Other areas in the ICU

Which other spaces, besides patient rooms?

In an ICU, patient rooms are only a small part of the spaces needed for the care of critically ill patients. A number of additional areas are essential to ensure everyday ICU activities.

The visitors' entrance is separate from patients' entrance: direct access is provided from outside the hospital, so that relatives can enter at any time.

Since it is not always possible to have immediate access to the ICU, relatives can wait in a dedicated lounge. To guarantee patient safety during special procedures, access to the ward is strictly regulated.

It is a dedicated place where physicians provide information regarding patient clinical conditions. Wherever necessary – and at least once a day – physicians update relatives about the patient's clinical status. While the ICU is – by its very nature – an open space enabling the concurrent observation of a number of patients, the consultation room is a separate area, where relatives can be received in a calm, private environment for meetings with the clinical staff.

Patients have a "dedicated corridor" to get in and out of the ICU whenever necessary, connecting the ICU with the Emergency Room and the Operating Rooms. Doors, corridors and elevators are specifically structured to allow the transit of patient beds, often equipped with cumbersome machinery.

This is where all the monitors for patient observation are located; usually, the monitoring area is set in the middle of the ward, so that both physicians and nurses can monitor all the patients at the same time.

This is where all the material needed for patient treatment is stored: syringes, gauzes, infusion kits, equipment for mechanical ventilation, catheters… in some ICUs, there are different storage areas for the different kinds of material (e.g., a dedicated room for mechanical ventilators and ultrasound systems…); all the material for daily patient care, like syringes, gauzes, drugs and infusion kits, is stored in a specific closet inside the ward. Each patient unit has its own hand truck.

The bureaucratic activity associated with patient care calls for staff dedicated to specific functions (training courses, handling of clinical records, contacts with the administration), besides standard secretarial duties.

Besides the patient unit, the ICU includes areas of study and work, fully integrated in the ward: the ICU chief, the medical and nurse coordinators usually have a personal office, where they can meet patients' relatives or speak with other health operators and consultants. In addition to this, some common areas with desks and computers may be present, where medical and nursing staff can study, keep their material and carry out specific research to improve patient care.

The nursing coordinator usually has a personal office for managing human resources and ICU materials. This is where all the activities related to the proper functioning of clinical instrumentation, ward management, drug and equipment procurement are planned.

Since nurses and physicians cannot leave patients while on call, in every ICU there is a kitchen, where they can eat, have a cup of coffee or exchange a few words.

The ICU staff works on a shift basis to ensure continuous assistance to patients. At the end of each shift, physicians and nurses discuss treatment regimens to identify optimum solutions and adopt a coordinated approach over time. Since the staff cannot leave patients unattended – because they may need urgent attention – a meeting room is available inside the ward.

This is where physicians and nurses change from their street clothes to their uniforms before stepping into the ward. This practice reduces the risk of infection transmission. This room is generally located outside the ICU, to avoid staff entering without sterile garments.

Other hospital areas where different ICU-related activities take place.

Incoming patients from home/outside the hospital are always examined first in the emergency room. The most critical patients (i.e., those needing prolonged intensive treatment) are then admitted to the ICU.

Intensive care specialists provide a continuous service to all of the hospital wards. Whenever an inpatient worsens and needs intensive treatment, ICU physicians are called to provide appropriate care and consider a potential admission to the ICU. Once life-threatening conditions are overcome and the patient's condition is stable, the patient is transferred from the ICU to the most appropriate hospital ward.

Every surgery ward has a post-op recovery room, a place dedicated to patient observation after surgery. Patients undergoing urgent or particularly complex surgery, or sick patients needing a surgical operation, often require intensive treatment and a period of post-operative observation in the ICU. Also, some patients may need surgery during their stay in the ICU.

The blood transfusion service works around the clock, providing all the blood components (red blood cells, fresh frozen plasma, platelets…) to patients who may need them.

ICU patients often need radiological checks; some of these are performed at the patient's bedside, others in the emergency room radiology unit.

ICU patients frequently need blood tests for monitoring purposes and to orient treatment decisions. For this purpose, the laboratory operates 24 hours a day.

In the unfortunate event of a patient's death, the body is transferred to the hospital mortuary, where a funeral chamber is prepared. Specialized operators are present to explain all that is needed in this situation. The corpse remains under observation at least 24 hours, or it may be transported home, if relatives so decide.

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