ICU floor space can be considered under the following headings: patient space, storage space, and staff space. Patient space
Although separate rooms are ideal for reasons of patient privacy and prevention of cross-infection, staffing costs are high, and a ratio of one single room to every six beds in an open area has been recommended. Not only are single rooms expensive of staff but they also occupy more floor space. United Kingdom recommendations suggest that at least 20 m2 (215 ft2) of floor area is required for each open-area bed space and 30 m 2 (323 ft2) is required for single rooms (Intensive..iCaire..Society
1996). This significantly exceeds the recommendation produced by the Society of Critical Care Medicine in the United States which recommends 150 to 200 ft2 for open bed areas. United Kingdom standards suggest that single rooms also require an anteroom of area 2.5 m 2 with facilities for washing and gowning, whilst beds in an open area should be provided with a 2.5-m wide unobstructed corridor space beyond the working area. However, the provision of services via gantry or stalactite systems may reduce these requirements.
Required storage space is directly related to the number of beds. Bulky items such as ventilators, trolleys, dialysis equipment, drip stands, monitoring equipment, infusion pumps, and blood warmers require considerable floor space and 5 m2 per bed space is recommended. Consumables such as syringes, infusion sets, filters, and items from the central sterile services department occupy another 5 m2 per bed. Linen must be stored; the space required depends on the frequency of delivery and laundry turn-round, but is estimated to be 2 m2 per bed space. Thus the total storage per bed space is 12 m2. Specialized beds, traction frames, portable imaging equipment, and seating for visitors all need storage, and this may add another 20 m2 to the requirements.
Space must be allowed for clean and dirty utility rooms, and a staff base sufficient to accommodate computer terminals, telephones, and stationery. In addition, a blood chemistry laboratory, technical workshop, and receptionist's desk must be accommodated. Medical and nursing staff require office space, and there must be a relatives' waiting room and an additional room for interviewing distressed relatives.
A separate seminar/conference room with projection facilities and a small library space, as well as seating for teaching or multidisciplinary meetings, requires a further 30 m2. This area may also include a radiology storage/viewing area if not separately accommodated.
A staff rest room of area not less than 21 m2 (increased by 3 m2 for every two beds beyond eight beds) should be provided well away from the relatives' room. Changing facilities, lockers, showers, and toilets must be provided, and the specific United Kingdom recommendations are 0.75 m 2 per nurse with a minimum of 15.5 m2 for female staff and 7.5 m2 for male staff (assuming fewer male nurses).
The ICU residents' room should have an area of 15 m2 and a kitchen facility for use by all staff also requires at least 15 m 2 Cleaning staff require an area for storing equipment and materials, which can be estimated as 6 to 8 m2 per eight beds.
As with any ward, separate clean and dirty utility areas are needed. The clean utility area for the preparation of sterile equipment and dressing trolleys etc. should be at least 10 m2, and the dirty utility area should be twice this size. A separate area of 2 m 2 is required for storing bagged clinical waste. Because of the large range and quantity of drugs used, most units require a satellite pharmacy or at least a drug storage area utilizing 15 m 2 of floor space. A satellite pharmacy would, of course, require a bench, sink, refrigerator, and air conditioning.
From the foregoing it can be seen that the direct patient area occupies no more than about 40 per cent of the total area of an ICU (JabJeJ.). Space outside the patient area is no less vital than circulation space around each bed, but storage space and staff space are often reduced in the interests of cost reduction. Few of us are given the opportunity to design a new ICU, but for those fortunate enough to have the funding to do so there is little excuse for repeating the mistakes of past generations since so much has now been written on the subject.
Table 1 Space allocation for a 12-bedded ICU
European Society of Intensive Care Medicine Task Force (1994). Guidelines for the utilisation of intensive care units. Intensive Care Medicine, 20, 163-4.
Faculty of Intensive Care, Australian and New Zealand College of Anaesthetists (1994). Minimum standards for intensive care units, IC-1. Australian and New Zealand College of Anaesthetists,
Guidelines/Practice Parameters Committee of the American College of Critical Care Medicine, Society of Critical Care Medicine (1995). Guidelines for intensive care unit design. Critical Care Medicine, 23, 582-8.
Intensive Care Society (1996). Standards for intensive care units. Intensive Care Society, London. Manji, M. and Bion, J.F. (1995). Transporting critically ill patients. Intensive Care Medicine, 21, 781-3.
D. Reis Miranda, L. J. Broerse
Numberand case mixof ,patients„,to„ ,h,e„ „admitted
Amountand „type,, ofequip.ms.n.la.n.d.,, technology
Calculating the,, staffing, ofthelCU Education,,training,and,, skills
Was this article helpful?