caA hole in the septum between the heart's two upper chambers is called an atrial septal

defect (ASD). A hole in the septum between the heart's two lower chambers is called a
ventricular septal defect (VSD).
ASDs and VSDs allow blood to pass from the left side of the heart to the right side. This
means that oxygen-rich blood can mix with oxygen-poor blood.
For this an open heart surgery is done

General hospital – patient entry

Reception – patient registration, appointment
OPD – consultation – write downs some diagnostic tests and procedures
CT scan – (radiology department) – to diagnose problems ( CT scan images are 3D.
The CT scanning machine rotates on an axis and takes various 2D images of an individual's
body from multiple angles.)

General doctor check-up – diagnosed with congenital heart defect (hole in the heart),
advised to go to multispecialty hospital
Multi-speciality hospital – entry
Reception – appointment, registration
Consultation – checking of medical history and advising
ICU (intensive care unit) – under observation
Cath lab - heart's condition was assessed, where a dye is injected.
Family’s role – to get the prescribed medicines for the patient from the pharmacy
ICU – under observation
Induction room –Anaesthesia is given
OT – operation theatre – in this case, Open heart surgery (stent surgery) took place.
Where a device is sent through a vein to where the hole is located. This device opens up
like an umbrella and tightens the hole. After six months the body is going to build a new
heart wall.
Doctor’s role – checks the patient’s records, hear to patient’s condition from nurse,
doctor’s changing room, scrub room, OT
Nurse’s role – informs the patient’s condition to the doctor, nurses changing room, scrub
room, prepares the equipment in OT from central sterilisation and supply unit.
ICU – under observation
Post OP rooms (post-operative care rooms) – the patient is under observation. If in case
the condition is critical, he is taken immediately to the ICU.
Assignment 2
It can be defined as a “service for patients with potentially recoverable diseases who can be benefit
from more detailed observation and treatment than is generally available in standard wards and
departments

I.C.U Staff

 Intensivist/s
 Resident doctors Nurses
 Respiratory Therapists
 Dietician/s
 Physiotherapist
 Clinical Pharmacist & Other support staff like cleaning staff, guards 4

There should be at least two barriers to the entry of ICU There should be only one entry and exit to
ICU to allow free access to heavy duty machines like mobile x-ray, -bed and trolleys on wheels and
sometime other repairing machines.
At the same time, it is essential to have an emergency exit for rescue removal of patients in
emergency and disaster situations
It is desirable to have access to natural light as much as possible to each patient.

Different zones in ICU - Patient care zone, Clinical support zone, Unit support zone, Family support
zone

Patient care zone LO BEDS, OXYGEN AND PATIENT KI RELATED

Clinical support zone LO Storage space, Wash station and Ancillary services

Ancillary services - pharmacy, Laboratory, Housekeeping, Kitchen, Bio-medical

unit support zone lo Administrative functions, Multipurpose conference room, Staff support room,
staff lounge lockers

Family support zone- Family lounge Consultation rooms, Meditation spaces, Family sleep rooms
Family nourishment
 WHY??
These units are one possible strategy to improve critical care cost-effectiveness and patient flow
without compromising quality

Step-Up Unit

 Reserved for those patients admitted to General Internal Medicine who

require a level of care that is intermediate between the Intensive Care Unit and
the ward.
 Patients can only be admitted to the Step-Up Unit through the Emergency
Room or from the General Internal Medicine ward.
 increased care requirements

STEP DOWN UNIT

Most SDU patients can be classified into three groups.

 The first is “stepdown” patients who were receiving intensive care (usually organ support)
but who no longer have full intensive care needs.
 The second group is “step-up” patients who are admitted to SDUs from regular ward with
increased care requirements. 
 The third main category of SDU patients is postoperative patients who are admitted either
directly from the operating room or after a short period of observation in a recovery room.

 that they no longer meet any criteria for full intensive care’

Storage areas:

Equipment Storage area (for equipment and supplies):

- An area must be provided for the storage and securing of large patient care equipment

items not in active use

- Space should be adequate enough to provide easy access, easy location of desired

equipment, and easy retrieval.

- Grounded electrical outlets should be provided within the storage area in sufficient

numbers to permit recharging of battery operated items.

- Storage areas for portable X-ray equipment, stretchers, fracture tables, warming devices

auxiliary lamps etc. these areas shall be out of corridors and traffic.
Conference Room

- A conference room should be conveniently located for ICU physician and staff use.

- This room must be linked to each relevant ICU by telephone or other intercommunication

system, and emergency call system.

- Cardiac arrest alarms should be audible in the room.

- The conference room may have multiple purposes including continuing education, house

staff education, or multidisciplinary patient care conferences.

- A conference room is ideal for the storage of medical and nursing reference materials and

resources such as VCRs, and computerized interactive and self-paced learning equipment.

- If the conference room is not large enough for educational activities, a classroom should

also be provided nearby.

Visitors lounge, waiting area

- Families and visitors to critical care unit often wait for a long period of time including

overnight stay, under high stressful situations. They tend to congregate at unit entries to be

readily accessible to staff interaction.

- Design shall address such issues as privacy, atmosphere, and aesthetics for all involved in

the care and comfort of patients in critical care units.

- A visitors' lounge or waiting area should be provided near each ICU or ICU cluster.

- Visitor access should be controlled from the receptionist area.

Administration office

- It is often desirable to have office space available adjacent to the ICU(s) for medical and

nursing management and administrative personnel.

- These offices should be large enough to permit meetings and consultations with ICU team

members and/or patients' families.

- Additional office space may be allocated for staff development personnel, clinical

specialists, and social services, as applicable.

- The ability to place these individuals in close proximity to an ICU may facilitate an
integrated and broad-based team approach to patient management.

Housekeeping room

- Housekeeping facilities shall be provided for the exclusive use of the ICU and there shall

be provision for storage of supplies and house keeping equipment.

- It should be 6-8m² of floor space for every 8 beds, with at least two electrical outlets

and a sink/sluice.

- It shall be immediately adjacent to the ICU

special procedure room

by keeping the patients in house and avoiding the stress of transporting them to the acute care
facilities for completion of these procedures.

time sensitive surgeries,requires rapid intervention.

avoiding the stress of transporting them to the acute care facilities for completion of these
procedures.