ICU Tours
Temi Yembra, Sarah Manning, Stephanie Allen, Sukanya
Bhattacharya, Surabhi Satam, and Kruti Shah
Piedmont Hospital
There were 5 ICUs
ICU Green
• Built in 1970
• Medical surgical ICU
• Very small rooms with odd angles
Round shaped ICU with central
nurse station
Advantages: Visibility into all rooms
Disadvantage: Not enough movement
space for equipment and furniture.
Piedmont Hospital
ICU Blue
• Medical, surgical ICU built 5 years ago
• 12 bed ICU
• Moderate room size
• No provision for family accommodation
• Room monitors are connected with the Central mother
monitor
ICU Red
• Open heart ICU
Piedmont Hospital
5 East ICU
•
•
Newly built about 2,3 years ago
10 beds ICU - small rooms
Stepdown Unit
Converted general patient rooms in ICU
Total 9 beds and rooms are very small
• Nurse station is far
Disadvantage - visualization problem
•
•
General Information
Visitation is open except during hand-off
Nurses
12 hour shifts
1:1 or 1:2 depending on patient condition
Physicians in ICU
•
Intensivists - Who specializes in the care of critically ill
patients, mostly in ICU.
•
Extenders – Expert physicians or nurses that replace
experienced doctors in the ICU in the midnight to early
morning shift.
Problem - Clinical Documentation
Changed to electronic 7 years ago
Physician and progress notes still on paper
Electronic medical records do not all talk to each other
Solution - Clinical Documentation
Develop a software to integrate medical records
- Within the hospital
- Ability to access records from other hospitals
- Helps know what medication the patient is taking
Problem - Patient Falls
Prevalent within men in their 50s - 60s
Side effects from getting up after receiving narcotics
Solution - Patient Falls
Created a falls protection program
Provide susceptible patients with green armbands to be
recognized
If possible, place such patients in rooms with cameras
Follow checklists and protocol
Other problems
Size of ICUs
- Too many cabinets in rooms
- Converted from regular patient rooms
Most walls are concrete made which is a problem in
- Taking any new telephone line through walls
- Making changes in the present room size
Scottish Rite
Average Staffing Ratio is 2 patients to 1 nurse
Age Ranges of populations Served
• Neonate, 30 days
• Infant, 30 days to 1 year
• Early Childhood, 1 year to 5 years
• Late Childhood, 5 years to 13 years
• Adolescent, 13 years to 17 years
• Adult, 17+ years
Scottish Rite
•
Neonatal ICU (NICU)
o 35 beds (3 isolation rooms)
o Pinwheel Design
o Sterile and non-sterile areas
o Typical healing time : 28 days
o Three types of alarms system
- Orange: To call the nurse
- White : Parents need help
- Blue :
Patient in crisis
Scottish Rite
•
Pediatric ICU (PICU)
o 26 beds in 3 L-shaped Pods
o Private Rooms (helps reduce infection rate)
o Overhead Boom
o 3 separate entrances- 2 for staffs 1 for visitor
o Typical healing time: 4 days
Problem - Privacy in NICU
•
•
•
Open layout (see and hear activity in other patient areas)
No Visitors During Shift Changes (7am and 7pm
May discourage parents from staying at the bedside
Research Opportunities
•
•
•
Best practices in communication
Alternative communication
o Mobile alerts
o Pagers
o Online access to full/limited medical records
NICU Layouts
o Bowling Ally
o Pinwheel
o Private Rooms
Problem - Family Space in ICU
Overarching Issue:
ALL patients must have a parent/guardian present to consent
NICU
• Parents/Visitors typically sit in "hallway" area
• There is very limited privacy for parents
• Area not suited for overnight visits
o Alternatives
 NICU Family Waiting Area
 7 Private Rooms Hospital-wide
 Ronald McDonald House
Problem - Family Space in ICU
PICU
• One sleeper chair per room
• No designated family area in
room
• If in Pod 2 or 3 the travel to the
family waiting area is far
Research Opportunity
•
Effectiveness of layout in Rehab at Scottish Rite
• Ample floor space
• Designated Family Area
• Allows for less strict visitation policy
•
Effectiveness of family oriented-layout at other hospitals
Research Opportunity
•
•
Waiting Area Design and Amenities
o Seating Area
o Sleeping Area
o Eating Area
o Secure Storage
o Entertainment Area
Paging/Locating System
Problem - POUS in PICU
•
•
•
•
Nurses and Respiratory
Therapists frequently leave
room to retrieve supplies
RN comment: Visit OMNI Cell
20+ times per day
OMNI cell is very far away for
some pods
RN loses visual when
retrieving supplies
Research Opportunity
•
•
•
•
•
Space in PICU ICU rooms allows more supply storage
Are carts being used effectively?
Are drawers and cabinets being used effectively?
What is the optimal par level of supplies in room?
What kinds of supplies are charged to the patient and
charged to the department?