1. Aseptic and Septic Operation Theatre Orientation
Introduction
Heart of an hospital-OT
Team
Skilled Surgeons
Nurses
MLOP
Anaesthetist

2. Separate theatres for septic and aseptic surgeries Aseptic Theatre:-
Cataract
PKP
Squint
Retina
Glaucoma
Septic (Minor Theatre):-
-Enucleation
Evisceration
DCR
DCT
Infected Cases

3. Planning of OT An should have High standard of asepsis
Maximum standard of safety for patients and staffs
Optimum utilization of space and staff time

4. Location of Aseptic Theatre
The Location Should be
Free from general traffic Eg: Away from road side
Free from noise and other disturbance
Free from contamination and possible sources of infection
Closure to ward

5. Operation Theatre Zones
Four Types of Zones
Sterile Zone
Clean Zone
Protective Zone
Disposable Zone

6. Sterile Zone Operation Room Scrub room Anaesthesia room(Block room)
Instruments sterilization

7. Clean Zone:- Pre operative block room Nurses work room Recovery room
Anaesthesia /Medication store

8. Protective Zone:- Reception room in OT
Waiting room for relative of patient
Dress changing room
Pre Anaesthesia room
General store room
Main Autoclave room
Trolley lay,Wheel chair,Stretcher
Control area of electricity

9. Disposal Zone:- Dirty /Blood stained linen Used head caps,mask,socks
Solid materials both disposable and non disposable should move with out crossing sterile & clean zones.

10. Operation Room Contains:- Airconditioning –maintains asepsis
Operating table
Adjustable chair for surgeons
Instruments trolley
Microscope & other necessary equipments,Phaco machine etc
A working space of around 1. 2 m around operation table
IV stand tray and fluids
One Bowlstand for rinsing hand with sterile water.

11. Instruments Surgical instruments sets and different ocular surgeries
Bipolar diathermy with points
Vitrectomy machine with vitrectomy probes
Boyle apparatus for GA

12. Sub sterilizing Area Instaclave with cheatle forceps and container
Stainless steel basin for cleaning the instruments
Electric water drums for boiling water or drum with clean sterile water.
Soft brush for cleaning the Instrument & instrument cover
Adequate water supply

13. Scrub Area Sink with running water facility
Hands should not touch surface of sink
Scrubbing Solution (Chlorhexidine, Iodine 7.5%)
With Soap and brush
6 minutes for scrubbing
First one minute for two times using soap then 2 minutes used for solution first time scrubbing with brush and full fore arm
Second 2 minutes with scrubbing solution for proximal half of fore arm

14. Location of Septic OT
Located at a place which has limited access to patients
Closure to ward
Away from aseptic OT
Should have separate dressing room,scrub room,sterilization section
Should have good ventilation
Good lighting system
Instruments and eye towels should be sterilized separately from other than linen like coats.
Flash autoclave or sterliser-in between cases

15. Staffing Pattern OT Manager is usually OT Nursing officer
OT Manger has to ensure
Availability of equipments ,instruments and nursing staffs
Proper care and maintenance of equipments
Theatre cleaning and sterility
Adherence to work discipline
Maintenance of OT records
Relationship with other departments

16. Staff Allocation Operation area Scrub nurse- 2 for 1Surgeon
Circulating nurse-1for 1 Surgeon
Block room-Local –1-3 persons,GA-2 persons

17. INFORMATION BOARD Notice board for display of daily operation
Schedule with details at entrance of OT
Helps to begin the preparations without delay

18. Roles of MLOP in OT Circulating MLOP:-
To give nursing care to patients during preparation for the surgery
Checks the case sheet
Helps doctors in giving local anaesthesia and counseling to the patient .
She makes available the sterile things and medicines supplied needed for surgery

19. Scrub MLOP
Scrub MLOP is a well trained person,who will be familiar with procedure of surgery
She assists the surgeon through out the surgery
Helps to wear sterile gown
Arranges instrument trolley

20. Dress code
Should wear only special theatre dress to minimize cross infection.
Should not leave outside OT with theatre linen
Caps must be worn to cover the hair completely
Face masks must be worn.
Dress colour-preferably light blue,green

21. Slippers and Overshoes
Should remove personal slippers outside OT
Feet must be washed
Theatre slippers should be worn
Slippers should be scrubbed after use daily
Theatre slippers should not be used outside the theatre

22. A dedicated OT MLOP
Should have a same of sincerity ,honesty and punctuality and compassion to all the patients.
Should have sufficient knowledge of medical terms

23. OT Discipline MLOP should come early before the start of surgery
Take all responsibility to arrange the theatre,ready to the patient and allocate the surgeon
Eating or drinking tea or coffee should be strictly prohibited in OT area

24. Personal Hygiene Hairs and Nails must be kept clean and short
No Nail polishing or jewellary
Cuts and abrasion should be corrected and reported to incharge person
Infectious diseases like common cold should get prompt and complete medical treatment

25. Patient Hygiene Should have their bath and wear clean dress
Diabetic ulcer patient Hansen or other infected diseases should be operated at the end
Disposable cap and shoes to every patient

26. Key Point to Remember
OT should be located away from pollution (Noise & Air)
The attender /visitors should not be allowed to stand in front of OT
MLOP should check the working conditions of equipments , electrification etc prior to surgery
MLOP should take responsibilities to inform/make arrangements for repair and replacement of equipment.
An extra supply of instruments should be available at request.
An extra supply of all OT dresses must be available for visitors and staffs
The medical personal should strictly follow the theatre discipline

27. Thank You