Design and construction experience of laminar flow clean operating room

Design and construction experience of laminar flow clean operating room

The laminar flow operating room is a systematic project. In the design, building materials, construction and other aspects, the construction party and the hospital must cooperate closely. The laminar flow operating room is maintained primarily by "filtering" of the air, "laminar flow" and maintaining a "positive pressure" condition in the room; it is the core project of the hospital surgical building, and the entire surgical building is operated around the surgical department; It is the image project of the hospital; it is also a semi-permanent infrastructure project, so it requires high reliability. For example, the size of the locker room is determined by the number and gender of the surgical staff, including anesthesiologists, caregivers, surgeons, and interns. Other auxiliary rooms in the surgical department are determined based on the needs of the function, the layout of the process, the number of personnel, and the area of ​​the surgical department.
*layout
At present, the design of the clean operation department mainly includes a two-channel type, a single-channel type, a central island type, and a unit type. For ease of management, I recommend that you build a dual channel.
*Auxiliary rooms and facilities
The overall design of the clean operating room requires clear division, clear and dirty, reasonable flow of people, logistics and sewage, auxiliary rooms, advanced functions and facilities, and forward-looking. Clean operating room should be cleaned, packaged, disinfected, sterilized, disposable items stored, anesthesia preparation, sterile equipment, sterile dressing, medical staff changing clothes, hand washing, patient changing bed, wake up, family waiting, negotiation room And other auxiliary rooms and facilities.
*area
In the design of the surgical department, we faced three puzzles: the first is the area, the second is the number, and the third is the choice of the shadowless lamp. The most important issue is the area. Hospitals in many places can also design a surgical department in an area of ​​>20m2 or >30m2, but the tower is easy to hit the wall after it is built. According to our own experience, the area of ​​the clean surgical department is better than 45m2, and 60m2~80m2 is more suitable.
*Rooms
Regarding the number of operating rooms, our standard is 25 beds in the operating room with 1 bed, which is a ratio of 1:25. According to such a ratio, how many sheets of the operating bed are designed according to the hospital bed, it is necessary to have a development perspective, because the difficulty and complexity of the operation are increasing now. To consider the development needs of the next 10 years, 15 years or even 20 years, it is necessary to reserve more beds for the future.
*Building Decoration
Many details of the design and construction drawings are not well considered; in the building, the drawings are different from the actual ones. For example, the suggestion I made was that the color of the operation room and the auxiliary room should be matched, and the color of the living area and the rest area should be matched.
*Run mode
Our hospital adopts advanced hand-integrated operation mode, which has proved its superiority through practice: convenient and quick cleaning, disinfection and sterilization process of equipment dressing; sterile articles are free from any external pollution; unified management avoids The inconvenience caused by the cross-disciplinary management in the actual work; will not cause confusion in the work, affect the smooth development of the surgery; improve the operating room utilization rate (turnover + speed), and save costs.
*Features
In the construction, we also boldly adopted a variety of colors to highlight our characteristics, such as the design of the women's locker room with a light pink, so that female medical workers to maintain a comfortable mood. The men's locker room is light blue, which plays a role in calming the mood of male medical workers. Most notably, the nurse station boldly uses red and white colors, which are very eye-catching. In addition, we also use the color of the clothes to distinguish people.

Laminar flow operating room management experience
Many hospitals have built a laminar flow operating room without scientific management. The blind pursuit of the operating room is so beautiful that the built laminar operating room loses the meaning of laminar flow, eventually causing the failure to meet the normative requirements. The situation of infection.
The head nurse must attend the training to clarify the concept and structural requirements, maintenance and maintenance of the laminar flow operating room. Doctors should also train and conduct lectures at various levels so that everyone can abide by the specifications and requirements of the operating room. Let everyone know the functional role of each area that is reasonably divided on the building, so that each staff member and cleaner can define their scope of activities, while relying on modern monitoring equipment to manage.
*Door management
The experienced nurse will control the number of people (visit card) and prohibit other items from being brought into the operating room (such as suitcases, camera bags, etc.). The staff must change their hats, clothes, and shoes when they go out. Visitors will change the disinfection suits. pants.
*Patient access management
Use internal and external exchange vehicles, regularly scrub the internal and external carts, the patient must wear the sick suit in the operating room, and the outpatients must wear disinfection gowns through the air shower into the operating room.
*Personnel management
Strictly control the number of operating rooms, prohibiting visitors from arranging rooms, prohibiting cell phone calls, dressing and dressing to be neat, and managing with monitoring equipment.
*Item management
Items must be unpacked and then enter the operating room, set up a first-class, two-level warehouse, with a special person to manage. The computer controls the operating room to enter and exit consumables and usage. The second-level warehouse nurses are responsible for distributing the surgical room items and the consumables usage statistics are used by each department.
*dirty management
To enter the dirt passage, you must wear a gown, a shoe, a fixed cleaner, and a special dressing for the dressing. Sterile, clean, polluted pools, mops, cleaning cars are separated and marked.
* Clean operation management of clean operating room
Clean areas, contaminated areas, and sterile areas are managed separately. The floor and walls are scrubbed regularly. The dirt corridor cleaners are strictly prohibited from entering the clean corridor. Surgical dressings and medical waste are transported out through dedicated channels.
*Environmental equipment management for clean operating rooms
First of all, the management of the filter. The air return is cleaned once a week, and the coarse air filter is replaced once every 3 months. The medium efficiency filter is replaced once every six months to one year. The high efficiency filter is replaced once every one to two years. Each replacement must be recorded. 0.1% chlorine flakes wipe the surface of the object and clean it once a week.
Second, device management. For the management of electrical appliances and medical gases, daily monitoring and sanitation are required.
*Surgical procedures and management of emergency and infected patients
Any patient diagnosed with a special infection such as gas gangrene must take a dedicated passage. The infected operation room should be located at the end or the other end of the surgical department, and an operation room with positive and negative pressure switching functions is specially provided. The infected patient enters the negative pressure operating room from the pollution elevator. The staff needs to change shoes in the buffer room of the negative pressure operating room. After the operation, the dirt corridor exits the operation room, and the sewage elevator enters the ward. Carts used to infect patients are carts in the dirt corridor, and carts in clean corridors cannot be used.
* Factors that lead to infection due to poor management
There are two conditions for the invasion of pathogenic microorganisms: one is the presence of pathogenic bacteria; the other is the presence of a certain concentration of pathogenic bacteria. The laminar flow system can effectively control the pathogenic bacteria to cause infection through the air route, but it has no disinfection and sterilization effect, and can not control the pollution brought into the operating room by other means. The shadowless lamp should not be too large and the arm should not be too thick. The blood around the operating table should be cleaned in time to prevent the iodine from spilling on the ground.
*The surgical department is always under control
In order to keep the surgical department in a controlled state, the pressure gradient distribution of the entire operating room cannot be affected by the opening of a clean operating room, and the directional flow of the positive pressure airflow between the rooms is destroyed, resulting in cross-infection caused by air infusion. Air Clean Technology is a multi-functional air filtration system designed scientifically to maximize the removal of aerosols and microorganisms in the air, and to control infection throughout the process, which is an effective means of creating a clean environment.

Suggest
The head of the hospital, the equipment department, and the head nurse of the operating room should participate in the laminar flow room training class organized by the Ministry of Health. The head nurse is best involved in the design of the drawings (according to the requirements of the Ministry of Health) and makes reasonable recommendations. The operating room nurses and designers, and the laminar construction engineers should get together and work together to come up with the best plan.
Scientific and standardized management is the only way to manage laminar flow operating rooms. Can be appointed as two team leaders, one to manage the problems in the mechanical part; another to manage the daily needs of parts and components, such as: doors, lights, towers, beds, gas, etc., weak electricity, strong electricity and so on.

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