Operating theatre suite planning and design

hospital-design

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Operating Theatre Suite Planning
and Design

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Objectives:
At the end of this lecture the student will be able to:
 Determine the location of the operating rooms
 Describe operating theatre suite accommodation
 Discuss zoning of operating theatre suite
 Describe Lighting of operating theatre suite
 Explore electrical outlets of operating theatre suite
 Explore air conditioning of operating theatre suite
 Discuss flooring of operating theatre suite
 Discuss wall finishes and color of operating theatre suite


Outline:
 Location of the operating rooms
 Number of operating rooms
 Operating theatre suite accommodation
 Zoning of operating theatre suite
 Lighting of operating theatre suite
 Electrical outlets of operating theatre suite
 Air conditioning of operating theatre suite
 Flooring of operating theatre suite
 Wall finishes and color of operating theatre suite

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Operating Theatre Suite Planning and Design

The operation theatre suite of a hospital is a complex place and the most
important facility of the surgical department. Operating theatre (OT) is
expensive to build and equip, but the experience of many institutions
indicates that the individual operating rooms or the operation theatre suit
have been usually under-designed.

Location of the operating rooms:
Grouping of all operating rooms in one central location in the form of an
operating theatre suite has many advantages as follows:
 Efficient use of staff and facilities
 Effective supervision of personnel
 Flexibility in scheduling operations
 Round the clock service
 Improved aseptic technique

Location of the suite must ensure that patients can be moved to and from
surgery with a minimum of travel through other hospital areas.
The main points to be considered in the location of the OT suite on a hospital
are:
 Accessibility to surgical wards, central sterile supply department,
emergency, and blood bank.
 Internal hospital traffic flow
 External traffic and disturbances


Number of operating rooms:
The number of operating rooms depends upon the predicted number of
operations per day, which in turn is related to the number of surgical beds,
and the average length of stay of surgical cases.


Operating room accommodation:
- The optimum size of the operating room depends on the type of surgery. E.g.
cardiothoracic surgery and neurosurgery calls for a larger number of
surgeons, nurses, technicians, plus a great deal of extra equipment such as

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heart lung machine, electronic monitoring equipment. Therefore, it will need
a larger room than usual, while an eye operating room which does not require
much space or equipment may be smaller.
- An instrumentation room adjacent to or in between two extra-large operating
rooms to accommodate such equipment in cardiothoracic and neurosurgery
has been found to be necessary.
- Operating rooms themselves account for about one-fourth of the total area
required for the suite.
- Operating theatre suite includes functional areas such as: operating rooms,
anesthesia store, anesthesia room, , scrub-up, sub-sterilization, sterile storage,
equipment storage, linen storage, doctors, and nurses locker/change room
with rest room and toilet, anesthetist’s room, and reception/preparation room.

Zoning:
The operating theatre is a potential source of hospital infection in general and
wound infection in particular. The aim of zoning is that when staff members,
patients or supplies enter the OT suite, the risk factors of carrying the chances
of infection with them get lesser and lesser, as they pass from the protective
through clean to aseptic zone.

General principles of zoning:
1. Staff working in the OT suite should be able to move from one clean area
to the other without having to pass through unprotected areas.
2. Soiled materials and waste should be removed from the operating rooms
without passing through clean areas.
3. Operating theatre ventilation should be independent of the air movement
of the rest of the hospital. Therefore, the direction of airflow within the OT
suite should be from cleaner to less clean areas.
Zones in the operating theatre suite:
The whole OT suite is planned on the concept of four zones, predicted on the
types of activities, patterns of circulation and degree of sterility to be
maintained. These zones are:
1. Sterile zone
Includes the actual operating rooms. Activities take place in this zone require
full aseptic conditions, such as exposure of living tissues and handling sterile
instruments

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2. Clean zone
It is designed around the aseptic zone. It is only accessible to staff having
changed their outer clothing in the protective zone. This zone contains patient
preparation area, storage space for clean surgical supplies, medical stores
including parental solutions, and instruments, anesthesia induction room,
stores, and anesthetists’ room are located in this zone.
3. Protective zone
It is outside the clean zone forming a barrier between the clean area of the
suite and the less clean rest of the hospital area. This zone contains theatre
nurse supervisors office, where stores are received, personnel enter the
department, where locker and change rooms are located, patients are received
and held.
4. Disposal zone
It is the corridor from where used instruments and used linen and waste is
taken out. It must have an independent access to the outside corridor. It has
only one way traffic from inside the operating room to the outside and never
vice versa.

Lighting:
- The surgeon’s requirement for light is that it should be powerful, cool,
shadow less, and capable of penetrating to the bottom of deep cavities.
- An emergency lighting system which comes into operation automatically is
also necessary in operation theatres to enable work to continue without a
break if the main supply fails.


Electrical outlets:
- All electrical outlet should be placed 5 feet from the floor, to be above the
level of a possible concentration of inflammable anaesthetic gases.
- Minimum six outlets are suggested, at least two of which should be for power
equipment of 15 Amp rating.

Air conditioning:
Full air conditioning with filtered air supply is a necessity in operation theatres
which tends to generate a need for greater floor to ceiling height than in other
hospital departments.

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Flooring:
The floor should be moderately conductive to be able to dissipate the
accumulated electrostatic charge. It should be conductive enough to dispel
static and yet not so conductive as to contribute to electric shock.

Wall finishes and color:
- The wall should be easy to wash and wipe
- Jointless mosaic surfacing for the wall is much more preferable than ceramic
because of the many joints whose rough surface of grouting may entrap dirt
and bacteria.
- Internal corners in the operating rooms are rounded to facilitate cleaning.
- Care should be taken that there are no shelves on the operating rooms walls
- The main door to the operating room should be wide enough to permit
unobstructed passage of a patient trolley.
- A clear door width of 90 cm is required for a staff dressed up in sterile gown
to pass.
- The colors used on the walls, floor and ceiling of operating rooms should be
light enough to ensure satisfactory integration of light by reflection , at the
same time soothing to the eyes.