Clean operating room layout and management
Hospital operating room is one of the most demanding in sterile clean place, operating room construction, layout, workflow and management are built around the requirements of sterile design.
First, the operating room of the rational distribution and building requirements
(A) the construction of the basic elements of the clean operating room
1. Meet the clean architectural requirements
Does not produce dust, no dust, corrosion, mildew proof, easy to clean, in line with fire safety requirements.
Reasonable arrangements for people and goods, the flow lines are short McNair, convenient health care activities. So as to improve efficiency, effectively prevent cross-infection. Building layout should be simple, people and goods can not be made too cumbersome and complicated. Otherwise, the staff will be abandoned, such as the freedom to move around, causing more pollution.
2. Clean operating room partition
Clean area - clean operating room, clean corridors, clean and sterile dressings and other auxiliary buildings;
Non-clean areas - clean area, locker rooms, offices, duty room, packing room and other auxiliary rooms; polluted - dirt corridor, cleaning and disinfection of the Natural Area: elevator hall, the family waiting room.
(B) the cleansing operation Process
(C) channel in the form of clean operating rooms
1. Single-channel - clean corridor should have dirt in situ sterilization and packaging conditions, dirt is removed from the preliminary disinfection clean area.
2. Dual - Clean dirt corridor and corridor.
Clean Corridor: doctors, patients, sterile items.
Dirt corridor: Postoperative dirt.
3. Multi-channel - doctors, patients, sterile, dirt path.
Separation benefits: reducing human, logistic capacity, to prevent cross-contamination.
Disadvantages: have to have enough flat space.
Operating room building requirements and their function closely linked, has its particularity. Tightness demanding, usually enclosed sterile operating room. Indoor necessary equipment such as cabinets, film viewer, desk, electrical outlets disk, paging systems, delivery outlet, return air, etc. located in the folder walls, smooth surface, no accumulation of dust. Renovated the operating room must be conducive to a clean environment, we must meet and does not adsorb dust is not generated, durable, wear-resistant drugs, and should be easy to wipe disinfection requirements.
Second, operating room management and operation
Clean operating room in our hospital and put into use at the end of 2007, the use of dual-channel layout mode.
(A) requirements burglary
Personnel entering the clean area to strict dress code, wearing special underwear too strict disinfection and shoes, to establish a strict registration system burglary personnel and to limit the number of visitors between surgery, operating room between each visit to a number not more than 4 people.
(B) setting a strict workflow
1. Clean the operating room of people, logistics is an important factor affecting indoor air cleanliness. Therefore, set strict work flow, a clear distinction between clean sewage flow line is one of the important principles of clean operating room flat portfolio.
The duties of each class to develop a stringent workflow, including: Nurse workflow, workflow scrub nurse, nurse special class workflow, workflow nurse on duty, even surgeries workflow processing contaminated surgical surgery, workers work processes. Rules to follow so that we work together, ordered to be investigated, improve work efficiency, while ensuring the quality of work.
Adjustment and maintenance aspects (c) surgical environment
1. 30min open air conditioning units from the previous night nurse in daily elective patient comes in, set the room temperature between 22 ~ 25 ℃, relative humidity of 50% to 60%. Intraoperative adjust the room temperature by a nurse at any time according to need surgeons and patients. Note that between movements, gentle and accurate language to maintain the care and operation room noise made when the intra-operative <50db.
2. laminar flow operating room under the principle of outstanding biological clean room characteristics to control dust particles have an important goal, it is necessary to emphasize the cleanliness of the air security conditions, it is strictly prohibited in the operating room shake clothing cloth to prevent particles in the chamber between flying.
3. saving measures
Laminar flow operating room large power consumption is an indisputable fact that we maintain the environment at the same time meet the requirements of the operation, by bacterial monitoring summed preoperative 30min open air conditioning units, surgery turns off the unit's method not only to meet the requirements of the surgical environment, and effectively save electricity costs of the hospital, safeguard the economic interests of our hospital.
4. Keep the operating room relatively closed state, to ensure the cleanliness of the air space
Air purification principle (1) laminar flow operating room is sterile filtered by the compressor air from the ceiling and the pollution of air into the surrounding introduced between the air chamber must always be in a positive pressure state, or they may cause inflow of air pollution.
(2) to strengthen nurses with surgical care initiative and foresight of training and study, surgical procedures and preoperative surgical requirements can clear the coordination efforts to achieve adequate preparations were to minimize the number of times the door switch, pay attention to the maintenance of room between closed state and purifying effect.
5. prevention of cross infection
Clean sewage diversion: Dual in our hospital operating room layout, the medical staff and patients, and postoperative sterile instruments, dressings, dirt and other access routes strictly separate room area. For infection after surgery using the instrument in situ sterilization room, dressing in situ contaminated packaging indicate the type of approach to ensure clean sewage diversion to prevent cross-infection. Since enabled laminar flow operating room since, with the completion of a total of more than cases of various types of surgery, sterile surgical infection rate of <0.3%.
Third, management of the operating room clean environment
With high standards of hardware facilities, but also must have a sound management measures to achieve the desired control objectives. Any part of the errors will undermine the entire sterile operating room environment, which not only does not reduce infection, and will increase indoor air pollution. From this perspective, the management should re in construction, there is no strict management, construction how high the standard operating room will not achieve the effect of reducing the infection.