Introduction.

Main Operating Theatre is a place where major surgeries are performed, this is the engine of the hospital where by life serving procedures are performed. Since the establishment of Bugando Medical Centre about 50 years ago, the main operating theatre was having only five rooms with the average capacity of operating only 25 patients per day. These was associated with a lot of inconveniences such as unnecessary cancellation of elective surgeries due to emergencies and long waiting time for surgeries up to three months as the same rooms ware used for emergencies.
From 2018, the hospital started theatre project whereby another five new rooms were constructed and the other five ware renovated to a high level of accepted standard. The modern main operating theatre has 10 operating room with modern equipment. Operating rooms for emergency cases are now at the emergency medicine department. We can operate a minimum of 50 patients per day and we have reduced the waiting time to a week.

Organisation:

• Waiting area: Through the main theatre entrance, this is the place where patients are received and prepared for surgery, some of the patients are given anesthesia at this area. This area is well equipped and has 10bed capacity
• Recovery area: This is the place where patients are kept after surgery recovering from anesthesia under a close monitoring. It’s well equipped with patient monitors and has 10 bed capacity
• Operating rooms: These twin rooms, five on each side connected by a corridor in between (sluice area). Operating room meet the accepted international standards, walls and floor is made of epoxy and swing doors. Each room is fitted with modern LED operating light, good anesthesia machine, modern operating tables and scrub sink.
• Sluice area: These is the corridor connecting the ten communicating operating rooms, where all the blood-soaked linen, used instruments from the paired operating rooms are taken to and cleaned. Its fitted with modern sluice sinks.
• Sterile equipment room: The area keeps all sterile equipment ready to be used in theatre from central sterilization unit.
• Autoclave room: The room ha two autoclaves for emergency sterilization of small equipment
• Frozen section room: Room special for making tissue diagnosis with five minutes while patient is still on operating table. This enables surgeon to make proper decision intraoperatively.
• 8Pharmacy room: Keep all the medicines and supplies needed in theatre, one should not go outside theatre during the procedure
• Offices: One room for Theatre In charge and Superintendents and five rooms shared by two operating room all equipped with computers and eHMS system for documentation
• Tea room:For all theatre staff with necessary utilities
• Teleconference room: Special room for Medical students, its fitted with two big screens where by students will not be overcrowding in the operating room for clinical practices. This will reduce the infection rate in theatre.
• Changing room: These are two big ground floor rooms for male and female

Staff:

• Theatre In charge: A surgeon overall in charge of all activities in theatre
• Theatre manager: Responsible for all theatre revenues
• Superintendents: In charge for theatre nurse, making roster, shifts and keep theatre equipment, they are two
• Anesthesiologist: Incharge of all anesthetist and anesthesiologist, making roster, shift and keep theatre equipment
• Specialist/super specialist: We have 50 specialist and super specialist in ten surgical department namely as General surgeon-7,Gastroenterologist-1, Orthopedic surgeon -5, Pediatric orthopedic surgeon-1, Obstetric and Gynecologist- 14, Gynecology Oncologist-1, Endocrine Gynaecologist-1, Urology ynacologist-1, Urologist-5, Pediatric Opthalmologist-1, Opthalmologist-1,ENT-Surgeon 5, Dental, oral maxillofacial surgeon-1, Cardiac and Chest surgeon-1, Neurosurgeon- 3, Anaesthesiologist-3
• Residents: 11 residents
• Registrars:15 registrars
• Theatre nurses:Total of 62,36 Nurses and 26 anesthetists

Functions:

• SOP/Guideline are established to monitor and guide all theatre activities
• Surgical directorate has ten department, each department has its own theatre room allocated
• They are capable of operating daily
• Each department has its own nurse in charge who is responsible for all equipment in the department