Transcript OT orientation

Aseptic and Septic
Operation Theatre Orientation
Introduction
• Heart of an hospital-OT
• Team
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Skilled Surgeons
Nurses
MLOP
Anaesthetist
Separate theatres for septic and aseptic surgeries
Aseptic Theatre:•
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Cataract
PKP
Squint
Retina
Glaucoma
Septic (Minor Theatre):-Enucleation
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Evisceration
DCR
DCT
Infected Cases
Planning of OT
• An should have
• High standard of asepsis
• Maximum standard of safety for patients and staffs
• Optimum utilization of space and staff time
Location of Aseptic Theatre
• The Location Should be
• Free from general traffic Eg: Away from road side
• Free from noise and other disturbance
• Free from contamination and possible sources of
infection
• Closure to ward
Operation Theatre Zones
• Four Types of Zones
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Sterile Zone
Clean Zone
Protective Zone
Disposable Zone
• Sterile Zone
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Operation Room
Scrub room
Anaesthesia room(Block room)
Instruments sterilization
• Clean Zone:•
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Pre operative block room
Nurses work room
Recovery room
Anaesthesia /Medication store
• Protective Zone:• Reception room in OT
• Waiting room for relative of patient
• Dress changing room
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Pre Anaesthesia room
General store room
Main Autoclave room
Trolley lay,Wheel chair,Stretcher
Control area of electricity
• Disposal Zone:• Dirty /Blood stained linen
• Used head caps,mask,socks
• Solid materials both disposable and non disposable
should move with out crossing sterile & clean zones.
Operation Room
• Contains:• Airconditioning –maintains asepsis
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Operating table
Adjustable chair for surgeons
Instruments trolley
Microscope & other necessary equipments,Phaco machine
etc
• A working space of around 1. 2 m around operation table
• IV stand tray and fluids
• One Bowlstand for rinsing hand with sterile water.
Instruments
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Surgical instruments sets and different ocular surgeries
Bipolar diathermy with points
Vitrectomy machine with vitrectomy probes
Boyle apparatus for GA
Sub sterilizing Area
• Instaclave with cheatle forceps and container
• Stainless steel basin for cleaning the instruments
• Electric water drums for boiling water or drum with clean
sterile water.
• Soft brush for cleaning the Instrument & instrument cover
• Adequate water supply
Scrub Area
• Sink with running water facility
• Hands should not touch surface of sink
• Scrubbing Solution (Chlorhexidine, Iodine 7.5%)
• With Soap and brush
• 6 minutes for scrubbing
• First one minute for two times using soap then 2
minutes used for solution first time scrubbing with
brush and full fore arm
• Second 2 minutes with scrubbing solution for proximal
half of fore arm
Location of Septic OT
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Located at a place which has limited access to patients
Closure to ward
Away from aseptic OT
Should have separate dressing room,scrub
room,sterilization section
Should have good ventilation
Good lighting system
Instruments and eye towels should be sterilized separately
from other than linen like coats.
Flash autoclave or sterliser-in between cases
Staffing Pattern
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OT Manager is usually OT Nursing officer
OT Manger has to ensure
Availability of equipments ,instruments and nursing staffs
Proper care and maintenance of equipments
Theatre cleaning and sterility
Adherence to work discipline
Maintenance of OT records
Relationship with other departments
Staff Allocation
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Operation area
Scrub nurse- 2 for 1Surgeon
Circulating nurse-1for 1 Surgeon
Block room-Local –1-3 persons,GA-2 persons
INFORMATION BOARD
• Notice board for display of daily operation
• Schedule with details at entrance of OT
• Helps to begin the preparations without delay
Roles of MLOP in OT
• Circulating MLOP:• To give nursing care to patients during preparation for
the surgery
• Checks the case sheet
• Helps doctors in giving local anaesthesia and
counseling to the patient .
• She makes available the sterile things and medicines
supplied needed for surgery
Scrub MLOP
• Scrub MLOP is a well trained person,who will be familiar
with procedure of surgery
• She assists the surgeon through out the surgery
• Helps to wear sterile gown
• Arranges instrument trolley
Dress code
• Should wear only special theatre dress to minimize cross
infection.
• Should not leave outside OT with theatre linen
• Caps must be worn to cover the hair completely
• Face masks must be worn.
• Dress colour-preferably light blue,green
Slippers and Overshoes
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Should remove personal slippers outside OT
Feet must be washed
Theatre slippers should be worn
Slippers should be scrubbed after use daily
Theatre slippers should not be used outside the theatre
A dedicated OT MLOP
• Should have a same of sincerity ,honesty and
punctuality and compassion to all the patients.
• Should have sufficient knowledge of medical
terms
OT Discipline
• MLOP should come early before the start of surgery
• Take all responsibility to arrange the theatre,ready to the
patient and allocate the surgeon
• Eating or drinking tea or coffee should be strictly
prohibited in OT area
Personal Hygiene
• Hairs and Nails must be kept clean and short
• No Nail polishing or jewellary
• Cuts and abrasion should be corrected and reported to
incharge person
• Infectious diseases like common cold should get prompt
and complete medical treatment
Patient Hygiene
• Should have their bath and wear clean dress
• Diabetic ulcer patient Hansen or other infected diseases
should be operated at the end
• Disposable cap and shoes to every patient
Key Point to Remember
• OT should be located away from pollution (Noise & Air)
• The attender /visitors should not be allowed to stand in
front of OT
• MLOP should check the working conditions of equipments
, electrification etc prior to surgery
• MLOP should take responsibilities to inform/make
arrangements for repair and replacement of equipment.
• An extra supply of instruments should be available at
request.
• An extra supply of all OT dresses must be available for
visitors and staffs
• The medical personal should strictly follow the theatre
discipline