Specification for ICU design in ICU:
I. ICU Overall Plan and Regional Design
A. Pre-planning ICU mode (integrated or multi-unit mode), number of beds (recommended 8-12 beds per unit of multi-unit ICU), visiting system, equipment requirements (nurses'station number, storage room number, equipment number, staff number, management and continuing education needs, etc.).
B. ICU should implement the system of access control. Traveling and free access to ICU are not allowed. Access to supplies and medical personnel must be separated from access.
C. Geographical location should be in good lighting and ventilation.
D. Be as close as possible to elevators, emergency rooms, operating rooms, radiology departments and laboratories.
1. Design of patient area
A. The distribution of wards must enable patients to be placed in the direct visual range of staff at any time and indirect visual (through visual monitors) in special cases to ensure the safety of patients in daily and emergency situations.
The best design of B and Zui is that patients can be directly visualized from the central nurses'station, and patients can be directly visualized from the sub-nurses' station in the multi-unit mode.
C. Sliding glass doors and partitions shall meet the above requirements and facilitate rapid access to the room in case of emergency.
D, patient call signal, alarm signal of monitoring equipment and ringing tone may deteriorate the rest environment in ICU, and may cause complaints in some cases. It should be set within a reasonable range (the International Noise Conference recommends that no more than 45 decibels should be used in emergency treatment areas during the day, 40 decibels in the evening and 20 decibels at night). Noise levels in most hospitals range from 50 to 70 decibels.
E. Sound-absorbing materials should be selected for ground cover, and the needs of infection control, cleaning and maintenance, and equipment movement should be considered. High sound absorption materials and structures should be selected for ceilings and walls. Cabinets, glass doors, non-direct door design are conducive to eliminating sound transmission and refraction, reducing noise levels.
2. Central Station
A. Central Nurse Station should provide comfortable working conditions to meet the needs of all staff. If it is a sub-nurses'station, each nurses' station should provide most of the functions of the central nurses'station.
B. Provide adequate lighting and wall clocks. Sufficient space for computers and printers should be provided for automated office conditions. Doctors and nurses should be provided with adequate work space and seats. Adequate file shelves are provided to store all commonly used medical documents for staff to access at any time.
3. X-ray Reading Area
Areas for reading and storing image data should be provided, with appropriate size reading lamp boxes and bright light sources.
4. Working area and storage room
A. It should be set in the ICU or close to the ICU. It can be equipped with Wardrobe Storage and monitoring equipment.
B. Rescue trucks and defibrillators are placed in fast-moving positions.
C. Set up separate dispensing areas, including refrigerators, lockable cabinets to store controlled drugs, and water tanks with hot and cold water. The area is at least 4.5m2. There are enough countertops to prepare medicines and enough cabinets to store medicines and appliances.
D. If it is a closed room, there should be transparent glass walls that allow patients to be observed during the preparation of medicines and ensure that only those permitted to enter are included.
5. Reception area
A. Reception areas should be set up in each ICU to control the entry of visitors into the ICU. The ideal location is that every visitor entering the ICU must pass through the area before entering the ICU.
B. Reception area should be connected with ICU or internal communication system.
C. Zui good staff entrance and visitor entrance are separated, if necessary, should ensure the security of visitor entrance.
6. Special Operating Room
A. If it is necessary to set up a special operating room, it should be located in or near the ICU.
B. Consideration should be given to the rapid access of patients from both inside and outside the ICU.
C. The area should be sufficient to accommodate the required equipment, including a complete monitoring system, lockers, first aid support equipment, and safety considerations.
D. The working level and storage should be adequate to ensure that all the envisaged operations can be completed without the staff leaving the room.
7. Cleaning Room and Waste Room
A. Cleaning rooms and dirt rooms should be separated and not connected. Good temperature control is required.
B. The sewage room should have an air discharge device. The floor is seamless for cleaning.
C. The cleaning room is used for storing clean and disinfected articles. Storage cabinets and shelves should be high enough from the ground to facilitate cleaning.
D. Waste room should have hot and cold water tank and floor leakage. Place capped containers for different kinds of waste. There are designated containers for articles contaminated by human tissues and body fluids. Provide special containers for needles and other sharp objects.
8. Equipment Storage
A. It is necessary to provide a regional storage area for temporarily unused large-scale equipment. The space should be conducive to access, storage and removal.
B. Provide enough sockets for charging and testing equipment.
9. Nutrition preparation area
A. A nutrition preparation area should be set up with operation plane, refrigerator, microwave oven, hot and cold water tank and ice maker. Refrigerators should not place laboratory reagents.
B. The sink should be indoors.
10. Staff rest area
A. Comfortable and private rest environment should be provided in or near the ICU. There are lockers, shower facilities and toilets. Provide refrigerators, microwave ovens, food storage, adequate seats.
B. Have or internal communication equipment with ICU. There should be emergency alarm lights inside.
11. Conference Room
A. The location should be easy for ICU employees to use.
B. Have or internal communication equipment with ICU. There should be emergency alarm lights inside.
C. The conference room may have many functions, such as internal study, continuing education, multi-disciplinary consultation, etc.
D. Ideal conference rooms should be able to store medical and nursing reference books, computers and electronic teaching equipment.
12. Visiting Rest/Waiting Areas
A. Visit rest or waiting areas should be provided within or near each ICU. The number of seats should be 1-2 times the number of beds.
B. Public and light meals, television and/or music equipment should be provided. Provide public toilets and water dispensers.
C. Warm tones, non-direct sunlight, windows and carpets should be considered in design. Various chairs including couch, straight back chair and reclining chair can be considered.
D. Popular science information, hospital introduction and community support information should be provided. It is recommended that there be a separate family room for discussion to protect privacy.
13. Patient transit pathway
The access from ICU to patients should be separated from other public channels to ensure fast and smooth access.
II. Design of Bed Surrounding
A. For the purpose of supporting all the required therapeutic functions.
B. The ground space of each bed should be able to accommodate all the equipment and personnel that patients may need for treatment. Each bed in large ICU should be at least 20 m2. Separated ICU should have 24 m2 per unit and 4.5 m less width zui, except accessory facilities (bathroom, lobby, storage cabinet). Single ICU has less than 24 M2 Zui per room, including anterior chamber. Zui in each lobby is less than 1.85 m2, providing hand washing, changing clothes and storage. If a toilet is provided, it must be for personal use.
C. Cardiac arrest/emergency alarm buttons must be set at each bedside in ICU. Alarms can be heard in any ICU room, such as the central nurses'station, staff lounge, conference room, etc. The source of the alarm should be identifiable.
D. The design of bedside computer terminal and patient intercom system should be considered.
E. Space should be provided for the storage of personal goods and treatment equipment. If drugs and syringes are stored at bedside, there should be lockers.
F. Every effort should be made to provide patients and employees with as little tension as possible. Therefore, the design of ICU should consider natural lighting and landscape. Set windows in as many rooms as possible to enable patients to distinguish between day and night. Fireproof curtains can absorb sound, beautify the environment and adjust light. The windows should be designed to be durable and easy to clean, and regular cleaning plans should be made.
G. Other facilities that should be provided for patients include clocks, calendars, or bulletin boards, pillow speakers connected to radio/TV sets. Television should be placed beyond the reach of the patient and controlled by the allowed person. If possible, it should be set up in each room.
H. Comfort considerations also include the establishment of privacy protection for patients. Curtains, doors and screens can control the patient's contact with the surrounding environment. There should be folding chairs beside the bed for family visits. The color of the room can also be considered to make the patient quiet and rest color. Pictures can be placed on the walls visible to the patient.
三、功能支持設(shè)施
A、每個ICU應(yīng)有完善的水、電、氧氣、壓縮空氣、負壓吸引、照明和環(huán)境控制系統(tǒng)，為正常和緊急情況下對患者提供治療。這些設(shè)施必須能滿足或超過管理機構(gòu)的標準。
B、一個多功能柱（自立的、天花板吊裝或地面安裝的）是zui好的方式，電源、氧氣、壓縮空氣、負壓吸引、溫度和光線控制都可以在這里得到。多功能柱應(yīng)可接近患者頭部，便于需要時緊急氣道管理用。如不能安裝多功能柱，應(yīng)把功能設(shè)施安裝在接近患者頭部的墻壁。
C、功能支持設(shè)施的配置應(yīng)考慮將來升級的可能，設(shè)計時及時向管理部門了解醫(yī)院的升級信息。
1、電源
A、每個ICU的電源應(yīng)是獨立的支線，主電源應(yīng)有應(yīng)急后備電源，以備突然斷電使用。ICU內(nèi)每個插座應(yīng)有各自的斷路開關(guān)，保證工作人員在緊急情況下能迅速接觸。
B、每張床位推薦配置16個插座，床頭插座距離地面0.9m。床旁和床尾插座應(yīng)接近地面，以防電線絆倒。
2、水源
A、每個ICU應(yīng)有單獨的閥門，以備水管破裂時用。
B、水槽大小應(yīng)使水不飛濺為度，水龍頭應(yīng)有以肘、膝、足或自動控制的開關(guān)。位置應(yīng)在兩張病床間，或進入病房處。水槽的設(shè)計是院內(nèi)感染控制的關(guān)鍵內(nèi)容。
C、如果病房內(nèi)設(shè)衛(wèi)生間，應(yīng)有便盆清洗設(shè)備，包括冷熱水和足控噴頭。
3、氧氣、壓縮空氣、負壓吸引裝置
A、采用中心供氧和壓縮空氣，氧氣和壓縮空氣標準參照相關(guān)規(guī)定。
B、每個床位zui少需要2個氧氣接口；必需1個壓縮空氣接口，zui好2個。
C、每個ICU和醫(yī)院總工程室應(yīng)有可視的和可聽的高、低壓報警設(shè)備。
D、所有區(qū)域必須設(shè)置手動閥門并明示位置，以備火災(zāi)、泄露、修理時關(guān)閉。
E、每個床位zui少3個負壓吸引接口，終端負壓zui少達290mmHg。當負壓低于194mmHg應(yīng)有可視報警。
4、照明
A、通常的頭頂照明和環(huán)境光線應(yīng)能滿足日常護理操作，也應(yīng)為患者創(chuàng)造良好柔和的休息環(huán)境。
B、zui好把光線調(diào)節(jié)裝置放在該病室外，以利于夜間盡量少打擾患者。日間全部照明亮度應(yīng)小于30fc，夜間持續(xù)照明小于6.5fc，短時照明小于19fc。
C、緊急時和操作時應(yīng)用的單獨的照明燈應(yīng)置于天花板上，照明應(yīng)大于150fc。
D、應(yīng)設(shè)計床頭閱讀燈，但不能干擾監(jiān)護設(shè)備和床的移動。照明小于30fc。
5、環(huán)境控制系統(tǒng)
A、在任何時間都要保持適當和安全的空氣質(zhì)量。
B、zui少需要每房間每小時6次完全的空氣交換，包括每小時2次與室外的空氣交換。
C、中央空調(diào)系統(tǒng)和氣體交換系統(tǒng)的空氣必須經(jīng)過適當?shù)倪^濾。
D、空調(diào)和暖氣設(shè)計的目的是使患者舒適，每個病房的溫度是可單獨調(diào)控的。
四、生理監(jiān)測功能的設(shè)計
A、每個病床應(yīng)有的監(jiān)測能力包括顯示和分析1個或多個心電導(dǎo)聯(lián)、zui少2個壓力監(jiān)測、直接或間接動脈血氧監(jiān)測。這些參數(shù)應(yīng)能以數(shù)字和模擬兩種形式提供可視波形、數(shù)字頻率、高/低和平均值。每種監(jiān)護設(shè)備必須有紙上記錄功能。
B、報警設(shè)置應(yīng)良好設(shè)定，可視可聽，且不能立即清除。
C、床旁監(jiān)護設(shè)備應(yīng)易于接近和觀看，且不能干擾接近和觀看患者。床旁護士和其他工作人員應(yīng)能掃視觀察患者的監(jiān)護狀況。通過中心監(jiān)護臺或床邊監(jiān)視器應(yīng)可同時觀察所有患者的監(jiān)護狀況。
D、所有監(jiān)護設(shè)備不能代替床邊觀察患者。
E、監(jiān)護設(shè)備放置處的承重能力，以后可能增加的設(shè)備，以及承重結(jié)構(gòu)的持久力都應(yīng)考慮，相應(yīng)的空間設(shè)計和電力負荷都要考慮。
1、心電監(jiān)護儀
A、可以1或多導(dǎo)聯(lián)連續(xù)顯示心電波形。
B、有完備的報警設(shè)定和記憶功能。
C、根據(jù)需要配備壓力檢測功能。
D、呼吸功能參數(shù)包括脈搏氧飽和度、ETCO2、呼吸頻率等。
E、心輸出量和血流動力學監(jiān)測。
五、計算機化設(shè)計
A、計算機化患者資料管理越來越流行，提供無紙化數(shù)據(jù)管理。床旁終端使工作人員可以在床旁獲得盡可能豐富的資料，包括醫(yī)囑命令、自動記錄監(jiān)護數(shù)值、實驗室數(shù)據(jù)、X線、各種報告等，并可以減少錯誤發(fā)生。
B、應(yīng)具有數(shù)據(jù)可移動功能（傳送到辦公室、其他科室等）
六、語音通訊系統(tǒng)
A、所有ICU應(yīng)具有內(nèi)部通訊設(shè)備，提供中心護士站與病房、會議室、員工休息室等地點的語音聯(lián)絡(luò)。探訪等待區(qū)域、輔助區(qū)域也應(yīng)包括在該系統(tǒng)。必要時關(guān)鍵部門如血庫、藥房、實驗室也應(yīng)包括在內(nèi)。
B、某些通訊可以增加可視方式以減少噪音。
C、除了標準系統(tǒng)，每個ICU應(yīng)有內(nèi)部與外部應(yīng)急通訊方法，以備常規(guī)系統(tǒng)失靈（如停電）。
七、實驗室
A、所有ICU應(yīng)有24小時實驗室服務(wù)。
八、醫(yī)生待診室
當住院醫(yī)生24小時在院時，應(yīng)提供ICU內(nèi)或緊鄰的待診室。提供衛(wèi)生間、浴室，有和/或內(nèi)部通訊系統(tǒng)連接，心跳驟停和緊急警報也應(yīng)連接。
九、管理人員辦公室
A、通常應(yīng)設(shè)計醫(yī)生和護士管理人員的辦公室。
B、應(yīng)足夠?qū)挸?，能允許小規(guī)模會議、會診，和患者家屬談話。
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