With the development of modern medical technology and the improvement of pregnant women's requirements for the delivery environment, the design and equipment configuration of hospital obstetrics and gynecology delivery rooms have become an important part of improving medical quality and patient satisfaction. A scientific, reasonable, functional and well-equipped delivery room can not only effectively ensure the safety of mothers and babies, but also provide a comfortable and humane delivery experience. This article will systematically explain the design and configuration requirements of obstetrics and gynecology delivery rooms from the aspects of delivery room layout, functional zoning, equipment configuration, safety standards, etc.
Obstetrics is a branch of obstetrics and gynecology, which mainly studies the etiology, pathology, diagnosis and prevention of female reproductive organ diseases, physiological and pathological changes of pregnancy and delivery, and female reproductive endocrine diseases. It is mainly used for diagnosis, waiting for delivery, delivery, treatment and recovery of parturients before, during and after delivery. Obstetrics mainly includes obstetric outpatient clinics, obstetric wards and delivery centers. When designing the obstetrics, we should establish a female-centered idea, create a safe, warm, comfortable and convenient space environment, create a relaxed and pleasant treatment atmosphere, and give women a sense of security and comfort.
1. Design and layout requirements of obstetrics
Site selection
The obstetrics clinic should be a separate area in consideration of privacy issues. Considering the inconvenience of parturients, it should be set up on the lower floors as much as possible. The delivery center should be arranged close to the obstetrics ward and the central operating room of the hospital to facilitate parturients.
Layout and setting of delivery room
The delivery room should be set up based on the principles of convenience, maternal and child safety, isolation and sterility, and should be adjacent to the operating room, obstetrics ward, mother-child room and neonatal room to form a relatively independent area.
Functional division of main areas
Obstetrics clinic
Reception and waiting area: reception desk, public waiting area.
Obstetrics diagnosis and treatment area: general outpatient clinic, special outpatient clinic.
Obstetrics treatment area: pregnant women training room, fetal heart monitoring room, B-ultrasound, electrocardiogram room.
Health education area: postpartum rehabilitation room, pregnant women school, health education, etc.
Medical and auxiliary rooms: office, demonstration room, changing room, duty room, toilet, etc.
Obstetric ward (antenatal and postpartum ward)
Ward area: single or double room, activity room and drying room.
Medical area: nurse station, examination room, conversation room/consultation room, newborn bathing room, clean product warehouse.
Meal preparation room, milk preparation room, bedding room, infusion preparation, material warehouse, medical equipment storage room, nursing room, waste room (temporary storage of garbage), cleaning and sanitary ware room.
Medical and auxiliary rooms: doctor's office, head nurse/director's office, demonstration room/conference room, staff lounge, male and female changing rooms, doctor's duty room, nurse's duty room, medical staff toilet.
Delivery center
Reception and waiting area: reception desk, public waiting area.
Prenatal preparation area: buffer zone, triage/assessment, pregnant women's activity room, treatment preparation, nurse station, bedding room, warehouse, anesthesia preparation room, medical equipment warehouse, clean product warehouse, sterile equipment storage room, pregnant women's bathroom.
Delivery area: ordinary delivery room, ordinary delivery room, isolated delivery room, isolated delivery room, LDR delivery room (delivery, delivery and recovery integration), LDRP delivery room (delivery, delivery, recovery, postpartum rehabilitation integration), emergency operating room, conversation room. The delivery area can be divided into clean area, semi-clean area, and contaminated area according to the degree of cleanliness.
Clean area: delivery room, delivery room, emergency operating room, sterile storage room, treatment room, instrument room, medicine room, medical office, lounge, conference room, duty room, nurse station, isolated delivery room, isolated delivery room.
Semi-clean area: shoe changing area, medical dressing room.
Contaminated area: family waiting area, conversation room, temporary storage room for waste, dirty quilt room, cleaning and disinfection room, etc.
Other auxiliary rooms: cleaning room, waste room, nurse duty room, doctor's office, staff lounge, medical staff toilet.
2. Plan layout design
Obstetrics clinic
Obstetrics clinic should be a separate area. The clinic area can adopt an integrated diagnosis and treatment mode, and set up specialized ultrasound rooms, fetal heart monitoring rooms, specialized testing rooms and other treatment rooms in the clinic area to reduce the number of maternal return visits.
The obstetrics clinic is equipped with an examination bed, the outside is the clinic, and the inside is the examination room to protect the privacy of the mother.
The obstetrics ward is generally similar to the standard nursing unit. The prenatal and postnatal wards should be set up close, and the ward area should be added with baby rooms and milk preparation rooms.
Birthing center
The delivery center is divided into traditional delivery room area and integrated delivery room area. Generally, it includes delivery room, emergency operating room, integrated delivery room, etc. These two areas need to be connected to each other to save medical manpower and realize efficient integration of medical resources.
The delivery center should be an independent area, preferably close to the central operating room of the hospital, on the same floor as the neonatal room, and have an internal passage to facilitate the transfer and treatment of mothers and babies.
The delivery area should be divided into three areas according to the degree of cleanliness, and the passages should also follow the three-area two-passage design. The isolated delivery room and the isolated delivery room should be set adjacent to each other to reduce the risk of cross infection.
A buffer zone, family waiting area and conversation room should be set at the entrance of the delivery center.
The delivery room in the delivery center is set near the delivery room.
Medical flow planning
Patient flow line of obstetric outpatient clinic: outpatient hall → self-service area → waiting area → clinic. Medical flow line: outpatient medical staff entrance → medical passage → medical staff changing → outpatient clinic area. Waste flow line: outpatient waste → waste washing room → waste disposal → waste ladder.
Patient flow line of obstetric ward: inpatient hall/delivery center → patient elevator → ward nurse station → ward. Medical and nursing flow line: ward medical and nursing staff entrance → medical and nursing passage → medical and nursing staff changing clothes → each ward. Waste flow line: ward waste → waste washing room → waste disposal → waste ladder.
Delivery center movement line patient flow line: inpatient lobby/ward → patient elevator → ward nurse station → delivery area → delivery room/operating room. Medical and nursing flow line: delivery room medical and nursing staff → medical and nursing passage → medical and nursing staff changing clothes → medical and nursing staff office area → integrated delivery room/delivery room/operating room. Waste flow line: delivery room waste → waste washing room → waste disposal → waste ladder.
Areas should be separated by doors or have obvious signs. If conditions permit, the delivery room of a hospital should have three passages, namely patient passage, staff passage, and waste passage. The patient passage should be close to the delivery room, the staff passage should be close to the dressing room, and the delivery room should have a waste passage so that the waste can be directly transported out from the outer corridor.
3. LDR delivery room
The LDR integrated delivery room is a single room that integrates delivery, delivery, and postpartum recovery.
LDRP is the abbreviation of Labor, Delivery, Recovery, and P (Postpartum), which is a family delivery room that integrates labor, delivery, postpartum recovery, and rehabilitation. The unit area should not be less than 28㎡. It is suitable for all labor and delivery processes except cesarean section and delivery under general anesthesia.
There is no need for the mother to move during the delivery process, making the natural delivery process smoother and more comfortable. Since the LDR and LDRP integrated delivery rooms are accompanied by family members throughout the process, in order to avoid affecting other delivery rooms, they should be set up independently or in a relatively independent location in the delivery room area, or in a relatively independent area of the obstetric ward. An integrated delivery bed should be set up in the room to meet the needs of delivery and hospitalization. Baby bathing facilities should also be configured to meet the requirements of baby bathing.
A cesarean section operating room should be set up in the delivery room area, and the net size of the operating room should be 5.4mX4.8m. The cesarean section operating room is used for emergency unplanned cesarean section operations, which can save precious time, avoid the patient's back and forth movement, and ensure the patient's privacy and safety. If there is no condition to set up a cesarean section operating room, a fast transfer channel should be set up between the delivery room area and the operating department to ensure that the mother can reach the operating room in a short time.
4. Obstetric decoration and electromechanical design
I. Decoration design
The wall and floor materials should be easy to scrub, collision-resistant and antibacterial materials.
In order to facilitate pregnant and postpartum patients to go to the toilet, the bathroom in the obstetric ward should be equipped with a toilet. If there is only a squat toilet, it is recommended to add a mobile simple toilet stool.
The decoration design of the ward should follow the principles of privacy, soft lighting, and convenience.
The isolation delivery room needs to have a separate passage for patients and medical staff.
Obstetric examinations need to set up an internal examination area, and the door of the examination room is generally 1.2m~1.3m wide. It is advisable to configure a milk preparation room and a mother-child room.
The humanized guide sign system design includes guidance signs, call buttons, audio and blind paths, etc., to provide patients with accurate and timely information services. Call buttons should be placed at the head of the bed in the ward to facilitate notification of medical staff for medical treatment.
To achieve barrier-free design of toilets and bathrooms, barrier-free toilets should be set up in public toilets and ward toilets, and necessary safety grab bars should be installed. The diameter of stainless steel pipes should meet the specified range, be suitable for gripping, be firmly installed, and have a bearing capacity of ≥0.8KN. No steps should be set at the entrance. If the position of the toilet must be raised due to ground reasons, a ramp can be set instead of the steps.
Fire doors must remain automatically closed in the event of a fire, and no thresholds should be set. The net width should not be less than 1.4m, and no steps should be set within 1.4m inside and outside the door.
The design of the ramp should focus on the control of the slope, so that the wheelchairs and beds of pregnant women can pass smoothly, and anti-slip measures should be designed to ensure that no accidents will occur due to inertia on the slope.
Mechanical and electrical design
The air conditioning system of the delivery room and related rooms such as the preparation room, shower room, and recovery room should be able to operate continuously for 24 hours.
The indoor temperature of the neonatal room should be maintained at 22℃~26℃ throughout the year. The indoor temperature of the premature baby room, neonatal intensive care unit (NICU) and immunodeficient neonatal room should be maintained at 24℃~26℃ throughout the year, and the noise should not be greater than 45dB (A).
The delivery room should adopt a fresh air air conditioning system.
The standard value of illumination in the baby care room should not be less than 200 lx, and the power density value should not exceed 5.5W/m2.
The water supply of the baby washing pool should prevent scalding or excessive cooling and be constant temperature. The terminal temperature can be adjusted, and the water supply temperature should be 35℃~40℃.
Information system design
Access control must be set up in the nursery and special care baby room.
A visual intercom system is set up at the entrance of the delivery room. Family members can directly call the nurse if they have items to be sent to the delivery room.
A display screen is set up at the entrance of the delivery room to provide the current status of the mother and reduce the anxiety of the family members.
5. Common medical equipment in the delivery room
Common medical equipment in the delivery room includes delivery bed (LDR is equipped with an integrated delivery bed), infant radiation warming table, gynecological examination lamp, fetal monitor, etc., which can be configured according to the requirements of different delivery rooms. In addition to the configuration of the medical equipment in the cesarean section operating room, it is also necessary to equip the equipment required for delivery.
Normal delivery room equipment should be located between the neonatal room and the delivery room, and the construction requirements of its floor and walls are the same as those of the operating room. The ratio of delivery bed to obstetric beds is generally 1:8-1:10. If there are many delivery beds, they should be divided into separate rooms. There are sterile instrument cabinets, sterile dressing cabinets, medicine cabinets, surgical instrument tables, neonatal rescue tables, surgical lighting lamps, baby scales, oxygen equipment, electric suction devices, central suction devices, Doppler fetal heart monitors, ultraviolet lamps, refrigerators, etc. There should be heating, cooling or air-conditioning equipment in the room. The room temperature is maintained at 24-26℃, and the relative humidity is 55%~65%.
Hospitals with conditions should be equipped with fetal heart monitors, electrocardiogram monitors, and resuscitation devices. In addition, surgical instruments, rescue instruments and emergency medicines for difficult labor should also be available.
Common obstetric surgical instruments for difficult labor include various types of forceps, various sizes of fetal head suction devices, scalp forceps, fetal membrane puncture needles, toothless and toothed ring forceps, large speculum, retractor, etc.
Common rescue instruments include central venous pressure measuring device, phlebotomy kit, neonatal tracheal intubation materials, sandbag 1kg), tongue forceps, mouth opener, tongue depressor, blood transfusion and infusion device, anesthesia machine, etc. If conditions permit, a intensive care unit can be set up, with fetal heart monitors, neonatal monitors, pacemakers, defibrillators, rescue equipment, etc.
Common emergency medicines, in addition to general operating room spare drugs, should be added with uterine contraction agents, pressors, hypotensive agents, hemostatics, diuretics, cardiotonic agents, anesthetics, etc.
The equipment of the isolation delivery room is simple. In addition to the above necessary conditions, its layout and equipment should be convenient for disinfection and isolation. It should not be located in the middle of the delivery room area. Special masks, hats, isolation gowns and shoes are available at the entrance. There are hand washing and hand disinfectant facilities at the entrance, and a screen door is installed. Laminar flow negative pressure room is available if conditions permit.
The disinfection dressing room is equipped with shelves and cabinets to store sterilized delivery kits and various instruments and dressings. The dehumidification floor plan should be reasonable. If conditions permit, the delivery room area of the hospital should have three passages, namely, the maternal passage, the staff passage and the sewage passage. The maternal passage should be close to the delivery room, and the staff passage should be close to the dressing room. The delivery room is equipped with a sewage passage so that the sewage can be directly transported out from the outer corridor. The sewage passage can also be used as a family visit passage. The delivery room and the delivery room with delivery and waiting should have a toilet. The delivery room should have a usable area of not less than 20㎡, and the net size of the delivery room should be 4.2m×4.8m.
For parturients with infectious diseases or suspected infectious diseases and parturients who have not been screened for blood-borne diseases, isolated delivery and isolated delivery should be adopted. The isolated delivery room and the isolated delivery room can be used together. The isolated delivery room should be equipped with a buffer room with hand hygiene facilities. It should not be located in the middle of the delivery room area, and should be equipped with independent entrances and exits.
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