ICU Pod System

ZASHAGALKA, RN · Jun 8, 2006

I am currently researching staffing ratios for ICUs utilizing the pod system as the pod system is new to us and we want to staff as efficiently as possible. If anyone knows of any hospitals that have criteria similar to ours (listed below), contact information would be extremely helpful!
What we have:
28 beds (7 pods with 4 beds each)
What we are:
Cardiovascular/Medical/Surgical ICU
What we need:
Staffing Ratios
# worked hours per patient day
Much thanks!

Any critical care staffing ratio > 2:1 is unsafe, regardless of unit design.

Period.

~faith,

Timothy.

LCRN · Jun 8, 2006

I am currently researching staffing ratios for ICUs utilizing the pod system as the pod system is new to us and we want to staff as efficiently as possible. If anyone knows of any hospitals that have criteria similar to ours (listed below), contact information would be extremely helpful!
What we have:
28 beds (7 pods with 4 beds each)
What we are:
Cardiovascular/Medical/Surgical ICU
What we need:
Staffing Ratios
# worked hours per patient day
Much thanks!

I work in a 2 unit ICU-->medical side with 16 beds and a surgical side with 14 beds. So all RN's have to be cross trained for both units. Each of our pods have 2 beds. When you're seated at your pod you have both of your patient's in view by the windows in front of you.

I'm not sure how it would work if you had 4 beds in a pod...would you have 2 nurses? or are your patients "stable" enough to have an nurse patient ratio of 1:4?

We also have multiple main master monitors that show all patient's readings on the walls in the hallway.

What do you men by # of hours worked per patient day?

LCRN

FGHburg · Jun 9, 2006

Thanks for the posts!

Currently, we have a minimum of 2 nurses per pod...sometimes more depending of staffing and patient acuity levels. Since our pods are "secluded" from the rest of the ICU team, we are interested in learning about other staffing ratios in ICUs with similar pod set-ups. How many techs are on the unit? Are there float nurses to back up the pods if 1 nurse has to leave? If so, how many float nurses do you schedule?

Basically, we understand the average 2:1 ratio. But what about additional staff???

weirdRN, RN · Jun 9, 2006

Granted I have only ever been in two ICUs but... There was 1:1 staffing and the Nurse took care of ALL patient care. If there was a patient that required more care, sometimes the other nurses would pitch in and help out depending on what needed done and their patient's status.

The two ICUs that I saw had very relaxed atmospheres, the staff appeared to have comraderie, and several nurses had been there for many years and siad they were no where near burn out.

LCRN · Jun 9, 2006

Thanks for the posts!
Currently, we have a minimum of 2 nurses per pod...sometimes more depending of staffing and patient acuity levels. Since our pods are "secluded" from the rest of the ICU team, we are interested in learning about other staffing ratios in ICUs with similar pod set-ups. How many techs are on the unit? Are there float nurses to back up the pods if 1 nurse has to leave? If so, how many float nurses do you schedule?
Basically, we understand the average 2:1 ratio. But what about additional staff???

In my unit--> We have one Charge unit without an assignment and one resource unit without an assignment this is because as ICU RN's we are responsibile for multipile tasks throughout the hospital--> MET team, Code team, bronch team, conscious sedation, difficult IV's on floors, and we assist the unit residents in triaging the patient's to come to the unit. Having said that we do not have any aids or techs in the ICU. We rarely have patient's that are 1:1 unless they meet specific criteria.

Our open heart fresh from OR are 1:1 for first 8 hours and then go to regular staffing. If we have a really sick heart with open chest and sternal retractors still in with balloon we'll keep them 1:1. So basically there is a nurse that has just one patient that day and helps out the RN that has the 1:1 patient because our pods are setup with 2 rooms.

If one of our patients have to be transported to CT or something we ask one of our "podmates" to watch our other patient for the 1/2 hour usually this does not cause a problem. Most of the time we take our breaks very close to our pods so we don't need to get someone to actually sit at our pods for the entire break.

Usually we do not have the luxury of having experienced critical care RN's float into our unit. When we our short and we have RN's float into our unit they may be vent proficient but are not used to gtts, cvvh, balloons so we must change assignments to assure that thay receive the most stable assignment at the time. Believe me we are happy for any help! However the most stable patient...can turn at any moment as I'm sure you may know.

We opened the pod system up in our new ICU a little over a year ago and I love it. I have my own little work area with my chart rack, a phone, and a computer. This provides a work station for the docs to come and speak to you regarding your patient's and for you to chart rather than in your patient's room.

I hope this helps, if you have any more questions please feel free to ask!

Lisa

ZASHAGALKA, RN · Jun 9, 2006

I would think - at a minimum - you would need two charge nurses that can 'float' for relief.

We have a 24 bed unit with one 'team leader' charge not taking pts during the day and two 'charges' that DO take pts at night. But, our unit is all together.

Your problem is the relative seclusion of the pods. I would think, at a minimum, two floating 'charges' not taking pts would suffice. I would resist the urge to assign them to specific 'pods' and have them both work 'in tandem' with each other.

For example, if one gets involved for a long period of time in one pod, another pod shouldn't be prohibited from taking a break because it's not the available charge's 'pod'.

I would think a couple of techs also.

Another idea: use acuity to your advantage if possible: if you have a say, 1-4 acuity rating, you can try to have a few pods w/ lower acuity (1-2) only and designate those pod an emergency resource pods where one of the nurses can leave in an emergency to help out. So, ONLY IF THE TWO CHARGES ARE OVER THEIR HEADS, a lower acuity pod can be your flex-up resource by temporarily being manned by one nurse (a tech has to also rotate into that pod and remain for the duration).

~faith,

Timothy.