감염 예방을 위한 인공신장실 의료 환경에 대한 고찰- 근거 기반의 디자인 중심으로
A Review of Renal Dialysis Unit Environment for Infection Prevention - Focused on Evidence Based Design
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Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.
Abstract
Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.
참고문헌 (33)
- [URL]
- Abdullah Assiri, "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus", New England Journal of Medicine, 369(5), pp.407~416 (2013), Massachusetts Medical Society[DOI]
- [URL]
- Marcelli D, "Richards N, Influenza A(H1N1)v pandemic in the dialysis population: first wave results from an international survey", Nephrol Dial Transplant, 24, pp.3566~3572 (2009)[DOI]
- [URL]
- Eleftheriadis T, "Infections in hemodialysis: a concise review - Part 1: bacteremia and respiratory infections", Hippokratia, 15(1), pp.12~17 (2011)
- Eleftheriadis T, "Infections in hemodialysis: a concise review. Part II: blood transmitted viral infections", Hippokratia, 15(2), pp.120~126 (2011)
- 엄중식, "감염관리를 위한 병원의 시설과 건축", 대한의사협회지, 61(1), pp.36~42 (2018), 대한의사협회[DOI]
- Government of Republic of Korea, "Schemes for reform of infectious disease preparedness and response in Korea" (2015)
- "Standards for Renal Dialysis Services" (2016)[URL]
- Government of U.S., "U.S. Code of Federal Regulations. Part 494 -CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES" (2016)
- Hong Kong College of Physicians & Central Renal Committee, "Accreditation of Renal Dialysis Unit" (2002)
- Ayman Karkar, "Infection control in hemodialysis units: A quick access to essential elements", Saudi Journal of Kidney Diseases and Transplantation, 25(3), pp.496~ (2014), Medknow[DOI]
- [URL]
- Kobayashi Hiromi, "Outbreak of extensively drug-resistant pulmonary tuberculosis in a hemodialysis facility", Kekkaku, 88(5), pp.477~484 (2013)
- The Facility Guidelines Institute(FGI), "Guideline for Design and construction of Healthcare Facilities" (2018)
- 박혜인, "Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities", Kidney Research and Clinical Practice, 37(1), pp.8~19 (2018), 대한신장학회
- 이영기, "혈액투석", 대한내과학회지, 86(2), pp.131~137 (2014), 대한내과학회[DOI]
- "투석실 감염관리 및 격리 운영 방안"[URL]
- 이영기, "Current status and standards for establishment of hemodialysis units in Korea", The Korean Journal of Internal Medicine, 28(3), pp.274~284 (2013), 대한내과학회[DOI]
- [URL]
- E. Lacson, "Hemodialysis Treatment Time: A Fresh Perspective", Clinical Journal of the American Society of Nephrology, 6(10), pp.2522~2530 (2011), American Society of Nephrology (ASN)[DOI]
- Ministray of health singapore, (2004)
- 노현진, "복막투석", 대한내과학회지, 86(2), pp.138~141 (2014), 대한내과학회[DOI]
- R Ram, "Tuberculosis in haemodialysis patients: A single centre experience", Indian Journal of Nephrology, 23(5), pp.340~ (2013), Medknow[DOI]
- Isaac See, "Outbreak of Clostridium difficile Infections at an Outpatient Hemodialysis Facility—Michigan, 2012–2013", Infection Control & Hospital Epidemiology, 36(08), pp.972~974 (2015), Cambridge University Press (CUP)[DOI]
- 진동찬, "우리나라 말기신부전 환자의 투석현황", 대한의사협회지, 56(7), pp.562~568 (2013), 대한의사협회
- 건강보험심사평가원 평가 3부, 2015년 5차 혈액투석 적정성평가결과 보고, , ~ (2017)
- 건강보험심사평가원 평가 3부, 2018년(6차) 혈액투석 적정성평가 및 가감지급사업 세부추진계획, , ~ (2017)
- 대한신장학회, "인공신장실 감염관리지침" (2017)
- 질병관리본부, "메르스 대응 지침", ~ (2017)
- 질병관리본부, "의료관련감염 표준예방지침" (2017)
- 제2차 감염병 예방관리 기본계획, "질병관리본부", ~ (2018)