Operating room PowerPoint Presentation, PPT - DocSlides

Operating room PowerPoint Presentation, PPT - DocSlides

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design & operation. Andy Yosten. September . 15, . 2015. agenda. Introduction. Codes & Standards . Operation Room (OR) Design Practices . New Technology & Strategies . Understand. latest changes to codes and standards for operating rooms. ID: 474459

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Presentations text content in Operating room

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Operating room

design & operation

Andy Yosten

September

15, 2015

Slide3

agenda

Introduction

Codes & Standards

Operation Room (OR) Design Practices New Technology & Strategies

Slide4

Understand latest changes to codes and standards for operating roomsDiscuss current operating room design practicesIdentify new technologies and how they affect operation strategies

Learning objectives

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Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2010)Incorporated ASHRAE 170 -2008 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2008Ventilation of Health Care Facilities

Codes & standards

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Recent Changes

Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2014)Incorporated ASHRAE 170 -2013 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2013Ventilation of Health Care FacilitiesIncorporates all addenda thru November 2013

Codes & standards

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Recent Changes

Humidity levelsReturn/exhaust grille locationOperating room classificationOR vs procedure roomSpace requirements

Codes & standards

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Evolution of the Operating room

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1900 – Roosevelt Hospital NYC

Library of Congress Prints

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1950 – Northfield, Minnesota

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2000 – Bethesda, Maryland

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2015 – Parkland Hospital

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User requirementsSpecialized proceduresRoom size and layoutLightingEquipment layoutBoomsImaging equipment

Design considerations

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Room size and layoutLightingEquipment layoutBoomsImaging equipment

HVAC Design Process

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Primary diffuser array shall extend a min. of 12 in. beyond footprint of tableNo more than 30% of diffuser array shall be used for non-diffusers such as lights, gas columns, ect.

Hvac Design process

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Air Curtain vs Laminar Flow

Design process

Laminar

Flow

Large volume of sterile air

Minimize entry of bacteria into sterile field

Constant volume can help with patient comfort

Air

Curtain

Dome-like sterile procedure area by increasing air velocity at the perimeter

Sterile field is washed with a slow moving column of air

Slot diffusers used to direct away down and away from the patient creating a boundary

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Operating

Room

Design Practices

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Primary diffuser array coordinationPlacement of lightingLocate columns and boomsImaging equipment supportsReturn air locations

HVAC/room Layout

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Pressure: + 0.01 in. wc Maintain positive pressure to all adjoining spaces at all times

Pressure relationships

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Patient comfortSurgeon and personnel comfortControl of pollutantsAbility to quickly raise and lower temperatureHumidity control

Temperature requirements

ASHRAE 170 -2013

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Best practicesSurgeon preferenceSetback controlHVAC design strategy

Air changes requirement

ASHRAE 170 -2013

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Filtration

ASHRAE 170 -2013

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FGI Guidelines (2010)

30% - 60% RHFGI Guidelines (2014)20% - 60% RHCMSMust document changeMonitor humidityEquipment Considerations

Humidity control

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Primary diffuser array to provide concentrated airflow over patient and surgical teamAirflow: Unidirectional, downward with average velocity of 25 to 35 cfm/ft2At least two low sidewall grilles at opposite corners installed approximately 8 in. Above floor

Particulate control

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NFPA 99 Health Care Facilities Code (2012) – Smoke purge systems are not requiredMost recently language existed in NFPA 56A (2005) and previous editions of NFPA 99CMS requirements

Smoke evacuation

Code excerpt: ASHRAE

170 -

2013

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Integrated operating room “Smart OR

Hybrid operating roomIntegrated ceiling solutionsUltra-clean operating room

New technologies & OR Strategies

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Combine patient-specific data will intelligent devices to support real time decisions

Support trends in robotic surgery technology

More space requiredControl room

New technologies

& OR

Strategies

Integrated Operating Room “Smart OR”

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Hybrid Operating Room

CT scanners, MRI scanners, fixed C-Arms

Larger surgery team of 8 to 20 people More space requiredControl room Vibration considerations

New technologies & OR Strategies

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Fully integrated ceiling system

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Ultra clean Surgical suites

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Best Practices

Dedicated AHU

Coils in series

Humidifier location

Energy efficiency – DOASBoom location – laminar flow sterile field

Hvac design

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Scheduled modes – “unoccupied setback”

Integrated optimizationFactorsStaff usageExisting conditionsCost

Setback strategies

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Operating room

design & operation

Andy Yosten

September

15, 2015

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