Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Chermside, QLD, 4032, Australia.
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Crit Care. 2023 Oct 21;27(1):402. doi: 10.1186/s13054-023-04685-2.
Intensive Care survival continues to improve, and the number of ICU services is increasing globally. However, there is a growing awareness of the detrimental impact of the ICU environment on patients, families, and staff. Excessive noise and suboptimal lighting especially have been shown to adversely impact physical and mental recovery during and after an ICU admission. Current ICU designs have not kept up with advances in medical technology and models of care, and there is no current 'gold-standard' ICU design. Improvements in ICU designs are needed to optimise care delivery and patient outcomes.
This manuscript describes a mixed-methods, multi-staged participatory design project aimed at redesigning and implementing two innovative ICU bedspaces. Guided by the action effect method and the consolidated framework for implementation research, the manuscript describes the processes taken to ensure the patient-centred problems were properly understood, the steps taken to develop and integrate solutions to identified problems, and the process of implementation planning and rebuilding in a live ICU.
Two innovative ICU bedspaces were rebuilt and implemented. They feature solutions to address all identified problems, including noise reduction, optimisation of lighting, access to nature via digital solutions, and patient connectivity and engagement, with solutions developed from various specialty fields, including IT improvements, technological innovations, and design and architectural solutions. Early evaluation demonstrates an improved lighting and acoustic environment.
Optimising the ICU bedspace environment and improving the lighting and acoustic environment is possible. The impact on patient outcomes needs to be evaluated.
重症监护病房（ICU）的存活率持续提高，全球 ICU 服务的数量也在增加。然而，人们越来越意识到 ICU 环境对患者、家属和医护人员的不利影响。过多的噪音和不理想的照明条件尤其会对 ICU 入住期间和之后的身心康复产生不利影响。目前的 ICU 设计没有跟上医疗技术和护理模式的进步，也没有当前的“黄金标准”ICU 设计。需要改进 ICU 设计，以优化护理服务和患者预后。
本文描述了一个混合方法、多阶段参与式设计项目，旨在重新设计和实施两个创新的 ICU 床位。该项目以行动效果方法和实施研究综合框架为指导，描述了确保正确理解以患者为中心的问题的过程，以及为确定的问题制定和整合解决方案的步骤，以及在实际 ICU 中进行实施规划和重建的过程。
两个创新的 ICU 床位得到了重建和实施。它们采用了一系列措施来解决所有确定的问题，包括降低噪音、优化照明、通过数字解决方案接触自然，以及增强患者的连接和参与感，这些措施来自多个专业领域，包括 IT 改进、技术创新以及设计和建筑解决方案。早期评估表明，照明和声学环境得到了改善。
优化 ICU 床位环境和改善照明及声学环境是可行的。需要评估对患者预后的影响。
