Theatre Design

The operating suite consists of three key areas ..

• The preparation room

• The scrub room

• The operating theatre

Operating department is located where ..

There is low traffic flow (with one entrance)

What are the two areas of the operating department divided into?

• Clean areas

• Contamination areas

• A clear divide required between these areas

The clean areas are ..

• Operating theatre

• Scrub room

• Sterile storage area

The contaminated areas are ..

• Changing room

• Preparation room

What is the aim of the theatre layout?

• Reduce infection

• To comply with health and safety legislation

• To ensure the ease of movement

• To ensure easy cleaning and hygiene

Walls and flooring should be ..

• Easy to clean

• Impervious

• Non-staining

• Hard wearing

Flooring should be ..

Non-slip

What shouldn’t be in the operating theatre?

• Drainage systems

• Taps

Walls and flooring must be able to withstand ..

Regular wet/deep cleaning

Why are ceramic wall tiles appropriate within the operating theatre as long as they are disinfected regularly?

They are hard wearing but the crevices between the tiles can be difficult to keep clean and can harbour bacteria, dust and moisture

Why should the flooring be cove forming - travel seamlessly up the bottom of the wall?

To prevent a build up of dust and dirt (polyvinyl chloride) and is easier to clean

Why should flooring and walls, including the ceiling, should be pained using a light coloured waterproof paint?

For visualisation and staff wellbeing

Doors and windows

• A one-way system

• Double swinging door and self-sealing

• Doors kept shut

• Frosted and permanently closed windows

Why is a one-way system is required?

To prevent unnecessary traffic and reduce bacterial contamination

What’s ideal for doors?

Not to have handles

What are double swinging self sealing doors required for?

Allows scrubbed staff to move through without touching the door with their hands and to decrease bacteria counts in the theatre

What must doors be?

Fire proof

Frosted windows are required to prevent ..

Internal and external distraction

Why must windows be closed?

To decrease bacterial contamination

Why is good quality glass preferred?

To prevent condensation as this can increase the risk of infection

What is the ambient temperature?

20 - 21 degrees Celsius

What is the preferred humidity?

40 - 60%

A positive pressure ventilation system is required to ..

• Ensure 20 air changes per hour

• Performed through a pressure gradient system

• May also be used for temperature control

Temperature and Humidity

• Essential for patient and staff comfort

• The correct levels are also required to control bacterial levels in the theatre

Heaters

• Wall mounted or built into the wall panels - as better as built in, easy to clean but can be expensive

• Fans cause air and dust movement and should not be used - however they are much cheaper

• Ideally theatres should be warmed through the PPV system (warm air)

Ventilation

20 air changes per hour is required to ensure a fresh flow of air. This helps to prevent dust and insects from entering the theatre. A pressure gradient is set up between the clean and contaminated areas.

Aim of theatre rules ..

To prevent the spread of infection as SSIs are one of the most common causes of mobility in the surgical patient

Surgical Site Infections can lead to ..

• Prolonged recovery and delayed healing

• Surgery failure

• Surgery repetition

• Increased medical intervention

• Increased cost for the client

• Sepsis

• Pain

• Increase mortality

A few golden rules for theatre hygiene

• Decontamination prior to disinfection​

• Use a broad-spectrum disinfectant​

• Use designated theatre cleaning equipment​

• Use disposable cleaning cloths or paper towels ​

• Hot wash mop heads after every use (washing machine) ​

• Use PPE when cleaning and wash hands when finished!​

Who should monitored cleaning protocols?

A designated theatre supervisor

What should be done at the start of each day?

• All flat surfaces and lighting in the operating theatre should be wiped down using a broad-spectrum disinfectant

• This is called damp dusting as it removes the dust that has settled overnight

What must happen between surgical cases?

• Collect all instruments and place them into a cool water and detergent solution ​

• Collect all waste materials and dispose of correctly​

• Wipe down the operating table and instrument trollies using a broad-spectrum disinfectant​

• Clean any items that have come into contact with the patient ​

• Including patient monitoring devises​

• Check the floors, walls and other surfaces and spot clean ​

What should happen at the end of the day?

• Remove all furniture from the theatre and disinfect (including wheels)

• Empty waste receptacles, disinfect and re-line​

• Check ceiling, walls, floor and all other surfaces and disinfect ​

• Check and restock supplies​

• Dry vacuum and wet mop the flooring (start furthest away from the door) ​

Weekly cleaning should involve ..

• A more thorough clean

• All equipment should be removed from the theatre and thoroughly scrubbed using a broad-spectrum disinfectant (including wheels)

• All walls and flooring should be thoroughly scrubbed using a broad-spectrum disinfectant

• Equipment and maintenance (including ventilation system)

• Replace all equipment and record the weekly clean