Friday, March 18, 2011

Lunder Building 9 and 10 medical oncology floors

The top five floors of the Lunder Building are adult inpatient units for neuroscience and cancer patients. While the patient floors follow a standard design, each has features specific to a particular patient population. This week, MGH Hotline describes the special features of Floors 9 and 10, which are devoted to cancer patients, and provides a general description of a Lunder Building patient floor, including the nursing, support services and common areas.

The patient floors in the Lunder Building were designed for specific patient populations, such as neuroscience and cancer patients, yet the layout also allows for flexibility for other types of patients in the future. Each floor will be composed of a single unit that is divided into two C-shaped interlocking subareas. Each subarea includes support space for a medication room, housekeeping closet, on-call suite and a staff locker room. This allows for easy communication and collaboration between the two subareas as well as fewer footsteps for nurses.

To prevent noise associated with maintenance and general operational activity from reaching patient rooms, corridors for patients and their visitors will be located away from hallways used for medications and support services. Housekeeping supplies, carts, equipment and dietary galleys will be kept away from patient rooms in separate "cut-through" hallways. To further lessen noise levels, clinical and operational supplies will be delivered to patient floors via service elevators that open into behind-the-scenes corridors.

The corner of each patient floor will house specialized spaces for staff lounges, family/multipurpose rooms and rehabilitation rooms.  A central pathway crossing diagonally within the unit will allow light to enter into the center of the unit, where a waiting area for family and visitors will overlook the atrium. Close to this area will be a conference room for multidisciplinary staff collaboration, a documentation room and a social work services office.

"Nursing care and observation will be provided at three locations," says Barbara Cashavelly, RN, nursing director of Phillips 21, a 20-bed medical oncology unit, which will transition to 32 beds on Lunder 9. "There will be central monitoring and key communication points at interaction work zones on each floor outside the patient rooms as well as decentralized computer stations and work counters across from patient rooms for multidisciplinary team consults. In addition, there will be nurses' stations within each patient room for documentation."

Lunder 9 and 10 will be designated medical oncology floors.  All of the patient rooms on Lunder 10 will be set up for protective isolation for bone marrow transplant and other patients. The unit will maintain a positive pressure environment in which the airflow is carefully managed to help minimize and prevent infection. Lunder 10 also will have an exercise room specifically designed and equipped for these patients.

"Lunder 9 and 10 will have an infusion suite each with two infusion chairs," adds Ellen Fitzgerald, RN, nursing director of
Ellison 14 and soon Lunder 10. "These will be used to provide an alternate location for intravenous hydration
and infusion therapy and for getting patients in early to start their chemotherapy before the room where they will stay is ready. Lunder 10 also will include a satellite pharmacy to provide chemotherapy production for the inpatient units in the building."

In preparation for occupying the Lunder Building, Cashavelly says this summer the nursing staff will be looking at the nursing workflow for their new unit in order to maintain continuity of patient care and safety. She adds that nurse practitioners will cover 28 beds between the two units.

For more information about the Lunder Building, access

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