Walter Reed Builds New Surgical Intensive Care Unit
New facility promises more patient privacy and improved care.
by Kenya McCullum
In a continued effort to provide family-oriented care, Walter Reed Army Medical Center (WRAMC) recently began an extensive renovation of its surgical Intensive Care Unit (ICU). The project, which will cost $2.7 million and take about eight months to complete, promises to increase patient comfort and allow WRAMC staff to provide more efficient care.
According to Nurse Methods Analyst Lieutenant Colonel David Colvin, patient privacy, which has been difficult to fully achieve in the current ICU, was a major consideration in the design of the new facility. In order to give patients the space they need, WRAMC is building private rooms for each patient that are equipped with bathrooms and doors for optimum privacy. In addition, each room in the new facility will have its own sprinkler to ensure the patients’ safety.
“We’re a family-oriented care center, so family is welcome in the ICU 24/7 and there’s always a family member there at any given time. When I have two families sitting in the same ICU room, the patients have cardiac arrest every now and then,” said Colvin. “One family will be there crying and the other family will be standing there looking completely scared and not sure what to do. We don’t really want to ask them to leave, because that’s not family-centered care. With the new private rooms, we’re going to completely get rid of these problems caused by having a single room.”
In addition to privacy, patients and families at Walter Reed’s new ICU will also be able to enjoy increased comfort in their rooms. There will be more space for those who want to stay with their loved ones overnight and increased quiet levels for patients to receive the rest they need for their recovery.
Walter Reed’s staff will also benefit from the layout of the improved ICU because its nurse’s stations will be located in an area that makes it easy for them to see inside patients’ rooms, allowing them to address problems immediately. And inside of the new rooms, there will be added space to comfortably fit equipment so that doctors and nurses can easily maneuver the patients and machines as they deliver treatment.
And of course, equipment is an integral part of patient care at Walter Reed. Although the medical center is rebuilding its ICU from the ground up, the facility will not be replacing its equipment during this transformation. Sigma and Phillips are among the companies that have supplied the medical center with the reliable products that it will continue to use.
SIGMA
Walter Reed is currently using the Spectrum smart infusion pump sold by Sigma, which is designed to reduce patient harm through the use of artificial intelligence. In order to avoid serious medication errors—which frequently occur in hospitals around the country—the device can be programmed to ensure that patients are administered the correct amount of medication every time the machine is used.
“Our product was selected by Walter Reed because it really is designed for rapid, intuitive workflow,” said Gary Colister of Sigma. “Traditional, nonsmart infusion pumps—that don’t have this software-based artificial intelligence— can be programmed in such a way to accidentally deliver medication doses far in excess or far below what you really intend to deliver. If I dial my phone the wrong way, I get a wrong number and might need a new friend, but if I add an extra zero on an infusion pump, I could give a tenfold increase in a medication— which could really cause serious trauma or even kill a patient.”
The Spectrum, which is used by other military medical facilities such as National Medical Center and Andrews Air Force Base, reduces harm to patients through its master drug library. This vital reference is programmed by Sigma from the information supplied by the client regarding the dosing practices of the medical facility. These dosing practices determine the quantities of medication that should be administered and can be set to hard settings (which cannot be reset) or soft settings (which ask the user to verify the amount before proceeding) to ensure that no mistakes in dosing are made. This is critical because dosing errors in infusion pumps can happen so quickly that the patient may be harmed before the user realizes that the wrong amount of medication was administered.
“If you handed someone a hundred pills, for instance, you would know by handing someone a hundred pills that it doesn’t make sense. But an IV therapy event is continuous. When I hit start on that pump, I walk away and it runs at a fast rate and no one is there in the background,” said Colister. “The infusion pump of the past could have harmed somebody and until the harm was happening and the patient was injured, there was no way to trade decision support that would intercept it.”
PHILIPS
For many years, Walter Reed’s ICU has been using monitoring systems supplied by Philips. The IntelliVue Information Center is a user-friendly monitor that medical professionals can easily navigate through Microsoft Windows screens, menus and commands. IntelleVue—which can supply full disclosures of up to 96 hours for over 3,000 patients—includes numerous decision support tools, such as alarms that indicate the level of urgency of a patient’s condition and trend displays that show users how patients are doing in real time. In addition, IntelliVue provides a number of clinical review applications and analysis tools that allow users to quickly review patients’ condition— including alarm history—over time.
Stacy Kelleher, patient monitoring account manager, said that Philips recently upgraded Walter Reed’s network with new central stations and database servers, so that the facility can benefit from updates to IntelleVue’s technology without the need to buy a whole new system. ♦