5.IDEAL OPERATION THEATRE.ppt for healthcare professionals

Ideal setup of icu

1. IDEAL
OPERATION THEATRE
Ltcol SV Saraswati

2. DEFINITION
Operation theatre which is centrally located
self sufficient , well connected to post op
wards , intensive care unit , blood
transfusion centre and near to other
important departments of the hospital.
The ideal physical design as per the health
care guidelines and modern, functional
equipment are included in definition

3. IMPORTANCE
•Design is essential component of ICP
Factors affecting infection rates
•Ventilation , temperature , location and design
are main factors
•Staff discipline , use of protective clothing
•Cleaning and disinfection of environment
•Absence of standard protocols

4. RECOMMENDAIONS
British medical council :
Seperation from geneal traffic
Seperation from air movement
Zoning
Staff traffic, material traffic, storage
Removal of dirty material without passing
through clean zone

5. ZONES OF OPERATING THEATRE
ZONE I – UNRESTRICTED ZONE
ZONE II – SEMI RESTRICTED
ZONE III – RESTRICTED ZONE
ZONE IV – WASTE DISPOSAL ZONE
RECEPTION
SUPPLIES
CHANGING ROOMS
STORAGE
PATIENT TRANSFER LOUNGE
SCRUBBING AND GOWNING AREA
OPERATING ROOMS
STERILIZATION
SEGREGATION
WASH ROOMS

6. VENTILATION
Objectives:-
To dilute bacteria by appropriate air changes
To prevent air entry from other rooms by using
different pressures
To create a pattern of air flow to remove
microbes from inside the OR
To provide comfortable environment with
controlled temperature , humidity and
ventilation

7. PLANNING
Sterile zone :-
Temperature : 23 *c +/- 3* c
Relative humidity : 40 % to 60 %
Fresh air allowance : 10 per hour to total 25 per
hour
Positive pressure = 25 pa
•Air filters : HEPA 0.3 microns 99% efficacy with
pre filtered system

8. 1
Pre Filter
Filters dust particles
Upto 5 micron in air
2
Electro-static precipitator
Presipitates dust particles
& also kills microbes
3
UV irradiation
256 nm wave length
Penetrates the cell wall
Microbes- destroys
4
Activated carbon filter
Absorbs all fumes and
Odour – delivers fresh air
enhanced
In oxygen
5
High efficiency particulate air HEPA filters
Any escaped microbes from earlier filters
Are trapped in HEPA which filters
0.3 micron with 99.97% efficiency
Outlook

9. AIR CHANGES
Other areas:-
Fresh air changes min 5 per hour total 15
HDPE washable filters – filtration level
upto 5 microns
AHU to maintain positive pressure
gradient
Aluminium AC ducts with differential
pressure gauge/ manometer across
HEPA to detect clogging/ ed air flow

10. DESIGN
•Ceiling : min 12 feet high washable
•Walls : washable , crack resistant , non
conductive
•Floor : washable ,antistatic,clear,epoxy flooring
( seamless,scratch proof, hard,stainfree)
•Shelves : no shelves and windows
•Drainage : none near the
ORcomplex .Concealed is best
•Air curtains : at the entry of sterile zone

11. DESIGN
•Laminar air flow : Low turbulance downward displacement airflow
•Water supply : purified water for scrubbing with foot pedal / time
sensors
•Elecrical points : Light points at eye level others on a pendulum. Nil on
floor
•Monitors ,eqpt etc : wall / wheel mounted
•Lighting : Dim in preop and bright in postop and other
areas ,shadowless in OR as well as bright ceiling lights
•Good functional generator / UPS back up

12.  OZONATED WATER IN
LAUNDRY – MRSA (ICP- laundry)
 VIGILANCE ON
VENTILATION AND WATER
SYSTEM
 SOPs FOR RECOVERY FROM WATER AND
DRAINAGE SYSTEM DISRUPTIONS
 IC CONCEPTS FOR MACHINES USING WATER
FROM DIRECT SUPPLY Eg HYDROTHERAPY,
DIALYSIS, DENTAL CENTRES
CDC GUIDE LINES FOR ICC
INTERNATIONAL OZONE ASSOCIATION,TEXAS 2006
WATER SUPPLY
DUST CONTROL BARRIERS