ICU Bed Designing and Space Issues

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Space per bed has been recommended from 125 to 150 sq ft area per bed in the patient care area or the room of the patient

recommendation has placed it even higher up to 250 sq ft per bed. In addition there should be 100 to 150% extra spac to accommodate nursing station, storage, patient movement area, equipment area, doctors and nurses rooms and toilet.

·      However in Indian circumstances after reviewing and feed back from various ICUs in our country

·      it may be satisfactory to suggest an area of 100 to 125 sq ft be provided in patient care area for comfortable working with a critically sick patient where all the paraphernalia including monitoring systems, Ventilators & other machines like bedside X-ray will have to be placed around the patient. Bedside procedures like Central lines, Intubation, Tracheostomy, ICD insertion and RRT are common. It may be prudent to make one or two bigger rooms or area which may be utilised for patients who may undergo big bedside procedures like ECMO, RRT etc and has large number Gadgets attached to them.

·      10 % (one to two) rooms may be designated isolation rooms where immunocompromised patients may be kept, these rooms may have 20% extra space than other rooms.

·      The planners may think about, if they are thinking of introducing newer technologies in their ICU like ECMO, Nitric Oxide and Xenon clearance etc. Do they need Lamellar flow for specific patient population in their ICUs. This will be highly specific for High end up ICUs and is not recommended in routine Provisions may be kept open for such options in future.

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 Partition between two room and maintaining privacy of patients

·      It is recommended that there should be a partition/separation between rooms when patient privacy is desired which is not unusual.

·      Standard curtains soften the look and can be placed between two patients which is very common in most Indian ICUs, however they are displaced and become unclean easily and patients privacy is disturbed

·      Therefore, two rooms may be separated by unbreakable fixed or removable partisans, which may be aluminium, wood or fibre. However permanent partitions takes away the flexibility of increasing floor space temporarily (In Special circumstances) for a particular patient even when the adjoining bed/room may not be in use.

·      There are also electronic windows which are transparent when the switch is off and are opaque when the switch is on, Although expensive now, the cost of this option may come down over time

 

 Pendant vs Head End Panel

 

 

One of the most important decisions is to how to plan bedside design Two approaches are usually practised

1 Head wall Panel

2 Free standing systems (power columns) usually from the ceiling Each can be fixed or moveable and flexible can be on one or both sides of the patient.

·      Flexibility is usually desirable,

·      Panels on head wall systems allow for free movements

·      Adaptable power columns can move side to side or rotate

·      Mounts on power columns are also usually adjustable

·      Flexible systems are expensive and counterproductive if the staff never move

·      Head wall systems can be oriented to one side of the patient or to both sides

·      Some units use two power columns, one on each side of the patient

·      Other units use a power column on one side in combination with some fixed side wall options on the opposite side

·      Ceiling mounted moveable rotary systems may reduce clutter on the floor and make a lot of working space available, However, this may not be possible if the weight cannot be structurally supported

·      Power columns may not be possible in smaller rooms or units.

·      Each room should be designed to accommodate portable bedside x-ray, Ultrasound and other equipment such as ventilators and IA Balloon pumps; in addition, the patient's window view (If available) to the outside should be preserved.