A Multi-Dimensional Comparative Assessment of Headwall Versus Ceiling Booms in Intensive Care Units
Debajyoti Pati (PI), Tom Harvey, and Jennie Evans
James Thomas, MD, Professor, University of Texas Southwestern
Getinge USA Grant
WHAT was the aim
The study objective was to assess the impact of headwalls and ceiling booms on flexibility, efficacy, ergonomics, team work and safety.
Why is it important
Should power, medical gases, and monitoring and communications systems be located in a headwall or a ceiling-mounted boom in intensive care unit (ICU) rooms? Often, only the financial costs could be determined for the options, whereas data regarding its potential influence on teamwork, safety, and efficiency are lacking. Hence, purchase decisions are more arbitrary than evidence based.
WHAT DID WE DO | HOW DID WE DO IT
This study simulated care delivery in settings with a traditional headwall and a ceiling boom. Observed were the way the following elements were managed and the extent either system affected flexibility, ergonomics, and teamwork: tubing for intravenous fluids, medical gases, and suction drainage; monitoring leads and equipment power cords; and the medical equipment itself. Simulation runs involving 6 scenarios were conducted with the voluntary participation of 2 physicians, 2 nurse practitioners, 2 respiratory therapists, and 4 registered nurses at a children's tertiary care center in December 2007.
What did we find
Analysis suggests that booms have an advantage over headwalls in case of high-acuity ICU patients and when procedures are performed inside patient rooms. However, in case of lower-acuity ICU patients, as well as when procedures are not typically conducted in the patient room, booms may not provide a proportionate level of advantage when compared with the additional cost involved in its procurement.
What is next
The observations articulated in this study several questions for further intellectual practical pursuits. This study took advantage of the provision of booms and headwalls a single ICU with a group of clinicians exposed to both settings. As a result, fixed medical gas columns could not be a part of the study. Further study is needed for a comparative assessment of headwalls, ceiling booms, and columns in order to offer the best solutions to the wide contextual variations across hospital ICUs. In addition, including data from actual family members is essential for better comprehension of the differences.