Separating out critically ill patients from those needing routine care and centralizing them at one place which is well equipped, properly designed and staffed by specially trained people who improves the chances of such patients survival. ICU can be subdivided into
- Intensive Care Cardiac Unit (ICCU)
- Medical Intensive Care Unit (MICU)
- Surgical Intensive Care Unit (SICU)
- Pediatric Intensive Care Unit (PICU)
- Neonatal Intensive Care Unit (NICU)
Considering the above facts, Hospaccx team participates in ICU planning and designing. This is macroficial study of ICU planning and designing if you want to get into more detail you can contact [email protected]
Advantages of centralizing critically ill patients
- It is easier to carry out multidisciplinary & continues management at one place.
- This method permits concentrated efforts to help acutely & seriously ill patients without diluting services for the remaining patients.
- It improves survival rate.
- It enables continues personal observation, constant monitoring using sophisticated equipment & use of life support systems without delay.
Location & layout
- If possible all the intensive care units should be housed at the same place or at least on the same floor. It is possible to avoid duplication of expensive equipment.
- Hospital in which a large number of casualty cases are getting admitted & superspeciality departments are also functioning it is desirable to have at least 10% beds as intensive care beds.
- Intensive care units need continues support from other departments, hence these services should be located as near the units as possible. On the other hand the unit should also be as near emergency departments as possible. Proximity of following sections is also desirable.
- Casualty & emergency services
- Operation theatres
- Recovery rooms
- Laboratory to carry out urgent biochemical & microbiological tests
- Radiology department
It is better to have six bedded unit whenever possible. If the bed requirement is more, the unit can be 12 to 16 bedded. If the unit is ‘C’ shaped or ‘U’ shaped, doctor & nurse can see every patient without difficulty.
Design & Construction
- If the space permits, it is desirable to have individual rooms of cubicles having full height glass walls. This arrangement reduces the chance of cross infection.
- Entrance should be 4ft. wide to permit easy transport of trolley or the entire ICU bed & other equipments.
- No Thorough fare can be allowed trough it Ideal Bed strength should be 8 to 14. More than 14 beds may put stress on ICU staff and may also have a negative bearing on patient outcome.
- Each room should be about 125 to 150 ft. in size & should be placed in such a way that there is adequate working space on all the sides for those who attend to the patient.
- To ensure adequate availability of floor space, most of the items like blood pressure apparatus, monitors etc. are placed on wall mounted stand. There must be minimum furniture in the room i.e. patient bed, over bed table and one chair for the relative.
- If the ward is not divided into cubicles, the beds should have distance of 41/2 ft. between them.
- The unit should be air conditioned with facility to regulate temperature of individual room. Temperature, humidity & movement of air should be regulated.
- Nurses station should be located at a place from where the nurse can easily see all the patients.
- Each cubicle can have attached toilet or mobile commode chair.
- Additional space equivalent to 100 % of patient room area should be allocated to accommodate nursing stn, storage etc.
FLOOR, WALL AND CEILING COVERINGS
- The ideal floor should be easy to clean, non-slippery, able to withstand abuse and absorb sound while enhancing the overall look and feel of the environment.
- Carts and beds equipped with large wheels should roll easily over it.
- In Indian context Vitrified non-slippery tiles seem to be the best option which can be fitted into reasonable budgets, easy to clean and move on and may be stain proof.
- Vinyl sheeting is another viable option, it can be non-porous, strong and easy to clean, however, the life of Vinyl flooring is not long and a small damage in one corner may trigger damage of entire flooring and make it accident prone. It may require frequent replacement making it to be inconvenient choice.
- Durability, ability to clean and maintain, mildew resistance, sound absorption and visual appeal.
- It has been very useful to have a height up to 4to5 ft. finished with similar tiles as of floor for similar reasons.
- For rest of the wall soothing paint with glass panels on the head end at the top may be good choice. Wooden paneling has also found favor with some architects but costs may go high. Door Stoppers and handrails should be placed well to reduce abuse and noise to minimum; it helps patient movement and ambulation.
- It is the ceiling surface patients see most often, sometimes for hours on end, over several days or weeks, In addition, bright spotlights or fluorescent lights can cause eye strain.
- Ceiling should be Soiling and break proof due to leaks and condensation.
- Tiles may not the most appealing or soothing surface, but for all practical purposes it is easier to remove individual or few tiles for repairs over ceiling in times of need.
- Ceiling design may be enhanced by varying the ceiling height, softening the contours, griddled lighting surfaces, painting it with a medley of soft colors rather than a plain back ground color, or decorating it with mobiles, patterns or murals, to make it more patient and staff friendly.
- It is recommended that no lines or wires be kept or run over ceiling or underground because damages do occur once in a while and therefore, it should be easy to do repairs if the lines and pipes are easily explorable without hindering patient care.
Furniture & Fixtures
- Central control station with sitting arrangements for 3 persons, who are on duty.
- Each patient should have equipment for continues monitoring with visual display and audiovisual alarm.
- Beds: Beds used should be mechanically or electrically operated beds which enable changing the position by raising or lowering desired site. Beds should also have lockable wheels to permit transporting or moving the same when required.
- Two outlets for oxygen, two for suction & one for compressed air are placed between two cots.
- Central monitoring station can be located at central station. However, it is desirable to acquire computerized individual monitor which are connected to the PC located at central monitoring station.
Other desirable facilities
- Emergency treatment room : e.g. dialysis, invasive procedures etc
- Isolation room : for infected patients, patients with polytrauma
10% beds should be reserved for patients requiring isolation.
- Storage space for linen, expensive items & drugs
- Storage for used & infected items
- A room where demonstration, teaching sessions, academic discussions can take place.
- Waiting & resting place for patient’s relatives. It is desirable to have toilet, drinking water & telephone facility.
Specific needs of pediatric & neonatal ICU
- Size of cots will be smaller.
- Incubators are required in neonatal unit.
- Infant warmer units for maintaining body temperature
- Infant ventilators
- One room for isolating infected or potentially infected babies.
- One room is required for respiratory care unit
- Waiting areas for mothers should have adequate facilities for them to rest & have meal as they are lactating mothers & breast milk is required for babies.
To conclude, ICU is highly specified and sophisticated area of a hospital which is specifically designed, staffed, located, furnished and equipped, dedicated to management of critically sick patient, injuries or complications. It is a department with dedicated medical, nursing and allied staff. It operates with defined policies.
Are you planning to design ICU? We can help you to design your dream project, below are the healthcare design services that we offer:-
- Healthcare Architecture Design services
- MEP Design
- Landscape Design services
- Structural Design services
- Interior Design services
It is the superficial and macro level study for more details kindly contact Hospaccx Healthcare business consulting Pvt. ltd on [email protected] or [email protected] or you can visit our website on www.hhbc.in