CNG TY TNHH BNH VIN A KHOA QUC T V ANH ----------- ( ( ( ----------THUYT MINH D N U T XY DNG BNH VIN A KHOA QUC T

V ANH II

A IM: PHNG BNH KHNH, QUN 2, THNH PH H CH MINHCH U T: CNG TY TNHH BNH VIN A KHOA QUC T V ANHCNG TY TNHH BNH VIN A KHOA QUC T V ANH

----------- ( ( ( ----------THUYT MINH D N U T XY DNG BNH VIN A KHOA QUC T

V ANH II

NI DUNG

5CHNG I: GII THIU CH U T V D N

5I.1. Gii thiu ch u t

5I.2. M t s b d n

5I.3. C s php l

8CHNG II: NGHIN CU TH TRNG

8II.1. c im t nhin v tnh hnh kinh t x hi Vit Nam

8II.1.1. c im v iu kin t nhin

8II.1.2. Tnh hnh kinh t

8II.1.3. Tnh hnh x hi

9II.2. Hin trng ngnh YVit Nam

9II.2.1. Tnh hnh chung

10II.2.2. Y t t nhn

11CHNG III: S CN THIT PHI U T

11III.1. Mc tiu ca thuyt minh d n

11III.2. S cn thit phi u t

12CHNG IV: A IM D N

12IV.1. V tr a l d n

13IV.2. iu kin t nhin chung ca khu vc d n

13IV.2.1. a hnh

13IV.2.2. Kh hu

13IV.2.3. a cht cng trnh

14IV.2.4. Thy vn

14IV.3. Hin trng cng trnh v h tng k thut

14IV.3.1. Hin trng s dng t

14IV.3.2. ng giao thng

14IV.3.3. Hin trng cng trnh h tng v kin trc

14IV.3.4. Hin trng cp in

14III.3.5. Cp Thot nc

14IV.4. Nhn xt chung

15CHNG V: MC TIU, CHC NNG, NHIM V CA BNH VIN

15V.1. Mc tiu

15V.2. Chc nng- nhim v

15V.2.1. Cp cu, khm bnh, cha bnh v chm sc sc khe

15V.2.2. o to cn b

15V.2.3. Nghin cu khoa hc v y hc

15V.2.4. Phng bnh

16V.2.5. Hp tc quc t v y hc

16V.2.6. Qun l kinh t trong bnh vin

17CHNG VI: PHNG N XY DNG C S H TNG

17VI.1. Gii php v kin trc v k thut

17VI.1.1. Gii php v kin trc

18VI.1.2. Gii php v kt cu

18VI.2. Gii php v cp thot nc

18VI.2.1. Cp nc

19VI.2.2. Thot nc

20VI.3. Gii php lp in

21VI.4. Gii php chng st

22VI.5. Gii php iu ha khng kh

23CHNG VII: NH GI TC NG MI TRNG

23VII.1. C s php l

23VII.2. nh gi tc ng tch cc n mi trng ca d n

23VII.3. nh gi tc ng tiu cc v bin php x l

24VII.4. Mc ch ca bo co nh gi tc ng mi trng

24VII.5. Tc ng mi trng ca d n

24VII.5.1. Tc ng trong giai on xy dng

26VII.5.2. Cc tc ng chnh trong giai on vn hnh

27VII.6. Bin php gim thiu v cc tc ng n mi trng

27VII.6.1. Gim thiu cc tc ng trong giai on thi cng

28VII.6.2. Gim thiu cc tc ng trong giai on vn hnh

32CHNG VIII: QUY M BNH VIN, B MY QUN L V T CHC NHN S

32VIII.1. Quy m bnh vin

32VIII.2. B my qun l bnh vin

32VIII.2.1. B phn qun l

32VIII.2.2. B phn chuyn mn

34VIII.3. T chc nhn s, cn b

35CHNG IX: PHM VI HOT NG CHUYN MN V TRANG THIT B Y T

35IX.1. Phm vi hot ng

35IX.1.1. Khoa ni

35IX.1.2. Khoa ngoi

36IX.1.3. Khoa sn

37IX.1.4. Khoa nhi

37IX1.5. Khoa hi sc cp cu

37IX.1.6. Khoa sn sc c bit

38IX.1.7. Khoa khm bnh

39IX.1.8. Khoa iu dng v phc hi chc nng

40IX.2. Trang thit b y t

45CHNG X: TNG MC U T D N

45X.1. C s lp tng mc u t

45X.2. Ni dung tng mc u t

45X.2.1. Ni dung

47X.2.2. Kt qu tng mc u t

49CHNG XI:NGUN VN U T-THC HIN D N

49XI.1. Ngun vn u t ca d n

49XI.1.1. Cu trc ngun vn v phn b vn u t

49XI.1.2. Tin thc hin d n v s dng vn

50XI.1.3. Ngun vn thc hin d n

51XI.1.4. Phng n hon tr vn vay v chi ph li vay

52XI.2 Tnh ton chi ph ca d n

52XI.2.1. Chi ph nhn cng

53XI.2.2. Chi ph hot ng

55CHNG XII: HIU QU KINH T-TI CHNH

55XII.1. Cc gi nh kinh t v c s tnh ton

55XII.2. Doanh thu t d n

56XII.3. Cc ch tiu kinh t ca d n

57XII.4. nh gi hiu qu kinh t - x hi

59CHNG XIII: KT LUN V KIN NGH

CHNG I: GII THIU CH U T V D N

I.1. Gii thiu ch u t

Tn cng ty

: Giy php KKD:

Chc v

:

I.2. M t s b d n Tn d n

: Tn ting Vit:

Tn ting Anh:

a im xy dng: Hnh thc u t: I.3. C s php l

Vn bn php l

Lut t ai 26/11/2003; Lut xy dng s 16/2003/QH11 c Quc Hi kha 11 nc Cng Ha XHCN Vit Nam thng qua ngy 26/11/2003; Ngh nh 90/2006/N-CP, ngy 06/9/2006 ca chnh ph Quy nh chi tit v hng dn thi hnh Lut Nh ; Ngh nh s 83/2009/N CP ngy 15/10/2009 v sa i b sung 1 s iu ca ngh nh s 12/2009/N CP ngy 12/2/2009 v qun l d n u t xy dng cng trnh; Ngh nh s 85/2009/N CP ngy 15/10/2009 ca Chnh ph hng dn thi hnh Lut u thu v la chn Nh thu xy dng theo Lut xy dng; Quyt nh s 33/2004/Q-BTC v vic ban hnh Quy tc, Biu ph bo him xy dng, lp t; Quyt nh s 05/Q-BXD ngy 24/01/2005 ca B trng B xy dng v vic ban hnh nh mc d ton xy dng c bn; Thng t s 03/2001/TT-BXD ngy 13/2/2001 ca B xy dng hng dn iu chnh d n cng trnh xy dng c bn; QCVN 03: 2009/BXD Quy chun k thut quc gia v phn loi, phn cp cng trnh XD dn dng, cng nghip v h tng k thut th c hiu lc t ngy 01/4/2010; Vn bn s 1776/BXD VP Ngy 16/8/2007 ca B Xy Dng v cng b nh mc d ton xy dng cng trnh Phn xy dng; Vn bn s 1777/BXD VP Ngy 16/8/2007 ca B Xy Dng v cng b nh mc d ton xy dng cng trnh Phn lp t; Thng t 05/2007/TT BXD ngy 25/7/2007 ca B Xy Dng v hng dn vic lp v qun l d n u t xy dng cng trnh; Cng vn s 1601/BXD VP ngy 25/7/2007 ca B Xy Dng v/v cng b ch s gi xy dng; Thng t 03/2009/TT BXD ngy 26/3/2009 ca B Xy Dng quy nh chi tit mt s ni dung ca Ngh nh s 12/2009/ N CP ngy 12/2/2009 ca Chnh ph v qun l d n u t xy dng cng trnh; Cn c quyt nh 628/BXD CSXD ngy 14/12/1996 ca B Xy Dng v vic ban hnh Quy chun xy dng; Ngh nh s 16/2005/N-CP ngy 07/02/2005 ca Chnh Ph v Qun l d n u t xy dng cng trnh; Ngh nh s 99/2007/N-CP ngy 13 thng 06 nm 2007 ca Chnh ph v Qun l chi ph u t xy dng cng trnh; Thng t s 05/2007/TT-BXD ngy 25/07/2007 ca B Xy Dng hng dn vic lp v qun l chi ph u t xy dng cng trnh; Cng vn s 1751/ BXD-VP ngy 14/08/2007 ca B Xy Dng v cng b nh mc chi ph qun l d n v t vn u t xy dng cng trnh; Ngh nh s 49/2009/N-CP ngy 16/12/2004 ca Chnh Ph v qun l cht lng cng trnh xy dng; Php lnh hnh ngh Y, Dc t nhn s 07/2003/PL UBTVQH11 ngy 25/2/2003; Ngh quyt s 46 NQ-TW ngy 23/2/2005 ca B Chnh tr v cng tc bo v, chm sc v nng cao sc khe nhn dn trong tnh hnh mi; Quyt nh s 243/2005/Q-TTg v chng trnh hnh ng ca Chnh Ph thc hin Ngh quyt s 46-NQ-TW ngy 23/2/2005 ca B Chnh tr; Ngh nh s 103/2003/N-CP ngy 12/9/2003 ca Chnh ph quy nh chi tit thi hnh mt s iu ca Php lnh hnh ngh Y, Dc t nhn;

Ngh quyt s 05/2005/NQ-CP ngy 18/4/2005 ca Chnh ph v y mnh x hi ha ca cc hot ng gio dc, y t, vn ha v th dc th thao; Thng t s 07/2007/TT-BYT ngy 25/5/2007 ca B trng B Y t hng dn v hnh ngh y, y hc c truyn v trang thit b y t t nhn;

Quyt nh s 437/Q-BYT ngy 20/2/2002 ca B trng B Y t v vic ban hnh danh mc trang thit b y t bnh vin a khoa tuyn tnh, huyn, phng khm a khoa khu vc, trm y t;

Cc ti liu tham kho

Quy trnh, quy phm, tiu chn thit k ng t, ng th hin hnh ca Vit Nam; Quy trnh kho st ng t 22TCN 263 2000; o ng mm Cc yu cu v ch dn thit k 22TCN 0211-06 ca B Giao Thng Vn Ti; o ng cng Cc yu cu v ch dn thit k 22TCN -02231 95 ca B Giao Thng Vn Ti; ng t Yu cu thit k TCVN 4054 05; Quy trnh thit k Cu cng theo trng thi gii hn 22TCN 18 79; Quy phm thi cng v nghim thu cu cng 22TCN266 2000; Tiu chun thot nc mng li bn ngoi v cng trnh Tiu chun thit k TCVN: 1984; Tiu chun Cng trn b tng ct thp lp ghp Yu cu k thut 22 TCN 159 86; Cn c tiu chun xy dng: Kt cu thp Gia cng lp rp v nghim thu Yu cu k thut TCVN 170:1989; Tiu chun k thut Cng trnh giao thng ng b - tp III Thi cng v nghim thu do b giao thng vn ti ban hnh nm 1996; Vn bn s: 5740/BGTVT KHCN ngy 5/2/2003 ca B Giao Thng Vn Ti v vic s dng vt liu lm lp mng di kt cu o ng mm; Cn c iu l bo hiu ng b 22 TCN 237 01; Tiu chun Thit k chiu sng nhn to ng ph, qung trng th (TCXDVN 259:2001). Tham kho cc tiu chun v in; S liu Bn hin trng v tnh hnh thc t ca khu vc thit k quy hoch chi tit, do cc c quan chc nng cung cp;

CHNG II: NGHIN CU TH TRNG

II.1. c im t nhin v tnh hnh kinh t x hi Vit Nam

II.1.1. c im v iu kin t nhin

Vit Nam c din tch khong 331,212 km nm v tr 8035 n 230 v Bc, 1020 n 1100 kinh ng. Bin gii gip Trung Quc pha Bc, gip Lo v Campuchia pha Ty, pha ng gip Bin ng.

Vit Nam c kh hu nhit i gi ma min Nam vi hai ma (ma ma t gia thng 4 n thng 10, ma kh t thng 11 n gia thng 3) v kh hu gi ma min Bc vi bn ma r rt (ma xun, ma h, ma thu, ma ng).

c im thi tit v kh hu l nhng nhn t nh hng n bnh tt v dch t Vit Nam.

II.1.2. Tnh hnh kinh t

Trong 10 nm tr li y, kinh t Vit Nam tng trng vi tc cao. Theo bo co Tng cc Thng k, tc tng trng tng sn phm trong nc (GDP) qu II/2011 l 5.67% so vi cng k, cao hn 0.24% so vi qu I nm nay nhng thp hn cng k nm ngoi 0.73%. Vi kt qu ny, GDP 6 thng u nm 2011 c ch tng 5.57% so vi cng k nm 2010, thp hn con s tng ng ca nm ngoi khong 0.61%. ng gp vo con s k trn, khu vc nng - lm nghip v thy sn tng 2.08%; khu vc cng nghip v xy dng tng 6.49%; khu vc dch v tng 6.12%. Khu vc sn xut kinh doanh v ang chu nh hng ca lm pht, li sut cao lm chi ph u vo tng cao tc ng n sn xut kinh doanh. Nhng nguyn nhn nh hng n tng trng 6 thng u nm 2011, theo B, l do mt bng li sut cn ang mc cao, ang vt qu kh nng chu ng ca mt b phn doanh nghip; li sut huy ng vn bnh qun tng khong 3% so vi cui nm 2010 (nm 2010 bnh qun khong 12%/nm), chnh lch gia li sut huy ng v cho vay kh ln (khong 3-4%); vic vay vn tn dng ca mt b phn doanh nghip, nht l doanh nghip nh v va cn kh khn; t l n xu c xu hng gia tng cc ch tiu lin quan khc, trong 6 thng u nm 2011, vn u t trc tip nc ngoi ng k c cp mi v tng vn gim gn 40% so vi cng k; tng s vn ng k kinh doanh mi ca doanh nghip dn doanh gim 5.4%. Xu hng ny th hin nh hng ca bt n kinh t v m n thu ht u t pht trin ca khu vc doanh nghip; qua c th s nh hng n mc tiu tng trng kinh t, gii quyt vic lm, bo m an sinh x hi trong thi gian ti.II.1.3. Tnh hnh x hi

Nhn chung i sng x hi ca ngi dn Vit Nam trong nhng nm qua c ci thin nhanh chng. Tuy nhin, theo bo co ca Tng cc Thng k th x hi Vit Nam 5 thng u nm/2011 cn tn ti mt s vn x hi sau:- Thiu i trong nng dn: Theo bo co s b, trong thng Nm c khong 72.5 nghn h thiu i vi 307.7 nghn nhn khu thiu i. So vi cng k nm 2010, s h thiu i gim 24.2% v s nhn khu thiu i gim 23.2%. khc phc tnh trng thiu i, t u nm, cc cp, cc ngnh v on th t trung ng n a phng h tr cc h thiu i 14 nghn tn lng thc v 3.8 t ng.

- Tnh hnh dch bnh, ng c thc phm: Trong thng Nm, trn a bn c nc c 2.4 nghn trng hp mc st xut huyt; 433 trng hp mc bnh vim gan virt; 107 trng hp mc bnh vim no virt; 36 trng hp mc cm A H1N1; 31 trng hp mc bnh thng hn. Tnh chung nm thng u nm, c nc c 13.7 nghn trng hp mc st xut huyt; 2.4 nghn trng hp mc bnh vim gan virt; 281 trng hp mc bnh vim no virt; 473 trng hp mc cm A H1N1 (13 trng hp t vong) v 131 trng hp mc bnh thng hn.

S trng hp nhim HIV/AIDS c pht hin trong thng ca c nc l 1.7 nghn ngi, nng tng s ngi nhim HIV/AIDS ca c nc tnh n gia thng 5/2011 ln 237.8 nghn ngi, trong 95.7 nghn trng hp chuyn sang giai on AIDS v 50.2 nghn ngi t vong do AIDS.

Cng tc kim tra, kim sot v sinh an ton thc phm mc d c cc ngnh chc nng quan tm v trin khai mnh nhng vn gp nhiu kh khn. Trong thng xy ra 10 v ng c thc phm lm 138 ngi b ng c. Tnh chung nm thng u nm, trn a bn c nc xy ra 32 v ng c thc phm, lm 1.6 nghn ngi b ng c, trong 6 trng hp t vong.

- Tai nn giao thng: Trong thng 4/2011, trn a bn c nc xy ra 1024 v tai nn giao thng, lm cht 854 ngi v lm b thng 776 ngi. So vi cng k nm 2010, s v tai nn giao thng gim 6.7%; s ngi cht gim 8.1%; s ngi b thng tng 4.6%. Tnh chung bn thng u nm, trn a bn c nc xy ra 4,581 v tai nn giao thng, lm cht 3,858 ngi v lm b thng 3,529 ngi. So vi cng k nm trc, s v tai nn giao thng gim 0.7%, s ngi cht tng 1.3%, s ngi b thng tng 4.1%. Bnh qun mt ngy trong bn thng u nm 2011, c nc c 38 v tai nn giao thng, lm cht 32 ngi v lm b thng 29 ngi.

II.2. Hin trng ngnh YVit NamII.2.1. Tnh hnh chungNgnh Y Vit Nam ang tng bc pht trin cng s pht trin ca nn kinh t c nc. Hin nay, mng li y t c s pht trin rng khp, 100% cc x phng c cn b y t hot ng.

Tnh n ngy 24/5/2010, trong khu vc Nh nc c 13,500 c s khm bnh cha bnh. Trong c 1,100 bnh vin cng vi 180,860 ging bnh, c u t nhiu trang thit b hin i nhng so vi nhu cu cung cp dch v y t th hu ht c s vt cht, nh ca, in nc, thit b thng dng ca cc bnh vin vn cha t tiu chun ti thiu. T l ngi c khm cha bnh trong 12 thng trc thi im phng vn (5/2010) l 40.9%, trong 37.1% c khm/cha bnh ngoi tr v 8.1% c khm cha bnh ni tr. T l ny thnh th cao hn mt cht so vi nng thn; nhm h giu nht cao hn nhm h ngho nht. Khi phi nhp vin, ngi dn ch yu n cc bnh vin nh nc. T l lt ngi khm cha bnh ni tr ti cc bnh vin nh nc nm 2010 trung bnh l 83.2%. Tuy nhin, ngi dn nng thn c t hn c hi c khm cha bnh ti cc bnh vin nh nc. Nm 2010 c 81% lt ngi khu vc nng thn khm, cha bnh ni tr ti cc bnh vin nh nc, trong khi t l ny khu vc thnh th l 90%. C 66.7% s ngi khm cha bnh ni, ngoi tr c th bo him y t hoc s/th khm cha bnh min ph, trong thnh th l 72.6%, nng thn l 64.1%. c bit c 74.4% s ngi thuc nhm h ngho nht c th bo him y t hoc s/th khm cha bnh min ph, trong khi nhm h giu nht ch c 71%. Nhng vng ngho nht nh Trung du v Min ni pha Bc v Ty Nguyn, nhng nhm dn tc thiu s c t l ny cao hn mc trung bnh ca c nc. Chi tiu cho y t, chm sc sc kho bnh qun 1 ngi 1 thng t khong 62 ngn ng, chim t trng 5.4% trong chi tiu cho i sng. Chi tiu cho y t, chm sc sc kho bnh qun 1 ngi 1 thng ca nhm h giu nht cao hn gp 3.8 ln so vi nhm h ngho nht, ca h thnh th cao hn 1.43 ln so vi h nng thn.

Mc d ngnh y ang pht trin nhng c s vt cht, khoa hc k thut, c ch chnh sch, dch v,...vn cha p ng y nhu cu cho hn 88 triu dn c nc.

II.2.2. Y t t nhn

Trc thi k i mi, h thng y t Vit Nam c xy dng v pht trin theo nh hng x hi ch ngha. Y t nh nc ng vai tr ch o trong s nghip chm sc v bo v sc khe cho nhn dn. Qua nhiu nm vn hnh, c nhng tn ti v mt c ch, chnh sch v nhm gii quyt nhng hn ch cng vi mc tiu p ng nhu cu a dng ca nhn dn trong vic gi gn sc khe, Nh nc ban hnh Php lnh mi v hnh ngh y dc t nhn. S c mt ca y t t nhn gip kh nng tip cn dch v y t ca ngi dn c ci thin.

Khi y t t nhn pht trin th cc bnh vin t cng pht trin theo. Tnh n thng 5/2010, theo s liu c tnh ca V iu tr, B Y t, khu vc t nhn, c nc c 103 bnh vin t nhn chim t l 9.6% so vi bnh vin cng lp. T nhn c tng s 6,274 ging bnh chim 3.5% so vi ging bnh cng lp. C 29 tnh, thnh ph trc thuc trung ng c bnh vin t nhn. iu ny th hin tim nng ca khu vc t nhn ng gp trong cung cp cc dch v iu tr ni tr thi gian ti. Bn cnh , phn b y t t nhn khng ng u, tp trung ch yu cc vng c iu kin kinh t pht trin, mt cn i r rt thnh th v nng thn cng nh gia cc vng a l.Tuy vy, vi s gip ca h thng y t cng, h thng y t ngoi cng lp tng bc trng thnh v pht trin, chia s c phn no s qu ti ca h thng y t cng, gp phn cng vi y t cng trong s nghip chm sc v bo v sc khe cho nhn dn vi cht lng dch v cao ngy cng tngCHNG III: S CN THIT PHI U TIII.1. Mc tiu ca thuyt minh d n Nghin cu nhng vn lin quan n xy dng d n. Thc hin xy dng d n Bnh vin a khoa quc t V Anh II vi quy m 2.000 ging.

nh gi tnh kh thi ca d n. Kt lun v a ra xut, kin ngh v d n xy dng bnh vin.

III.2. S cn thit phi u t

Trong dn gian, chng ta thng hay ni:"C sc kho l c tt c". Tuy cu ngn ng khng ng trong mi trng hp nhng r rng khng c sc kho th khng c g c. u t cho sc khe l u t cho s pht trin v tng lai lu di. Hiu r vai tr ca y t ng thi nhn thy hin nay bnh vin cng khng c u t tng xng, tnh trng qu ti tr thnh ni bc xc ca ngnh; khng nhng th, hng nm c mt s lng ng k bnh nhn phi ra nc ngoi iu tr nh Thi Lan, Singapore, Trung Quc Hu ht cc i tng ny u l nhng ngi c iu kin kinh t tt, h ra nc ngoi iu tr khng hn v h khng tin vo tay ngh cacc Bc s Vit Nam, m i khi h ra nc ngoi iu tr v bn cnh vn chuyn mn h cn i hi c th hng mt dch v y t cht lng cao (ging bnh, phng bnh, thi phc v, giao tip). Mt khc, sau khi Bnh Vin a Khoa Quc T V Anh ti ng Phan Vn Tr qun G Vp, TP.HCM i vo hot ng th bnh vin khng ch em li li ch cho ngi u t m cn p ng tt, kp thi cho nhu cu thc t v nhu cu khm cha bnh ca ngi dn, gp phn vo s pht trin kinh t chung cho TP.HCM gii ta bt p lc v vic khm cha bnh ti cc qun khc trn a bn TP.HCM.

T nhng l do trn, cng ty TNHH Bnh vin a khoa Quc t V Anh chng ti quyt nh u t xy dng bnh vin V Anh II, c c cu chc nng hp l, ng b v h thng h tng k thut v h tng x hi vi nhng tiu chun kinh t k thut ph hp, bnh vin ngy cng xng ng hn vi hai ch Quc t. Ngoi ra, vi quy m 2,000 ging nm trong phm vi 1.5ha ti phng Bnh Khnh, Qun 2, TP.HCM, sau khi xy dng bnh vin a khoa Quc t V Anh II s gp phn to cng n vic lm cho b phn dn c ti khu vc, lm ng b ha quy hoch v s pht trin ca Qun 2 cng nh Tp.HCM.

Bng tm lng ca nhng thy thuc chng ti khng nh y l d n mang tnh an sinh x hi, c ngha cng ng rt cao. Do xy dng Bnh vin a khoa Quc t V Anh II l vic lm cn thit v cp bch trong tnh hnh hin nay.CHNG IV: A IM D N

IV.1. V tr a l d n

D n Bnh vin a khoa Quc t V Anh II nm trn a bn phng Bnh Khnh, Qun 2, Tp.HCM. Bnh vin c v tr c a, him c v mang tm chin lc. Nguyn nhn l do Qun 2 ang c Nh nc u t xy dng mi hon ton tr thnh mt khu th Th Thim c h thng h tng giao thng, h tng x hi hin i ng b.

c nh gi l t Vng do pha Ty bnh vin gip rch C Tr l ranh gii t nhin thuc ca ng th mi Th Thim. Pha ng Nam l v tr mt tin gip i l V Vn Kit (i l ng Ty c), cn li gip cc d n xin u t khc. V th bnh vin c v tr thun li ch cn 5 pht chy xe vo trung tm thnh ph v bnh nhn t nhng tnh ln cn n bnh vin rt d dng.

Ngoi ra, y l ni c nhiu d n ang c u t xy dng vi s pht trin rt nhanh v kh thi. Tuy nhin, hin nay ch c cc d n pht trin v bt ng sn, thng mi v hnh chnh m cha c mt d n Bnh Vin no c u t xy dng mang tm quc t.Tm li, d n Bnh vin a khoa Quc t Phc An Khang khng nhng c v tr c a m cn l mt d n tnh cht an sinh cng ng cao.IV.2. iu kin t nhin chung ca khu vc d n

IV.2.1. a hnh

Khu t bng phng, nn t c sc chu ti yu (0,7kg/cm2-1,0kg/cm2) nn cng trnh xy dng cn c gii php kt cu mng an ton cho loi nn t ny.

IV.2.2. Kh hu

Khu vc xy dng d n c kh hu cn nhit i gi ma tng t cc vng thuc Tp.HCM.

Nhit :

Nhit trung bnh nm l 27,50C

Nhit trung bnh thng cao nht: thng 4- vi 360C

Nhit trung bnh thng thp nht: thng 12- vi 25.20C

Lng ma:

Lng ma nhiu nht l thng 9:388mm

Lng ma t nht l thng 2: 3mm

S ngy ma bnh qun trong nm: 154 ngy

Tr lng ma trong nm l 1,979mm

m

- m trung bnh 75%/ nm, thng cao nht l 90%, thng thp nht l 60%.

Gi

-Ma ma t thng 5 n thng 10, hng gi Ty Nam- ng Bc

-Ma kh t thng 11- thng 4, gi ng Nam- Ty Bc

Nng

-Tng s gi nng trong nm t 2,600-2,700 gi/nm, trung bnh mi thng 220 gi

- Thng 3 c s gi nng cao nht, khong 300 gi, trung bnh 10 gi/ngy.

IV.2.3. a cht cng trnh

Khu vc xy dng bnh vin l khu t yu. Lp t bn nm st trn mt c chiu dy t 15m n 20m. S liu kho st ti mt s vng ln cn d n c cu to a cht nh sau:

Lp 1: Bn st xm xanh, mm nho c ln xc thc vt c chiu dy bnh qun 18 -20 mt, phn b u khp.

Lp 2: St mu xm xanh loang trng trng thi do cng c chiu dy bnh qun 15 mt.

Lp 3: St pha mu vng trng thi do nho.IV.2.4. Thy vn

Khu vc d n nm gn sng Si Gn, chu nh hng trc tip ch bn nht triu khng u t sng Si Gn. Theo s liu quan trc, mc nc sng Si Gn ca Trm kh tng thy vn cung cp. Bng quan h gia mc nc thp nht v cao nht tng ng vi tn sut P% (ly theo cao chun Hn Du) nh sau:

Tn sut (P%)1%10%25%50%75%99%

H max1,551,451,401,351,311,23

H min-1,98-2,20-2,32-2,46-2,58-2,87

Mc nc cao nht tai tram Phu An (sng Sai Gon) co kha nng dao ng t 1,40 m n 1,45 m, tai Nha Be t 1,38 m n 1,42 m.

IV.3. Hin trng cng trnh v h tng k thutIV.3.1. Hin trng s dng t

D n bn vin c dng t cn h ca Block A v B trong Khu cao c thng mi v cn h cao cp Thi Bnh, vi din tch 2.000m2.IV.3.2. ng giao thng

Mt tin d n l i l V Vn Kit hay cn c bit nhiu hn bi tn gi l i l ng Ty.

ng trong khu vc d n hin cha c xy dng.IV.3.3. Hin trng cng trnh h tng v kin trc

t quy hoch cho d n hin ang hnh thnh v xy dng, hin trng khu t ch yu l t rung v t vn.IV.3.4. Hin trng cp in

Ngun cung cp trc tip t Nh my in 375 MW Hip Phc. ng dy trung th: 22KV

III.3.5. Cp Thot nc

Cp nc: Ngun nc trc tip t Nh my nc Th c (cng sut thit k 35.000m3/ngy m), t trm cung cp nc ph tr (cng sut thit k 2.000 m3/ngy m) v t trm cung cp nc d phng (cng sut thit k 6.000 m3/ ngy m).

Thot nc: Hin d n ang thit k h thng thot nc.

IV.4. Nhn xt chung

Qua vic phn tch cc yu t, Cng ty TNHH Bnh vin a khoa V Anh nhn thy iu kin t nhin v h tng k thut ti khu vc phng Bnh Khnh, qun 2, Tp.HCM khng nh hng ln n qu trnh thi cng xy dng cng nh khai thc s dng m cn rt thun li bao gm c yu t v tr a l c a v c s h tng hin i.CHNG V: MC TIU, CHC NNG, NHIM V CA BNH VINV.1. Mc tiu

Bnh vin a khoa Quc t V Anh II tham gia khm cha bnh v chm sc sc khe cho ngi t nguyn chi tr cc dch v y t ang sinh sng v lm vic ti TP.HCM ni ring v nhn dn cc tnh ln cn ni chung.

Phi hp vi cc bnh vin nh nc, t nhn, c s c vn u t nc ngoi nghin cu khoa hc, o to cn b, p dng k thut mi gp phn tham gia cng tc chm sc v bo v sc khe cho nhn dn. Vi cc dch v sau:1/. Cc dch v ngoi tr:

Dch v t vn, qun l v chm sc sc khe nh k.

Dch v t vn, khm, cha bnh ngoi tr.

Dch v t vn, chun on hnh nh.

Cc dch v ph tr, cung cp thuc, hng dn s dng thuc, t chc hi tho khoa hc, t chc cc lp bi dng nghip v cho cc c s y t trong vng ....

2/. Cc dch v ni tr: Dch v khm v iu tr bnh, chm sc v iu dng bnh trong ni tr hng ngy.

Dch v t vn, khm v cha bnh trong trng hp cp cu 24h/24h hng ngy.

Cc dch v chun on, pht hin bnh v phu thut iu tr bnh.

Dch v chm sc c bit.

Cc dch v khc: n - - Git gi .... phc v bnh nhn.

V.2. Chc nng- nhim v

V.2.1. Cp cu, khm bnh, cha bnh v chm sc sc khe

Cp cu, khm, cha bnh ni tr v ngoi tr;

Chuyn ngi bnh khi vt qu kh nng iu tr ca bnh vin;

Khm sc khe nh k, qun l sc khe, khm sc khe cho ngi Vit Nam i lao ng nc ngoi.

V.2.2. o to cn b

-o to cn b thng xuyn cho cn b nhn vin bnh vin, cc bnh vin khc khi c yu cu nng cao trnh chuyn mn nghip v;-L c s thc hnh o to cn b y t t bc trung hc tr ln n i hc (Nu c yu cu ca c quan qun l ngnh y t v cc c s o to)

V.2.3. Nghin cu khoa hc v y hc

- Tham gia tng kt, nh gi cc ti nghin cu khoa hc;

- Kt hp vi cc bnh vin, vin tham gia cc cng trnh nghin cu v iu tr bnh, y t cng ng v dch t hc trong cng tc chm sc sc khe ban u cp c s, cp B.

V.2.4. Phng bnh

Thc hin tt cng tc phng bnh trong bnh vin, phi hp vi cc c s y t d phng a phng tham gia pht hin v phng chng cc bnh dch nguy him. Tham gia cng tc truyn thong gio dc sc khe thc hin cng tc phng chng dch bnh, bnh ngh nghip.V.2.5. Hp tc quc t v y hc

Tham gia cc chng trnh hp tc quc t vi cc c nhn, t chc nc ngoi theo quy nh ca nh nc.

V.2.6. Qun l kinh t trong bnh vin

Qun l kinh t minh bch, thng nht theo quy nh ca php lut Vit Nam.CHNG VI: PHNG N XY DNG C S H TNGVI.1. Gii php v kin trc v k thutVI.1.1. Gii php v kin trcBnh vin l t hp ca ba khi cng trnh chnh: Ta nh chnh l c s hot ng cho cc khoa iu tr ni v ngoi khoa; Ta nh ph gm Trng Cao ng Quc t Y dc V Anh, l ni hc tp v chuyn mn cho i ng nhn vin bnh vin v cc sinh vin y khoa; Khu vc tng hm v h thng cy xanh, h ncTa nh chnh c xy dng theo cu trc ca ta nh 18 tng trn nn mng vung vc vi din tch 3,573m2 c khong 2,000 ging v din tch trung bnh t 15m2/ging 30m2/ging.

Bnh vin c 2 snh ln:

i snh chnh hng v mt tin i l V Vn Kit (i l ng Ty)

Snh phc v cho cp cu hng v mt ng ni b, c cng m ni vi ng i l V Vn Kit.

Bnh vin c hp khi kin trc hin i, c xy dng bng cc loi vt liu c cht lng cao, c mu sc v hnh thc ph hp vi cnh quan xunh quanh, ph hp vi ni dung s dng l mt bnh vin a khoa hin i c bit ch trng n khoa ni, ngoi - sn v khoa nhi.

Bn thit k c pht trin da trn s phn tch k lng v mt lu thng v ti a ha tng quan lin kt gia chuyn khoa ny vi chuyn khoa khc. Mi l trnh u c c nh cn thn gim thiu khong cch gia cc chuyn khoa. M hnh sc tch v khoa hc ny cng c tnh ton tng thm hiu qu cho cc dch v lin quan n c in.

Tng quan bnh vin nhn t trn xung l mt cu trc ca ta nh phng nh phin bao gm nhiu phng bnh, chia thnh 2 khu vc ti mi tng. Bnh vin b tr mt thang my trung tm gia cc khu vc phng bnh nh mt trc thng ng, nhm a khch n hai dy hnh lang mi tng i ti cc phng bnh. Gia cc hnh lang phng, cc dch v y t v h tr cng c b tr vi cc li i thng nhau.

n tng ca cu trc vng vng ny cn c h tr bi vic xy thm mt knh bn ngoi thng xung ti tng gia (ni t cc vn phng hnh chnh) v nhng phn nh ra c hai bn. Tng quan thit k bnh vin va th hin tnh kin c v hin i, va phn b nhng phng tin iu tr ti tn nht trong mt mi trng an ton nht.

Cc ni tht mi c trang b trong bnh vin hin nay cng phn nh phn no mc tiu ny. l s tng hp nhng ng nt n gin v s sp xp cc phi cnh a dng gia cc b mt cng v mm. Mu sc cng tht phong ph, mi khng gian u gi nguyn sc thi tng th ng nht nhng li c cch iu mt cch ph hp. iu ny th hin r mi tng quan gia cc khu vc hot ng khc nhau yu t hp l v thuyt phc - trong khi vn m bo tnh c trng ca tng khu vc d nhn bit.

Tng thng ca ta nh c thit k nh mt khu vn dnh cho bnh nhn v nhn vin bnh vin. Phng hp hi tho v khu vc hnh chnh nhn ra khu vn ny. Ngoi ra, phng my c in c b tr sn thng ngay pha trn khu vc phng m cho php tp trung cc hot ng bo tr cho phng m m khng phi i xuyn qua khu vc phng m pha di.

Khu vc tng hm

Khu vc tng hm c thit k ngay pha bn di khu t d n vi din tch s dng khong 3.573 x vi 1 tng hm. Khi i vo hot ng, h thng tng hm s p ng khu vc xe cho cn b cng nhn vin, sinh vin, bnh nhn v ngi i thm nui trong bnh vin v h thng k thut.

Cc khu ph tr

Cc khu ph tr bao gm: h thng cy xanh, bi xe v ng giao thng ni b. Khi ph tr ny s c u t xy dng qui m, hin i v theo chiu su nhm p ng nhu cu v vn dn sinh nh: th dc th thao, gii tr, th gin.

VI.1.2. Gii php v kt cu

Hai khi cng trnh chnh v ph ca bnh vin c tch vi nhau bi 1 khe ln, khe ln s c x l chng thm chng dt.

Bnh vin c kt cu khung btng ct thp ton khi tng ngn c xy t bng gch 4 l v xi mng 75 phn hon thin c thc hin theo thit k k thut chi tit.

Kt cu khung ca bnh vin c xc nh theo cc tiu chun:

Kt cu b tng ct thp cho nh thp tng TCVN-55741991

Kt cu b tng ct thp cho nh cao tng TCXD: 198-1997

Kt cu mng nh cao tng vi mng cc khoan nhi theo TCXD: 206-1998

Ti trng v h s tnh ton TCVN 2737-1995

Ti trng gi theo TCXD 229-1999

Kt cu c tnh theo cc phn mm:

-AP-2000

-STAAD III STAAD PRO

VI.2. Gii php v cp thot nc

VI.2.1. Cp nc

Theo QCXD VN s 01-2008, tm tnh lng nc cung cp cho vic khm cha bnh, sinh hot, cu ha v dch v cng cng c cung cp t ngun nc chung ca Tp.HCM:

D tnh yu cu s dng nc427m3- Khu vc khm cha bnh ngoi tr: 100 l/ngy x 500 lt ngi/ngy50m3 Khu vc ni tr: 200 lt ngi/ngy x 2,000 ging400m3 Phc v sinh hot cho CB CNV bnh vin: 200 lt ngi/ngy x 900 ngi180m3( Nc phc v sinh hot, lm vic: 240m3( Cng trnh cng cng v dch v90m3Trong : - Ti cy, ra ng 9% x 240m322 m3

- Dch v git, ra xe,... 9% x 240 m322 m3

- Dng cho khu x l nc thi 4% x 240 m310 m3

- D phng v r r 15% x 240 m336 m3

( Phc v cng cng v PCCC97 m3Trong :- Phng chy cha chy c d phng60 m3

- Khoa dinh dng, cn tin cafe,....37 m3B d tr nc di t:

D kin xy dng 4 b cha nc khu vn c cy xanh pha sau bnh vin, mi b c dung tch 120m3 vi kch thc 6,5 x 6,5 x 3,0 c ni lin thng gia cc b.B nc trn mi:

Nc phc v cho khm cha bnh, sinh hot, d tr cu ho: 40%x480m3 = 192 m3

Nc cu ho trong 10 pht 6 a im: 6 x 10 x 60 x 5lt/giy

= 18 m3

Tng cng: = 210 m3

D kin xy dng 4 b cha trn tng k thut v mi 1, mi b c dung tch 60m3 vi kch thc 4,5 x 3,5 x 3,5m c ni lin thng gia cc b.

Chn my bm nc ln mi:

D kin lp t 2 my bm loi Grundfos ca an Mch c thng s k thut:

Lu lng Q = 100m3/ gi

Chiu cao y H = 60 m

Mng li ng ng cp nc:

ng ng cp nc cho b cha nc trn mi v a nc xung cc tng dng loi ng PVR, ng ng dn nc sinh hot dng loi ng PVC.

ng ng cp nc cu ho, dng cho loi ng thp trng km c sn mu .

Mng li ng ng cp nc c t trong cc hp gaine, trn trn cc hnh lang v c chn kn trong tng cc ni s dng .

VI.2.2. Thot ncMng li h thng thot nc c chia thnh 3 nhm:Nhm 1: Mng li ng tip nhn v chuyn nc thi phi x l ca cc khu khm bnh ngoi tr, khu vc ni tr, cc phng nghip v v phng dch v v khu x l nc.

Khi lng nc phi x l:

Bnh vin : 2000 ging x 0,8m3/ ngy : 1,600m3

CB-CNV : 900 ngi x 0,15m3/ ngy : 135m3 1908m3/ngy = h s 1,1 x 1,735m3

Ti khu vc x l, nc thi c kim sot theo tiu chun 20TCN-51-84 quyt nh pha ch cc cht kh trong giai on x l.

Ti khu vc x l, nc c x l, c kim sot theo tiu chun TCVN 5945-1995 v TCXD 188196 trc khi x vo h thng ng thot nc ca bnh vin.

Trm x l nc thi v quy trnh x l s c th hin trong thit k k thut .

Nhm 2: Mng li ng tip nhn nc thi phc v, sinh hot ca CB CNV qua b t hoi v nc thi qua ti cy ra ng:90m3Trong :- Nc thi sinh hot ca CB CNV 150 lt ngi/ngy x 900 ngi135m3

- Nc thi ti cy ra ng22m3Nhm 3: Mng li rnh, ng v h ga tip nhn khng cng mt lc nc ma trn mt din tch xy dng, nc cu ha hoc nc cho cc dch v cng cng.

Tm tnh lu lng 60m3 s trc tip vo h thng ng thot nc bnh vin.

Nhng khi lng trn l c s ban u tnh ton khi thit k k thut h thng ng thi nc.

H thng ng nc thi c cu to :

i vi h thng nc thi phi qua x l dng ng PVC

i vi nc thi sinh hot, nc mt dng vo h thng mng xy t bng gch ng v btng.

VI.3. Gii php lp inNgun in s dng c cung cp t ngun cp in ca qun 2, Tp.HCM.D tnh yu cu s dng in

in nng s dng c tnh theo phn khu chc nng trong gi hot ng cao im:

Th tKhu vcTm tch nh mc (W /m2)

1Khi cc khoa, phng k thut nghip v250

2Khi cc phng iu tr ni tr200

3Cng trnh ph v sn bi20

in nng tiu th

Phn in cao th:

- Xy dng trm bin th ngoi tri, c 3 my bin p loi Kios vi my ct cho php t ng ng ngt li in khi xy ra s c theo nguyn l bo v c chn lc.

- My bin p Kios 3 pha 2 cun dy, cch in bng du v c silicon chng chy vi cc thng s k thut:

- Cng sut: 2 x 3000 KVA v 1500 KVA

- in p my: 22 KV ( 2 x 2,5% /0,4 KV.

- S u dy: Dyn 11.

- Cng sut trm bin th: 2 my x 3000 KVA + 1 my x 1500 KVA

My bin p Kios 3 pha 2 cun dy cch in bng u c silicon chng chy vi cc thng s k thut:

Cng sut: 1500 KVA

in p: 22KV + 2 x 2,5 % / 0,4 KV

S u dy: Dyn - 11

Cng sut trm bin th: 1 my x 1500 KVA x cos ( 0,8 = 1.200 KW/h

Phn in h th:

Cc trm bin p h th c phn chia phc v cho cc loi ph ti nh sau:

+ Trm TR1: loi bin th du 3 4W - 22kV/0.4kV 3000 KVA phc v cho ti chiu sng v ngun cm.

+ Trm TR2: loi bin th du 3 4W - 22kV/0.4kV 3000 KVA phc v cho ti c nh iu ha khng kh, bm nc, qut, thang my

+ Trm TR3: loi bin th du 3 4W - 22kV/0.4kV 1500 KVA phc v cho cc loi ph ti thit b y t.

- Cn c vo cng nng s dng ca cc ph ti, s phn chia cc loi ph ti thnh 2 loi:

+ Cc ph ti quan trng cn cp in lin tc trong trng hp xy ra s c trn li in s c cp in ca my pht d phng.

+ Cc ph ti bnh thng c th ngng cp in trong trng hp xy ra s c trn li in.

- Trn c s 2 loi ph ti trn, thanh h th c chia lm 2 phn, trong c 1 phn ph ti quan trng s c lp vo b chuyn i ngun in t ng (vit tt ATS).

My pht in d phng:

D kin ph ti quan trng phc v cho cc khoa cp cu, khoa ngoi, khoa xt nghim, khoa chun on hnh nh, khoa sn, cu thang my ,v.v .

Cng sut ph ti:

- Chn my pht in Diezel d phng c cng sut 5000 KVA - 3 4W, in p 380/220V

H thng dy dn in:

- Trn mi tng, cn c vo cc ph ti v v tr thch hp s b tr cc t in ph hp. T t in, qua h thng dy, dn in n cc ph ti.

- Chi tit h thng dy dn in v t in s c ghi c th trong thit k k thut.

- Ton b h thng dy dn in, dy dn truyn tn hiu gi y t, in thoi, tivi, v.v c t trn khay treo trn trn hnh lang hoc chn sn trong tng.

VI.4. Gii php chng st

Cn c c im cng trnh l 2 khi nh lin k vi khi nh cao 18 tng, tiu chun ni t chng st hin hnh 20 TCVN84 v tiu chun ni t an ton in TCVN 4756-86 ca b xy dng.

Trn khi nh 18 tng s lp t u thu st trc tip cng ngh pht xoay in cao th PULSAR 60 gm :

u thu st PULSAR 60 pht tn hiu in cao th vi bin tng s nht nh to ra ng dn st ch ng bo m nguy c st nh l nh nht v c hiu qu lu di.

u thu st PULSAR 60 l thit b ch ng khng s dng ngun in, khng gy ting ng, c bn knh bo v Rp = 107m, ph kn ton b khu bnh vin.

Cp thot st l 2 ng dn ng trn c din tch 70 mm2 m bo kh nng thot st nhanh chng v an ton cho cng trnh.

H thng ni t chng st gm cc ph kin: cc thp m ng, bn ng lin kt, bn ng tip t, ph kin u ni, ha cht lm gim v n nh in tr tt, hp kim tra tip a ch ni t c b tr theo h thng to thnh nhiu in cc tn nng lng st.

H thng ni t an ton in, ging h thng ni t chng st nhng c yu cu in tr t lun lun Rn 4(.

bo m tuyt i an ton trong vic chng st, trn nc khi nh 5 tng cao 24m, s lp t thit b ct st thng minh 3 pha du ngun ng dng cng ngh MCV.V25-B/4 v V20-C/4 s ngn nga hiu qu xung in lan truyn, s tn nng lng st lan truyn xung t m bo an ton cho cng trnh thit b.

VI.5. Gii php iu ha khng khVic iu ha khng kh trong bnh vin, c thit k theo:

iu ha khng kh trung tm: cho cc khng gian ln tp trung v c yu cu nhit thch hp trong khm v iu tr bnh.- D kin b tr 3 my lnh trung tm hot ng c lp trn mi, khi bnh vin 5 tng nhng v tr thch hp cp lnh trc tip cho cc khu vc, m bo dn dng truyn khng kh lnh 60 m

- ng dn truyn khng kh lnh t trn trn cc hnh lang cc tng c ca x lnh trc tip vo cc phng s dng.

iu ha khng kh bng cc my lnh ring bit cho cc phng ni tr

Khi thit k k thut, cc my lnh s c lp t nhng v tr thch hp cho s dng v khng nh hng n mt tin cng trnh.

CHNG VII: NH GI TC NG MI TRNG

VII.1. C s php l

Bo v mi trng m bo s pht trin bn vng kinh t x hi c ng v Nh nc c bit quan tm, nht l nhng thnh ph l trung tm vn ha chnh tr v kinh t ca tnh v cc vng ph cn.

Lut bo v mi trng c Quc hi thng qua v Ch tch nc k sc lnh ban hnh lut vo ngy 10/01/1994.

Ngh nh 175/N-CP ca Chnh ph v vic hng dn thc hin lut bo v mi trng.

Quyt nh 290/Q-MTG ngy 21/12/1996 cng b 97 tiu chun bt buc p dng v bo v mi trng Vit Nam.

Vic xy dng Bnh vin a khoa Quc T V Anh II ng gp mt phn vo vic thay i cnh quan th Tp.HCM, ng thi cng c nhng yu t nh hng tch cc v tiu cc n mi trng cn phi c x l nhm bo v mi trng.

VII.2. nh gi tc ng tch cc n mi trng ca d nVic xy dng Bnh vin a khoa Quc T V Anh II hin i vi y c s h tng gm: ng v sn bi, h thng in, h thng cp v thot nc. s gp phn to ra b mt th mi cho Tp.HCM v vng ph cn trong cc mt:

Bnh vin ni ring v h tng th ni chung c nng cp gp phn ci thin iu kin sng, bo v sc khe cng ng, to nn v p cnh quan th thnh ph, thc y kinh t x hi pht trin.

Bnh vin c xy dng mi c h tng k thut hin i s ci thin tt hn iu kin v sinh mi trng ti khu vc, hn ch nhim mi trng t v khng kh, nng cao cht lng cuc sng v iu kin pht trin kinh t x hi.

VII.3. nh gi tc ng tiu cc v bin php x lKhi bnh vin c xy dng hon chnh, bt u hot ng vi quy m ln hn trc nn cng phi quan tm n cc nhim sinh ra t qu trnh hot ng khm cha bnh v sinh hot trong phm vi bnh vin, cn phi c phn loi v x l m bo v sinh mi trng.

i vi nc thi t qu trnh khm cha bnh, s c thu gom v c h thng ng ng dn ring vo khu x l nc thi c kim sot theo TCVN 5945-1945 v TCXD 188-196 trc khi c x vo h thng nc thi.

i vi nc thi v sinh, phi qua x l ti cc b t loi trc khi c x vo h thng nc thi.

i vi rc thi l cc bnh phm, dng c y khoa, ti mi phng nghip v u c cc thng rc sinh hot, thng rc thi v cc vt nhn v cc ti nilon cha ring cc loi bnh phm a n trm t rc theo thit k k thut.

Trong qu trnh lm vic, bnh vin c quy nh c th v phng chng nhim khun bo v sc khe cho CBCNV, trnh vic ly lan bnh truyn nhim.VII.4. Mc ch ca bo co nh gi tc ng mi trng

Mi trng bao gm cc yu t t nhin v yu t nhn to quan h mt thit vi nhau din ra thng xuyn xung quanh loi ngi, n nh hng n i sng, sn xut, s tn ti, pht trin ca con ngi v thin nhin.

D n xy dng Bnh vin a khoa Quc t V Anh II vi cng sut 2000 ging ti Qun 2, Tp.HCM c nhiu hot ng c th gy tc ng n mi trng xung quanh ngay c trong giai on thi cng v giai on vn hnh

nh gi tc ng mi trng cho d n ny nhm t c cc mc ch:

Th nht xc nh c y cc tc ng tiu cc d n n mi trng t giai an xy dng ti khi i vo giai on vn hnh.

Th hai nghin cu a ra cc bin php, gii php khc phc nhng mt hn ch v pht huy cc mt tch cc ca d n.

VII.5. Tc ng mi trng ca d n

VII.5.1. Tc ng trong giai on xy dng

Cc tc ng tiu cc ca d n xy ra trong giai on u cho n khi hon thnh cng trnh, l:

- Cng tc di di cc h dn, gii to v gii phng mt bng c th s gy kh khn bc u cho cc h dn thuc din gii to trong d n, lm nh hng n i sng hin ti, thay i tp tc, thi quen sng ven sng ca h (nu c)

- nhim bi do qu trnh vn chuyn vt liu xy dng: Trong qu trnh san lp mt bng v trong khi xy dng cng trnh; nhim bi pht sinh nhiu trong qu trnh vn chuyn ct, , t, xi mng, st thp, vt liu xy dng, vt liu trang tr, ngoi ra bi cn c th pht tn t cc ng vt liu, bi ct v.v, bi pht sinh t cc hot ng ny s tc ng n ngi dn xung quanh khu vc cng trnh.- Bi t qu trnh ch nhm sau khi sn tng: Bi sn s pht sinh trong qu trnh ch nhm b mt sau khi sn v s c khuch tn vo gi gy nhim mi trng. Tuy nhin, cng on ch nhm b mt tng sn ch din ra trong thi gian ngn v qu trnh c che chn nn tc ng ny khng ng k, ch tc ng cc b trc tip n sc khe cng nhn lao ng ti cng trng.- nhim nc thi xy dng v nc thi sinh hot:

Trong cng tc o khoan mng, ng cc to ra bn ct v c bit l du m r r t cc my thi cng gy nhim ngun nc mt mc nht nh;

Nc thi sinh hot pht sinh t hot ng ca cc cng nhn xy dng trn cng trngThnh phn nc thi sinh hot ch yu bao gm:

Cht rn l lng (SS);

Cc cht hu c (COD, BOD);

Dinh dng (N, P);

Vi sinh vt (virus, vi khun, nm).

D kin s lng cng nhn lm vic ti cng trng ti a khong 150 ngi. Nu cng nhn xy dng c php tm ti cng trng v mc dng nc ti a l 80 lt/ngi/ngy th lu lng nc thi sinh hot pht sinh khong 12 m3/ngy. Nu khng c bin php khng ch nhim th ti lng nhim pht sinh khong 12 kgCOD/ngy (tnh ti lng pht thi ti a khong 80 gCOD/ngi/ngy).

Trng hp cng trng xy dng 1.5 2.0 nm, phn b tr nh v sinh c b t hoi, nh v sinh cho ph n, nh tm hn ch ti lng nhim c gim thiu 2 ln.

- Cht thi rn xy dng v sinh hot:

Cht thi rn sinh hot

Nu cng nhn xy dng c php t chc n ung ti cng trng v vi mc thi ti a l 0,20 kg/ngi/ngy th tng khi lng cht thi rn pht sinh ti a ti khu vc d n trong giai on xy dng l 30 kg/ngy. Trong , thnh phn hu c (tnh ring cho rc thi thc phm) chim t 60 70 % tng khi lng cht thi, tc khong 18 - 21 kg/ngy. Cc thnh phn cn li ch yu l v hp, bao b ng thc n tt c rc thi s c thu gn v hng ngy giao cho cng ty v sinh mi trng thnh ph mang i x l.

Cht thi xy dng

Cht thi xy dng bao gm bao b xi mng, st thp vn, gch Nu khng c thu gom th s nh hng n mi trng v v m quan th. Cht thi xy dng s c thng xuyn thu gn sch trong cng tc v sinh cng nghip ti cng trnh.

Du m thi

Du m thi theo qui ch qun l cht thi nguy hi c phn loi l cht thi nguy hi (m s: A3020; m Basel: Y8).

Du m thi t qu trnh bo dng, sa cha cc phng tin vn chuyn v thi cng trong khu vc d n l khng th trnh khi.

Lng du m thi pht sinh ti khu vc d n ty thuc vo cc yu t sau:

S lng phng tin vn chuyn v thi cng c gii trn cng trng;

Chu k thay nht v bo dng my mc.

Lng du nht thi ra trong mt ln thay nht/bo dng.

Kt qu iu tra kho st du nht thi trn a bn TP.HCM cho thy:

Lng du nht thi ra t cc phng tin vn chuyn v thi cng c gii trung bnh 7 lt/ln thay

Chu k thay nht v bo dng my mc: trung bnh t 3 - 6 thng thay nht 1 ln ty thuc vo cng hot ng ca phng tin.

Da trn c s ny, c tnh lng du m pht sinh ti cng trng trung bnh khong 12 - 23 lt/ngy.

- Ting n

Ting n trong giai on xy dng ch yu l do hot ng ca cc phng tin vn chuyn v thi cng nh my i, xe lu, my ko, my cp t Mc n s gim dn theo khong cch, mc n cch ngun 1 m v d bo mc n ti a ca cc phng tin vn chuyn v thi cng c trnh by trong Bng sau:

TTCc phng tinMc n cch ngun 1m (dBA)Mc n cch ngun 20 m (dBA)Mc n cch ngun 50 m (dBA)

Khong Trung bnh

1My i93,067,059,0

2Xe lu72,0 ( 74,073,047,039,0

3My ko77,0 ( 96,086,560,552,5

4My cp t80,0 ( 93,086,560,552,5

5Xe ti82,0 ( 94,088,062,054,0

6My trn b tng75,0 ( 88,081,555,547,5

7My nn kh 75,0 ( 87,081,055,047,0

TCVN 5949-1998

(6 ( 18h)50 ( 75 dBA

Mc n ti a do hot ng ca cc phng tin vn chuyn v thi cng ti v tr cch ngun 20 m nm trong gii hn cho php ca tiu chun TCVN 5949-1998. Tuy nhin, ting n s nh hng ng k n khu vc dn c xung quanh nu cc hot ng ny trin khai sau 22 gi.

VII.5.2. Cc tc ng chnh trong giai on vn hnh

Tc ng do cht thi y t

Theo qui nh, cht thi ti cc bnh vin, trung tm y t s bao gm cc loi nh sau:

Cht thi ly nhim:

- Cht thi sc nhn (loi A): L cht thi c th gy ra cc vt ct hoc chc thng, c th nhim khun, bao gm: bm kim tim, u sc nhn ca dy truyn, li dao m, inh m, ca, cc ng tim, mnh thu tinh v v cc vt sc nhn khc s dng trong cc hot ng y t.- Cht thi ly nhim khng sc nhn (loi B): L cht thi b thm mu, thm dch sinh hc ca c th v cc cht thi pht sinh t bung bnh cch ly.

- Cht thi c nguy c ly nhim cao (loi C): L cht thi pht sinh trong cc phng xt nghim nh: bnh phm v dng c ng, dnh bnh phm.

- Cht thi gii phu (loi D): Bao gm cc m, c quan, b phn c th ngi; rau thai, bo thai v xc ng vt th nghim.

Cht thi ho hc nguy hi:

- Dc phm qu hn, km phm cht khng cn kh nng s dng.

- Cht ho hc nguy hi s dng trong y t

- Cht gy c t bo, gm: v cc chai thuc, l thuc, cc dng c dnh thuc gy c t bo v cc cht tit t ngi bnh c iu tr bng ho tr liu

- Cht thi cha kim loi nng: thu ngn (t nhit k, huyt p k thu ngn b v, cht thi t hot ng nha khoa), cadimi (Cd) (t pin, c quy), ch (t tm g bc ch hoc vt liu trng ch s dng trong ngn tia x t cc khoa chn on hnh nh, x tr).

Cht thi phng x:

- Cht thi phng x: Gm cc cht thi phng x rn, lng v kh pht sinh t cc hot ng chn on, iu tr, nghin cu v sn xut.

- Danh mc thuc phng x v hp cht nh du dng trong chn on v iu tr ban hnh km theo Quyt nh s 33/2006/Q-BYT ngy 24 thng 10 nm 2006 ca B trng B Y t.

Bnh cha p sut:

Bao gm bnh ng oxy, CO2, bnh ga, bnh kh dung. Cc bnh ny d gy chy, gy n khi thiu t.

Cht thi thng thng:

Cht thi thng thng l cht thi khng cha cc yu t ly nhim, ho hc nguy hi, phng x, d chy, n, bao gm:

- Cht thi sinh hot pht sinh t cc bung bnh (tr cc bung bnh cch ly).

- Cht thi pht sinh t cc hot ng chuyn mn y t nh cc chai l thu tinh, chai huyt thanh, cc vt liu nha, cc loi bt b trong gy xng kn. Nhng cht thi ny khng dnh mu, dch sinh hc v cc cht ho hc nguy hi.

- Cht thi pht sinh t cc cng vic hnh chnh: giy, bo, ti liu, vt liu ng gi, thng cc tng, ti nilon, ti ng phim.

- Cht thi ngoi cnh: l cy v rc t cc khu vc ngoi cnh.

Tc ng do nc thi y t

Trung bnh, mi ngy, lng nc thi pht sinh tnh trn mt ging bnh l 750 lt. Nc thi bnh vin c u ra gm cc vi sinh vt gy bnh, cc loi thuc, cc nguyn t phng x, v cc ha cht c hi khc. Cc cht nhim pht sinh t bnh vin ch yu l cc ha cht cha tr ung th, cht khng sinh, cc hp cht halogen, . Cng vi cc cht nhim ny, vi sinh vt gy bnh trong NTBV gy ra nhim nng n cho mi trng t nhin, c bit l cho cc loi sinh vt v ngun tip nhn. Tnh cht nc thi 1 s bnh vin nh trong Bng sau:CH TIU Trung bnhTCVN

1 pH (mg/l) a- Trung ng 6,16,5-8,5**

b- Tnh 7,2

3 H2S (mg/l) a- Trung ng 4,5 1,0**

b- Tnh 8,1

4 BOD5 (mg/l) a- Trung ng 89,7 30**

b- Tnh 169,1

5 COD (mg/l) a- Trung ng 130,0 80*

b- Tnh 222,8

6 Tng nit (mg/l) a- Trung ng 13,4 40*

b- Tnh 18,6

7 Cht rn l lng (SS) (mg/l) a- Trung ng 21,6 100**

b- Tnh 35,0

8 Tng phtpho (mg/l) a- Trung ng 2,0 6**

b- Tnh 1,4

* QCVN 24:2009/BTNMT loi B, **TCVN 7382:2004 mc II

VII.6. Bin php gim thiu v cc tc ng n mi trng

VII.6.1. Gim thiu cc tc ng trong giai on thi cng

1/- Gim thiu nhim do bi

Kim sot kh thi i vi bi pht sinh do qu trnh t nhin liu ca ng c t trong t cc phng tin thi cng vn chuyn:

Tt c cc phng tin v thit b phi c kim tra v ng k ti Cc ng kim cht lng theo ng quy nh hin hnh.

Ch thu xy dng c yu cu phi cung cp danh sch thit b c kim tra v ng k cho ch D n.

nh k bo dng cc phng tin v thit b xy dng.

Kim sot bi khuch tn t cc hot ng xy dng: Hot ng thu gom, chuyn ch vt liu san i: p dng bin php cn gi bng tng ro hoc ti nc. Cc xe ti chuyn ch:

C tm bt che ph (hiu qu kim sot 2%).

Ti nc 2 ln/ngy (hiu qu kim sot 37%).

V sinh sch s cc phng tin v thit b trc khi ra khi cng trng xy dng.2/- Qun l du m thi trong sut thi gian thi cng Du m thi pht sinh t qu trnh bo dng v sa cha cc phng tin vn chuyn, my mc v thit b thi cng c phn loi l cht thi nguy hi theo Quyt nh s 23/2006/Q-BTNMT v thng t s 12/2006/TT-BTNMT vi M s A3020, M Basel Y8. V vy, du m thi phi c thu gom v qun l thch hp. C th, cc bin php kim sot tc ng ca du m thi nh sau:

Khng chn lp/t/ b du m thi ti khu vc d n.

Hn ch vic sa cha xe, my mc cng trnh ti khu vc d n.

Khu vc bo dng c b tr tm trc trong mt khu vc thch hp v c h thng thu gom du m thi ra t qu trnh bo dng.

Du m thi c thu gom v lu tr trong cc thng cha thch hp trong khu vc d n. Ch u t s k hp ng vi cng ty v n v c chc nng n thu gom v vn chuyn i x l theo Quyt nh s 23/2006/Q-BTNMT v thng t s 12/2006/TT-BTNMT.3/-. Thu gom v x l rc thi sinh hot Tt c cht thi sinh hot pht sinh t hot ng ca cng trnh u c thu gom vo cc thng cha c np y v hp ng vi cc n v thu gom rc ca a phng n thu gom hng ngy.

Ngoi ra nh thu xy dng cng phi c trch nhim thu gom tt c rc thi nm trong phm vi ca cng trng m bo khng pht sinh cc ng rc t pht ti khu vc nh thu chu trch nhim.

VII.6.2. Gim thiu cc tc ng trong giai on vn hnh

1/- Gim thiu tc ng do cht thi rn

Bnh vin s thc hin y v nghim tc cc qui inh v qun l cht thi y t ca mnh, c th nh sau:

Qui nh m mu sc ca cht thi y t

Mu vng ng cht thi ly nhim.

Mu en ng cht thi ho hc nguy hi v cht thi phng x.

Mu xanh ng cht thi thng thng v cc bnh p sut nh.

Mu trng ng cht thi ti ch.

Ti ng cht thi

Ti mu vng v mu en phi lm bng nha PE hoc PP, khng dng nha PVC.

Ti ng cht thi y t c thnh dy ti thiu 0,1mm, kch thc ti ph hp vi lng cht thi pht sinh, th tch ti a ca ti l 0,1 m3.

Bn ngoi ti phi c ng k ngang mc 3/4 ti v c dng ch KHNG C NG QU VCH NY.

Dng c ng cht thi sc nhn

Dng c ng cht thi sc nhn phi ph hp vi phng php tiu hu cui cng.

Hp ng cht thi sc nhn phi bo m cc tiu chun:

Thnh v y cng khng b xuyn thng.

C kh nng chng thm.

Kch thc ph hp.

C np ng m d dng.

Ming hp ln cho vt sc nhn vo m khng cn dng lc y.

C dng ch CH NG CHT THI SC NHN v c vch bo hiu mc 3/4 hp v c dng ch KHNG C NG QU VCH NY.

Mu vng.

C quai hoc km h thng c nh.

Khi di chuyn vt sc nhn bn trong khng b ra ngoi.

i vi cc c s y t s dng my hu kim tim, my ct bm kim tim, hp ng cht thi sc nhn phi c lm bng kim loi hoc nha cng, c th dng li v phi l mt b phn trong thit k ca my hu, ct bm kim.

i vi hp nha ng cht thi sc nhn c th ti s dng, trc khi ti s dng, hp nha phi c v sinh, kh khun theo quy trnh kh khun dng c y t. Hp nha sau khi kh khun ti s dng phi cn cc tnh nng ban u.

Thng ng cht thi Phi lm bng nha c t trng cao, thnh dy v cng hoc lm bng kim loi c np y m bng p chn. Nhng thng thu gom c dung tch t 50 lt tr ln cn c bnh xe y.

Thng mu vng thu gom cc ti, hp cht thi mu vng.

Thng mu en thu gom cc ti cht thi mu en. i vi cht thi phng x, thng ng phi lm bng kim loi.

Thng mu xanh thu gom cc ti cht thi mu xanh.

) Thng mu trng thu gom cc ti cht thi mu trng.

Dung tch thng tu vo khi lng cht thi pht sinh, t 10 lt n 250 lt.

Bn ngoi thng phi c vch bo hiu mc 3/4 thng v ghi dng ch KHNG C NG QU VCH NY.

Biu tng ch loi cht thi:

Mt ngoi ti, thng ng mt s loi cht thi nguy hi v cht thi ti ch phi c biu tng ch loi cht thi ph hp (Ph lc 3 ban hnh km theo Quy ch ny):

Ti, thng mu vng ng cht thi ly nhim c biu tng nguy hi sinh hc.

Ti, thng mu en ng cht thi gy c t bo c biu tng cht gy c t bo km dng ch CHT GY C T BO.

Ti, thng mu en ng cht thi phng x c biu tng cht phng x v c dng ch CHT THI PHNG X

Ti, thng mu trng ng cht thi ti ch c biu tng cht thi c th ti ch.

Thu gom cht thi rn trong c s y t

Ni t thng ng cht thi.

Mi khoa, phng phi nh r v tr t thng ng cht thi y t cho tng loi cht thi, ni pht sinh cht thi phi c loi thng thu gom tng ng.

Ni t thng ng cht thi phi c hng dn cch phn loi v thu gom.

S dng thng ng cht thi theo ng tiu chun quy nh v phi c v sinh hng ngy.

Ti sch thu gom cht thi phi lun c sn ti ni cht thi pht sinh thay th cho ti cng loi c thu gom chuyn v ni lu gi tm thi cht thi ca c s y t.

Mi loi cht thi c thu gom vo cc dng c thu gom theo m mu quy nh v phi c nhn hoc ghi bn ngoi ti ni pht sinh cht thi.

Cc cht thi y t nguy hi khng c ln trong cht thi thng thng. Nu v tnh ln cht thi y t nguy hi vo cht thi thng thng th hn hp cht thi phi c x l v tiu hu nh cht thi y t nguy hi.

Lng cht thi cha trong mi ti ch y ti 3/4 ti, sau buc c ti li.

Tn sut thu gom: H l hoc nhn vin c phn cng hng ngy chu trch nhim thu gom cc cht thi y t nguy hi v cht thi thng thng t ni cht thi pht sinh v ni tp trung cht thi ca khoa t nht 1 ln trong ngy v khi cn.

Cht thi c nguy c ly nhim cao trc khi thu gom v ni tp trung cht thi ca c s y t phi c x l ban u ti ni pht sinh cht thi.

Vn chuyn cht thi rn trong c s y t Cht thi y t nguy hi v cht thi thng thng pht sinh ti cc khoa/phng phi c vn chuyn ring v ni lu gi cht thi ca c s y t t nht mt ln mt ngy v khi cn.

C s y t phi quy nh ng vn chuyn v gi vn chuyn cht thi. Trnh vn chuyn cht thi qua cc khu vc chm sc ngi bnh v cc khu vc sch khc.

Ti cht thi phi buc kn ming v c vn chuyn bng xe chuyn dng; khng c lm ri, vi cht thi, nc thi v pht tn mi hi trong qu trnh vn chuyn.

Lu gi cht thi rn trong cc c s y t

Cht thi y t nguy hi v cht thi thng thng phi lu gi trong cc bung ring bit.

Cht thi ti s dng, ti ch phi c lu gi ring.

Ni lu gi cht thi ti cc c s y t phi c cc iu kin sau:

Cch xa nh n, bung bnh, li i cng cng v khu vc tp trung ng ngi ti thiu l 10 mt.

C ng xe chuyn ch cht thi t bn ngoi n.

Nh lu gi cht thi phi c mi che, c hng ro bo v, c ca v c kho. Khng sc vt, cc loi gm nhm v ngi khng c nhim v t do xm nhp.

Din tch ph hp vi lng cht thi pht sinh ca c s y t.

) C phng tin ra tay, phng tin bo h cho nhn vin, c dng c, ho cht lm v sinh.

C h thng cng thot nc, tng v nn chng thm, thng kh tt.

Khuyn khch cc c s y t lu gi cht thi trong nh c bo qun lnh.

Thi gian lu gi cht thi y t nguy hi ti c s y t.

Thi gian lu gi cht thi trong cc c s y t khng qu 48 gi.

Lu gi cht thi trong nh bo qun lnh hoc thng lnh: thi gian lu gi c th n 72 gi.

Cht thi gii phu phi chuyn i chn hoc tiu hu hng ngy.

i vi cc c s y t c lng cht thi y t nguy hi pht sinh di 5 kg/ngy, thi gian thu gom ti thiu hai ln trong mt tun. 2/- Gim thiu tc ng do nc thi

Qui trnh x l thi ca bnh vin c trnh by trong Hnh 1. Vi cng ngh x l ny nc thi ca bnh vin s t tiu chun cho php hin hnh. Khi nc thi dn vo khu x l nc c kim sot theo TCXD 188-196-5945-1995 v trc khi thi vo h thng nc thi cng cng c kim sot theo TCXD

CHNG VIII: QUY M BNH VIN, B MY QUN L V T CHC NHN S

VIII.1. Quy m bnh vin

Bnh vin a khoa Quc t V Anh II c quy m 2,000 ging bnh.VIII.2. B my qun l bnh vin

VIII.2.1. B phn qun l

- Hi ng qun tr v Tng gim c

- Ban Gim c

- Phng T chc - K hoch tng hp

- Phng iu dng

- Phng ti chnh k ton

- Phng t chc- Hnh chnh qun tr

VIII.2.2. B phn chuyn mn

Khoa khm bnh: bao gm cc chuyn khoa nh sau+ Bung cp cu lu bnh

+ Phng khm chuyn khoa ni

+ Phng khm chuyn khoa ngoi tng qut

+ Phng khm chuyn khoa ph sn K hoch ha gia nh

+ Phng khm chuyn khoa nhi

+ Phng khm chuyn khoa mt

+ Phng khm chuyn khoa tai mi hng

+ Phng khm chuyn khoa rng - hm - mt

+ Phng khm chuyn khoa phu thut thm m

+ Phng khm chuyn khoa tm thn thn kinh

+ Phng khm chuyn khoa da liu

+ Phng khm chuyn khoa iu dng, phc hi chc nng

+ Phng khm chuyn khoa truyn nhim

+ Phng khm chuyn khoa y hc c truyn.Khoa ni (300 ging)+ n v iu tr cc bnh thong thng v ni khoa tng hp

+ n v lc thn

+ n v ni tit

+ n v tim mch

+ n v h hp

+ n v tiu ha

+ n v xng c khp

+ n v ung bu

Khoa ngoi (300 ging)+ n v ngoi tng hp

+ n v chn thng chnh hnh, thn tit niu, xng c khp+ n v phu thut thm m

+ n v phu thut tim mch

Khoa phu thut gy m hi sc (60 ging)

+ Bung phu thut

+ Bung tin m

+ Bung hu phu

Khoa sn ph khoa (250 ging)

+ Bung

+ Bung ch

+ Bung khm sn

+ Bung khm ph khoa

+ Bung hu sn

+ Bung k thut k hoch ha gia nh

+ Bung truyn thong t vn

Khoa nhi (200 ging)Lin khoa mt, tai mi hng, rng hm mt (150 ging)

Khoa sn sc c bit (50 ging)

Khoa truyn nhim (200 ging)

Khoa y hc c truyn (200 ging)

Khoa iu dng phc hi chc nng (200 ging)

+ n v vn ng tr liu

+ n v vt l tr liu

+ n v thy tr liu

Khoa cn lm sng

+ Xt nghim: huyt hc, sinh ha, vi sinh, min dch, gii phu bnh

+ Chn on hnh nh:X-quang, CT-Scanner, cng hng t, siu m, ni soi.

+ Thm d chc nng: in tm , in no .

Khoa dc

12345678910111213

1. Khoa khm bnh

2. Khoa ni

3. Khoa ngoi

4. Khoa phu thut gy m hi sc

5. Khoa sn ph khoa

6. Khoa nhi

7. Lin khoa mt, tai mi hng, rng hm mt

8. Khoa sn sc c bit

9. Khoa truyn nhim

10. Khoa y hc c truyn11. Khoa iu dng phc hi chc nng12. Khoa cn lm sng

13. Khoa dc

1. Phng t chc k hoch tng hp

2. Phng y t

3. Phng vt t thit b y t

4. Phng hnh chnh qun tr

5. Phng ti chnh k ton

6. Ca hng thucVIII.3. T chc nhn s, cn b

T chc bin ch nhn s ca bnh vin: tng s: cn b, nhn vin. Bao gm cn b nh sau:

- Gio s, bc s

- Dc s i hc

- Dc s trung hc

- iu dng

- K thut vin

- N h sinh

- Nhn vin khc

Gim c bnh vin c chng ch hnh ngh t nhn do B trng B Y t cp. Bc s trng khoa lm sang, cn lm sang v cc nhn vin y t lm vic chuyn mn c iu kin hnh ngh theo quy nh ti thng t s 01/2004/TT-BYT ngy 6/1/2004 ca B trng B Y t hng dn v ngnh y, dc t nhn.CHNG IX: PHM VI HOT NG CHUYN MN V TRANG THIT B Y TIX.1. Phm vi hot ngIX.1.1. Khoa niKhoa Ni Tng Hp ca Bnh Vin a Khoa Quc T V Anh II nhn iu tr cc bnh l ni khoa tng qut nh: Bnh l h hp: Vim phi, vim ph qun, hen ph qun, gin ph qun, bnh phi mng tnh, v.v..

Bnh l tiu ha, gan mt: vim lot d dy t trng, vim ty, x gan, vim gan, bnh l i trng,v.v Bnh l thn tit niu: nhim trng tiu, u x tin lit tuyn, vim vi cu thn cp, hi chng thn h, suy thn cp, suy thn mn, v.v

Bnh l huyt hc

Bnh l i tho ng Bnh l tuyn gip Cc bnh ung th v.v Bnh l mch vnh Tng huyt p Thiu mu c tim, suy tim, nhi mu c tim cp, bnh tim mch kt hp vi bnh i tho ng, v.v Khoa Ni Tim Mch hin c n v Thm D Tim Mch chuyn su gn nh y cc nghim php: in tm thng quy, in tm gng sc, siu m tim, siu m tim gng sc, holter nhp tim, holter huyt p, CAVI test nh gi x cng ng mch, kch thch nh, v.v...

n V Thm D Tim Mch chuyn su ca Bnh Vin V Anh II cn c trang b ng thi c hai h thng my chp ct lp in ton 64 lt ct ( my chp CT ) v my cng hng t 1.5 Tesla ( my MRI ) gip nh gi tnh trng vi ha v hp ng mch vnh, tnh trng cu ni ng mch vnh sau phu thut, v.v MRI tim mch cn gip nh gi hnh thi hc ca tim, kho st ti mu c tim, tnh sng cn ca c tim, v.vIX.1.2. Khoa ngoi

Khoa Ngoi ca Bnh Vin a Khoa Quc T V Anh II bao gm cc chuyn khoa: - Tiu Ha Gan Mt: vim rut tha, tc rut, hp hu mn v, vim ti mt, tr chy mu, tr tc mch, tr vim tc, p xe gan, v.v v cc bnh khng cp cu thng gp nh Ung th thc qun, ung th d dy, lot d dy t trng, co tht tm v, tr ni ngoi, bu t trng, bu rut non, ung th rut gi trc trng; t vn v tm sot ung th i vi cc loi ung th thng gp nh: Thc qun, D dy, Rut non, i trng, Gan, Ti mt, Ty, Lch, Trc trng, Hu mn, v.v

- Chn Thng Chnh Hnh: iu tr cc loi chn thng v bnh l v xng khp t nhng gy xng tay, chn n gin (ch cn iu tr bng c nh ngoi nh treo, bt ng bng cc vt liu tng hp hay b bt ) n phc tp ( phi phu thut c nh bn trong xng gy ), chn thng ct sng; cc loi phu thut kt hp xng bng np vt cho n thay khp hng, khp gi, chnh hnh chi, ti to dy chng, thay dy chng mi do chn thng trong th thao v trong sinh hot; iu tr nhng bnh l nh vim, p-xe, u bu v chn thng, vt thng m mm nh da, t chc di da, gn, m c v khp- Tit Niu: vim quanh thn, si thn, u thn v tuyn thng thn, si v cc teo hp t b thn, niu qun ti niu o; bnh l vim, u bu v si bng i; vim tuyn tin lit (TTL), bu si lnh TTL v ung th TTL;chn on n iu tr ca bng i, TTL, niu qun - b thn, ct b u tuyn thng thn

- Lng Ngc Mch Mu: bu c lnh tnh n c tnh, phu thut m v ni soi bu nhn tuyn gip, nang gip mng; iu tr cc tn thng m mm lng ngc, c bit l bu lnh v c ca tuyn v cho c nam v n; chn on v iu tr cc hch vng c, trn xng n v nch cng nh cc ca phu thut m v ni soi lng ngc; chn on v iu tr cc bnh l phi, mng phi, hch vng trung tht; phu thut ni soi ct t hch giao cm ngc iu tr chy m hi tay.IX.1.3. Khoa snDch v Sn khoa-Tm sot trc sanh

- Tm sot tr sau sanh ( xt nghim mu )

- Dch v sanh khng au

- Dch v gim au sau m ( 48 gi )

- Dch v ly mu cung rn ( T bo gc )

- Khm thai trn gi: Theo di sc khe m, theo di thai k, tm sot d tt bm sinh thai nhi, pht hin sm d tt thai (xt nghim mu, siu m 4D), chch nga cho m, in thoi nhc lch khm nh k, xe a n khi sanh.Dch v Ph khoa- Theo di nh k sc khe:- Pht trin, iu tr bnh l ph khoa.- Tm sot ung th: Pht hin sm ung th c t cung vi h thng soi c t cung hin i.- Tm sot ung th v.- Dch v k hoch ha gia nh:Nga thai bng que cy di da (tc dng 3 nm), ph thai bng thuc, ht thai di gy m.

- May thm m- Phu thut ni soi: Ct t cung, bc u x t cung, bc u nang bung trng, thai ngoi t cung, iu tr v sinh.

Trang thit b:

- H thng M ni soi OR1 tin tin nht trn th gii hin nay v c trang b cng mt h thng mng ton cu gip chuyn ti hnh nh trc tip ca phu thut sang cc nc tin tin khc trong trng hp cn s c vn chuyn mn.-p dng phng php sng lc d tt sm t 11 --> 24 tun, vi h thng my mc hin i v phn mm phn tch tin tin nht ang c p dng Chu u. Vi h thng my siu m cc k hin i nh: 2 chiu ( 2D ), Doppler mu, 3 chiu ( 3D ), 3 chiu thi gian tht ( 4D ), cc b m mang thai s c kho st d tt thai nhi mt cch sm nht c bit l cc d tt b mt. Khng nhng th, cc ng b, b m s c trc tip nhn thy mi c ng ca b yu trong bng m. Ngoi ra, my 3D, 4D vi phn gii cao, o chnh xc n 0,1mm cho php o m da gy ( NT ) thai nhi t 11W 13W6D nhm pht hin sm mt s d tt lin quan n ri lon nhim sc th ( NST ), tim mch My siu m 3D, 4D cho hnh nh sng ng, r nt khng nhng b mt thai nhi m c th kho st cc c quan bn trong ca thai nhi nh gan, thn, tim, phiIX.1.4. Khoa nhi

Khoa Nhi c t chc theo m hnh mi, nng ng v thn thin nhm p ng nhu cu ca cc gia nh bn rn M hnh Nh Tr - Bnh Vin.

- Phng Khm Tr: Khm sc khe nh k, t vn chm sc, dinh dng; Khm sc khe ch nh chng nga phng bnh; Khm v iu tr ngoi tr cc bnh l nhi khoa thng thng; Khm v sng lc cc tr bnh l nng cn ch nh nhp vin theo di v iu tr, lun m bo an ton tt nht cho cc em b.

- Phng khm cp cu: x tr cp cu cc em b bnh l h hp, tim mch, tiu ha, thn kinh, st xut huyt, st co git, cc bnh l ngoi khoa,

- Khu iu tr ni tr nhi:Cc em b lun c chm sc nh nh ca mnh vi h thng phng c tin nghi cao cp, c trang tr cc hnh nh ph hp tm l tr. Phng c trang b cc my mc thit b h tr cho cng tc iu tr t kt qu tt nht.

- Khu iu tr s sinh: Khu iu tr s sinh c trang b cc my mc thit b rt hin i: my gip th, my th p lc dng lin tc qua mi ( NCPAP Nasal Continuous Positive Airway Pressure ), my monitoring, lng p cho tr non thng nh cn, warmer si m cho cc b, n chiu vng da v h thng oxy, kh nn,

IX1.5. Khoa hi sc cp cu

phc v cng tc iu tr, chm sc bnh nhn, bnh vin thc hin cc th thut iu tr nh:

- t ni kh qun

- Cp cu ngng tim ngng th

- t Catheter tnh mch trung tm

- Thng kh c hc: Th my xm ln v khng xm ln

- Chc d mng phi, chc d mng bng, chc d ty sng.

Bnh vin trang b h thng my th, my monitor, my sc in, my lm kh mu ng mch, my siu m, ng b v hin i nht t tiu chun quc t, gip cp cu, theo di v pht hin nhng thay i nh nht ca Bnh nhn mt cch chnh xc, nhanh nht.

IX.1.6. Khoa sn sc c bit

Mi trng hp cn cp cu v hi sc: suy h hp do cc bnh phi (k c bnh phi tc nghn mn tnh), cp cu thn kinh, tim mch, sn, nhi, tai mi hng, ngoi khoa, v.v Cc bnh nhn nng cn c chm sc v hi sc tch cc, hay cn s theo di lin tc s c chuyn v khu sn sc c bit. Ti y, chng ti c bit quan tm n vn v sinh v an ton cho bnh nhn. Nguyn tc v trng c tun th nghim ngt, dng c y t ch c s dng mt ln duy nht. Ngoi ra, h thng chung bo ng, monitor trung tm b tr trong phng bnh m bo s theo di tnh trng bnh nhn mt cch tt nht.IX.1.7. Khoa khm bnh

Phng khm rng hm mt

gip hm v rng chc khe, gng mt ti tn, chng ti c th thc hin cc loi hnh dch v nh sau:

- Nha khoa d phng: khm sc khe rng hm mt nh k, ngn nga su rng bng bt h rnh.

- Nha khoa iu tr: trm rng, cha ty, nh rng, ly cao rng, nh bng rng, ty trng rng.

- Nha khoa thm m: iu chnh mu rng b hng do thuc: tetracycline, nhim fluor, nhim phn.

- Nha khoa phc hi: lm rng gi tho lp, lm rng s c nh

H thng gh my nha khoa cao cp VOYAGER II, my ty trng rng nhanh ti phng nha 24 pht, my co vi rng siu m th h mi, h thng X-quang k thut s hin i nht hin nay, c bit vi h thng my ni soi rng cao cp s gip bnh nhn pht hin nhanh v sm tnh trng bnh l rng ming.

Phng khm tai mi hng

My massage mng nh TM100 (Tympanic Membrane massager TM 100):My to ra p lc kh rt thp vi tn s c bit tc ng ln mng nh, tai gia v tai trong dng iu tr trong: ri lon vi nh, vim tai gia, bnh Meniere. My iu tr Laser mc thp LT-200 (Low Level Laser Therapy LT-200)Laser mc thp vi di bc sng 5mW650nm lm bin i hiu ng sinh hc ca mu v lm tng sc khng min dch chng li bnh nh vic tng tc di chuyn ca nguyn bo si, thc y vic to endorphins, gim s kt dnh ca mu. Dng iu tr trong: Vim mi d ng v nhim trng, Vim tai gia cp v mn tnh. My iu tr bc x NET 1300 (Infrared irridiating therapy NET 1300)Tia bc x i xuyn qua da lm tng nhit vng su ca da v lm tng tun hon mu. Dng iu tr trong: Vim tai ngoi, vim tai gia, vim mi, vim thanh qun.My ra mi SI 1000 ( Nasal Washer SI 1000 )

Pht tn thuc thnh cc ht nh 15 m, ng tiu chun y t, khng gy ting n. Dng iu tr trong: Vim mi xoang, d ng mi xoang.

-My Phun Kh Dung NET 1580 (Nebulizer Net 1580)

Pht tn thuc xng thnh cc ht nh 10 m, ng tiu chun y t, khng gy ting n. Dng iu tr trong: Vim mi, vim thanh qun, cm mo, vim ph qun.H thng my ni soi Karl Storz.

Cc ng soi cng 0 , 30 , 70 vi ng knh 4mm, 2,7 mm v b dng c phu thut ni soi mi xoang h tr ti a trong cc ca phu thut ni soi Tai Mi Hng. Bn Khm Tai Mi Hng th h mi NET -3000 (ENT UNIT, NET 3000)Vi y tnh nng phc v cho vic khm tai mi hng: bn dng c khm, n c phim, bn my ni soi, my vi tnh, hp ng gn, my h gng, my ht, my xt thuc. c bit gh ngi iu chnh bng in mi t th thun li nht cho cng tc thm khm v to s thoi mi nht cho bnh nhn.IX.1.8. Khoa iu dng v phc hi chc nng

- Vt l tr liu: H thng my mc hon ton mi vi cc loi nh: Vi sng, siu m, in xung gim au TENS, in xung gim au giao thoa, hng ngoi, parafin. c bit, bnh vin cn trang b cc my massage bng p sut khng kh, massage dng nc iu chnh nhit t 25oC 40oC , massage dng ln vi iu chnh cc thng s theo chiu cao, laser dng qut vi 8 phng thc iu tr, my ko ct sng km nhit lm m vng lng khi ko.Cc dng bnh iu tr ti phng vt l tr liu- Vt l tr liu ngoi khoa+ Vt l tr liu trc v sau phu thut ngc, bng.+ Laser sinh hc nng lng thp: iu tr vt thng h nhim trng , vt thng bn chn tiu ng, vt lot,bng, vt m, tiu phu sau 48 gi gip vng tn thng lnh tt, khng li so hay so rt nh.

- Vt l tr liu chn thng chnh hnh+ Vt l tr liu trc v sau phu thut c xng khp: Thay khp gi, khp hng; Ni gn, ti to m mm, ti to dy chng khp gi; Gy xng v trt khp; Xng chm lin.

+ Vt l tr liu chn thng:Chn thng m mm; So kt dnh+ Vt l tr liu mt s bnh l c xng khp:Long xng; Thoi ha khp; Vim khp; Vim gn, vim c, vim bao hot dch khp ,vim chu vi vai; Hi chng chm xoay, tennis elbow, De Quarvain, ngn tay bt;

+ Vt l tr liu tn thng thn kinh ngoi bin: Lit thn kinh quay, tr, gia; Tn thng m ri cnh tay; Lit thn kinh hng khoeo ngoi, hng khoeo trong; Lit VII ngoi bin.+ Vt l tr liu mt s bnh l ct sng: Trt t sng; Vo ct sng; Vim ct sng dnh khp; Thoi ha ct sng; Hi chng c vai, au tht lng; Thot v a m ct sng- Vt l tr liu ni thn kinh+ Vim a dy thn kinh+ Vim a r v dy thn kinh (Guilain Barre)+ au thn kinh ta+ au thn kinh lin sn+ au hu zona.+ Bin chng thn kinh chi di do tiu ng+ Di chng tai bin mch mu no+Parkinson- Vt l tr liu h hp + Vim phi+ Abces phi+ Vim ph qun+ COPD+ Trn dch, trn kh mng phi - Vt l tr liu tim mch+ Suy tim I, II theo NYHA+ Sau nhi mu c tim + Gin tnh mch, suy tnh mch , vim tc ng mch chi+ X cng ng mch chi di do tiu ng- Vt l tr liu tai mi hng

+ au u vn mch, cng c+ Vim sn vnh tai+ Lit VII ngoi bin sau phu thut.+ Khn ting+ Ri lon ni, nut- Vt l tr liu sn khoa+ Trc v sau sinh+ Sa sinh dc- Tm sot d tt bm sinh i vi tr s sinh+ Tc tuyn sa , vim tuyn v, abces tuyn v+ So sau m bt con , rn da- Vt l tr liu nhi

+ H hp nhi+ Vo c do c+ Chn khoo+ Trt khp hng

Bc t ph ca chng ti l:- Tm ra phng php mi iu tr thnh cng tt c cc trng hp tc tia sa sn ph sau sinh.

- iu tr vt thng nhim trng mn tnh lu lnh v vt thng bn chn tiu ngbng LASER sinh hc nng lng thp, bc sng 660nm v 830nm, kch thch m si v da nhanh lnh, t hoc khng li so.IX.2. Trang thit b y tTTThit bTTThit b

1My CT a ct lp136My lc kh di ng v trng Erhance

2My MRI137Bn khm bnh

3My nh dng vi khun138Bn khm ph khoa

4Thit b m soi bng Moniter139Bn khm ph khoa hi chun

5My o mt xng140Bn khm ph khoa, gh, gi nm, bc

6My siu m 3 chiu141Bn khm thai, gh, bc, gi nm

7My siu m mu s h142Bn khm tr em, gh, bt, gi nm

8143Bn khm a khoa, bc, gi nm

9My phn tch sinh ho t ng144

10145Bn dng c

11Bn m a nng146Bn ph khoa, gi nm

12My phn tch min dch t ng147B tiu phu

13Bn m ni soi bng148Cn treo 5kg

14My phn tch huyt hc t ng ( 18 - 22 s )149Cng y

15My hp tit trng 300 lt 150Ging bnh nhn

16My siu m 3D151Ging cp cu

17My siu m trng en Toshiba KTS152Ging sn ph

18My Xquang chp thng quy 300MA153n cc tm tit trng

19n m treo trn 180.000 ~ 200.000 / ccx154n cc tm t ng

20My th hi sc a nng155n c phim X Quang

21My X quang di ng156Pipette tay cc loi

22B thao tc iu khin v cp dng Manual157Xe ch phng tin cp cu

23My lc nc siu sch158Xe ln

24My lm khun lm khng sinh 159Xe y bnh nhn

25Knh hin vi soi ngc 3D k thut pha nh ni 3 chiu160Xe y cp thuc

26Dao m in Bipolair161Xe y dng c

27T p xc162Xe y vt

28My o in gii dng in cc chon lc163Xe tim chch

29B i phu164Ging bnh nhn

30B hu thai165Bn hi sc s sinh

31H thng tng m, loa cho cc phng BV166B lc Coda Incubator

32Monitor theo di bnh nhn 7 thng s167Ambu bp bng ngi ln

33My p in168Ambu bp bng tr em

34Cryopreser vation system169Micropipette 10 - 100 ul

35Lng p tr s sinh170Micropipette 20 - 200 ul

36My pht rung tim - to nhp tim171Bc tho tht

37B m bch phn 6 knh172Cn tr em

38My soi c t cung173Cn tr s sinh

39My L 4261 IVF Dual workstation 174My hy bm tin

40T cp vi sinh175Ging tr em

41Monitoring176Bnh oxy

42H thng Video - Camera phng m177B dng c khm

43My pht in d phng cng sut 300 KVA178Gng tay cao su ch

44My t in c t cung179Khung thp khng r cc c treo phim X quang

45My sa phim t ng180n khm bnh

46Tu CO2 181n bung ti

47182Xe y bnh oxy

48183My nc nng

49My phn tch sinh ho bn t ng184n c phim X Quang loi 4 phim

50My lc kh xuyn tng ADS lami 185T trng k

51Bn gm bc - gh - chu 186n m nh sng lnh

52My o ng mu t ng187n khm bnh

53Nikon SMZ 1000 includes 188Cn ngi ln c thc o

54H thng tng m hi trng 189Cn trng lng c thc o

55Oxy trung tim190Mng lc HEPA

56B hp tit trng ( Autoclavi ) 50 lt191B ht iu ha kinh nguyt

57Doupler tim thai 192ng h Oxy u ging

58My ly tm193Van cp Oxy c gn ng h

59Dao m Laser cc loi 194My o huyt p, ng nghe

60Nikon SMZ 800 includes 195Cn sn ph

61My ly tm 24 ng bo qun196Cn trng lng 120kg

62T cy CO2 197Cng tay

63T p 37o - 56oC198n iu tr hng ngoi

64Dao m siu m199Ni luc bm kim tim

65Coda Unit200Ni luc dng c

66Knh hin vi 201Van chnh bnh Oxy v ng h

67My nh dng virus202Chu tm

68My in tim203Waming Block B01

69B v tim204B n NUQ

70n m mt bng di ng205Xe y thuc 40 x 60cm

71Doppler tim thai206Xe y dng c phu thut

72Gic ht ( Ventu ) 207Xe ng thuc gy m

73Bn gi m mu208Dng c ht nht tr em bng tay

74n iu tr vng da209B khm ph khoa

75My ht nht - m ph sn210B t vng trnh thai

76My ht in ( ht bng )211Canule m kh qun cc c

77Bnh nit lng tr mu 212Hp hp bng gc, vi cc loi

78My to oxy t ng213Hp ng bng bng

79B dng c bc l tnh mch 214Hp thu gom vt sc nhn

80H thng Monitor hng dn bnh nhn215Huyt p k

81Thit b ra tay cho phu thut 216Huyt p k s sinh

82T sy ln217Huyt p k tr em

83T sy in 250oc218Bn Mayo

84T sy in loi nh 250oc219Huyt p k ngi ln

85Bung m220Gi truyn huyt thanh

86Bnh cha nit lng 30 lt221Nng tay

87H thng sn xut ng dn kh 222Ti chm nng lnh

88L si in223n si m

89My lc224n si m hng ngoi

90Thit b lm m tr em225B kim c t cung

91Thit b soi i226Ging t thi

92T sy nh227Km sinh thit c t cung

93My ra siu m228n g

94My phn tch nc tiu t ng 10 thng s229B thng i n 150 x 6mm

95My lc kh di ng v trng Sunpre230ng nghe bnh tr em

96My ht m231B dt

97232B lm m Oxy

98Ca knh c lp bn trong233B thng niu o n

99Chu Inox nh234

100T sy235Ba th phn x

101Thc dy236Ca nh m

102B dng c m 237Gi ng nghim cc loi

103B my vi tnh238Gi Inox pipet

104My m khun lc239ng ng thp 1000ml

105My vi tnh my in240Bm tim dng 1 ln

106T sy 30o ~ 300oc241

107Knh hin vi 242

108My d PH243ng nghe

109B dng c sinh244ng nghe bnh ngi ln

110T m 30o ~ 70oc245ng nghe huyt p

111B no thai246ng nghe tim phi

112H thng lc HEPA247ng ng cao 1000ml

113Electric pump ( pipette Mate )248Thng nc lc cho cc khoa, phng

114Khay ngm dng c249Khay Inox ng dng c 30 x 40cm

115T m250B thng tiu

116Pipette t ng cc loi (p10, p20, p100, p1000 )251Kp pogi

117Bnh phong tr252

118B dng c m kh qun253M vt khm ph khoa

119Bm thc n cho tr s sinh254M vt nh

120B t ni kh qun255M vt trung

121Bm tim in256Thng rc y t

122Bm tim in cc loi257X ng dng c

123Fosop ( kim )258B tiu nm

124Gi tip nhn vt cha hp v hp259Khay Inox ng dng c 22 x 27cm

125My thu hnh 21 inches260Tha no t cung c 8mm

126B ht no261Cc thy tinh 250ml

127T ng dng c262Khay dng c

128Bn tr s sinh tm263 li

129B iu ho ga CO2 ( 2 ng h )264Nhit k y hc 420C

130B lc Coda Inline Filter265Bnh kim

131My ht m tr em266Bm tim thy tinh 20ml

132My ht nht tr em267Knh lp

133B trung phu268Gng tay phu thut

134H Thng Oxy269

135n c Xquan 6 phim270Khay m thuc

CHNG X: TNG MC U T D N

X.1. C s lp tng mc u t

Tng mc u t cho d n u t xy dng nh my c lp da trn cc phng n trong h s thit k c s ca d n v cc cn c sau y:

- Lut Xy dng s 16/2003/QH11 ngy 26/11/2003 ca Quc Hi Nc Cng ho X hi Ch ngha Vit Nam;

- Ngh nh s 12/2009/N-CP ngy 12/2/2009 ca Chnh ph v vic Qun l d n u t v xy dng cng trnh;

- Ngh nh s 209/2004/N-CP ngy 16/12/2004 ca Chnh ph v vic Qun l cht lng cng trnh xy dng v Ngh nh s 49/2008/N-CP ngy 18/04/2008 ca Chnh ph v vic sa i b sung mt s iu ca Ngh nh 2009/2004/N-CP;

- Thng t s 05/2007/TT-BXD ngy 27/05/2007 ca B Xy dng v vic Hng dn vic lp v qun l chi ph d n u t xy dng cng trnh;

- Ngh nh s 123/2008/N-CP ngy 08/12/2008 ca Chnh ph quy nh chi tit thi hnh Lut thu gi tr gia tng;

- Thng t s 129/2008/TT-BTC ngy 26/12/2008 hng dn thi hnh Ngh nh s 123/2008/N-CP;

- Thng t 130/2008/TT-BTT ngy 26/12/2008 hng dn thi hnh mt s iu ca Lut Thu Thu Nhp Doanh Nghip.

- Ngh nh s 148/2004/N-CP ngy 23/07/2004 sa i, b sung Khon 1 iu 7 Ngh nh s 158/2003/N-CP;

- Thng t s 02/2007/TTBXD ngy 14/2/2007. Hng dn mt s ni dung v: lp, thm nh, ph duyt d n u t xy dng cng trnh; giy php xy dng v t chc qun l d n u t xy dng cng trnh;

- nh mc chi ph qun l d n v t vn u t xy dng km theo Quyt nh s 957/Q-BXD ngy 29/9/2009 ca B Xy dng;

- Ngh nh s 99/2007/N-CP ngy 13/06/2009 ca Chnh ph v qun l chi ph u t xy dng cng trnh;

- Thng t 33-2007-TT/BTC ca B Ti Chnh ngy 09 thng 04 nm 2007 hng dn quyt ton d n hon thnh thuc ngun vn nh nc;

- Thng t 203/2009/TT-BTC ca B Ti Chnh ngy 20 thng 10 nm 2010 hng dn ch qun l, s dng v trch khu hao ti sn c nh;

- Cc vn bn khc ca Nh nc lin quan n lp Tng mc u t, tng d ton v d ton cng trnh.

X.2. Ni dung tng mc u t

X.2.1. Ni dung

Mc ch ca tng mc u t l tnh ton ton b chi ph u t xy dng bnh vin a khoa quc t V Anh II, lm c s lp k hoch v qun l vn u t, xc nh hiu qu u t ca d n.

Tng mc u t bao gm: Chi ph xy dng v lp t, Chi ph vt t thit b; Chi ph t vn, chi ph qun l d n, Chi ph t v cc khon chi ph khc; D phng ph (bao gm tr li vay trong thi gian xy dng) chim 10% cc loi chi ph trn.

Chi ph xy dng v lp t

Chi ph xy dng v lp t cng trnh bnh vin vi 2,000 ging bnh v cc cng trnh ph tr khc nh: tng hm, cnh quan, mt nc, giao thng, h thng h tng, k thut,..c tnh ton da vo sut vn u t cho bnh vin a khoa phn xy dng. Chi ph vt t thit b

Chi ph mua sm thit b khm v iu tr bnh v cc thit b cn thit khc cho hot ng ca bnh vin; chi ph vn chuyn, bo him thit b; thu v cc loi ph c lin quan, cng c tnh ton da trn sut vn u t cho bnh vin a khoa phn thit b. Chi ph qun l d n

Chi ph qun l d n tnh theo nh mc chi ph qun l d n v t vn u t xy dng cng trnh.

Chi ph qun l d n bao gm cc chi ph t chc thc hin cc cng vic qun l d n t giai on chun b d n, thc hin d n n khi hon thnh nghim thu bn giao cng trnh vo khai thc s dng, bao gm:

Chi ph t chc lp d n u t.

Chi ph t chc thm nh d n u t, tng mc u t; chi ph t chc thm tra thit k k thut, thit k bn v thi cng v d ton xy dng cng trnh.

Chi ph t chc la chn nh thu trong hot ng xy dng;

Chi ph t chc qun l cht lng, khi lng, tin v qun l chi ph xy dng cng trnh;

Chi ph t chc m bo an ton v v sinh mi trng ca cng trnh;

Chi ph t chc nghim thu, thanh ton, quyt ton hp ng; thanh ton, quyt ton vn u t xy dng cng trnh;

Chi ph t chc nghim thu, bn giao cng trnh;

Chi ph khi cng, khnh thnh;

Chi ph t vn u t xy dngBao gm: Chi ph t vn lp d n u t;

Chi ph lp thit k cng trnh; Chi ph thm tra thit k bn v thi cng, tnh hiu qu v tnh kh thi ca d n u t, d ton xy dng cng trnh;

Chi ph lp h s yu cu, h s mi s tuyn, h s mi thu v chi ph phn tch nh gi h s xut, h s d s tuyn, h s d thu la chn nh thu t vn, nh thu thi cng xy dng, nh thu cung cp vt t thit, tng thu xy dng; Chi ph gim st kho st xy dng, gim st thi cng xy dng v gim st lp t thit b;

- V cc khon chi ph khc nh: Chi ph qun l chi ph u t xy dng: tng mc u t, d ton, nh mc xy dng, n gi xy dng cng trnh, hp ng; Chi ph t vn qun l d n; Chi ph t v ph chuyn quyn s dng tDin tch t cn u t cho d n l 9,000 m2, vi n gi l 100 triu ng/m2 tng ng gn 4,854 USD/m2 bao gm cc khon chi ph nh: chi ph mua t v bi thng gii phng mt bng; chi ph san lp v chi ph chuyn quyn s dng t,

Chi ph khc

Chi ph khc bao gm cc chi ph cn thit khng thuc chi ph xy dng; chi ph thit b; chi ph qun l d n v chi ph t vn u t xy dng ni trn:

Chi ph thm tra tng mc u t; Chi ph bo him cng trnh;

Chi ph kim ton, thm tra, ph duyt quyt ton vn u t; Chi ph thm nh kt qun u thu;

Chi ph lp bo co nh gi tc ng mi trng; D phng ph

D phng ph bng 10% chi ph xy lp, chi ph thit b, chi ph qun l d n, chi ph t vn u t xy dng v chi ph khc ph hp vi Thng t s 05/2007/TT-BXD ngy 25/07/2007 ca B Xy dng v vic Hng dn lp v qun l chi ph d n u t xy dng cng trnh.X.2.2. Kt qu tng mc u t

Bng d tr chi ph xy dng v thit b

VT: 1,000 ngTN HNG MCVTS LNGN GI (VN)N GI(USD)GI TR TRC THUVATGI TR SAU THU

I/ u t xy dng cng trnh

1. Bnh vinging2000519,11325,2001,038,226,000103,822,6001,142,048,600

2. Tng hmm300030001469,000,000900,0009,900,000

3. Cnh quan, mt ncm5173500242,586,500258,6502,845,150

4. Giao thng, h thngh tng k thutm9870400193,948,000394,8004,342,800

TNG CNG1,053,760,5001,159,136,550

II/ u t trang thit b my mc

My mc thit bging2,000675,87532,8091,351,750,000135,175,0001,486,925,000

TNG CNG1,486,925,000

Tng mc u t

STTHNG MCGT TRC THUVATGT SAU THUQUI I RA USD

IChi ph xy lp1,053,760,500105,376,0501,159,136,55056,268,765

II.Gi tr thit b1,486,925,000148,692,5001,635,617,50079,398,908

III.Chi ph qun l d n19,055,1411,905,51420,960,6551,017,508

IV.Chi ph t vn u t xy dng25,865,2342,586,52328,451,7571,381,153

4.1Chi ph lp d n u t3,048,823304,8823,353,705162,801

4.2Chi ph lp thit k13,172,0061,317,20114,489,207703,360

4.3Chi ph thm tra tnh hiu quv tnh kh thi ca d n u t406,51040,651447,16121,707

4.4Chi ph thm tra TKBVTC368,81636,882405,69819,694

4.5Chi ph thm tra d ton cng trnh316,12831,613347,74116,881

4.6Chi ph lp HSMT thi cngxy dng210,75221,075231,82711,254

4.7Chi ph lp HSMT mua sm thit b446,07844,608490,68623,820

4.8Chi ph gim st thi cng xy dng6,111,811611,1816,722,992326,359

4.9Chi ph gim st lp t thit b1,784,310178,4311,962,74195,279

VChi ph t v ph chuyn mc ch s dng t900,000,00090,000,000990,000,00048,058,252

VIChi ph khc31,249,2153,124,92234,374,1371,668,647

6.1Chi ph kim ton7,622,057762,2068,384,263407,003

6.2Chi ph thm tra ph duytquyt ton7,622,057762,2068,384,263407,003

6.3Chi phi lp bao cao anh giatac ng mi trng50,0005,00055,0002,670

6.4Chi phi bo him xy dng15,806,4081,580,64117,387,049844,032

6.5Chi ph thm nh kt qu u thu148,69314,869163,5627,940

VIICHI PH D PHNGGdp = GCp*10%261,685,50926,168,551287,854,06013,973,498

TNG CNG NGUN VN U T3,778,540,599377,854,0604,156,394,659201,766,731

Vi tng s vn cn u t xy dng c cng trnh l hn bn ngn t ng tng ng hn hai trm triu USD ( bao gm VAT).CHNG XI:NGUN VN U T-THC HIN D N XI.1. Ngun vn u t ca d nXI.1.1. Cu trc ngun vn v phn b vn u t

T gi USD/ng = 20,600

VT : 1,000 ng

STTKhon mc chi phThnh tin trc thuThu VATThnh tin sau thu

1Chi ph xy dng (VN)1,053,760,500105,376,0501,159,136,550

2Chi ph thit b 1,486,925,000148,692,5001,635,617,500

3Chi ph t vn u t25,865,2342,586,52328,451,757

4Chi ph qun l d n 19,055,1411,905,51420,960,655

5Chi ph thu t900,000,00090,000,000990,000,000

6Chi ph khc31,249,2153,124,92234,374,137

7D phng ph261,685,50926,168,551287,854,060

TNG CNG3,778,540,599377,854,0604,156,394,659

Tng mc u t4,156,394,659

XI.1.2. Tin thc hin d n v s dng vn

D n c thc hin gm 2 giai on u t xy dng v kinh doanh nh sau: Giai on 1: thi gian l 2 nm, t qu IV nm 2011 n qu III nm 2013. Kt thc giai on ny d n s hon tt 75% tng cng trnh gm cc hng mc c bn v mt phn s ging bnh. Sau d n bt u i vo hot ng kinh doanh giai on 1 vi s cng trnh va hon thin khong 1,000 ging bnh. Giai on 2: thi gian l 1 nm 3 thng, t qu IV nm 2013 n ht qu IV nm 2014. Trong giai on ny d n s tip tc xy dng v a vo hot ng kinh doanh 25% s cng trnh cn li. Kt thc giai on ny d n nghim thu vi tng s cng trnh l 2,000 ging bnh theo tiu chun bnh vin a khoa quc t.

Theo , Tin s dng vn ca d n qua cc nm c thc hin nh sau:

STTThi gianNm 2011Nm 2012Nm 2013Nm 2014

Hng mc

1Chi ph xy dng (VN)57,956,827.50463,654,620.00405,697,792.50231,827,310.00

2Chi ph thit b 81,780,875.00654,247,000.00572,466,125.00327,123,500.00

3Chi ph t vn u t19,916,229.908,535,527.100.000.00

4Chi ph qun l d n 6,288,196.508,384,262.006,288,196.500.00

5Chi ph thu t990,000,000.000.000.000.00

6Chi ph khc1,718,706.8513,749,654.8012,030,947.956,874,827.40

7D phng ph14,392,703.00115,141,624.00100,748,921.0057,570,812.00

1,172,053,538.751,263,712,687.901,097,231,982.95623,396,449.40

XI.1.3. Ngun vn thc hin d nSTTThi gianT l Tng

Hng mc

1Vn ch s hu 50%2,078,197,329.53

2Vn vay ngn hng50%2,078,197,329.53

Cng100%4,156,394,659

Vi tng mc u t 4,156,394,659,000 ng (Bn ngn mt trm nm mi su t ba trm chn mi bn triu su trm nm mi chn ngn ng tng ng hn hai hai trm triu triu USD).

Trong : Ch u t b vn 50% tng u t tng ng vi s tin 2,078,197,329,530 ng khong 100 triu USD. Ngoi ra vi ngun vn vay l 50% trn tng vn u t, tc tng s tin cn vay l 2,078,197,329,530 ng khong 100 triu USD. Ngun vn vay ny d kin vay trong thi gian 23 nm vi li sut trn tm tnh l 12%/nm, tuy nhin chng ti k vng c cho vay vi mc li sut u i nht c th.

Phng thc vay vn: n gc c n hn trong thi gian xy dng, ch tr li vay theo d n u k v vn vay trong k. Bt u tr n t khi d n i vo hot ng. Tr n gc u hng nm v li vay tnh theo d n u k.

Tin rt vn vay v tr n vay c trnh by bng sau: Nm2011

QuIV

N u k -

Vay trong k 2,078,197,329.53

Tr n: 62,345,919.89

+ Li pht sinh 62,345,919.89

+ N gc -

N cui k 2,078,197,329.53

S vn vay ny k vng s c gii ngn mt ln khi d n bt u i vo xy dng d kin l thng 10/nm 2011 vi s tin l 2,078,197,329,530 ng 100 triu USD. Trong thi gian xy dng cui mi qu s tr ton b li vay ch cha tr vn gc v cha c ngun doanh thu vi li vay trong thi gian xy dng l 62,345,919,890 ng/qu. Li vay trong thi gian xy dng c chi tr bng s tin d phng ph hoc t ngun vay vn ngn hng.

Khi d n i vo khai thc kinh doanh, c ngun thu s bt u tr vn gc. Thi gian tr n theo tng qu d tnh trong 20 nm vi li sut 12%/nm, s tin phi tr mi qu bao gm li vay v vn gc vi nhng khon bng nhau.

Qua hoch nh ngun doanh thu, chi ph v li vay theo k hoch tr n cho thy d n hot ng hiu qu, c kh nng tr n ng hn rt cao, mang li li nhun ln cho nh u t v cc i tc hp tc nh ngn hng.

K hoch vay tr n theo cc k c th hin c th qua bng k hoch vay tr n trong phn ph lc.

XI.1.4. Phng n hon tr vn vay v chi ph li vay

Phng n hon tr vn vay c xut trong d n ny l phng n tr li v n gc nh k hng nm t khi bt u hot ng d n. Phng n hon tr vn vay c th hin c th ti bng sau:T l vn vay50%

S tin vay 2,078,197,329.53

Thi hn vay20Nm

n hn13Qu

Li vay3%Qu

Thi hn tr n80Qu

K hoch tr li vay v n vayNmNm 2011Nm 2012Nm 2013Nm 2014Nm 2015

Li vay 62,345,920 249,383,680 249,383,680 249,383,680 244,707,736

N vay 62,345,920 249,383,680 249,383,680 320,561,940 348,617,604

NmNm 2016Nm 2017Nm 2018Nm 2019Nm 2020

Li vay 232,238,552 219,769,368 207,300,184 194,831,000 182,361,816

N vay 336,148,420 323,679,236 311,210,052 298,740,868 286,271,684

NmNm 2021Nm 2022Nm 2023Nm 2024Nm 2025

Li vay 169,892,632 157,423,448 144,954,264 132,485,080 120,015,893

N vay 273,802,500 261,333,316 248,864,132 236,394,948 223,925,761

NmNm 2026Nm 2027Nm 2028Nm 2029Nm 2030

Li vay 107,546,708 95,077,524 82,608,340 70,139,156 57,669,972

N vay 211,456,576 198,987,392 186,518,208 174,049,024 161,579,840

NmNm 2031Nm 2032Nm 2033Nm 2034Tng cng

Li vay 45,200,788 32,731,604 20,262,420 7,793,236 2,048,063,433

N vay 149,110,656 136,641,472 124,172,288 111,703,074 3,918,441,027

Hng qu ch u t phi tr vn gc cho s tin i vay 25,977,467,000 ng v s tin ny tr trong 20 qu tip theo. Cn s li vay ch u t s tr km vi li gc da vo d n u k ca mi qu. Theo d kin th n qu IV/2034 ch u t s hon tr n ng hn cho ngn hng.

XI.2 Tnh ton chi ph ca d n

XI.2.1. Chi ph nhn cng

Chi ph ny bao gm lng ca tng cn b cng nhn vin v cc khon ph cp khc nh ph cp chc v, nng lc,..ngoi ra cn c chi ph BHXH,BHYT, tr cp khc bng 20% chi ph lng cho CBCNV.mi nm chi ph ny c tnh trung bnh khong 70,937,810,000 ng. K hoch chi lng th hin c th bng sau bng sau:TT S lngChi ph lng/ thngTng lng thngChi ph BHXH, BHYT (thng)Tng lng nmChi ph BHXH, BHYT (nm)

1Tng gim c119,05019,0503,000247,65036,000

2Gim c ti chnh116,44016,4402,400213,72028,800

3Gim c chuyn mn116,44016,4402,400213,72028,800

4Ph gim c chuyn mn113,70013,7002,000178,10024,000

5K ton trng110,96010,9601,600142,48019,200

6iu dng trng310,96032,8804,800427,44057,600

7Trng khoa1010,960109,60016,0001,424,800192,000

8Gio s, bc s609,590575,40084,0007,480,2001,008,000

9Dc s i hc208,220164,40024,0002,137,200288,000

10K s, c nhn kinh t, C nhn xt nghim456,850308,25045,0004,007,250540,000

11iu dng, k thut vin, n h sinh, dc s trung, s cp5005,4802,740,000400,00035,620,0004,800,000

12Th k y khoa,cng nhn thanh trng954,110390,45057,0005,075,850684,000

13Cng nhn, nhn vin phc v hnh chnh1004,110411,00060,0005,343,000720,000

Tng chi lng 838136,8704,808,570702,20062,511,4108,426,400

XI.2.2. Chi ph hot ng

+ Chi ph qung b v truyn thng

gip d n sm n gn v phc v c hiu qu cho cng ng, ch u t trch khong 0.2% doanh thu hng nm phc v cho cng tc truyn thng qung b hnh nh ca bnh vin V Anh.+ Chi ph in, nc

Chi ph in nc cho cc hot ng ca nh xng, vn phng chim 0.7% doanh thu. + Chi ph bo tr:

my mc, vt dng c hot ng tt v bn qua thi gian, ch u t trch khong 0.3% gi tr nh xng v my mc thit b bo tr.

+ Chi ph bo himChi ph bo him my mc thit b, nh xng hng nm bng 0.5% gi tr MMTB, nh xng, gi s tng 3%/nm. + Chi ph BHXH,BHTN,qu tr cp, khen thng,...

Chim 20% lng nhn vin hng nm.

+ Chi ph phc v ging dy

Ngoi chi ph bo tr, hng nm doanh nghip u t thm 3% doanh thu trang b thm cc vt dng, thit b cng nh p ng cc nhu cu cn thit nhm lm cho cng tc ging dy c thun li v c hiu qu. + Chi ph vn chuyn

Chim 0.5% doanh thu hng nm.

+ Chi ph khc

Chi ph ny chim 5% cc loi chi ph t d n.BNG TNG HP CHI PH HOT NG CA D N

Nm2013201420152016

Hng Mc CP1234

Chi ph qung b v truyn thng 682,500 4,217,850 4,923,571 5,668,008

Chi ph in nc2,388,75014,762,47517,232,49719,838,027

Chi ph bo tr: % gi tr ti sn (khng tnh tin t)7,622,0577,850,7198,086,2418,328,828

Ph bo him13,973,77014,392,98314,824,77215,269,515

Qu phc li , bo him tht nghip, tr cp, khen thng2,106,6002,169,7982,234,8922,301,939

Chi ph vn chuyn1,706,25010,544,62512,308,92714,170,020

Chi ph thuc men, dng c y khoa chuyn dng119,437,500738,123,750861,624,855991,901,365

Chi ph x l rc thi3,412,50021,089,25024,617,85328,340,039

Chi ph khc861,8082,820,8433,224,0213,648,943

TNG CNG152,191,735815,972,293949,077,6291,089,466,684

CHNG XII: HIU QU KINH T-TI CHNHXII.1. Cc gi nh kinh t v c s tnh ton

Cc thng s gi nh trn dng tnh ton hiu qu kinh t ca d n trn c s tnh ton ca cc d n trin khai, cc vn bn lin quan n gi bn, cc ti liu cung cp t Ch u t, c th nh sau:

Thi gian hot ng ca d n l 50 nm v i vo hot ng t qu IV nm 2013; Vn ch s hu 50%, vn vay 50%; Cc h thng my mc thit b cn u t m bo cho d n hot ng tt; Doanh thu ca d n thu c t cc hot ng phc v ca trung tm.

Chi ph khu hao Ti sn c nh: p dng phng php khu hao theo ng thng, thi gian khu hao s c tnh ph thuc vo thi gian d bo thu hi vn. Trong tnh ton p dng thi gian khu hao theo ph lc nh km. Li sut vay i vi ni t tm tnh: 12%/nm; Thi hn tr n 20 nm, tr 1 nm 4 ln c gc v li;

Thu thu nhp doanh nghip ca d n thu sut p dng l 25%.XII.2. Doanh thu t d n

Bng tng hp doanh thu ca d n qua cc nm

VT: 1,000

NM2013201420152016

TN SN PHM1234

iu tr ni tr325,000,0002,008,500,0002,344,544,8002,699,018,400

Cng sut50%75%85%95%

S ging bnh c s dng/tun1,0001,5001,7001,900

S tun trong nm13525252

Gi iu tr

trung bnh/ngi/tun25,00025,75026,52227,318

- Chi ph dch v/1ging7,0007,2107,4267,649

- Chi ph iu tr/1 ging18,00018,54019,09619,669

Khm v cha bnh ngoi tr16,250,000100,425,000117,240,500134,985,500

Cng sut50%75%85%95%

Lt iu tr/ngy250375425475

S ngy trong nm65260260260

Gi iu tr

trung bnh/ngi/1lt1,0001,0301,0611,093

Tng doanh thu 341,250,0002,108,925,0002,461,785,3002,834,003,900

Doanh thu ca bnh vin gm iu tr ni tr v khm, cha bnh ngoi tr:

iu tr ngoi tr: gi nh thi gian lu tr v iu tr ca mt bnh nhn/1 ging bnh l 1 tun. Phc v ti a l 2000 ngn ging bnh /1 tun. Vin ph gm ph dch v v ph iu tr. Khm v iu tr ngoi tr cho khong 500 lt bnh nhn/ngy.

Cng sut hot ng cui nm 2013 l 50% v theo tin xy dng thi gian ny thuc giai on 1 ca d n, cc nm tip theo d n tng dn cng sut hot v t ti a vo nm 2017.

XII.3. Cc ch tiu kinh t ca d nBo co thu nhp ca d n: Nm20132014201520162017

Doanh thu341,250,0002,108,925,0002,461,785,3002,834,003,9003,072,628,000

Chi ph hot ng152,191,735815,972,293949,077,6291,089,466,6841,179,767,537

Chi ph nhn cng15,627,85362,511,41065,636,98168,918,83072,364,772

Chi ph khu hao14,485,38014,485,38014,485,380102,837,614102,837,614

Chi ph li Vay249,383,680249,383,680244,707,736232,238,552219,769,368

Li nhun trc thu-90,438,648966,572,2371,187,877,5741,340,542,2201,497,888,709

Thu TNDN (25%)0241,643,059296,969,394335,135,555374,472,177

Li nhun sau thu-90,438,648724,929,178890,908,1801,005,406,6651,123,416,532

Qua bng bo co thu nhp c th nh gi c y