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65 - Evidence-based design of the cardiothoracic critical care

from SECTION 6 - Structure and Organisation in Cardiothoracic Critical Care

Published online by Cambridge University Press:  05 July 2014

D.K. Hamilton
Affiliation:
Texas A & M University
R.S. Ulrich
Affiliation:
Texas A & M University
Andrew Klein
Affiliation:
Papworth Hospital, Cambridge
Alain Vuylsteke
Affiliation:
Papworth Hospital, Cambridge
Samer A. M. Nashef
Affiliation:
Papworth Hospital, Cambridge
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Summary

Introduction

Critical care units are the locus of some of the most important and complex clinical episodes in the hospital, and as such deserve careful attention to design. There is a growing body of evidence relating the physical environment to outcomes.

Key issues in the design of future cardiothoracic critical care units

Typical geometries

Selecting a geometric floor plan to increase observation of patients and to reduce the travel distance of staff while performing their duties in a critical care unit is important. Each patient bed should have an exterior window.

Although the intuitive response is often to suggest a variation of circular forms, careful study of unit shape has shown that there is no single ideal geometry. Good floor designs have been demonstrated in semi-circles, hexagons, octagons, squares and diamonds, along with some irregular shapes. A strong recommendation is to limit unit size to the range of 7 to 10 beds, breaking larger units into pods or clusters of smaller numbers. The most successful designs are symmetrical, or nearly so, and efficiently compact.

Patient safety

The Institute of Medicine has indicated that nearly 100,000 preventable deaths occur annually in hospitals in the United States. These can often be attributed to error, hospital-acquired infections, and in some cases, falls.

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Publisher: Cambridge University Press
Print publication year: 2008

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