Facilities for Surgical Procedures - Revision history

Tobyvan: /* Sterile Zone */

2020-07-14T15:08:06Z

Sterile Zone

Tobyvan: /* Location */

2020-06-29T20:48:56Z

Location

← Older revision		Revision as of 22:48, 29 June 2020
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	*controlled access from an external corridor is highly desirable.		*controlled access from an external corridor is highly desirable.

	[[File:Departmental relationships and critical adjacencies.jpg\|alt=Departmental relationships and critical adjacencies\|none\|thumb\|~~533x533px~~\|Departmental relationships and critical adjacencies]]		[[File:Departmental relationships and critical adjacencies.jpg\|alt=Departmental relationships and critical adjacencies\|none\|thumb\|414x414px\|Departmental relationships and critical adjacencies]]

	===Sterile Core Principle===		===Sterile Core Principle===
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	\|}		\|}
	[[File:Relationships within the Operating Theatre Unit.jpg\|alt=Relationships within the Operating Theatre Unit\|none\|thumb\|466x466px\|Relationships within the Operating Theatre Unit (OTU)]]		[[File:Relationships within the Operating Theatre Unit.jpg\|alt=Relationships within the Operating Theatre Unit\|none\|thumb\|466x466px\|Relationships within the Operating Theatre Unit (OTU)]]
	~~<br />~~

	===Traffic Flow Paths===		===Traffic Flow Paths===
	The OTU design must prevent cross-traffic of staff and supplies from the decontaminated/soiled areas to the sterile/clean areas. The use of facilities external to the operating theatre for soiled/decontaminated processing, clean assembly and sterile processing must be designed to move the flow of goods and personnel without compromising universal precautions or aseptic techniques in both departments.		The OTU design must prevent cross-traffic of staff and supplies from the decontaminated/soiled areas to the sterile/clean areas. The use of facilities external to the operating theatre for soiled/decontaminated processing, clean assembly and sterile processing must be designed to move the flow of goods and personnel without compromising universal precautions or aseptic techniques in both departments.
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	[[Category:Clinical Services]]		[[Category:Clinical Services]]

	== References ==		==References==
	<references />		<references />

Tobyvan: /* Refernces */

2020-06-29T20:45:25Z

Refernces

← Older revision		Revision as of 22:45, 29 June 2020
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	\|}		\|}

	==~~'''~~Acknowledgements~~'''~~==		==Acknowledgements==

	'''Documents of particular reference'''		'''Documents of particular reference'''
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	Fiona Stanley Tertiary Hospital, Perth		Fiona Stanley Tertiary Hospital, Perth
	[[Category:Clinical Services]]		[[Category:Clinical Services]]
	== ~~Refernces~~ ==
			== References ==
	<references />		<references />

Tobyvan: /* Acknowledgements */

2020-06-29T20:43:42Z

Acknowledgements

← Older revision		Revision as of 22:43, 29 June 2020
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	Fiona Stanley Tertiary Hospital, Perth		Fiona Stanley Tertiary Hospital, Perth
	[[Category:Clinical Services]]		[[Category:Clinical Services]]
			== Refernces ==
	<references />		<references />

Tobyvan: /* References and Regulations */

2020-06-29T20:42:53Z

References and Regulations

← Older revision		Revision as of 22:42, 29 June 2020
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	[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)<ref>FGG Architects</ref>]]		[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)<ref>FGG Architects</ref>]]

	==~~References and~~ Regulations==		==Regulations==

	~~===References===~~
	~~<references />~~

	~~===Regulations=~~==

	*All local Municipal laws and regulations.		*All local Municipal laws and regulations.

Tobyvan at 20:42, 29 June 2020

2020-06-29T20:42:02Z

Tobyvan at 20:38, 29 June 2020

2020-06-29T20:38:14Z

← Older revision		Revision as of 22:38, 29 June 2020
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	*Post-operative care is the management of the patient after the procedure until discharge and includes care in the recovery area in the operating theatre unit and the inpatient facility.		*Post-operative care is the management of the patient after the procedure until discharge and includes care in the recovery area in the operating theatre unit and the inpatient facility.

	===Surgical disciplines<ref name=":0" />===		===Surgical disciplines<ref name="G.McDonald and D Sheard" />===
	<u>The most common surgical disciplines include:</u>		<u>The most common surgical disciplines include:</u>

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	*Orthopaedic surgery - this involves surgical treatment related to the musculoskeletal system.		*Orthopaedic surgery - this involves surgical treatment related to the musculoskeletal system.

	===Surgical techniques<ref name=":0" />===		===Surgical techniques<ref name="G.McDonald and D Sheard" />===
	<u>These include the following:</u>		<u>These include the following:</u>

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	**Surgical-site infections result in a higher healthcare burden. It is estimated that surgical-site infections (SSI) double the cost of treatment through length of stay (LOS) alone. This estimate excludes re-admissions		**Surgical-site infections result in a higher healthcare burden. It is estimated that surgical-site infections (SSI) double the cost of treatment through length of stay (LOS) alone. This estimate excludes re-admissions

	====Space separation and differentiation within the operating theatre:<ref name=":0" />====		====Space separation and differentiation within the operating theatre:<ref name="G.McDonald and D Sheard" />====
	Surgical procedures pose a risk of infection to the patient, necessitating that the space to perform these procedures be carefully planned accordingly. These procedures should occur in areas which must provide adequate space to accommodate the patient, the surgical team while performing the procedure, and the equipment required for the procedure. The set-up of an operating theatre is primarily influenced by the aseptic principles that have to be applied.		Surgical procedures pose a risk of infection to the patient, necessitating that the space to perform these procedures be carefully planned accordingly. These procedures should occur in areas which must provide adequate space to accommodate the patient, the surgical team while performing the procedure, and the equipment required for the procedure. The set-up of an operating theatre is primarily influenced by the aseptic principles that have to be applied.

Tobyvan: /* Patient careG.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare” */

2020-06-29T20:36:00Z

Patient careG.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare”

← Older revision		Revision as of 22:36, 29 June 2020
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	*CSSD staff.		*CSSD staff.

	===Patient care<ref name=":0">G.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare”</ref>===		===Patient care<ref name="G.McDonald and D Sheard">G.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare”</ref>===
	The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.		The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.

Tobyvan: Undo revision 2581 by Tobyvan (talk)

2020-06-29T20:35:13Z

Undo revision 2581 by Tobyvan (talk)

← Older revision		Revision as of 22:35, 29 June 2020
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	*CSSD staff.		*CSSD staff.

	===Patient care===		===Patient care<ref name=":0">G.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare”</ref>===
	The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.		The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.

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	====Anaesthetic induction room (optional)====		====Anaesthetic induction room (optional)====
	<blockquote>''"The provision of anaesthetic rooms immediately adjacent to the operating room has also become a source of controversy. In many European hospitals the provision of the anaesthetic room has been removed in favour of holding areas. This is in response to the modern-day provision of better-equipped day-surgery suites, which have removed many of the minor procedural and short theatre-time cases from the inpatient theatre suite. The anaesthetic room therefore is no longer required as a holding area and, if the premedication can be delivered at ward level, the dwell time outside the operating room can be completed elsewhere. In a patient-focused environment, however, the anaesthetic room provides a soothing environment where carers can wait with the frail elderly or the very young and provide comfort right up to the point of intubation."''</blockquote>The provision of anaesthetic rooms (induction rooms) immediately adjacent to the operating room depends on the facility and procedure type.		<blockquote>''"The provision of anaesthetic rooms immediately adjacent to the operating room has also become a source of controversy. In many European hospitals the provision of the anaesthetic room has been removed in favour of holding areas. This is in response to the modern-day provision of better-equipped day-surgery suites, which have removed many of the minor procedural and short theatre-time cases from the inpatient theatre suite. The anaesthetic room therefore is no longer required as a holding area and, if the premedication can be delivered at ward level, the dwell time outside the operating room can be completed elsewhere. In a patient-focused environment, however, the anaesthetic room provides a soothing environment where carers can wait with the frail elderly or the very young and provide comfort right up to the point of intubation."''<ref name=":1">Ron Bridgefoot Principal of HASSELL</ref></blockquote>The provision of anaesthetic rooms (induction rooms) immediately adjacent to the operating room depends on the facility and procedure type.

	The anaesthetic induction room is for holding patients on mobile beds or trolleys prior to operative procedures at times when the operating theatre is not available. Local, regional or general anaesthetics can be administered in this area.		The anaesthetic induction room is for holding patients on mobile beds or trolleys prior to operative procedures at times when the operating theatre is not available. Local, regional or general anaesthetics can be administered in this area.
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	*The room should have splayed corners for ease of cleaning. The ventilation return/extraction duct is commonly placed behind the splayed corner.		*The room should have splayed corners for ease of cleaning. The ventilation return/extraction duct is commonly placed behind the splayed corner.
	*Space allocation must be large enough for correct techniques and small enough to minimise unnecessary movements of personnel, patients and supplies.		*Space allocation must be large enough for correct techniques and small enough to minimise unnecessary movements of personnel, patients and supplies.
	*The speed of the development of technology has had, and will have in future, significant implications for the design of OTs. “The challenge for planners and architects is to design surgical facilities that are not only functional but have sufficient flexibility to adapt to the changes and rapid developments in surgical technology“		*The speed of the development of technology has had, and will have in future, significant implications for the design of OTs. “The challenge for planners and architects is to design surgical facilities that are not only functional but have sufficient flexibility to adapt to the changes and rapid developments in surgical technology“ <ref name=":2">Facilities for surgical procedures in acute general hospitals (HBN 26)[https://www.gov.uk/government/publications/facilities-guidance-for-surgical-procedures-in-acute-general-hospitals]</ref>
	*Size is very dependent on the equipment to be utilised within the OT. Anaesthetic machines, for example, have increased in size due to the number and complexity of the integral patient-monitoring systems.		*Size is very dependent on the equipment to be utilised within the OT. Anaesthetic machines, for example, have increased in size due to the number and complexity of the integral patient-monitoring systems.

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	===='''Day-surgery unit'''====		===='''Day-surgery unit'''====
	<blockquote>"Day-surgery units are defined as “self-contained, dedicated units, suitable for carrying out surgical procedures and treatments on adult and child patients whose discharge is planned for the same day as their admission" </blockquote>Day-care services mainly include day surgery, endoscopy, and medical investigation and treatment. Provision of a large theatre size is preferable to accommodate a variety of surgical procedures. The infrastructural requirements for a day-surgery unit theatre are principally the same as that of a general theatre.		<blockquote>"Day-surgery units are defined as “self-contained, dedicated units, suitable for carrying out surgical procedures and treatments on adult and child patients whose discharge is planned for the same day as their admission"<ref>NHS Scotland, SHPN52 Accommodation for Day Care, 2002 </ref> </blockquote>Day-care services mainly include day surgery, endoscopy, and medical investigation and treatment. Provision of a large theatre size is preferable to accommodate a variety of surgical procedures. The infrastructural requirements for a day-surgery unit theatre are principally the same as that of a general theatre.
	[[File:One-way patient flow through day unit.png\|alt=One-way patient flow through day unit\|thumb\|663x663px\|One-way patient flow through day unit]]		[[File:One-way patient flow through day unit.png\|alt=One-way patient flow through day unit\|thumb\|663x663px\|One-way patient flow through day unit]]

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	==Case Studies==		==Case Studies==
	[[File:Theatre and CSSD plan (Courtesy of Mitchells Plain (District) Hospital).png\|alt=Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)\|none\|thumb\|750x750px\|Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)]]		[[File:Theatre and CSSD plan (Courtesy of Mitchells Plain (District) Hospital).png\|alt=Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)\|none\|thumb\|750x750px\|Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)<ref>MPDH Architects in Association</ref>]]



	[[File:Theatre and CSSD layout (Courtesy of King George V (District) Hospital).png\|none\|thumb\|1478x1478px\|Theatre and CSSD layout (Courtesy of King George V [District] Hospital)]]		[[File:Theatre and CSSD layout (Courtesy of King George V (District) Hospital).png\|none\|thumb\|1478x1478px\|Theatre and CSSD layout (Courtesy of King George V [District] Hospital)<ref>Osmond Lange Architects</ref>]]
	<br />		<br />
	[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)]]		[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)<ref>FGG Architects</ref>]]

	==Regulations==		==References and Regulations==

			===References===
			<references />

			===Regulations===

	*All local Municipal laws and regulations.		*All local Municipal laws and regulations.
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	Fiona Stanley Tertiary Hospital, Perth		Fiona Stanley Tertiary Hospital, Perth

	~~== References ==~~
	[[Category:Clinical Services]]		[[Category:Clinical Services]]
	<references />		<references />

Tobyvan: /* References and Regulations */

2020-06-29T20:33:16Z

References and Regulations

← Older revision		Revision as of 22:33, 29 June 2020
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	*CSSD staff.		*CSSD staff.

	===Patient care~~<ref name=":0">G.McDonald and D Sheard “ A Practical Guide to Decontamination in Healthcare”</ref>~~===		===Patient care===
	The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.		The surgical team has the responsibility of caring for the patient during the perioperative period, which includes the pre-, intra- and post-operative management of the patient - i.e. care given to the patient before, during and after surgery.

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	====Anaesthetic induction room (optional)====		====Anaesthetic induction room (optional)====
	<blockquote>''"The provision of anaesthetic rooms immediately adjacent to the operating room has also become a source of controversy. In many European hospitals the provision of the anaesthetic room has been removed in favour of holding areas. This is in response to the modern-day provision of better-equipped day-surgery suites, which have removed many of the minor procedural and short theatre-time cases from the inpatient theatre suite. The anaesthetic room therefore is no longer required as a holding area and, if the premedication can be delivered at ward level, the dwell time outside the operating room can be completed elsewhere. In a patient-focused environment, however, the anaesthetic room provides a soothing environment where carers can wait with the frail elderly or the very young and provide comfort right up to the point of intubation."''~~<ref name=":1">Ron Bridgefoot Principal of HASSELL</ref>~~</blockquote>The provision of anaesthetic rooms (induction rooms) immediately adjacent to the operating room depends on the facility and procedure type.		<blockquote>''"The provision of anaesthetic rooms immediately adjacent to the operating room has also become a source of controversy. In many European hospitals the provision of the anaesthetic room has been removed in favour of holding areas. This is in response to the modern-day provision of better-equipped day-surgery suites, which have removed many of the minor procedural and short theatre-time cases from the inpatient theatre suite. The anaesthetic room therefore is no longer required as a holding area and, if the premedication can be delivered at ward level, the dwell time outside the operating room can be completed elsewhere. In a patient-focused environment, however, the anaesthetic room provides a soothing environment where carers can wait with the frail elderly or the very young and provide comfort right up to the point of intubation."''</blockquote>The provision of anaesthetic rooms (induction rooms) immediately adjacent to the operating room depends on the facility and procedure type.

	The anaesthetic induction room is for holding patients on mobile beds or trolleys prior to operative procedures at times when the operating theatre is not available. Local, regional or general anaesthetics can be administered in this area.		The anaesthetic induction room is for holding patients on mobile beds or trolleys prior to operative procedures at times when the operating theatre is not available. Local, regional or general anaesthetics can be administered in this area.
Line 1,235:		Line 1,235:
	*The room should have splayed corners for ease of cleaning. The ventilation return/extraction duct is commonly placed behind the splayed corner.		*The room should have splayed corners for ease of cleaning. The ventilation return/extraction duct is commonly placed behind the splayed corner.
	*Space allocation must be large enough for correct techniques and small enough to minimise unnecessary movements of personnel, patients and supplies.		*Space allocation must be large enough for correct techniques and small enough to minimise unnecessary movements of personnel, patients and supplies.
	*The speed of the development of technology has had, and will have in future, significant implications for the design of OTs. “The challenge for planners and architects is to design surgical facilities that are not only functional but have sufficient flexibility to adapt to the changes and rapid developments in surgical technology“ <ref name=":2">Facilities for surgical procedures in acute general hospitals (HBN 26)[https://www.gov.uk/government/publications/facilities-guidance-for-surgical-procedures-in-acute-general-hospitals]</ref>		*The speed of the development of technology has had, and will have in future, significant implications for the design of OTs. “The challenge for planners and architects is to design surgical facilities that are not only functional but have sufficient flexibility to adapt to the changes and rapid developments in surgical technology“
	*Size is very dependent on the equipment to be utilised within the OT. Anaesthetic machines, for example, have increased in size due to the number and complexity of the integral patient-monitoring systems.		*Size is very dependent on the equipment to be utilised within the OT. Anaesthetic machines, for example, have increased in size due to the number and complexity of the integral patient-monitoring systems.

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	===='''Day-surgery unit'''====		===='''Day-surgery unit'''====
	<blockquote>"Day-surgery units are defined as “self-contained, dedicated units, suitable for carrying out surgical procedures and treatments on adult and child patients whose discharge is planned for the same day as their admission"~~<ref>NHS Scotland, SHPN52 Accommodation for Day Care, 2002 </ref>~~ </blockquote>Day-care services mainly include day surgery, endoscopy, and medical investigation and treatment. Provision of a large theatre size is preferable to accommodate a variety of surgical procedures. The infrastructural requirements for a day-surgery unit theatre are principally the same as that of a general theatre.		<blockquote>"Day-surgery units are defined as “self-contained, dedicated units, suitable for carrying out surgical procedures and treatments on adult and child patients whose discharge is planned for the same day as their admission" </blockquote>Day-care services mainly include day surgery, endoscopy, and medical investigation and treatment. Provision of a large theatre size is preferable to accommodate a variety of surgical procedures. The infrastructural requirements for a day-surgery unit theatre are principally the same as that of a general theatre.
	[[File:One-way patient flow through day unit.png\|alt=One-way patient flow through day unit\|thumb\|663x663px\|One-way patient flow through day unit]]		[[File:One-way patient flow through day unit.png\|alt=One-way patient flow through day unit\|thumb\|663x663px\|One-way patient flow through day unit]]

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	==Case Studies==		==Case Studies==
	[[File:Theatre and CSSD plan (Courtesy of Mitchells Plain (District) Hospital).png\|alt=Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)\|none\|thumb\|750x750px\|Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)~~<ref>MPDH Architects in Association</ref>~~]]		[[File:Theatre and CSSD plan (Courtesy of Mitchells Plain (District) Hospital).png\|alt=Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)\|none\|thumb\|750x750px\|Theatre and CSSD plan (Courtesy of Mitchells Plain [District] Hospital)]]



	[[File:Theatre and CSSD layout (Courtesy of King George V (District) Hospital).png\|none\|thumb\|1478x1478px\|Theatre and CSSD layout (Courtesy of King George V [District] Hospital)~~<ref>Osmond Lange Architects</ref>~~]]		[[File:Theatre and CSSD layout (Courtesy of King George V (District) Hospital).png\|none\|thumb\|1478x1478px\|Theatre and CSSD layout (Courtesy of King George V [District] Hospital)]]
	<br />		<br />
	[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)~~<ref>FGG Architects</ref>~~]]		[[File:Theatre layout (Courtesy of Edendale (Regional) Hospital).png\|none\|thumb\|1168x1168px\|Theatre Layout (Courtesy of Inkhozi Albert Luthuli Central Hospital)]]

	==~~References and~~ Regulations==		==Regulations==

	~~===References===~~
	~~<references />~~

	~~===Regulations=~~==

	*All local Municipal laws and regulations.		*All local Municipal laws and regulations.
Line 2,910:		Line 2,905:

	Fiona Stanley Tertiary Hospital, Perth		Fiona Stanley Tertiary Hospital, Perth

			== References ==
	[[Category:Clinical Services]]		[[Category:Clinical Services]]
	<references />		<references />