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Aseptic and Septic Operation Theatre Orientation. Introduction Heart of an hospital-OT Team Skilled Surgeons Nurses MLOP Anaesthetist. Separate theatres for septic and aseptic surgeries Aseptic Theatre:- Cataract PKP Squint Retina Glaucoma Septic (Minor Theatre):- - Enucleation

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aseptic and septic operation theatre orientation
Aseptic and SepticOperation Theatre Orientation

Introduction

  • Heart of an hospital-OT
  • Team
    • Skilled Surgeons
    • Nurses
    • MLOP
    • Anaesthetist
slide2
Separate theatres for septic and aseptic surgeries

Aseptic Theatre:-

  • Cataract
  • PKP
  • Squint
  • Retina
  • Glaucoma

Septic (Minor Theatre):-

-Enucleation

  • Evisceration
  • DCR
  • DCT
  • Infected Cases
planning of ot
Planning of OT
  • An should have
    • High standard of asepsis
    • Maximum standard of safety for patients and staffs
    • Optimum utilization of space and staff time
location of aseptic theatre
Location of Aseptic Theatre
  • The Location Should be
    • Free from general traffic Eg: Away from road side
    • Free from noise and other disturbance
    • Free from contamination and possible sources of infection
    • Closure to ward
operation theatre zones
Operation Theatre Zones
  • Four Types of Zones
    • Sterile Zone
    • Clean Zone
    • Protective Zone
    • Disposable Zone
slide6
Sterile Zone
    • Operation Room
    • Scrub room
    • Anaesthesia room(Block room)
    • Instruments sterilization
slide7
Clean Zone:-
    • Pre operative block room
    • Nurses work room
    • Recovery room
    • Anaesthesia /Medication store
slide8
Protective Zone:-
    • Reception room in OT
    • Waiting room for relative of patient
    • Dress changing room
    • Pre Anaesthesia room
    • General store room
    • Main Autoclave room
    • Trolley lay,Wheel chair,Stretcher
    • Control area of electricity
slide9
Disposal Zone:-
    • Dirty /Blood stained linen
    • Used head caps,mask,socks
    • Solid materials both disposable and non disposable should move with outcrossing sterile & clean zones.
operation room
Operation Room
  • Contains:-
    • Airconditioning –maintains asepsis
    • Operating table
    • Adjustable chair for surgeons
    • Instruments trolley
    • Microscope & other necessary equipments,Phaco machine etc
    • A working space of around 1. 2 m around operation table
    • IV stand tray and fluids
    • One Bowlstand for rinsing hand with sterile water.
instruments
Instruments
  • Surgical instruments sets and different ocular surgeries
  • Bipolar diathermy with points
  • Vitrectomy machine with vitrectomy probes
  • Boyle apparatus for GA
sub sterilizing area
Sub sterilizing Area
  • Instaclave with cheatle forceps and container
  • Stainless steel basin for cleaning the instruments
  • Electric water drums for boiling water or drum with clean sterile water.
  • Soft brush for cleaning the Instrument & instrument cover
  • Adequate water supply
scrub area
Scrub Area
  • Sink with running water facility
  • Hands should not touch surface of sink
  • Scrubbing Solution (Chlorhexidine, Iodine 7.5%)
    • With Soap and brush
    • 6 minutes for scrubbing
    • First one minute for two times using soap then 2 minutes used for solution first time scrubbing with brush and full fore arm
    • Second 2 minutes with scrubbing solution for proximal half of fore arm
location of septic ot
Location of Septic OT
  • Located at a place which has limited access to patients
  • Closure to ward
  • Away from aseptic OT
  • Should have separate dressing room,scrub room,sterilization section
  • Should have good ventilation
  • Good lighting system
  • Instruments and eye towels should be sterilized separately from other than linen like coats.
  • Flash autoclave or sterliser-in between cases
staffing pattern
Staffing Pattern
  • OT Manager is usually OT Nursing officer
  • OT Manger has to ensure
  • Availability of equipments ,instruments and nursing staffs
  • Proper care and maintenance of equipments
  • Theatre cleaning and sterility
  • Adherence to work discipline
  • Maintenance of OT records
  • Relationship with other departments
staff allocation
Staff Allocation
  • Operation area
  • Scrub nurse- 2 for 1Surgeon
  • Circulating nurse-1for 1 Surgeon
  • Block room-Local –1-3 persons,GA-2 persons
information board
INFORMATION BOARD
  • Notice board for display of daily operation
  • Schedule with details at entrance of OT
  • Helps to begin the preparations without delay
roles of mlop in ot
Roles of MLOP in OT
  • Circulating MLOP:-
    • To give nursing care to patients during preparation for the surgery
    • Checks the case sheet
    • Helps doctors in giving local anaesthesia and counseling to the patient .
    • She makes available the sterile things and medicines supplied needed for surgery
scrub mlop
Scrub MLOP
  • Scrub MLOP is a well trained person,who will be familiar with procedure of surgery
  • She assists the surgeon through out the surgery
  • Helps to wear sterile gown
  • Arranges instrument trolley
dress code
Dress code
  • Should wear only special theatre dress to minimize cross infection.
  • Should not leave outside OT with theatre linen
  • Caps must be worn to cover the hair completely
  • Face masks must be worn.
  • Dress colour-preferably light blue,green
slippers and overshoes
Slippers and Overshoes
  • Should remove personal slippers outside OT
  • Feet must be washed
  • Theatre slippers should be worn
  • Slippers should be scrubbed after use daily
  • Theatre slippers should not be used outside the theatre
a dedicated ot mlop
A dedicated OT MLOP
  • Should have a same of sincerity ,honesty and punctuality and compassion to all the patients.
  • Should have sufficient knowledge of medical terms
ot discipline
OT Discipline
  • MLOP should come early before the start of surgery
  • Take all responsibility to arrange the theatre,ready to the patient and allocate the surgeon
  • Eating or drinking tea or coffee should be strictly prohibited in OT area
personal hygiene
Personal Hygiene
  • Hairs and Nails must be kept clean and short
  • No Nail polishing or jewellary
  • Cuts and abrasion should be corrected and reported to incharge person
  • Infectious diseases like common cold should getprompt and complete medical treatment
patient hygiene
Patient Hygiene
  • Should have their bath and wear clean dress
  • Diabetic ulcer patient Hansen or other infected diseases should be operated at the end
  • Disposable cap and shoes to every patient
key point to remember
Key Point to Remember
  • OT should be located away from pollution (Noise & Air)
  • The attender /visitors should not be allowed to stand in front of OT
  • MLOP should check the working conditions of equipments , electrification etc prior to surgery
  • MLOP should take responsibilities to inform/make arrangements for repair and replacement of equipment.
  • An extra supply of instruments should be available at request.
  • An extra supply of all OT dresses must be available for visitors and staffs
  • The medical personal should strictly follow the theatre discipline
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