How would you make inpatient rooms better?

[Email4KH]

If you could do anything to inpatient rooms (excluding making them bigger ), what would you change? Think in terms of patient comfort, nurse convenience, ergonomics, furnishings, storage, etc.

What are your pet peeves about inpatient rooms?

[AfloydRN, BSN, RN]

I agree w/ burnout- ALL privates. There is no patient confidentiality w/ a roommate and their family listening. Make the bathrooms more user friendly too.

[NotReady4PrimeTime, RN]

So many of the things already mentioned would improve our patient rooms. We recently got new cardiorespiratory monitors, and they're beautiful... but they're on wall-mounted arms at the head of the bed, and are suspended so high you need to be 7 feet tall or Inspector Gadget to make changes to parameters or review events. All our electrical outlets are also along that head wall. Put a pump tree holding 20 pumps in one corner, the bed in the center and a ventilator, nitric oxide and heliox in the other corner, then wheel in an ECMO circuit, and try to plug the sucker in! The blood fridge for ECMO goes into one of the corners near the front of the room. Interspersed with the electrical outlets we find our suction valves, oxygen and medical air... a foot above the floor. We use sump chest tubes on our fresh cardiacs, the cones for which have to be passed along the side of the bed to the head, dropped down behind the bed then threaded through behind the pump trees (always 2 when the patient first arrives, ours and the OR's) and then attached to a canister and the suction regulated. Oh, and then we have to measure the output from the chest tube(s) q30 minutes for the first four hours... (Is it any wonder I have housemaid's knee?):smackingf Oh!! Even better... let's put two ventilated patients into the room together. We'll just bring in the monitor-on-wheels and put it up there by the head wall too. We do have good lighting, and smooth no-threshold flooring, a supplies cart that holds all manner of important things, and a bar fridge to store meds in. We should have thermometers and diaper scales in each room, since they're often used for isolation, but we don't. In fact, we only have four of each for the whole unit... 16 beds.

[cisco]

I completely agree about having more outlets at waist level. I worked at one hospital that had computers in every room to chart on but, they were located at a level where you had to stand to do your charting. So, working a twelve hour shift there was NO chance to sit down and do charting, only standing. My legs were killing me by the end of the shift...NURSES should be included in the design of medical facilities!!!

[RGN1]

Already mentioned but I would definitely get all the carpeting out of the ward & rooms for starters! Apart from the hygiene aspect it also makes it very hard to move anything from the theatre trolley to the bedside table.

I also agree about the plug sockets, we have to use extension leads virtually every time & that has it's own health & safety problems, especially if the patient has young kids.

I would also like to be able to lock the door if I'm carrying out intimate procedures or care because I'm fed up of no-one taking any notice of the light that is supposed to protect our patient's privacy & dignity!! Or maybe the light could be set up to electrify the door handle when the door is shut as an extra warning!

[kjnorris]

I have had the pleasure of working in four physilaties in Illinois. Of the four i worked in a small hospital that had just remodeled, They did the unique thing of asking the nursing staff for suggestions first. the new rooms had outlets waist high, bathrooms with large open showers and small family waiting area in the room with thier own tv and pull out couch. The head of the bed had a cabinet that wrapped around the bed area in side it had the sphygmometer and all the extra out lets for the gasses and holes in the bottom of these cabinets to allow for the wiring to go through. This looked very clean and tidy. to further the satisfaction of thier patients the hosp. acquired a pt. health network that pt. were able to access from thier bed to learn more about procedures and how to improve thier current health. the only suggestions i had were to include drug education teaching as to expedite discharges. There were also internet access avialable in the room so patients recovering could access e-mail or family could use to keep up with thier business needs. Although these are major changes its flow was good. a sink by the door with a cabinet for linens and a counter along the wall, only a foot wide, but dressing supplies and misc. other supplies in it. Two tv's in the room one for the patient the other for the visitor(13") but both dvd capable. the hosp. only made privates that could not expand to double for the sole purpose of becoming more HIPPA compliant. I would like to see this plan in all hospital rooms as i hate the idea that during remodeling most hospitals want to be able to go into over load with the extra space a room gives. These rooms were user friendly the only changes i would have made is the location of the bathroom door as the foot of the bed you only had a foot and half space between the bed and bathroom wall.

[twinmommy+2, ADN, BSN, MSN]

Definatly, enough electricical outlets and having IV pumps that actually hold a charge so when the pt ambulates like s/he is supposed to, it doesn't beep the minute its off the plug.

[Jellibum]

Can they make a volume switch on those pumps and call bells for O/N?? sometimes they're so LOUD!! Make a day room for ambulant pts and their families to go and sit/do stuff (TV, DVD, Playstation etc). Sliding doors for the bathrooms - no swinging doors as they NEVER leave enough room between the bed and the doorway. Night lights for the hallways that can have dimmer switches for the pts to get some sleep! and so they can be turned up when needed! Personal air vents over the pt bed - like those on airplanes for aircon/heating when required... Black out curtains, info kiosk (touch screen info) for pt's and families that shows general info for hospital-visiting hours,location of cafe/bank/shops, where to go for....???, ice machines and microwaves in a common accessible area... all bed areas to have lifting machines on rail network above the bed on the ceiling - saves trying to find a spare machine. Emergency pager system - saves finding a button that you can't reach or cant access - it's on your hip. Well, thats all i can think of for now... thanks :) that made me feel better!

[Beech1184]

I worked in the Planning Department of Tertiary Referral Hospital of 1300 beds many years ago as the Nursing Representative. We used a Room Data Sheet for every type of room. Here you list all of the normal activities then all the urgent or emergent activities, need for privacy, that will take place in the room and identify how many people will be involved and what equipment will be required, whether the equipment should be out in the open or stored in a drawer, closet othe other fashion. We looked at ambient lighting & ventilation, Task lighting, special lighting, such as red lamps that give you enough light to see the patient but not really disturb them if they are resting. privacy curtains should be just inside the entry door leaving the room free for activities. the you just have to convince the powers that be to spend the money to build it right. Good Luck

Once you have all the information you can not only design the room but identify what the room is to be used for as compared to othe rooms.

We looked at a shared equipment closet between two rooms with appropriate negative pressure air circulation to prevent cross contamination between the two rooms.

When you have your room data sheet completed you can identify how much space, equipment and furniture you need for the different activities

[paradisemakai]

No. 1 pet peeve:

Inaccessible sharps container. Who are these people with screwdrivers that put one sharps container in a room with two patients and it's in the front of the room so if you're taking care of the patient by the window you have to walk all the way around two patients and their family members to dispose of a needle.

No. 2 and this is truly wishful thinking: Some kind of device that raises the bed on command to a back-friendly height and then automatically lowers it when the nurse steps away. Ahh...my back feels better just thinking about it.

[anticoagulationurse]

All the appropriate equipment (sharps, sink, gloves, linens, etc) in the same location in every room. In addition to all of the previously mentioned wonderful ideas!

[lamielpn]

Lights on at least 2 walls, not just the headwall. Better uverhead ltghting. The head wall kight wouldnt make all that noise when the cord is pulled. The bathrooms would have enough for a person on each side of the commode and farther away from the sink. This way if someone does fall, you can get to them, plus, if they fall near the sink, they run the risk of further injury from striking the sink.Toilet seats that can be swivelled left or right. Where I work, every one has a private room, so all that I have said is what the current rooms need to have tweaked.Also, call buttons near the floor, where most people remain once they fall.

[Marjie]

Would love to see flat plugs or recessed outlets so you don't break outlets when raising and lowering the bed.