4 Must-Know Updates for Design and Maintenance of the Surgical Suite

What You Need to Know: Revised Guideline for Design and Maintenance of the Surgical Suite

“A nurse contributes valuable knowledge in any interdisciplinary team that designs and constructs new and renovated perioperative spaces,” according to AORN Guidelines Editor-in-Chief Erin Kyle, DNP, RN, CNOR, NEA-BC. She says, “Nurses also need to keep up with evolving standards around OR maintenance parameters such as air quality.”

Feel confident and competent to take your seat at the table in design and maintenance discussions by catching up on specific information outlined in the latest update to the Guideline for Design and Maintenance of the Surgical Suite, which just published electronically on eGuidelines+.

Kyle says those taking a first look at the revised guideline should start with these four updates:

1. Understand the Importance of the Periop RN on the Interdisciplinary Team

(Recommendation 1.4.1)

When engaging in any interdisciplinary team to discuss a periop renovation project, the perioperative RN provides essential input about:

• Clinical workflows
• Equipment
• Space utilization
• Workplace safety such as mitigating ergonomic hazards

Specific to patient safety during a renovation project, Kyle says nurses should be involved in verifying construction barriers and infection prevention measures are in place. “Nurses play a vital role in collaborating with all stakeholders in a renovation project to ensure a safe environment of care and to resolve any problems that arise during planning and construction.”

2. Share Patient Needs when Developing the Functional Plan

(Recommendation 2.8.1)

When contributing to the development of the functional plan, the perioperative RN should consider both current and known future perioperative needs, such as:

• Patient acuity, privacy, and safe patient handling and mobility
• Infection prevention needs such as physical distancing
• Workflow design features that facilitate smoother workflow and improve productivity

“Space and technology expansion such as interoperability infrastructure is an important area nurses should be able to speak to,” Kyle adds.

3. Be Able to Assess Risks

(Recommendation 2.9)

Nurses need to take the lead on assessing safety risk mitigation with a new or renovated space, including risks associated with:

• Infection control
• Safe patient handling
• Fall prevention
• Medication safety
• Behavioral and mental health
• Security
• Air quality

Specific to infection control during renovation and construction, Kyle suggests nurses be familiar with the CDC’s recommended environmental infection control measures related to internal construction and repair project steps, which are specifically outlined in the revised guideline.

4. Catch Up on the Latest Building Standards

(Recommendations 3, 13 and 14)

Day-to-day maintenance parameters should be discussed more widely as a team, Kyle suggests, including:

• Heating, ventilation, and air conditioning (HVAC) system design and function
• Number of air changes in perioperative spaces
• Humidity range parameters and what the temperature and humidity levels are in the OR when procedures are performed in the room
• Airflow pressure gradients (positive versus negative) in the perioperative environment

Basic air quality parameters from the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 170 are discussed in Recommendation 3 and outlined in Table 5 in the guideline update.

“Remember the critical role air quality plays in protecting all patients from surgical site infections,” Kyle cautions.

She also says nurses should be aware of the development of more stringent air quality controls that have come out after the COVID-19 pandemic to prevent the spread of airborne illnesses, such as required installation of minimum efficiency reporting value (MERV) 13 filters in new federal buildings. “We expect such enhanced air quality control recommendations to influence revised health care building standards.”

Learn More

Use these tools to navigate the latest Guideline for Design and Maintenance of the Surgical Suite and discuss the updates:

• Read the updated guideline
• Review the list of Key Takeaways for the revised guideline
• Check out the Guideline First Look article in the June issue of AORN Journal