Pod design and impact on nursing

[lee1]

Our newly opened CCU unit which has expanded is now in POD design. This means that there are 2 long hallways. A small nursing station situated between every 2 rooms with a computer and windows to look in and see the patient is the curtain is not drawn for privacy. The nurses assigned are expected to sit at these pods. The central nursing station is now very small enough for the charge nurse and unit secretary to sit at.

The charts are now all at the pods.

There is a central monitor at 3 pod areas and 1 at the main desk.

Some nurse are complaining of feelings of alienation as we all used to work at the central station and had a better overall feeling of what was going on in the unit and what patients were having critical problems. There were also more people looking at the central monitors.

Any thoughts???? Does anyone else have this design???

[Marie_LPN, RN, LPN, RN]

The problem we have with our pod design is that if census is down, the nurse has room everywhere, so if they work at one station, they are right near some pts. while they chart. If a light rings they can't always see it. And we also have that sharp-as-a-bowling-ball coordinator who will put two pts. that are crawlers in 2 different pods, and the nurse has her hands full and spilling over when while helping one back to bed, teh other one has also mastered their bed escape.

Other than that, it would be a great idea if we were full.

[llg, PhD, RN]

Yes. I think Pod designs have had huge impacts on nursing -- and that those impacts have been largely unstudied and underappreciated.

Pods may be great in keeping each patient's area more private and free from the distractions happening throughout the entire unit, but they isolate nurses. The isolation inhibits teamwork, mentoring, the ability of the new nurse to become integrated into the staff, the interaction between junior and senior staff members, etc. As a staff development educator, I have seen lots of negative effects for the nursing staff.

Also, I have seen a Pod design reduce the flexibility in making assignments. To keep nurses from having to care for patients in multiple pods, you sometimes have to assing them combinations of patients that "don't fit well together" into one assignment. etc.

We need to take these things into consideration as we plan new units. Perhaps the Pod design is best overall, but if we choose a Pod design, we have to make the other changes in other practices (staffing patterns, staff development resources, etc.) to accommodate and compensate for the "unintended consequences" of the new design.

I will be interested to read what others have to say on this topic. It is a pet interest of mine.

llg

[New2CVICU]

We are using this "Pod" system. Our pods are supposed to let us look in on our patients at all times. Sometimes that is not possible because the assignments are spread out and we usually end up taking three patients.

[lee1]

Originally posted by New2CVICU

We are using this "Pod" system. Our pods are supposed to let us look in on our patients at all times. Sometimes that is not possible because the assignments are spread out and we usually end up taking three patients.

3 ICU pt to 1 nurse???? What is your acuity??? Does your state BON regs allow this?? Certainly your national AACN association does not. Are you able to retain nurses with this ratio?

Are you able to give high standards of care??? Do you have increased incidence in infections, falls, med errors???