Critical Care bed in the ICU

Stephanie AllenSukanya BhattaccharyaSarah ManningSurabhi SatamTemidayo Yembra

Introduction

When it comes to life-threatening illness or injury,Critical care beds offer design enhancements and safety features that assist in the efficient delivery of care

• Specificationso Frame: L2160 x W1100o Bed: L1900 x W980o Back: 0 ~ 80° o Knee: 0 ~ 35°o Adjustable heighto Nursing Panel

Types

• InToucho Benefits patiento Benefits caregivero Touchscreen padso USB upgradeable

• Positionable bedo Customizableo Modern

Types (cont)

• Epic IIo Integrated scaleo Side rail controlso Back rest position

• Resuscitation bedo Multi-careo Easily maintainableo Tilting, Weighing, X-Ray

Issues

• Obesityo Number increasingo Proper equipmento Patient lifts

Issues (cont)

• Impatient fallso Control out of reacho Height of bedo Automatic adjustment

Objectives

• Lateral Tiltingo Prevents complicationo Assists treatment

• Impatient fall protectiono Side rails

Objectives (cont)

• X-Ray scanningo Reduces patient

transfero Ease for staff

• Pressure redistributiono Proper mattresseso Prevent pressure

sores

Objectives (cont)

• Accurate Weighingo Constant examinationo Accurate resultso Eliminates patient

transfer

• Staff supporto Multi-function screens

Objectives (cont)

• Recoveryo Mobilizing lifts & railso Ease on healthcare

staff

• Optimization of heart and lung performanceo Treatment positionso Prevent complications

Clinical Documentation in the ICU

What is Clinical Documentation?

Clinical documentation in a patient's record includes any and all documentation that relates to the care of the patient during the patient's stay or encounter.

In the inpatient setting, some of the important pieces of the patent’s clinical documentation include:

• Patient History & Physical• Progress Notes• Orders• Procedure Reports• Anesthesia Reports• Pathology Reports• Radiology/Nuclear Medicine Reports• Cardiology Reports• Consultation Reports• Notes Provided by Nursing Staff• Discharge Summary

Why is Clinical Documentation Important

• Patient Care & Quality• Legal Protection• Operations and Management• Strategic and Financial Planning• Research• Reimbursement & Revenue

The move toward Electronic Medical Records (EMRs) and Critical Care Information Systems

(CCIS)

EMRs are meant to facilitate more efficient work processes for staff by automatically gathering physiological data, allowing medical records to be accessed both at the point-of-care and at terminals throughout the ICU.  

A CCIS is a computerized patient charting system that has been specifically designed for use in intensive care, providing a physician with access to a central data repository containing patent information including, demographic data and physiological data retrieved from bedside monitors.

Bumps in the Road: Physician Note Taking in the ICU

Some of the problems identified as occurring during the note taking process are as follows:• Collecting relevant and correct patient information• The EMR systems are too rigid and time consuming to

navigate• Information requested by the physicians is not known

during the ‘rounds process, requiring after-the-fact lookup and documentation annotation

• Repetition of patient treatment and observation information in different sections of the EMR

Ongoing CCIS Prototype Work: activeNotes

Clinical Documentation in the Remote ICU Model

With respect to clinical documentation sophisticated ICU clinical information systems (CISs) must provide the remote care team with access to all relevant patient data, including lab test results, medication lists, progress notes, and bedside flow sheet documentation.

The patient’s EMR must be imported from the hospital information systems (eg, lab results, pharmacy) and ICU devices (bedside monitors, ventilators), and can be used by ICU nurses and physicians for establishing/tracking care plans, charting patient data, and generating progress notes.

Implementation of EMR's

Success Factors• Collaboration and Communication• Staff Training• Implementation Plan and Schedule• Resource Availability• Ease of Use• Staff Buy-in

Issues• Cost• Lack of Training• Resistance to Change• Duplicate Work• System Errors (i.e. system downtime) 

EMR Design Considerations

• Information Overloado Summary information

• Dashboard• Ease of Use

o Intuitiveo Follows work flow

 

Thank You…