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Week 3 418 Notes

Critical Care Nursing

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7 views

Week 3 418 Notes

Critical Care Nursing

Uploaded by

paula nalugon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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WEEK 3 418: CRITICAL CARE NURSING

CARE BUNDLES
WHAT ARE THEY AND WHY USE THEM

Purpose
● Continuous Monitoring and treatment.
● Required emergency interventions.
● Care for patients who are medically unstable or seriously ill.
● Care for patients who do not have much chance for recovery due to the
severity of their illness or traumatic injury.

History
● 1854 Crimean war – Florence Nightingale
● Dr. W.E. Dandy – 3 bedded Neurosurgical unit in US
● 1927 first hospital for premature born infants in Chicago
● II nd world war – shock wards
● outbreak polio Epidemic – respiratory ICU
● 1950 peter safar anesthetist ‘Advanced support of Life’ (sedated & ventilated)
● Nurses practice – sick patients located near the nurses station receive more
attention.
● development of various specialty & ICU significantly reduced the mortality and
hospital stay time
● Major surgeries – liver transplant, kidney transplant and pancreatectomy

Location
● Should be a geographically distinct area within the hospital, with controlled
access.
● No through traffic to other departments should occur.
● Supply and professional traffic should be separated from public/visitor traffic.
● Location should be chosen so that the unit is adjacent to, or within direct
elevator travel to and from, the Emergency Department, Operating Room,
Intermediate care units, and the Radiology Department.
Design of the unit

BED STRENGTH
● IDEALLY 8 TO 12 BEDS
● LARGER AREAS DIFFICULT TO ADMINISTER AND SMALLER AREAS NOT
BEING COST EFFECTIVE
● 3 TO 5 BEDS PER 100 HOSPITAL BEDS FOR A LEVEL III ICU / 2 TO 20 OF
THE TOTAL NUMBER OF HOSPITAL BEDS
● 1 ISOLATION BED FOR EVERY 10 ICU BEDS

BED SPACE BEDS


● 150 200 SQUARE FEET PER OPEN BED WITH 8 FEET IN BETWEEN
BEDS. The beds should be 2.5 - 3 meters (7-9 feet) apart , to allow free
● movement of staff and equipment, reducing risk of cross contamination.
● 225 250 SQUARE FEET PER BED IF IN A SINGLE ROOM.

Infrastructure
● PATIENTS MUST BE SITUATED SO THAT DIRECT OR INDIRECT (E.G. BY
VIDEO MONITOR) VISUALIZATION BY HEALTHCARE PROVIDERS IS
POSSIBLE AT ALL TIMES.
● THE PREFERRED DESIGN IS TO ALLOW A DIRECT LINE OF VISION
BETWEEN THE PATIENT AND THE CENTRAL NURSING STATION.
● MODULAR DESIGN SLIDING GLASS DOORS PARTITIONS TO FACILITATE
VISIBILITY.
Partitions
● Privacy partitions should be of material that is easily cleaned and should be
cleaned weekly and any time that it becomes soiled or contaminated.
● If curtains are used,they should be changed weekly and between patients.

Central Station
● provide a comfortable area of sufficient size to accommodate all necessary
staff functions.
● There must be adequate overhead and task lighting, and a wall mounted
clock should be present.
● space for adequate computer terminals and printers is essential

Environment
● SIGNALS ALARMS ADD TO THE SENSORY OVERLOAD NEED TO BE
MODULATED.
● FLOOR COVERINGS AND CEILING WITH SOUND ABSORPTION
PROPERTIES.
● DOORWAYS OFFSET TO MINIMIZE SOUND TRANSMISSION.
● LIGHT SOFT MUSIC (EXCEPT 10 PM TO 6 AM).

Ancillary area
● Nurses station
● Utility room
● Admission room
● Room for specialized equipment
● Conference or class room
● Nurses waiting/resting room
● Doctors waiting/resting room
● Lab
● Pantry
● Visitors room
● Store room & Changing room
Infrastructure
1. Rails alongside the bed
2. Wall sockets for oxygen and pressurized air as well as for suction. At least 2
oxygen and pressurized air outlets are needed and 3 aspirators per patient.
3. A bell or intercom for calling the nurse should be at each bed.
4. A table and a telephone with an outside line should be at the bedside.
5. Armchairs should be on hand, preferably adjustable ones, to allow patients to sit
up if they can.

Types
Specialized types of ICUs include:

Neonatal intensive-care unit(NICU) Neurotrauma intensive-care unit


Special Care Nursery (SCN) (NICU)
Pediatric intensive-care unit (PICU) Neurointensive-care unit (NICU)
Psychiatric intensive-care unit (PICU) Burn wound intensive-care unit
Coronary care unit (CCU) (BWICU)
Cardiac Surgery intensive-care unit Trauma Intensive care Unit (TICU)
(CSICU) Surgical Trauma intensive-care unit
Cardiovascular intensive-care unit (STICU)
(CVICU) Trauma-Neuro Critical Care (TNCC)
Medical intensive-care unit (MICU) Respiratory intensive-care unit (RICU)
Medical Surgical intensive-care unit Geriatric intensive-care unit (GICU)
(MSICU) Mobile Intensive Care Unit (MICU)
Surgical intensive-care unit (SICU) Post Anaesthesia Care Unit (PACU)
Overnight intensive recovery (OIR)

Models
● Open ICU model is one where specialty teams have full admitting rights and
where an intensivist is merely "consulting".
● Closed ICU model is one where the intensivist is the admitting medical officer
and the specialty teams collaborate with ICU staff

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