Guidelines for Intensive Care Unit Design

Surgery and Anesthesiology, Albany Medical College, Albany, NY, USA.
Critical care medicine (Impact Factor: 6.31). 05/2012; 40(5):1586-600. DOI: 10.1097/CCM.0b013e3182413bb2
Source: PubMed


To develop a guideline to help guide healthcare professionals participate effectively in the design, construction, and occupancy of a new or renovated intensive care unit.
A group of multidisciplinary professionals, designers, and architects with expertise in critical care, under the direction of the American College of Critical Care Medicine, met over several years, reviewed the available literature, and collated their expert opinions on recommendations for the optimal design of an intensive care unit.
The design of a new or renovated intensive care unit is frequently a once- or twice-in-a-lifetime occurrence for most critical care professionals. Healthcare architects have experience in this process that most healthcare professionals do not. While there are regulatory documents, such as the Guidelines for the Design and Construction of Health Care Facilities, these represent minimal guidelines. The intent was to develop recommendations for a more optimal approach for a healing environment.
Relevant literature was accessed and reviewed, and expert opinion was sought from the committee members and outside experts. Evidence-based architecture is just in its beginning, which made the grading of literature difficult, and so it was not attempted. The previous designs of the winners of the American Institute of Architects, American Association of Critical Care Nurses, and Society of Critical Care Medicine Intensive Care Unit Design Award were used as a reference. Collaboratively and meeting repeatedly, both in person and by teleconference, the task force met to construct these recommendations.
Recommendations for the design of intensive care units, expanding on regulatory guidelines and providing the best possible healing environment, and an efficient and cost-effective workplace.

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Available from: Sandra Swoboda, Apr 09, 2014
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    • "Job satisfaction and supportive healthy environments are significant for nurses staying on at ICUs and significant for the future of ICUs (Alameddine et al., 2009). Critical care management is a complex task requiring not only high levels of competences and skills in nursing staff but also well-adjusted facilities (Chambers and Bowman, 2011; Thompson et al., 2012). The interplay between several aspects of the built environment, such as working space, sound levels, natural light and view, together with patients' critical condition, shaped nurses' everyday experiences. "
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    Nursing in Critical Care 03/2014; 19(3). DOI:10.1111/nicc.12082 · 0.65 Impact Factor
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    • "The vast amounts of data generated from the ever-increasing number of studies conducted and published, and a belief that standardizing approaches to patient management may improve patient outcomes, have led to a surge in the numbers of guidelines developed by international groups or societies. Guidelines for sepsis management [35], nutrition [36], red blood cell transfusion [37], ICU design [38], and many other aspects of critical care structure and process have all been published. The use of locally produced or adapted protocols has also been encouraged and these are now present on many ICUs, although the use of checklists, such as FASTHUG [39], may represent a more flexible approach to individual patients, particularly in units with adequate numbers of well-trained staff. "
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    ABSTRACT: The first ICUs were established in the late 1950s and the specialty of critical care medicine began to develop. Since those early days, huge improvements have been made in terms of technological advances and understanding of the pathophysiology and pathogenesis of the disease processes that affect critically ill patients. Progress in therapeutics has been less dramatic, but process of care has improved steadily with important changes, including less iatrogenicity, better communication with patients and families, and improved teamwork, which have helped improve outcomes for ICU patients. Critical care medicine is one of the fastest-growing hospital specialties and, looking back, it is clear just how far we have come in such a relatively short period of time. With the ICU set to occupy an increasingly important place in hospitals worldwide, we must learn from the past and wisely embrace new developments in technology, therapeutics, and process, to ensure that the goals of critical care medicine are met in the future.
    Critical care (London, England) 03/2013; 17 Suppl 1(Suppl 1):S2. DOI:10.1186/cc11500 · 4.48 Impact Factor
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    ABSTRACT: In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical design of these award-winning ICUs may help design better ICUs.
    Critical care nursing quarterly 01/2014; 37(1):3-32. DOI:10.1097/CNQ.0000000000000002
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