Planning and Designing of OT

7/31/2019 Planning and Designing of OT

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PLANNING AND DESIGNING OF

OPERATION THEATER

BY PAUL PRIYARAJ.J


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OPERATION THEATER(OT) Operation theater so called in the United Kingdom because they

traditionally consisted of semicircular amphitheater to allow

students to observe the medical procedures.

It is also called as operating room or surgical suite(which includes

entire surgical facilities like operating rooms, hall, ways,

workrooms, storage and front desk etc).

The oldest operating theater is in London, which was built in the

year 1822 and the other one is in Boston, dating back to 1824.


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DEFINITION

OT is that specialized facility of the hospital

where life saving or life improving procedures

are carried out on the human body by invasive

methods under strict aseptic conditions in a

controlled environment by specially trained

personnel to promote healing and cure withmaximum safety, comfort and economy.


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AN INSIDE VIEW OF OPERATION TEATER


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AIMS OF PLANNING To promote high degree of asepsis

Ensure maximum safety to patients and staff

Ensure maximum standard of safety.

Optimize utilization of OT and staff time.

Optimize working conditions. Patient & staff comfort in terms of thermal, acoustic and lighting

requirements.

Allow flexibility.


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Facilitate coordinated services.

Minimizes maintenance.

Ensure functional separation of spaces.

Provide soothing environment. Regulates flow of traffic.


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CRITERIA FOR PLANNING

Environmental Criteria

Economic Criteria

Work flow Criteria

Functional Criteria


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PHYSICAL FACILITIES

LOCATION

The best location for the OT is which permits a convenient

and uncomplicated flow of patients, staff and clean supply

traffic. It should be close to surgical wards and ICU and shouldreceives patients from the floor through non public corridor,

elevators and ramps. Convenient access to elevators is also

essential.


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ORIENTATION

Northern orientation of operation theater is considered to be

most suitable to ensure adequate day light within the theater

and to avoid glare.

Physical layout of operating room should be excluded of

contamination from outside area with proper traffic patterns

within the suite and separation of clean areas from

contaminated areas within the surgical suite.


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LAY OUT OF OT


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FACTORS DETERMINING THE

NUMBER OF OT Type of Hospital Hospital bed compliments

Number and type of surgical patients

Number and type of surgical specialties Number and type of surgeons

Number of operation per day

Average length of stay of surgical patient

Hospital Policy


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Estimated cleaning time for OT between surgeries

Allowance for emergency surgeries

Allowance for septic cases

Allowance for staff breaks


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NUMBER OF OT(COPP-1964)

No of OT Required

No of hospital

beds

Indoor OPD + Emergency

300

500

750

1000

Minor Major Minor Major

2 3 1 X

2 5 1 1

2 8 1 1

2 10 1 1


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SIZE OF THE OPERATING ROOM

General Operating Room 40 sq.meter.

CVTS, NEUROLOGY, ORTHOPEDICS 60 sq.meter and

additional adjoining room is required for Heart Lung Machine.

Endoscopy suite will require Procedure Room 20 sq. meter.

For OT of 200-300 bed hospital the optimum size is 18 x 18

to 18 x 20 but not more than 400 sq. feet.


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ZONING OF OT The OT is divided into 4 zones;

1. PROTECTIVE ZONE

2. CLEAN ZONE

3. STERILE ZONE

4. DISPOSAL ZONE

1.PROTECTIVE ZONE

This is at the entrance of operating theater. The main facilities

which lie in this area are:


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a. Patients waiting area and reception

b. Trolley bay

c. Lifts

d. Stairse. Switch room

f. Pre anesthesia room, changing room, store room.


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2. CLEAN ZONEIt provides

a. Pre-operating room

b. Recovery room

c. Theater work room

d. X-ray room, plaster room

e. staff nurse room and anesthesia store room


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3. STERILE ZONE

This zone will include:

a. Operating Suite in particular

b. Scrub room

c. Anesthesia roomd. Instruments trolley area

4. DISPOSAL ZONE: It will include dirty room, disposal corridor

and janitors corridor.


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DESIGN PARAMETERS OT should be planned so as to ensure:

Avoidance of unrelated hospital traffic flow in the area.

Convenient functional relationship and communication with

surgical ward, ICU, CSSD, blood bank, medical imaging and

laboratory services.

Avoidance of outdoor source of noise.

Provision for future expansion/alterations.

The walls should be galvanised iron/ Stainless steel panels,

joints filled with epoxy and the surface is treated with anti

bacterial paint.


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Hermetically Sealed Automatic Sliding Door

Hermetically Sealed Automatic

Sliding Doors are preferred in

the laminar flow operating

theatres.


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FLOORSIt should be fire resistant and

should have only high quality

antibacterial rubber floorings.


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WALLS

Walls and ceiling should be

aesthetically pleasingnonporous, fire resistant,

water and stain proof,

seamless, non-reflective and

easy to clean.


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CEILING

It should be cement plaster with

washable paints. Corners should be

rounded off for easy cleaning.


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COLORING OF OT

Light Blue or Egyptian yellow is preferable.

AIR CONDITIONING

a. Desirable Temperature is 22 C.

b. Minimum of 10-14 air changes per hour with 50% humidity.

c. 1.5 Ton capacity of AC per 18 Sq. Meter is adequate.


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ILLUMINATIONS

a. OT.General 400 LUXb. Operating Room 1000 LUX

c. OT.Cavity 5000 LUX

d. Recovery Room 300 400 LUX

e. Other Area 150 300 LUX


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FIRE PROTECTION, FIRE DETECTION AND FIRE

FIGHTING;

a. Alarm system for fire detection.

b. Fire extinguisher and fire hydrants should be provided.

c. Fire exit routes to be clearly earmarked with red paint and well

illuminated.

WATER SUPPLY;

500 Liters/bed/day is the normal requirement.


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ELECTRICITY:

Normal requirement is 3kV/bed/day. There should be provisions

for inverters and standby generator facility. All electric wiringshould be concealed.

Following physical facilities must be provided in

operating theater complex: Reception and office - 140-160 Sq. feet

Transfer area

Entrance

Cloak room - 80 100 sq. feet


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Surgical Scrub Sink

Taps in the scrub room

should be knee/elbow

operated.


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X-Ray Viewers

There should be X-

ray film illuminators

preferably recessed

into the wall.


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Pressure Differential Meter

This device providesconvenience to monitor air

pressure inside the modular

operating theatres


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Pass Through Boxes

Pass through boxes withinterlocking systems are

used where clean zone

needs to be isolated from

unclean area.


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Recovery Room: A special ward for reception of patient

immediately after surgery.

The require size is 70-80 sq. feet/bed.


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OT should have facilities for high speed autoclaves/ sterilizers for

immediate/emergency requirements of sterilizing equipment.


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Control Panels

Surgeon Control Panels are

individually designed and

customized for each hospital

project.


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Stainless Steel StorageCabinets for OperatingTheatres

Storage cabinets should be

embedded in wall panels

to enhance the usability

and also maintain the

hygiene of operating

theatres.


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Direct Digital ControlSystem

High tech innovative directdigital control systems (DDC)

provides the complete

information as well as

freedom of controlling

temperature, humidity etc

from touch screen surgeons

control panels.


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EQUIPMENTS OF OT

1. OT tables

2. Anesthesia machines

3. Anesthesia ventilators

4. Defibrillator

5. Neonatal multi parameter monitor6. Cautery machine

7. Central suction

8. C-arms


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9. Phako emulsification machine

10. AO drilling system

11. Arthroscope

12. Endoscopic surgery system

13. Lithoclast & Lithotripter

14. The equipments in cardiac surgery OT

Heart lung machine

Octopus

Defibrillator

Fibrillator

Multiparameter


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Hemotherm

ACT machine.


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THANK YOU

Planning and Designing of OT

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