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ICU Planning and Designing in India – Guidelines 2010
Guidelines Committee ISCCM
Dr Narendra Rungta (Convenor)
Members – Dr Deepak Govil, Dr Sheila Nainan, Dr Manish Munjal Dr J,Divatia (President) , Dr C K Jani (Secretary)

Background
ICU is highly specified and sophisticated area of a hospital which is specifically designed, staffed, located, furnished and equipped, dedicated to management of critically sick patient, injuries or complications. It is a department with dedicated medical, nursing and allied staff. It operates with defined policies; protocols and procedures should have its own quality control, education, training and research programmes. It is emerging as a separate specialty and can no longer be regarded purely as part of anaesthesia, Medicine, surgery or any other speciality. It has to have its own separate team in terms of doctors, nursing personnel and other staff who are tuned to the requirement of the speciality (1,2,57,58,75) . In India the scenario of ICU development is fast catching up and after initiatives, promotion, education and training programmes of ISCCM during last 15 yrs, there has been stupendous growth in this area but much needs to be done in area of infrastructure, human resource development, protocol, guidelines formation and research which are relevant to Indian circumstances. An acceptable and logistically feasible no compromise can be made on quality and health care delivery to critically sick, yet an acceptable guidelines can be adopted for making ICU designing guidelines which may be good for both rural and urban areas as also for smaller and tertiary centres which may include teaching and non teaching institutes . There are pre-existing guidelines on the website of ISCCM, made in 2003. There has been a sea change since then and therefore need for new guidelines. The existing guidelines have been taken as base line for the present recommendations. Following areas are covered. (4,5,6,7,9,18,35,38,77)

1

Initial Planning
Team Formation and Leader/Coordinator
Data Collection and analysis
Beginning of the Process and decide about Budget allocation , aims and objectives

2

Decision About ICU Level, Number of beds, Design and Future Thoughts Planning level of ICU like I, Level II or Level III or Tertiary Unit Number of beds and number of ICUs as needed for the institution Designing each bed lay out and providing optimum space for the same Modulation according to various types of space availability

Free hanging power columns Vs head end panel facilities

3

Central Nursing Station designing and planning
Location, space, Facilities

1

4

Equipmentation
Will depend on number of beds, target level of the ICU
Most important decisions will be No of Ventilated beds and Invasive monitoring
ICU Vs HDU
Collecting information about various equipments available with specifications

5

Support System Recommendations
Storage
Communication
Computerisation
Meeting needs of Nursing and Doctors
Meeting needs of relatives and Attendants
Relationship and Coordination with other areas like ER and other super speciality ICUs

6

Environmental Planning
Effective steps and planning to control nosocomial infections Flooring, walls, pillars and ceilings
Lighting
Surroundings
Noise
Heating/ AC/Ventilation
Waste disposal and pollution control
Protocol about allowing visitors, shoes etc inside ICU

7

Human Resource development
Doctors , Nurses , Respiratory Therapist , Computer Programmer , and support staff like Clerks ,X-ray technician, Lab technicians , Cleaning staff who are trained to the needs of ICUs . This is a very Critical area and turn over is very high because of big gap between demand and supply and can put a lot of stress on the team and patient outcome.

8

Other areas like
Research
Data Collection
Documentation
Record keeping

Team Formation
Team may consist of following Intensivist
Administrator
Finance officer
Architect and...
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