icu tours temi yembra, sarah manning, stephanie allen, sukanya bhattacharya, surabhi satam, and...
TRANSCRIPT
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 stationAdvantages: Visibility into all roomsDisadvantage: 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 Designo Sterile and non-sterile areaso Typical healing time : 28 dayso 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 Podso Private Rooms (helps reduce infection rate)o Overhead Boomo 3 separate entrances- 2 for staffs 1 for visitoro 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 alertso Pagerso Online access to full/limited medical records
• NICU Layoutso Bowling Allyo Pinwheelo 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 Amenitieso Seating Areao Sleeping Areao Eating Areao Secure Storageo 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?