Infrastructure Guidance for COVID-19/Alternate Care Sites/Examples of Accommodation Schedules for COVID-19 Wards for Mild to Severe Cases

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Examples of Accommodation Schedule - Ward for Mild to Severe Cases

(based on work by edwina fleming)

Patient Spaces

room type	general description	spatial requirement
ward room ‘mild & moderate’ acuity	large multi-bed ward.	# side cupboard room/ward must be under controlled access room selection should consider space with impervious floors and washable walls room to be supplied wall and bed side mounted hand sanitiser deep cleaning is required once the site is decommissioned room must have openable windows for ventilation or a temporary ventilation system installed as appropriate for the planned occupancy. Refer to the engineering section in this document. Spacing between adjacent beds: 1600mm Severe 2200mm Critical Bed spacing: 2200mm between foot of bed and opposite bed (minimum) 600mm spacing between the bed head and wall.
Ward room Critical & Severe acuity	Large multi-bed ward up.	# Side cupboard Room/ward must be under controlled access Room selection should consider space with impervious, smooth floors and washable walls Room to be supplied wall and bed side mounted hand sanitiser Room must have openable windows for ventilation or a temporary ventilation system installed as appropriate for the planned occupancy. Bed spacing: 2m between beds (minimum). 600mm spacing required at the head of the bed. Bed spacing: 2 m between foot of bed and opposite bed (minimum) Area setup similar to in hospital ICU.
Ward room Recovery	Large multi-bed ward.	* To match requirements for mild & moderate acuity cases
Bathroom	Toilet, shower/bath, basin	* Communal portable showers are acceptable, shared between green and orange status ward. Separate communal showers for the recovery ward Communal portable toilets are acceptable, shared between green and orange status ward. Separate communal showers for the recovery ward Deep cleaning is required once the patient is discharged before a new patient is admitted. Room must have openable windows for ventilation, if not possible the extraction and ventilation system to engineer's design (see ventilation section of ACS guideline) Minimum one disable toilet and shower should be provided. Showers, toilets and wash basins to be provided at a ratio of 1 for every 8 patients. Area requirement: per shower: 2 m2, per toilet and hand wash basin: 3.5 m2.
Standard bed service required per bed	Nurse call One per bed	Task light One per bed
If rooms have access to external balcony, access can be granted, however if room balconies are adjoined, access must be restricted.
If room has access to external garden, this must be restricted, unless external patio can be cordoned off.

Service spaces

Shared Spaces
Room type	General description	Spatial and other requirement
Utilities
Linen store	Room utilised for controlled storage and distribution of clean linen.	# Must be decontaminated before first use. Must be under controlled access (lock or other). Room selection should consider hard surfaces. To be provided with shelving (e.g. 450mm depth, four-tier, 600mm running length per 10 beds) Area requirement depends upon the number of beds served.
Clean utility Surgical store Medicine stores	Separate/ combined rooms to be utilised for controlled storage. Lockable. General cupboard utilised for controlled storage and distribution of medication, can be shared with surgical store. See above note	# Must be once of decontaminated before use. Must be under controlled access (lock or other). Room selection should consider hard surfaces. Room to be supplied with gloves, apron and surgical masks and wall mounted hand sanitiser Clinical hand wash basin Area requirement if combined 16 m2
Housekeepers store		#
Dirty linen/utility room	Room utilised for controlled storage of dirty/contaminated linen. Used linen to be stored in bags and bagged into waste bag for transport to laundry. Wash hand basin.	# Must be once of decontaminated before use. Must be under controlled access (lock or other). Room selection should consider hard surfaces. Room to be supplied with gloves, apron and surgical masks and wall mounted hand sanitiser. Area requirement 8 m2.
Body hold room	Room utilised for the deceased patients, prior to collection by mortuary.	# Must be under controlled access (lock or other). Room selection should consider hard surfaces. Room must have mechanical ventilation. Room to be supplied with body bags, gloves, apron and surgical masks and wall mounted hand sanitiser.
Equipment store		# Area requirement 12 m2
Dirty utility/ waste combined	Storage and handling of waste, prior to collection	# Urinate and defecation into bedpan. Treated with 5,000 ppm of sodium hypochlorite (1:10 dilution of bleach solution) for 30 minutes and then carefully disposed of into the sanitary sewer. Area requirement 12 m2
Nurse station and records	Nurse record keeping and	# Area requirement 12 m2 Clear/transparent screen between patients and nurses (from duty station to ceiling) Crash cart bay Clinical hand wash basin
Room type	General description	Spatial and other requirement
Clinical
Consultation/counselling room/ can be dual function	For patient follow up and minor treatment not performed at bed side.	# Area requirement 14 m2 Services required: Oxygen and power outlets. Examination light (consultation), Clinical hand wash basin, Examination couch, 1x consultation room for every ward
Emergency procedure room	For minor procedures that do not require theatre – Operating theatres are not provided at ACS sites	# One single procedure room, central between all wards Area requirement 31 m2 Services required: Oxygen & medical gas, Power outlets. Examination light, Hand wash basin Soap dispenser, Glove, Respirators, gowns and aprons. Appropriate ventilation, refer to engineering services
Laboratory room	Room utilised for analysing samples in the GeneXpert, storage of samples, and data capturing. Autoclaves may be provided.	# Area requirement 12 m2
Room type	General description	Spatial and other requirement
Access
Donning area for staff	Entrance room into the facility, for all staff donning	# Staff access Patient access Controlled visitor access only Floors and wall to be washable All PPE to be provided (Gown, apron, respirator, visor, and gloves) Medical waste dispensing to be provided Wall mounted hand sanitised and mobile or fixed clinical hand wash basin. Staff ONLY to access central locker area Appropriate ventilation to be provided, (refer to ACS engineering services section)
Doffing area for staff	Exit room from the facility, for all staff doffing	# Staff exit Patient discharge only Controlled visitor exit only The estimated area to be based on total facility staff. Floors and wall to be washable Medical waste dispensing to be provided Bins for disposable PPE. Decontamination facilities for reusable PPE. Wall mounted hand sanitised and mobile or fixed clinical hand wash basin. Staff ONLY to access central locker area (refer to image 1) Appropriate ventilation to be provided, (refer to engineering services section
Trolley wash area	Trolley wash area	# External area close proximity to ambulance drop off. Water connection and water hose Plumbing, consider fluid discharge to the sewerage system Hard floor surface.
Wheelchair and porters	Storage area for distribution of wheel chairs to patients	# Location is at the entrance of the facility. Area to be provided, minimum of 4 m2 Wall mounted hand sanitised to be provided
Room type	General description	Spatial and other requirement
Staff
Staff change room	Central between the entrance and exit room (Refer to donning and doffing area)	# A minimum of 9m² or 4m² for a single person, increasing by one m² for each additional person is required. Space provision should take into account peak numbers of full time staff, volunteers, students and visitors at any one time. Estimate number of staff 60, SANS requirements, Male: Showers x4, toilet x2, urinals x3 and hand wash basins x3. Female: Showers x4, toilet x5 and hand wash basins x3. Separate male and female. Total minimum area for staff change: 22 m2 SANS 10400 part S & P Lockers to be provided
style="border-top:none;border-bottom:1.5pt solid #000000;border-left:1.5pt solid #000000;border-right:1pt solid #000000;padding:0.176cm;" | Staff rest rooms	#	# Staff rest areas must be provided with a kitchenette and accessible to staff change areas to reduce the number of ablution facilities. Provision for 4-6 people at a time, depending on shared status and total staff Electrical points, sink and hydroboil or similar
Room type	# General description	# Spatial and other requirement
Public
24 Hour Help Desk	Basic information and public	# Reception area for visitors and deliveries. Recommended 9 m2. Room to be supplied with surgical masks and a wall mounted hand sanitiser Perspex or glass screen
External waiting area	Waiting area for parents of ill children, and caretaker of elderly	# Recommend a 30 m2 area, 1.5 m2 per person totals 15-20 people with an estimate waiting time of 15-30 minutes Well ventilated room, or external under cover area. Room to be supplied with surgical masks and a wall mounted hand sanitiser
Public Toilets	For waiting parent or caregiver only	# Male, female and disabled ablution facilities to be provided in accordance with the National Building Regulations, refer to SANS 10400 part S & P.
No shared meeting or socialising area to be provided
No shared dining area to be provided for patients, in room dining only

Support Services

Room type	General description	Spatial requirement
Central Sterilise Service Department (CSSD)
# Dirty Receiving # Dirty Utility # Decontamination and cleaning/wash area with throughput instrument washing # Trolley wash/Park – external # Store -linen and consumables # Clean Packing area # A table top autoclave Instrument washer # Sterile pack store # Issue - Collection hatch # Female change room with toilet and shower # Male change room with toilet and shower		Total area required inclusive of circulation: 110 m2
This is short-term temporary or mobile assembly requirement. Service required: water, electricity and sewer holding tank
Room type	General description	Spatial requirement
Diagnostics (Radiology fixed and mobile)
# Records # Chest X-Ray (floor-standing, mobile/ Lodox) # Reporting/Viewing Room # Computer server room # Store # Staff toilet # On call room # On call ensuite # Dirty Linen/ Utility		Total area required inclusive of circulation: 95 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity.
Room type	General description	Spatial requirement
Pharmacy (discharge dispensing and bulk storage)
# Dispensing shelving area Dispensing counter with glass/ Perspex screens # Fridges area # Counter - data capture # Office - Pharmacy Manager # Wet Compounding cubicle # Dry Compounding cubicle # Store prepack manufacture # Ward med script preparation area # Enclosed delivery area with covered unloading platform # Receiving Desk # Unpacking area # Bulk Store - general # Flammable store # Cold Room and fridges # Schedule Drugs safe # Vaculiter store with mobile racking # Store Expired or waste medicines		Total area required inclusive of circulation: 280 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity and sewer holding tank. This is medicine storage and ward distribution, the only dispensing that will occur, is for discharged patients.
Room type	General description	Spatial requirement
Laboratory services (testing and data capture)
# Reception counter- receiving specimens Testing with perspex/ glass screen # Receiving/Data capture # Specimen Holding # Toilet - staff # Blood storage fridge		Total area required inclusive of circulation: 37 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity and sewer holding tank. This is a testing, and data capture local site service – supported by NHLS,
Room type	General description	Spatial requirement
Administration
# Open plan clerks office # Meeting boardroom - command centre # Cleaners Room # Kitchenette # Training Room # Ablutions-Female Staff # Ablutions- Male Staff # Ablutions-Disabled Staff Medical records – Secure space for patient mediacl records. Should adhere to the same applicable legal authorities and guidance governing the routine collection, use, and storage, of personal information.		Total area required inclusive of circulation: 127 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity. This is only essential administration.
Room type	General description	Spatial requirement
Bulk stores (all supplies)
# Good receiving # Dispatch area # Secure store – surgical supplies # Secure store – medical supplies # Secure store – soap and cleaning consumables # Secure store - Medical equipment store # Secure store - Toxic material store # Secure store - Flammable store # Dirty utility, with space for empty boxes		Total area required inclusive of circulation: 180 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity. This is bulk storage for all goods and the asset management and distribution thereof.
Room type	General description	Spatial requirement
Mortuary short term hold (Viewing included)
# Waiting # Office : Service manager # Body receiving area # Viewing room with complete glass/ perspex separation between body and viewing space # Cold room for 20 bodies (2 tier) + # Hearse loading area - covered and enclosed # Cleaners Room # Trolley Wash # Dirty Utility # Change room with toilet and shower - female staff # Change room with toilet and shower -male staff		Total area required inclusive of circulation: 148 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity and sewer holding tank. This unit will not be freezing bodies, only refrigeration will be provided. Local mortuary services will be involved to ensure at 24hr service turnaround time, in line with Health ministers directive (08-04-2020).
Room type	General description	Spatial requirement
Laundry, outsourced service model (Holding with basic sluicing only)
# Manager`s Office Contaminated side # Trolley wash area Dirty Linen Receiving and Holding # Bulk Dirty Linen Sorting # Dirty linen collection - covered open area # Sluicing facilities may be required # Washing machines & dryers # Loading & unloading washing machines # Staff ablutions # Store - cleaning materials # Staff change, locker, shower and toilet # Clean linen receiving - open covered area # Clean linen issue # Trolley park # Change room with toilet and shower - female staff # Change room with toilet and shower -male staff		Total area required inclusive of circulation: 184 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity. This only a holding site, with outsourced local contractors as per local Health Department procurement
Room type	General description	Spatial requirement
Kitchen, outsourced service model (Receive and Dispatch only)
# Goods receiving & off loading # Staff dining area with a servery to the delivery area # Food supervisor`s office # Store - Cleaning and equipment # Preparation area # Food Trolley park area # Food Trolley wash area # Tray stack area # External waste area		Total area required inclusive of circulation: 100 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity. This only a holding and supply site, with outsourced local contractors as per local Health Department procurement
Room type	General description	Spatial requirement
Engineering services and temporary plant
# Electrical plant room(s): transformer, generator, switchgear # Water plant room(s): booster pump(s), water treatment, water storage # Sewage plant room(s): treatment plant, booster pump(s) if necessary for this site # Site medical gasses: storage for full and empty cylinders, medical gas manifolds & plant room, medical air compressors, vacuum system # Hot water: Gas heater/ Calorifier at each ward (geysers at each ablution in the ceiling void) # Life saving UPS Cold room plant: Mortuary, kitchen # Ventilation (HVAC) where there is inadequate natural ventilation # Server room		Total area required inclusive of circulation: 440 m2
This is short-term temporary or mobile assembly requirement. Provision of all essential series and short bulk connection to all municipal service.
Room type	General description	Spatial requirement
Waste management, outsourced service model (Holding only)
•Office - manager •Green, yellow, red bin wash area •Green, yellow, red storage area for clean bins •Storage area for Green, yellow, red waste awaiting collection •Storage area for domestic waste skip •bins •Change room with toilet and shower - female staff •Change room with toilet and shower -male staff# General waste is stored in black bag or bin, Infectious waste in red, sharps in yellow and pharmaceutical in green Office - manager # Green bin wash area # Green bin storage area # Storage area for plastic waste # Storage area for domestic waste skip # Storage area medical waste waiting to be removed # Storage for clean medical waste boxes and sharp bins # Change room with toilet and shower - female staff # Change room with toilet and shower -male staff		Total area required inclusive of circulation: 149 m2
This is short-term temporary or mobile assembly requirement. Service required water, electricity. This only a holding site, with outsourced local contractors as per local Health Department procurement