1. Work Organization in the Surgical Department

Question 1

1. Areas of different restriction level (examples, requirements)

Answer 1

Levels:
1. Restricted area: operating rooms, sterile supply room, scrub sink area-req.: scrub suit, hair covering, mask, clean shoes/shoe coverings (+mask, gloves) (MOST CLEANEST AREA)
2. Semirestricted area: hallways between operating rooms, instruments and supply processing area, storage area, utility rooms, nurse’s workstation-req.: scrub suit, hair covering, mask, clean shoes/ shoe coverings (same as restricted area).
==>restricted areas separated from unrestricted areas by locker room, No food and drink in these areas.
3. Unrestricted area: central control point monitoring entrance into restricted area, anesthesia and preparation rooms, dressing rooms, lounges, offices-req.: scrub suit. > patients clipped and vacuumed, initial surcigal preparation, soiled linen and trash kept in unrestricted area.

Question 2

2. Traffic patterns between areas : surgery planning (order in which they should be carried out)

Answer 2

Unrestricted area > semirestricted area > restricted area > unrestricted area.
positive air pressure: air flows from clearest areas to least clean area: high to low air pressure.
Movement of contaminated and sterile equipment separated. Minimize traffic in/out of rooms-movement of airborn contaminants reduced.

Question 3

3. Different rooms in surgical department, their objectives and requirements

Answer 3

1. Operating room/threatre: req.: large enough for equipments and personnel, only necessary equipment, soft, white light with regulated intensity, no heating effect, 360 degree rotation, adjustable surgical table, ventilation, optimal airflow, 17-20 degree and less than 50% humidity (HEPA-filter), easily cleanable surfaces.
2. Scrub sink area, gowning and gloving area: SSA-centrally located, ideally motion-sensitive, only for scrubbing hands, never to clean equipment/dispose of body fluids, antiseptic soap, scrub brushes, fingernail cleaners. GGA-separate from scrub sink area, inside or outside operating room.
3. Nurse’s workstation, instrument and supply processing area, storage: -NW(also instrument processing)-centrally located in surgical area, cleaning , sterilization of instruments, surgery log, surgery (ane) protocols, autoclave refrigerator, blanket warmer, formalin containers, should be divided into 2 separate areas to prevent cross-contamination. -Storage: everything in surgery been used to, but unnecessary for current procedure, can be combined with nurse’s workstation.
4. Anesthesia and patient preparation room: necessary equipment and drugs organized, transportable crash cart advisable, 17-20 degree, less 50% humidity.
5. Minor (septic) procedures operating room: separate room adjacent to anesthesia preparation area, minor contaminated surgical procedures, equipments: operating table, spotlight, gas, suction lines, suture material, instrument packs, antiseptic preparation materials.
6. Patient recovery room: oxygen supply, warming possibilities, monitoring, 21-25 degrees.