Follow these guidelines on temperature, humidity
[Editor’s note: To help our readers, Same-Day Surgery is printing advice in the top 10 areas that receive the most questions at the Center for Nursing Practice, Research, and Health Policy at the Association of Operating Room Nurses (AORN) in Denver. The ninth topic, included in this month’s issue, covers temperature and humidity.]AORN does not independently make a recommendation for temperature and humidity in the operating room. AORN supports the regulations from the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, as published by the American Institute of Architects Committee on Architecture for Health with assistance from the Department of Health and Human Services, both in Washington, DC. The publication, Guidelines for Construction and Equipment of Hospital and Medical Facilities, recommends the following (see box, below right):
o Location: operating room.
• temperature: 70-75 degrees;
• humidity: 50-60%;
• exchange per hour: 15;
• recirculation by room unit (fans): no;
• pressure relation to adjacent area: positive;
• exchange outdoor air per hour: 3.
o Location: anesthesia gas storage.
• temperature: 70-75 degrees;
• humidity: 45-60%;
• exchange per hour: 8;
• recirculation by room unit (fans): no;
• pressure relation to adjacent area: not designated;
• exchange outdoor air per hour: not designated.
o Location: recovery room.
• temperature: 70-75 degrees;
• humidity: 30-60%;
• exchange per hour: 6;
• recirculation by room unit (fans): no;
• pressure relation to adjacent area: not designated;
• exchange outdoor air per hour: 2.
Although other publications may have some slight variations of the above recommendations, AORN believes these to be the most authoritative published at this time. These regulations superseded the Hill-Burton regulations under which many hospitals functioned following World War II and until recent years. As hospitals completed their commitments related to funding provided by the Hill-Burton Act, Hill-Burton regulations no longer applied. The current guideline publication as noted above is published as a continuation of minimum requirements. (Editor’s note: Also check your state requirements.)
Some confusion has existed due to the publication Guideline for Prevention of Surgical Wound Infections, 1985, from the Centers for Disease Control and Prevention (CDC) in Atlanta. In this document, the CDC identified a higher number for the recommended air exchanges in the operating room. Although the CDC has not and does not intend to update the 1985 document, as of 1996, the CDC agrees with the above recommendations for air exchanges in the operating room.
In some areas of the United States, maintenance of the recommended relative humidity is difficult. Special centralized units are needed to maintain the recommended figure. Such units should be self-regulating to maintain the humidity at a constant within the recommended range. Room units of any kind are not recommended in each operating room. Such units create unwanted dust and turbulence and/or dispense harbored mold and bacteria into the environment. A relative humidity that is too high can result in damp or moist supplies with added opportunity for mold growth. A relative humidity that is too low can result in excessive bacteria-carrying dust within the surgical environment.
The following sources provide additional information related to the surgical environment:
• American Institute of Architects Committee on Architecture for Health with assistance from the U.S. Department of Health and Human Services. Guidelines for Construction and Equipment of Hospital and Medical Facilities. Washington, DC: AIA Press, 1993; 23-26.
• H. Laufman, ed. Hospital Special-Care Facilities: Planning for User Needs. New York: Academic Press; 1981.
Reprinted with permission from AORN Online (http://www. aorn.org/), 1997. AORN Inc., 2170 S. Parker Road, Suite 300, Denver, CO 80231.
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