Intensive nursing care unit - a person centered model for increased patient safety

Purpose and goal

The aim of this project was to create a care environment in a multi bed room, called nursing intensive care unit (NICU), for patients with advanced nursing needs with the goal to reduce the incidence of hospital induced complications and decrease the sense of uncertainty. The result showed that hospital induced complications were few among patients who were cared for at the NICU, that patients felt safe when having the staff nearby. The length of stay were half as long in the NICU compared to the patients treated in usual care.

Expected results and effects

There were no occurrences of fall accidents at the NICU when staffed, however three occurred when not being staffed. For other patients, in the usual care, 26 fall accidents were reported. No pressure ulcer was found at the NICU compared to two in usual care. One patient suffered from a pneumonia at the NICU and three patients in the usual. The average length of stay was 7.3 days at the NICU and 15.5 in usual care. The working environment was less stressful than on regular nursing stations where the nurses tended to spend more time.

Planned approach and implementation

Nursing staff were trained in patient safety and the meaning of healthcare environment. They designed the care environment, decided on equipment and work routines. All patients were assessed for risks of malnutrition, impaired oral health, fall and pressure ulcers. Measures taken were followed and meetings were held regularly with nursing staff. In summary, we consider that the NICU concept advantageously can be scaled up to other units around the clock as we in this project see that the occurrence of hospital induced complications in the usual care probably could have been avoided.