The 2018 FGI Guidelines - Proposed Revisions to Procedure, Operating, and Imaging Room Requirements
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The 2018 FGI Guidelines
Proposed Revisions to Procedure, Operating,
and Imaging Room Requirements
Bryan Langlands AIA, ACHA, EDAC, LEED GA
The views and opinions expressed in this
presentation are the opinion of the speakers and not
the official position of FGI or the Health Guidelines
Revision Committee.
PROPOSED CHANGES TO SURGERY SECTIONS
Clarification of procedure room and operating room requirements intended to
support space for equipment and staff present for procedures provided
Section 2.1-3.2.2 (H) and 3.8-3.1 (OP) Procedure Room
Section 2.1-3.2.3 (H) and 3.7-3.4 (OP) Operating Room
Section 2.2-3.3.4 (H) Hybrid Operating Room
New classification structure for imaging rooms based on procedures performed and
environmental controls needed to allow flexibility in imaging room requirements as
procedures and equipment change over time
Section 2.2-3.4.1.2 (H) and 2.1-3.5.2 (OP) Imaging Rooms
Table 2.2-2 (H)
2018 FGI PROCEDURES
An understanding of the following is required to inform the planning of diagnostic, surgical, and
interventional spaces.
• Level of invasiveness, likelihood of infection
• Type of sedation used to conduct procedure
Level of • Number of staff expected in the room during procedure
Invasiveness • Equipment needed to support procedure
Infrastructure Which, in turn, determine the design requirements:
Requirements
Equip & Staff Type of • Room classification
required Sedation Procedure room (formerly Class A)
Operating room (formerly Class B & C)
Type of Imaging room (new Class 1, 2, and 3)
• Room size
• Room finishes
• Room Infrastructure (MEP systems)
INVASIVE PROCEDURE
A procedure that is performed in an aseptic surgical field and penetrates the protective surfaces of
a patient’s body (e.g., subcutaneous tissue, mucous membranes, cornea).
An invasive procedure may fall into one or more of the following categories:
§ Requires entry into or opening a sterile body cavity
(i.e., cranium, chest, abdomen, pelvis, joint spaces)
§ Involves insertion of an indwelling foreign body
§ Includes excision and grafting of burns that cover more than 20 percent of total body area
§ Does not begin as an open procedure but has a risk, as determined by the physician, of
requiring conversion to an open procedure
2018 GUIDELINES OBJECTIVE
• To make it easier for designers to know when what type of room is acceptable
• To make it easier for designers to right-size procedure and operating rooms
Task group concerns and discussions included increasing patient acuity and
complexity of outpatient surgical procedures, growing number of 23-hour-stay
post-procedure outpatient services, and need for consistency and standards for
environments
Inpatient Operating Room Outpatient Operating Room
Minimum 400 SF
Minimum 20’ width
THREE MAJOR TYPES OF ROOMS….
Procedure Imaging Room
Use
Room Type Type
A room designated for the performance of
1
patient care that may require high-level
Exam/ Class 1
disinfected or sterile instruments but is not
Treatment Imaging required to be performed with the
Room Room environmental controls of a procedure
room.
A room designated for the performance of
patient care that requires high-level
2
Class 2 disinfection or sterile instruments and
Procedure
Imaging some environmental controls but is not
Room required to be performed with the
Room
environmental controls of an operating
room.
A room that meets the requirements of a
restricted area, is designated and equipped
3
Class 3 for performing surgical or other invasive
Operating Imaging room procedures, and has the environmental
Room
(Hybrid OR) controls for an OR as indicated in ASHRAE
170. An aseptic field is required for all
procedures performed in an OR.
2018 GUIDELINES MINIMUM ROOM SIZES 48 SF
48 SF
(6’ x 8’)
80 SF 120 SF 130 SF 130 SF
Anesthesia
OP Exam Hospital Exam Procedure Room Work Area Procedure Room
(WITHOUT Need for Anesthesia Equip) (WITH Need for Anesthesia Equip)
48 SF 48 SF
255 SF 270 SF 400 SF 600 SF
15’ 20’
Outpatient OR Outpatient OR Hospital OR Hybrid
(WITHOUT Need for Anesthesia Equip) (WITH Need for Anesthesia Equip) (ALWAYS PLANNED for WITH Anesthesia Equip)STUDY BY AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Operating Room Architectural Flow Diagram
Copyright © 2017 American Society of Anesthesiologists. All rights reserved.
What is the minimum
SF required for an Nurses Anesthesiologists
Anesthesia Work Area?
Surgeons Perfusionists
Realizing Improved Patient Care through Human-centered
Operating Room Design:
A Human Factors Methodology for Observing Flow Disruptions in
the Cardiothoracic Operating Room
Anesthesiology. 2013;119(5):1066-1077.
doi:10.1097/ALN.0b013e31829f68cfCLEARANCE ZONE DIAGRAM
Establishing the Anesthesia Work Area
Anesthesia Patient area
Work Area
8’ 48 SF
6’
8’
Anesthesia 6’ x 8’ work zone
8’
7’
GURNEY 3’ X 7’ Gurney for planning purposes
6’ x 8’ Anesthesia Work Zone at Head
3’CLEARANCE ZONE DIAGRAM
Establishing the Anesthesia Work Area
Any room (Exam, Treatment, or Imaging rooms)
Perimeter where general anesthesia will be administered
Circulation using an anesthesia machine and supply carts
8’
shall have 48 square feet at the head of the
2’ table, gurney, or chair for an anesthesia work
zone.
6’
8’
Anesthesia 6’ x 8’ work zone
Gray and White area is 2’ area shared between
anesthesia and circulator.
The anesthesia work zone is a 6’ x 8’
space at the head of the table, but when
the anesthesia care provider(s) are not 6’ x 8’ Anesthesia Work Zone at Head
actively setting up sedation of the 2’ x 8’ at Perimeter, may serve as Circulation
patient 2’ at the top of that zone can be
used as part of the circulator pathway.ROOM CLASSIFICATION
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Patient care that may 4 total ACH for general exam room
Exam Room require high-level
6 total ACH for exam rooms programmed for use Ceilings: Cleanable with routine housekeeping equipment
disinfected or sterile
or Accessed from an by patients with undiagnosed gastrointestinal
instruments but does symptoms, respiratory symptoms, or skin symptoms Floor: No special requirement
unrestricted area
Treatment not require the
No pressure requirement Walls: No special requirement
Room environmental controls
of a procedure room Standard diffuser and return array
Ceilings: Smooth and without crevices, scrubbable, non-absorptive,
non-perforated; capable of withstanding cleaning chemicals; without
Patient care that requires crevices; lay-in ceiling permitted if gasketed or each ceiling tile weighs
high-level disinfection or at least one pound per square foot and no perforated, tegular, serrated, or
sterile instruments and 15 ACH / Positive pressure highly textured tiles. Lay-in ceiling permitted if gasketed or each ceiling
Accessed from an
Procedure some environmental tile weighs at least 1lb/SF
unrestricted or a Standard diffuser and return array
Room controls but does not Floor and wall base assemblies for cystoscopy, urology, and
semi-restricted area
require the endoscopy procedure rooms: Monolithic with an integral coved wall
environmental controls base that is carried up the wall a minimum of 6’
of an operating room
Wall finishes for endoscopy: Free of fissures, open joints, or crevices
that may retain or permit passage of dirt particles
Invasive procedures*
20 total ACH / Positive pressure Ceilings: Monolithic, scrubbable, capable of withstanding cleaning
Any procedure during Primary supply diffuser array extend a minimum of
and/or disinfecting chemicals, gasketed access openings
which the patient will Accessed from a
Operating 12’ beyond the footprint of the surgical table on Floor and wall base assemblies: Monolithic with an integral coved wall
require physiological semi-restricted each side base that is carried up the wall a minimum of 6’
Room area
monitoring and is
At least two low sidewall return or exhaust grilles Wall finishes: Free of fissures, open joints, or crevices that may retain
anticipated to require spaced at opposite corners or as far apart as possible or permit passage of dirt particles
active life supportEXAMINATION ROOM A room with a bed, stretcher, or examination table and capability for periodic monitoring (e.g., measurement of blood pressure or pulse oximetry) in which procedures that do not require a specialized suite can be performed (e.g., pelvic examination). TREATMENT ROOM A standard patient room in an emergency department (ED) or urgent care center that may be used for a variety of functions, including patient examination and various treatments or procedures, including wound packing, suture placement, or casting. This room may contain specialized equipment as identified in the functional program.
EXAM ROOM CLASSIFICATION
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Patient care that may 4 total ACH for general exam room
Exam Room require high-level
6 total ACH for exam rooms programmed for use Ceilings: Cleanable with routine housekeeping equipment
disinfected or sterile
or Accessed from an by patients with undiagnosed gastrointestinal
instruments but does symptoms, respiratory symptoms, or skin symptoms Floor: No special requirement
unrestricted area
Treatment not require the
No pressure requirement Walls: No special requirement
Room environmental controls
of a procedure room Standard diffuser and return array
80 SF 120 SF
OP Exam Hospital ExamPROCEDURE ROOM A room designated for the performance of patient care that requires high-level disinfection or sterile instruments and some environmental controls but is not required to be performed with the environmental controls of an operating room.
ROOM CLASSIFICATION
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Patient care that may 4 total ACH for general exam room
Exam Room require high-level
6 total ACH for exam rooms programmed for use Ceilings: Cleanable with routine housekeeping equipment
disinfected or sterile
or Accessed from an by patients with undiagnosed gastrointestinal
instruments but does symptoms, respiratory symptoms, or skin symptoms Floor: No special requirement
unrestricted area
Treatment not require the
No pressure requirement Walls: No special requirement
Room environmental controls
of a procedure room Standard diffuser and return array
Ceilings: Smooth and without crevices, scrubbable, non-absorptive,
non-perforated; capable of withstanding cleaning chemicals; without
Patient care that requires crevices; lay-in ceiling permitted if gasketed or each ceiling tile weighs
high-level disinfection or at least one pound per square foot and no perforated, tegular, serrated, or
sterile instruments and 15 ACH / Positive pressure highly textured tiles. Lay-in ceiling permitted if gasketed or each ceiling
Accessed from an
Procedure some environmental tile weighs at least 1lb/SF
unrestricted or a Standard diffuser and return array
Room controls but does not Floor and wall base assemblies for cystoscopy, urology, and
semi-restricted area
require the endoscopy procedure rooms: Monolithic with an integral coved wall
environmental controls base that is carried up the wall a minimum of 6’
of an operating room
Wall finishes for endoscopy: Free of fissures, open joints, or crevices
that may retain or permit passage of dirt particlesCLEARANCE ZONE DIAGRAM
PROCEDURE ROOM – INPATIENT & OUTPATIENT
(WITHOUT Need for Anesthesia Equipment) PROCEDURE ROOM ZONES W/O NEED FOR ANESTHESIA EQUIP
Patient area
Circulation pathway where the circulator
walks to perform duties. Cannot walk into
sterile field.
Movable equipment zone where the required
movable equipment is stored and provides
for door swing and opening of fixed drawers
or opening of door and drawers on carts
3’
CFA Clear Floor Area - 130 SF
7’
GURNEY 3’-0” Clearance at Head & Foot
3’-6” Clearance at Sides
3’-6” 3’ 3’-6” 130 SF CFA
3’CLEARANCE ZONE DIAGRAM
PROCEDURE ROOM – INPATIENT & OUTPATIENT
(WITH Need for Anesthesia Equipment) PROCEDURE ROOM ZONES WITH NEED FOR ANESTHESIA EQUIP
Patient area
Circulation pathway where the circulator
walks to perform duties. Cannot walk into
sterile field.
2’ Movable equipment zone where the required
3’ movable equipment is stored and provides
6’ for door swing and opening of fixed drawers
48 SF or opening of door and drawers on carts
3’ Anesthesia 6’ x 8’ work zone
8’
Gray and White area is 2’ area shared between
anesthesia and circulator.
CFA Clear Floor Area - 130 SF
7’
GURNEY 3’ X 7’ Gurney for planning purposes
6’ x 8’ Anesthesia Work Zone at Head
3’-6” 3’ 3’-6” 2’ x 8’ at Perimeter, may serve as Circulation
3’-0” Clearance at Head & Foot, 3’-6” Clearance at Sides
3’
130 SF CFA + 24 SF (3’ x 8’)2018 GUIDELINES MINIMUM ROOM SIZES
Exam, Treatment & Procedure Rooms
48 SF
80 SF 120 SF 130 SF 48 SF 130 SF
OP Exam Hospital Exam Procedure Room Anesthesia Procedure Room
Work Area
(WITHOUT Need for (6’ x 8’) (WITH Need for
Anesthesia Equip) Anesthesia Equip)2018 GUIDELINES MINIMUM ROOM SIZES
Operating Rooms
48 SF 48 SF
255 SF 270 SF 400 SF 600 SF
15’ 20’
Outpatient OR Outpatient OR Hospital OR Hybrid
(WITHOUT Need for Anesthesia Equip) (WITH Need for Anesthesia Equip) (ALWAYS PLANNED for or Specialty
WITH Anesthesia Equip)OPERATING ROOM A room that meets the requirements of a restricted area, is designated and equipped for performing surgical or other invasive procedures, and has the environmental controls for an OR as indicated in ASHRAE 170. An aseptic field is required for all procedures performed in an OR.
ROOM CLASSIFICATION
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Patient care that may 4 total ACH for general exam room
Exam Room require high-level
6 total ACH for exam rooms programmed for use Ceilings: Cleanable with routine housekeeping equipment
disinfected or sterile
or Accessed from an by patients with undiagnosed gastrointestinal
instruments but does symptoms, respiratory symptoms, or skin symptoms Floor: No special requirement
unrestricted area
Treatment not require the
No pressure requirement Walls: No special requirement
Room environmental controls
of a procedure room Standard diffuser and return array
Ceilings: Smooth and without crevices, scrubbable, non-absorptive,
non-perforated; capable of withstanding cleaning chemicals; without
Patient care that requires crevices; lay-in ceiling permitted if gasketed or each ceiling tile weighs
high-level disinfection or at least one pound per square foot and no perforated, tegular, serrated, or
sterile instruments and 15 ACH / Positive pressure highly textured tiles. Lay-in ceiling permitted if gasketed or each ceiling
Accessed from an
Procedure some environmental tile weighs at least 1lb/SF
unrestricted or a Standard diffuser and return array
Room controls but does not Floor and wall base assemblies for cystoscopy, urology, and
semi-restricted area
require the endoscopy procedure rooms: Monolithic with an integral coved wall
environmental controls base that is carried up the wall a minimum of 6’
of an operating room
Wall finishes for endoscopy: Free of fissures, open joints, or crevices
that may retain or permit passage of dirt particles
Invasive procedures*
20 total ACH / Positive pressure Ceilings: Monolithic, scrubbable, capable of withstanding cleaning
Any procedure during Primary supply diffuser array extend a minimum of
and/or disinfecting chemicals, gasketed access openings
which the patient will Accessed from a
Operating 12’ beyond the footprint of the surgical table on Floor and wall base assemblies: Monolithic with an integral coved wall
require physiological semi-restricted each side base that is carried up the wall a minimum of 6’
Room area
monitoring and is
At least two low sidewall return or exhaust grilles Wall finishes: Free of fissures, open joints, or crevices that may retain
anticipated to require spaced at opposite corners or as far apart as possible or permit passage of dirt particles
active life supportCLEARANCE ZONE DIAGRAM
OPERATING ROOM – INPATIENT
INPATIENT OPERATING ROOM
20’
Patient area
Sterile field where scrub and physician work
Circulation pathway where the circulator
walks to perform duties. Cannot walk into
48 SF
sterile field.
Movable equipment zone where the required
movable equipment is stored and provides for
door swing and opening of fixed drawers or
opening of door and drawers on carts
7’ Anesthesia 6’ x 8’ work zone
OR TABLE
Gray and White area is 2’ area shared between
anesthesia and circulator.
2’-6” 3’ 3’ 3’ 3’ 3’ 2’-6” CFA Clear Floor Area - 400 SF
3’ 3’ X 7’ Gurney for planning purposes
3’ at Sides & Foot – Sterile Field
2’ 3’ at Sides, 2’ at Foot – Circulation
2’-6” at Sides, 2’ at Foot – Equipment
2’
20’ Minimum Width, 400 SF Minimum CFACFA & CLEARANCE ALLOWANCE Revised text in 2018 FGI in order to acknowledge inevitable encroachments and other intrusions to space. Fixed encroachments shall be permitted to be included when determining Column minimum CFA requirements for an OR encroachment provided: 1) There are no encroachments into the sterile field 2) The encroachments do not extend more than 12 inches into minimum CFA outside the sterile field 3) The encroachment width along each wall does not exceed 10 percent of the length of that wall
OPERATING ROOM - OUTPATIENT
WITHOUT Need for Anesthesia Equipment
Procedures (100s of) that may be Procedures that are typically performed in
performed in an OR environment but may an OR environment but may only require
only require Local Anesthesia (numbing Local w/ Sedation (MAC – Monitored
medication), and do not necessarily have Anesthesia Care) and do not necessarily
need for extensive anesthesia equipment: have need for anesthesia extensive
equipment:
• Small excision • Carpal tunnel
• Cosmetic procedures • Cataract removal
• Eyebrow lift • Cystoscopy
• Blepharoplasty • Hysteroscopy
• Podiatry • Bunionectomy
• Hammertoe correction • Hand procedures
• Excisions of small massCLEARANCE ZONE DIAGRAM
OPERATING ROOM – OUTPATIENT
(WITHOUT Need for Anesthesia Equipment) OUTPATIENT OR ZONES W/O NEED FOR ANESTHIA EQUIPMENT
Patient area
15’ Sterile field where scrub and physician work
Circulation pathway and
movable equipment zone
3’ CFA Clear Floor Area - 250 SF
7’
OR TABLE
3’ 3’ 3’ 3’ 3’ 3’ X 7’ Gurney for planning purposes
3’ at Sides & 3’ Foot & Head – Sterile Field
3’
3’ at Sides & 2’ Foot – Circ. & Equip
15’ Minimum Width, 255 SF Minimum CFA
2’OPERATING ROOM - OUTPATIENT
WITH Need for Anesthesia Equipment
Procedures that are typically performed in Procedures that are typically performed in
an OR environment but could use general an OR environment requiring “intubation”
medication propofol or mask, but have a or using gas anesthesia (sevoflurane)
greater risk of requiring emergency care requiring anesthesia machine with vent
where access to full anesthesia care and capability:
equipment is advised:
• Breast augmentation • Extended abdominoplasty
• Mini tummy tuck • Shoulder arthroscopy
• Knee arthroscopy • Partial knee replacement
• Laparoscopy • Spinal fusion
• Cysto with holmium laser lithotripsy • Pediatric tonsillectomyCLEARANCE ZONE DIAGRAM
OPERATING ROOM – OUTPATIENT
(WITH Need for Anesthesia Equipment) OUTPATIENT OR ZONES WITH NEED FOR ANESTHIA EQUIPMENT
15’
Patient area
Sterile field where scrub and physician work
Circulation pathway and
1’-6” movable equipment zone
48 SF CFA Clear Floor Area - 270 SF
3’
7’
OR TABLE
3’ 3’ 3’ 3’ 3’ 3’ X 7’ Gurney for planning purposes
3’ at Sides & 3’ Foot & Head – Sterile Field
3’ 6’ x 8’ Anesthesia Work Zone at Head
3’ at Sides & 2’ at Foot – Circ. & Equip
2’ 15’ Minimum Width, 270 SF Minimum CFAIMAGING ROOM CLASSIFICATION
Environmental Controls
Room Type Use
Location Ventilation Surfaces
• Diagnostic radiography, fluoroscopy,
mammography, computed tomography Ceilings: Cleanable with routine housekeeping equipment; lay-in ceiling
(CT), ultrasound, magnetic resonance
Class 1 imaging (MRI), and other imaging
Accessed from 6 total ACH permitted
an
Imaging modalities unrestricted
No pressure requirement Floor: Cleanable and wear-resistant for the location; stable, firm, and slip-
resistant
Room • Services that utilize natural orifice entry area Standard diffuser and return array
and do not pierce or penetrate natural Walls: Washable
protective membranes
Ceiling: Smooth and without crevices, scrubbable, non-absorptive, non-
perforated; capable of withstanding cleaning chemicals; without crevices;
lay-in ceiling permitted if gasketed or each ceiling tile weighs at least one
15 total ACH
Accessed from pound per square foot and no perforated, tegular, serrated, or highly textured
• Diagnostic and therapeutic procedures
Class 2 such as coronary, neurological, or an Positive pressure for catheterization tiles
Imaging peripheral angiography unrestricted No pressure requirements for other Flooring: Cleanable and wear-resistant for the location; stable, firm, and
or a semi-
Room • Electrophysiology procedures restricted area
rooms slip-resistant
Standard diffuser and return array Floor and wall base assemblies: Monolithic floor with integral coved wall
base carried up the wall a minimum of 6 inches
Wall finishes: Washable; free of fissures, open joints, or crevices
Class 3 20 total ACH, Positive pressure Ceiling: Monolithic, scrubbable, capable of withstanding cleaning and/or
disinfecting chemicals, gasketed access openings
Imaging • Invasive procedures* Primary supply diffuser array extend a
Accessed
room • Any Class 2 procedure during which the minimum of 12’ beyond the footprint of Flooring: Cleanable and wear-resistant for the location; stable, firm, and
from a semi- slip-resistant
patient will require physiological the surgical table on each side
restricted
(Hybrid monitoring and is anticipated to require area At least two low sidewall return or Floor and wall base assemblies: Monolithic floor with integral coved wall
Operating active life support exhaust grilles spaced at opposite base carried up the wall a minimum of 6 inches
Room) corners or as far apart as possible Wall finishes: Washable; free of fissures, open joints, or crevicesIMAGING ROOM CLASSIFICATION
An imaging room is a room in which
imaging services are provided.
Depending on what takes place
within the imaging room, the room
maybe used for diagnostic,
therapeutic, or invasive procedures,
and as such should be designed to
the same standards as required for
those same procedures to take place
in non-imaging settings.
Proposed new classification system
for Imaging rooms.
T30 April 4 + 5, 2017 | 2018 FGI Guidelines: A New Class ActCOMPARISON
Exam/Treatment Room & Class 1 Imaging Room
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Diagnostic radiography, fluoroscopy,
Ceilings: Cleanable with routine
mammography, computed tomography (CT), housekeeping equipment; lay-in ceiling
Class 1 ultrasound, magnetic resonance imaging 6 total ACH
permitted
Imaging (MRI), and other imaging modalities No pressure requirement
Floor: Cleanable and wear-resistant for the
Room Services that utilize natural orifice entry and Standard diffuser and return array location; stable, firm, and slip-resistant
do not pierce or penetrate natural protective Walls: Washable
membranes
Accessed from
an unrestricted 4 total ACH for general exam
area room
Exam Room 6 total ACH for exam rooms
Ceilings: Cleanable with routine housekeeping
Patient care that may require high-level programmed for use by patients
or disinfected or sterile instruments but does not with undiagnosed gastrointestinal equipment
require the environmental controls of a symptoms, respiratory Floor: No special requirement
Treatment procedure room
symptoms, or skin symptoms
Walls: No special requirement
Room No pressure requirement
Standard diffuser and return
arrayCOMPARISON
Procedure Room & Class 2 Imaging Room
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Ceiling: Smooth and without crevices, scrubbable, non-absorptive,
non-perforated; capable of withstanding cleaning chemicals; without
crevices; lay-in ceiling permitted if gasketed or each ceiling tile weighs
Diagnostic and therapeutic 15 total ACH
at least one pound per square foot and no perforated, tegular, serrated,
procedures such as coronary, Positive pressure for catheterization or highly textured tiles
Class 2 neurological, or peripheral No pressure requirements for other Flooring: Cleanable and wear-resistant for the location; stable, firm,
Imaging Room angiography rooms and slip-resistant
Electrophysiology procedures Standard diffuser and return array Floor and wall base assemblies: Monolithic floor with integral coved
wall base carried up the wall a minimum of 6 inches
Wall finishes: Washable; free of fissures, open joints, or crevices
Accessed from an
unrestricted or a
semi-restricted Ceilings: Smooth and without crevices, scrubbable, non-absorptive,
non-perforated; capable of withstanding cleaning chemicals; without
area
crevices; lay-in ceiling permitted if gasketed or each ceiling tile weighs
Patient care that requires high- at least one pound per square foot and no perforated, tegular, serrated,
15 ACH
level disinfection or sterile or highly textured tiles. Lay-in ceiling permitted if gasketed or each
Procedure instruments and some Positive pressure ceiling tile weighs at least 1lb/SF
Room environmental controls but does Standard diffuser and return array Floor and wall base assemblies for cystoscopy, urology, and
not require the environmental endoscopy procedure rooms: Monolithic with an integral coved wall
controls of an operating room base that is carried up the wall a minimum of 6’
Wall finishes for endoscopy: Free of fissures, open joints, or crevices
that may retain or permit passage of dirt particlesHYBRID OPERATING ROOM A room that meets the definition of an operating room and is also equipped to enable diagnostic imaging before, during, and after surgical procedures. Imaging equipment is permanently installed in the room and may include MRI, fixed single-plane and bi-plane tomographic imaging systems, and computed tomography equipment. Note: Use of portable imaging technology does not make an OR a hybrid operating room.
COMPARISON
Operating Room & Class 3 Imaging Room
Environmental Controls
Room Type Use
Location Ventilation Surfaces
Ceiling: Monolithic, scrubbable, capable of
withstanding cleaning and/or disinfecting
Class 3 chemicals, gasketed access openings
Imaging Invasive procedures*
Flooring: Cleanable and wear-resistant for the
room Any Class 2 procedure during which the location; stable, firm, and slip-resistant
patient will require physiological monitoring Floor and wall base assemblies: Monolithic
(Hybrid and is anticipated to require active life floor with integral coved wall base carried up
Operating support the wall a minimum of 6 inches
20 total ACH, Positive pressure
Room) Wall finishes: Washable; free of fissures,
Primary supply diffuser array
open joints, or crevices
Accessed from extend a minimum of 12’ beyond
the footprint of the surgical table
a semi- on each side
restricted area
At least two low sidewall return or
Ceilings: Monolithic, scrubbable, capable of
exhaust grilles spaced at opposite
withstanding cleaning and/or disinfecting
corners or as far apart as possible
chemicals, gasketed access openings
Invasive procedures*
Operating Floor and wall base assemblies: Monolithic
Any procedure during which the patient will with an integral coved wall base that is carried
Room require physiological monitoring and is up the wall a minimum of 6’
anticipated to require active life support
Wall finishes: Free of fissures, open joints, or
crevices that may retain or permit passage of
dirt particlesTHREE MAJOR TYPES OF ROOMS….
Procedure Imaging Room
Use
Room Type Type
A room designated for the performance of
1
patient care that may require high-level
Exam/ Class 1
disinfected or sterile instruments but is not
Treatment Imaging required to be performed with the
Room Room environmental controls of a procedure
room.
A room designated for the performance of
patient care that requires high-level
2
Class 2 disinfection or sterile instruments and
Procedure
Imaging some environmental controls but is not
Room required to be performed with the
Room
environmental controls of an operating
room.
A room that meets the requirements of a
restricted area, is designated and equipped
3
Class 3 for performing surgical or other invasive
Operating Imaging room procedures, and has the environmental
Room
(Hybrid OR) controls for an OR as indicated in ASHRAE
170. An aseptic field is required for all
procedures performed in an OR.2018 FGI PROCEDURES – SUMMARY
Type of Room
Level of Risk of Sterility of Infrastructure
Invasiveness Infection Environment Room Finishes
Level of
Invasiveness 1 Non
Invasive
Low Low,
4-6 ACH
Low
Infrastructure
Requirements
Equip & Staff
required
Type of
Sedation 2 Limited 15 ACH
3 Invasive,
Any
High High, 20
ACH
High2018 FGI PROCEDURES – SUMMARY
Size of Room
Number of Type of Amount of Minimum
Staff Req’d Sedation Equipment Room Size
Level of
Invasiveness 1 Low None Limited 80-120 SF
Infrastructure
Requirements
Equip & Staff
required
Type of
Sedation 2 Varies, may
be General
15 ACH 130 SF
3 High
General
Anesthesia
High 255 SF OP
400 SF IPYou can also read
