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美国30个儿科重症监护病房的物理空间:一项全国性调查。

Physical space of thirty pediatric intensive care units in the United States of America: a national survey.

作者信息

Karam Oliver, Ahmed Aziez, Bizzarro Matthew, Bogue Clifford, Giuliano John S

机构信息

Department of Pediatrics, Pediatric Critical Care Medicine, Yale School of Medicine, New Haven, CT, United States.

Department of Pediatrics, Neonatal-Perinatal Medicine, Yale School of Medicine, New Haven, CT, United States.

出版信息

Front Pediatr. 2024 Sep 18;12:1473805. doi: 10.3389/fped.2024.1473805. eCollection 2024.

Abstract

INTRODUCTION

The design of Pediatric Intensive Care Unit (PICU) rooms significantly impacts patient care and satisfaction. The aims were first, to describe the current physical space across PICUs in the USA, and second, to identify what proportion of PICUs are compliant with current guidelines.

METHODS

A descriptive cross-sectional survey was conducted, targeting division chiefs and medical directors of PICUs nationwide. The survey collected data on unit type, construction and renovation dates, room sizes, and available amenities. According to the Guidelines for Design and Construction of Hospitals, PICU rooms are recommended to be single rooms, at least 200 sq ft, have a window and a private bathroom. Data were anonymized and reported as median and interquartile ranges or frequencies and percentages.

RESULTS

Thirty units responded. Among the respondents, 26 had general PICUs, 9 had cardiac ICUs, and 3 had intermediate care units, with some units containing multiple types of ICUs. The median annual admissions were 1,125, with a median occupancy rate of 78%. Twenty-three percent of units had at least one double room, and 3% had triple or quadruple rooms. The median room size was 265 sq ft (IQR 230; 304), the smallest room size was 220 sq ft (IQR 179; 275), and the largest single room size was 312 sq ft (IQR 273; 330). Thirty-seven percent of units had bathrooms in every room, while 80% had windows in every room. Additionally, 46% of units had dialysis capabilities in every room, and 7% had negative pressure capabilities in every room. The median building year was 2008 (IQR 2001;2014), with 36% of units having undergone at least one renovation. Larger rooms were associated with more recent build dates ( = 0.01). Only 30% of the PICUs met the guidelines for physical space. These compliant units were built at a median of 4 years ago (IQR 1; 8).

CONCLUSION

This study highlights the variability in PICU room design and amenities across healthcare facilities. Many units still fall short of meeting the guidelines for room size, windows, and private bathrooms. Future research should investigate the relationship between room characteristics and patient outcomes to inform better design practices, with a goal of improving patient experiences and clinical outcomes.

摘要

引言

儿科重症监护病房(PICU)的房间设计对患者护理和满意度有重大影响。目标一是描述美国各PICU目前的物理空间,二是确定符合现行指南的PICU所占比例。

方法

开展了一项描述性横断面调查,目标是全国PICU的科室主任和医疗主任。该调查收集了关于病房类型、建设和翻新日期、房间大小以及可用设施的数据。根据《医院设计与建设指南》,建议PICU病房为单人房间,面积至少200平方英尺,有窗户和独立卫生间。数据进行了匿名处理,并以中位数和四分位间距或频率及百分比形式报告。

结果

30个科室做出回应。在受访者中,26个设有普通PICU,9个设有心脏重症监护病房,3个设有中级护理病房,有些科室包含多种类型的重症监护病房。年入院人数中位数为1125人,入住率中位数为78%。23%的科室至少有一间双人房,3%有三人或四人房。房间面积中位数为265平方英尺(四分位间距230;304),最小房间面积为220平方英尺(四分位间距179;275),最大单人房间面积为312平方英尺(四分位间距273;330)。37%的科室每个房间都有卫生间,80%每个房间都有窗户。此外,46%的科室每个房间都具备透析能力,7%每个房间都具备负压能力。建筑年份中位数为2008年(四分位间距2001;2014),36%的科室至少经历过一次翻新。房间越大,建成日期越近(r = 0.01)。只有30%的PICU符合物理空间指南。这些符合标准的科室中位数是在4年前建成的(四分位间距1;8)。

结论

本研究突出了不同医疗机构中PICU病房设计和设施的差异。许多科室在房间大小、窗户和独立卫生间方面仍未达到指南要求。未来研究应调查房间特征与患者预后之间的关系,以指导更好的设计实践,目标是改善患者体验和临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/11445063/43f3b7ac7642/fped-12-1473805-g001.jpg

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