Final Draft 10-18-96
Revised February 1997
Narrative
GENERAL CONSIDERATIONS
housekeeping closets; gas storage area;
Current Direction
appropriate staff office; control and
With the recent change in direction of the VA
communication area; patient holding area;
from an inpatient oriented service to a
and other support rooms or areas as is
primarily outpatient service many new and
deemed appropriate.
innovative approaches to service have been
The "Sterile Field"
inaugurated.
The term "sterile" indicates that no micro-
One approach is Short Stay Surgery. The
organisms are present, as determined by
procedure unit is a one-day surgical and
known microbiologic techniques. We use the
diagnostic department of Ambulatory Care. In
term, "sterile field" to describe the sterile
this special unit patients have surgical or
zone in the operating room, which includes
diagnostic testing and return home - all in the
the space immediately surrounding the
same day. One result is reduced cost of
patient's incision. Everything that enters this
hospitalization. A highly trained professional
field must be sterile or as free of micro-
staff of doctors and nurses and efficient use
organisms as is possible.
of materials also help to reduce costs.
The air supply system must be designed to
Sizes of Ambulatory Suites are determined by
minimize airborne bacteria from entering the
VA planning models and approved by
sterile field, This helps to minimize the
authorized planning officials. Much of the
number of micro-organisms in those areas
current and future work in planning and under
which could contaminate the sterile field.
construction will be in clinics, because of the
costs involved the trend is away from huge
Usually, we consider three levels of concern
urban medical centers and more toward
within surgery in order to minimize the
smaller suburban clinics with the majority of
number or organisms present: (1) the sterile
patients being ambulatory (short term surgery
field as noted above, (2) the restricted area
and diagnostic testing) These clinics will do
which includes the operating room proper,
more General Surgery and Orthopedic work
the clean core just outside the operating
while Cystoscopic, Vascular and Cardiac
room and the support spaces adjacent to the
work will continue to be done in the larger
operating room such as the storage areas for
medical centers.
sterile supplies and instruments; (3) a semi-
restricted area to include spaces such as the
The surgical suite, is a group of rooms
instrument work room, non-sterile supply
consisting of the individual rooms in which
storage, personnel lounges and lockers,
surgery is performed, plus all the required
offices, and control desk.
support rooms.
Various support areas are required. These
include staff lockers and lounge areas;
anesthesia workroom; scrub areas for the
staff; storage space; connection to the Supply
Processing
and
Distribution
(SPD)
VA DESIGN GUIDE
AMBULATORY SURGERY
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