ST. FRANCIS MEDICAL CENTER DEDICATES PROGRESSIVE INTERMEDIATE NURSING UNIT

For patients who need more monitoring than is offered in a regular hospital room but not the care provided in intensive care, St. Francis Medical Center offers the PIN.

To better serve patients, physicians and staff who use the Progressive Intermediate Nursing Unit, St. Francis just spent more than $500,000 to remodel it and the progressive care unit.

The new unit was dedicated Friday afternoon, and visitors could look through the refurbished rooms and hear about the unit's new features.

The remodeling enlarged the PIN unit from four beds to eight, allows open visualization of patients while allowing patients some privacy, created an isolation room capability and makes use of a new nurse call system, said Debbie Sprandel, patient care manager.

The PIN is part of St. Francis' step-down approach, said Steven C. Bjelich, president and chief executive officer of St. Francis. "We want to provide a continuum of care so patients get treated in the appropriate setting," he said.

St. Francis opened the PIN unit soon after it began its open heart surgery program, Sprandel said.

The physicians wanted a step-down area for patients who didn't need the level of care that the intensive care unit provides but needed more monitoring that was available in a regular hospital room, she said.

The PIN unit offers open visualization like intensive care and a higher staff-patient ratio than a hospital ward. Because there is not as much need for specialized equipment and monitoring, the PIN is less costly for the patient and the hospital than the ICU unit.

"The PIN allows us to move patients out of ICU quicker than if the only option was moving them to a closed room," Sprandel said.

Before the remodeling, the PIN unit was one large room with four beds and one bathroom.

The remodeled unit features four rooms, two on each side of a large hallway. Glass walls allow nurses an unobstructed view of the eight beds, two in each of four rooms. The beds sit at either end of the long, narrow rooms with an accordion-type partition that can be pulled out to offer patients privacy. There also is a bathroom in each room.

"It's very open so nurses can keep an eye on the patients, yet it offers more privacy to the patient and will be more accessible to the family than ICU," said Dr. Teena Sharrock, a hospitalist at St. Francis who was at the open house.

The enclosed rooms also make it possible to send patients needing isolation to a PIN room, which wasn't possible in the open setting. The remodeled PIN has one room that can serve as an isolation room.

"In the old unit, if a patient had an infection or a fever, we couldn't accept them," Sprandel said. "But now we have one room we can change from a double to a single and use for patients needing isolation."

Another new feature is a state-of-the-art patient call system that cost $300,000, more than half the cost of remodeling the unit.

Sprandel said the new system should improve efficiency of care in several ways.

When the patient pushes the call button, it will go directly to the nurses' phone. This should shorten response time.

Physicians can dial nurses directly instead of going through a unit manager.

And when doctors are making rounds, nurses can be summoned when the doctor reaches the patient's room instead of the nurse having to wait for the doctor to make his way down the hall.

Patients should begin being admitted to the remodeled PIN in about three weeks, Sprandel said. The types of patients using the PIN may be expanding along with the increased number of beds created by the remodeling.

The majority of patients admitted to the old PIN unit were those recovering from angioplasties, in which a catheter inserted through an artery in the groin is used to open blockages in the veins. Because of the risk of bleeding, these patients need close observation but not an ICU setting, Sprandel said.

The increased capacity "will allow us to look at taking other therapies out of ICU and into a step-down unit," she said.

For instance, renal biopsy patients now go from radiology to ICU because of the chance of bleeding. There is talk of moving them to the PIN setting instead.

"It's nice because a lot of patients are too sick to be on the floor but don't need the intensity of ICU," said Sharrock. "I think I'll be using PIN a lot."