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ICU Tours

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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 ... – PowerPoint PPT presentation

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Title: ICU Tours


1
ICU Tours
  • Temi Yembra, Sarah Manning, Stephanie Allen,
    Sukanya Bhattacharya, Surabhi Satam, 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
  •     11 or 12 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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