What is the modern development trend of clean operating room?

Operating room is the product of the combination of modern medical technology and engineering technology, and it is the core part of hospital surgery. Clean operating room is an important symbol of modern hospitals, which embodies the level of facilities, medical care and management of modern hospitals. What should a modern clean operating room look like? The author thinks that it should be an organic unity composed of cleanliness, digitalization and humanization. Modern clean operating room is the premise, humanization and digitalization are the development trend, and it is also the symbol of high-standard operating room in the next few years. A clean and sterile operating room environment is an important guarantee for the success of the operation. The purpose of cleaning the operating room is to maintain a sterile environment to the maximum extent and reduce intraoperative infection; At present, the standard for the construction of clean operating room in China is the Technical Specification for the Construction of Hospital Clean Operating Department issued by the Ministry of Construction in 2002. However, there are several noticeable problems in the construction of modern clean operating room. 1. The location of clean operating room should meet the requirements of integration with equipment supply room and technical layer. The integrated management of operating room and supply room is beneficial to strengthen the management of surgical instruments and simplify the workflow. When designing and constructing the operating room, we should try our best to design the operating room between the supply room and the upper and lower floors of the technical floor, and form a vertical connection as much as possible. There should be an internal elevator or logistics system between floors. At the same time, the operating room should be adjacent to blood bank, pathology department and other related departments, and equipped with convenient information channels and logistics channels. 2. Operating room layout There are five common layout designs at present: central cleaning type, central air supply type, peripheral air supply type, peripheral recycling type and one-way passing type. Each type has its own characteristics. When visiting foreign hospitals, the author found that the central cleaning type and the central supply type are widely used. By comparison, the author thinks that the combination of centralized cleaning and centralized supply is more reasonable. The center of the operating department is set as a sterile goods area, with operating rooms around it and connected by clean corridors; The sewage walks along the veranda, which not only conforms to the aseptic principle of cleaning and sewage diversion, but also meets the rapid and convenient material supply, which can effectively improve work efficiency. In short, in the layout of the plane and the passage, we should follow the principles of functional conformity, short and agile flow and cleaning. 3. Purification air conditioning system Using purification air conditioning system to purify air is a key technical measure to maintain the cleanliness of clean operating room and reduce the postoperative wound infection rate. Excessive noise and insufficient fresh air volume are the problems existing in operating rooms built in many hospitals in China at present, which should be paid great attention to. Noise mainly comes from air volume control motor and air supply pipeline, which can be eliminated by installing muffler, increasing air inlet diameter, reasonably controlling and distributing flow and rotating air duct. Insufficient fresh air volume is mainly caused by unreasonable design or filter blockage; When designing the air volume value, attention should be paid to matching the cleanliness requirements and setting it reasonably. The shortage of fresh air caused by filter blockage can be solved by management measures and technical means; For example, according to the different amount of dust in seasonal changes, formulate corresponding maintenance and cleaning plans and rationally configure filter devices, and timely and effectively clean filters. Increasing the speed of the air volume control motor can also increase the fresh air volume, but at the same time it will bring the problems of energy consumption and noise increase. Secondly, patients in humanized operating room have the weakest psychological endurance and the most special psychological needs, so more attention should be paid to environmental psychological factors in the indoor environment design of hospital clean operating department. The humanized design of operating room includes the color and lighting of operating room, background music and the creation of indoor microclimate. These can alleviate the psychological stress of patients undergoing surgery, make the surgical medical staff work in an orderly and pleasant environment, and are of great help to improve the success rate of surgery and the working efficiency of the whole operating room. We can reconstruct the operating room environment from the following aspects. 1. Clean and pleasant visual environment A clean and tidy operating room environment can make patients feel safe and reliable, eliminate their inner fears and cooperate with the operation in the best psychological state. Therefore, indoor drugs, equipment and other items must be prepared and placed neatly; Using surgical hanging tower, medical equipment and instruments are concentrated on the hanging tower, which is convenient for medical staff to operate; Clean up the ground to avoid accidents caused by staff kicking against equipment cables. The psychological feeling of color is also a factor worthy of attention. Only a colorful space can form a psychological environment that caters to human nature. White is monotonous and indifferent, which easily makes patients feel fear. At present, the interior design of hospital buildings has developed from the traditional single white to multi-colors, and the colors of clean operating rooms should be rich. The color of various operating rooms is generally green, because green and blood red are complementary colors, which can reduce the eye fatigue of medical staff and promote the psychological calm of patients. In places where patients must pass, such as bed changing rooms, anesthesia rooms, clean corridors, etc., walls and ceilings can adopt soft tones with high brightness and low color purity to make the space atmosphere lively and reduce the sense of closure and oppression. 2. Low noise and comfortable hearing environment noise will increase patients' irritability and affect surgeons, so eliminating noise is a problem that must be considered in the design of operating room (noise includes both internal and external aspects of operating room). At present, the background music system has been regarded as an indispensable facility in the design of operating rooms in large modern hospitals. Playing slow-paced, lyrical and smooth background music during the waiting period and during the operation to create a comfortable and harmonious environment and atmosphere can alleviate the tension of patients, eliminate the fatigue of surgical medical staff and create a pleasant working environment for medical staff. 3. Indoor microclimate patients are all people with diseases, and they are particularly sensitive to air quality, which has a great influence on patients' psychological state. Therefore, improving the microclimate of clean medical space and making patients feel comfortable is also an important means to create a good psychological environment. The room temperature and relative humidity of clean operating room are controlled by air conditioning system, and the determination of room temperature and relative humidity must consider factors such as controlling bacterial reproduction and making patients feel comfortable. Incorporate humanization into the construction of operating room, get rid of the influence of traditional medical model completely, and shift the focus of operating room work from simply paying attention to surgery to serving patients, so that surgical patients can get care and care like relatives, relieve their psychological and physical pain, and fully embody the overall service concept of "people-oriented, patient-centered". Third, the digital operating room Digital operating room is a specific environment in which digital technology is applied to the operating room, so that doctors can obtain a lot of important information related to patients in real time, which greatly improves work efficiency. With the development of information network technology, the popularization of medical equipment digitalization and the wide application of PACS technology and system integrated control, the digitalization of operating room has become an inevitable trend. 1. Digitization of medical equipment At present, the development of medical imaging technology is very rapid. All kinds of medical images, biochemical and physiological indexes, electronic medical records, vital signs of patients, etc. examined before operation can be displayed through the terminal of the operating room. And can be selectively or centrally displayed in the surgical field of vision according to the needs of doctors. So that the surgeon is convenient and intuitive. Modern surgery requires improving accuracy and minimizing trauma; Therefore, digital surgical treatment planning system and precise positioning system (such as stereotactic brain surgery) are widely used in surgical treatment. Various digital imaging technologies provide rich tools for making surgical plans and guiding surgical operations. For patients who need image examination or various monitoring during operation, various intraoperative digital devices can directly provide real-time images and data for doctors' diagnosis reference; At the same time, it is input into PACS system of operating room. The application of various digital medical equipment and PACS system in operating room greatly facilitates doctors and improves the success rate and efficiency of surgery. 2. Digitization of system control In addition to the digitalization of medical devices, the clean operating room itself is a 1 equipment system that relies on digital control. Only the air conditioning system should monitor and control the temperature, humidity, pressure, ventilation, fresh air volume and other parameters of each operating room, and maintain the pressure difference in different clean areas. The clean operating room should strictly control the flow of personnel, and the perfect internal communication system can ensure the information communication of medical staff during the operation. In order to intuitively understand the operation room, it is necessary to install an all-round digital TV monitoring system. Operation arrangement, personnel arrangement, equipment disinfection, consumables storage management, and the whole process record management (time, personnel, anesthesia, operation information release) of each operation, etc. This series of complicated processes also need computer comprehensive information management. By setting up a central control room in the operating room, these devices and systems are centrally controlled and managed and integrated into a central control system, which can intuitively display and control the entire operating room. At the same time, you can exchange information with the outside world through the interface. 3. Digital live teaching, academic exchange, remote consultation, surgical teaching monitoring and broadcasting system are also widely used. The patient's family can watch the operation as needed; On the other hand, in case of medical accidents or medical disputes, it can be well documented. Finally, the digital system in operation is integrated with the existing hospital information system (including HIS and PACS), and then integrated into the hospital information sharing platform through the interface to realize real-time data monitoring and query. The implementation of digital and network management can facilitate teaching, discussion and consultation while operating. Due to the cost, concept, technology and other reasons, the number of hospitals that realize the digitalization of operating rooms in China is still very small. Therefore, it is necessary to reserve relevant interfaces and wiring during the construction and renovation of operating rooms to prepare for the future digitalization. The construction of modern clean operating room is a complex system engineering, which involves the cooperation and development of many disciplines and departments. It emphasizes not that a single operating room can reach a certain index, but a modern engineering and management system of "whole process and all-round control". The construction of modern operating room must be humanized and digitized on the basis of cleanliness. It can be expected that in the future, the construction of operating room will be digital and networked, and at the same time, the logistics automation will be realized. The organic integration of logistics and information flow in operating room will become an important symbol of intelligent operating room in the future.