The usual practice for surgeon and others needing scrubbing- up is to change in a changing/locker room from street clothes into theatre clothes, waterproof apron and footwear and proceed to the scrub-up area.
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After scrubbing-up, they put on sterile gown, mask cap and gloves. Therefore, the scrub- up area should be in as close proximity as possible to the operating room and communicate with it through a doorway.
Space should be provided for two people to scrub-up simultaneously. The room should be so planned that gowning can be done without danger of contamination by splashing from the scrub sink.
The taps at the sinks should be at least 3 feet apart to give each person adequate elbow room. Space should be sufficient to allow people to pass behind those scrubbing-up without crowding them.
Taps should be at a height of 4?-4? above floor level. Elbow operated taps are more convenient than those which are knee or foot-operated.
2. Anesthesia Room:
The advantage to the anesthetist of a separate room for induction is that he can have close at hand all the apparatus and instruments he needs, and he and his patients are away from the bustle in the operating room while preparation for an operation is in progress.
An area of approximately 160 sq ft is essential for the working space and equipment. Nothing should be kept in the anaesthesia room except the equipment and drugs necessary for anaesthesia.
3. Substerilising Room:
Substerilising room is used both for washing used instruments and for sterilisation. In this case all lying up of trolleys is done in the operating room itself.
Division of the room into two portions with separate doorways into the operating room preserves a distinction between “dirty” and “sterile” procedures.
In such a plan, the substerilising room is between a pair of operating rooms with access from a lobby which also gives access to other rooms in the suite. The substerilisation room work should be kept to the minimum, generally restricted to flash sterilisation of instruments.
4. Anesthesia Equipment Room:
A separate room is necessary for the storage of anesthetic gases and anesthesia equipment. This room should be convenient to the operating room but should open into the corridor.
It requires outside ventilation either natural or artificial. A small amount of shelving will be needed.
The darkroom is furnished for spot development of films from operating rooms including fracture room. It should be equipped with a developing tank unit, film storage box, light proofing and sink.
6. Fracture Room:
A fracture room is needed in the OT suite. Fixed equipment includes a stainless steel work counter for preparation of plaster bandages. Adjacent to this is a plaster sink with plaster trap.
Viewing box is essential. A door with a minimum width of 4? to 6? (preferably 5?) will permit passage of a stretcher with a patient having extended traction of a limb. It is desirable to have a splint and plaster closet connecting with the fracture room.
7. Locker and Changing Room:
The locker rooms should be large enough to contain full length lockers for clothes and other belongings for as many people as need to change, and should include a washbasin and WC.
In addition, racks for theatre footwear, hooks for aprons, and shelves for caps and masks should be apart from a dirty linen container for discarded OT clothing. A few easy chairs, a writing table and chair complete the furniture.
Locker rooms are separately provided for doctors (separate for male and female), nurses, and technicians and nursing orderlies. If the number of visitors to the OT suite warrants, it may be expedient to provide a separate locker room for them.
8. Instrument Stores:
In the very small hospital, a separate instrument store may not be required as built-up cabinets in the corridors usually serve this purpose. In larger hospitals, a separate instrument store is almost a necessity. A minimum area of 150 sq ft should be provided.
Cabinets with glass doors are placed on each side of the room. The cabinets should have adjustable shelving not more than 15 inches deep.
9. Trolley Parking:
A trolley parking area can be a recess at the entrance of the OT suite.
10. Cleaner’s Closet:
The sweeper/Safaiwala or cleaner, as he is called differently by different people, is an essential part of the OT suite, moving from operating room to operating room. He must be provided with a closet in the OT suite for storing his buckets, mops, brushes and cleaning materials at one end of the clean corridor.
11. Viewing Gallery:
Observers’ (viewing) galleries were quite common in teaching hospitals till the sixties.
However, the view of the operating field was always unsatisfactory. The advent of closed circuit television has changed the situation now and viewing galleries in operating rooms have become a thing of the past.
12. Recovery Room:
The advantages of a room/ward for observation and nursing of patients immediately following surgery, where they can be watched until the anesthetist is satisfied with their condition are obvious.
Estimates of the number of beds to be provided in a recovery room vary. Anesthetists cannot forecast beyond doubt which patients they may wish to keep in the recovery room until their physical condition is sufficiently satisfactory for return to the surgical ward.
Ideally, the recovery room/ ward should provide for the greatest estimated number of patients to be operated under general anesthesia in one day.
Failing that, the number of beds should equal the average number of patient operated upon daily. At the least, provision of one recovery bed per operating room would be inescapable.
Opinions differ as to whether an open ward or single bedrooms should be provided in a recovery unit. The practice to provide an open ward with curtains which can be drawn between beds has been found quite satisfactory.
The recovery ward should be arranged in such a manner that all patients are clearly in the view of those who work around the nursing station with a good view of their faces.
Recovery room has accommodation for a utility room with sink, cupboard for instruments and drugs, and a desk. Oxygen and suction should be available at each bedside since either may be needed very quickly.
If beds are kept in single rooms, the doors must be wide enough to allow beds and any special apparatus which may accompany the patient lopes through easily.
Enough space should be left between beds for several people to attend to a patient simultaneously and use bulky apparatus.
Where insufficient space or other difficulties prevent the provision of a full-fledged recovery unit, it should be possible to provide a small recovery bay for at least two dents.
13. OT Supervisor’s Room:
The operation theatre suite nurse supervisor is responsible for the administration and supervision of nursing service in the OT suite.
The position is sometimes called OT assistant director OT services, OT matron and assistant superintendent OTs, and the title reflects the complexity of the administrative responsibilities.