Theatre Design Flashcards by Shona Jack

What are the four prime requirements of a theater

easily cleaned
safe environment
comfortable
control and prevention of infection

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Name Eight construction points of the theater design

Hard wearing
Easily washable and waterproof
Horizontal surfaces - minimal
Edges - rounded

Plugs - waterproofed and recessed
Flooring - hard wearing, non-porous, non-slip
Air - filtered and higher pressure
Temperature - 15-20 C

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four things that should be recessed into the wall

Radiography viewer/ Computer Monitor
White Board
Wall Clock
Plugs

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Name two properties of the materials used in the construction of exposed surfaces in the theater

non-porous

impervious to harsh cleaning agents

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describe the requirements for entry/exit doors to theater

Maximum of two doors leading into theater
Two-Way swinging doors to allow free passage without using hands or arms to open
Doors should be used as little as possible to reduce air currents

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describe the ideal air in theater

Air pressure should be higher than in other rooms
Ventilators should have filters to remove bacteria
12 air changes should occur hourly

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maintenance equipment used to clean the theater should not be used in other areas of the hospital
T/F

True

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Name three items of clothing personnel should wear when entering the theater

Cap
Mask
Freshly laundered scrub suit

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Surgical personnel should understand (non) sterile boundaries and adhere to principles of aseptic technique
T/F

True

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Name 6 roles of the circulating nurse

IPAPER

In attendance when surgery is in progress
Positions the patient
Attaches equipment
Preps extra instruments
Extra pair of eyes and ears
Records information

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Name 6 roles of the scrubbed nurse

PAPRCF

Preps instrument trolley and is responsible for everything on it
Assists the surgeon
Passes instruments and swabs
Retracts tissues
Cuts sutures
Familiarity with the procedure

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Name 10 common breaks in aseptic technique

Jewelry
Long dirty nails
Exposed hair
Skin Conditions and Touching the Face
Respiratory conditions
Loose fitting masks
Wet hands
Wet Drapes
Touch contamination
Torn gloves
Leaning over sterile area
Too many visitors
Opening contaminated gut/viscera
Soiled gowns

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Name the 7 components of the theater suite

Sterile storage area
Scrubbing up area
Changing rooms
Recovery room
Operating suite
Prep area
Washing/ Sterilization area

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Name 8 pieces of ancillary equipment

Pulse oximeter
ECG
BP monitor
Capnograph
Oesophageal stethoscope
Operating light
Restraint, lifting and positioning equipment
Additional surgical instruments
Diathermy
Suction unit

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Name 5 features of the ideal ops table

Height Adjustable
Tilt function
Drainage
Heated top
Hooks for securing positioning ties
Castors for easy maneuvering

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Name 4 positioning aids

Sandbags
Ties
Trough
Foam Wedges

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Describe 4 types of lifting equipment

Blanket
Stretcher (soft or with a frame)
Hoist (electronic, wheeled or manual/sling)
Trolley

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describe how the patients head should be positioned for transportation while anesthetized/ unconcious

Head and neck should be pulled forward

tongue can be pulled forward and tucked under the lower jaw

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What is diathermy used for

cutting and coagulation of tissue by applying heat produced by high frequency electrical current

continuous waveforms cut tissue
interrupted waveforms aid coagulation

Why use diathermy

can reduce surgical time

reduces amount of suture material required

allows rapid control of haemorrhage

Enables visualization of surgical field

Describe the two types of diathermy

Monopolar

used pencil finger switch
Pt must be earthed

Bipolar

activated by foot pedal
earth plate not required; current passes through tips of the forceps across the tissue

Name 4 uses of a suction unit

aspiration of the oropharynx and nasopharynx
in endoscopy units
suction of fluid and blood during surgery
thoracocentesis following surgery

Describe the heating that can be used in theater

wall mounted radiators are difficult to clean
panel heating in walls or underfloor is ideal
ambient temp 15-20C

Do not use fan heaters - can cause dust and air movement

Describe the lighting used in theater

use natural daylight where possible
lighting should be concealed in ceiling or wall
plus portable overhead light
good lighting is essential

Describe the ventilation used in theater

should provide min. 12 air changes per hour positive ventilation system recommended to allow higher air pressure compared to the next room to reduce airborne bacteria entering theater

Why do some instruments have gold handles

to indicate they have Tungsten Carbide inserts in the tips for a strengthened gripping surface

describe the cleaning procedure at the start of the day

damp dusting of all surfaces and furniture using disinfectant solution removing traces of dust that may have settled overnight

describe the cleaning procedure between cases

wipe clean the table, trolley, stands, equipment, leads, kick bucket with disinfectant all waste should be removed and appropriately disposed of floors should be mopped if dirty, inc under table if fluids

describe the cleaning protocol at the end of the day

all waste material should be removed and disposed of wash down surfaces, equipment, table, lights, scrub sinks with disinfectant floor should be swept to remove debris and hair then mopped using disinfectant

Describe the weekly cleaning protocol for the theater

all equipment should be removed, floors and walls should be scrubbed use a broad spectrum disinfectant with detergent properties. this should be left to dry, not rinsed all equipment should be meticulously wiped over

name three surgical categories in terms of urgency

emergency necessary (urgent) elective (non-urgent)

name four surgical categories in terms of infection potential

clean clean contaminated contaminated infected

describe clean surgery

a wound made aseptically, does not enter contaminated viscus, no break in sterile technique

give an example of clean surgery

spay | orthopedic

describe clean-contaminated surgery

a wound made aseptically, the wound enters the oropharynx, respiratory, alimentary or urogenital tracts. no source of contamination.

give an example of clean-contaminated surgery

lung lobectomy traceotomy gastrotomy ceaser

describe contaminated surgery

a major spill of contaminated material or break in sterile technique, entry into viscus with bacterial load

give an example of contaminated surgery

oral surgery cystotomy ex lap into the large intestine

describe infected surgery

surgical site is known to be infected

give an example of infected surgery

pyo infected wound abscesses

give four reasons for delaying surgery

investigative/diagnostic procedure required fluid therapy or transfusions required other injuries which require treatment first stabilization of the patient eg. diabetic, shock client consent required

how can infection be reduced intra-operatively

* adhere to aseptic technique * change instruments, drapes, gloves and gown if long op or working with infected tissue * lavage op site with sterile fluids * antibiotic cover for long ops * reduce number of people in theater/ traffic

name 4 factors which contribute to SSIs

the patient the surgeon the surgical site the environment

name 2 advantages of using alcohol over medicated hand prep

longer duration of efficacy rapid action dont need to dry hands wider spectrum of activity

which combination of skin prep is most effective

70% alcohol and 4% chlorhexidine

which preventative measure contributes to the greatest reduction in SSIs

effective hand hygiene