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Operating theatre design question

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  • #70949
    John Ferguson
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    Author:
    John Ferguson

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    Dear Brains trust

    A colleague (a healthcare architect) has been planning the perioperative suite and the surgeons have insisted on placing the scrub bay on the theatre side of the exit bay. See extract from the scheme design drawing below (attached). They seem to believe that the air pressurisation in the theatre will keep water spray/bugs etc out of the main area of the OR. Also they don’t want to have to gown then go back out scrub and then return to the theatre through the doors to glove and operate.

    Placing scrub bays inside ORs is not a practice that I have seen anywhere else in the world – has anyone experience with this please?

    My view is that this is not a practice to support but I’d be interested in other views and evidence please!

    Kind regards
    John

    [cid:image001.png@01CF410A.DE25A080]

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [cid:image002.jpg@01CF410A.DE25A080]

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    #70953
    Anonymous
    Inactive

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    Anonymous

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    Hi John,

    I have seen this type of design in New Zealand and in some VERY old theatres
    but it is not consistent with current perioperative practices in my
    experience.

    So in my opinion, no it is not acceptable to have the scrub bay inside the
    theatre.

    I am also concerned about the description of gowning then scrubbing and then
    gloving – the actual practice is to scrub, then enter the OR to gown and
    glove.

    I don’t have time to dredge up evidence to support this – but maybe checking
    the references in the Australasian Health facility Design Guidelines and the
    equivalent American guidelines may be useful.

    Regards

    Terry McAuley

    Sterilisation & Infection Prevention and Control Consultant

    STEAM Consulting

    E: terry@steamconsulting.com.au

    W: http://www.steamconsulting.com.au

    A: PO BOX 779

    Endeavour Hills

    VIC Australia 3802

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    Of John Ferguson

    Dear Brains trust

    A colleague (a healthcare architect) has been planning the perioperative
    suite and the surgeons have insisted on placing the scrub bay on the theatre
    side of the exit bay. See extract from the scheme design drawing below
    (attached). They seem to believe that the air pressurisation in the theatre
    will keep water spray/bugs etc out of the main area of the OR. Also they
    don’t want to have to gown then go back out scrub and then return to the
    theatre through the doors to glove and operate.

    Placing scrub bays inside ORs is not a practice that I have seen anywhere
    else in the world – has anyone experience with this please?

    My view is that this is not a practice to support but I’d be interested in
    other views and evidence please!

    Kind regards

    John

    cid:image001.png@01CF1C1A.3FD5FE30

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health

    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital

    Clinical Microbiologist, Hunter Area Pathology, Pathology North

    Conjoint Associate Professor, University of Newcastle, Adjunct Professor,
    University of New England

    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-H
    ealth-Hunter-New-England-LHD.jpg

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    #70954
    Beth Bint
    Participant

    Author:
    Beth Bint

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    Good morning John

    The Australian Health Facilities Guidelines illustrates very clearly operational flows and air pressure controls required for operating units – refer Part B Health Facility Briefing and Planning: 520 Operating Theatres p 41 to p 44.

    Scrub bays must have negative air pressure in relation to the operating theatre which would not be possible if the scrub bays are incorporated in to the theatre room.

    Regards

    Beth

    Beth Bint

    Clinical Nurse Consultant | Infection Management and Control Service
    Level 1 Lawson House, Wollongong Hospital 2500, NSW
    Tel. 02 4222 5869 | Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au

    [cid:image001.jpg@01CF41BC.04870B90]

    Dear Brains trust

    A colleague (a healthcare architect) has been planning the perioperative suite and the surgeons have insisted on placing the scrub bay on the theatre side of the exit bay. See extract from the scheme design drawing below (attached). They seem to believe that the air pressurisation in the theatre will keep water spray/bugs etc out of the main area of the OR. Also they don’t want to have to gown then go back out scrub and then return to the theatre through the doors to glove and operate.

    Placing scrub bays inside ORs is not a practice that I have seen anywhere else in the world – has anyone experience with this please?

    My view is that this is not a practice to support but I’d be interested in other views and evidence please!

    Kind regards
    John

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #70955
    Roel Castillo
    Participant

    Author:
    Roel Castillo

    Position:

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    Thanks Terry
    Thanks Beth

    The SMEs have spoken. To my experience, the disconnect between architects and clinicians will certainly impact on the latter, patient care being compromised. What may I suggest is to sit down and exhaust all possible clinical input before agreeing to the design.

    Good luck
    Roel

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Beth Bint
    Sent: Monday, 17 March 2014 8:37 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Operating theatre design question

    Good morning John

    The Australian Health Facilities Guidelines illustrates very clearly operational flows and air pressure controls required for operating units refer Part B Health Facility Briefing and Planning: 520 Operating Theatres p 41 to p 44.

    Scrub bays must have negative air pressure in relation to the operating theatre which would not be possible if the scrub bays are incorporated in to the theatre room.

    Regards

    Beth

    Beth Bint

    Clinical Nurse Consultant | Infection Management and Control Service
    Level 1 Lawson House, Wollongong Hospital 2500, NSW
    Tel. 02 4222 5869 | Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au

    [http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Illawarra-Shoalhaven-LHD.jpg]

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of John Ferguson
    Sent: Sunday, 16 March 2014 11:30 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Operating theatre design question

    Dear Brains trust

    A colleague (a healthcare architect) has been planning the perioperative suite and the surgeons have insisted on placing the scrub bay on the theatre side of the exit bay. See extract from the scheme design drawing below (attached). They seem to believe that the air pressurisation in the theatre will keep water spray/bugs etc out of the main area of the OR. Also they dont want to have to gown then go back out scrub and then return to the theatre through the doors to glove and operate.

    Placing scrub bays inside ORs is not a practice that I have seen anywhere else in the world has anyone experience with this please?

    My view is that this is not a practice to support but Id be interested in other views and evidence please!

    Kind regards
    John

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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