Technical Specifications for a Surgical Healthcare Mobile Unit

Surgical Healthcare Mobile Unit

1. Introduction to Surgical Healthcare Mobile Units

Surgical Healthcare Mobile Unit; Educational, surgical healthcare mobile units refer to purpose-designed and fabricated vehicles operated by, or under the license of, healthcare providers. In Latin America and the Caribbean, the term “surgery” refers to general surgical procedures, which go beyond “cosmetic surgery” in terms of complexity. The mobile surgical healthcare units have a straight-line impact on the satisfaction of communities in rural areas and a right of the peripheries of metropolitan centres, and, automatically, very restricted physical access and availability of surgical services. Timely surgical care in these vulnerable locations can prevent further deterioration of the health of the most fragile populations and improve the quality of life of rural families. General surgical procedures prevent loss of life and are essential for the quality of surgery, especially during early childhood growth and development.

In rural communities, engaging and promoting intercultural development will allow communities to access “white” medicine surgery. The provision of intercultural and safe surgical care makes an important contribution to social trust and social cohesion, and thus “human development” and the general satisfaction of many families in disadvantaged areas. The scarcity of health personnel in many rural regions and the lack of capacity of the health services peripheries of the mega-urban centers rely on the implementation of strategies to increase access to essential surgical treatment. This can be enhanced by the provision of elective and emergency surgical care in health facilities, the decentralization of surgical cases in public care to other large public hospitals centres, and in the present case, the complementation of the provision of surgical care in some suitable spaces, using non-standard methods of providing surgical outpatient-linked care.

2. Design and Layout Surgical Healthcare Mobile Unit

Design and layout are keywords. The external and internal layouts have been studied according to architectural layout and ergonomic parameters. The technological systems and their components are designed to minimize any damage from exhaustibility and/or wear. High-quality materials, like stainless steel on internal surfaces, are used. Insulation and isolation of rooms from external noise have been studied too. The layout of the mobile unit is also designed to increase, as much as possible, the visibility of the relative system. The simplicity and functionality of the design, both externally and internally, are key features of the mobile unit.

Exterior design The vehicle dimensions are 12.0 m × 2.55 m × 4.0 m (length × width × height) and are optimized in compliance with the laws that rule circulation from one country to another without any particular transport service. The exterior design solution studies the aerodynamics. From the shape of the body to design the external look and benefits from the image of an innovative, high-tech brand marked the advanced targets. The importance of communicating the idea of innovation and modernity led to a solution in conformity with the strategic vision of maximizing the visibility and corporate image at any stage of the hospital business.

Interior layout Surgical operations require, above all, a good correlation of space and spatiality. In this case, at all stages of surgical procedures, the clinical applications are studied continuously as a result of direct feedback with doctors. The clinical choices are made in terms of the different target patients. The spatial organization of the rooms and of each individual technical device guarantees the necessary operating proximity and the spatiality that allows clinicians and technicians to position the various medical devices, according to their ergonomic functions and the best access.

2.1. Exterior Features Surgical Healthcare Mobile Unit

The mobile unit shall be constructed and designed to permit safe mobility for travel on well-paved local, state, and federal routes on roadways with speed limits ranging from 35 to 55 miles per hour within the contiguous United States. The towed mobile units shall have tandem axles and all-steel frame construction with support legs and a hydraulic leveling system for easy setup. The construction shall also make use of steel beams longitudinally and laterally running the full length of the body. The basic structural members of street-side and curbside walls shall not be less than 2″ tube 7-gauge steel vertical studs on 16″ centers providing a solid attachment surface for all components, as well as an exceptionally strong cellular beam. The exterior walls of the mobile unit are to be comprised of welded steel frame construction with a pre-painted steel outer skin and insulated with polyurethane foam.

Exterior walls of the mobile units shall be clean-cut, capable of being fabricated to close tolerances, and painted with the selected color choice. On the towable mobile units, there shall be a painted fiberglass structural (painted, textured, and painted with UV protection) exterior running the length of the curbside, including an extended front section with a one-piece seamless design. Hinged doors with electrically powered entry steps shall provide access to patient and HCW entry/exit directly off the main and/or central corridors. Exterior entry doors and windows are made with anti-bacterial gaskets that shall have one-piece continuous anti-bacterial gaskets. Security screen doors shall be provided on all main entry doors. Each side door window shall be equipped with vision panels composed of multiple thermoplastic sheet laminations spaced to produce an impact-resistant panel. Exterior surfaces of the glass are to have a smooth finish, impervious to air, water, and smoke, with the exterior glazed windows being gasket-sealed to the door. Windows shall be clear laminated impact, tinted glass and fixed for safety purposes. Intake and exhaust ports of air handling systems shall have large insect-resistant, foam core filters inaccessible to occupants or patients. In the ceiling of the mobile unit shall be a visual smoke detector suitable for use in healthcare facilities. The overall design and construction of the exterior of the mobile units result in an efficient, high aesthetics, durable, and weather-resistant healthcare unit.

2.2. Interior Features

The surgical healthcare mobile unit should be constructed in such a way that the exceptionally limited floor space is used to the best advantage. The set-up should be promoted to create a comfortable atmosphere for both the operator and patient, and patient flow and work procedures should be easily accessible. To make it easier to service the unit, all structural parts and shelves and cupboards should be removed from the walls and the floor. Only smooth surfaces should be used for walls, floors, ceilings, joineries and furniture (appropriate for cleaning according to the recommendations of the Hygiene Department in Healthcare).

Joint material should be, as far as possible, resistant to handling agents and disused cleaning agents. Lack of contact means (clean areas) should be discarded to create comfortable and have both visual and auditory stress and reduction. Equipment in working areas must be ergonomically desirable. In fact, surgeons appreciate better satisfaction when operating in daylight. As a result, decent windows should be made to allow for natural lighting. Adequate cladding and/or protection must be put in place to ensure that distortion of light makes safe control difficult. An investigative drawer that can be taken somewhere on the table can be really convenient to reduce transport/distance rates. The height of benches can be tailored to the user or client. The Quick-Set table has a low frame and close feet in 720 Model holes. This model fits well with long legs. This bulb and lamp compartment were placed using the right tension and power. Durable, quite easily accessible protected bulbs at least 100 lux. Such effects can of course vary from natural light to sunlight. Bends can also vary. Lots of skin lamps can be mounted on floors or walls. It does not necessarily mean that more sophisticated ventilation systems with special filtering may be introduced here such as laminar flows.

3. Medical Equipment and Technology

Medical equipment and technology: Assembled surgical healthcare mobile units need to have an integrated set of ready-to-use surgical equipment. The recommended surgical instruments and equipment are given in Section 1 as an itemized list. When used and then cleaned, the medical equipment associated with each surgical inventory will need to be integrated back onto the system where it is checked and restocked, cleaned, and sterilized using an integrated system to make it ready for use at the next surgical procedure. In addition to this, surgical procedures, staff training, and consultancy where required are given in Sections 2, 3, and 4.

Imaging technology: In most well-equipped hospitals, a combination of ultrasound (sonar) and radiology are available to give an indication of visual problems that indicate the need for some form of surgery, as well as diagnosing the nature and extent of any surgical problem, including those that may require follow-up. X-rays are also useful for guide wire procedures. It is expected that for small rural primary healthcare units with minimal or no laboratory facilities, an imaging service using a simple-to-use portable hand-carried ultrasound should be pretty much standard once a surgeon is established there as part of the primary healthcare work. Larger, more mobile surgical healthcare units ideally will be able to add radiology services for larger work-ups and field surgical services.

Integration of advanced medical equipment and technology: Beyond workplace-supported medical imaging, mobile surgical healthcare units can also confirm their role with advanced medical technology becoming available, ideally integrated into the mobile surgical healthcare unit. For emergency and elective medical conditions, advanced medical technology equipment is necessary so that surgery can be performed safely and effectively. The specific medical equipment that will be able to utilize largely depends on the cohort of patients to cater and also needs to be integrated into filters and oxygen concentrator use.

3.1. Surgical Instruments Surgical Healthcare Mobile Unit

Just as important as the physical structure in which the medical care will be provided are the tools that are to be used within the clinic. There are several tools that are necessary to be able to conduct different types of surgeries. After surgery, these tools need to be cleaned and sterilized prior to being put back into use.

Three Different Types of Sterilization: 1. Heat Effect – with heat from 121° to 134° Celsius (for an average of 10-20 minutes). 2. Steam and Vapor Sterilization – with humid heat from 121° to 134° Celsius (for 10-30 minutes). 3. Dry Heat Sterilization – with temperature for 1 to 5 hours. Tools need to be well thought out for easy sterilization – do not hold germ-harboring liquid.

Ergonomic Design Required: Tools Used Need to be Precise More specific to the settings of this medical unit, some areas to address are the following: – Instruments should be designed to fit within the size and shape of any designated pocketed compartment (draw scavenger chest, port tables, etc.) permanently affixed to the unit, and should be ergonomically designed to allow either left- or right-handed clinicians to readily and safely use the item with a sterile glove. – The instruments should be designed with such preciseness and accuracy that they are easy to use, further lessening the need or number of assistant staff. – Tools developed and designed in more advanced societies may need to be re-designed to fit the local setting. For example, when adding ultrasound or x-ray, these should be more portable tools.

Products/Ordering Equipment If specific tools do not exist, manufacturers should be tasked with engineering instruments or equipment that is portable, sterilizable, instantaneous, mobile, user-friendly, and multifunctional. If new items are engineered, tools or equipment developed by these engineering organizations shall become proprietary securities of the mobile healthcare unit and all its services.

3.2. Imaging Equipment

Surgical mobile units are equipped with imaging equipment in order to allow diagnostic as well as interventions. For the diagnostic, a sophisticated imaging end solution is a prerequisite as not all patients are road seed. This implies a diagnostic Imaging System like portable X-ray, ultrasound, or any other form of portable imaging.

The surgical mobile unit is equipped with one shop package X-Ray 100 mAs that can either be wall or ceiling mounted. The X-Ray Generator can be movable when the use of the patient table requires it to be in another position. All imaging equipment exposes the staff and accompanying helpers to radiation. Maximum efforts are made to reduce this radiation as much as possible and also to limit the persons who are daily exposed to radiation. Especially operators are in this situation. Below, the most important characteristics and systems are illustrated that are utilized in the surgical healthcare environment. to optimize the image, the following characteristics are important: • Flat panel detector • 17-inch LCD screen • 6” viewing area to optimize workflow and safety, the following characteristics are important: • Full quiet one-touch operating system • Automatic dose regulation • Sirius (auto position, auto settings). Normally, the operator position during the use of the C-arm X-ray is quite close to the source with close to maximum scatter and dose. The C-arm X-ray systems used in the Truck innovation are certified according to the upcoming new norms IEC 60601-2-43. The advantages of the performance specifications of C-arm periscopic option over the conventional full-size options are: • Less scatter due to a pest beam quality setting. • In addition, with the flat panel detector, higher image diagnostic quality. • Lower radiation with a higher mono-pitch and the flat panel detector.

Preferably, the C-arm was also equipped with an image intensifier 50cm which, in combination with the high-resolution monitor, further raises the image quality. The image consolidation of direct and live image sources will result in imaging identical to the intervener and the radiologist. In order to increase the working environment and patient safety, the use of the C-arm in lift position is made possible. The C-arm also integrated dose-saving systems that can be automatically regulated in order to minimize the over-irradiation due to suboptimal radiological settings. The system is further equipped with a remote-controlled patient table for optimal working facilities and security during interventions.

4. Safety and Regulatory Compliance

Safety The safety of patients, staff, and others involved is the primary concern associated with the mobile surgical unit. The mobile healthcare unit arrives at the customer’s location in the out-of-hospital setting. The mobile unit is a functioning piece of healthcare real estate. This means that the patient is treated inside it as a regular healthcare facility. Consequently, patient safety is of paramount importance, as is the safety of the healthcare staff working within the mobile unit. Patients who are treated within the facility have the same rights and raise the same safety concerns as those treated within a fixed healthcare institution (e.g., a hospital). Healthcare staff working within the mobile unit are also covered by all labor laws and safety standards. The mobile unit needs to follow all state and federal (OSHA) requirements as any regulated healthcare facility.

Regulatory Compliance The mobile surgical facility needs to meet all requirements as do hospitals or ambulatory surgical facilities. This means that the mobile unit must be licensed and regulated as an Ambulatory Surgical Treatment Center (ASTC) as set forth under the state health code governing surgical care. The Joint Commission has regulations for ambulatory surgical centers. Medicare has regulations that apply for ambulatory surgery center as set forth in 42CFR416 as an approved ambulatory surgery center. The mobile unit must be inspected and approved to operate as an approved ambulatory surgery center by the local State Office of Licensure and Certification agency. Breakdowns of inspectional requirements are as follows.

5. Maintenance and Service Surgical Healthcare Mobile Unit

A maintenance schedule will be produced for each set of equipment to ensure proper routine maintenance. This will be agreed upon with help from the medical director and the operating team, and all records will be kept by the Mobile and the local Operating Team. Service contracts should be held by the equipment users and local hospital equipment departments to cover all equipment and to be paid for from central funds. Service engineers should be accredited by the manufacturer. Mobile must be given at least 3 months’ notice to allow the mobile unit to undergo maintenance and obtain all equipment from the hospital prior to this. A positioning and carriage unit should be identified and used for all heavy equipment movement. Regular staff training will be conducted on the installation, use, maintenance, and potential troubleshooting of all equipment.

Adequate consumable stocks for the surgery will be held in the unit. These stock levels will be monitored by the medical director (or designated replacement) and a log held on the unit and at the local operating hospital. Due to the market and the urgent need for surgery, all stocks in the pharmacy should be controlled. If the expected use of consumables is required on a short-time scale, an urgent replacement order should be made. The response time would then be less than the time needed for closure of the national inventory stock. An urgent spare-part service contract should be held by Mobile to supply any equipment or spares when required. If required, a surgical team would be relocated to the local hospital or diverted to northern centers where appropriate temporary surgery is available.

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