Biomedical Engineering Reference
In-Depth Information
Pharmacy
The pharmacy is included in the overall design of a health
care facility to provide medications for patient care.
Hospitals of considerable size can include a pharmacy
within the OR.
Instrument processing
Instrument processing can be managed in a variety of
ways, depending on the resources and preferences of
a particular institution. Regardless of the sterilization
method, a process must be present for delivering con-
taminated instruments to the processing area and redis-
tributing the appropriate instruments to the surgical
location. Sterilization methods can be divided into two
categories: centralized and decentralized.
A centralized processing department is designed to
serve a large volume and can be located within the OR.
Smaller hospitals sometimes utilize a centralized
processing department that serves the entire facility.
Centralized instrument processing can employ an as-
sortment of sterilization processes. The two most
common methods include steam sterilization and ethyl-
ene oxide (EtO) sterilization. Autoclaves are devices that
sterilize instruments using steam, with temperature,
exposure time, and pressure as variables. Variables in EtO
sterilization are EtO gas concentration, moisture, tem-
perature, and time. Dry-heat sterilization and chemical
sterilization are other methods of instrument processing
that can be utilized in health care facilities.
Decentralized instrument processing is the practice of
sterilizing instruments inside, or within the immediate
proximity of, a surgical suite. Perhaps the most common
method involves the use of autoclave technology. An au-
toclave can be designated for each operating suite or shared
among a cluster of suites. Table-top sterilizers are used for
flash sterilization located in common areas in the OR. They
are autoclavable at around 270
F for 3 to 5 minutes.
Figure 4.3-1 Clinical engineering department engineers and
technicians support the OR.
time considerations, patients, surgeons, anesthesiologists,
support staff, equipment and supply availability, and post-
anesthesia care. The control desk alsomight be involved in
patient billing and recordkeeping.
Technical support services
Technical support services are vital to the productivity of
the OR. Support for OR technology must be immedi-
ately available to ensure the efficiency and safety of the
surgical environment. Support groups serving the OR
include anesthesia technical support and clinical engi-
neering (see
Figure 4.3-1
). Anesthesia technical support
is located within, or in the immediate vicinity of, the OR.
The anesthesia workroom is primarily used for cleaning,
testing, and storing anesthesia equipment. In larger fa-
cilities, clinical engineering support workrooms also
might be situated within the OR. Later in this chapter,
the responsibilities of the clinical engineering de-
partment will be discussed in detail.
Materials management
Patient support service areas
A hospital also must allocate space for the delivery,
storage, and distribution of supplies to the OR. The
process of waste disposal also must be accommodated.
Trash and biological waste must be properly stored,
handled, and eliminated. In addition, the OR must es-
tablish a manner for processing surgical drapes, scrubs,
and other linens used in the surgical environment.
Patient support service areas include personnel, equip-
ment, and supplies used to provide assistance to a variety
of OR functions. Space must be incorporated into the OR
floor plan to accommodate services such as equipment or
patient transporters, orderlies, and nurse's aides.
Housekeeping areas
Equipment storage areas
Housekeeping areas are the workspaces for housekeeping
and turnover team personnel, equipment, and supplies.
Turnover team members are responsible for cleaning and
setting up surgical suites between cases.
A common dilemma is the lack of sufficient storage
space. The OR layout must include areas for the storage
