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KNOWLEDGE

Clean operating room management

| 2006-09-28

First, the establishment of infection control team


 This is a prerequisite for improving the working system and implementing quality standards. Hospital infection control by the hospital staff, section chief, head nurse, infection control nurses, general nurses, disinfection nurses, maintenance personnel to form a monitoring group.


Its responsibilities:


① responsible for the establishment of the operating room operating system and quality standards, making management has rules, quality evaluation of quantitative standards.


② hospital infection control staff on a regular basis for quality inspection;


③ nurse supervisor to implement the working system and weekly inspection;


④ general nurses responsible for the implementation of health and cleaning work and inspection;


⑤ infection surveillance nurses are responsible for the surgical environment, the surface of the items and the hand of the operating personnel monitoring, analysis of results, data storage and information reporting;


⑥ disinfection nurses responsible for the implementation of disinfection items, sterilization;


⑦ equipment maintenance personnel responsible for cleaning air conditioning unit testing, cleaning and maintenance. Combine with the environmental quality inspection system to cultivate good working habits of operating room staff and form a well-organized working atmosphere in which everyone is involved in the management.


    Second, strictly implement human, material and clean, dirty their own way


    Clean surgical department is the air, people, logistics units gathered, is the coexistence of pollution and sterile sites. To improve the cleanliness of the surgical department and reduce the incidence of infection, under the reasonable airflow - air purification conditions, we must strictly human, physical distribution, cleaning, sewage diversion to ensure the cleanliness of the clean air and surgical procedures need surgical procedures . The staff enters the restricted area after changing clothes from the unrestricted area to the restricted area and enters the operating room from the inner corridor door of the clean area. After the patient is dressed, the lift enters the hall of the operation department and enters the operation hall through the lift. Operating room. Aseptic surgical package between the surgery by the corridor to the sterile or surgical room, surgical instruments and dressings contaminated by the outer corridor sent to the disposal. The implementation of the staff channel, aseptic channels, the patient access and sewage channels of the process, people, logistics, cleaning, sewage stream tends to rationalize.


    Third, rational use of different cleanliness of the operating room


Surgery Division I, Ⅱ, Ⅲ, Ⅳ (negative pressure) between the surgery. Negative pressure surgery in the outermost surgical department. Aseptic surgery according to different cleanliness were arranged for different surgery. Class I special clean surgery arrangements for brain surgery, cardiac surgery, joint replacement, organ transplantation and other operations, Class III standard clean operation arranged thoracic surgery, plastic surgery, urology, hepatobiliary and pancreas and other general surgery aseptic surgery. Class Ⅲ and Ⅳ General clean surgical arrangements for general surgery, obstetrics and gynecology, emergency surgery. Then Taiwan surgery, should do aseptic surgery and then do infection surgery. Do not perform both aseptic and infectious procedures in the same surgery. Special infection surgery must be strictly carried out after the implementation of the operating table disinfection of the surface and the environment, and the implementation of surface and air culture standards before they can be enabled.


    Fourth, to strengthen staff management


A full-time guard control staff access, surgical staff according to "surgery notice" list, check into the operating room by the computer; undergraduate doctors (including training, intern) to visit undergraduate surgery, should be in the "surgical notice" is marked Visitor name, issuing operating room key card, with the card before entering. A surgery, large-scale operation of the visiting staff no more than 5 trips, no more than 3 between the small surgery, not more than 20 times a day. To carry out special surgery, can be set to broadcast broadcasts to visit.


    Visitors to surgery, need to contact the relevant departments of the hospital in advance, and fill out the "visit the surgery application form" before entering. Visit the operating room construction or management, should be 1 day in advance to apply, with the consent of the operating room before visiting. Generally only allowed to visit the semi-restricted area and visit the corridor to visit the restricted area, to enter the restricted area, not more than 4 people. It is forbidden to visit the operation where the operation is being performed. Relatives and friends of patients, unrelated personnel, declined to visit. Special infection surgery marked on the door of the operation room refused to visit.


    Into the operating room staff must wear the operating room equipped with disinfectant clothing, pants, shoes and hats, masks, etc., leave it on the designated location; surgery patients should wear empty clean clothes into the operating room.


    Fifth, to ensure positive pressure between the operating state


Strict control of the surgical portals, surgical staff and visitors into the operating room, quickly to the designated location, minimize staff walking, can not be inter-string surgery. Before and after the operation to keep the door closed, such as no one out, the door control in the closed state, in order to avoid frequent air flow when opening and closing the door pollution. The door leading to the corridor (dirt passage) is not allowed to open during surgery. According to special fixed relative surgery, the use of articles positioned to place the surgery-related liquid, suture, electricity, pedals, microscope, laparoscopy and other fixed in a special operation room, reducing the number of access to the operation. At the same time, it is also guaranteed that a basic nurse will be fixed in each clean operation room every day to prevent a nurse from visiting the two operation rooms and increasing the number of access to and from the operation room. In the operation, the number of staff, the operation is static and airtight, can have a direct impact on the clean effect. It has been reported in the literature that the number of dust particles in the operation of medical staff (dynamic) was significantly higher than before the operation (static) (p <0.001), the more the number of operations, the greater the number of dust particles in the air. The more the number of door switch the worse the effect of cleaning.


    Sixth, strengthen health care management


All cleanings of the clean surgical department must be cleaned in a wet manner, while cleaning the air conditioning unit system. Surgery without shadow lamp, operating bed, equipment vehicles, closet surface and the ground should be before the operation every day, after hand water, disinfectant each wipe 1. Thoroughly clean once a week, brush 1 time. In addition to the daily, weekly provision of cleaning, the monthly hygiene cleaning again, including the operation of the wall scrub. Cleaning tools used should not be easy to use defibrillating fabric material, mop to use after cleaning to dry, polluted ground available chlorine disinfectant mopping. Equipment, articles into the clean surgical department, should be installed, wipe clean. Isolation shoes surgical staff daily cleaning with disinfectant 1.


    Seven, the purification process management


Clean operating room should be observed daily and register the indoor temperature, humidity and static pressure, so that it is adjusted to maintain the temperature of 22-25 ℃; relative humidity to maintain not less than 55%. Static pressure is 6-8mmHg (0.4-1.07KPd), in order to ensure the clean effect. The monthly wind speed, air volume, pressure and sterilization should be checked. General 30 minutes before surgery will purify the air conditioning unit switch to the operating state, the switch transferred to high-speed operation, closing off the laminar flow for internal hygiene cleaning work. If not for a long time in the operating room, in addition to do a good job before the vent and other cleaning work, should be turned on 3 hours in advance. Emergency surgery, the purification zone of the corridor restricted air-conditioning units, should be at a low speed operation 24 hours to prepare for emergency surgery and air cleaning. Clean air rooms should be sterilized every month. After the fumigation of ozone freshening fresh air inlet, boot 2 minutes, let the gas filled pipe and surgery, closed 6 hours after the boot ventilation. Class I, II, III, IV clean operating room rough filter, medium filter, return air wet wipe cleaning every two weeks, preoperative clean boot less than 30min best. The high efficiency filter should be replaced 1-2 years

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