Chapter 5 Flashcards
Where is the general location of the surgical department?
In an area that is easily accessible to departments such as ED, L&D, ICU, CSPD, along with areas with limited traffic and the general public does not have access.
What is the goal of surgical department designs?
quickly providing each operating room (OR) with the necessary supplies during and after each case, while keeping clean and contaminated traffic patterns separate.
What are the different surgical department designs?
Race track plan.
Hotel plan.
Specialty grouping plan.
What does the race track plan look like?
A series of OR’s around a clean central core. the front entrance to each OR is from the outer corridor, and supplies are retrieved through a rear entrance to the room leading to the central-core storage and work areas. The soiled entrance areas are situated outside this central-core area to allow for separation of the two areas and related traffic. Scrub sinks are also situated in the outer corridor with easy access through the main entrances to the OR.
What does the hotel plan look like?
the ORs are situated along a central corridor, with separate clean core and soiled work areas. The primary difference in this plan is that all traffic enters and exits the surgery department through a single entrance or a primary entrance and holding area entrance situated along the same corridor.
What does the specialty grouping plan look like?
ORs are grouped by specialty (e.g., neurosurgery, general surgery), each with its own closely associated clean storage areas and, in some cases, each with its own soiled instrument work area.
What are some proper storage techniques?
Not placing sterile packs too close to ceilings or floors
Temperature should be between 68-78 degrees
Relative humidity should be from 20-60 percent (defined by ANSI)
Separate storage rooms are used for large equipment such as OR tables
What can you wear in an unrestricted area
Street clothes
What can you wear in a semi-restricted area?
Scrubs and hair cover
What do you have to wear in a restricted area?
Everything plus mask
What are some unrestricted areas?
Registration- health history is reviewed, additional testing is completed, pt questions are answered
Pre-op holding- Pt is prepped for holding; IV’s/lines are established, regional blocks are administered, and room is shielded from view of OR
PACU- pt is transported to recover from surgery
Lab
Radiology
Pathology- Specimens are sent for diagnosis.
What are some semi-restricted areas?
Decontamination and assembly rooms- contaminated supplies are sent to be washed
Central Supply and Processing (CSPD)- Supplies are sterilized and instruments are put into sets or packs.
What are some restricted areas
OR Suite
Substerile room- contains a sink and an autoclave steam sterilizer for cleaning and immediate use steam sterilization
What are components of electrical outlets in the OR?
They are kept higher up to prevent fluids splashing, some are red (connected to generator), and extension cords should never be used.
What connects to the two suction outlets in the OR?
Anesthesia will use one and the surgical team will use the other
How are gas outlets color coded?
Oxygen is green
Nitrous oxide is blue
Compressed air is yellow
nitrogen is black
(there must be emergency shut off valves outside the OR)
What are some components of surgical lights in the OR?
Provide a range of intensity and focus, horizontal and vertical range, provide glare-free illumination, light handles allow you to adjust, focal point should not leave a dark center in the middle, easily accessible for cleaning
-Non glare (blue/white beam)
-Non reflective instruments (ebony)
-Non-reflective colors (blue/green to prevent eye fatigue)
What are some restrictions for the supply room/core
12-18 floor/ceiling requirements
Temperature 68-73 degrees
Humidity 20-60% (regulated by ANSI)
separate storage for large equipment
What are some components of electrical outlets in the OR?
Mounted above the floor to prevent splashing
On a GFI system (110v or 220v)
Red outlets are connected to generators
Extension cords should never be used
What ventilation system is used in the OR/Why is it used?
Positive uni-directional (Laminar)
It removes airborne contamination, removes anesthetic gases/ toxic fumes, and provides a comfortable working environment
How many air exchanges must happen within the OR?
20-25 per hour
How much air in the OR must be fresh (come from outside)
20%
Which filter is used in the OR?
High efficiency particulate air filters (HEPA) filters. They remove particles as small as .5-5 micrometers
What should the temperature in the OR be kept at?
68-73 degrees; 69 is optimal
What should the humidity in the OR be kept at?
20-60%
(for comfort, decrease of static discharge, and infection control)
What are some components of doors in the OR?
Should be kept close during all procedures and traffic going in and out should be limited.
What are some components of computers in the OR?
They are used to chart, view labs, access DPC’s, and for the family to receive patient update status
What are some components of viewing boxes in the OR?
They are mounted in the OR so they can be seen by the sterile team
What are some components of cabinets in the OR?
They are mounted in the wall to prevent buildup.
What is a surgical boom?
They are articulating arms that are mounted from the ceiling containing shelving for equipment, monitors, and outlets.
Know OR Equipment
What are some components of OR tables?
There are a wide variety (fracture, urology, wilson frame); They are narrow, padded, flexible, and cleanable; They have breakpoints and the knees, waist, and head; It has removable sections at the head and foot; Adjustable height.
Back Table
large table on which a back table pack is placed and opened to create a sterile field. Sterile equipment, instruments, and supplies are then placed on this table for the CST in the first scrub role to arrange for use during the surgical procedure. The back table also serves as an area for the circulator to open additional sterile supplies that are needed during the surgical procedure.
Mayo Stand
small stand that is moved up to the operative field and extends across the patient. The height is adjustable and it is draped with a sterile Mayo stand cover. The CST in the first scrub role obtains the surgical instruments that will be used most often from the back table and places them on the Mayo stand.
