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Definition2
Nursing Unit or Ward
Grouping of accommodation for patients withservice facilities which enable a team of nurses tocare for inpatients under best possible conditions
Easy observability & quick response Cohesive functioning
Classification of Ward Accommodation4
Primary Bed accommodation Nursing station Treatment Room
Auxiliary Drs’ room Nurses room Stores Clean Utility
Classification of Ward Accommodation5
Sanitary Toilet block
Dirty Utility
Janitors’ room
Ancillary Ward Pantry
Day room
Conference room
Functions of Nursing Unit6
Physical facilities
Nursing care
Low cost
Optimum patient environment
Congenial work environment
Evolution of Wards7
Nightingale Ward
Established by Florence Nightingale
Traditional nursing unit
35-40 patient beds
Own kitchen, stores, supplies
Centered around Head Nurse
Advantages versus Disadvantages9
ADVANTAGES Easy visibility of patients
DISADVANTAGES Cross Infection
Nurses Fatigue Factor
Lack of privacy
Noise
Lack of personal contact
Planning Considerations10
Economy in space
Patient and his needs
Increasing complexities of nursing procedures
Technical advancement in medicine
Concept of Hospital Infection
Changing expectations of pts
Progressive Patient Care12
Definition:
Tailor-made according to the need of the patient
Intensive Care Intermediate care Self care Long term care
Progressive Patient Care13
Intensive care
Critically ill patients Unable to communicate needs Requires continuous observation & extensive nursing
care Equipped with life saving equipments, drugs &
supplies.
Progressive Patient Care14
Intermediate care
Moderately ill patients. Require moderate amount of nursing care
Self care
Patients are ambulant during period of convalescence
Able to look after themselves. Minimal nursing care required.
Progressive Patient Care15
Long Term care
Prolonged nursing care Services not available at home
The basis for PPC system is the amount & type of nursing
care required & degree of dependence of the patients on
others.
Physical Facilities16
Area
Location
Size
Shape
Ancillary Accommodation
Water & Electricity supplies
Communication
Air-conditioning
Auxiliary Accommodation
Ward Size and Configuration17
Multistoried buildings
Each floor plan, template of the plan of the floor above.
Horizontal lay out: 150-200 beds
Economy in deployment of nursing staff
Rigs Ward19
Grouping of patients into 6 beds & 4 beds
Serious patients –2 beds
Isolation room –1 bed for infectious patients
Beds arranged parallel to longitudinal wall of the ward
Circular Nursing Unit for seriously ill patients (ICU)
Rectangular units for mobile patients.
Rigs Ward20
Disadvantages –
Direct observation
Communication
Nurses fatigue factor
More Nursing staff
Costly to build & maintain
Modular Grids21
Standardised Planning Grid 1.6
6 grids 3.2m x 4.8m =14sqm
Central corridor = 2.50 m.
4 bed room = 5m x 6m
Ancillary rooms 15m2
Common Service Facilities22
Combining 2 wards
Economy in deployment of nurses
Flexibility in use of beds
Common core of work area
Economical in building design
Efficient functioning
Physical Planning23
Hospital bed 1m x 2.15m
Floor space for bed in multiple bed room – 7.0 m2
per bed
Single bed room - 14 m2 per bed
2 bed room – 21.00 m2
Distance between wall & side of bed > 0.65 m
Centre to centre distance between 2 beds - 2.15 m
Physical Planning24
Ceiling height – 3.0 m
Width of corridors- 2.4m
Windows - 20%of floor area
Doors - 1.2m
Dado - 0.2m
Nursing Station25
Central & close to patients
Critical patients close to N.S
Sister’s room, WC,
Built in cupboard for storage of drugs , dressings & instruments
Closet for narcotics & dangerous drugs
Electric panel for nurses call station visible
Sanitary Facilities26
Sanitary Annex
WC - 1 for 8 beds
1 BR - 1 for 12 beds
1 Wash basin - 1 for 10 beds
Urinal - 1 for 16 beds.
Dirty utility room & karamchari (safai) workers closet
SERVICES27
Water & electricity supplies
Round the clock water supply
300-500 litres for per bed.
Electrical Sockets - industrial switch - 15 amp
- 5 amp
Alternate source of light supply
SERVICES28
Communication
Effective two-way communication
> 500 beds - paging system
Air conditioning (HVAC)
Positive pressure
Provide patient comfort
Reduce Hospital Infection Rate.
ANCILLARY SERVICES29
Treatment & Dressing Room
Isolation room
Ward pantry
Clean Utility Room
Day Room
Auxiliary accomodation
Norms for Nursing Staff 30
Staffing Norms
Nursing Supdt. 1 per hospital
Dy. Nursing Supdt. 1 upto 400 beds
1 addl. for every 200 additional Beds
Asstt. Nursing Supdt. 1 for 100-150 beds for 3-4 wards
Norms for Nursing Staff31
Ward Sisters: 1 for 25-30 beds or one per ward Teaching Hospital: 1 nurse for 3 beds * Non-teaching hospital: 1 nurse for 5 beds *
For ICU / CCU: 1:1 1 nurse for 1 bed *(+ 30 % leave reserve)
Extra nursing staff to be provided for Departments & Research functions.
For each 250 beds - one infection control nurse.
Nursing Hours required32
Category Direct Nursing Nurse patientof illness hours / patient / ratio
day (24 hrs) Critically ill patient 8-10 1:1
ICU care Moderately ill patients 3-5 1:3(T)
HDU care 1:5(N.T) Mildly ill patients 1-2 hrs 1:6
self care (Ambulatory) Chronically ill patients 30 min. 1:12(T)
to 1 hrs 1:18(N.T)