On-Site Sterilization
Sterilizers for flash sterilization of instruments should be located as close as possible to the Operating Rooms, preferably in a shared
space adjacent to the Operating Rooms with immediate access from the semi-restricted corridor for service. Surgical instruments
needing flash sterilization are carried by the circulator in a tray from the Operating Room, through the semi-restricted corridor, into
the Sterilizing/Decontamination Room, and then returned to the Operating Room. Sterilizers may be steam, electric or plasma. A
minimum of two Sub Sterile Rooms with on-site sterilizers should be provided in each core of a Surgical Suite. A minimum of 3'-8"(1.1
meters) door width should be provided to the on-site sterilization area to accommodate equipment movement in and out of the room.
Scrub Alcoves
There are two alternative locations for scrub sink alcoves. In the alternative most typically seen in existing VA surgical suites, the
scrub sink alcoves are located within the clean core. The appropriately attired staff exits the staff lockers/lounge directly into the
clean core, use the scrub sinks, and then enter the Operating Room. In the other alternative, the scrub sink alcoves are located in
the semi-restricted corridor. This alternative reduces traffic through the clean core and is the current industry standard. As ties to
Medical Schools increase and more surgical residents are trained at the VA, the preferred arrangement for new Surgical Suites
should reflect the current industry standard.
All surgical team members must thoroughly wash (scrub) their hands prior to each surgical intervention. It is desirable to have at
least one scrub sink adjacent to the Operating Room, with an observation window above it, so that at least one member of the
surgical team can monitor the patient and the general status of the Operating Room prior to entering the room. Transfer of the patient
to the operating table and induction of anesthesia takes place while the surgical team scrubs for the operation.
Even though the use of alcohol gels is taking the place of traditional scrubbing at surgical scrub sinks, scrub sinks are still required
since some surgical staff members are allergic to the gels.
Provide laser shades at all window openings into all Operating Rooms. This includes the scrub area and all observation windows in
Operating Room doors and Control Rooms.
Design Guide - Surgical Service
Narrative
Guide Plate:
2j
Page 10 of 14
Date: August 2005
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