NICU (A Neonatal Intensive Care Unit) is the abbreviation of neonatal intensive care unit, which belongs to the specialized ICU, and is also affiliated with the neonatal department, which is closely related to obstetrics. The streamlines of NICU and logistics are more complex, and the intensity and frequency are also higher.
The environment requires no noise interference, no pollution, and easy to disinfection, and it is a unique area in the hospital building, generally located at the end of the ward building, with independent access doors and controllable environment.
The architectural layout of the NICU ward
The relationship between NICU and surgery is also very close, which is convenient for treatment and prevention of infection, and convenient for the transport of children, so it should be set up close to the operating room, and should be as close as possible to the relevant diagnosis and treatment rooms and functional areas, including the center**, imaging department, pediatric emergency room, pediatric surgery, laboratory, pathology department, etc. It is conducive to the collaboration between professional departments.
The NICU ward of the Women's and Children's Specialized Hospital is larger than that of the General Hospital.
The number of beds in the NICU of the pediatric specialty hospital accounts for 37. The scale is 10-50 beds;
The number of beds in the neonatal nicu of general hospitals accounts for 10 of the number of pediatric beds in hospitals6. The scale is 14-28 beds, and there are recovery beds, accounting for 65 of the total number of beds.
The NICU ward is best suited to 10-20 bedsIn this way, the role of medical staff can be fully played, the utilization rate of equipment can be improved, and the best social and economic benefits can be obtained, and the number of beds in the NICU with more than 20 beds should be managed by partition. The NICU should have 20 beds vacant at all times so that critically ill children can be taken at any time. The ratio of NICU beds to non-ventilator beds should be considered, with a ratio of 7:3 preferable.
The total number of beds in the independent unit NICU is not less than 4. Each bed has a minimum floor space of 10 .
NICU beds should be infant incubators or radiation rescue beds. The size of all kinds of baby cots is generally 600*1200mm.
The area of the newborn bathing room should not be less than 15;The area of the milk room and the bottle washing room should be greater than 4.
Doctor-patient communication room 5 or so;**Visitation 5 is sufficient;The instrument room should be greater than 20.
If part of the equipment in the department needs to be cleaned in the department, the equipment cleaning room should be greater than 25;The dirt area should be divided into two separate rooms: dirt cleaning and dirt temporary storage.
The NICU should be equipped with a doctor's office, a workstation, a room, a dispensing room, an instrument room, a dressing room, a cleaning room, a sewage treatment room, and a duty room. It should also be equipped with small laboratories, demonstration classrooms, family reception rooms, family visiting rooms, and nutrition preparation rooms.
Diagram of the relationship between the NICU ward and other departments.
Functional partitioning of the NICU ward
Functional partition: It is divided into clean and sterile area, clean area, semi-polluted area and polluted area.
1) ** Guardianship area (clean and sterile area), main care ward, recovery ward, isolation ward and nursing auxiliary room. The recovery ward is often set up in conjunction with the neonatal unit, and this part is further divided into areas such as premature infants, full-term infants, phototherapy areas, observation areas, and isolation baby rooms.
2) Nursing auxiliary room (clean and sterile area), * station, dispensing room, baby washing room, milk mixing room, milk disinfection room, ** room, instrument room, cleaning room.
3) Back office area (cleaning area), sanitation pass, men's and women's locker rooms, doctor's office, duty room, restaurant, lounge-level conference demonstration classroom.
4) The entrance reception area (semi-polluted area) includes the patient entrance room, the admission treatment room, the family conversation room, the waiting area and the visiting area.
5) Sewage treatment area (polluted area), including sewage treatment room, sewage washing room, cleaning channel directly to the sewage ladder.
6) Functional partition diagram, see figure for details.
Figure NICU ward functional zoning map.
The way the NICU ward is laid out1) According to the definition of neonatology, in the NICU ward, the main active groups are four categories: patients, doctors, and interlocutors.
2) The main flow lines of the NICU ward can be divided into doctor flow lines, ** flow lines, disease flow lines, and visiting personnel. Among them, patients are also involved in external transport routes. The main streamlines of items are clean streamlines and sewage streams.
3) The NICU should adopt a three-channel form to separate the flow lines of patients, medical care and logistics, and avoid mixed and cross-interference. It is required to meet the requirements of nosocomial infection control, and follow the principle of clean and dirty partitioning and character diversion.
4)**Follow the ladder order of non-clean area - semi-clean area - clean area and sterile area.
Hygienic requirements for NICU wards
The environmental requirements of the ICU should comply with the relevant provisions of the current national standard "Hospital Disinfection and Hygiene Standards" GB15982, the total number of bacterial colonies in the air is 4CFU (15min, diameter 9cm flat dish), the intensive care unit with clean room should be designed according to the standard design, and the premature infant room and neonatal intensive care (NICU) and immunodeficiency neonatal room should be clean room. For patients who have just undergone transplant surgery, their resistance to the external environment is relatively low, so it should be designed according to the level of clean room.
It is not recommended to routinely install UV lamps in ICU wards for indoor air disinfection and surface disinfection. If natural ventilation is adopted, the building structure and conditions for adequate ventilation of the ward should be provided;When equipped with mechanical ventilation facilities for mechanical ventilation, it is necessary to consider the flow direction of indoor air during actual use, and must be able to form a reasonable airflow organization to avoid more diffusion caused by pollution with the help of airflow.
If there is no clean ICU ward, it is advisable to install an air purifier with enzyme sterilization and filtration technology or an ultraviolet circulating air sterilizer in the ward, and the number of installations should meet the requirements of space treatmentThe sterilizer should be purchased from the products approved by the Ministry of Health, and installed and used in strict accordance with the approved disinfection space sizePay attention to the applicable space where the sterilizer is used, and disinfect the space according to the approved instructions to ensure that it is effectiveThe circulating air volume (m h) of the sterilizer used must be more than 8 times the volume of the room;Can be used when it is occupied. Non-obstructive air purifiers and more efficient filters are not recommended for isolation wards.