Hygiene of medical facilities

Indoor spaces must comply with hygienic limits for chemical, physical and biological indicators.
 * This obligation must be ensured by the operator (§13).
 * Hygienic requirements for the operation of medical facilities (§ 15).
 * The operation must create hygienic and anti-epidemic conditions to prevent hospital infections.
 * The measures are contained in the operational regulations of the medical facility, which are approved by the public health protection authority (hygienist); the operator must report the occurrence of an infection to the relevant public health protection authority.
 * Persons who provide health care must comply with hygienic requirements for water supply, cleaning, disinfection and sterilization (§ 17).

Disinfection
The law explains that disinfection is a procedure to destroy microorganisms using physical or chemical methods and their aim is to interrupt the path of infection from the source to a susceptible person. A higher level of disinfection is a procedure that kills bacteria, viruses, microscopic fungi and some bacterial spores.

Sterilization
It is a procedure that kills all microorganisms including spores, worms and their eggs and leads to the irreversible inactivation of viruses. Sterilization is divided according to different procedures into physical sterilization (hot air, moist heat – autoclave, plasma and radiation) and chemical sterilization (formaldehyde and ethylene oxide).

Laundry handling
We change bedding at least once a week, always after contamination, after operations, after bandages, after discharge of the patient. Disposable material is used to cover examination tables and couches wherever the exposed part of the body comes into contact with the mat during the examination, this mat must be replaced after each patient. When handling, it is necessary to know that any linen used is contaminated and it is not permissible for the patient to help in handling it. It is stored in transport containers and sorted without unnecessary shaking and is taken to the laundry every day.

Nosocomial infections
Hospital (nosocomial) infection is defined as an infection arising in connection with a healthcare interaction that was not present, nor was it in the incubation period at the beginning of this interaction. Interaction with health care means the provision of hospital, outpatient and follow-up care. They represent a significant complication of health care, which has negative consequences in terms of increased morbidity, mortality and increased costs of care. They negatively affect the quality of life of patients and the performance of the health system. It is an important indicator of the quality of health care provided.

Audit and its criteria

 * Hand hygiene
 * Disinfection program
 * Storage of disinfectants
 * Disinfectant replacement interval
 * Decontamination of instruments
 * Storage of sterile material
 * Treatment of used linen
 * Barrier treatment
 * Waste disposal

The correct procedure for regular hand washing

 * 1) Wetting hands in water.
 * 2) Apply soap to all surfaces.
 * 3) Rubbing both hands together.
 * 4) Placing the right palm on the back of the other hand with intertwined fingers and vice versa.
 * 5) Placing palms together with intertwined fingers.
 * 6) Applying the backs of the fingers to the palm of the other hand followed by rubbing the fingers.
 * 7) Alternating rubbing of the left thumb clenched in the right palm and vice versa.
 * 8) Alternately wiping the front and back of the fingers of the right hand clasped in the left palm and vice versa.
 * 9) Rinsing hands with water.
 * 10) Dry thoroughly with paper towels.

Dining
Hospital catering operations are usually provided by contract. All food is prepared centrally and the same requirements apply to its preparation as in other catering establishments. Ready meals are transported to the inpatient wards and served immediately. Suitable means of transport are allocated for transport. Transport areas must be kept clean, regularly cleaned and disinfected. The temperature of the food must not fall below 65 °C during the entire period of transport and delivery.

Resources
www.zdn.cz
 * ws: Hygiena zdravotnických zařízení