Designing Safe Intensive Care Units of the Future

Barach, Paul; Forbes, M. Potter; Forbes, Ian

doi:10.1007/978-88-470-1436-7_40

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…The work environment in the ICU is governed by the regulations of the Swedish Work Environment Authority (). There is, however, a great need for improvements with regard to lighting, noise, safety and ergonomics both for patients and for staff (Applebaum, Fowler, Fiedler, Osinubi, & Robson, ; Barach, Potter Forbes, & Forbes, ; Pereira et al, ). There is also a great need for functional teams that can create a benign and caring environment (San Martín‐Rodríguez et al, ) and an atmosphere that is conducive to emotional work (Hammonds & Cadge, ).…”

Section: Philosophical and Theoretical Frameworkmentioning

confidence: 99%

Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments

2019

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This paper focuses on the patient's perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the intensive care unit (ICU) patient room. It also addresses the question of whether the aspects that support at‐homeness are applicable to ICU patient rooms. The concept of “at‐homeness” in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at‐homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of well‐being in situations involving severe illness or life‐threatening conditions.

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Section: Philosophical and Theoretical Frameworkmentioning

confidence: 99%

Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments

2019

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“…Alarms lack clinical context to support management decision-making and may not accurately represent patient state during interventions [19] , [20] . The large number of false alarms in the ICU causes alarm fatigue and contributes significant stress to patients and care-providers [20] , [21] .…”

Section: Introductionmentioning

confidence: 99%

Clinician-Driven Design ofVitalPAD–An Intelligent Monitoring and Communication Device to Improve Patient Safety in the Intensive Care Unit

Flohr

Beaudry

Johnson

et al. 2018

IEEE J. Transl. Eng. Health Med.

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The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD, to improve the efficiency of clinical decision-making, communication, and thereby patient safety. We observed individual ICU clinicians, multidisciplinary rounds, and handover procedures for 54 h to identify data needs, workflow, and existing cognitive aid use and limitations. A prototype was developed using an iterative participatory design approach; usability testing, including general and task-specific feedback, was obtained from 15 clinicians. Features included map overviews of the ICU showing clinician assignment, patient status, and respiratory support; patient vital signs; a photo-documentation option for arterial blood gas results; and team communication and reminder functions. Clinicians reported the prototype to be an intuitive display of vital parameters and relevant alerts and reminders, as well as a user-friendly communication tool. Future work includes implementation of a prototype, which will be evaluated under simulation and real-world conditions, with the aim of providing ICU staff with a monitoring device that will improve their daily work, communication, and decision-making capacity. Mobile monitoring of vital signs and therapy parameters might help improve patient safety in wards with single-patient rooms and likely has applications in many acute and critical care settings.

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“…Current Intensive Care Units (ICU) are often an in-humane environment, resulting in permanent physical and psychological damage in up to 50% of ICU veterans (Barach, Potter Forbes, & Forbes, 2009). Contributing factors are lack of space for family members, lack of windows providing outside nature views and noise levels that exceed WHO guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…Contributing factors are lack of space for family members, lack of windows providing outside nature views and noise levels that exceed WHO guidelines. These factors increase stress, deprive patients of sleep and may delay healing (Barach, et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of an Ambient Color Coded Display to Communicate Changes in the Patient's Condition to ICU Nurses and Improve the Therapeutic Environment

Koch

Görges

Weir

2010

Proceedings of the Human Factors and Ergonomics Society Annual

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PROBLEM STATEMENT: For Intensive Care Units (ICUs) patients frequent noise, confusing patient monitors and loud alarms decrease the quality of stay, and may event extend its length. Nurses frequently enter the patient's room to check the patient monitor to become aware of changes, potentially disturbing patients and family. Ambient displays can communicate changes by subtly changing the environment, and have been shown to be unobtrusive and not disturbing to its users. An ambient display, visible from the doorway, would allow nurses to be aware of patient changes before alarms occur. OBJECTIVE: Our hypothesis is that color coded ambient displays using the standard vital sign colors are intuitively understood by clinicians and can communicate deviations in patient state. METHODS: We designed an ambient display, which communicates changes in patient's vital signs by changing its background color. A heuristic evaluation was performed, followed by an intrusive questionnaire of nurse without prior explanation of the color-coding. RESULTS: The results of the heuristic evaluation indicated that simultaneous changes could not be displayed. In the intrusive evaluation nurses correctly identified patient changes 73% of the time. Additionally, nurses correctly recalled 92% of vital sign colors used on their current patient monitor. DISCUSSION: Our findings confirm that color coded ambient displays using the standard vital sign colors are intuitively understood by clinicians and can communicate deviations in patient state. Future research needs to evaluate ambient displays in real ICU environments and identify nurses, patients' and families' reactions to such displays.

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Designing Safe Intensive Care Units of the Future

Cited by 8 publications

References 3 publications

Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments

Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments

Clinician-Driven Design ofVitalPAD–An Intelligent Monitoring and Communication Device to Improve Patient Safety in the Intensive Care Unit

Evaluation of an Ambient Color Coded Display to Communicate Changes in the Patient's Condition to ICU Nurses and Improve the Therapeutic Environment

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