In-Depth Comparison of Spatial Configuration, Nurse’s Walking Distance, and Patient Visibility in Selected Intensive Care Units of District Hospitals in Khyber Pakhtunkhwa, Pakistan

Abstract

Intensive Care Units (ICU) fall in the category of most needed departments of a healthcare center irrespective of its size, catchment area and frequency of use. Patients are very closely monitored and cared for in these units, and the availability of trained nursing staff is never compromised whatsoever the circumstances be. Placement of nursing station therefore becomes critical as the staff has to keep eye on each individual patient from their nursing counter, ensuring their access to the patient if and when needed without any delay. Primary objective of this study was to examine a number of key aspects in each selected ICU including circulation space, staff area, grossing factor, gross area, bed area allotment per patient, patient visibility, and the nurses' walking distance. The methodology adopted for this study was to draft the existing ICUs plans of the sample District Hospitals of Khyber Pakhtunkhwa and compare the different aspects of spatial configuration. For visibility “Targeted Visibility Method” was used to find visibility of patient in beds. Nurse walking distance, patient visibility, gross area, grossing factor, services, patient area, circulation area, staff area and DGSF (Departmental Gross Square Feet) of Intensive Care Unit (ICU) were calculated using AutoCAD and MS excel. In second step the concluded results from selected District Hospitals were compared with each other to find out design appropriateness. The analysis led to the fact that a strong correlation existed between Nurse Walking Distance and Visibility. This fact became more evident through comparison with other selected hospitals. From the selected sample hospitals, Karak and Batkhela District Hospitals’ ICU wards demonstrated relatively higher Patient Area per bed and circulation area percentage in comparison to other District Hospitals. It was found that a strong correlation existed between Patient Area per bed and circulation area. Maximum Nurse walking to patient bed was found to be 75'-0" in Hangu District Hospital followed by Kohat District Hospital with 62'-4", Batkhela with 31'-9", Mansehra with 30'-6" and Karak with 22'-9".