DescriptionThe Patient Bay - Neonatal, Intensive Care / High Dependency provides the space, services and facilities for the medical care of newborns that are premature, medically unstable and/or critically ill. The patient bay also provides amenities for family integrated care, including space and furniture that supports skin-to-skin contact (kangaroo care), breastfeeding/expressing breast milk, and rest for parents and family.Hours of Operation24 hoursOccupancy1 patient; 1-2 visitors; 1-2 staff (with up to 6 additional staff as required)Additional Considerations~ A width of 1m around the humidicrib/care station is to be maintained clear of any fixed items to support access for staff and equipment in an emergency.
~ Requirements for receiving critically ill transferred newborns with NETS (Newborn & Paediatric Emergency Transport Service) are to be confirmed at project level.
~ Lighting within the patient bay and from adjacent corridor areas should be carefully considered and should be dimmable and adjustable to suit requirements at different times of day. Continuous bright light is detrimental and causes stress for newborns. Lighting should be zoned to allow separate control for lighting in the family area. Direct overhead lighting should be avoided. The use of cyclic lighting controls may be considered and are to be confirmed at project level.
~ Visual access to the room from a Staff Station is required.
~ In planning of the overall department, room layouts should not be mirrored. Layouts are to be "handed", with any specific items being "mirrored" to be confirmed at project level to suit clinical service requirements.
~ The patient bay may be configured with either half height walls or full height walls to the sides of the bay. Height of walls and provision of any glazing is to be determined at a project level to suit the overall department layout and requirements for patient observation. Location of wall mounted items and configuration of privacy curtains and tracks are to be confirmed to suit wall heights. Where half height walls are provided, curtains of a shorter length may be provided above to ensure visual privacy can be achieved as required. Curtains and curtain tracks are optional; units may choose to use portable screens in lieu of ceiling mounted privacy curtains.
~ Support for care of multiples (twins, triplets, quads) with a small number of bays configured without a separating wall may be considered when determining the overall layout of unit.
~ Alcohol-based hand rub (ABHR) may be provided in wall mounted dispensers or in a holder that can be attached to a trolley. 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 and support use by family and visitors as required.
~ A Type A handwashing basin is to be located nearby and may be shared between 4-6 bays (subject to the unit layout and ease of access from each bay). Refer to Part D Section 4.1.2-5 for more information.
~ Per clinical services planning, enclosed bays may be provided. Where a patient bay is enclosed, a handwashing basin (Type A) and a glazed sliding door (minimum 1400 clear opening) is to be provided. Additional area will be required to accommodate the basin, the door circulation and any dedicated dirty linen and waste receptacles (depending on operational models).
~ For enclosed bays, the extent of glazing is to be determined at project level to suit the overall department layout and requirements for patient observation. Provision of integral blinds or extension of the privacy curtain track over internal glazing is to be determined to suit requirements for observation, family privacy and infection prevention and control requirements (IPC).
~ For requirements for enclosing and adapting the patient bay for provision of an isolation room, e.g. provision of an anteroom, access to PPE, air handling and pressure, etc. refer to ‘AusHFG Part D: Infection Prevention and Control’ and ‘AusHFG Isolation Room- Engineering and Design Requirements’.
~ Medical services panel(s) may be provided instead of a pendant and requirements must be confirmed at project level to suit clinical services requirements and equipment selection. Where medical services panel is provided instead of pendant, ceiling height is to be 2700mm. Ceiling height of 3000mm is only required for pendant installation and arm clearances.
~ Life of components, and access for maintenance and replacement of pendants is to be considered during design.
~ Overall content and configuration of the medical services panels/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 or pendant/rail/wall mounted equipment.
~ The frequency of use and storage of nitric oxide cylinders is to be confirmed at project level to clinical service requirements and operational models for medical gas cylinder storage. A medical gas outlet for scavenge or mobile scavenging equipment may be required where nitric oxide is to be used.
~ Provision of external windows for natural light and external outlook is desirable and may be provided to individual patient bays or shared by a group/pod of bays. Overall department layout will determine location of external windows. Ability to achieve blocking/blackout of light as needed to be assessed to support patient and family rest. Integral blinds to be provided to windows in neonatal special care patient areas to meet cleaning and infection prevention and control (IPC) requirements; refer to Part D Section 6.4 for more information.
~ Furniture to accommodate family within the room is to be confirmed at project level to ensure the selected items provide comfortable seating, support breastfeeding and expressing breast milk, enable skin-to-skin contact (kangaroo care) and can be used for sleeping. Operational models for provision of linen, the extent and configuration of property storage to be provided, and the ability/requirement to fold-up or pack away furniture used for sleeping when it is not in use must also be considered. Fixed joinery items may be considered; however, freestanding furniture is recommended to support flexible arrangements. Cleaning processes/products, and infection prevention and control (IPC) requirements must also be considered in assessment of furniture and upholstery selection.
~ Refer to HPU 390 Neonatal Care Unit for information on overnight stay rooms for family and rooming-in models that are separate from the patient bay.
~ Provision and storage of chairs for visitors that can be shared between bays and brought to a patient bay as needed to accommodate larger groups for short periods is to be considered.
~ A dedicated power outlet, clearly separate from the Medical Services Panel (MSP), is recommended to support family and visitor use/charging of portable devices. Inclusion of integral USB outlets will depend on local ICT policies.
~ Access to patient bays for mothers who are inpatients and may be brought in on a patient bed (when they are not able to be brought in a wheelchair) is to be considered. Visits and transportation from the inpatient unit are typically managed by the inpatient staff. The mother’s bed must be able to be located so that corridors to other patient bays are not blocked for staff and equipment. The location must also ensure access to the head of the mother’s bed can be achieved easily if their condition deteriorates.
~ Storage of breast milk/formula (fridge within neonatal cubicle or in central room) to be confirmed at project level to suit local jurisdictional and operational service requirements. Provision of fridges for storing breast milk/formula requires BMS monitoring.
~ Requirements for staff notetaking/write-up within the bay, including use of electronic medical records, are to be confirmed at project level to suit clinical service requirements and local ICT policies. This may include the use of workstations on wheels (WOWs) that are kept with staff members and require parking areas and charging facilities within the unit, or provision of fixed wall mounted computers in each bay, requiring tap-on login capability. Facilities with paper-based medical record systems or hybrid paper/digital systems may require provision of a document holder within the bay. Provision of wall mounted computers will require side walls to be raised to provide adequate structural support within the wall.
~ Additional ICT requirements (cameras, display screens, building services, etc.) for virtual care such as patient monitoring/assessment, staff support, family consultation etc. (e.g. in rural and remote facilities) are to be confirmed at project level to suit clinical service requirements.
~ Mobile duress coverage is to be assessed and planned at a department level and coverage of all patient areas is to suit local security and WHS policies and operational service requirements.
~ The configuration of the Nurse Call system, including provision of “quiet call” systems that aim to reduce noise by alerting staff on handheld devices, is to be assessed at project level to suit clinical services requirements and local ICT policies.
~ High noise levels are detrimental to newborn health. Ceiling and wall finishes are to be suitable for the cleaning required in clinical environments, with acoustic treatments that meet infection prevention and control requirements to be considered and assessed to reduce the impact of noise within the patient bay.
~ Projects are to confirm the types of medical procedures requiring equipment to be powered from an isolated supply within the patient bay to confirm the requirement for provision of a line isolation monitor within the bay.
~ 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.