On March 19, Cleveland Clinic opened a 19-bed cardiovascular ICU, the first new inpatient space on its main campus in a decade. “It will provide significant access for patients trying to get care at Cleveland Clinic,” says Robert Wyllie, MD, Chief of Medical Operations, during an open house for the new unit. “This will allow us to expand our services to the people of Northeast Ohio and the nation.”
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The 18,164-square-foot unit includes several innovative features to support not only patients, but also the 104 caregivers working on the unit. “When building healthcare spaces, there has traditionally been a heavy focus on the patient,” says Rosslyn Van Den Bossche, MBA, BSN, NE-BC, Assistant Director of Nursing for Cleveland Clinic’s Sydell and Arnold Miller Heart & Vascular Institute and Critical Care. “What was unique with this build was the emphasis also given to the caregiver.”
Innovations on the nursing unit include the following:
- Nursing Perches – In addition to two centralized nursing stations, the CVICU has 10 nursing perches. Nine of the perches are built into notches in the hallways between two rooms, and one is outside a single room. Each perch includes two workstations so nurses can monitor patients in both rooms, as well as a monitor for clinical providers to view test images. From the workstation, caregivers can look through peek-a-boo windows into the rooms and open and close shades for visual access or privacy.
- “The perches allow for more intensive viewing and monitoring of the activity of patients,” says Van Den Bossche. “The visual is right there in the hallway for any caregiver to see.” Nurses can work from the perch or inside the room, depending upon the activity and patient needs.
- Mounted In-room Workstations – “Within each room there are full workstations mounted to a boom where nurses can work,” says Van Den Bossche. “Nurses have everything within their reach and at their fingertips.” The workstations include monitors, single sign-on “tap and go” technology, and a barcode medication scanner and printer. Everything is attached to the workstation so the top surface remains uncluttered.
- A Boom System – The boom, which has two fully articulating arms, features an integrated patient lift system in one arm that can be operated with a remote control. Nurses can place an attached sling under patients to move them into a chair or back onto the bed. “We tried to build everything into the booms so there are minimal items plugged into the walls that would keep us tied to one wall,” Van Den Bossche explains. “The patient can be positioned in any direction in the room so they are not constantly staring at the same wall. We can use the full footprint of the room and move the patient around.”
- Circadian Rhythm Lighting – Lighting in the unit has two separate programmable programs: One in the patient rooms is on a 24-hour day/night cycle, while the hallways and clinical areas are on a 12-hour cycle corresponding to caregiver shifts. “As nurses begin their shifts, the lighting is cooler and brighter,” says Van Den Bossche. “As their 12-hour shift winds down, the light gets warmer and softer.”
- In-room Amenities – Each room includes several features that help reduce clutter and streamline work processes for caregivers. For instance, every room has its own supply cart positioned under a cabinet. Personal protective equipment is tucked in a corner, and cabinet doors are equipped with a slot for disposable medical glove boxes. In addition, there are utility hoppers in each room so caregivers can easily dispose of soiled linens and patient gowns. “We use all the space to its fullest capacity,” says Van Den Bossche.
All of these design features and more help make Cleveland Clinic’s new CVICU a cutting-edge nursing unit. “What excites me most about the unit is having all the tools to help patients come here and receive exceptional care from our amazing team of caregivers,” says Daelle Waldron-Gearhart, MSN, RN, Nurse Manager of the cardiovascular ICU. “This is the dream culture we have always wanted!”