ICU BEDSIDE ENVIRONMENT: A Nursing Perspective
Section snippets
THE EARLY ICU ENVIRONMENT
Intensive care units emerged in the late 1950s as architecturally discrete areas for treating unstable patients. Although these early areas were just general care units with a few beds designated as special care beds, it was recognized that the nursing care for the patients in these beds would be of higher intensity. Few units at that time boasted new complex technology, but rather used the sphygmomanometers, chest tubes, tracheostomy tubes, catheters (the “old stuff”) in a new location.8 The
ICU AS A STRESSFUL ENVIRONMENT
It has often been said that the ICU is a stressful place in which to work and a hostile environment for patients. The environmental stressors that have been reported in the literature as affecting ICU patients center around the physical and psychological comfort of the patient, staff interaction with the patient, the physical environment of the ICU, family, the illness, and the fear of death.2 In addition to these are the inability to communicate, the drugs used to sedate patients, the
THE BEDSIDE ENVIRONMENT OF THE FUTURE
Understanding the current state of the ICU environment is critical to creating the ICU of the future. The major goals of the ICU environment of the future will be to accommodate even sicker patients, make use of available technologies, increase the flexibility of the ICU environment, and incorporate a more healing environment into the ICU. There are multiple ways to accomplish these goals, and it should be recognized that the concept of creating flexibility in the critical care unit is not
TAKING THE HOSTILITY OUT OF THE ICU BEDSIDE ENVIRONMENT
In addition to accommodating the high technology of the future and the care providers who will use that technology to improve the outcomes of the critically ill patients, a healing environment must be created. The maximum flexibility in the ICU bedside environment will be obtained when all of the environmental controls for the patient room are serving an individual patient room.11 Thermostats, light switches, sound systems, window blinds, and so forth should be controlled separately for each
CONCLUSION
Here is a little glimpse into the ICU of the future.
The nurse presses her communication (COMM) badge to alert the multidisciplinary team that the patient who had been admitted during the night with respiratory failure and pneumonia, Mr. Wheeze, and his wife who was staying in the ICU room with him were awake. The team came to the unit and entered Mr. Wheeze's room. The artificially created views from the windows that surrounded Mr. Wheeze's bed were of a beautiful, sunny fall day. The music, a
THE ICU BEDSIDE ENVIRONMENT OF THE FUTURE IS BEING CONSTRUCTED TODAY
Research has demonstrated that the environment in the ICU is a stressor for most patients and staff. These studies will be used to design a better ICU for critically ill patients. The concept of the universal bed to care for the patient throughout the acute illness seems to be the most flexible idea for the delivery of critical care in the future. All components of the bedside environment will be very different in 2010. It is believed that the total number of patients requiring critical care
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Cited by (20)
How do intensive work environments affect nurses' absenteeism and turnover intent?
2022, Applied Nursing ResearchCitation Excerpt :ICU is a term used interchangeably with critical care environment (CCE) to designate a location where registered nurses (RNs) can monitor groups of unstable patients and provide immediate medical assistance with state-of-the-art equipment. Over time, ICUs have become more technologically oriented with the arrival of more medical devices and ancillary personnel (Jastremski, 2000). However, whatever changes took place, one factor remained constant on these units, namely, the expertise of the RNs and the care they rendered, available nowhere else, to patients with complex and life-threatening conditions.
Factors affecting stress experienced by surrogate decision makers for critically ill patients: Implications for nursing practice
2014, Intensive and Critical Care NursingCitation Excerpt :In addition, SDMs appear to experience greater emotional trauma when they perceive that providers are not clear or transparent in discussing prognosis or when they appear to avoid prognostication altogether (Apatira et al., 2008; Evans et al., 2009). Structural factors and policies have been found to contribute to stress and family discomfort, such as limited space to visit, restricted visiting hours, limitations on number and age of visitors, and inadequate waiting areas (Bazuin and Cardon, 2011; Jastremski, 2000; Vandijck et al., 2010). Many of these studies rely on recall and are conducted after the episode of critical illness has concluded.
Current views of health care design and construction: Practical implications for safer, cleaner environments
2010, American Journal of Infection ControlCitation Excerpt :Evidence supports this concept because transfer of critically ill patients can increase risk of ventilator-associated pneumonia.25 There has been a parallel movement to decentralize nursing care to facilitate close proximity of the nurse to the patient.26 Decentralization has resulted in creation of units in a “racetrack” configuration: single occupancy rooms on the periphery of a common corridor with workstations (including viewing windows) in between every 2 rooms, increased entry of natural lighting, and zones of space dedicated for personnel and family.
Positive effect of colors and art in patient rooms on patient recovery after total hip or knee arthroplasty: A randomized controlled trial
2022, Wiener Klinische Wochenschrift
Address reprint requests to Connie A. Jastremski, MS, MBA, RN, ANP-CS, FCCM, Director of Nursing, Rome Memorial Hospital, 1500 N. James Street, Rome, NY 13440
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SUNY Health Science Center, Upstate Medical University, College of Nursing, Syracuse; and Rome Memorial Hospital, Rome, New York