How to build a clean operating room in a hospital？

The operating room is one of the most important areas in the hospital, and its cleanliness is crucial to the safety and success of surgical operations. In the construction of operating room projects, the design, material selection and process flow of the operating room should be fully considered to ensure that the surgical environment meets cleanliness standards and can effectively control the risk of infection.

In the construction process (design, construction, commissioning, testing, and operation) of hospital clean operating rooms, due to insufficient management efforts and failure to keep up, there are many problems with the construction quality and performance parameters of some clean operating rooms.

1. The design of clean operating rooms is the foundation of the operating room, and the quality of the design directly affects the performance of the operating room. Doctors from some hospitals reported:
◆The amount of fresh air in the operating room is insufficient, making working in the operating room uncomfortable, and the positive pressure in the operating room cannot be maintained. The pollution outside will affect the cleanliness of the operating room.
◆The relative humidity in the operating room is too high in summer and cannot be lowered, which is not conducive to the control of microorganisms.
◆The operating cost of the operating room is too high, the power consumption is too high, and it is not energy-saving.

2. There are different types of construction units, good and bad. Therefore, it is very important to choose an experienced and professional construction team.

3. There is a lack of supervision measures for the construction quality of clean operating rooms and standards for standardizing the evaluation of operating room construction quality.

4. After the clean operating room is completed, a qualified and authoritative third party should debug, inspect and inspect the construction quality of the operating room, including the construction and decoration materials, the operation status and stability of the purification air-conditioning system. , conduct a comprehensive evaluation of the performance parameters of the operating room (cleanliness, bacterial colony count, temperature and humidity, pressure, noise, etc.), as well as the reliability of the equipment selected in the operating room and the energy saving of system operation, to further standardize the construction market of clean operating rooms. .

5. The hospital’s investment in management strength and personnel is relatively lacking, which is another aspect that affects the construction quality of clean operating rooms.

How to do a good job in operating room construction
Cooperation is the prerequisite
(1) Cooperation among all parties involved in construction, design, and construction is an important prerequisite for successful operating room construction.
◆The builder has involved experts in clean technology from the beginning of the project. Experts are familiar with the latest development directions and have rich professional experience, allowing projects to achieve a high starting point, avoid detours, and leave no regrets when planning and designing projects. During the program design demonstration, it can ensure reasonable functions, sufficient floor height, and reasonable design of load-bearing equipment parts on the floor. During civil construction, holes, pre-embedding work, waterproofing layer construction and other work should be reserved. The general contractor should carry out overall scientific planning during installation and construction, and make overall arrangements for various professional contracting units and other cooperating units.
◆The depth of the designer’s design drawings must meet the construction requirements. The design of the hospital's clean surgery department is first of all process design. The biggest difference between hospital buildings and ordinary civil buildings is that hospitals have complex functions and complicated streamlines. The design of the clean surgical department is first of all process design, and then architectural design. After determining the layout that meets the requirements of cleanliness standards and has a reasonable layout, professional designs such as clean air conditioning, decoration, medical gas, electrical, water supply and drainage can be carried out to meet functional requirements, safety and convenience, which are issues that a designer must consider. .

The functional layout of the clean surgery department is the basis. The clean surgery department consists of a clean operating room and auxiliary function rooms serving the operating room. The clean surgical department should be its own area and should be close to the closely related surgical nursing unit. It should be strictly divided into clean area and non-clean area. A buffer room or transfer window must be set up between the clean area and non-clean area. The clean area should be divided according to different requirements for air cleanliness levels, and partition doors should be set up between different areas. Clean area - various levels of purified operating rooms, surgical preparation rooms, scrubbing rooms, sterile dressing and instrument storage rooms, disposable items and precision instrument rooms, recovery rooms, patient changing rooms, clean corridors, etc. Non-clean area - doctor and nurse duty room, demonstration classroom, dressing packaging, high-pressure sterilization room, instrument cleaning room, plaster room, frozen section room, shoe changing, dressing, bathing, and air shower room. Purification air conditioning units, surgical special medical gas central stations and power distribution should generally be concentrated on one floor (equipment floor) alone.

It is not advisable to design and construct at the same time. Nowadays, many medical buildings are designed by non-medical architectural professional design institutes, which have little understanding of the medical purification profession. The purification part is left to the construction unit for "secondary in-depth design". Some projects are rushed to the deadline during design and demonstration, causing many regrets. . For example: problems with air duct opening reservations, building civil walls in the operating room, equipment layer waterproofing and drainage pipe problems. In short, the more detailed the consideration in the early stage, the less regrets you will have in the later use process.

Reasonable design is the main way to achieve building energy conservation. Equipment selection, natural fresh air utilization, waste heat recovery and other energy-saving systems all determine whether energy saving can be achieved during system design.

◆The construction party should construct according to national specifications and design drawings (if the design depth of the drawings is not enough, continue to complete the detailed design). Be honest and trustworthy, construct according to specifications; have rich experience, work hard, and give correct solutions to some detailed problems in the design. For example: many operating rooms feel stuffy and have insufficient fresh air. According to the design specifications, each operating room requires 800m3/h~1000m3/h, but after the system has been running for a period of time, there is a problem of insufficient fresh air. The lack of fresh air is caused by the difficulty in replacing and cleaning the fresh air inlet filter, which is not cleaned and replaced on time. The projects we do are all equipped with filter boxes at the fresh air outlets that can be easily disassembled and cleaned, and are larger than the original design, increasing the filter area, extending the replacement cycle, or using fresh air units that can automatically replace the filter element.

enough space
(2) Key points of the building structure of the operating room. The floor where the operating room is located has high requirements for floor height. Various complex pipelines are arranged in the ceiling, including ventilation ducts, water supply and drainage ducts, smoke exhaust ducts, strong and weak current bridges, wires and cable piping, Systems such as air conditioning water pipes require sufficient space.

Things to note:
◆During design and construction, consider the arrangement of various professional pipelines in the technical mezzanine, especially the issue of conflict between the air supply and return pipes and the fire smoke exhaust pipes.

◆Consider the layout of the hanging tower and air ducts, as well as the supply, return and exhaust ducts and corresponding air outlets.

◆Coordinate and consider the layout of the ceiling plan, which needs to reflect the layout of various air vents, lamps, broadcasts, smoke detectors, pendants, shadowless lights, etc., to reduce rework during construction.

operating room equipment
(3) Key points for the construction of operating room equipment layer
In addition to enough space on the equipment floor to install various large-scale equipment, it is also necessary to reserve certain locations and passages for maintenance and management personnel to perform maintenance and repair work on the purification air-conditioning system, such as replacing filters, checking fans, motors, humidifiers, and automatic controls. systems and various valves, etc. The floor height of the surgical department purification equipment in some projects is very low. The building floor height is usually only 2.1m, and the height of the beam base is only 1.6m. The installation of the equipment is very crowded and difficult, resulting in a decline in the quality of the project installation. After the project is completed, there is not enough space for maintenance. , the system equipment cannot be properly maintained, and various failures soon occur. Therefore, it is recommended that the space requirements of the equipment floor should be paid attention to during the building design stage. It is recommended that the floor height of the equipment floor should be greater than 2.8m, and the net height of the bottom of the beam should not be less than 2.2m.

Things to note:
◆As the main body of the ventilation system of the operating room, the equipment layer plays a role in connecting it with the operating room. Therefore, it is very important to leave holes in the equipment layer.
◆To determine the holes for the equipment layer, you need to determine the process layout first, and then make a professional air-conditioning design plan based on the layout.
◆When reserving openings on the equipment layer, a margin must be considered, otherwise it will be difficult to expand after reinforcement.
◆The floor of the equipment layer must be waterproofed, so the reserved holes must be made into waterproof platforms.
◆The equipment floor must be properly equipped with a floor drain for cooling water discharge from the purification unit. It is not recommended that the condensate water pipe from the unit to the floor drain be too long.

Finally, regular maintenance and upkeep are important measures to keep the operating room clean. Hospitals should establish a sound equipment maintenance management system, conduct regular testing, cleaning and maintenance of equipment and instruments in the operating room, promptly discover and eliminate existing problems, and ensure the normal operation and stable performance of the equipment.

To sum up, good construction of the operating room is the key to ensuring the cleanliness of the operating room. Through reasonable design, material selection and process flow, as well as regular maintenance and upkeep, we can ensure that the operating room environment meets clean standards and provide patients with safe and efficient surgical services.