Management System and Resources
ICU Physical Design
The Intensive Care Unit
 May constitute up to 10% of total hospital beds
 Multidisciplinary ICUs require more beds than
single-specialty ones
 Large ICUs are divided into “pods” (8-15 px)
for clinical management
Intensive Care
 The practice of administering IMMEDIATE and
CONTINUOUS care to client with actual or
potentially life-threatening health disorder:
 Brain injuries
 Cardiovascular Dysfunctions
 Pulmonary Dysfunctions
 Childbirth
 Shock and Trauma
 Infection and Sepsis
 Endocrine Abnormalities
 Multisystem Alterations
 Complex Surgical Procedures
GOAL of an ICU
 Create a healing environment
 Improves the physical and/or
psychological states of patients, staff,
and visitors.
 Helps to reduce medical errors
 Improve patient outcomes
 Reduce length of stay
 Increase social support for patients
 Cost-reducing
Layout of an ICU
 Should allow rapid access to relevant acute areas
 Available, open, round-the-clock
communication lines between departments
 Safe transport of critically-ill patients
 Single entry and exit point with receptionist
 Areas dedicated to public reception, patient
management, and support services.
 Total floor area = 2.5 – 3 times the area devoted
to patient care
The High-Dependency Unit
 A specially staffed and equipped area
 Proved a level of between intensive and general
ward care
 Located within or immediately adjacent to an
ICU complex and are often staffed by the ICU
personnel
 Provides invasive monitoring and support for
patients with or at risk of developing acute (or
acute-on-chronic) single organ failure.
 May act as a “step-up” of “step-down” unit.
Levels of ICU Care Provision
Level 1
 Small district hospitals
 Provide resuscitation and short-term
cardiorespiratory support.
 Mechanical ventilation
 Simple invasive cardiovascular
monitoring
 MAJOR ROLE: Monitor and prevent
complications of “at-risk” medical and surgical
patients
 Policies are established to determine which
patients require transfer and where they ought to
be transferred
 Established relationship with levels 2
&/or 3 units
 Certified intensive care specialist medical
director
 Some training and experience with critically-ill
children
Level 2
 Larger general hospitals
 Provide a high standard of general intensive care
 Multisystem life support
  With medical officer on site  Patients should be able to be seen at all
 Access to pharmacy, pathology, and times
radiology facilities at all times
 Certified intensive care specialist medical II. Clinical Support Zone
director and majority of other specialists  Adequate space for staff interaction, mentoring,
 Patients admitted must be referred to the and socialization
attending intensive care specialist for  Houses:
management  Central monitor
 Referral and transport policies with level 3 unit  Satellite pharmacy
should be in place  Drug Preparation area
 Satellite sterile and non-sterile items
 Communication (telephone, computer,
Level 3 patients’ records, reference books, and
policy and procedure manuals)
 Major tertiary referral hospital  Critical care is primarily at the bedside
 Provide all aspects of intensive care
management for indefinite period III. Unit Support Zone
 Committed to education and research  Storage areas
 Complex investigations and imaging  Separate clean and dirty utility rooms
and support by specialists of all  Laboratory Area 1: Facility for estimating blood
disciplines gases, glucose, electrolytes, hemoglobin, lactate,
 Staffed by intensive care specialists with and clotting status.
trainees  Pneumatic tube or equivalent system to transfer
 Junior medical staff specimens to pathology
 Critical care nurses  Offices
 Allied health professionals
 Washrooms
 Clerical and scientific staff
 Staff lounge
Patient Care Zone  Conference room
3-Zones Area:
1. Patient Care Zone
 Family Zone
2. Clinical Support Zone UHW ICU – Equipment at the Bedside
3. Unit Support Zone

I. Patient Care Zone

 Patient Zone
 Single rooms for isolation – equipped
with anterooms for handwashing,
gowning, and storage of isolation
materials
 Suitable and safe air quality
 Negative-pressure ventilated for
contagious respiratory
infections
 HEPA (High-Efficiency
Particulate) filtration
 Each bed: Non-splash hand
wash basin (elbow/foot operated
taps), hand disinfection facility
 Adequate and appropriate lighting for
clinical observation