Graphic Standards: Critical Care

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Critical Care

Graphic StandardsProgramming and Schematic Design

June 1999

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Table of Contents

Table of Contents

Function 3

Staff 4

Advantages ofMovable Modular Casework 5

Functional Areas 6Nurses Station 6

Medication Preparation 8

Nourishment/Nutrition 9

Patient Room 10

Isolation Room 11

Equipment Storage 12

Clean Utility 13

Soiled Utility 14

Satellite Lab 15

Satellite Pharmacy 16

Administrative Office 17

Conference Room 17

Waiting Area/Lounge 18

Family Consultation 18

Functional Program 19

Bubble Diagram 20

Block Diagram 21

Preliminary Plan 22

Schematic Plan 23

Future Trends 24

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Function

FunctionFrom the beginning of organized nursingcare, it was recognized that nurses were

able to provide the best nursing care if

the sickest patients were placed closest tothe nurses station, often with a higher

nurse/patient ratio for these patients.

From this concept, both the surgicalrecovery room and the critical care unit

have developed and withstood the test of

time.

Critical care units are patient units

responsible for a specifically defined and

limited number of acutely ill, unstable, orpotentially unstable patients who require

constant instrument monitoring and a

core of full-time nurses and staff withspecialized training.

Critical care units are intensive and

stressful environments, and it is commonfor these patients to experience multiple

“emergencies” during their stay.

Accordingly, these units are normallyequipped and provided with a much

higher quantity of medical/surgical

supplies, a larger variety of medications,and more types of support equipment and

procedure capabilities in order to deal

with this high incidence of “emergen-cies” without a time delay.

Patient stays in the critical care unit are

usually short, and once a stable conditionis maintained, they are transferred to

another appropriate patient unit.

The most common critical care unitsinclude cardiac care units (CCUs) and

intensive care units (ICUs). The larger

and more specialized hospitals willprovide more specialized types of critical

care.

Respiratory Intensive Care Unit (RICU)

This medical unit is most frequentlyfound in regions of the country subject to

environmental stress (smog) and/or

industrial conditions (mines, chemicalplants), and care is directed toward

patients with severe respiratory illnesses.

Burn Unit

This highly specialized unit cares

exclusively for victims of burn accidentsand their constant need for intense

infection control. This unit often contains

an operating room for skin grafting anddebridement, as well as hydrotherapy

equipment.

Neurological Intensive Care Unit (NICU)

This surgical unit cares for patients who

have undergone neurological or cerebralsurgery.

Neonatal Intensive Care Unit (NICU)

This unit provides exclusive care to the

premature and/or distressed newborn.

Transitional Care Unit(TCU/Step-Down Unit)

The focus of this unit may vary among

hospitals, but care is usually given to the

stabilized “graduate” of the critical careunit, who still needs more nursing care

than that provided on the standard patient

unit.

Types of Critical Care Units

A small community hospital may have

one or two critical care units; one forgeneral intensive care and one for

coronary care. Larger regional and/or

teaching hospitals may have severalspecialty critical care units. The most

common are the following:

Medical Intensive Care Unit (MICU)

This unit will usually treat acutely ill

patients with medical diseases orproblems such as diabetes, drug

reactions, respiratory infections, and

cerebral vascular conditions.

Surgical Intensive Care Unit (SICU)

Patients in this unit will have had majorsurgical procedures or complications

requiring more than the normal post-

operative care.

Coronary/Cardiac Care Unit (CCU)

This unit is a specialized medical unitrestricted to patients with acute cardiac

conditions.

Cardiovascular/Open Heart Unit (CVU)

This unit is a specialized surgical unit for

patients following open-heart or majorvascular surgery.

Pediatric Intensive Care Unit (PICU)

Patients in this unit range in age from the

newborn (excluding neonates) to sixteen

years of age, and cover a wide range ofpediatric medical and surgical acute

illnesses. Children require specialized

and unique nursing care and need to beisolated from adult intensive care units.

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Staff

StaffPhysician Staff

Physicians

The physician coverage consists of the

attending physician and the appropriate

house staff. Because of the complexity ofillnesses, there may be many specialized

consulting physicians, (e.g., a neurolo-

gist) and a chief physician assigned to theunit to oversee the medical practices of

the unit.

Nursing Staff

Nurse Manager

The nurse manager, sometimes called

head nurse or nursing care coordinator, is

a professional registered nurse (RN),often with advanced education, training,

and experience in critical care nursing.

This position is responsible for themanagement of the entire unit, including

the standards of patient care, capabilities

of the nursing staff, and consultation andinterface with the medical staff on patient

care problems.

Assistant Nurse Manager/Charge Nurse

The charge nurse is a professional

registered nurse (RN), usually withadditional training and experience, and is

the primary resource or management

staff on a particular work shift. Theresponsibilities of the charge nurse are

similar to those of the nurse manager for

day-to-day operations.

Staff Nurse

The staff nurse is a registered nurse (RN)with the primary responsibility for the

total management of the patient’s care, or

a portion of that care, including theadministration of standard nursing

procedures and treatments, and the

evaluation of the patient’s condition andresponses to treatments.

Licensed Vocational Nurse

Licensed vocational nurses (LVN),

licensed practical nurses (LPN), or

patient care assistants, having less skilledtraining and education than RNs, are

responsible for only those duties

appropriate to their experience. Patientcare is supervised by the RN.

Support Staff

Unit Secretary/Clerk

Clerical staff within the critical care unit

perform such tasks as receptionist,

physician order entry, filing of reports,telephone communication, and

coordinating administrative activities.

Unit Staff

Technicians, orderlies, and volunteers

assist staff nurses in the routine andsimple tasks in caring for patients, always

under the supervision of an RN.

Support Staff

A variety of other ancillary staff may

have limited functions on the unit, suchas IV therapists, phlebotomists,

respiratory therapists, pharmacists, and

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Advantages of Movable Modular Casework

Financial Advantages

The initial cost of movable modularcasework is competitive with fixedcasework or millwork. However, thelife cycle cost of movable modularcasework is far less than fixedcasework because of

· Longer product life.

· Minimal maintenance cost.

· Continual reuse of thecomponents for new or different

functions.

· Ability to install and reconfigurewith little downtime.

· Accelerated depreciation rate,

especially important to “for-profit” organizations.

For preliminary budget purposes,

movable modular casework for acritical care unit has an average

price in the range of $320 to $479

per linear foot.

This range will be affected by the

density of overhead and under-

counter storage components and thetype of support structure used (wall-

mounted versus panels).

Movable Modular Casework

The use of movable modular casework inthe critical care unit offers the followingmajor advantages and differences whencompared with fixed casework ormillwork:

· Ability to reuse, relocate, or

reconfigure all components asfunctions change.

· Better use of vertical space where

needed.

· Individual parts replaceable.

Additionally, movable modular casework

can be used advantageously in threedistinct functional areas:

· Med prep areas.

· Nurses station.

· Storage of medical/surgical supplies.

Med Prep Areas

Movable modular casework com-

ponents provide a transport system for

replenishment or exchange of medica-tions as well as a double-locking

capability for securing controlled

substances and narcotics.

Cantilevered workstations with modular

drawers, cassettes, and sinks provide

space for mixing IVs or preparingmedications.

Advantages of Movable Modular CaseworkHospital critical care units may differ somewhat in square footage, method of operation,and staffing based on the size of the hospital, type of hospital, and scope of services, but

each hospital’s critical care units have certain functional areas in common. The following

pages describe the advantages of movable modular casework, give a brief description ofthe functional areas of critical care units, and provide typical plan views of movable

modular casework applications.

Nurses Station

The nurses station designed using movablemodular casework provides the flexibility toaccommodate the changes in technology andin nursing care philosophy:

· Ability to install and reconfigure to meetchanging needs and staffing requirements.

· Ability to accommodate and continuallychange the numbers and sizes of monitorsand patient information systems.

· Unlimited electrical capabilities as well asquick and easy access to electrical power.

· Integral interior and exterior lighting.

· Integral computer support componentssuch as keyboard trays, turntables, etc.

· Integral form trays and chart racks ascomponents of the modular system.

Medical/Surgical Supply Storage

The storage of medical/surgical supplies in acritical care unit is located as close to thepatient’s bedside as possible with a widevariety of back-up supplies located in a cleanutility room, medication, and/or treatmentroom. Movable modular caseworkcomponents function as a movable system,utilizing a variety of cart sizes for handlingprocedures and supplies:

· Lockers for replenishment or exchange.

· L carts.

· Procedure/supply carts.

· Bulk supply carts.

· Crash carts.

· Wire carts.

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Functional AreasNurses Station

The nurses station is the critical care

unit’s communication center, with acentral location in the unit, allowing full

vision of all patient beds and quick

access to patients. The location should beimmediately identifiable to visitors, staff,

and patients and located in a position to

control personnel traffic, access topatient rooms, and delivery and retrieval

of supplies and medications.

The critical care unit nurses station iscommonly considered a workstation for

centralization of administrative tasks

associated with patient care. Nursesstations are generally busy, intense

environments that support many

functions, processes, staff members, andpieces of equipment.

Within the nurses station, the staff

manages patient records and charts,communicates regarding the patient’s

condition, views patient monitors, orders

tests and treatments, and dispensesmedications.

Nurses stations tend to be most

congested during the first and secondshifts when physicians are making

rounds, visitors are present, tests and

medications are ordered, specimens arecollected, and most supplies are being

delivered or retrieved.

Hospitals may decentralize nursesstations to place activities and supplies

closer to patients. Decentralized stations

tend to support a sub-set of activitiesfound in the central workstation.

Nurses Station

Doctors’ Dictation

An area, usually a sit-down area with someacoustical control and access to

telephones, should be provided for

physicians to review patients’ charts,dictate progress notes, and write patient

orders.

Charting

A stand-up or sit-down area should be

provided with access to patient charts bynurses and physicians. This area is

generally maintained by the unit clerk or

unit secretary. With the advent of bedsidecomputerized patient charting, there may

be a reduction of the charting space

required within the nurses station.

Cart Storage

An area must be provided to store andquickly access crash carts and procedure

carts. This area should be accessible to

supplies for restocking carts and haveelectrical access to maintain rechargeable

equipment.

Regulations for Nurses Stations

National, state, and local legislation/codes

will impact planning decisions such as

· The requirements for regular- or

hospital-grade electrical receptacles.

· The amount of paper stored in thenurses station.

· Access for persons with disabilities.

· Prevention of cumulative traumadisorders (CTDs).

· Accommodation of appropriate

ergonomic principles into computer/monitor work areas.

Monitor Station

This is the most rapidly changing area ofthe critical care unit. There is continual

change in size and numbers of monitors

due to constant changes in monitoringtechnology. The size, activity, space

requirements, and number and types of

monitors in a nurses station will varywith the number of beds and the acuity

level of the patients it serves. Often the

monitor station will require a separateroom for the CPU (with uninterrupted

power source) and electrical equipment

(printers, etc.).

There are two methods for integrating

monitors with nursing care. Unit staffing

may require nurses to view both thepatient and the monitor. The alternative

is a monitor station which requires a

technician dedicated solely tocontinuous viewing of patient monitors.

Because of the stress of the responsibil-

ity and fatigue incurred in the repetitivenature of the work, the layout of the

monitor station will need to include such

ergonomic considerations as

· Viewing range, heights, and angles.

· Dissipation of heat generated by the

equipment.

· Monitor screen glare and overhead

lighting.

· Seating appropriate for three shiftsof personnel.

· Distractions from other areas.

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Nurses Station

Plan View of a Nurses Station

The nurses station will vary insize and configuration

depending on the number of

patients it serves and thecomplexity of the equipment it

must accommodate. A critical

care unit nurses station willrange in size from 1200 to 2400

square feet.

92 linear feet work surface

8 linear feet overhead

storage

400 filing inches

4 lockers

1750 square feet

Movable Modular Casework and Furniture Systems Applications

A modular frame system may be used for the structural design of the nurses station

with the following components as required:

· Cantilevered work surfaces.

· Monitor shelves and angled monitor

work surfaces.

· Computer tools and keyboard trays.

· Unlimited high- and low-voltage

electrical capabilities, includingintegration with emergency power

systems.

• Maximum cable management.

· Pass-through chart shelves.

· Internal task lighting.

· External identification lighting.

· Lateral filing components.

· Procedure and crash carts.

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Medication Preparation

Plan View of a MedicationPreparation Area

A medication preparation area will range

in size from 80 to 200 square feet.


2 emergency carts

2 procedure carts

2 medication carts

152 square feet

Movable Modular Casework Applications

These areas may vary from unit to unit. The amounts and types of medical supplies

stored here also will vary depending on the type of replenishment or exchange systemused. Movable modular casework components can be used for work areas and storage

and may include

Medication Preparation

The medication preparation area in

critical care is similar to a general

medical unit except that it may includemore STAT drugs of all types and more

IVs and injectables than oral unit dose

medication.

A refrigerator, usually under the counter,

is required for medications that require

temperature control. There also will be aneed for a lockbox for controlled

substances.

It is common to find medication storedby the patient’s bedside so it is

immediately accessible rather than on a

medication cart.

Medications may also be inventoried in

an automated dispensing machine.

· Cantilevered work surfaces with

modular drawers or cassettes.

· Lockers with drawers or cassettes.

· Medication cart.

· Double-locking drawers for the

necessary security of controlled

substances and narcotic medications.

· Cantilevered sink unit.

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Nourishment/Nutrition

Nourishment/Nutrition

Critical care patients are frequently fed

intravenously so there is less need here

for a dedicated nourishment room.Regardless of its size and location, there

will be a need for an ice machine,

refrigerator, and space to prepare tubefeedings.


Movable modular casework components

can be used for work areas and storageand may include


drawers.

· Overhead shelving.

· Cantilevered sink unit.

Plan View of a Nourishment/NutritionArea

A nourishment/nutrition area will rangein size from 80 to 150 square feet.


16 linear feet overhead storage

80 square feet

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Patient Room

Patient Room

Critical care patient rooms are generally

larger to accommodate large amounts of

equipment and supplies and will varyaccording to the unit’s specialty. The most

common environment is a ward with beds

sectioned (for privacy) by cubicle curtainsand a nurses station placed in the center of

the room allowing full view of the

patients.

Often, critical care units will have

individual patient rooms, usually with

video monitors (allowing nurses to viewpatients) or a glass wall on the front of the

patient room to ensure visibility. Cardiac

and other units may dim the lighting at alltimes to maximize patient sleep.

Usually, any necessary minor surgical

procedures are performed here to avoidmoving the patient to another area.

Treatment rooms are generally not found

on critical care units; treatment is usuallyconfined to the patient’s room.

There generally is a “headwall” behind

each patient’s bed or a freestanding utilitycolumn to mount monitors and equipment

and to supply suction, air, oxygen, and

regular electrical and emergency electricalservices.


Movable modular components for the patient room may include

Plan View of a Patient Room

Patient rooms will range in size from160 to 250 square feet.



1 L cart or C frame storage unit

for bedside storage

1 locker for supplies

210 square feet

· Bedside supplies placed in an L cartwith drawers or in a C frame storage

unit hung on a rail next to the bed.

· Locker within or adjacent to thepatient room to house immediate

necessary supplies and linen.

· Cantilevered work surface or mobiletable with a keyboard tray as a station

for nurse charting done on a bedside

computer.

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Isolation Room


Movable modular components within an

isolation room may include

· L cart with drawers used as a bedside

stand for general patient care items,

such as bed pan and wash basin.

· L cart with C frame storage unit and

drawers placed in an anteroom or

outside in the hall and used as anisolation cart to hold gowns, masks,

head coverings, and gloves for staff

entering the isolation room.

· Locker placed in an anteroom to

house necessary medical/surgical

supplies.

Plan View of an Isolation Room

An isolation room will range in size from

160 to 300 square feet.



1 L cart or C frame storage unitfor bedside storage

1 locker for supplies

1 isolation cart

280 square feet

Isolation Room

Isolation rooms are used by patients with

highly communicable diseases or those

who are unusually susceptible toinfection.

Cleanliness and contamination are key

concerns in these rooms. Only the mostnecessary supplies are stored in these

rooms. An anteroom is provided, usually

with a sink and protective clothingsupplies for those entering the room.

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Equipment Storage

An equipment storage room is often

available on critical care units and is

relatively large because of the largeamount of equipment used here (e.g.,

ventilators, dialysis machines, cardiac

and respiratory equipment, etc.). Much ofthe equipment must be accessible to

electrical outlets to maintain battery

charges.


Movable modular casework components

can be used to store large and smallequipment and may include

· Modular shelving units.


Plan View of an Equipment StorageRoom

An equipment storage room will range insize from 120 to 250 square feet.

16 linear feet storage

1 bulk supply cart

180 square feet

Equipment Storage

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Clean Utility

Plan View of a Clean Utility Room

A clean utility room will range in size

from 120 to 200 square feet.



5 lockers

1 bulk supply cart

145 square feet

Clean Utility

The clean utility room on the critical care

unit requires more space than provided

on medical/surgical units; many moresupplies, linens, procedure trays, and

procedure carts are used on critical care

units.

The more specialized the unit, the more

specialized are the supplies stored for

future use. This room may or may nothave a sink depending on codes.


Movable modular casework components can be used for work areas and storage and

may include


drawers.

· Extra-deep modular shelving units.

· Lockers for medical supplies and

linen.


· Procedure carts.

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Soiled Utility

Plan View of a Soiled Utility Room

A soiled utility room will range in sizefrom 120 to 200 square feet.



155 square feet

Soiled Utility

The soiled utility room houses the soiled

linen and used equipment and supplies

awaiting collection for disposal orreprocessing. This room typically has a

sink and a flushing-rim sink.


Movable modular components can be used for work areas and overhead storage

including


drawers.

• Cantilevered sink unit.

· CST frame storage units or extra-

deep modular shelving units foroverhead storage.

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Satellite Lab

Plan View of a Satellite Lab

A satellite lab will range in size from

150 to 400 square feet.



1 locker (optional)

332 square feet


Work areas can be different configura-

tions based on the size and space of thecritical care unit the satellite lab services

and generally require

· Stand-up and sit-down work surfacesfor specimen preparation.

· Heavy-duty work surfaces and/or

process tables for automatedinstruments.

· Process tables at seated height for

microscope use.

· Overhead shelving for reagents and

manuals.

Satellite Lab

A satellite lab makes it possible to

decentralize a lab’s services to respond

quickly to a department’s specific needs.These labs usually will have “mini”

versions of the chemistry, hematology,

and urinalysis areas found in the primarylab.

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Satellite Pharmacy

Satellite Pharmacy

A small satellite pharmacy may exist on

the critical care unit. This decentraliza-

tion of the pharmacy function allows formore rapid response to the needs of the

patient and allows the pharmacist more

involvement in the clinical therapy of thepatient.

The satellite pharmacy is staffed,

stocked, and serviced by the primarypharmacy department.

The space will vary in size but will

usually contain a small drug picking area,sink, refrigerator, computer, printer, label

printer, and controlled substance storage.

Some satellite pharmacy areas may havea small laminar flow hood.

Modular carts are appropriate for the

transfer of medications to the satellitepharmacy.


The same movable modular casework

components used in the main pharmacyare appropriate for the satellite

pharmacy, allowing for continual

flexibility and change in the space.

Plan View of a Satellite Pharmacy

A satellite pharmacy will range in sizefrom 120 to 250 square feet.



80 drug bins average

1 medication cart

1 locker

140 square feet

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Administrative Office, Conference Room

Administrative Office

There may be a need for private offices

within the units for small conferences

and meetings with staff that require someprivacy and confidentiality.

Movable Modular Casework andFurniture Systems Applications

Administrative offices may be furnishedwith modular furniture systems and

seating.

Either full-height fixed, demountablewalls or freestanding modular panels are

appropriate.

Consistency between systems used inadministrative and clinical areas allows

for compatibility and flexibility when

dealing with future changes.

Plan View of anAdministrative Office

An administrative office will

range in size from 90 to 120square feet.


12 linear feet overheadstorage

40 filing inches

93 square feet


These areas may be furnished with

modular furniture systems and seating.

Conference Room

Critical care units may require a variety

of meeting spaces. These areas range

from large rooms for staff meetings tosmaller rooms where physicians or

nurses consult with a patient’s family

members.

Plan View of a Conference Room

A conference room will range in size




80 filing inches

220 square feet

Shelf storage, tackboards, and markerboards are helpful in these rooms.

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Waiting Area/Lounge, Family Consultation

Waiting Area/Lounge

Waiting rooms and lounges may be

available for visitors of one or more

units. Sometimes critical care units willhave smaller private areas for family

members who spend extended time at the

hospital.

The areas should be accessible to public

phones. Seating generally is organized in

small groupings. A workstation usually isprovided for the volunteer assigned to the

information desk.


These areas may be furnished with

modular furniture systems and seating.

Freestanding modular panels areappropriate to divide the space into

smaller, more private groupings.

Plan View of a Waiting Area/Lounge

A waiting area/lounge will range in size


216 square feet

Family Consultation

Critical care units tend to have one room

designated for private meetings with

family members or for patient home caretraining.


These areas may be furnished withmodular furniture systems and seating

and may include a table, marker board,

shelving, and comfortable seating.

Plan View of a FamilyConsultation Room

A family consultation room

will range in size from100 to 150 square feet.

4 linear feet storage

125 square feet

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Functional Program

Functional Program

Number Department Area Square Feet

Movable Modular Casework

Nurses Stations @________ sq. ft.

Dictation Areas @________ sq. ft.

Medication Preparation Areas @________ sq. ft.

Nourishment/Nutrition Areas @________ sq. ft.

Patient Rooms @________ sq. ft.

Isolation Rooms @________ sq. ft.

Equipment Storage Rooms @________ sq. ft.

Clean Utility Rooms @________ sq. ft.

Soiled Utility Rooms @________ sq. ft.

Satellite Labs @________ sq. ft.

Satellite Pharmacies @________ sq. ft.

Staff Toilets @________ sq. ft.

Janitor’s Closet

Subtotal

Modular Furniture Systems

Administrative Offices @________ sq. ft.

Conference Rooms @________ sq. ft.

Waiting Areas/Lounges @________ sq. ft.

Family Consultation Rooms @________ sq. ft.

Subtotal

TOTAL NET SQUARE FEET

Net-to-Gross Conversion Factor X

TOTAL GROSS SQUARE FEET

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Bubble DiagramThe bubble diagram of the criticalcare unit demonstrates typical

departmental relationships and

interaction between areas.Necessary adjacencies within the

department become clear.

Bubble Diagram

NURSES STATION

NOURISH

ADMIN CONFERENCE

EQUIPMENT

MEDICATION

FAMILYCONSULTATION

PATIENT ROOMS

WAITING

CLEANUTILITY

SOILEDUTILITY

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Block Diagram

Block DiagramThe block diagram demonstrates the adjacencies and relative sizes for the areas withina typical critical care unit. Evaluation of the work flow and materials flow from the

bubble diagram has determined this initial general layout.

The size of each area is determined by combining the typical movable modularcasework plans for each identified function. Traffic patterns are developed, and an

overview of the general work process can be evaluated.

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Preliminary Plan

Preliminary PlanThe preliminary plan clarifies the criticalcare unit space requirements by showing

the location of all the fixed walls and

open areas and identifies entrances, exits,and exact traffic patterns.

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Schematic Plan

Schematic PlanThe schematic plan shows all of thespecific movable modular casework,

modular furniture systems, and materials

handling components appropriate for atypical critical care unit.

NURSES STATION

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Future Trends

Methods of Patient Care

Nursing care is moving toward the

“patient-focused” care concept. The

emphasis of this concept creates a non-institutional environment, breaking down

barriers between the staff and the patient,

bringing services to the patient ratherthan taking the patient to the services,

and encouraging family interactions with

the staff and patient.

Critical care units moving toward this

method of nursing care will be creating

new spaces for social, educational, andfunctional activities and providing an

atmosphere of comfort, dignity, and

control for the individual patient and thefamily:

· Traditional nurses stations will

change due to the use of bedsidecomputers for documentation of

patient care, and conference areas

will increase so the family can playan active part in the care plan.

· More medical supplies, linen, and

individual patient medications maybe stored in closer proximity to the

patient room.

· Satellite pharmacies are becoming anintegral part of critical care units.

Future TrendsIncreased Levels ofAcuity in Patients

Because of the increasingly aging

population, there will continue to be an

increase in the level of acuity of theinpatient census. The census of the

critical care units will continue to rise.

The treatment of these more acutely illpatients will continue to require

increased supplies, medications, and

support staff on the critical care units.

Healthcare delivery will continue to

move toward being a more high-risk

business, forcing extensive newregulations and policies, and thus

continue to produce constant changes in

medical procedures and nursingfunctions performed on the critical care

units.

New Technologies

Rapidly changing technology, new

instrumentation, and more sophisticated

methods of treatment will necessitate re-evaluation of the use of space, movement

of supplies and inventories, and

particularly the ability to make rapidchanges with minimal downtime. For

example, automated medication

dispensing machines are appearing oncritical care units.

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Health & Medicine

Graphic Standards: Critical Care