DescriptionThe Patient Bay - Intensive Care provides an acuity adaptable, curtained bay for a patient requiring intensive medical treatment, nursing care and monitoring for potentially life threatening conditions.Hours of Operation24 hoursOccupancy1 patient; 1-2 visitors; 1-2 staff (with up to 6 additional staff as required)Additional Considerations~ Visual access to the room from a Staff Station is required.
~ In planning of the overall department, room layouts should not be mirrored. Layout are to be "handed", with any specific items being "mirrored" to be confirmed at project level to suit clinical service requirements.
~ The dialysis machine, RO water machine, and the dialysis wall box and its associated large cooling water trap with sealed lid are optional. These items may not be provided in all services or to all bedrooms/bays within a service. Provision is dependent on the clinical service requirements in relation to the delivery of dialysis. The various dialysis therapies will have specific implications for plumbing and pipework in relation to flushing, maintenance and wastewater/effluent handling. See HPU 360 Intensive Care for more information.
~ Overall content and configuration of the medical services pendants is to be confirmed at project level, including type and quantity of medical gases, power and data. The final arrangement will be dependent on clinical service requirements and will vary depending on clinical needs and the selection of mobile vs pendant mounted equipment. Pendants may be provided as one pendant with two arms on a single mounting point, or as single arms on multiple mounting points to increase the reach around the bed space (e.g. when the bed is located as shown or rotated 90 degrees) to support clinical care. Tertiary facilities that act as ECMO retrieval centres or otherwise perform a significant number of ECMO procedures may consider including a pendant located at the foot of the bed to enhance delivery of this treatment by supporting femoral access and connection to the required medical equipment.
~ Alcohol-based hand rub (ABHR) may be provided in a wall mounted dispenser or in a holder that can be attached to the end of the patient bed. The location of ABHR is to be confirmed at project level to support staff to comply with the ‘5 Moments of Hand Hygiene’ practices and local IPC policies.
~ Access to natural light and outlook is essential (with non-reflected light and views preferred). To balance this requirement with clinical requirements, the room should provide the ability to provide care with the bed in various orientations. This Standard Component shows the bed oriented vertically on the page with the head of the bed toward the window, supporting quick access by staff to either side from the entry to the room. The bed may be re-oriented to provide views to the window as a patient’s clinical state improves. The reach of the arms of the pendant should support provision of clinical care when the bed is turned 90 degrees.
~ Design to suit local cultural requirements to be considered at project level and supported by community consultation. For more information refer to ‘AusHFG Culturally Sensitive Planning and Design’ and local policies and guidance on culturally responsive design.
~ Requirements for staff notetaking/write-up within the room, including use of electronic medical records, are to be confirmed at project level to suit clinical service requirements and local ICT policies. Configurations such as a ceiling mounted arm at the foot of the bed with a computer and keyboard mounting bracket, or provision of a computer based on a fixed bench as an alternative to a workstation on wheels (WoW), may be considered and assessed at project level. Provision may be dependent on alignment with local ICT strategies, policies and workflows as well as cost impact.
~ Connection of the patient monitor to a central monitoring system is required.
~ Additional ICT requirements, particularly in remote facilities (e.g. for patient monitoring, virtual patient consultation/monitoring, etc.) are to be confirmed at project level to suit clinical service requirements.
~ The configuration of the patient lifter track (i.e. linear track, H-track, pendant mounted, etc.), weight rating/safe working load (SWL) requirements, and extent (i.e. for bed to chair/wheelchair/commode transfer only, full room coverage, full transfer to ensuite, etc.) are to be confirmed at project level to suit clinical service requirements and local WHS policies for patient handling. Coordination of the lifter track with room lighting, pendants, examination light, patient entertainment system and any ceiling mounted services is to be carefully considered.
~ Patient entertainment systems may be mounted on the wall or ceiling. Configuration of the patient entertainment (type, size, mounting and location) is to be confirmed at project level to suit local ICT policies and operational models. Services (power, data and/or AV connection) are to be confirmed to suit selected systems. Appropriate structural support in the wall or ceiling is required for mounting the patient entertainment system.
~ The ability for slave monitoring (i.e. mirror content from the pendant mounted patient monitor) to be provided through the screen for the patient entertainment system for added visibility of information in emergency situations is to be considered to suit project requirements. Where slave monitoring is not possible through patient entertainment system display screen, and is required to suit models of care, an additional slave display screen and associated services may be required.
~ A wall clock should be visible in all patient bays. Clocks can support orientation of patients to the time of day, helping to reduce confusion and delirium. However, it has been noted they may also cause distress (e.g. from a sense of time passing too slowly or losing chunks of time). Clock products with the ability to turn off/dim the display may be considered to flexibly respond to patient preferences/needs. The placement of the clock within the room and type of clock provided, including connections to a master clock system, is to be confirmed at a project level.
~ The use of switchable glass in lieu of integral blinds to observation windows may be considered at project level and inclusion would be based on an assessment of maintenance, product lifecycle and downtime requirements. For longevity of the product, switchable glass must be turned off (i.e. be opaque) for a period of time each day; this must be considered in relation to where this product is intended to be used to ensure the downtime requirement does not compromise patient observation.
~ Operational models, work health and safety requirements and IPC policies regarding the changing/laundering of privacy curtains is to be confirmed at project level.
~ Mobile duress coverage is to be assessed and planned at a department level and coverage of all patient spaces is to suit local security and WHS policies and operational service requirements.
~ Furniture to accommodate a carer within the room is to be confirmed at project level, including consideration of anticipated length of stay, operational models for provision of linen, provision of carer property storage, and the ability/requirement to fold-up or pack away furniture used for sleeping when it is not in use. Fixed joinery items may be considered to provide this function; however, freestanding furniture is recommended where flexibility is required. Cleaning processes/products, and infection prevention and control (IPC) requirements must also be considered in assessment of furniture and upholstery selection.
~ Lighting is to be designed support clinical observation of patients (e.g. accurate colour rendering, appropriate colour temperature, etc.) as per AS/NZS 1680. Consideration of lighting systems that are automated to support circadian rhythms (e.g. through intensity tuning, color tuning, etc.) may be considered at project level.
~ Positioning of light fixtures is to be coordinated with ceiling mounted equipment (e.g. pendant, examination light, patient lifter track, display screen, etc.) to ensure appropriate, uniform illumination of the patient for observation when needed. It is recommended to avoid direct of light fittings over the patient’s head (noting that the bed is movable and may be arranged in different configurations to meet clinical needs and equipment set-up).
~ A dedicated power outlet, clearly separate from outlets for clinical use, is recommended to support patient and visitor use/charging of portable devices. Inclusion of integral USB outlets will depend on local ICT policies.
~ Size, type and quantity of waste bins, including sharps bins, will be dependent on clinical service requirements, operational models for waste management and local infection prevention and control (IPC) policies.
~ Provision of emergency/standby power or uninterruptible power supply (UPS) is to be confirmed to suit site and service requirements. Confirmation to be based on risk assessment considering the impact of a power outage on patient care/safety.
~ Provision of cleaner’s power outlets is to be rationalised across the department and spaced in accordance with AS/NZS 3003.
~ Notes applied to floor finish ratings relate to AS4586 and associated HB198 requirements. Compliance with current regulations must be verified by project teams on each project.