1. Introduction to CCU.pptx

An introduction to critical care unit

1. CRITICAL CARE UNIT

2. Content Introduction to CCU Organizational set up Policies Staffing norms Principles of critical care nursing

3. Definition of ICU An intensive care unit (ICU) or critical care unit (CCU) is a specialized section of a hospital that provides comprehensive and continuous care for persons who are critically ill and who can benefit from treatment.

4. DEFINITION of critical care nursing Critical care nursing is a comprehensive, specialized and individualized nursing care services which are rendered to patients, with life threatening conditions and their families.

5. GOALS OF CRITICAL CARE 1. Towards the survival of the critically ill patients and restoring quality of life 2. Restoring optimal physiological, psychological, social and spiritual potential 3. Helping the families of the critically ill patient in coping with crisis

6. ORGANIZATION AND PHYSICAL SETUP OF CCU DESIGN OF INTENSIVE CARE UNIT 1.The Design Team : Multidisciplinary team consist of ICU medical director, ICU nurse manager, the chief architect, hospital administration and the operating engineering staff . 2.Location /Entry/ Exit Points of ICU in Hospital There should be a single entry and exit point to ICU. However, it is required to have emergency exit points 3. ICU Bed Designing and Space Issues : Space per bed from 125 to 150 sq ft area

7. ORGANIZATION AND PHYSICAL SETUP OF CCU 4. Floor and Wall Coverings : Should be easy to clean, non slippery 5. Patient Areas : Patients must be situated so that direct or indirect visualization by healthcare providers is possible at all times .

8. ORGANIZATION AND PHYSICAL SETUP OF CCU 6. Central Nursing Station : This is the nerve centre of ICU 7.Work Areas and Storage : Work areas and storage for critical supplies should located within or immediately adjacent to each ICU. 8. Special Procedures Room If a special procedures room is desired, it should be located within or immediately adjacent to the ICU. 9.Clean and Dirty Utility Rooms Clean and dirty utility rooms must be separate room

9. ORGANIZATION AND PHYSICAL SETUP OF CCU 10. Equipment Storage : An area must be provided for the storage and securing of large patient care equipment items not in active use, 11. Nourishment Preparation Area : 12. Staff lounge 13. Receptionist Area 14. Visitors lounge 15. Conference room 16. Administrative office

10. Levels of ICU LEVEL 1 It is recommended for small district hospital, small private nursing homes, rural centers Ideally 6 to 8 beds Provides resuscitation, mechanical ventilation and short-term cardio respiratory support including defibrillation. It should be able to ventilate a patient for at least 24 to 48 hrs and non invasive Monitoring like - SPO2, H R and ECG, temperature etc Able to have arrangements for safe transport of the patients to secondary or tertiary centers

11. Levels of ICU LEVEL 2 Recommended for larger general hospitals Provide complex, multisystem life support Bed strength 6 to 12 Monitoring for a period of at least several days or for longer periods

12. Levels of ICU Director be a trained/qualified intensivist Multisystem life support Invasive and non invasive ventilation Invasive monitoring Long term ventilation ability Access to ABG, electrolytes and other routine diagnostic support 24 hrs

13. Levels of ICU Level 3 Recommended for tertiary level hospitals • Bed strength 10 to 16,care given for indefinite periods Headed by intensivist • Have all recent methods of monitoring, invasive and non invasive • Long term acute care of highest standards and multisystem care • Bedside x-ray, USG, 2d-echo available • Own or outsourced CT scan and MRI facilities should be there

14. Levels of ICU Level 3 Bedside broncoscopy Bedside dialysis and other forms RRT available • optimum patient/nurse ratio is maintained with 1/1 pt /nurse ratio in ventilated patient. • Doctors, nurses and other support staff be continuously updated in newer technologies and knowledge in critical care

15. Principles of critical care nursing ANTICIPATION EARLY DETECTION & PROMPT ACTION COLLABORATIVE PRACTICE COMMUNICATION PREVENTION OF INFECTION CRISIS INTERVENTION AND STRESS REDUCTION

16. Principles Anticipation : Recognize the high risk patients and anticipate the requirements 2. Early Detection and Prompt Action : The prognosis of the patient depends on the early detection of variation, prompt and appropriate action to prevent complication.

17. Principles 3. Collaborative Practice : Collaborative practice fosters a partnerships for decision making and ensures quality and compassionate patientcare. 4. Communication : Intraprofessional , interdepartmental and interpersonal communication has a significant importance in the smooth running of unit .

18. Principles 5. Prevention of Infection : Critically ill patients requiring intensive care are at a greater risk than other patients 6 Crisis Intervention and Stress Reduction : As patient advocates, nurses assist the patient to express fear and identify their grieving pattern and provide avenues for positive coping.

19. Ethical principles governing critical care BENEFICENCE AND NONMALEFICENCE Do good Do no harm AUTONOMY Right to self determination JUSTICE Distinguish right from wrong in patient care

20. STAFFING NORMS Critical care unit consists of many different, highly trained staff, working together, caring for seriously ill patients.

21. INTENSIVE CARE DOCTORS Termed as intensivist or ICU consultant Responsible for co-ordination of patient care in ICU and will consult with other specialists Skilled in diagnosing and treating critical illnesses and injuries

22. RESIDENT DOCTORS PGs from anaesthesia, medicine, respiratory medicine One PG resident with one graduate resident for an ICU with 10-14 beds

23. INTENSIVE CARE NURSES Responsible for co-ordination and implementation of treatment and care of critically ill patients Undergo special training and education and have experience in caring critically ill patients Capable of providing constant and continuous bed side care Ratio: 1:1 in ventilated or MODS patients 1:2 or1:3 N-P ratio for less seriously ill

24. ALLIED HEALTH PROFESSIONALS ICU team cannot care for the patient without help of other health care professionals Respiratory therapist Physiotherapist Pharmacist Technician Occupational therapist Nutritionist

25. ALLIED HEALTH PROFESSIONALS CONTD…. Biomedical engineer Cleaning staff Computer operator Counsellor

26. Vancouver style of writing reference

27. REFERENCES Linda D.Urden , Kathleen M Stacy ;Critical care nursing Diagnosis and management; Mosby Publication. 5 th ed ; Missuri Javed Ansari, a text book of medical surgical nursing-II , pee vee publications Lewis, bucher , heitkemper , harding , kwong , roberts . Lewi’s medical surgical nursing.3 rd south asia edition. Vol 2. New delhi : elseiver publications ; Https:// icuconsultants.Com/criticalcare.Html