> UC-NB|j-F 3 ai^ ft^^ Standardization for Tuberculosis Wards or Pavilions of County Hospitals ^ommmmmi MAR 22 I960 LIBRARV JiS!!?SITy OF QALIFORNIA Bureau of Tuberculosis California State Board of Health California State Printing Office 191G 22436 STANDARDIZATION FOR TUBERCULOSIS WARDS OR PAVILIONS OF COUNTY HOSPITALS. In determining the eligibility of hospitals for the state tuberculosis subsidy, they will be graded by the State Board of Health, according to location, construction, treatment and care of patients, and diet. Location and grounds — will count one to five points. Construction and type of building — one to twenty-five points. Treatment and care — one to thirty-five points. Diet — one to thirty-five points. A hospital must receive a total of eighty points to be eligible for the state subsidj^ Location. Any buildings or pavilions to be constructed in the future must be on a part of the grounds separate from the general hospital. Counties contemplating construction must bear this in mind and consult with the Bureau before locating their building. Accessibility, transportation, length of time in reaching the hospital, and its proximity to other county buildings will be the points on which location will be graded. Buildings. The Bureau discourages the erection of an expensive type of building unless it is a part of a general plan for a large county or city and county hospital. In the smaller counties, inexpensive buildings have been erected to care for as many as forty patients for about $14,000.00. Buildings will be graded on their construction and on the type of building, also their capacity relative to the need of the tuberculosis poor of the county. They will be classified as separate buildings, pavilions, cottages, wards in a general hospital, "shacks" or tent houses. Class A Structure. A separate huilding.- — -It must have proper accommodations for a head nurse ; sufficient baths, toilets and lavatories for patients ; a diet kitchen for preparing food which can not be transported; two kitchen sinks or adequate facilities for washing and disinfecting dishes. If the building is separate from the general hospital and run as a sana- torium, it must have an examination room. There must be isolation rooms for advanced cases; not less than one isolation room for every ten patients. In the wards, there must be a minimum distance between beds of 3 feet 6 inches. "Wards must be sufficienth^ lighted, preferably by electricity. Wards need not be heated, but dressing rooms, bath- rooms and patients' dining-room must be heated in cold weather. Class B Structure. A ward in the general hospital. — The requirements regarding equip- ment and sufficient isolation rooms and food will be the same as for Class A. Class B structures must have a separate dining-room for ambulatory patients. (2) C: -!■■ Class C Structure. HEAIJ The "shack'' hjpe or tent house. — It can not l)e used except for earlier lBRai cases. Any erection of a "shack" or tent house will be discouraged unless a nursing force is provided adequate for giving patients the necessary care. Equipment. In structures of any of the three classes, the following requirements must be met: In buildings having over thirty-six (36) beds, one tub or shower bath for every twelve (12) patients; one lavatory for every six (6) patients; one toilet for every six (6) patients; two dental lavatories and two slop sinks for every thirty-six (36) patients; two kitchen sinks are desirable. The stove in the kitchen mu.st be large enough so that if food is to be prepared there, it can be done without inconvenience. There must be back rests for bed cases ; ambulatory cases must be provided with inexpensive canvas reclining chairs. If trays are used, they must be kept clean. The more expensive aluminum trays last much longer than the common papier mache, which will not be allowed in the future. The use of granite iron dishes and tin spoons is dis- couraged. Call bells must be provided in each w^ard ; properly ventilated lockers must be provided for each patient ; scales also must be provided. Wards and rooms must be screened and wards and sleeping rooms must be canvassed. A platform or sun porch must be provided. Treatment and Care. If there is not a resident staff connected with the hospital, a visiting staff must be arranged. This can be done through the County Medical Society. There must be one interne for every fifty patients. Daily records must be kept. There must be a complete examination on admis- sion and frequent subsequent examinations. The diagnosis and type of tuberculosis must be recorded and the complete record of the patient must be kept where it is accessible to the representative of the State Board of Health. Temperature must be taken four times a day and accurate charts miLst be kept. Nursing. In Class A buildings there must be one registered nurse who has had special training in tuberculosis nursing, and one nurse for every sixteen patients ; also one orderly. In Class B buildings nursing must be supervised by the superintendent of nurses, and one pupil nurse provided for every sixteen patients. Admission. The admission blanks furnished by the State Board of Health must be filled out in full and sworn to by the patient and the superintendent of the hospital. Care of Patients. Adult patients must be segregated as far as possible, according to the stage of the disease. Bed cases must be placed in the smaller wards, so that it will be convenient for dying cases to be taken into the isolation rooms. Children must be segregated in a small ward of their own. (3) 832 Bedding must be disinfected after death or removal of each patient. Patients needing extra heat at night must be given hot water bottles or soapstones. Property of Patients. Provision must be made for the safe storage of any valuables or money deposited b}^ the patient. Food. Care must be taken in handling and serving food for patients so it will be attractive. There is an enormous waste of food in hospitals, due to the fact that patients frequently can not eat the food served them. It must be remembered that patients suffering with tuberculosis nearly always have serious stomach disturbances and fickle appetites, and the serving of food to these patients must be done with this in mind. If the food is to be transported from the general hospital, it, must be sent over in a fireless cooker or reheated before being served. Tea must be made in the diet kitchen, and coffee, if sent from the general hospital, must be hot, when served. We recommend that coffee and toast and eggs be prepared in the diet kitchen. A suggested diet list will be submitted by the State Board of Health. RETURN TO the circulation desk of any University of California Library or to the NORTHERN REGIONAL LIBRARY FACILITY Bldg. 400, Richmond Field Station University of California Richmond, CA 94804-4698 ALL BOOKS MAY BE RECALLED AFTER 7 DAYS 2-month loans may be renewed by calling (510)642-6753 1-year loans may be recharged by bringing books to NRLF Renewals and recharges may be made 4 days prior to due date DUE AS STAMPED BELOW PEC 19 1994 ^'•Q'/n?79.q7