Planning and rational layout of clean laminar flow operating room

2019-06-25 13:55:17   Editor: Yan Hong shares    0

Planning layout is the most critical part of the clean operating room construction, directly affecting the use of the clean operating department, and once completed, it is difficult to modify. The internal layout and channel form of the clean surgical department should conform to the principle of short-term functional flow and clear and clean, to reduce cross-infection, effectively organize the air purification system, and economically meet the clean quality requirements.


The quality of the operating room directly affects the success or failure of the operation. It is a symbol of the comprehensive technology of a hospital. The laminar flow operating room is more advanced than the ordinary operating room. It uses air cleaning technology to control the degree of microbial contamination. To meet the requirements of various types of surgery in order to achieve air cleanliness in the control space environment. The following are some views on the construction of laminar flow operating room (hereinafter referred to as "operating room").


First, the purpose of the operating room design


The operating room, as a working environment that reflects a high level of therapeutic medicine in the surgical field, should meet the following requirements:


1. All functions that meet the needs of surgery.


2. Require maximum protection of the sterile environment and reduce traumatic infections.


3. Requires the creation of a comfortable environment that is most conducive to work for medical staff.


Second, the basic conditions of the operating room design


1. Reasonable graphic design is the premise of the operating room design. In the construction, the surgical department is an important part of the overall design of the hospital. The configuration of the surgical department, the height of the floor, the distance between the columns, the relationship with other departments, etc. will It has a major impact on the overall hospital design. At the same time, the development of the hospital is changing with each passing day. We must leave enough room for development in the operating room. In medicine, we prevent the intersection in the hospital through reasonable flow design and layout design. infection.


2. Can fully consider its general and special functions, such as BCR, intraoperative radiotherapy, surgery on the same day.


3. In software design, the construction and design of the operating room automation control, operation management system, operating room arrangement, item management system, logistics system, etc. will provide a good overall operation of the operating room. Foundation and guarantee.


4. The central operating room must be sustainable.


Third, the main points of the operating room design

1. The best position of the operating room in the hospital. It is closely related to the central supply room, surgical ward, centralized treatment room, emergency department, clinical laboratory, pathology, radiology, etc.


2. Division of the clean area of the operating room. According to its functional requirements, it can be roughly divided into highly clean areas, clean areas, sub-clean areas and non-clean areas.


3. Maintain cleanliness. Management of entrances and exits. Division of low-clean areas and high-clean areas. Establishment of air-conditioning systems.



Fourth, the location and area of the operating room

1. Location and area of the surgical department within the hospital

The surgical department should prevent surgical infections, nosocomial infections and maintain a clean environment for the first purpose. Secondly, the position of the surgical department must be determined with the efficiency and safety of the surgery. The best solution is to use the entire level or the end of the surgical ward. Department. As much as possible to the central material supply room, centralized treatment room, special radiology treatment room on the same level or set up a dedicated elevator to connect with these departments.


2. Number of operating rooms

A. The criteria for designing 2 operating rooms per 100 beds seem to be the most common.


B. Japan’s Kobayashi pointed out the use of such a formula:


a) Operating room under normal circumstances: number of operating rooms = number of beds / 100 × (1.5 ~ 1.8)


b) Special, when a large number of operating rooms are required: number of operating rooms = number of beds / 100 × (1.9 ~ 2.4)


C. More detailed algorithm: number of operating rooms = B × 365 / T × 1 / W × 1 / N (B: total number of beds requiring surgery (including surgery, obstetrics, ENT, etc.)


T: average hospital stay days


W: Operating room working days throughout the year


N: average number of daily operations per operating room


3. The shape and size of the operating room:

In the operating room, the center is a rectangular operating table with surgeons, nurses and surgical instruments on both sides. The head is an anesthesiologist, anesthesia equipment, monitoring equipment, etc. There are roving nurses and other medical staff around the operating table. Therefore, the rectangle close to the square seems to be the most suitable for the operating room. Recently, in order to avoid the accumulation of dust and induce the flow of air conditioning return air, often cut four corners to make the operating room octagonal.


The wall of the operating room is equipped with equipment and equipment necessary for surgery. For example, power sockets, medical gas terminals, reading lights, instrument cabinets, surgical clocks, thermal storage, cold storage, etc. Therefore, the operating room is not The bigger the better. There are reports that the minimum must be ×, but with the advancement of medical care, the introduction of anesthesia equipment, surveillance equipment, special surgical equipment, we recommend that the general operating room should have an inner diameter of at least 7 ~ 6m × 6 ~ 5m.


The minimum area of the operating room is specified in the "Guidelines for Architectural Design of Hospitals and Medical Facilities" published by the American Institute of Constructors' Health Facilities:


A. General operating room 37.16 m2;


B. Cardiovascular and brain surgery operating room 55.74 m2;


C. Orthopedic operating room 55.8 m2;


D. The operating room under the endoscope is 32.6 m2. There are also three types of large, medium and small areas in China. We recognize the characteristics of each hospital and operating room, and take into account different needs as much as possible. Chiba in Japan The area of the aseptic operating room (BCR) of the affiliated hospital of the Chiba University School of Medicine is 75 m2 (×). The area of the cardiovascular surgery room of the Chiba North General Hospital affiliated to the National Medical University is 88.7 m2 (×).


Fifth, the type of graphic design of the surgical department

1. Streamline separation and plane type

One of the purposes of the operating room is to ensure maximum access to a sterile, clean environment and to reduce traumatic infections. As the name suggests, it requires that, although it is not possible to achieve sterility, the operating room-centered cleaning area and the surgical department The division of the boundaries of the outer non-clean areas, the setting of the intermediate sub-clean zone, and how to handle the flow or weigh of people and objects is still our design focus.


As the importance of operating room cleaning management is constantly being recognized, we have found that patients, physicians, nurses, staff, machines, and items in the operating room can be roughly divided into six types according to the stage of treatment and work:


1. Patient before surgery;


2. Patients after surgery;


3. Pre-operative staff;


4. Staff after surgery;


5. Pre-operative sterilization;


6. Equipment after surgery.


According to these six flow directions, it can be subdivided into dozens of plane types. Today, we introduce the most common five plane types to you.


2. The type of operation room

A. Central Clean Type: The doctors and nurses who wash their hands and the sterilization equipment enter the operating room from the central clean side. After the operation, they leave the room from the opposite side (outer aisle side). The patient's operating room Access is from the side of the outer aisle


B. Central Supply Type: There are sterilized materials transported by elevators or elevators, which are sent to the operating rooms through the central hall. Those who work in the central hall must enter the room after washing and changing clothes. Others The staff, including the hand washing doctor, the nurse and the patient, enter and leave the operating room from the side of the peripheral aisle. The used equipment is moved out of the operating room by the peripheral aisle side.


C. Side Supply Type: The layout of the layout is almost the same as that of the central supply type, except for the sterilization equipment around the operating room. The flow of the doctors, nurses, etc., and the patients are just the opposite.


D. Sanitary Recycle Type: From the viewpoint of preventing infection, it is considered that the treatment of contaminated equipment and pots and suction bottles after use is the most important. In this way, the equipment and operating room after use will be used. The waste generated is sent out from the side of the outer aisle. All other equipment, staff, patients, etc. are all in and out of the central side. This type of plane is called peripheral recycling type.


E. One Way Type: This type is that the flow direction of the patient, the staff and the equipment is carried out in one direction, and the reverse direction is not allowed. The cleaning flow is not allowed to intersect with the non-clean flow direction. It is the most thorough. Design.