LAYOUT PLAN OF UNIT

Introduction:
Basically People go to hospital for two purpose; either seek out door consultation
in OPD or for admission in hospital. Inpatient ward is for those patients who need
treatment under healthcare personal’s supervision. Patient are admitted in Inpatient
Ward for short and long term depending on severity of their disease.
Inpatient Department consists of a ward with Nursing Station, Beds, and all other
facility & services necessary for good patient care. It is one of the important aspects of
hospital as every ratios and calculation for hospital planning and designing process is
based upon the no. of bed it consists.
The IPD forms 33%-50% of the structure of hospital construction and most of the
equipment and staffs are in this department with maximum amount of patient care,
training, medical teaching and research concentrated in this department . IPD is the area
which gives maximum output of services and name and fame to the hospital too and so
maximum vigilance is required to prevent litigation and to gain patient satisfaction.

Need for Inpatient Department:

 To provide highest possible quality of medical and nursing care.
 To make a provision of essential equipment, Drugs, and other material
required for patient care.
 To provide comfortable and desirable environment to patient on
temporary substitution of home.
 To provide facilities for visitors.
 To provide suitable atmosphere for highest possible degree of job
satisfaction among healthcare personal and high level of patient
satisfaction.
 To provide opportunity for education, Training and research
Different Types of Ward Designs:

1) Open ward or Nightingale Ward:

This type of ward was designed in 1770 by Frenchman, later it was adopted by
Florence Nightingale and is known by her name.
The characteristics of Nightingale ward is:
 Patient Bed in two rows at right angle to the longitudinal wall.
 It may have side rooms for utilities and perhaps one or two side rooms, that can
be used for patient occupancy when patient isolation or patient privacy is
important.
 Nursing Station, Doctor’s room and others facility at one end. Bathroom and WC
at the other end.
 Good Visibility and economical and easy to construct, plenty of fresh air &
ventilation.
 Noisy and no privacy for patient Risk of cross infection Fatigue of Nurses Space
between bed reduced
 It has got a nursing station in centre of ward, Ancillary and Auxiliary service at
one end and utility service at other end. The nurse travel time has been reduced
and the supervision over patients condition also improved in modified pattern of
ward.

2) Rig’s Pattern Ward (Unilateral or Bilateral):

It was first made in Rigg hospital in 1910 in Copenhagen. Ward unit is divided
into small compartments separated from each other . Each compartments having 4-6 or
more beds arranged parallel to the longitudinal wall. Bed may be on one side or both
side of nursing station. Isolation room (1 or 2) can be kept in ward. Advantage of RIG’s
Ward /Bay Ward is there would be privacy for patient, Risk of cross infection
minimized, less noisy, Isolation of infectious cases can be easier.
Disadvantage of Rigg’s ward include Communication between patient and nurse is
more difficult Direct observation of patient is difficult. More staffing required Costly
and difficult to maintain than Open ward.

Abstract Changes in the design of hospital wards have usually been determined by
architects and members of the nursing and medical professions; the views and
preferences of patients have seldom been sought directly. The Hospital Anxiety and
Depression scale and the Disturbance Due to Hospital Noise questionnaire were
administered to 64 female patients on bay and Nightingale wards together with a
questionnaire designed for this study. Perceptions of social and physical factors of ward
design were examined, and their relationship to psychological well-being and sleep
patterns. The results show that the bay ward seemed to offer a more favourable
environment for patients but some of the disadvantages of bay wards are balanced by
better staffing levels and better and more modern facilities. Visibility to nurses was
lower on the bay ward. The Nightingale ward was perceived as significantly noisier
than the bay ward and noise levels were significantly correlated to anxiety scores.
Paradoxically the increase in noise levels appeared to improve the perceived level of
privacy on the Nightingale ward. Seventy-five per cent of patients were found to prefer
the bay ward design, and since neither design appears to have major disadvantages their
continued introduction should be encouraged. However, recommendations are made
concerning the optimizing of patients' well-being within the bay ward setting.

3) Ward Unit Ancillary Accommodation Primary Accommodation Sanitary

Accommodation Auxiliary Accommodation:
Primary Accommodation: It consists of single bedroom or multiple bedroom for
patients and a nursing station.
Ancillary accommodation: service for direct support of treatment. Eg: portable x-ray,
side lab,Pantry,Dietician service in ward, mobile pharmacy.
Auxiliary accommodation :Service in indirect support of treatment . Eg:Store,
housekeeping, doctor’s room, nurse’s room, seminar –teaching room.
Sanitary accommodation : Consists of WC, Bathroom, Janitor’s room ,sluice room.
PLANNING & DESIGNING OF WARD:
The main aim of the General ward is to maintain hygiene and provide easy
visibility and access to the Nurses to provide care for the patients. Based on these factors
they include:

1) Location:
Away from parking and crowd area, adjacent to support and diagnostic services,
should be away from mortuary.
2) Circulation:
Vertical or Horizontal. Vertical circulation can be arranged with less space with
central vertical spine for lifts, conveyers and stairs and pipe lines. Reduces patient errors
and cross infections. Horizontal circulation: eliminates requirement of expensive
vertical transportation system. suitable for inpatient up to 300 bed strengths.
3) Size of ward:
Depending upon type of patient, kind of nursing and manpower, NHS,UK
recommends 24 bed/ward Traditionally it’s 32(+/-)10 beds/ward
Area of ward :90 -110 sq.feet /bed (8-10 sq.meter)
Distance between center of two bed -2.25 meter,not less than 2 meter.
Distance between two bed -1.25 meter Width of corridor -2.4 meter
Distance between bed end and wall-0.25m Distance between bed wall and bed
nearest to side wall-0.65 meter.
Nursing Area 60 sq feet/5.5 m sq. Modular grid-1.6 m i.e 3 grid unit for each bed
space / 1.5 grid unit for toilet.

4) Ceiling Height :
At least 3 meter. Height of suspended ceiling fan –at least 2.6 meter.
Windows: if only in one wall then it should be 20% of floor area , if multiple
windows then 15% of floor area.
Corridors: the width of corridor recommended is 2.4 m to faciliate movement of
trolley,bed ,stretchers
Door : should not be less than 1.2 meter wide and 2.25 m tall.
 Bed side locker/cupboard-must Chair sofa/sofa cum bed- for visitors
Other facilities-depending upon rooms(private/semiprivate/deluxe/semi deluxe)

5) Nurse station:
Should not be less than 60 sq. feet with nursing table ,sisters room and build in
cup board. with provision of large glass window for observation is possible.
Doctors room :120 sq ft
Nurse room :120 sq feet Space for stretcher trolley 21 sq ft
Store room :200 sq ft
Clean utility room -80 sq ft
Sluice room -120 sq ft
Toilet with washroom/bathroom & WC-50-70 sq ft
Only WC -4-5 sq ft Only shower -6.5 sq ft
Dirty utility -120 sq ft
Janitors closet -7 sq ft
Recommended- urinal (1 for 16 bed )
Wash basin (1 for 10 bed )
Ward pantry -100 sq ft

6) Water & electricity supply:

300 ltr water /bed/day round the clock supply For electricity, Point should be
carefully designed with every cubicle having switches / one industry switch for machine
like portable x ray/ natural lights should be planned / provision of night light

7) Communication:
There should be effective communication source between nurse and patient and
nurse and other units.
8) Fire safety:
There must be provision for fire extinguisher ,with fire exit stairs with ramp
Ramp width-1.5 meter (1:12 feet ) ( (4.8 degree angle; 8.3% grade) Hot and cold water
supply Nurse call system Clock Oxygen cylinder/suction pipe /thermometer holder.iv
stand etc.