The document outlines essential considerations for operating theater (OT) design and operation including location, size, staffing, and waste management. It highlights parameters for ensuring efficiency and sterility, the roles of various staff, and classifications of surgical procedures. Additionally, the document details protocols for managing biomedical waste and the importance of maintaining aseptic techniques within the OT environment.

1. Mr.Ramprasad.S
Asst.Professor
Dept.Neurosciences Nursing

2. Introduction

3. Essentials required for OT
1. Location with in the hospital
2. Quantity
3. Size
4. Design
5. Equipment required

4. Parameters for OT
1. Avoid unrelated hospital traffic
2. Avoid outdoor noise
3. Keep a provision for future
expansion
4. Sliding doors
5. Smooth non slippery floors
6. Easy access to departments

5. • Provision for high efficiency
autoclave
• Radiology film illuminators
• Emergency communication system

6. Location with in the hospital
1. Centralization
2. Help in optimum man power
3. Avoid crowding
4. Easy team training
5. Minimization of issues related to
surgical supplies
6. Effective supervision

7. Should be easy accessible to
1. Surgical wards
2. Location of blood bank
3. CSSD
4. Proximity of diagnostic such as
radiology, pathology,ICU.

8. Size of OT
1. QUANTITY
based on
1. Cost benefit consideration
2. Patient load and disease occurrence
3. Availability of space
4. Number of surgical beds
5. Average length of stay of surgical
patients.

9. Design
Major operating room
Recovery room
Sub sterilizing area
Sterile instruments supply and storage

10. Scrub area
Clean up area
Male dressing room
Female dressing room
Nurse station
Wheeled stretcher area

11. Operation theater zones
Zone 1
Zone 2
Zone 3

12. Zone 1
Also called as outer zone and
unsterile zone or non restricted zone
or interchange area.
This zone avoids the exposure to
contaminated areas after changing to
surgical attire.

13. Zone 2
Also called as middle intermediate
zone or semi restricted area and should
be in-between two zones.
This should be large to receive the
supplies for surgery.

14. Zone 3
Also called as inner most or most
sterile area or restricted zone.

15. Classification of OT

16. classification is based on,
1. Extent of surgery involved
2. Type of service provided
3. Sharing of OT
4. Urgency Situation

17. 1.Extent of surgery involved
a. Minor OT
b. Major OT

18. 2. Type of service provided
a. Out patient OT
b. Inpatient OT

19. 3. Sharing of OT
A. Decentralized
 Neurosurgery
 Orthopedic
 CTVS
 ENT
 Eye
 General surgery
 Gynec
 Renal
B. Centralized

20. 4. Urgency Situation
A. Emergency OT
B. Elective OT

21. Staffing Of OT

22. The staffing can be measured in many
ways,
1. Number of hours worked
2. Hours associated with direct patient
care
3. Workload calculation

23. Benefits of good staffing
1. Improves patient outcome
2. Lowers mortality rate
3. Increase OT efficiency
4. Reduce patient waiting time for
surgery
5. Balance workload

24. OT staffing is based on
1. Total number of hours of cases
2. Number of cases operated per day
3. Type of cases
4. Nature of cases
5. Prescribed norms and policies and
procedures

25. Policies of OT

26. 1. Functions of OT
2. Duties and responsibilities of
doctors and nurses and technicians
3. Checklist for preparing OT for
surgeries
4. Maintenance of records of surgeries

27. 5. Methods of aseptic techniques
should be followed
6. Maintenance of sterility in different
zones.
7. Disposal of Medical Waste

28. Staffing Pattern Of OT

29. OT in charge
Nursing StaffSupport StaffOperating staff
Chief
surgeon
Supportin
g surgeon
perfutionist
anesthetist
Technicians
Helpers
Scrub
Nurse
Circulati
ng
Nurse
Procurement Nurse

30. Members of OT Team

31. 1. OT in Charge
2. Operating consultant
3. Collaborating surgeons
4. Scrub nurse
5. Circuiting nurse
6. Anaesthetists

32. 7. Percussionist
8. OT technicians
9. Pre recovery staffs
10.Post recovery staffs
11. Sterilization staffs
12. Store keeper
13. Helping staffs

33. Role of Nurse in OT

34. 1. Pre operative check for the
availability of the materials for
surgery
2. Psychological preparation of the
patient
3. Follow correct aseptic techniques
4. Positioning of the patient

35. Proper administration of medications
as per policies.
Delivering of high quality patient
care.
 Nursing care based on EBP.
 Participate in risk assessment and
reporting.

36.  Assess, plan , implement and
evaluate care.
Maintaining of resources
Organize and prioritize the workload
Support other staffs in maintaining
health

37. Principles of OT Attire

41. General Principles
Aware of the dress
policy
No one should go out after
change into OT attire
All staffs must
change to OT
attire
Must change
the attire if
any soiling
occur
Focuses on
maintaining
Asepsis
Safety spectacles should be worn when required

49. Air conditioning unit 1
Anaesthesia machine 1
C/S set 1
Instrument table 1
Laparotomy set 1
Laryngoscope 1
OR light 1
OR table 1

50. Oxygen unit 1
Spinal set 1
B P apparatus adult 1
B P apparatus paediatric 1
Stethoscope 1
Suction apparatus 1
Wheeled stretcher 1

52. Criteria for selection of suture
Tissue contamination
Surgeon
preference
Speed of
healing
Cost &
availability
Aesthetic concern
Tension desired in wound healing

53. Absorption Material structure
Material origin
Absorbable
Non
Absorbable
Monofilament
Multifilame
nt
Natural Synthetic
1. Polyglycotic
acid
2. Catgut
3. Polydiaxone
1. Silk
2. Catgut
3. Nylon
4. Polyster
1. Catgut
2. Nylon
3. Stainless steel
4. polypropylene
1. polygly
cactin
2. polyest
er silk
1. silk
2. catgut
1. all other
available
sutures
Types of suture

54. Interrupting Sutures Continuous
Sutures
Mattress
Suture
Simple Sub cuticular
Running
intra dermal
pull out
Running
cuticular
Suture Techniques

55. Simple Interrupted

56. Sub Cuticular

57. Continuous Sutures

58. Running cuticular

59. Mattress Suture

61. DEFINITION
Waste generated in the diagnosis, treatment
and immunization of human beings or
animals, in research or in the production and
testing of biological products.

62. CLASSIFICATIONS OF HOSPITAL
WASTE

64. CATEGORIES OF BIO-MEDICAL
WASTE

65. Option Waste Category
Cat 1
Human anatomical waste (human
tissues, organs, body parts)
Cat 2
Animal waste animal tissues,
organs, body parts carcasses,
bleeding parts, fluid, blood and
experimental animals used in
research, waste generated by
veterinary hospitals/ colleges,
discharge from hospitals, animal
houses)

66. Option Waste Category
Cat 3
Microbiology & Biotechnology waste
(wastes from laboratory cultures,
stocks or specimens of micro-
organisms live or attenuated vaccines,
human and animal cell culture used
in research and infectious agents from
research and industrial laboratories,
wastes from production of biological,
toxins, dishes and devices used for
transfer of cultures)

67. Cat 4
Waste Sharps (needles, syringes, scalpels
blades, glass etc. that may cause puncture
and cuts. This includes both used &
unused sharps)
Cat 5
Discarded Medicines and Cytotoxic drugs
(wastes comprising of outdated,
contaminated and discarded medicines)
Cat 6
Solid Waste (Items contaminated with
blood and body fluids including cotton,
dressings, soiled plaster casts, line
beddings, other material contaminated
with blood)

68. Cat 7
Solid Waste (waste generated from
disposable items other than the waste
sharps such as tubing, catheters,
intravenous sets etc.)
Cat 8
Liquid Waste (waste generated from
laboratory & washing, cleaning , house-
keeping and disinfecting activities)
Cat 9
Incineration Ash (ash from incineration of
any bio-medical waste)
Cat 10
Chemical Waste (chemicals used in
production of biological, chemicals, used in
disinfect ion, as insecticides, etc)

69. COLOR CODING & TYPE OF
CONTAINER

70. Colour
Coding
Type of
Containers
Category Treatment Options
as per Schedule 1
Yellow Plastic bag 1,2,3,6 Incineration/deep burial
Red
Disinfected
Container/
Plastic bag
3,6,7 Autoclaving/Microwaving
/Chemical Treatment
Blue/
White
transluc
ent
Plastic
bag/puncture
proof
container
4,7 Autoclaving/Microwaving
/ chemical treatment and
destruction/shredding
Black Plastic bag 5,9,10
(Solid)
Disposal in secured
landfill

73. Waste
Managemen
t

74. Why waste has to
be treated?

76. STEPS IN WASTE
MANAGEMENT

77. SURVEY
SEGREGATI
ON
STORAGE
TRANSPORTA
TION
TREATMEN
T
DISPOSAL
MINIMIZA
TION

79. Personal Protective
Equipment