maintenance of therapeutic environment in ot.pptx

environment of ot

1. MAINTANENCE OF THERAPEUTIC ENVIRONMENT IN OPERATION THEATRE University institution of nursing

2. THERAPEUTIC ENVIRONMENT Therapeutic environment can be defined as the total of all external conditions and influences affecting an individual in the illness situation.

3. RULES TO MAINTAIN THERAPEUTIC ENVIRONMENT Infection prevention in the operating room is achieved through prudent use of aseptic techniques in order to prevent contamination of the open wound. Isolate the operating site from the surrounding unsterile physical environment. Create and maintain a sterile field in which surgery can Be performed safely.

4. ACHIEVING A THERAPEUTIC ENVIRONMENT Adequate comfort, food, cleanliness, and rest Freedom from injury Individualized patient care Friendly, courteous, accepting atmosphere Feeling of security and self worth Diversional activities for the patient

5. APPLICATION OF PRINCIPLES OF THERAPEUTIC ENVIRONMENT Method of vaccuming and dusting and other general Cleaning should be done. All organic material should be removed from equipment or surfaces before disinfection process. Cleaning and disinfection by chemicals that will not harm surfaces, materials should be selected. Cleaning and disinfection solution should be used in required concentrations for adequate time and according to directions. Use disposable equipments as much as possible.

6. FACTORS AFFECTING AN OPTIMUM ENVIRONMENT Temperature Humidity Air movement / ventilation Purity of air Lighting Low noise Psycho-social environment

7. STEPS TO MAINTAIN THERAPEUTIC ENVIRONMENT Proper preparation of client Hand washing Surgical hand scrub Using barriers such as gloves and surgical attires Maintaining a sterile field Using standard surgical technique Maintaining safe environment in operating room

8. MAINTAINING A STERILE FIELD A sterile field must be established and maintained in order to reduce the risk of contaminating surgical/procedure area. Placing only sterile items within the sterile field. Opening, dispensing, or transferring sterile items without contaminating them. Considering items below the level of draped client to be unsterile. Not allowing sterile personnel to reach across unsterile Areas or vice versa or to touch unsterile items.

9. The neckline, shoulder, and back are considered to be unsterile Areas of the gown. Recognizing that the edges of a package containing a sterile item are considered unsterile. Recognizing that a sterile barrier has been penetrated is considered contaminated. Not placing sterile items near open windows or doors. Sterile drapes should be used to establish a sterile field. Items used within a sterile field should be sterile. A sterile field should be constantly monitored and maintained. Moisture in sterile field should be avoided. If a solution soaks through a drape then it should be covered with another sterile drape. Policies and procedures for basic aseptic technique should be written, reviewed annually and readily available .

10. PRINCIPLES IN OPERATION THEATRE Doors and windows must be kept close as much as possible. Ward nurse must handover patient to theatre nurse with All details like pre-medication details, iv line. Patient should be shifted to ot always in trolley. Patient should remove all jewelries and in ot gown and cap. Initially patient is kept in preoperative room and later shifted to theatre. Ideally anesthetist, surgeon, and theatre nurse accompany patient. Ot nurse should confirm consent form, case sheet, site and side of surgery.

11. Separate theatre shoes should be worn by surgeon, anesthetist, ot nurse, and assistants Unnecessary movements, talking loudly, commenting, laughing should be avoided All person entering theatre should wear ot dress, cap, mask, footwear Clothes, dress should be washed, ironed, and clean and kept ready for everyday use. Mobile phones should be switched off Any public person or relatives should not be allowed inside operation theatre.

12. One senior nurse is made in charge of theatre in all Activities Ot nurse and assistant should accompany patient to postoperative nurse Patient should be shifted outside ot once anesthetist confirm the fitness for shift

13. C O N CLU S ION THE OPERATION ROOM ENVIRONMENT IS A HIGH RISK ENVIRONMENT, THE RISK CAN BE MINIMIZED BY ADHERING TO STRICT RULES AND REGULATION FRAMED BY TIME TO TIME BASED ON EVALUATION OF RISK ENCOUNTERED BY THE HEALTH CARE PROVIDERS, CLIENTS AND FAMILY AND HOSPITAL ADMINISTRATION