Evaluation standard of on-site disinfection of epidemic situation in COVID-19

Mainly transform hotels, schools, etc. As a temporary special place for close contacts under medical observation.

Technical requirements for health protection of temporary special places for medical observation and treatment during the epidemic in COVID-19.

1 range

This standard specifies the general requirements, disinfection measures, personal protection and health management of temporary special places for medical observation and treatment during the epidemic in COVID-19.

This standard is applicable to indoor gymnasiums, exhibition halls, hotels, schools and other temporary special places. During the epidemic period in COVID-19, such as the treatment of mild patients with neocoronary pneumonia, isolation of suspected patients, medical observation of close contacts, etc.

2 normative reference documents

The following documents are essential for the application of this document. For all dated reference documents, only the dated version is applicable to this document. For undated reference documents, only the latest version (including all revisions) is applicable to this document.

GB5749 Hygienic standard for drinking water

GB 18466 "Discharge Standard of Water Pollutants in Medical Institutions"

GB 19 193 general rules for disinfection of epidemic spots

GB50849 Code for Architectural Design of Infectious Disease Hospitals

WS/T3 1 1 technical specification for hospital isolation

WS/T396 Code for Cleaning and Disinfection of Central Air Conditioning Ventilation System in Public Places

regulations on the management of medical waste

Measures for the Administration of Medical Wastes in Medical and Health Institutions Former Ministry of Health

The former State Environmental Protection Administration's Technical Guide for Hospital Sewage Treatment.

3 Terms and definitions

The following terms and definitions apply to this document.

3. 1

Temporary special place

During the COVID-19 epidemic, it was transformed into a temporary place for treating mild patients, isolating suspected patients and carrying out medical observation on close contacts.

3.2

contaminated area

Areas where mild patients and suspected patients receive medical treatment, as well as temporary storage places and disposal places for articles contaminated by their blood, body fluids, secretions and excreta, including wards, disposal rooms, sewage rooms and treatment rooms for patients entering and leaving hospitals.

3.3

Semi-polluted area

Areas that may be contaminated by patients' blood, body fluids or pathogenic microorganisms are located between clean areas and contaminated areas, including medical staff offices, treatment rooms, nurse stations, inner corridors, articles used by patients and medical equipment treatment rooms.

3.4 Clean the area

Areas that are not easily polluted by patients' blood, body fluids and pathogenic microorganisms, and areas where patients with infectious diseases are prohibited from entering, including duty rooms, bathrooms, toilets and storage rooms for medical staff.

3.5 Dual Channel Dual Channel

Pollution channels and clean channels. Contamination channels include entry and transfer channels for mild patients, suspected patients and close contacts, and clean channels include entry channels for health care workers.

COVID-19 is a temporary special place for treating mild patients.

4. 1 General requirements

4. 1. 1 site selection requirements

4. 1. 1. 1 Mainly transform indoor sports venues and exhibition halls as temporary treatment places (such as receiving hospitals) for mild patients in COVID-19.

4. 1. 1.2 The site selection should try to avoid high-density residential areas, kindergartens, schools and other crowded activity areas.

4. 1. 1.3 A sanitary space of at least 20m shall be set between the site and the surrounding buildings. When the greening conditions are not available, the isolation sanitary distance shall be no less than 30m.

4. 1. 1.4 Set up obvious danger signs on the periphery of the construction site.

4. 1.2 Building requirements

4. 1.2. 1 The buildings in the site should have proper orientation and meet the basic requirements of safety, lighting, sunshine, ventilation and fire control.

4. 1.2.2 Underground space should not be transformed into such temporary special places.

4. 1.3 functional partition

4. 1.3. 1 The site shall be divided into "polluted area, semi-polluted area, clean area" and "polluted passage and clean passage", and the "two passages" shall be completely separated.

4. 1.3.2 Each partition shall be physically isolated and clearly marked.

4. 1.3.3 Set a buffer room between the polluted area and the semi-polluted area.

4. 1.3.4 The sickbed area should be divided into beds and men and women. The number of beds in each area shall not exceed 50, and the spacing between beds shall be greater than1.2m. Each bed shall be equipped with necessary personal daily necessities such as bedding, bedside table, storage box and trash can.

4. 1.4 water supply

Each sickbed area should be provided with a separate drinking water supply point, and tap water and boiled water should be provided. The quality of drinking water should meet the requirements of GB5749.

4. 1.5 ventilation

4. 1.5. 1 The place shall be equipped with mechanical ventilation system. The mechanical air supply and exhaust system in the polluted area, semi-polluted area and clean area in the place should be set independently according to the area to ensure ventilation in the place.

4. 1.5.2 clean air should pass through the clean area first, and then flow to the semi-polluted area and the polluted area.

4. 1.5.3 Natural ventilation or mechanical ventilation should be adopted in narrow spaces such as clean areas.

4. 1.5.4 Natural ventilation should be adopted in polluted and semi-polluted areas; When mechanical ventilation is used in polluted areas, the exhaust air volume should be at least 10% more than the supply air volume.

4. 1.5.5 When the centralized air conditioning system is adopted in the polluted area, the all-air air conditioning system should be operated under the maximum fresh air volume, and the return air should be turned down as much as possible.

4. 1.5.6 weekly cleaning, disinfection or replacement of the cooling tower, air handling unit, air supply outlet, condenser and other operating equipment and components of the central air conditioning system. Technical requirements for cleaning and disinfection shall refer to WS/T396.

4. 1.6 Sewage Treatment

4. 1.6. 1 The drain pipe shall be sealed; The drainage vent pipe should be well ventilated around, and it is not allowed to connect with the exhaust pipe of air conditioning and ventilation system. Drainage requirements shall be in accordance with GB50849.

4. 1.6.2 Sewage and wastewater in each district should be collected separately, and disinfected and biochemically treated. Sewage treatment should be carried out in accordance with GB 19 193 and Technical Guide for Hospital Sewage Treatment, and the treated water quality should meet the requirements of GB 18466.

4. 1.6.3 The wastewater from the temporary toilets and washrooms cannot be directly discharged, but is collected and treated separately from the sewage and wastewater in each district.

4. 1.7 toilet hygiene

4. 1.7. 1 When patients use the temporary toilet, they should take a special passage; Foam sealed mobile toilets are the first choice. Every 20 people in the men's toilet are allocated a squatting position, and every 10 people in the women's toilet are allocated a squatting position. If necessary, it should be appropriately increased according to the actual needs of patients. Temporary toilets should be located in the downwind of the site, more than 200 meters away from the feeding area and water supply point.

4. 1.7.2 The patient excreta and other excreta in the temporary toilet need to be disinfected by dosing or centralized harmless treatment. Arrange special personnel to give medicine and disinfect it twice a day. Arrange special feces removal machinery and equipment to remove the treated feces in time.

4. 1.7.3 The fixed toilets inside and outside the premises are only used by medical personnel.

4. 1.7.4 toilet feces should be strictly managed according to the requirements of infectious disease hospitals, and direct discharge is strictly prohibited. Collect excreta in a special container and discharge it after disinfection. The disinfection method shall be implemented according to GB 19 193.

4. 1.7.5 The toilet should be equipped with hand washing facilities, hand sanitizer (or soap), quick-drying hand disinfectant, non-contact dryer, etc. Stick a "six-step washing method" step diagram near the sink.

4. 1.8 garbage disposal

4. 1.8. 1 The domestic garbage in the clean area should be placed in special garbage bins, and each ward unit should be equipped with special garbage bins, which should be covered with medical waste garbage bags and stamped. Garbage should be cleaned up every day or in time.

4. 1.8.2 the disposal of medical wastes shall comply with the regulations on the management of medical wastes and the measures for the management of medical wastes in medical and health institutions.

4.2 Disinfection measures

4.2. 1 Disinfection of object surface

When there are visible pollutants on the surface of diagnosis and treatment facilities and equipment, as well as bed rails, bedside tables, chairs and doorknobs. Pollutants should be thoroughly removed before disinfection. When there are no visible pollutants, spray, wipe or soak with available chlorine 1000mg/L chlorine-containing disinfectant or 500mg/L chlorine dioxide disinfectant, and rinse with clean water after 30 minutes.

4.2.2 Disinfection of tableware (drinking utensils)

After removing food residues, the tableware should be boiled and disinfected for 30 minutes, or soaked in chlorine-containing disinfectant with available chlorine of 500mg/L for 30 minutes, and then washed with clear water.

4.2.3 Disinfection of pollutants (patient's blood, secretion and vomit)

4.2.3. 1 A small amount of pollutants can be carefully removed by using disposable absorbent materials (such as gauze and rag). ) and chlorine-containing disinfectant with effective chlorine of 5000mg/L ~ 10000mg/L (or disinfectant wet wipes/dry towels that can reach a higher disinfection level).

A large number of pollutants in 4.2.3.2 should be completely covered with disinfectant powder or bleaching powder containing water-absorbing components, or covered with disposable water-absorbing materials, and a sufficient amount of chlorine-containing disinfectant with effective chlorine of 5000 mg/L ~ 10000 mg/L should be poured on the water-absorbing materials for more than 30min (or sterilized dry towels that can reach a high disinfection level) and carefully removed. Avoid contact with pollutants in the cleaning process, and the pollutants after cleaning should be disposed of centrally according to medical waste.

The secretion and vomit of 4.2.3.3 patients were collected in a special container, and soaked in chlorine-containing disinfectant with available chlorine of 20000mg/L for 2 hours according to the ratio of substance to drug 1:2.

After removing pollutants, 4.2.3.4 should disinfect the polluted environment or the surface of objects. Containers containing pollutants can be disinfected with chlorine-containing disinfectant with effective chlorine of 5000mg/L for 30min, and then cleaned.

4.2.4 Disinfection of skin and mucosa

When contam3minated by pollutants for 3 minutes, the pollutants should be removed immediately, and then the disposable absorbent material dipped in 0.5% iodophor or 3% hydrogen peroxide disinfectant should be wiped and disinfected for more than 3 minutes, and then cleaned with clean water; Mucosa should be washed and disinfected with plenty of normal saline or 0.05% iodophor.

Hand hygiene

Personnel involved in field work should strengthen hand hygiene measures. You can choose alcohol-containing quick-drying hand disinfectant or alcohol-compounded quick-drying hand disinfectant, or you can directly wipe and disinfect with 75% ethanol. People who are allergic to alcohol can choose effective non-alcoholic hand disinfectants such as quaternary ammonium salts. Under special circumstances, you can also use 3% hydrogen peroxide disinfectant, 0.5% iodophor or 0.05% chlorine-containing disinfectant to wipe or soak your hands, and extend the disinfection time appropriately. When there are pollutants visible to the naked eye, you should first wash your hands with hand sanitizer under running water, and then disinfect them according to the above method.

Terminal disinfection.

After the temporary special place is terminated, the articles and environment in the place shall be disinfected at the end. See GB 19 193 for specific requirements.

4.3 Personal protection

4.3. 1 Equipped with protective equipment and facilities.

Temporary special places should be equipped with masks, gloves, protective clothing, protective screens or goggles, hand disinfectants and first-aid supplies for medical, cleaning, disinfection and security personnel, and set up places and facilities to put on and take off protective clothing.

Staff protection

4.3.2. 1 Medical personnel should wear work clothes, disposable working caps, disposable gloves, protective clothing, medical protective masks, medical protective screens or goggles, shoe covers, etc. At work.

4.3.2.2 cleaning, disinfection, security and other categories of staff working in temporary special places, should wear overalls, disposable work caps, disposable gloves, protective clothing, medical protective masks or electric air filter respirator, protective screen or goggles, work shoes or rubber boots, waterproof boots, etc.

When working in 4.3.2.3, you should talk less, avoid gathering, and do a good job in hand hygiene.

Patient protection

Wear a mask, avoid close contact and do a good job of hand hygiene.

4.4 Health management

4.4. 1 Strengthening environmental sanitation

The internal and external environment of temporary special places shall be kept clean, and mosquitoes, flies, cockroaches and mice shall not breed.

4.4.2 Keep the canteen clean.

Routine cleaning shall be carried out on the operating table, surfaces and floors of various objects every day, and chlorine-containing disinfectant with effective chlorine of 500mg/L or other effective disinfectants shall be used for disinfection. Disposable tableware should be used for meals, and cold dishes should be avoided.

4.4.3 Ground anti-skid

Anti-skid measures should be taken in temporary special places; If the floor of the corridor, toilet, bathroom, toilet and other areas of the place is not anti-slip, temporary anti-slip mats should be laid.

5. Suspected patients in COVID-19 were isolated in temporary special places.

5. 1 General requirements

5. 1. 1 site selection requirements

Mainly transform community health service centers and township hospitals as isolated places to receive suspected patients in COVID-19.

Refer to 4. 1. 1.2 for site selection requirements.

5. 1.2 functional partition

5. 1.2. 1 The site is divided into "polluted area, semi-polluted area, clean area" and "polluted passage and clean passage", which are operated and used in different regions.

5. 1.2.2 Set a buffer room between the polluted area and the semi-polluted area, and the setting requirements shall be in accordance with WS/T3 1 1.

5. 1.2.3 Suspected patients should be isolated in a single room, and they are not allowed to leave the room without authorization during isolation.

5. 1.3 Ventilation

5. 1.3. 1 Open the window regularly for ventilation, strengthen the air circulation, and make adjustments according to the weather conditions; Or install ventilation equipment to strengthen ventilation. When conditions permit, install circulating air air disinfection machine.

5. 1.3.2 When using air conditioning system, split air conditioning should be selected. When using split air conditioning, open the window for ventilation at regular intervals (ventilation for more than 30 minutes), and the exhaust fan in the bathroom is always on.

5. 1.4 Sewage and feces treatment

There should be a separate septic tank Sewage should be disinfected before entering the municipal drainage pipe network. Chlorine-containing disinfectant is put in regularly, and after disinfection for 1.5h, the total residual chlorine reaches 10mg/L, and the disinfected sewage should meet the requirements of GB 18466.

If there is no separate septic tank, use a special container to collect excrement, and then discharge it after disinfection. The disinfection method shall be implemented according to GB 19 193.

5. 1.5 garbage disposal

The domestic waste of suspected patients should be collected in a unified way and treated as medical waste. The disposal of medical waste should follow the requirements of the Regulations on the Management of Medical Waste and the Measures for the Management of Medical Waste in Medical and Health Institutions, and be disposed of according to the process after being put into a double-layer yellow medical waste collection bag.

5. 1.6 hand washing facilities

Hand washing facilities should be set up in public areas of workplaces and wards, and hand sanitizer (or soap), quick-drying hand disinfectant and non-contact dryer should be selected. Stick a "six-step washing method" step diagram near the sink.

5.2 disinfection measures

Places should be cleaned and disinfected, including countertops, floors, door handles, hands, skin, mucous membranes and other surfaces. Refer to 4.2 for specific disinfection methods.

When replacing the isolated suspected patient in the room, the articles and environment in the room should be disinfected according to GB 19 193.

5.3 Personal protection

5.3. 1 Equipped with protective equipment and facilities.

Temporary special places should be equipped with masks, protective clothing, gloves, protective screens or goggles, hand disinfectants and first aid supplies for medical, cleaning, disinfection and security personnel. Set up places and facilities for putting on and taking off protective clothing.

Staff protection

See 4.3.2 for personal protection of employees in the workplace.

5.3.3 Protection of suspected patients

Wear a mask, narrow the range of activities, reduce contact with public goods and facilities, and strengthen hand hygiene.

Temporary special place for medical observation of close contacts.

6. 1 General requirements

6. 1. 1 site selection requirements

6. 1. 1. 1 Mainly transform hotels and schools as temporary special places for receiving medical observation of close contacts.

6. 1. 1.2 The site shall be a multi-storey single-family building.

6. 1. 1.3 A green isolation sanitary space of at least 20m shall be set between the site and other adjacent buildings; Adjacent buildings should not include densely populated areas and crowded places (such as residential areas, commercial centers, primary and secondary schools and places where children and the elderly gather); Priority is given to suburban hotels, schools, etc.

6. 1.2 Building requirements

Reference 4. 1.2.

6. 1.3 functional partition

6. 1.3. 1 The medical observation area for close contacts should be separated from the staff working area, and the close contact passage should be separated from the staff passage and used in different areas.

6. 1.3.2 Each partition shall be physically isolated and clearly marked.

6. 1.4 water supply

The quality of drinking water should meet the requirements of GB5749.

6. 1.5 Sewage and wastewater treatment

6. 1.5. 1 There should be a trap under the basin in the guest room, and the floor drain in the bathroom should be sealed with water.

6. 1.5.2 The condensed water of split air conditioner should be collected centrally or discharged to the bathroom floor drain.

6. 1.5.3 Independent septic tanks and sewage discharge pools shall be set up; Sewage should be treated according to 5. 1.4 before entering the municipal drainage pipe network. The disinfected sewage should meet the requirements of GB 18466.

6. 1.6 ventilation

6. 1.6. 1 Windows should be opened regularly for ventilation and adjusted according to weather conditions; Or install mechanical exhaust equipment to strengthen air circulation.

6. 1.6.2 When using air conditioning system, split air conditioning should be selected. Before using split air conditioner, open the window for ventilation for 30 minutes, then turn on the air conditioner, adjust the maximum air volume to run for more than 10 minutes, and then close the doors and windows; After the split air conditioner is turned off, open the window for ventilation. Under the premise of meeting the indoor temperature, the windows should not be completely closed when the air conditioner is running.

6. 1.7 garbage disposal

6. 1.7. 1 Domestic garbage of close contacts shall be collected and treated as domestic garbage. When close contacts are turned into suspected patients or diagnosed, the domestic garbage generated by them will be treated as medical waste.

6. 1.7.2 The disposal of medical wastes shall comply with the Regulations on the Management of Medical Wastes and the Measures for the Management of Medical Wastes in Medical and Health Institutions.

6. 1.8 hand washing facilities

Reference 5. 1.6.

6.2 disinfection measures

6.2. 1 Disinfection of object surface

Guest rooms should be cleaned and disinfected by close contacts themselves. For high-frequency contact with the surface of objects (such as desktop, bedside table, furniture, door handle, etc. ), use available chlorine 500mg/L chlorine disinfectant or other effective disinfectant to spray or wipe regularly.

Staff should clean and disinfect public areas and external environment. High frequency contact with the surface of objects (such as elevator buttons, handrails, door handles, etc.). ) and public toilets, use chlorine-containing disinfectant with effective chlorine of 500mg/L or other effective disinfectants to wipe regularly.

6.2.2 Disinfection of tableware (drinking utensils)

Refer to 4.2.2.

Hand hygiene

Refer to 4.2.5.

6.2.4 terminal disinfection

When the close contacts are diagnosed as COVID-19 and leave the medical observation place, the articles and environment in the place should be disinfected by professionals according to GB 19 193.

6.3 Personal protection

Staff protection

6.3. 1. 1 Medical personnel should take protective measures according to 4.3.2. 1 when conducting sample collection, epidemiological investigation and psychological comfort.

6.3. 1.2 Room service personnel should wear work clothes, medical protective masks and disposable gloves, and protective masks or goggles if necessary. Work clothes should be kept clean and cleaned regularly. When you have symptoms such as fever and cough, you should go to the designated hospital for medical treatment in time according to the regulations, and wear a mask throughout the hospital and hospitalization.

6.3. 1.3 During work, reduce personnel conversation, avoid gathering, and do a good job in hand hygiene.

6.3.2 Protection of close contacts

Mainly in the isolation room, strengthen hand hygiene. Wear a mask when passing through public areas to avoid contact with outdoor items and facilities.

6.4 Health management

6.4. 1 There is no sputum in public areas, no sundries in corridors, no sanitary corner, and no dust on stair handrails.

6.4.2 No sputum, dirt, water, etc. On the ground outside the construction site; Clean up the garbage in time, without bare garbage; The trash can is very tidy.

6.4.3 Close contacts shall be isolated in a single room, and shall not leave the room without authorization during isolation.

6.4.4 Conduct temperature measurement and health monitoring for employees every day, and make records. It is forbidden to work in spite of illness. If there are suspected patients in the staff's home, they should be isolated according to the relevant regulations, and it is strictly forbidden to take up their posts.

6.4.5 Restaurant staff should eat in different peaks and eat alone. During the epidemic, the restaurant should be completely separated from the kitchen to prevent the air in the restaurant from flowing to the kitchen.

6.4.6 Close contacts shall implement the food delivery system, and the service personnel shall deliver the food to the door of the isolation room.

6.5 others

6.5. 1 Flexible packaging fabrics, such as carpets, shall be removed from the existing ground on the site; Or laying a disposable floor mat.

6.5.2 The site shall be equipped with first-aid personnel, equipment and facilities.

Legal basis:

According to Annex 3 of the Notice on Printing and Distributing the Work Plan for Medical Treatment of COVID-19 Epidemic in Autumn and Winter, Guidelines for Prevention and Control of COVID-19 Epidemic in Medical Institutions.

Five, COVID-19 key departments of epidemic prevention and control work guide.

(twelve) COVID-19 epidemic prevention and control guide blood purification center (room) 4 copies. Disinfection and isolation and medical waste management.

(2) Surface disinfection of environmental objects: There are no visible pollutants on the surfaces of hemodialysis machines, therapeutic vehicles and other objects: spray, wipe or soak with 500mg/L chlorine-containing disinfectant or disinfectant with the same sterilization effect, and clean with clean water after 30 minutes. The surfaces of medical instruments, articles and hemodialysis machines contaminated by pollutants such as patients' blood, body fluids and secretions: firstly, use disposable absorbent materials to remove pollutants, and then use 1000mg/L chlorine-containing disinfectant or 500mg/L chlorine dioxide disinfectant to wipe and disinfect for 30 minutes; Or use disinfection products that complete adsorption disinfection at one time.