Part One
- Introduction to the operations unit
The operations unit is one of the vital specialized departments in the hospital, so it must be dealt with with special skills. Because the nursing administration represents an important member of the health team, nursing must be familiar with all the skills specific to the field of operations.
Nursing service message for the Operations Unit Department
The hospital's nursing administration is committed to raising the health standard of patients and providing them with the best nursing services in line with the hospital's goals and procedures. It also works to raise the scientific and practical level of all members of the nursing staff in the operations unit and change their attitudes towards modern trends in nursing and medical sciences.
Operations suite
The operations wing is divided into four basic sections, each of which serves a specific purpose:
1) Geographical location:-
◾ The operating suite must be in a suitable location in all hospital departments so that it is easily accessible.
◾ Make sure it is far from places of pollution.
◾ Away from the heat of the sun and wind.
◾ It is on the first floor and is connected to the hospital via a private corridor.
◾ Centralization of equipment and devices. The presence of special devices and equipment in all operating rooms should be taken into account in order to avoid duplication of equipment and devices.
◾ The size of the hospital. The larger the hospital is in relation to the number of beds, the greater the number of operating rooms, i.e. (2 rooms for every 50 beds).
◾ Number of employees in the operations wing.
◾ Operating rooms should be spacious to facilitate movement of workers.
◾ Operations personnel must be particularly skilled and competent and receive continuous training.
Components of the operations wing units:-
Clean area includes:-
◾ Anesthesia room.
◾ Hand washing room.
◾ Recovery room.
2) The protective zone includes:
◾ Patient reception room.
◾ Office of the Chief Operating Officer.
◾ Doctors office.
◾ A room for storing surgical supplies.
◾ Doctors’ break.
◾ Plastering room.
◾ A room for endoscopes.
3) The sterile area includes:
◾ Operating rooms of all types.
◾ Sterile instrument storage rooms.
◾ Sterile package storage rooms.
◾ Sterile instrument store.
◾ The area for receiving used machines and tools has a special entrance other than operations.
Operating room contents:-
◾ A large electric flashlight with a number of special type bulbs for all lighting in one place, and it has a sterile arm so that the surgeon can move it in any direction suitable for him.
◾ Operations table: It moves in all directions according to the type of operation.
◾ Accessory holder: It has a leg and armrest, a leather belt to stabilize the patient, and a small armrest.
◾ For the head, a special support for brain operations, and shoulder supports.
◾ A large table to place sterile furnishings on.
◾ A large table to place the machines for the process.
◾ A table to place anesthesia medications.
◾ A table for placing laryngeal tubes for anesthesia.
◾ Monitor device (cardiogram).
◾ Mobile electric extractor device.
◾ Movable electrical cautery device (diaathermy).
◾ Round wheelchairs with and without backs.
◾ A scale and an electronic panel with a regular clock and a clock to determine the operation time.
◾ Pneumatic toricity.
◾ Gauze counting holder.
◾ Metal ladder.
◾ A holder with a plate on it to place the used gauze in.
◾ Holder with a plate of hot (sterile) solutions.
◾ 2 solution holders.
Special equipment:-
Ophthalmology operating room:
◾ Vitreous system (therectomy)
◾ Surgical microscope.
◾ An electric wheelchair for the microscope.
◾ Cooling device for cataract operations.
◾ Electric autoclave.
Orthopedic operating room:-
◾ A special table for orthopedic operations that is installed in the main table.
◾ A television X-ray device to photograph operations while they are being performed.
◾ C-Arm condenser X-ray machine.
Neurosurgery operating room:
◾ A special device to place the patient semi-sitting and hold the head steady.
◾ Electric saw for the bones of the skull.
Ear, nose and nose operations room:
◾ Surgical microscope device for ear operations.
◾ A chair for the microscope.
◾ Laryngoscope with light source.
Urology room:
◾ Complete cystoscope with light source and cables.
◾ A device for cutting prostate and bladder tumors.
◾ A device to break up stones
Obstetrics and Gynecology Room:-
◾ A baby bed equipped with suction and oxygen.
◾ Laparoscopy to perform tube clearing operations and diagnose cases.
◾ Microscope for gynecological operations.
Open heart operating room:-
◾ Heart lung machine.
◾ Electrical defibrillator (DC shock).
◾ Cell saver device
◾ Endoscopic device for extracting leg veins (Endoscopic vein harvest).
◾ Patient warming device (Bair hugger).
◾ Clotting time (ACT) device
◾ Intra aortic ballon pump.
◾ Cardiac ultrasound device + laryngoscope probe (transeosophygeal echo)
◾ Implanted arterial pressure measuring device.
Operating room equipment for human organ transplantation:
The operating room requires the following:
It applies to the operating room standards and descriptions issued by a decision of the Minister of Health, as well as the quality standards determined by the Supreme Committee for Human Organ Transplantation.
B- It must have the following minimum medical equipment:
◾ An efficiently working anesthesia machine equipped with a suitable ventilator.
◾ The presence of ampobags in reserve, the availability of oxygen cylinders and administration devices, and the availability of more than one source of oxygen.
◾ Electrical heart monitor.
◾ A device to measure the percentage of oxygen saturation in the blood.
◾ A device to measure the pressure of carbon dioxide in exhaled air.
◾ A device to measure non-invasive blood pressure regularly every five minutes.
◾ A device for treating ventricular fibrillation on a monitor screen, and the necessary medications for cardiopulmonary resuscitation.
◾ Suction device.
In the event of major surgeries or critical cases, the following must be available in addition to the previous equipment:
◾ A device to measure invasive blood pressure.
◾ A device to measure the percentage and type of drug in exhaled air.
◾ The anesthesia ventilator must have multiple warning methods when a malfunction occurs, and multiple modes of artificial respiration should be given.
Recovery room:-
The recovery room must be equipped with the following equipment:
◾ Devices that monitor EKG, blood oxygen saturation, and blood pressure.
◾ Ventricular fibrillation device on hand.
◾ Ambubag.
◾ Suction device.
The room must be supervised by an anesthesiologist.
Laboratory:
The facility's internal laboratory must have the ability to perform all the necessary analyzes for organ transplants, which include the following:
◾ Complete blood count.
◾ Blood chemistry analyses.
◾ Measuring the level of different immunosuppressive drugs in the blood according to the type of user and developing them as needed.
◾ Possibility of making tissue compatibility before implantation.
◾ The ability to perform all the tests necessary to diagnose infections, such as various viruses, bacteria, fungi, and parasites.
◾ The ability to perform all analyzes of aerobic and anaerobic cultures, blood cultures, body fluids, and so on.
Blood bank:
◾ The medical facility must have at least a storage blood bank, which has the following:
◾ Blood refrigerator with sufficient capacity.
◾ Chiller for plasma and cryo.
◾ Automated platelet shaking device.
◾ Availability of a system for compatibility of blood types.
◾ Records for receiving and deleting blood and blood products.
◾ A team consisting of a doctor who holds the Egyptian Blood Transfusion Fellowship or its equivalent, assisted by a team of technicians and secretaries.
Diagnostic Radiology Unit:-
The medical facility must have an advanced diagnostic radiology unit with the following devices:
◾ Regular X-rays, chest x-rays, and all areas of the body according to the case.
◾ The ultrasound device is capable of doing Doppler and echo, in addition to standard examination, with the possibility of using this in operating rooms, intensive care, and patient rooms, and the availability of different types with the required sensors with different frequencies as needed.
◾ Advanced Curved Arm Moving Arm (CARM) machine with a robotic monitor for use in interventional radiology in operating rooms and during surgery.
◾ X-ray devices for imaging arteries with dye, either by traditional methods or through digital devices.
◾ A spiral CT scan device, the possibility of studying organ imaging by triple examination, the possibility of taking samples, etc.
◾ The CT scan machine can be replaced by providing an advanced MRI machine.
◾ Digital records and medical statistics: The facility must have an advanced program to store, process, and retrieve medical information for all organ transplant patients, including all analyses, x-rays, photos, and reports, so that this information can be circulated between medical facilities and easily accessed, while preserving the patient’s privacy.
◾ The organ transplantation program must be linked electronically to the website of the Supreme Committee for Human Organ Transplantation for ease of performance and maximum benefit.
Requirements for organ transplantation:-
◾ For facilities that carry out kidney transplant operations: they must have a team of doctors with a high level of qualification, assisted by a team of trained nurses, and a number of dialysis machines of not less than three, with the possibility of performing the minimum number of urinary tract endoscopes, such as Cystoscopy, stent extraction, renal tube placement, and ureteroscopy when needed.
◾ For facilities that perform liver, pancreas, and intestine transplants: they must have an advanced endoscopy unit for the gastrointestinal tract, which includes upper and lower GI endoscopy, the possibility of treating varicose veins through endoscopy, and the ability to perform diagnostic, interventional, and therapeutic bile duct endoscopy (ERCP). .
It is not permissible to establish an intestinal transplant center except in facilities that have previously been licensed to perform liver transplant operations, and it is not permissible to establish a pancreas transplant center except in centers licensed to perform liver or kidney transplant operations.