Hospital Expansion

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Specializes in Med/Surg.

My hospital is starting a six story expansion to be completed, hopefully, within the next three years. I am taking part in a committee that will try to make the new tower as "user-friendly" for staff and patients as possible. As I only have experience working where I do now, I came here for some input.

What are the things that stand out on your unit as far as things you would want included in a possible expansion?

What about centralized vs. decentralized nursing stations?

Would you rather have all of your patients headboards on the left/right side of the room or have them head/head with the wall in between

(Hopefully this makes sence, basically laying O-->---------

Is there anything that doesn't work on your unit that you'd caution against?

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Since im at work i can only add this tidbit. Head to head beds. That way if you have a hearing or vision impaired person that only has the disability on one side, you can put them in a room with their "good" side toward the door. That way they can see or hear you come in. No one likes to be startled that someone has walked into their room and they didnt even know it.

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Specializes in Oncology.

Power outlets! 'Nuff said.

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Specializes in Med/Surg.
Since im at work i can only add this tidbit. Head to head beds. That way if you have a hearing or vision impaired person that only has the disability on one side, you can put them in a room with their "good" side toward the door. That way they can see or hear you come in. No one likes to be startled that someone has walked into their room and they didnt even know it.

And this is exactly why I posted here! I would have NEVER even thought about that. :yeah:

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Specializes in Community, OB, Nursery.

I am a big fan of decentralized nursing stations - that way nurses can be near their patients, assuming they are all (or mostly) in the same 'pod'. The floor I currently work on has two wings - one with a centralized nursing station, one that's decentralized. I find the decentralized stations to be much more efficient - a computer at each one for looking up labs etc/checking orders, all the charts for the that pod in that area, and less nurses/doctors/social workers/lactation consultants fighting over the same crowded area.

Apart from that - I would want a room that has space for an IV pole that has an unencumbered path between the bed and the bathroom. Doesn't particularly matter (at least not to me) where it's located, as long as I don't have to wrangle it around a chair, a bedside table, or other equipment (including the bed itself).

If only all managers or hospital designers actually asked bedside nurses...:)

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At our brand new facility the thought is to have the pt facing a "nonclinical" wall: nothing in view on the wall that looks like a hospital. Therefore, the sharps containers and gloves are at the head of the bed. Fine unless the pt is up in a chair and the chair is in front of those "clinical" items. I agree with the vote for outlets...more the better!

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Specializes in Med/Surg, Ortho, ASC.

Flat thresholds! Nothing to boost the IV pole over as you take your patient to the bathroom.

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Specializes in Gerontology.

I would have all private rooms. No more moving beds to accomadate isolation, or the correct sex. It never fails - if the empty bed is female, they want to send a male and we move beds. Next day, empty bed is a male, we need female. We move beds.

Or Pt A doesn't like Pt B. We move beds.

Pocket doors on the bathrooms so you don't have to manover around a door when taking a pt to the bathroom.

Blinds on the windows, not curtains that gather dust.

And if I am really dreaming - each room can control its own heat/cooling! (yeah- like THAT will ever happen!)

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Here is what I like.

Enough computers to go around if computer charting is used.

Plenty of outlets (I work ICU and need all I can get)

Doorways wide enough to fit a regular bariatric bed through.

Enough room to move a stretcher for transfer without having to take half the furniture out of the room to fit the stretcher in.

Some sinks located outside patient rooms.

Enough horizontal space to rest a chart and med book on.

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Specializes in Med/Surg.

For anyone that can answer, other than the closer proximity to other co-workers WHAT IS THE ADVANTAGE to a centralized nursing station? We have three nursing stations on our 27 bed floor. I think that is perfect considering how many confused patients we get. Our "main" nursing station doesn't even face a patients room, how are we supposed to keep "an eye" on our confused patients with this setup.

Other than that, I must say I am very lucky to work on the unit I do, all of our rooms are large, I'd say about 500 sq feet with the iso rooms being larger and having a staging area, private, all rooms have blinds, recliners, some have flat screens, paintings, crown molding, and they have their own thermostats. Yet I feel this sometimes lends to the patients forgetting they are in a hospital and that their goal is to go home at some point, especially for our indigent and lower socioeconomic patients.

I totally agree with the flat thresholds especially working on an ortho floor! And doors that will open 180 degrees will be a must in my opinion as well.

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For the most part I prefer decentralized. We have a little alcove w/ computer b/n every two rooms w/ windows so we can see the patients while outside of the room charting. Puts the nurse closer to the patient and further away from the gossip. We do have 3 workstations that are for everyone. During the day they are flooded with SW, doc's, PT... etc. Although nursing does use them some it's not all that much. On nights however this is where the nurses all hang out. The only problems I see with the decentralized concept are:

1. supplies - it is hard to keep staplers and tape in each little alcove and a pain to get up in the middle of charting to go get tape to post rhythm strips, etc. Even though we are 98% computerized charting, there are still some forms that we keep in a centralized place and it is time consuming to run back and forth.

2. It can actually put me further away from some of my patients. For example if I am charting outside of room 2 form my patients in room 1&2, I'm further away form my patients in room 10 & 11 then I would be if I were at a central station. But this also is an assignment issue too.

Still... overall I much prefer decentralized.

Sensors for lights in the bathroom, so that they come on when the patient steps in.

Outlets.... lots and easy to get to.... absolutely!

Sinks that don't splash. We have a beautiful new hospital and the sinks splash, causing the area around the sink to always be wet. Because there are often supplies there, they get ruined and thrown out. Lots of $ down the drain. As much as we try to keep supplies away from the sink they always seem to gravitate there and it is a mess. As I was trying to think of how I would describe our sinks I found this link and thought it was interesting. Actually the website looks like it may have some good info.

Faucet and Sink Design Contribute to Splashing, ICU Outbreak with Resistant Organism and 12 Deaths | News | News | Healthcare Design

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Specializes in Oncology.
For anyone that can answer, other than the closer proximity to other co-workers WHAT IS THE ADVANTAGE to a centralized nursing station?

We have video monitors and cardiac monitors. I can't imagine them getting multiples of all of these so they can be seen by all. They're at the nurses station. Ditto the radio ;)

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