Operating Room 医院建设中手术部的策划-节选
Function 功能-医院建设
The OR (surgery department) of hospital is that area responsible for the surgical procedures, or operations, performed on hospital inpatients and ambulatory outpatients. 手术部是指为住院病人或急诊病人做手术的区域。
Because surgical procedures are performed under the strictest sterile techniques and infection control concepts, the design of the department and the flow of patients, staff, and supplies must be rigidly controlled. The surgery department includes a required number of operating rooms, pre- and post-anesthesia areas, technical support functions, equipment and supply areas, and administrative staff space. 由于手术需要在最严格的消毒环境和感染控制下进行，因此空间布局、病人和员工流量需受到严格控制。手术部包括一定数量的手术室、麻醉前和麻醉后恢复室、技术支持区、设备供应区和员工区。
Traffic Flow 交通流量
Today the more commonly used design combines a clean core with peripheral corridors, sometimes called the “racetrack” design. This hospital will adopt clean core OR design. 目前手术室普遍的设计是把清洁中心和外围走廊连接起来，也被叫做“跑道”式设计。
This plan will typically have three basic zones of traffic flow. 此方案有三个基本的流通区。
Unrestricted Areas 非限制区
The unrestricted area allows visitors or staff attired in street clothing to enter the surgery department. Their movement is limited to the locker rooms, staff lounge, and from the main entrance to the control station. 非限制区允许访客或员工穿着便服进入手术部。他们只能在更衣室、员工休息室和控制站入口区活动。
Semi-Restricted Areas 半限制区
These areas are within the department and beyond the control station, requiring personnel to be attired in scrub suits or dresses, shoe covers, and hair covers. 半限制区在手术部里面、控制台前方，要求人员穿着消毒服、鞋套和头套。
Restricted Areas限制区
The most restricted areas of the department are the operating rooms, the clean core, and the scrub areas. A face mask must be worn in these areas in addition to the scrub suit and hair and shoe covers. 手术部中最严格的限制区是手术室、清洁中心和刷手区。这一区域内的人员必须带口罩，穿消毒服，戴头套和鞋套。
Flow of Patients 病人流通
Patients are brought to the surgery department on stretchers from the patient units. After notification of the control station staff, patients are moved to a preoperative holding area to wait for the available operating room. Medications and/or intravenous fluids may be administered while patients are in the pre-operative holding area. 医护人员用推车将手术病人从病房推到手术部。控制台员工核对后，病人被推到术前准备区等候可用的手术室。在术前等候区病人接受给药和/或静脉注射。
Surgery procedures are scheduled for predetermined times in specific rooms with a minimal amount of turnaround time between cases for cleaning and case preparation. 手术需在提前订好的时间和手术室内进行，两台手术之间的清洁时间和准备时间要缩短到最小。
Patients will then be moved to the designated operating room, the anesthesia administered, and the surgical procedure performed. 病人被推到指定手术室，麻醉师麻醉，开始手术。
Following surgery, patients are moved to the post-anesthesia care unit where they remain until responding and awake, and are then returned to the patient unit. 手术完成后，病人被推到麻醉后恢复室，恢复意识后被推回到病房。
Flow of Supplies 供应品流通
The surgery department is the primary user of sterile equipment and supplies in the hospital, sterile processing department (Central Supply) are being located either adjacent to or in a direct line above or below the surgery department. Today, the supplies and instruments for surgery are centralized, reprocessed, and distributed from the sterile processing department, eliminating the costly duplication of reprocessing equipment and reducing both inventory and labor costs by utilizing movable modular casework and carts. 手术部是医院里消毒器械和物品的主要使用部门，因此现在的消毒部门位于手术部旁边或与手术部上下相连。当前，手术用供应品和器械在中心供应室集中放置、再加工，然后分发出去。这就降低了重复加工器械的成本，降低了搬运这些物品的人力和推车成本。
The method of choice for the delivery of surgical supplies and instruments is the case cart system. Rather than instruments and supplies for each operative case being housed in casework and compiled in the operating room, the sterile processing department will assemble the appropriate supplies and send them to surgery as a specific case cart. This case cart is stocked with all of the materials, instruments, and supplies necessary for a single designated surgical procedure, with a cart prepared in advance for all daily scheduled surgery cases. Thus the turnaround times between cases can be kept to a minimum. Case carts are also supplied and kept ready for the most frequently performed emergency cases.可选择推车系统来运送手术物品。每台手术用的器械和物品无需再堆放在手术室内，消毒运送部门将集合相应物品并用推车将其送到手术室。这种推车上配有一台特定手术需要的所有材料和器械，另预先备有一台推车以供应常规手术。如此，两台手术间的时间就被缩短到最短。推车时刻为最常见的急诊手术准备着。
For the clean core/peripheral corridor type of plan, there is dual access to the operating rooms with the clean supplies and case carts flowing from the clean central core into the operating room and the dirty supplies and contaminated case carts moving into the peripheral corridor to the decontamination area. This type of flow provides the best opportunity for infection control, preventing the clean and dirty supplies from crossing paths. 在消毒中心岛设计中，有两条通道通向手术室。消毒物品和推车从洁净中心进入手术室，污物和污物车从另一通道直通污染区。这种流动型方案可最大可能地控制感染，避免清洁物品和污物交叉接触。
Materials Handling Components 材料管理
Movable modular materials handling components can be especially useful for supporting effective and efficient delivery, storage, use, and removal of the supplies used in the surgery department. 它的使用可提高运送、存储、使用手术用品的效率。
Components can be rearranged to suit any needed configuration as static storage, either wall-hung or freestanding. 各组件能根据需求重新安排，即可固定放置也可手提。
The quick-delivery capability allows specialized supplies to be stored in a central location and transported to an operating room on demand. Each component can become mobile by combining it with a wheeled component and used for transport as well as storage. 快速运送能力使得特殊用品能够在存放中心与手术室间快速移动。每个组建都能装上轮子，不仅能储放而且可用于运输。
Case carts.
• L carts. L型推车
• Crash carts.急救车
• Specialty procedure carts. 移动专科治疗车
• Lockers.柜子
• Supply carts. 供应品车
• Process tables. 移动处理桌
• Extra-deep modular shelving.外延式货架
Staff 员工
Surgery departments typically have two lines of authority – physicians and nurses – and an administrative staff. 手术部门员工分两类：医护人员和行政人员。
Physician Staff 医生
Chief of Surgery手术部主管
The chief of surgery (an MD or DO) will oversee the physicians, the surgical procedures, and/or the administration of anesthesia, as well as make recommendations concerning the medical aspects of the department. 手术部主任要监督医生和手术过程、管理麻醉并对手术部医疗问题做出决策。
Chief of Services 服务部主管
The chief of services is an MD who oversees a specialty service such as orthopedics. 服务部主任由医学博士担任，提供专业服务，如骨科手术。
Chief of Anesthesiology 麻醉主管
The chief of anesthesiology (an MD or DO) is the administrative head of the anesthesia department and supervises the anesthesiologists, nurse anesthetists, and anesthesia technicians. This position manages anesthesiology supplies, equipment, and procedures.麻醉部主管是麻醉部门的行政主管，负责监管麻醉师、麻醉护士和麻醉技术的使用，也要管理麻醉供应品、器械和流程。
Operating Room 手术室
Staff 员工
OR Supervisor 手术室管理员
An operating room supervisor or director of surgical services is usually an RN with extensive operating room experience and may have an advanced degree in nursing, management, or business. This position will be in charge of nursing; responsible for such business aspects of the department as budgets, inventory, scheduling, and staffing; and responsible for balancing the needs of administration, physicians, operating room staff, and patients.手术管理员通常是注册护师，有丰富的手术室工作经验，高级护理文凭或管理类文凭。他负责管理护理工作，科室财务、收益、安排工作和人事，平衡医师、护士与手术室员工、患者之间的关系。
Head Nurse/Clinical Nurse Manager 护士长
This person usually is a registered nurse (RN) with or without an advanced degree; works with one or more specialty services, such as cardiovascular; and is influential in decisions regarding supplies, equipment, policies, and procedures for that specialty area. 护士长通常是名注册护师，有或没有高级护理文凭，在供应品、仪器管理和决策制定中有影响力的人。
Circulating Nurse 循环护士
This is a registered nurse (RN) who coordinates activity in the operating room for a particular surgical procedure, opens supplies for the scrub nurse, assists with moving the patient, applies dressings, etc. 他应是名注册护师，负责协调手术室、为手术助理护士提供供应品，协助移动病人，提供消毒衣物等。
Scrub Nurse/Instrument Nurse 手术助理护士/器械护士
This registered nurse (RN) or surgical technician maintains the sterile operating field, and organizes and passes sterile instruments and supplies to the surgeon. 她应是名注册护师或手术技师，维护消毒操作区，组织和递送消毒器械和手术用品。
Surgical Technician手术技师
Typically, this technician has completed a one-year program in preparation for working in a surgery department and is familiar with instruments, surgical procedures, and sterile techniques. 手术技师需有一年在手术部工作经验，熟悉各种器械、手术流程和消毒技术。
Administrative Staff行政人员
Manager of Post-Anesthesia Care Unit 麻醉后护理区管理员
The manager of the post-anesthesia care unit (PACU) is a registered nurse (RN) with administrative responsibilities for the PACU. This person may be a major decision maker or influential in equipment and facility decisions as they relate to this unit. 她应为注册护师，负责麻醉后恢复室的行政事务，是这一区域内供应品供应的主要决策者。
Manager of Ambulatory Surgery 急诊手术管理员
This may be the operating room supervisor or a separate RN manager who reports to the administrator of ambulatory services. Frequently, this person supervises a patient holding and recovery area separate from the main surgery department and is responsible for department staff and budgets. 可由手术部主管或单独的助理护士担任（该护士需向急诊手术主管报告），负责监管与主要手术区相隔的病人区，管理部门人员和财务。
Anesthesia Supervisor 麻醉监护师
The anesthesia makes decisions on supplies, budgets, and equipment purchases frequently in conjunction with the chief of anesthesiology. This person may be a nurse anesthetist or technician. 负责管理麻醉物品、设备和部门财务，通常由麻醉部主管担任，也可是麻醉护师或技师。
OR Materials Manager 手术室材料管理员
This position, many times found in larger and/or teaching hospitals, may report to the director of surgical services, the director of sterile processing, or the director of materials management. This person is responsible for ordering supplies and, sometimes, instruments and equipment. 大医院或教学医院里大多有该职位。他可向手术服务部主管、消毒部主管或材料管理部主管报告。负责订购供应品，设备等。
Functional Areas功能区-医院工艺设计
Control Station控制站 医院规划
The control station is primarily a clerical area located in a position to control traffic into the surgery department. Similar to a nurse station, it is the communications center of the surgery department. A control station may be configured in a variety of shapes and sizes depending on the size of the department and the number of operating rooms. 控制台最初为办事员区域，控制通往手术部的交通。与护士台类似，是手术部的通信中心。控制台形状千差万别，规模取决于部门规模和手术室数量。
A control station tends to differ from a nurses station in that less people generally work out of this area, and usually there are no patient monitors located here. 与护士站不同的是这个区域外的工作人员很少，通常没有病人监护员。
Surgeries are scheduled; patient charges, records, and administrative functions are maintained; and intra- and interdepartmental communications are channeled through the control station. 控制台要安排医师；安排病人，管理病案，从事行政事务，进行部门对内对外的沟通。
Space should be provided for requisitioned items to be delivered or picked up by other departments. 这一区域也暂时存放要被运走或被其他部门取走的物品。
A control station will range in size from 20 to 40 square meters. 一个控制站大小在20-40平方米之间。
Pre-Operative Holding, Scrub Area 术前准备区，刷手区
Pre-Operative Holding术前准备区
Patients arriving for surgical operations are held in this area until the appropriate operating room is ready. This area may also be called pre-anesthesia as patients may be given medications or intravenous
fluids under close observation of the nursing staff. 等候手术的病人在此区域直到相应的手术室准备完毕。这一区域也叫麻醉前区域，再次病人可在护士的严密观察下接受静脉注射和药物。
Plan View of a Pre-Operative Holding Area术前准备区方案
A pre-operative holding area will range in size from 30 to 70 square meters. 这一区域大小在30-70平方米。
6 linear feet work surface
10 linear feet overhead storage
2 L carts
1 procedure cart
Scrub Area刷手区
Scrub areas are placed strategically outside operating rooms. For the clean core/ peripheral corridor plan, the scrub sinks are best located in the peripheral corridor. 刷手区应位于手术室外。洁净中心或外围走廊的方案设计，刷手池应设在外围走廊。
Surgical scrub sinks are generally ceramic or stainless steel with foot or knee controls. It is helpful to place shelves above the sink to hold scrub brushes and masks. 手术刷手池材质基本上为陶瓷或不锈钢，由脚或膝盖控制。最好在池子上方装架子以防刷手刷和口罩。
Plan View of a Scrub Area刷手区方案
8 linear feet overhead storage (2 feet per sink)
Operating Room手术室
Operating Room手术室
An operating room is the area where surgical procedures are performed under strict sterile techniques. 手术室内的手术须在严格消毒环境下进行。
The half of operating rooms is orthopedic dedicated for both open and minimum invasive surgeries. Special supplies and equipment are either stored in OR or the storage room next the OR.手术室一半为骨科专用手术室，包含骨科专用设备的摆放空间及储存间
The other half operating rooms are generic and used for many different procedures which will maximize the use of the space. Special supplies and equipment are moved in and out as needed. 手术室另一半为通用手术间，要本着最大化利用空间的原则被用于不同手术。特殊物品和设备根据需要运进运出。
Operating rooms should have positive pressure ventilation systems, with controlled temperature and humidity, to prevent corridor air from entering. 手术室应有正向压力通气系统，要控制室内温度和湿度，防止走廊内空气进入。
The general layout of the OR should place the work surface for the circulating nurse near the entrance door and the movable modular casework on the wall at the foot end of the table depending on the head orientation of the patient. 一般手术室应在门口附近有循环护士工作台，患者脚方向的墙上有可移动标准工作台（根据病人头的朝向而定）。
Little or no built-in casework should be used in the operating room for sanitization purposes and because：出于卫生清洁的目的，手术室内尽量少装或不装固定台面。因为：
• Built-in casework inhibits change.固定台面很难更换
• It is difficult to sanitize.难以消毒
• It increases construction costs due to the need for soffits and recesses.由于需要底座和凹槽，增加了建筑成本
• It increases the floor space needed.占用了底面空间
L carts or procedure/supply carts used for：运送车可用来运送和固定：
• Anesthesia supplies and equipment.麻醉供应品和设备
• Suction and cautery equipment. 抽吸和电烧设备
• Monitoring equipment.监护仪
• Prep and dressing.衣物
• Anesthesia carts.麻醉车
Stainless steel case carts which can also be used as a back table.不锈钢推车
Lockers used for：柜子用来存放：
• General supply storage.供应品
• Backup supplies.备用物品
• Specialty procedure carts.特殊用品
Process tables used as：操作桌用来：
• Administrative/computer workstations.电脑台
• Back table for instruments.后桌
Plan View of an Operating Room手术间方案
An operating room will range in size from 40 to 60 square meters. 一间手术室大小在40-60米。
1.2 linear meter work surface 0.5米长的工作台面
1.2 linear meter overhead storage 0.5米长的顶柜
1 locker for anesthesia supplies 1个麻醉用品柜
3 lockers for backup supplies 3个备用物品柜
1 L cart 1个L型推车
1 anesthesia cart case carts as required 1个麻醉推车
Sub-sterile消毒区
Sub-sterile rooms are workrooms, located between two operating rooms. They most frequently contain the “flash” sterilizer and the blanket/solution warmer, as well as storage of clean supplies and equipment. 消毒区通常位于两间手术室之间。他们通常由冲洗式消毒器和加热机，也存放有清洁用品和设备。
Plan View of a Substerile Room消毒间布局方案
A substerile room will range in size from 8 to 20 square meters. 大小在8-20平方米间
2.4 linear meter work surface 2.4米长的工作台
2.4 linear meter overhead storage 2.4米长的顶柜
1 locker for supplies1个供应品柜
120 square feet12平方米
Clean Core洁净中心
Clean and sterile supplies are stored in the clean core, a large internal corridor adjacent to and opening into all operating rooms.清洁和消毒物品被放在洁净中心岛，一条大的内部通道毗邻并可通往所有手术室。
This area is accessible only to those in surgical attire. 只有穿手术服得人可进这一区域。
The area may allow for freestanding or built-in sterilizers, blood refrigerator, and freestanding or table-top warming cabinets. 这一区域要有独立或固定的消毒设备、血样冷藏柜和加热柜。
Plan View of a Clean Core 设计
A clean core will range in size 25 square meters per operating room.面积在25平米/每间手术室之间
2.4 linear meter work surface 2.4米长工作台
2 lockers per operating room 2个柜子/间手术室
1 case cart per operating room 1个推车/间手术室
Post-Anesthesia Care Unit (PACU/Recovery Room) 麻醉后恢复区
This area is usually adjacent to the operating room and generally near the critical care units. Patients are brought to this area after surgery to recover from anesthesia and regain stable vital signs.这一区域要毗邻手术室和主要护理区。术后患者在这里进行麻醉后恢复直到有稳定的体征。
After patients are stable, they are transferred to a patient unit or, in the case of outpatient surgery, patients are moved to secondary recovery before being discharged.患者情况稳定后，被送往住院区。被接管前被运往二级恢复室。
The space is usually in an open area with patients separated by cubicle curtains or modular panels. Those patients who need to be isolated are kept in a separate isolation recovery room. 这一区域通常在一个开放空间内，但病人用拉帘或隔板隔开。需要被隔离的患者要被放在单独的恢复室。
The layout of this space generally includes a medical headwall for each patient stretcher, a nurses control station, a medication preparation area, an area for supplies and equipment, and hand washing sinks.这一区域的布局一般包括：每张病床配一扇医用墙的护士控制台、药品准备区、供应品和设备区、洗手槽。
Plan View of a Post-Anesthesia Care Unit 设计
A post-anesthesia care unit will range in size from 10 to 30 square meters per bed. 面积在10—30平米/床之间
54 linear feet work surface 54英尺工作台
46 linear feet overhead storage 46英尺顶柜
40 filing inches 40英寸文件夹
1 C frame storage unit per bed 1张床有一个1个C臂储物柜
lockers as required 按需要配柜子
L carts as required 按需要配L型推车
procedure carts as required 按需要配运送车
bulk supply carts as required 按需要配供应品车
Equipment Storage 设备存放区
There is a large amount of equipment that needs to be stored for use in the operating rooms and a variety of ways of storing this equipment. Peripheral corridor alcoves or single-corridor alcoves can be planned for stretcher storage, a single large room for general equipment storage, and/or specific
smaller rooms for specialty equipment storage such as orthopedic, cardiac surgery, etc.有大量设备需要放在这里以供手术室使用，有很多种方式来存放这些设备。外围走廊上的内置柜或单向走廊上的内置柜都能放置担架，一间大屋子来放置一般设备，或\并且有一些小屋子来放置特殊器械，如骨科和心外科手术用器械。
Much of this equipment must be accessible to electrical outlets to maintain battery charges.这些设备大多需要接上电源以保持电量。
In addition to needing floor space for housing large equipment, overhead shelving can be used so equipment can be placed underneath for maximum use of space. 除了可用地面空间来放设备外，顶柜也可用来放，以最大化利用地面空间。
Movable Modular Casework Applications可移动标准工作组件的应用
An equipment storage area can be planned using movable modular casework components and may require：需配有：
• Extra-deep modular shelving units and/or lockers with shelves to keep smaller items off the floor.外延式货架离地放置小物品
• Cantilevered work surfaces. 悬臂式工作台
• Wire carts.带电线的推车
Plan View of an Equipment Storage Room设计
An equipment storage room will range in size from 150 to 400 square feet.面积在150—400平米之间
4 linear feet work surface 4英尺工作台
32 linear feet storage 32英尺储物柜
1 locker 1个柜子
220 square feet 220平米
Clean/Sterile Storage 消毒物品存放区
Clean/sterile storage areas differ in each surgery department depending on how supplies are distributed to the department and the layout of the department:这一区域根据手术部不同而各有区别，主要取决于供应品通过何种途径到达手术部以及部门的布局。
• Supplies may be sent to this area on a replenishment and/or exchange system from general stores and/or sterile processing.供应品或许通过补充或交换系统从一般存放室或消毒处理室运来
• Case carts may be partially or entirely assembled in this area, or case carts may be sent to this area
from sterile processing.装满物品的部分或全部推车集中在这里，或者从消毒处理区推来。
Movable Modular Casework Applications 可移动标准工作组件的应用
A clean/sterile storage area can be planned using movable modular casework components and may require：需配有：
• Process tables to stage supplies for packing case carts (if assembled here).放置供应品的处理桌
• Regular and extra-deep modular shelving units.标准外延型货架
• Lockers to store clean/sterile supplies or to be used as case carts.储存清洁物品的柜子或推车
• Specialty procedure carts.特殊物品运送车
• Stainless steel case carts.不锈钢推车
• Space for wire carts to hold sterile linen, bulky supplies, and instrument trays.放置清洁被服、大体积供应品和设备的空间
Plan View of a Clean/Sterile Storage Area 设计
A clean/sterile storage area will range in size from 225 to 400 square feet.面积在225—400平米
lockers or wire carts as required 依需要放柜子或推车
bulk supply or wire carts as required 依需要放装满物品的推车
279 square feet 279平米
.........节选，如需详细信息，请直接联系我们