PRINCIPLES OF CRITICAL CARE UNIT.pptx

principal

1. PRINCIPLES OF CRITICAL CARE UNIT KUSUM LATA (Nursing Trainer) GNC SLBSGMCH (Nerchowk)

2. PRINCIPLES Anticipation Early detection and Prompt Action Collaborative Practice Communication Prevention of infection Crisis intervention and Stress Reduction

3. ORGANIGATION OF CRITICAL CARE UNIT DESIGN CONSIDERATION: Critical Care Unit is vital area in the hospital and organization of a critical care unit and it is a strategically planned process. There should be a single entry and exit. However, it is required to have emergency exit point in case of emergency and disaster.

4. DESIGN OF ICU 3. There should not be any traffic of goods or hospital staff. Supply and professional traffic should be seprated from public/visitor traffic. 4. Safe , easy ,fast , transport of a critically sick patient should be a priority in planning its location. Therefore, the ICU should be located in close proximity or ER, OT, Trauma ward etc. 5. Corridor, lifts and ramps should be spacious enouh to provide easy movement of bed/trolley of a critically sick patient. 6. Close ,easy proximity is also desirable to diagnostic facilities, blood bank , pharmacy etc.

5. Continue… BED STRENGTH: It is recommended that total bed strength in ICU should be between 8-12 and not less than 6 or not more than 24 in any case. 3-5 beds per 100 hospital beds for a level III ICU or 2 to 20 % of the total no. of hospital beds. 1 isolation bed for every ICU beds.

6. Continue…… BED AND ITS SPACE : 150-200 sq.ft per open bed with 8 ft in between beds. 225-250 sq.ft per bed if in a single room. Beds should be adjustable ,no head board, with side rails and wheels. Keep bed 2 ft away from head wall.

7. Continue……….. ASSESSORIES: 3 Oxygen outlets,3 suction outlets (gastric , tracheal and underwater seal), 2 compressed air outlets and 16 power outlets per bed. Storage by each bedside . Hand rinse solution by each bed side. Equipment shelf at the head end. Hooks and devices to hang infusions/ blood bags , extended from the ceiling with a sliding rail to position.

8. Continue……… ……….. 6. Infussion pump should be mounted on stand or poles. 7. Level II ICUs may require multi channel invasive monitors. 8. Ventilators, infusion pumps , portable x ray unit, fluid and bed warmers , portable lights, defibrillators, anaesthesia machines and difficult airway management equipments are necessary.

9. Continue ……………. STAFFING: Medical Staff - The best senior medical staff to be appointed as an Intensive Care Director. Less preffered are other specialists from anaesthesia /medicine who has clinical commitment elsewhere. Junior staff are intensive care trainers and trainees on deputation from other deciplines . Nursing Staff- The major teaching tertiary care ICU requires trained nurses in critical care.

10. Continue…. The number of nurses ideally required for such unit is 1:1 ratio.So 1 nurse for 2 patients is acceptable. The no of trained nurses should be worked out by the type of ICU. 3.Allied Services- Respiratory services, nutritionist , physiotherepist , biomedical engineer, technicians ,computer programmer, clinical pharmacist, social worker , counsellors and other support staff, guards and guard IV workers.