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Safe storage
ORs are designed to be positively pressurized to prevent infil-
tration of airborne particulate into the room or, worse, into the
sterile field. But if the OR's main door is opened, room air can escape
into the adjoining hallway, causing the air pressure in the OR to drop.
That pressure drop disrupts the regular currents of the laminar flow,
potentially causing airborne contaminants to settle in the sterile field.
Installing built-in cabinets or investing in mobile storage units to
ensure often-used supplies are always within arm's reach will help
limit foot traffic into and out of ORs.
Plus, less is more when outfitting your ORs. "Keep it simple," stress-
es George R. Tingwald, MD, AIA, ACHA, director of medical planning,
design and construction at Stanford (Calif.) Health Care. He's a sur-
geon and an architect, so he knows a thing or two about designing
ORs with infection control in mind. "Store fewer pieces of equipment
and fewer carts in the rooms, and certainly nothing that cannot be
cleaned, if not between each procedure, then on a very regular basis.
All equipment in the room should be used regularly."
Dr. Tingwald says hanging equipment on ceiling-mounted booms is a
space-saving design but warns that many turnover teams don't clean
the equipment — and the wires connected to it — often or well
enough. "Just because the equipment isn't on the floor doesn't mean it
doesn't get dirty," he adds.
Speaking of carts and equipment (and waste cans), do you routinely
place them in front of floor-level exhaust grills? Well, don't. Blocking
the grills alters air flow in the OR, and possibly even in the sterile
field, says Larry Lee, CIH, a certified industrial hygienist and owner of
Pacific Industrial Hygiene in Kirkland, Wash. He suggests you tape off
a 3-foot "no parking zone" on the floor in front of exhaust grills to
keep the area clear and OR air flowing as intended.
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