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Operation theatre services

Operation Thea

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Operation theatre services

  1. 1. Hospital Administration Made Easy<br />PLANNING AND ORGANIZATIONOF OPERATION DEPARTMENT<br />DR.N.C.DAS<br />
  2. 2. PLANNING AND ORGANIZATION OFOPERATION DEPARTMENT<br />With recent technological development in medical science and increase public demand the modern surgical practices is becoming more complex and expensive affairs.<br />About 50% of all hospital beds are allocated to surgical departments.<br />Surgical facilities, therefore represents a central life saving activity. <br />Therefore its success or failure highly influence the hospital reputation.<br />(v) This has led to a detailed scientific planning of the operation theater complex. <br />
  3. 3. 1. To promote highest standard of asepsis. <br />To ensure maximum safety for patients and staff from installation hazards.<br />Optimum utilization of OT and staff time. <br />Smooth and effective functioning of OT. <br />Good working environment for doctors and staff. <br />Allow flexibility by use of multiple operation suits. <br />OBJECTIVE OF PLANNING<br />
  4. 4. PLANNING CRITERIA<br />To meet the objectives and functions of the OTs, the planning consideration<br /> must meet the following criteria's. <br />ERGOMETRIC<br />OR<br />WORK FLOW<br />FUNCTIONS<br />Location <br />Size<br />No of OTs<br />Grouping of OTs<br />Zoning <br />Equipment <br />Installation <br />Space for free movement of <br />Staff, patients, supplies<br />PLANNING <br />CRITERIA <br />ENVIRONMENTAL <br />TECHNICAL <br />Lighting <br />Air Conditioning <br />Ventilation <br />Water Supply <br />Fire Safety <br />Plumbing <br />Clothing <br />OT Staff <br />Functional Areas <br />Preparation of patient <br />Sterilization Units <br />Scrub Station <br />Designing & Finishing<br />
  5. 5. FUNCTIONAL CONSIDERATION<br />LOCATION:<br />Maximum six suits in one OT complex, preferably ground floor. <br />Easy access to CSSD, sterilization unit, emergency and surgical wards. <br />Maximum protection from sun, sounds, heat and wind. <br />Independent of general traffic flow. <br />Easy access to other areas of OT.<br />SIZE:<br />General OT unit 18’ x 18’ or 40 Sqmeter. <br />Super specialist OT unit 60 Sqmeter. <br />Additional room for heart lung machine, c-arm etc. <br />Paired OTs help in proper utilization of instruments and equipments. <br />
  6. 6. NUMBER OF OTs<br />1.No. of OTs = One OT unit for 50 surgical beds.<br />2. No. of operations/ day = No. of Surgical beds <br />Average length of stay surgical patient<br />3. No. of operations/ day = No. of Surgical beds x % of Bed occupancy x 365<br />ALS x 100 x No. of working OT days<br />The number of operations per suit should not exceed 06 per day or 8 to 10 hr. <br /> per day.<br />
  8. 8. NO. OF OTs AS PER HOSPITAL BEDS<br />(COMMITTEE ON PLAN PROJECT)<br />In addition of this additional OT suits for CTVS, Renal & Paediatric Surgery.<br />
  10. 10. ZONING OF OTs<br />Based on the bacterial consideration and to provide maximum asepsis the entire OT complex can be divided into various zones. <br />CLEAN <br />ZONE <br />PROTECTIVE <br />ZONE <br />ZONNING <br />DISPOSAL <br />ZONE <br />ASEPTIC <br />ZONE <br />
  11. 11. Reception, Patient identification and Case sheet check <br />Waiting area for relatives <br />Changing room for OT staff and surgeons <br />Pre- anesthesia room <br />Store room, trolley boy<br />Autoclaves <br />Record and controller room <br />OT in charge, Electric Control <br />Seminar and meeting room <br />Entrance to observation gallery <br />PROTECTIVEZONE <br />
  12. 12. CLEAN ZONE<br />Patient preparation Room <br />Recovery Room <br />Plaster Room, Blood Storage, Frozen Section<br />Work Room for doctors, sisters<br />Nurses Duty Room <br />Anaesthesia Room <br />Equipment Room, drugs, lines, X-ray board <br />Clean closet, telephone and fire fighting equipments<br />
  13. 13. STERILE OR ASEPTIC ZONE<br />Main Operating Suits <br />Scrub Station <br />Anaesthesia Station<br />Instrument Sterilization and trolley lying<br />DISPOSAL ZONE <br />Dirty Wash up Room <br />Disposal Corridor; connected to clean zone <br />Janitor Closet <br />SCRUB STATION<br />96 cm height with water taps with sensors 10 cm high. Both hot water and <br />cold water, soap liquid and scrubber. <br />
  14. 14. ENVIRONMENTAL FACTORS<br />ELECTRICITY: <br />Ensure round the clock electric supply <br />Stand by generator system <br />UPS for all equipments and gazettes <br />Central field illumination 2000-3000 candles/ sqmt<br />Floor around table 200-300 candles/ sqmt<br />Minimum Glares, four power outlets on each wall at height of 1.5 meter <br />Structured cabling system, Isolation Circuit for appliances<br />Separate copper earthing, avoid extension cords<br />OPERATING LIGHT:<br />Shadow less, mobile, hanging pendent easily maintainable OT light. <br />Intensity should be 4000 lux at incision and 8000 lux at 9 cm deep. <br />
  15. 15. AIR CONDITIONING<br /><ul><li>Control asepsis, controlled air flow, positive pressure.
  16. 16. Maintenance of temperature 220C for comfort.
  17. 17. Humidity 55 % + 5 percent.
  18. 18. 100% fresh air with 20 changes per hour.
  19. 19. Filter of 1 to 3 micron size to be used.
  20. 20. Central air-conditioning system.
  21. 21. False ceiling 1 meter below the roof. </li></ul>VENTILATION <br /><ul><li>There should be +ve pressure ventilation with lowering pressure gradient from sterile to protective zone. Laminar flow.
  22. 22. All anaesthetic gases to be vented out to exhaust.
  23. 23. Flow of air 2 to 3 cu meter/ minute.
  24. 24. Air removal from floor level through weighted levers. </li></li></ul><li>PLUMBING<br /><ul><li>Swearage shaft should not pass through operating room.
  25. 25. Impervious lining to seal contamination.
  26. 26. Toilets to be provided in change room area.
  27. 27. All fire safety measures to be taken.
  28. 28. Gas pipe line system to be ensured. </li></ul>WATER SUPPLY<br /><ul><li>Adequate and running fresh water supply to be ensured.
  29. 29. Taps should be easily handled or foot operated.
  30. 30. Ensure self water flow after de salination. </li></li></ul><li>AUTOCLAVE ROOM<br />Provision of steam supply. <br />Proper maintenance of autoclaves.<br />Linen supply should be regular and adequate. <br />Theater sterilization unit. <br />Attached to the theater. <br />Equipments to be kept in cup boards. <br />Diagnostic/ operating instruments in Lysol.<br />OT ADMINISTRATION<br /><ul><li>Operation Theater Committee
  31. 31. Each unit must have from 4-7 O.T staffs. </li></ul>Chief Surgeon <br />O.T Assistant <br />Chief Anaesthetist<br />Anaesthesia Assistant <br />Scrub Nurse <br />Anaesthetic Nurse <br />Circulating Nurse <br />O.T Nurse for assisting <br />Attendants, Safaiwala, OT technicians <br />
  33. 33. PATENT RELATING ACTIVITY<br /><ul><li>Reception and pre – operative preparation.
  34. 34. Identification of patient and part to be operated.
  35. 35. Shifting patient to OT table.
  36. 36. Administration of anaesthesia, intubation positioning.
  37. 37. Preparation of surgical area and draping.
  38. 38. Intubation after operation, recovery from anaesthesia.
  39. 39. Shifting of patient to recovery room. </li></ul>SUPPORTING ACTIVITY<br /><ul><li>OT Dressing
  40. 40. Scrubbing and hand washing
  41. 41. Gowning, putting gloves
  42. 42. Checking of equipments and instruments </li></li></ul><li>ADMINISTRATIVE ACTIVITIES<br /><ul><li>Preparation of operation schedule
  43. 43. Preparation of OT list
  44. 44. Requisition of patient
  45. 45. Identification of patient, part and records
  46. 46. Shifting patient to OT
  47. 47. Preparation for doctors and assisting staff</li></ul>CLERICAL ACTIVITIES<br /><ul><li>Operation Note
  48. 48. Transfusion Record
  49. 49. Consent to patient for operation
  50. 50. Post of operative advise </li></li></ul><li>HOUSE KEEPING <br /><ul><li>Collection of soiled linens
  51. 51. Counting and collection of soiled instruments, disposables
  52. 52. Counting of abdominal sponges
  53. 53. Cleaning of OT table and area
  54. 54. Preparation to receive next patient</li></ul>STORE KEEPING<br /><ul><li>Ensure require medicines and instruments are ready.
  55. 55. Indent and stocking of essential drugs and injections.
  56. 56. Different kind of fluids and blood. </li></li></ul><li>INTERNAL DESIGNING<br />WALLS:<br /><ul><li>Melanin facing walls for easy cleaning
  57. 57. Height should be 3-3 ½ meter.
  58. 58. Pale color to be used.
  59. 59. Resistant to minor damage or impact.
  60. 60. Free of cravices and flaking.
  61. 61. All corners to be smoothly carved.
  62. 62. Door should be 1.5 meter wide, swinging and 7 feet height. </li></ul>ROOF:<br /><ul><li>Same as walls, but can take the load of OT lights, X-ray unit, TV camera,</li></ul> gas and electric panels. <br />FLOOR:<br />-Easily washable, non staining, impervious <br /><ul><li>Moderately electro conductive
  63. 63. Vinyl conductive flooring is best</li></li></ul><li>FIXTURES AND INSTALLATIONS<br /><ul><li>Minimum equipments in OT suits.
  64. 64. Adequate free area around the table for free movement.
  65. 65. Tables connected to Gas Pipe Lines .
  66. 66. No loose over head beams or pipes.</li></li></ul><li>hospiad<br />Hospital Administration Made Easy<br />THANK YOU<br /> http//<br />An effort solely to help students and aspirants in their attempt to become a successful Hospital Administrator.<br />DR. N. C. DAS<br />