Ergonomics patient care unit

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Design Care of a Patient Care Unit: Ergonomics

Consideration

Presented by:

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Objectives The objectives of the project are:

o Study the existing layout of a simple Patient Care Unito Identify the various limitations with the design and the reasons

behind themo Suggest the improvements in the layout while considering

ergonomics for a newcomero 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

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What is a Patient 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

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Chief Medical Officer

Reception &

Enquiry Counter

Asst. Medical Officer 1

Asst. Medical Officer 2

Asst. Medical Officer 3

Consultancy Room

Medical LabWash Room

Rest Bed

ECG Room

Dressing & Primary

treatment Room

Medical Store

Wash Room

StoresDisposal area

Seating Arrangement

Weighing Machine

Str

etch

er

Parking

Ambulance

Existing Layout

Chief Medical Officer

Reception &

Enquiry Counter

Asst. Medical Officer 1

Asst. Medical Officer 2

Asst. Medical Officer 3

Consultancy Room

Medical LabWash Room

Rest Bed

ECG Room

Dressing & Primary treatment

RoomMedical Store

Wash Room

StoresDisposal

area

Seating Arrangement

Weighing Machine

Str

etch

er

Existing Layout – Medical Office

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Basic Requirements in Patient 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

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Relatives’ waiting room with 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

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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.

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Additional approaches to improving 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

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Electronic medical records (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

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Infrastructure 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

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)

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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

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Proposed LayoutErgonomics Consideration

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Visual communications to be made

Destination Path to be followed

Asst Medical OfficerConsultancy RoomMedical LabWash RoomRest BedWeighing Machine / Stretcher

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Chief Medical Officer

Reception & Enquir

y Counte

r

Asst. Medical Officer 1

Asst. Medical Officer 2

Asst. Medical Officer 3

Consultancy Room

Medical LabWash Room

Rest Bed

ECG Room

Dressing & Primary

treatment Room

Medical Store

Wash Room

StoresDisposal area

Seating Arrangement

Weighing Machine

Str

etc

her

Parking

Ambulance

Modified Layout –

Ambulance Location

Easy movement of stretcher from

bigger door

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Improve Patient

Confidentiality and Privacy

Risk factors

involved in patient

falls in hospitals

.

Administrative and procedur

al informati

on

External building

cues

Local informati

on

Global structure

Improvements

Improvements

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Other ImprovementsReduce staff stress 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-to-understand signs and numbers, consistent and clear paper, mail-out and electronic information

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• Effective Communication

• Compassionate Care

• Responsiveness• Accountability• Teamwork• Respect

Characteristics of a Good Patient

Care Unit

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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

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At present:

Description Number per 1000

Doctors 0.8

Beds 0.9

Nurses and Housewife's

1.0Source: http://data.worldbank.org

The number of 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.

Service Levels

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Safety Tips for patients 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.

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Queries