descriptip of HLD

2. Zones in an operation theater
• Outer – till the changing area
• Clean zone- from the door of changing room till the enterance of opration
theatre
• Sterile zone- operation theatre
• disposal zone- waste segregation and disposal area

3. Entrance into ot complex
• All outside belongings have to be kept in the changing area
• Wash your feet before entering the clean area to negate any contamination
• Carry bare minimum items when you enter the clean and sterile area
• Ensure that your OT dress and footwear is clean
• Wash your hands before start your work in the clean area

4. Cleaning protocol
• The 3 bucket system:
• Mopping with soap solution

5. Fumigation

6. • All cleaning procedures have to be supervised by the nursing officers
• Fumigation has to be recorded and reported to the next shift for the
continuity of care

7. High level disinfection
• High-level disinfection traditionally is defined as complete
elimination of all microorganisms in or on an instrument,
except for small numbers of bacterial spores.
• Eg : glutaraldehyde (cidex)

9. • Basically used when the equipment cannot withstand high temperature of
sterilization via a mechanical method.
• Reduces wear and tear
• Less change of physical damage

10. In NIMHANS
• We use 2% glutaraldehyde solution which comes in with activator
• Effective against fungi, bacteria, virus, spores, including pseudomonas,
tubercle bacillus, HIV, HBV Antigens
• Soaking time – minimum of 30 minutes , average -45 minutes

11. Importance of documentation
• “ not documented id equal to not done”
• Documentation should be
1. Timely
2. Accurate
3. Complete
4. Concise
5. Legible

12. • Eg : the following things have to be mentioned while writing due slips for
implants used:-
• Date & OT
• Patients name, age, sex, unit, UHID/N.no
• Name of the surgery
• Name of the surgeon: consultant and resident
• Name of the scrub nurse

13. Inventory checking
• Inventory checking basically means to have an account of the stock in hand
• Daily checking helps us to know any missing items and helps to locate them
early
• Helps us to know our functioning capacity and intimate other HCP

14. OT CHECKING
• Check for complete equipments in the ot
• The cables must be neatly folded
• All extra items must be removed from the ot. Eg: syringes, urobags
• Plasters or labels stuck on the walls must be removed
• Look out for blood stains especially on ot table, ventilators, suction bottles