Ergonomics Design of a Patient Care Unit

1. Design Care of a Patient Care
Unit: Ergonomics Consideration
Presented by:
1

2. Objectives
 The objectives of 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 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
3

4. Medical Lab
Consultanc
y Room
Asst.
Medical
Officer 3
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
Officer 3
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 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
6

7. 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
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 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
9

10.  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
10

11. 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)
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

13. Proposed Layout
Ergonomics Consideration
13

14. Visual communications to be made
Destination
Path to be followed
Asst Medical Officer
Consultancy Room
Medical Lab
Wash Room
Rest Bed
Weighing Machine / Stretcher
14

15. 15

16. 16

17. Medical Lab
Consultancy
Room
Weighi
ng
Machi
ne
Asst.
Medical
Officer 3
Rest Bed
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
involved in
patient
falls in
hospitals.
External
building
cues
Administrat
ive and
procedural
information
Improve
ments
Local
information
Global
structure
18

19. Other Improvements
Reduce 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-tounderstand signs and numbers, consistent and clear paper, mail-out and electronic
information
19

20. Characteristics of a Good 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 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.
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 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.
23

24. Queries
24