FUTURE MODEL FOR PEDIATRIC ICU (PICU) PATIENT ROOM: OPTIMIZE CARE IN TERMS OF PATIENT SAFETY AND STAFF EFFICIENCY BY DESIGN

Abstract

Objectives: This study is to identify the desired physical environment, amenities and spaces in multi-beds patient room in Pediatric Intensive Care Units that could support safe and speedy care delivery. Study Design: This qualitative and quantitative case study is to 1) improve efficiency for care delivery by design (e.g., minimize steps Registered Nurses [RNs] take in delivering care); and 2) minimize the risk of HAIs (e.g., reduce contact transmissions). Methods: A 35 hours observation was conducted in five consecutive weekdays in the PICU triple-patient rooms to record 13 RNs’ work steps, walking paths, and high contact surfaces. In-person interviews with six of the observed nurses were conducted to understand their daily care delivery activities and opinions of the current and future patient room design. Results: Opportunities to enhance RNs’ work efficiency in the current multi-bed patient room are the spatial and amenities designs around the patient bedsides, the disposal area, and the preparation and supply closet. Four surfaces with high possibility of contact transmission are identified, including patient bedrails, IV pumps and poles, tubing and medical equipment around the bedside, and vital sign monitor screens. Conclusions: Design recommendations are provided for improving efficiency by design via rethinking room layout, arrangement and amenities, and enhancing infection prevention by minimizing opportunities for contact transfer based on Lean and evidence-based design. Overall, the findings of this study will inform the future patient room design for Pediatric ICU.