SRG 140 Principles and Practices of Surgical Technology

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SRG 140 Principles and Practices of Surgical
Technology

• Perioperative Surgical Environment
• Lecture 140-2

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Henry Brooks Adams

• Every man should have a fair-sized cemetery in
  which to bury the faults of his friends.

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Text

• Surgical Technology Principles and Practices
  Chapter 5

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Objectives

• Describe the purposes of the OR design
• Understand the working environment of the
  Operating Room
• Describe the different areas in a surgical suite
  and their purpose
• Describe the physical components of the surgical
  suite
• Describe the function of the physical components
  of the surgical suite
• Identify the standard operating room furniture
• Identify support services that work with the OR
  team in care of the patient

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OR Design Principles

• Includes the work areas, floor plan, and
  environmental systems, and design
• Design is based on 3 main principles
• Infection control
• Safety
• Efficient use of personnel, time and space

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Infection Control

• Clean and contaminated areas should be kept
  physically separated
• If that is not possible, then contaminated
  objects are contained
• Containment means confinement

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Safety

• Environment systems
• Lighting
• Heating
• Electrical circuits
• Ventilation
• In-line gases and vacuum
• Maintenance plans and standards

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Efficiency

• Describes the use of physical effort and
  materials
• Describes the use of time traffic patterns
• Efficient use of space

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Architectural Design

• Floor plans
• Traffic flow
• Design features
• Floors
• Ceilings
• Walls

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Areas of the OR

• Unrestricted
• Located outside the OR near the entrance
• Allows access to the changing rooms
• In this area, street clothes are allowed
• Included in this area- offices and main desk

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Areas of the OR

• Semi-restricted
• Scrub suit, hat and shoe covers
• Usually no physical barrier between areas-marked
  by painted line on the floor
• Includes offices, corridors, patient holding
  area, scrub sink area, equipment and supply
  rooms, PACU, and anesthesia workroom,

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Areas of the OR

• Restricted-
• must have on scrub suit, hat, shoe covers and
  mask
• Includes the OR room itself
• Sub-sterile areas
• Clean core areas
• Sterile storage areas

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Physical Components of the OR

• Equipment
• Electric outlets
• Suction outlets
• Gas outlets
• Lights
• View box
• OR table and attachments
• Anesthesia machine
• Anesthesia cart
• Computer terminal

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Standard OR furniture

• Back table
• Mayo stand
• Ring stands- single and double
• Kick bucket
• Linen, biohazadous waste and trash hampers
• Suction
• Standing/step stool
• Rolling stools
• Prep table

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Other OR Equipment

• Blanket warmer
• Clock with a second hand
• Timing clock
• Documentation center
• Flash autoclaves
• Specimen prep area

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Characteristics of the OR

• Size- 400-600 square feet, but getting bigger
  with new technology
• Walls- nonporous, easy to clean, light in color,
  fire and water proof, no glare and non reflective
• Ceilings- nonporous, easy to clean, light in
  color, fire and water proof
• Floors- solid without seams, easy to clean, light
  in color and waterproof

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Cabinets and Doors

• Cabinets
• - Recessed
• - Sliding cabinet doors
• - Nonporous and waterproof
• Doors
• - Should be kept closed
• - Surface-mounted sliding doors
• - Nonporous and waterproof

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Environmental Controls

• Airflow
• Humidity
• Temperature
• Electricity
• In-line gas and suction
• Lighting

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Airflow Ventilation System

• Provide clean air
• Remove airborne contaminates
• Positive-pressure air supply
• Air Changes-
• Air exchange rate of at least 20 per hour
• Filtered with high-efficiency particulate air
  filter (HEPA)
• 20 of the air change per hour be fresh outside
  air (OSHA)
• Laminar airflow- 800 to 900 per hour

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Temperature and Humidity

• Temperature- 65-75 degrees F
• Humidity- 50-55
• Provide-
• Comfort for the patient
• Comfort for the OR team
• Infection control

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Electricity

• Electrical outlets must be grounded
• Both 110-volt and 220-volt is available
• Emergency back-up system
• Default alarm system

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In-Line Gas and Suction

• In-line source of oxygen, nitrous oxide and
  compressed air
• Righty tighty and lefty lossey
• In-line suction lines with pressure sensors and
  filters

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Lighting

• Overhead fluorescent lights
• OR spot lights
• Surgeons headlight
• Fiberoptic light sources

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Direct Support Services

• Preoperative or Same-Day Check-In unit
• Preoperative Holding Area
• Postanesthesia Care Unit (PACU)
• Laboratory Department
• Radiology Department
• Pathology Department
• Bio-Medical and Maintenance
• Environmental Services
• Central Sterile Supply and Processing
• Laundry