Anaesthesia Equipment and Anaesthetising Facilities: Facilities
Introduction The requirements for healthcare facilities providing surgical services are described in the Infrastructure Unit Support Systems (IUSS) Health Facility Guides: Facilities for Surgical Procedures (Gazetted 30 June 2014 – Appendix B ) that supersedes regulation R158 on Infrastructure and should be interpreted in conjunction with the current National Core Standards (NCS) Regulations ( Ap
Introduction
The requirements for healthcare facilities providing surgical services are described in the Infrastructure Unit Support Systems (IUSS) Health Facility Guides: Facilities for Surgical Procedures (Gazetted 30 June 2014 – Appendix B) that supersedes regulation R158 on Infrastructure and should be interpreted in conjunction with the current National Core Standards (NCS) Regulations (Appendix A [Core standards]).
Please note: Recommendations have been adopted to accommodate the legislation providing for the designation of hospitals as Gazetted on 2 March 2012 by the National Department of Health (NDoH), “Regulations relating to categories of hospitals” in which hospitals are designated according to the number of beds, the staffing skills and registration of both medical and nursing staff, ability to provide critical care, and the outreach and support services that the facility undertakes and receives.
District hospital (Level 1)
This category is divided into small (50–150 beds), medium (150– 300 beds) and large (more than 300 beds). District hospitals provide a 24-hour service staffed by general practitioners and clinical nurse practitioners, on an inpatient, ambulatory and emergency basis. A district hospital receives outreach and support from general specialists based at regional hospitals.
Regional hospital (Level 2)
It has between 200–800 beds and provides 24-hour service in internal medicine, paediatrics, obstetrics and gynaecology, and general surgery, with additional services in at least one of the following: orthopaedic surgery, psychiatry, anaesthesia, and diagnostic radiology. Services include trauma and emergency services, and the facility must provide short-term ventilation in a critical care unit. A regional facility receives referrals from several district hospitals in its geographic area and should receive outreach and support from tertiary hospitals.
Tertiary hospital (Level 3)
It has 400–800 beds, provides the services of a regional hospital, and has subspecialties of internal medicine, paediatrics, obstetrics and gynaecology, and general surgery. The critical care unit will provide intensive care under the supervision of a specialist or specialist intensivist. Tertiary hospitals receive referrals from regional hospitals and may provide training for healthcare professionals.
Central hospital (Level 4)
It has a maximum of 1 200 beds and provides tertiary services. In addition, it provides central referral and national referral services, must conduct research, must provide training for healthcare professionals, and must be the main teaching platform for a medical school.
Specialised hospital
It has a maximum of 600 beds and provides specialised services like psychiatry, infectious diseases, tuberculosis or rehabilitation services.
Private facilities
The Health Act (2012) only provides for “for-profit” and “not-for-profit” categories of private hospitals. For the purposes of these guidelines, the committee regards most private healthcare facilities with inpatient beds to meet the criteria of at least a regional hospital. Therefore, the facility needs to meet the applicable standards.
Stand-alone, day-care facilities
Stand-alone, day-care facilities providing sedation and anaesthesia in a theatre must be equipped to the level expected of a regional hospital.
Facilities for office-based sedation
Facilities that provide office-based sedation only must be equipped according to the standards required in the SASA “Guidelines for the safe use of procedural sedation and analgesia for diagnostic and therapeutic procedures in adults: 2021.” (Appendix C)
Note:
- Where hospitals provide a combination of levels of care, the facilities and equipment must meet the requirements for the higher level of care.
- Private practitioners should familiarise themselves with requirements by some hospital groups/facilities for facility agreements and electronic record keeping. (Appendix D).
South African Society of Anaesthesiologists (SASA) Practice Guidelines_2022_Reviewed by: P Bettings