Preparation of the Operating Room

Abstract

The history and general principles of OR design are discussed, including physical layout and design standards, which encompass the layout and storage of devices and equipment. As both patient and staff safety are paramount, all of the risks that can be mitigated by good design are discussed: biologic, ergonomic, chemical, and physical. Environmental issues in the OR are listed and include temperature, humidity, and lighting. The proper use, storage, and risks of electronic and mechanical devices are discussed. Infection control is addressed and includes hand hygiene, gloves and protective barriers, antimicrobial prophylaxis and nonpharmacologic preventive measures. A housekeeping section discusses the benefits of segregating clean, clean-contaminated, and dirty cases. OR scheduling is noted. Tables outline International Commission on Radiological Protection–recommended radiation dose limits; key principles of the Joint Commission Universal Protocol; devices used in the operating room; standard equipment for endovascular operating rooms; benefits of voice activation technology in the laparoscopic operating room; criteria for defining a surgical site infection; factors that contribute to the development of surgical site infection (SSI); Centers for Disease Control and Prevention hand hygiene guidelines; distribution of pathogens isolated from surgical site infections: operating room cleaning schedules; classification of operations in relation to the epidemiology of SSIs; and basic principles of OR efficiency. Figures depict patient positioning and basic components of an ultrasound transducer, This review contains 3 figures, 12 tables, and 214 references.