picu room design

Pediatric Critical Care Columnist · Sep 14, 2010

Our unit is a mix of open beds and single rooms pressed into service as double rooms. 5 of our open beds have columns, which should be a good thing but the way the unit is configured, the way equipment is oriented at the bedside and the sheer amount of equipment at each bedside makes it not good. I think if we had more room I might like the columns better than a headwall, which is what we have in the rooms. It seems no matter which configuration, it's very difficult to reach the outlets, the suction and oxygen regulators, the collection canisters, the light switches and so on. In the rooms, there aren't enough things at waist level, too many outlets are near the floor. So we do a lot of stooping, bending, twisting or crawling on the floor to get to them. At the open beds we put a lot of miles on our legs accessing the columns because the space is so crowded that we usually have to go all the way around the unit the the end of the row of beds then down behind all the columns to get to the one we want, and then all the way back to the bedside. Look here (photo on the left) for an example of what I mean: http://www.picu.med.ualberta.ca/images/EcmoPatients.jpg Now imagine that same space with a computer-on-wheels at each bedside... We will be expanding into a mothballed unit across the hall someday and will hopefully then have more room. But I don't know that there'll be any renovations to the space we're in now.

ittybabyRN, RN · Sep 16, 2010

NICU nurse here but have floated to the PICU. Our PICU is pretty new, opened in 2007, private rooms with moveable "booms". Seems to work pretty well depending on how the room is set up initially, because once the bed gets in there, and the vent, the iv poles, and then the ecmo/cvvh etc, things stay where they are put. Each room also has a back area with a parent chair, a couple cabinets for supplies/linens. A sink, a nurse server cart, and a stationary computer/work area for the nurse. The rooms have sliding glass doors and curtains for privacy if needed.

In the NICU we have a headwall which works for the most part however when you have a small bed surrounded by the oscillator, nitric, nears monitor, multiples poles/pumps and again sometimes ecmo, cvvh, cooling blankets...all the plugs are usually stretched somewhere where feet will end up being in order to reach the headwall. In the nicu we also have private room, nurse server carts, a parent chair and area as well as a computer which is on an "arm" that can be pulled down to chart and tucked up and away when not in use.

Redneckmedic63 · Sep 18, 2010

Although our current PICU is in a place once used as an adult ICU, we are looking at moving to a new unit in the next 5 years. Our new adult ICU's were all built with very spacious rooms utilizing columns - I have occassionally floated there and found that to be a VERY user friendly setup.

Using wall-mounted equipment just doesn't allow good access to airways in an emergency, and makes management of equipment such as head bolts and EEG's difficult on complicated patients. These set-ups save room, but are not as user-friendly (especially to those of us suffering from BNLRS - "big nurse-little room syndrome" LOL)

Booms are nice, but you are at the mercy of where the boom will swing.

I believe everyone has their preferences, and all designs have their benefits...

JZ

kessadawn, BSN, RN · Sep 21, 2010

In our PICU, everything is on the wall at the head of the bed. It is very difficult to get to any of it when you have a patient with lots of equipment, especially if you are vertically-challanged like me! I never realized there were other options until reading these posts. We have private rooms, and they are decently sized at least, it's easy to get around the bed, just difficult to plug in that 50th piece of equipment.

Pediatric Critical Care Columnist · Sep 21, 2010

So you're saying you're short, Kessa? :jester:

I'm by no means short, but I have a heck of a time with all the STUFF we have to have at our bedsides. Our monitors are wall-mounted on goosenecks that don't actually give much range. They're all but impossible to reach to make adjustments to the settings unless you stand on a stool. And too, putting two stretchers into a single room rigged out to "accommodate" two patients adds a whole new meaning to crowded house. One of our rooms is laid out in such a way that when we have two patients in it, you have to sidle past the foot of the bed to get to the pumps and the monitor; the terminal for our charting package is wall-mounted only about 18 inches from the foot of the bed. And to get to the med fridge in that room one has to move the ventilator. Safe, huh?

kessadawn, BSN, RN · Sep 22, 2010

Holy pickles, move the vent to get to the meds!?!?!? Barely getting past the foot of the bed? What the heck happens if there's a code?

And yes, I am 5 foot 2 inches and shrinking daily I think! :)

Pediatric Critical Care Columnist · Sep 23, 2010

If there's a code in any of our two-for-one rooms, the other patient's bed and "stuff" gets pushed up against the wall if it's Bed A or against the counter if it's Bed B, except in the Harry Potter Room (which used to be a storage room) where we just hope to God there isn't a code when we've got 2 patients in there. (Sometimes it's our only empty bed and we have cannulated for ECPR in there.) We've had codes in the two-fer rooms before, and in one memorable incident the physician intubating the patient had to crawl under the head of the bed between the neighbour's vent and the coding patient's IV pole to get to the patient's head (too big to turn sideways on the mattress). The fire marshall routinely tours and directs that the unit is too cluttered, but it's never completely addressed.

kessadawn, BSN, RN · Sep 23, 2010

O.M.G. That's all I can say.