Guide List 5 - 6 ....... Dispatcher's Control Station Equipment & Utility Plan Design Standards Equipment Guide List
Contents - Section 5
SPECIAL EQUIPMENT
VS-503: WASHER/STERILIZER VS-210: STEAM STERILIZERS HW-546: AUTOMATIC CART WASH
ELECTRICAL
Lighting
General Special 30 FC - 2 W/SF -
Power
General Emergency * *
Notes: *VS-210: POWER DOOR - 15A, 120V; CONTROL - 1.0A, 120V *VS-503: CONTROL - 10A, 120V; PUMP - 10A, 208V, 3 PH; *COMPRESSOR - 3/4 HP, 208V, 3 PH *HW-546: 20A, 480V, 3PH, 3 WIRE
COMMUNICATIONS
ADP Radio Notes: **CONNECT TO HOSPITAL SYSTEM YES** Telephone Intercom EMPTY CONDUIT
Public Address -
***VS EQUIP: SEE PG-08-6 FOR STEAM, HEAT GAIN, EXHAUST CAPACITY
S-2
CF
VL20
CC
CC VL86 CC CC VV
1 1 1 AR
CC VS-504 CC
1 1
VV
VC CC
1 AR
AR
CC
AR
VS-508
CC
AR
CC
AR
CC
AR
CC
AR
CC
AR
VV
CC CC VV
1 1 1
CC
AR
SYMBOL
AI A
QUANTITY B C D
DESCRIPTION
Slab Depression -
Power
General Emergency 1800 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: YES Telephone Intercom EMPTY CONDUIT
Public Address -
VS-351
CC
VS-325
CC
VC
VS-360
CC
AR
VV
CC
AR
CC
AR
CC
AR
VV CC CC VV CC
1 1 1 1 AR
SPECIAL EQUIPMENT
VS-325: ETO STERILIZER VS-360: ETO DISPOSER SYSTEM
ELECTRICAL
Lighting
General Special Notes: *LOBBY **SERVICE AREA ***VS-325: POWER DOOR - 17A, 120V; CONTROL - 3A, 120V; ***VACUUM PUMP - 8A, 208V, 3 PH; RECEPTACLES: 800 W VS-360: 40A, 208V, 3 PH 50 FC - 3 W/SF* 30 FC-2 W/SF**
Power
General Emergency *** ***
COMMUNICATIONS
ADP Radio Telephone Intercom -
Public Address -
NOTE: PROVIDE EMERGENCY POWER SYSTEM FOR THE ETO STERILIZER/AERATOR, ETO EXHAUST AND ETO MONITORING EQUIPMENT. VC 1 AERATOR, FOR 100% ETHYLENE OXIDE GAS STERILIZER, SINGLE DOOR, RECESSED THROUGH ONE WALL OR FREE STANDING UNIT, FOR RECESSED UNIT PROVIDE MOUNTING RACK, FOR FREE STANDING UNIT PROVIDE STACKING RACK, PROVIDE ELECTRIC AND EXHAUST AS REQUIRED ENCLOSURE PLENUM, CRS, BETWEEN TOP OF AERATOR AND CEILING, PROVIDE EXHAUST LOUVER IN PLENUM ENCLOSURE PANEL ABOVE DOOR (PG-08-1, MCS 11710) STERILIZER/AERATOR, ETHYLENE OXIDE GAS, SINGLE DOOR, RECESSED THROUGH ONE OR TWO WALLS, (CHAMBER SIZE: 24" X 36" X 48"/24 CU. FT.), PROVIDE STEAM, WATER, DRAIN, ELECTRIC AND EXHAUST AS REQUIRED (PG-08-1 & PG-08-6, MCS 11710) STERILIZER/AERATOR, 100% ETHYLENE OXIDE GAS, SINGLE DOOR, RECESSED THROUGH ONE WALL OR FREE STANDING UNIT, FOR RECESSED UNITS PROVIDE MOUNTING RACK, FOR FREE STANDING UNIT PROVIDE STACKING RACK, PROVIDE COMPRESSED AIR, ELECTRIC AND EXHAUST AS REQUIRED ETHYLENE OXIDE DISPOSER SYSTEM, 838 MM X 889 MM X 2083 MM (33" X 35" X 82"), PROVIDE ELECTRIC AND EXHAUST AS REQUIRED (PG-08-1 & PG-08-6, MCS 11710) CONTINUOUS MONITORING DEVICE, ETHYLENE OXIDE GAS WITH ADDITIONAL SENSORS/ALARMS, ETO SPECIFIC TO .01 PARTS-PER-MILLION NOTE: PROVIDE ONE EMISSION CONTROL DEVICE FOR NO MORE THAN TWO ETO STERILIZERS CC AR MODULAR WALL, ENCLOSURE PANELS, CRS, FROM FLOOR TO FINISHED CEILING, WITH EXHAUST LOUVER IN MODULAR PANEL ABOVE DOORS OF STERILIZERS (PG-08-1 & PG-08-6, MCS 11710) CART, LOADING, FOR USE WITH STERILIZER/AERATOR, CHAMBER SIZES: 610 MM X 914 MM X 1219 MM/1524 MM (24" X 36" X 48"/60") (PG-08-1, MCS 11710) CARRIAGE, TRANSFER, FOR USE WITH STERILIZER/ AERATOR, CHAMBER SIZES: 610 MM X 914 MM X 1219 MM/1524 MM (24" X 36" X 48"/60") (PG-08-1, MCS 11710)
CC
AR
VS-325
CC
VC
VS-360
CC
AR
VV
CC
AR
CC
AR
ELECTRICAL
Lighting
General Special 50 FC - 3 W/SF -
Power
General Emergency 800 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: Telephone Intercom -
Public Address -
CC CC CC VV
1 1 1 1
P-505
CC VV
1 1
Power
General Emergency 2000 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: Telephone Intercom YES -
Public Address -
VV
AR
CC CC CC P-418 CC VV VV CC VV VV VV VV CC
1 1 1 1 1 AR 1 1 1 AR 1 AR
Power
General Emergency 2000 W RECEPTACLES -
COMMUNICATIONS
ADP Radio Notes: *CONNECT TO HOSPITAL SYSTEM Telephone Intercom EMPTY CONDUIT
VV CC
1 1
VV VV CC CC VV VV VV CC
AR AR 1 1 1 1 1 1
VV CC
1 AR
Contents - Section 6
Clean Areas
Preparation Area: Minimum 18.6 NSM (200 NSF), Add 12.3 NSM (132 NSF) for each additional sterilizer, Maximum 46.5 NSM (500 NSF) As in the decontamination area, space is based on the number of sterilizers needed to process reusable supplies and equipment. The minimum of 18.6 NSM (200 NSF), will provide space for loading zone/access to 3 pass-through sterilizers (1 washer/ sterilizer/ sanitizer, 1 steam, and one EtO gas sterilizer) and an ultrasonic washer and sink. Ethylene Oxide Gas Cylinder Storage: 2.8 NSM (30 NSF) If all 100% EtO sterilizers (which use a cartridge), are to be used, space for cylinder storage is unnecessary. Sterile/Clean Storage Area: Minimum 22.3 NSM (240 NSF) Maximum 46.5 NSM (500 NSF) Total annual SOPC visits (not including psychiatric visits) x .0035 + 200 Clean Receiving and Bulk Storage Area: 7.4 NSM (80 NSF) This space is provided for receipt, breakdown, and temporary holding of bulk sterile/clean supplies. Dispatch Area: The issuing and control of medical-surgical supplies and equipment is accomplished in this area. A visual register (quantity and location) of issued supplies and equipment is maintained in the Dispatcher's Control Station/Office. Space for this area should be computed as follows: A) Sterile/Clean Area x 0.1 PLUS B) Dispatcher's NSM (70 NSF) Control Station/Office: 6.5
Soiled Receiving
Decontamination Area: Minimum 18.6 NSM (200 NSF), 12.3 NSM (132 NSF) each additional sterilizers; Max. 46.5 NSM (500 NSF) Space in this area is based on the number of sterilizers required to process reusable supplies and equipment. The minimum of 18.6 NSM (200 NSF) provides space for loading zone/access to 3 passthrough sterilizers (1 washer/ sterilizer/ sanitizer, 1 steam, and 1 ethylene oxide [EtO] sterilizer) and 1 ultrasonic washer and sink. Manual Equipment Wash: 7.4 NSM (80 NSF) This room is used to decontaminate carts and equipment used in delivery of patient care. Housekeeping Aids Closet: 3.7 NSM (40 NSF) For safety reasons this HAC will be used only for the decontamination area. Locker, Toilet, Shower: 7.4 NSM (80 NSF). Space provided will accommodate two lockers and a bench (2.3 NSM, 25 NSF), toilet with lavatory and water closet (2.8 NSM, 30 NSF), and a shower at 2.3 NSM
Page 6-1
Equipment Storage and Testing Room: Maximum 7.4 NSM (80 NSF) Equipment, after decontamination, is tested and stored in this room. This equipment is used for patient care and is assigned and stored in SPD as opposed to equipment used in patient care that is permanently assigned to other areas. This area will also, accommodate SPD and Surgical case carts. Housekeeping Aids Closet: 3.7 NSM (40 NSF) A separate HAC for the clean area is not needed if another one (in addition to the one in the decontamination area) is located in the immediate area.
Page 6-2
Section 7 Miscellaneous
Page Glossary of Terms............................. 7 - 1 Example Layout for SPD ................... 7 - 3
Contents - Section 7
GLOSSARY OF TERMS
AERATOR: A machine designed to speed up the removal of EtO residues from sterilized items by subjecting them to warm, circulating air. BIOBURDEN: The number and types of viable microorganisms with which an item is contaminated. When measured, bioburden is expressed as the total count of bacterial and fungi colony-forming units per single item. CENTRAL SERVICE: A department in the hospital that provides supplies and equipment to patients and medical staff. Another name for SPD. CLEANING: The physical removal of debris. It has two major effects. First, it results in a reduction in the number of microorganisms present. Second, it removes organic matter, such as blood and tissue, and other debris, which may interfere with sterilization or disinfection. DECONTAMINATION: The process of rendering contaminated items safe for handling. DISINFECTION: A process that destroys most forms of microorganisms on inanimate surfaces. The three levels of disinfection are high-level, intermediate-level and lowlevel. ETHYLENE OXIDE GAS STERILIZER (EtO): Sterilization at relatively low temperatures possible with ethylene oxide gas. Using a heated unit at 49C (120F), sterilization can be achieved in 2 - 3 hours. PRIMARY STOCK: Medical supplies stored within the confines of the SPD Department SECONDARY STOCK: Medical supplies stored in user areas such as wards, clinics, nursing care units, and intensive care units. STERILIZATION: The process which destroys all types and forms of microorganisms, including viruses, bacteria, fungi, and bacterial endospores.
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