Hospitals are complex environments that require safety measures to protect patient health. The clinical engineer plays an important role in ensuring a safe hospital environment. The World Health Organization (WHO) has established standard precautions and additional transmission-based precautions for infection control, including hand hygiene, protective equipment, cleaning, and waste handling. Proper ventilation systems and cleaning protocols are also necessary to maintain safety, especially in high-risk areas like operating rooms.

1. BIOSAFETY IN HOSPITAL ENVIRONMENT
Dr.T.V.Rao MD
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2. HOSPITALS ARE COMPLEX
ENVIRONMENTS
NEED SAFETY
• Hospitals are representative of complex environment in
which different aspects including patients, staff,
equipment, services, and information are interfaced.
Maintaining a safe environment reflects a level of
competent healthcare that must be fulfilled for patient
safety. In this context, the clinical engineer plays an
important role in providing safe environment within
hospital. In general, many factors affect hospital
environment internally and externally
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3. WHO has classified
infection control
practices
• WHO has classified
infection control practices
into two main categories:
standard precautions and
additional (transmission-
based) precautions. These
category items are
Standard precautions
include the following items
• Hand washing and
antisepsis (hand hygiene)
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4. Hand Washing a Great step in Saving
Lives
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5. WHO has classified
infection control
practices
• Use of personnel
protective equipment
when handling blood,
body substances, and
secretions
• Appropriate handling
of patient care
equipment and soiled
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6. Safe Practices in
Hospitals a
Priority
• Prevention of
needlestick / sharp
injuries
• Environmental
cleaning and spills-
management
• Appropriate handling
of waste
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7. Additional (transmission-
based) precautions while
ensuring standard
precautions include
• Airborne
precautions
Droplet precautions
Contact precautions
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9. CLEANING THE
ENVIRONMENT THE GREAT
PRIORITY
• Cleaning is an
essential first step
prior to any
disinfection process
to remove dirt, debris
and other materials
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10. Neutral detergent
solution is essential
•The use of a neutral detergent
solution is essential for effective
cleaning. It removes dirt while
improving the quality of
cleaning by preventing the
build-up of biofilms and thus
increasing the effectiveness of
chemical disinfectants.
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11. Concentration of the
detergent matters
• If disinfectants are used, they must
be prepared and diluted according
to the manufacturer’s instructions.
Too high and/or too low
concentrations reduce the
effectiveness of disinfectants. In
addition, high concentrations of
disinfectant may damage surfaces
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12. Start Cleaning from
Clean to less clean
areas
• Cleaning should always
start from the least soiled
areas (cleanest) first to the
most soiled areas (dirtiest)
last and from higher levels
to lower levels so that
debris may fall on the floor
and is cleaned last
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13. Discarding after the
use of Diluted
Disinfectant
solutions a Priority
Detergent and/or
disinfectant solutions must
be discarded after each use.
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high risk areas such as operating rooms and intensive care units
require special ventilation systems through filtration systems
(e.g., HEPA filters) and pressure relationship to adjacent areas.
In general, clean atmosphere reduces the risk of airborne
infection, and dangerous of gases explosion.

14. Stop Dry
Sweeping and
stop use of
Brooms
• Avoid cleaning methods that
produce mists or aerosols or
disperse dust, for example
dry sweeping (brooms, etc.),
dry mopping, spraying or
dusting.
• Start Using vacuum Cleaner
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15. Regular Surveillance not essential
But essential in times of Outbreaks of Infection
•Routine bacteriological
monitoring to assess the
effectiveness of
environmental cleaning is
not required, but may be
useful to establish the
potential source of an
outbreak and/or for
educational purposes
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16. Environmental
cleaning to be done as
guided by Standard
Operative procedures
• Require cleaning according to
written protocols (for example,
daily, weekly, after each patient
use, etc.). This should include
the use of appropriate personal
protective equipment, cleaning
methods conforming to the
type/s of surface and cleaning
schedules, etc.
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18. Cleaning and Sterility of Medical and other
equipment
• Schedules and
procedures should be
consistent and updated
on a regular basis and
education and training
must be provided to all
cleaning staff. Please
refer to the
manufacturer’s
instructions for medical
equipment to ensure that
the item is not damaged
by the use of
disinfectants.
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19. High hand-touch surface
Any surface with
frequent contact with
hands
• Requires special attention
and more frequent
cleaning. After thorough
cleaning, consider the use
of appropriate disinfectants
to decontaminate these
surfaces.
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20. Minimal touch surface
(floors, walls, ceilings, window
sills, etc.)
• Minimal contact with
hands. Not in close
contact with the patient
or his/her immediate
surroundings
• Requires cleaning on a
regular basis with
detergent only or when
soiling or spills occur.
Also required following
patient discharge from
the health care setting.
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21. Surface contaminated
with blood and body
fluids
• Any areas that are visibly
contaminated with blood or
other potentially infectious
materials
• Requires prompt cleaning
and disinfection
• All spills must be carefully
cleaned up and the surface
cleaned and disinfected
according to hospital policy
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22. Water Quality
• Water is a strategic
energy resource that
should be used and
managed properly. In
hospitals, water is a
necessary utility which
is obtained from
outside sources. This
utility may serve as a
medium for the spread
of infections from
outside sources to the
hospital
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23. Quality check of the
Water a priority in
Health care
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3
• A complete chemical analysis of
water is required to establish
quality levels. This analysis may
be performed by local public
health agencies or by hospital
staff. If the hospital has storage
water tanks, they should be
cleaned regularly and the
quality of water should be
sampled periodically to check
for bacterial contamination.
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24. The risks of poor
healthcare HVAC
• Healthcare HVAC
breakdowns and poor
performance are very
serious problems. That’s
because patients’ lives
can be at risk if
temperatures and
humidity deviate from
safe levels.
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25. High humidity: a huge
healthcare HVAC
problem
• High heat and humidity
are unpleasant for
healthy people. Yet these
conditions are especially
harmful to those with
respiratory problems.
They also are dangerous
to those recuperating
after surgery at a
rehabilitation center or
nursing home.
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26. High Humidity helps to
spread bacteria
• High humidity promotes
the spread of bacteria.
This is a concern at any
location, but it’s even
more troublesome at
healthcare facilities where
people often have
compromised immune
systems
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27. Purpose of
HVAC
• The purpose of HVAC
system is to provide and
maintain environmental
conditions, including
proper airflow, heating, and
cooling within a certain
area or the entire hospital.
Installation of HVAC is one
of the most important
factors by which the
architect can combat
bacterial infection, and at
the same time create
environmental comfort.
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28. HVAC system
•HVAC system is designed to
meet specific values of
temperature, relative
humidity, and air changes
frequency within different
areas in hospital based on
standards of design,
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29. High Risk areas need
special attention
2
9
• High risk areas such as operating
rooms and intensive care units
require special ventilation
systems through filtration
systems (e.g., HEPA filters) and
pressure relationship to adjacent
areas. In general, clean
atmosphere reduces the risk of
airborne infection, and
dangerous of gases explosion.
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30. • Program File Created by Dr.T.V.Rao MD for benefit of
Medical and Nursing professionals in the Developing
countries with Resources from WHO and Google
•Email
•doctortvrao@gmail.com
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