what is the layout of your unit

[kidsccrn]

Hi,

Just a question for all you PICU nurses. We will be moving to our new Children's Hospital soon, the setup is scarey to us oldies. The unit is all individual rooms no windows between rooms (parent group did not want any). Of course the nurses are nervous it will be a big change. We now have an open floor plan with 2 isolation rooms but have a window between the 2 rooms. We will have a nurses "mini station" between two rooms which will have windows to visualize from the hallway. Our concern is what happens if you are in with your other patient and the other kid is intubated and tries to bolt etc.

I'm trying to stay optimistic so my question is does anyone else have this setup? (It will be a 15 bed unit ) How do you guys sedate ventilated kids drip/prn? I think it will be ok on days because the parents will be awake at the bedside. What about night shift when the parents are sleeping? Parents will be sleeping in the room on a pull out bed.

I'd appreciate any ideas and what is working or not working for you. Thanks

[tryingtohaveitall]

Our PICU sounds very similar to the OP's new unit. We have 15 beds, 13 rooms with 2 that can be doubled for sibs or times of high census. Before our renovation we were a 19 bed unit and yes, we do miss those 4 beds.

There are charting stations inbetween every 2 rooms with a computer and windows to the rooms. We haven't had any change in accidental extubations, though we do try to keep the vented kids closer to the main nursing station and avoid the far end rooms if possible.

We try to maintain a nice level of sedation where they aren't sitting up, but they will breathe on their own, unless they're requiring high ventilatory support. Our first drugs of choice are Versed and Fentanyl drips, for those very difficult to sedate kids we'll add in prns of many different drugs. We have definitely seen a great deal more Precedex use in the last few years. It is rare to have kids paralyzed, when we do it's Vecuronium.

Hope this helps!