COLLEGE of ARCHITECTURE

HEALTHCARE WASTE MANAGEMENT

AND GUIDELINES IN PALNNING AND DESIGNING OF HOSPITAL
DESIGN 5
(REASEARCH)

MANANSALA, JEFFREY P.
SUBMITTED BY:

ARCH. CHRISTOPHER COMA

SUBMITTED TO:
 TABLE OF CONTENTS

INTRODUCTION………………………………………………………………………………………………….PG.1
TYPES OF WASTER……………………………………………………………………………………………..PG.1 TO PG.3

HEALTH RISK………………………………………………………………………………………………………PG.4
GUIDELINES IN THE PLANNING AND DESIGN OF A
HOSPITAL AND OTHER HEALTH FACILITIES………………………………………………………..PG.5 TO PG.8
SPACES AND DIMENSIONS………………………………………………………………………………..PG.8 TO PG.10
SPACE AREA NOTES…………………………………………………………………………………………..PG.10
SUMMARY AND CONCLUSION…………………………………………………………………………..PG.11
REFERENCES……………………………………………………………………………………………………..PG12
INTRODUCTION PG.1
Healthcare began as a purely reactionary, healing practice in which people learned the healing
properties of a plants through trial and error and then passed that knowledge on to others. Later, he
became the subject of the concentrated study of many different cultures, including Persian, Egyptian,
Greco-Roman, Indian and Chinese. In the 19th century, many technological, chemical, and biological
advances were made, enabling physicians to better understand, diagnose, and treat diseases. The
discoveries were anesthetics, syringes, antiseptics, X-rays, and penicillin. Around the beginning of the
20th century, the development of modern healthcare began. Doctors started making pre-payments for
their services, which today approximate the field of health insurance and administration.

Types of waste

Infectious waste

This is the Waste contaminated with blood and other body fluids like, from discarded
diagnostic samples, cultures and stocks of infectious substance from laboratory work like waste from
autopsies and infected animals, laboratories or waste from infected patients by Swabs, bandages
and disposables and medical devices.

Non-hazardous or general waste

Waste which poses no unique biological, chemical, radioactive or physical hazard.
 PG.2
Radioactive waste
Such as radionuclide-contaminated goods like radioactive diagnostic or radiotherapeutic materials.

Cytotoxic waste
Waste containing compounds with genotoxic properties (i.e. extremely dangerous, mutagenic,
teratogenic or carcinogenic compounds), such as cytotoxic medicines used in the treatment of cancer
and their metabolites.

Pharmaceutical waste

expired, unused and contaminated drugs and vaccines.

 PG.3
Chemical waste
solvents and reagents used in laboratory preparations, disinfectants, sterilisers and
heavy metals used in medical devices and batteries like mercury in broken thermometers.

Sharps waste
syringes, needles, disposable scalpels and blades.

Pathological waste

human tissues, organs or fluids, body parts and contaminated animal carcasses;
 PG.4
Health risks
Waste from health care involves potentially dangerous microorganisms that can

affect patients in hospitals, health workers and the general public.

Other possible hazards can include drug-resistant microorganisms
that spread into the atmosphere from health facilities.

Adverse health outcomes associated with health care waste and by-products also include

• Toxic exposure during the processing or incineration of health care waste to pharmaceutical
products, in particular
• to antibiotics and cytotoxic drugs released into the surrounding environment and to substances
such as mercury or dioxin.
• sharps-inflicted injuries
• Chemical burns in the sense of the
activities of disinfection, sterilization or waste treatment
• Air contamination resulting from the release of
particulate matter during the incineration of medical waste
• In conjunction with open burning and the operation
of medical waste incinerators, thermal injuries occur and Burns with radiation.

Environmental Impact of HealthCare waste

Inadequate health care waste management may potentially expose health care workers, waste
handlers, patients and the community at large to infection, adverse effects and accidents, and
environmental degradation risks. It is necessary that all medical waste materials are segregated,
properly treated and disposed of safely at the point of generation. HealthCare waste (HCW) is a
healthcare through-product comprising sharp, non-sharp, blood, body parts, chemicals,
pharmaceuticals, medical products.
Health-care waste involves highly hazardous micro-organisms which can infect patients in hospitals,
health-care workers and the general public. The spread of drug-resistant micro-organisms from health-
care facilities into the environment may include other emerging infectious risks.
 PG.5
GUIDELINES IN THE PLANNING AND DESIGN OF A HOSPITAL AND OTHER HEALTH FACILITIES

1 Environment: A hospital and other health facilities shall be so located that it is readily accessible to
the community and reasonably free from undue noise, smoke, dust, foul odor, flood, and shall not be
located adjacent to railroads, freight yards, children's playgrounds, airports, industrial plants, disposal
plants.
2 Occupancy: A building designed for other purpose shall not be converted into a hospital. The
location of a hospital shall comply with all local zoning ordinances.
3 Safety: A hospital and other health facilities shall provide and maintain a safe environment for
patients, personnel and public. The building shall be of such construction so that no hazards to the
life and safety of patients, personnel and public exist. It shall be capable of withstanding weight and
elements to which they may be subjected.
3.1 Exits shall be restricted to the following types: door leading directly outside the building,
interior stair, ramp, and exterior stair.
3.2 A minimum of two (2) exits, remote from each other, shall be provided for each floor of the
building.
3.3 Exits shall terminate directly at an open space to the outside of the building.

4 Security: A hospital and other health facilities shall ensure the security of person and property within
the facility.

5 Patient Movement: Spaces shall be wide enough for free movement of patients, whether they are on
beds, stretchers, or wheelchairs. Circulation routes for transferring patients from one area to another
shall be available and free at all times.
5.1 Corridors for access by patient and equipment shall have a minimum width of 2.44 meters.
5.2 Corridors in areas not commonly used for bed, stretcher and equipment transport may be
reduced in width to 1.83 meters.
5.3 A ramp or elevator shall be provided for ancillary, clinical and nursing areas located on the
upper floor.
5.4 A ramp shall be provided as access to the entrance of the hospital not on the same level of
the site.
6 Lighting: All areas in a hospital and other health facilities shall be provided with sufficient illumination
to promote comfort, healing and recovery of patients and to enable personnel in the performance of
work.
 PG.6
7 Ventilation: Adequate ventilation shall be provided to ensure comfort of patients, personnel and
public.
8 Auditory and Visual Privacy: A hospital and other health facilities shall observe acceptable sound
level and adequate visual seclusion to achieve the acoustical and privacy requirements in designated
areas allowing the unhampered conduct of activities.

9 Water Supply: A hospital and other health facilities shall use an approved public water supply system
whenever available. The water supply shall be potable, safe for drinking and adequate, and shall be
brought into the building free of cross connections.
10 Waste Disposal: Liquid waste shall be discharged into an approved public sewerage system
whenever available, and solid waste shall be collected, treated and disposed of in accordance with
applicable codes, laws or ordinances.
11 Sanitation: Utilities for the maintenance of sanitary system, including approved water supply and
sewerage system, shall be provided through the buildings and premises to ensure a clean and healthy
environment.
12 Housekeeping: A hospital and other health facilities shall provide and maintain a healthy and
aesthetic environment for patients, personnel and public.
13 Maintenance: There shall be an effective building maintenance program in place. The buildings and
equipment shall be kept in a state of good repair. Proper maintenance shall be provided to prevent
untimely breakdown of buildings and equipment.
14 Material Specification: Floors, walls and ceilings shall be of sturdy materials that shall allow
durability, ease of cleaning and fire resistance.
15 Segregation: Wards shall observe segregation of sexes. Separate toilet shall be maintained for
patients and personnel, male and female, with a ratio of one (1) toilet for every eight (8) patients or
personnel.
16 Fire Protection: There shall be measures for detecting fire such as fire alarms in walls, peepholes in
doors or smoke detectors in ceilings. There shall be devices for quenching fire such as fire extinguishers
or fire hoses that are easily visible and accessible in strategic areas.
17 Signage. There shall be an effective graphic system composed of a number of individual visual aids
and devices arranged to provide information, orientation, direction, identification, prohibition, warning
and official notice considered essential to the optimum operation of a hospital and other health
facilities.
 PG.7
18 Parking. A hospital and other health facilities shall provide a minimum of one (1) parking space for
every twenty-five (25) beds.
19 Zoning: The different areas of a hospital shall be grouped according to zones as follows
19.1 Outer Zone – areas that are immediately accessible to the public: emergency service,
outpatient service, and administrative service. They shall be located near the entrance of the
hospital.
19.2 Second Zone – areas that receive workload from the outer zone: laboratory, pharmacy,
and radiology. They shall be located near the outer zone.
19.3 Inner Zone – areas that provide nursing care and management of patients: nursing service.
They shall be located in private areas but accessible to guests.

19.4 Deep Zone – areas that require asepsis to perform the prescribed services: surgical service,
delivery service, nursery, and intensive care. They shall be segregated from the public areas but
accessible to the outer, second and inner zones.
19.5 Service Zone – areas that provide support to hospital activities: dietary service,
housekeeping service, maintenance and motor pool service, and mortuary. They shall be
located in areas away from normal traffic.

20 Function: The different areas of a hospital shall be functionally related with each other.
20.1 The emergency service shall be located in the ground floor to ensure immediate access. A
separate entrance to the emergency room shall be provided.
20.2 The administrative service, particularly admitting office and business office, shall be
located near the main entrance of the hospital. Offices for hospital management can be located
in private areas.
20.3 The surgical service shall be located and arranged to prevent non-related traffic. The
operating room shall be as remote as practicable from the entrance to provide asepsis. The
dressing room shall be located to avoid exposure to dirty areas after changing to surgical
garments. The nurse station shall be located to permit visual observation of patient movement.

20.4 The delivery service shall be located and arranged to prevent non-related traffic. The
delivery room shall be as remote as practicable from the entrance to provide asepsis. The
dressing room shall be located to avoid exposure to dirty areas after changing to surgical
 PG.8
garments. The nurse station shall be located to permit visual observation of patient movement.
The nursery shall be separate but immediately accessible from the delivery room.
20.5 The nursing service shall be segregated from public areas. The nurse station shall be
located to permit visual observation of patients. Nurse stations shall be provided in all inpatient
units of the hospital with a ratio of at least one (1) nurse station for every thirty-five (35) beds.
Rooms and wards shall be of sufficient size to allow for work flow and patient movement.
Toilets shall be immediately accessible from rooms and wards.
20.6 The dietary service shall be away from morgue with at least 25-meter distance.
21 Space: Adequate area shall be provided for the people, activity, furniture, equipment and utility.

Space Area in Square Meters

Lobby
Waiting Area 0.65/person
Information and Reception Area 5.02/staff
Toilet 1.67
Business Office 5.02/staff
Medical Records 5.02/staff
Office of the Chief of Hospital 5.02/staff
Laundry and Linen Area 5.02/staff
Maintenance and Housekeeping Area 5.02/staff
Parking Area for Transport Vehicle 9.29
Supply Room 5.02/staff
Waste Holding Room 4.65
Dietary
Dietitian Area 5.02/staff
Supply Receiving Area 4.65
Cold and Dry Storage Area 4.65
Food Preparation Area 4.65
Cooking and Baking Area 4.65
Serving and Food Assembly Area 4.65
Washing Area 4.65
Garbage Disposal Area 1.67
Dining Area 1.40/person
Toilet 1.67
Cadaver Holding Room 7.43/bed
Clinical Service
Emergency Room
Waiting Area 0.65/person
 Toilet 1.67
Nurse Station 5.02/staff
Examination and Treatment Area with 7.43/bed
Lavatory/Sink
Observation Area 7.43/bed
Equipment and Supply Storage Area 4.65
Wheeled Stretcher Area 1.08/stretcher
Outpatient Department
Waiting Area 0.65/person
Toilet 1.67
Admitting and Records Area 5.02/staff
Examination and Treatment Area with 7.43/bed
Lavatory/Sink
Consultation Area 5.02/staff
Surgical and Obstetrical Service
Major Operating Room 33.45
Delivery Room 33.45
Sub-sterilizing Area 4.65
Sterile Instrument, Supply and Storage Area 4.65
Scrub-up Area 4.65
Clean-up Area 4.65
Dressing Room 2.32
Toilet 1.67
Nurse Station 5.02/staff
Wheeled Stretcher Area 1.08/stretcher
Janitor’s Closet 3.90
Nursing Unit
Semi-Private Room with Toilet 7.43/bed
Patient Room 7.43/bed
Toilet 1.67
Isolation Room with Toilet 9.29
Nurse Station 5.02/staff
Treatment and Medication Area with Lavatory/Sink 7.43/bed
Central Sterilizing and Supply Room
Receiving and Releasing Area 5.02/staff
Work Area 5.02/staff
Sterilizing Room 4.65
Sterile Supply Storage Area 4.65
Nursing Service
Office of the Chief Nurse 5.02/staff
Ancillary Service
 Space Area in Square Meter
Primary Clinical Laboratory
Clinical Work Area with Lavatory/Sink 10.00
Pathologist Area 5.02/staff
Toilet 1.67
Radiology
X – Ray Room with Control Booth, Dressing Area 14.00
and Toilet
Dark Room 4.65
Film File and Storage Area 4.65
Radiologist Area 5.02/staff
Pharmacy 15.00

Notes:
1. 0.65/person – Unit area per person occupying the space at one time
2. 5.02/staff – Work area per staff that includes space for one (1) desk and one (1) chair, space for
occasional visitor, and space for aisle
3. 1.40/person – Unit area per person occupying the space at one time

4. 7.43/bed – Clear floor area per bed that includes space for one (1) bed, space for occasional visitor,
and space for passage of equipment

5. 1.08/stretcher – Clear floor area per stretcher that includes space for one (1) stretcher
 PG.11

SUMMARY AND CONCLUSION

The most common problems associated with health-care waste are lack of knowledge of health
hazards related to health-care waste, inadequate training in proper waste management, lack of waste
management and disposal systems, insufficient financial and human resources and the low priority
granted to the matter. Many countries either do not have, or do not implement, appropriate
regulations. The specific allocation of responsibility for waste handling and disposal is an essential
issue.

Developing policies and procedures to steadily enhance waste segregation, destruction and disposal
practices along with strict supervision and control, with the great objective of achieving national and
international standards.
selecting safe and environmentally-friendly management options, to protect people from hazards
when collecting, handling, storing, transporting, treating or disposing of waste.

Designing a healthCare facility includes proper Deciding of safe and environmentally responsible
management solutions to protect individuals from threats as waste is collected, managed, stored,
transported, processed or disposed of.
Raising awareness of the dangers and safe and sound practices associated with health-care waste is
one of the keys for successful healthcare design.
 PG.12
REFERENCES

Nwachukwu, N., Orji, F., & Ugbogu, O. (2013, May 15). Health Care Waste Management – Public
Health Benefits, and the Need for Effective Environmental Regulatory Surveillance in Federal
Republic of Nigeria. Retrieved October 19, 2020, from
https://www.intechopen.com/books/current-topics-in-public-health/health-care-waste-
management-public-health-benefits-and-the-need-for-effective-environmental-regulat

Health-care waste. (n.d.). Retrieved October 19, 2020, from https://www.who.int/news-room/fact-

sheets/detail/health-care-waste

AZ. Alagoz, G., M. Askarian, M., M. Askarian, P., MK. Debere, K., MM. Hassan, S., M. Karamouz, B.,
. . . GMA. Mostafa, M. (1970, January 01). Impact of intervention on healthcare waste
management practices in a tertiary care governmental hospital of Nepal. Retrieved October 19,
2020, from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-1005

Why Health Care Waste Management. (2018, July 09). Retrieved October 19, 2020, from
https://noharm-global.org/issues/global/why-health-care-waste-management