Operation Theatre And Its Supporting Areas.

.For 200 Bedded Cardiac Hospital

Submitted by

Nausheen Fatima M.Arch III semester J.M.I

Flow diagram

Reference :

Pre-operative Patient Flow

Zones of OT
Zone 1 - Protective, which contains the reception points, change areas and trolley bays. It includes: Change rooms for all medical and paramedical staff with conveniences

Transfer bay for patient, material & equipments Rooms for administrative staff Stores & records Pre & post-operative rooms I.C.U. and P.A.C.U.
Sterile stores

Zones of OT
Zone 2 - Clean areas, which contain pre-operational holding, recovery and staffing tearooms. Connects protective zone to aseptic (sterile) zone and has other areas also like

-Equipment store room -Maintenance workshop -Kitchenette (pantry) -Firefighting device room
-Emergency exits -Service room for staff - Close circuit TV control area

Zones of OT
Zone 3 - Sterile area including the operating rooms, anesthetic rooms and setup areas. Zone 4 - Disposal area, Disposal areas from each OR & corridor lead to disposal zone, including the dirty utility, disposal corridor and c lean up areas.

General Layout of OT

Sub areas (excluding OT place)

Pre-operative check in area (reception) Holding area- This area is planned for IV line insertion, preparation, catheter / gastric tube insertion, connection of monitors, & shall have O2 and suction lines. Facility for CPR should be available in this area. Induction room (anaesthetic room). Post anaesthetic care units (PACU): preferably adjacent to recovery room. Additionally 80 sq ft (7.43 sq m) for each patient bed, clearance of 5 ft (1.5 m) between beds and 4 ft (1.22m) between patient bed sides and adjacent walls should be planned Staff room Sanitary facility for staffThe anaesthesia gas / cylinder manifold room / storage area-

Sub areas (excluding OT place)

Offices for staff nurse and anaesthesia staf Rest roomsLaboratory Seminar room- Since Store roomTheatre sterile supply unit (TSSU)- Within this area, following are desirable i. Temperature between 180-220C, humidity of 40%50% is the aim. ii. Air conditioned with 10-12 air exchanges per hour iii. Storage of sterile drapes, sponges, gloves, gowns and other items ready to use. iv. Option to store in from one side and remove from other side . v. Proper inventory to prevent running out of stock Scrub room-

Areas for OT and supporting services

S.NO. FACILITIES F.AREA M2 TOTAL AREA M2

A 12-

PROTECTIVE ZONE RECEPTION WAITING 10.50 35.0 10.50 35.0

34-

ANAESTHETIST & SURGEON EXAM. ROOM

DOCTOR CHANGE ROOM

3X14.0
2X14.0

42.0
28.0

5678-

NURSER CHAGE ROOM

TRAINEES CHANGE ROOM SANITORY THEARE STORE A- LINEN

14.0
14X2 10.50

14.0
28.0 10.50

98.0

98.0

B-APPLIANCES & MED STORE

C-INSTRUMENT & DISPOSABLESTORE 91011TROLLEY BAY AUTOCLAVE ROOM THEATRE WORK &PREPARAT ION

98.0
112.0 14.0 14.0 14.0

98.0
112.0 14.0 14.0 14.0

12-

GAS STORE

7.0

7.0

Areas for OT and supporting services

S.NO. FACILITIES F.AREA M2 TOTAL AREA M2

B 13

CLEAN ZONE A- PRE OPERATIVE ROOM (FOR EACH BED) 7.0 7.0

B- RECOVERY ROOM ( FOR EACH POST OPERATIVE BEDS) 14151617-

10.50 X4

42.0

NURSING STATION
ORA DUTY ROOM PUMP STORAGE ROOM (ONLY FOR CARDIO THORACIC SURGERY) BLOOD STORAGE & FROZEN SECTION 10.50 10.50 21.0 10.50 10.50 21.0

18192021-

X-RAY UNIT WITH DARK ROOM

SEMINAR ROOM OT. MARTON ROOM PANTRY

17.50
28.0 14.0 7.0

17.50
28.0 14.0 7.0

Areas for OT and supporting services

S.NO FACILITIES F.AREA M2 TOTAL AREA M2

C
21-

STERILE ZONE
ANAESTHESIA 14.0 14.0

2223-

CLEAN UTILITY
OPERATION THEATRE A- MAJOR OT X 3 VASCULAR THORACIC 5X CARDIC OT

14.0X4

56.0

42.0

126.0

56.0

280.0

B- MINOR OT
24SCRUB UP

28.0
10.50

28.0
10.50

D25-

DISPOSAL ZONE
DIRTY WASH UP ROOM ( COMMON FOR 2 OT) 14.0 14.0

Areas for OT and supporting services

CENTRAL STERILE SERVICE DEPARTMENT
S.NO. FACILITIES F.AERA TOTAL AREA

M2
12-

M2
28.0
21.0

RECEPTION
CHECKING / SORTING &GRADING

28.0
21.0

345-

CLEANING
AUTO CLAVE / STERELIZER PREPARATION / PACKING

14.0
35.0 28.0

14.0
35.0 28.0

67-

STORAGE
STERILE STORE

28.0
21.0

28.0
21.0

891011121314-

ISSUE COUNTER
STAFF CHANGE ROOM TROLLEY BAY OFFICE & RECORD TROLLEY / HAND WASH JANITORE CLOSET SANITARY

10.50
10.50 14.0 10.50 7.0 3.50 5.25

10.50
10.50 14.0 10.50 7.0 3.50 5.25

Recommendations for OT
Recommended size is 6.5 m x 6.5m . Doors: Main door to the OT complex has to be of adequate width (1.2 to 1.5 m) Electric point : Adequate electric points on the wall (at < 1.5 m height from the floor) Scrub area : to be planned for at least for 2-3 persons in each OT. Corridors not less than 2.85 m width for easy movement of men, stretcher & machines. Separate corridors for uses other than going into OT.

Types of OT complxes
The Single theatre suite with, scrub-up and gowning, anesthesia room, trolley preparation, utility and exit bay plus staff change and limited ancillary accommodation.

The Twin theatre suite with facilities similar to 1, but with duplicated ancillary accommodation immediate to each OT, sometimes sharing a small post anesthesia recovery area

Hybrid OT combine the traditional diagnostic functions of a cath lab with the surgical functions of an operating room

Hybrid OT layout

Hybrid OT layout

Hybrid OT layout

Room Size
A hybrid OT should be larger than a standard OT The operating room should ideally be between 50- 85 square meters, with a minimum clear area of 37- 45 square meters. Staff calculation for hybrid OT- 8-20 people

Step up of a hybrid OT at Rikshospitalet in Oslo, Norway.

Hybrid OT recommended area is at least 70m2

Additional space for control room and a technical room is mandatory , adding up with washing and prep rooms to a total of approximately 150m2

Twin OT Layout

Twin OT layout