13.3.1 Responsibilities of Operating Room Personnel in Environmental Management

The purpose of environmental management: while taking both nursing quality and personnel safety into account, operating room personnel should minimize the amount of waste so that it meets waste disposal standards and costs are controlled.

(1) All staff members should have environmental awareness and conserve energy such as water and electricity.

(2) During surgery, surgical supplies should be opened only when their use is confirmed.

(3) Disposable or reusable surgical supplies should be purchased according to surgical needs and their impact on the environment.

(4) Surgical waste should be differentiated as infectious and non-infectious, packed separately in bags of different colors, and collected and sorted for disposal by designated personnel.

(5) Containers holding blood, body fluids, or disinfectant solutions should be waterproof and leak-proof. When handling them, harm to staff should be reduced as much as possible; at the same time, in accordance with relevant national laws and regulations, the risk of exposure to the environment should be minimized.

(6) Priority should be given to purchasing items that meet national recycling standards, and products made from recycled raw materials should be purchased whenever possible to reduce the amount of waste and lower costs.

(7) For sterile items, priority should be given to purchasing items sterilized by high-pressure steam sterilization, so as to reduce the harm of chemical sterilization to human health, save time, and lower costs.

13.3.2 Safety Management of the Operating Room Environment

With the increasing use of complex, high-tech, and potentially dangerous surgical equipment and instruments, awareness of safeguarding the safety of patients and staff should be enhanced. Operating room staff should master relevant knowledge such as the operation, maintenance, and troubleshooting of special equipment and instruments, so as to ensure patient safety and prevent occupational injuries.

(1) Chemical injuries

1) Anesthetic waste. Sources of contamination include: spills of volatile anesthetics, gases exhaled by patients after anesthesia, and gases discharged from anesthesia machines. The toxicity of these contaminants mainly damages the liver, kidneys, and immune function; long-term exposure in pregnant women can easily cause miscarriage and fetal malformations. Preventive measures: inspect anesthesia equipment regularly, at least once every six months, checking for gas leaks and checking the functions of flow meters, ventilators, etc.; check whether the anesthetic waste gas scavenging tubes are leaking; air monitors may be used to determine the concentration of anesthetic waste gases in the operating room.

2) Bone cement. Long-term exposure can cause irritation to the skin, eyes, and respiratory tract; high concentrations can cause palpitations, headache, and even coma. Adequate protection of the eyes and respiratory tract should be provided when handling it.

3) Chemical disinfectants. Chemical disinfectants frequently used in the operating room, such as iodine preparations, formalin, and chlorides, are harmful to the skin and mu ...are irritating to membranes and eyes or even toxic; therefore, reasonable operating procedures should be established for their use, and appropriate protective tools and protective measures should be provided.

(2) Physical Injuries

1) Fire. The three conditions for combustion are an ignition source, combustible material, and an oxidizer. The operating room contains many such substances, so special attention should be paid to the following:

① The operating room floor should have good antistatic capability; attention should be paid to keeping the floor clean and maintaining its performance.

② Protect power outlets and switches; violent operation is prohibited; use them properly and never overload them.

③ Surgical gowns that generate static electricity should not be selected.

④ The relative humidity of the operating room is better kept at no less than 40%.

⑤ Electronic instruments should not be placed directly on the floor.

⑥ Designated personnel should regularly inspect and maintain all electrical equipment.

⑦ Handle flammable solutions such as alcohol and ether with care.

2) Electrical injuries. Use the electrosurgical unit correctly; when using it, remove combustible materials such as alcohol from the operating table; check the integrity of gloves at all times during surgery and replace them promptly to avoid electrical shock injuries.

3) Radiation injuries. Long-term exposure can cause cell mutation, chromosomal abnormalities, carcinogenesis, fetal malformation, or stillbirth. Before radiation is used in the operating room, there must be a warning or notification; staff should avoid it as much as possible, and lead aprons and lead screens should be provided for protection.

4) Hypothermia. The use of anesthetic drugs, body exposure, and the infusion and irrigation of unwarmed fluids can all lead to loss of the patient's body temperature; hypothermia increases the patient's risk of postoperative infection and death. Preventive measures are as follows.

Before surgery: adjust the room temperature appropriately and provide warming blankets to protect the patient's body temperature.

During surgery: lower the room temperature according to surgical needs, but unnecessary exposure should be reduced; monitor body temperature; use warmed fluids for infusion and irrigation.

After surgery: monitor body temperature and provide warming blankets for protection.

5) Biological injuries. Improper handling of patients with infectious diseases can affect the safety of staff and even other patients; the handling of surgical items used for such patients should strictly follow relevant regulations; during surgery, operating techniques should be strictly executed to avoid sharp instrument injuries; if an injury occurs, it should be treated promptly and reported to the relevant hospital departments for registration, testing, and follow-up.