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Ergonomics patient care unit
The document outlines considerations for improving the layout and design of a patient care unit to better support patient care and staff ergonomics. It begins by describing the objectives and additional factors to consider like safety, services, and housekeeping. An overview of what a typical patient care unit includes is provided. The existing layout is shown and limitations are identified. Basic requirements to improve the patient and visitor experience are covered. The proposed new layout addresses the limitations and improves visibility, flow, and access. Additional ergonomic and operational improvements are suggested around wayfinding, reducing staff stress, and increasing effectiveness. Characteristics of a good patient care unit and guidelines for staffing and safety are also outlined.
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Ergonomics patient care unit
- 1. Design Care ofa Patient Care Unit: Ergonomics Consideration Presented by: 1
- 2. Objectives The objectivesof the project are: o Study the existing layout of a simple Patient Care Unit o Identify the various limitations with the design and the reasons behind them o Suggest the improvements in the layout while considering ergonomics for a newcomer o Present the complete new layout with ergonomics consideration Additional work: • • • Suggest the safety considerations to be considered Servicing levels that should be present in the unit Housekeeping considered is also to be considered 2
- 3. What is aPatient Care Unit ? Patient Care Unit is the place where the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions. Any Patient Care Unit has the following basic amenities: Doctors Nurses Operation Threatre Patient Wards and Waiting hall Equipment Testing Labs 3
- 4. Medical Lab Consultanc y Room Asst. Medical Officer3 Weigh ing Machi ne Rest Bed Stretcher Existing Layout Dispos al area Wash Room ECG Room Dressing & Primary treatment Room Stores Asst. Medical Officer 2 Asst. Medical Officer 1 Seating Arrangement Wash Room Medical Store Receptio n& Enquiry Counter Chief Medical Officer Ambulance Parking 4
- 5. Medical Lab Disposal area Wash Room Asst. Medical Officer3 Rest Bed Stretcher Consultancy Room Weighi ng Machin e Stores ECG Room Dressing & Primary treatment Room Medical Store Wash Room Asst. Medical Officer 2 Asst. Medical Officer 1 Seating Arrangement Receptio n& Enquiry Counter Existing Layout – Medical Office Chief Medical Officer 5
- 6. Basic Requirements inPatient care unit for convenience of visitors ( patients, their family and care takers) Includes the requirements in any Patient Care Unit, some of which are lagging in existing layout 6
- 7. Relatives’ waiting roomwith a telephone, tv, beverage facilities etc Location should be chosen so that the unit is adjacent to, or within direct elevator travel to and from, the emergency department, operating room, intermediate care units, and the radiology department Patients must be situated so that direct or indirect (E.g. by video monitor) visualization by healthcare providers is possible at all times The preferred design is to allow a direct line of vision between the patient and the central nursing station Modular design – sliding glass doors & partitions to facilitate visibility Floor coverings and ceiling with sound absorption properties 7
- 8. Lighting – focussed& central lighting. Air-conditioning (central) 25 ± 2 degrees centigrade. Cleaning – vacuum cleaning & wet mopping of the floor. Fumigation is no longer recommended Natural illumination and view - windows are an important aspect of sensory orientation; helps to reinforce day/night orientation. Window treatments should be durable and easy to clean, and a schedule for their cleaning must be established. Handwashing areas – uninterrupted water supply, disposable paper towels / hand drier. (No cloth towels please) Telephones & computers for communication. 8
- 9. Additional approaches toimproving sensory orientation for patients may include the provision of a clock, calendar Bulletin board, and/or pillow speaker connected to radio and television Shelving & cabinets off the ground for storage Waste & sharps disposal Work areas and storage for critical supplies should be located immediately adjacent to each ICU There should be a separate medication area of at least 50 square feet containing a refrigerator for pharmaceuticals, a double locking safe for controlled substances, and a table top for preparation of drugs and infusions 9
- 10. Electronic medicalrecords (EMR) • • • • • Bedside terminals Interfaced with existing hospital data Systems, data retrieval (laboratory Results, x-ray reports, etc. Remote data transmission capabilities (to offices, on-call rooms, etc.) Monitoring equipment Therapeutic equipment Digital & analogue display Audio & visual alarms Battery back up & charging 10
- 11. Infrastructure Patients must besituated so that direct or indirect (E.g. By video monitor) visualization by healthcare providers is possible at all times The preferred design is to allow a direct line of vision between the patient and the central nursing station Modular design – sliding glass doors & partitions to facilitate visibility Signals & alarms – add to the sensory overload; need to be modulated Floor coverings and ceiling with sound absorption properties Doorways – offset to minimise sound transmission Light & soft music (except 10 pm to 6 am) 11
- 12. Contd… Lighting – focussed& central lighting Air-conditioning (split / central) – 25 + or – 2 degrees centigrade Cleaning – vacuum cleaning & wet mopping of the floor Fumigation is no longer recommended Natural illumination and view - windows are an important aspect of sensory orientation; helps to reinforce day/night orientation Window treatments should be durable and easy to clean, and a schedule for their cleaning must be established 12
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- 14. Visual communications tobe made Destination Path to be followed Asst Medical Officer Consultancy Room Medical Lab Wash Room Rest Bed Weighing Machine / Stretcher 14
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- 17. Medical Lab Consultancy Room Weighi ng Machi ne Asst. Medical Officer 3 RestBed Stretche r Modified Layout – Ambulance Location Wash Room ECG Room Dispos al area Dressing & Primary treatment Room Asst. Medical Officer 2 Asst. Medical Officer 1 Seating Arrangement Stores Wash Room Medical Store Recept ion & Enquir y Counte r Chief Medical Officer Easy movement of stretcher from bigger door Ambulance Parking 17
- 18. Improvements Improve Patient Confidenti ality and Privacy Risk factors involvedin patient falls in hospitals. External building cues Administrat ive and procedural information Improve ments Local information Global structure 18
- 19. Other Improvements Reduce staffstress and fatigue and increase effectiveness in delivering care Poor ergonomic design of patient beds and nurses’ stations leads to back stress, fatigue, and other injuries among nursing staff Increase staff effectiveness, reduce errors, and increase staff satisfaction by designing better workplaces Nurses spend a lot of time walking. Time saved walking was translated into more time spent on patient-care activities and interaction with family members Way finding system, as the name implies, is not just about better signage or colour lines on floors Integrated systems that include coordinated elements such as visible and easy-tounderstand signs and numbers, consistent and clear paper, mail-out and electronic information 19
- 20. Characteristics of aGood Patient Care Unit • Effective Communication • Compassionate Care • Responsiveness • Accountability • Teamwork • Respect 20
- 21. Housekeeping Hand washing areas– uninterrupted water supply, disposable paper towels / hand drier Sterilising area – large water boiler / geyser & exhaust fans Clean and a dirty utility with no interconnection Shelving & cabinets off the ground for storage Waste & sharps disposal Work areas and storage for critical supplies should be located immediately adjacent to each ICU There should be a separate medication area of at least 50 square feet containing a refrigerator for pharmaceuticals, a double locking safe for controlled substances, and a table top for preparation of drugs and infusions 21
- 22. Service Levels The numberof doctors in a Patient care unit should be based on the population it is catering to. According to WHO guidelines, there should be at least 1 physician per 1000 people. At present: Description Number per 1000 Doctors Beds Source: http://data.worldbank.org 0.8 0.9 Nurses and Housewife's 1.0 22
- 23. Safety Tips forpatients by hospitals Prevent central line-associated blood stream infections. Re-engineer hospital discharges. Consider working with a Patient Safety Organization. Limit shift durations for medical residents and other hospital staff if possible. Use good hospital design principles Measure your hospital's patient safety culture. Build better teams and rapid response systems. 23
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