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ICU Tours

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

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ICU Tours

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  1. ICU Tours TemiYembra, Sarah Manning, Stephanie Allen, Sukanya Bhattacharya, SurabhiSatam, and Kruti Shah

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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

  8. Problem - Patient Falls Prevalent within men in their 50s - 60s Side effects from getting up after receiving narcotics

  9. 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

  10. 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

  11. 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

  12. Scottish Rite • Neonatal ICU (NICU) • 35 beds (3 isolation rooms) • Pinwheel Design • Sterile and non-sterile areas • Typical healing time : 28 days • Three types of alarms system             - Orange: To call the nurse             - White :   Parents need help             - Blue :      Patient in crisis

  13. Scottish Rite • Pediatric ICU (PICU) • 26 beds in 3 L-shaped Pods • Private Rooms (helps reduce infection rate) • Overhead Boom • 3 separate entrances- 2 for staffs 1 for visitor • Typical healing time: 4 days

  14. 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

  15. Research Opportunities • Best practices in communication • Alternative communication • Mobile alerts • Pagers • Online access to full/limited medical records • NICU Layouts • Bowling Ally • Pinwheel • Private Rooms

  16. 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 • Alternatives • NICU Family Waiting Area • 7 Private Rooms Hospital-wide • Ronald McDonald House

  17. 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

  18. 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

  19. Research Opportunity • Waiting Area Design and Amenities • Seating Area • Sleeping Area • Eating Area • Secure Storage • Entertainment Area • Paging/Locating System

  20. 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

  21. 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?

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