Among all the
industries, one of the most important is medical and healthcare infrastructure.
And among this, what’s even more crucial is the operation department. To carry
the operations seamlessly and eliminate any risks associated with surgical
procedures, modular OT (operation theatre) is designed.
What
are NABH Guidelines for Modular Operation Theatre?
NABH has set specific
standards and guidelines to be followed by all hospitals and make smart investments.
But, before knowing these NABH guidelines for modular operation theatre, let us
walk you through NABH and its standards.
NABH is responsible
to overlook the accreditation programs and quality standards for healthcare
organizations.
The up-gradation of
these standards is done every 5 years, considering all aspects right from
maintenance to personnel hiring.
NABH
Guidelines for Modular Operation Theatre in India
Among these, a
critical area is the accreditation of operation theatre. OT is the place in
hospitals where medical professionals carry out interventional procedures in a
sterile environment.
A constant check is
done for the infiltration of contaminants or airborne particles. Additionally,
the installation of HEPA filters or Laminar Airflow is done for supplying clean
air in the OT.
A modular OT is an
upgraded version of the OT in which seamless integration of systems having
ceiling panels and modular walls is done.
As
per the NABH OT guidelines, they are classified into two types:
• Type A: This is also named the
Super-speciality OT. In this, surgical proceedings including neurosurgery,
orthopedic surgery, transplant surgeries, etc. are carried out.
• Type B: These are also called general
OT. In these, less critical surgeries are carried out, including IVF, day-care
procedures, ophthalmology among other general proceedings.
Modular OT: Values
defined under NABH standards
• There should be a provision of
value-added services that are credible
• The services should constantly be
improvised
• The stakeholders hold the right to
get complete information along with open communication
• To enhance the services provided,
there should be constant incorporation of creativity and learning processes
NABH
OT Guidelines: Operation Theatres
The following aspects
should be kept in consideration when planning the design for the modular OT:
• Every modular operation theatre
should have a dedicated Air Handling Unit (AHU). This should not have any link
with air conditioners of other areas.
• No OT should have a split or window
A/C. These can be a direct pocket for microbial growth and the spread of
infection.
• The paint used in these rooms should
be antifungal and antibacterial.
• The OT door should be automatic,
touch-free (if possible) and sealed.
• The general lights should be
cleanroom.
• Safety precautions must be taken
against the static charges.
• For equipment like a laser, there
should be an installation of a separate power circuit.
• The flooring, ceiling and walls
should be anti-static. Following this, its regular cleaning should be done
being smooth and non-porous.
Air
conditioning guidelines for modular OT
The modular operation
manufacturers must keep the following guidelines into consideration during the
installation process of A/C:
• There should be a standard occupancy
of 5-8 people.
• The standard equipment load should
range between 5-7 kW. With this, a lightning load of 1 kW needs to be
considered.
• For super specialty OT, the load can
be extended to 7-9 kW.
• While designing this system, special
care must be taken for humidity and ambient temperature.
Requirements
for a general OT
The various factors
to be considered as per the NABH OT guidelines for a general OT include the
following: Air change per hour:
• According to the international guidelines,
there should be a minimum air change of 20. However, this can also differ on
the basis of location and biological load. Among these, the fresh air component
is supposed to be a minimum of 4 fresh air changes out of 20.
• Positive pressure:
It is required to
constantly maintain a positive pressure between the OT and the outside areas.
These are crucial to prevent the entry of outside air inside the OT zone. The
minimum pressure that must be maintained is 2.5 Pascal.
• Air filtration:
The OTs should have
well-maintained 2 filtration levels having all efficiencies as mentioned above.
• Humidity and temperature:
Inside the OT, the
temperature should be around 21℃ (+/-3). While the relative humidity in this area
should be in the percentage of 20-60%. Installation of
appropriate devices must be done in the area to keep a check on the temperature
and humidity levels.
System
maintenance in modular OT- NABH OT Guidelines
The maintenance
standards include the following:
• The Air Handling Unit (AHU) blower
should be operational round the clock, even during non-functional hours.
• For energy conservation, the
installation of variable frequency devices (VFD) can be done.
• The air changes can be made, but
keeping in consideration that positive pressure is maintained.
• The system validation should be
carried out based on the ISO 14664 standards.
• These should include a temperature
and humidity check, calculation of air change rate, pressure differential
levels in the OT, validation of HEPA filters by carrying out appropriate tests.
• Preventive system maintenance should
be carried out in regular time intervals, especially cleaning every 15 days.
Other maintenance should be done as guided by the modular operations
manufacturers.