Level 5: Surgery and Post-Anesthesia Care Unit (PACU)

Adding operating rooms to the children’s hospital will offer several advantages. Everyone working on Level 5 has been specially trained to meet the unique needs of pediatric patients. This level of expertise can’t be found anywhere else in Iowa, ensuring the best possible care.

The new ORs will increase capacity for pediatric surgeries. A dedicated pediatric OR also means increased capacity for adult surgeries in the main OR within University of Iowa Hospitals & Clinics.

Eight spacious pediatric operating rooms will be same-handed in design. This means their layout is similar, and equipment and supplies will be located in the same place in every room. Same-handed design improves efficiency and reduces the potential for error. To ensure the cleanest air possible, all ORs will have high-efficiency particulate air (HEPA) filters at the vents. These filters supplement the hospital-wide HEPA filtration system.

Six of the eight ORs will be located on the south side of our new hospital. Two larger ones−nearly 800 square-feet each−will be located in the center of Level 5. One of these, OR 7, will be the cardiac OR. The other, OR 8, has been designated for neurosurgery and spine surgeries.

Two new pediatric cardiac catheterization (cath) labs opened in the summer of 2016 and will remain on Level 5 of UI Hospitals & Clinics. All pediatric patients treated in the cath labs will receive preoperative and postoperative treatment on Level 5 of our new children’s hospital.

A family lounge and restroom will be located near the public elevators on Level 5. A larger lounge, playroom, lockers, and stroller parking will be available on Level 4.

The north side of Level 5 will feature 32 private prep and recovery rooms. Private rooms have been shown to reduce recovery times. They also increase patient and family satisfaction. Twelve of these rooms (at or near the west end) will form the post-anesthesia care unit (PACU).

PACU rooms will be designated for first-stage recovery. This is the immediate post-anesthesia period of care. Patients require constant monitoring during this stage; every patient in the PACU will have one nurse assigned to them. The current PACU consists of one open bay serving many patients, while the PACU in the new children’s hospital will have all private rooms.

PACU rooms will be same-handed, or identical, in design. Each one will feature a headwall system that provides access to medical gases, oxygen, and more. AcuDose machines also will be installed in every PACU room. Two of the PACU rooms will serve as isolation rooms for patients with contagious illnesses. These rooms will provide a negative pressure environment in which air flow has been designed to keep germs from leaving the room and entering the hallway.

Patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) and Pediatric Intensive Care Unit (PICU) will be taken directly from surgery to their rooms on Level 3. The patient rooms in the PCICU and PICU have been designed to meet the needs of patients with the most acute conditions.

The remaining 20 pre/post rooms on Level 5 will be used for surgery prep and second-stage recovery. Second-stage recovery requires a less acute level of care than first-stage recovery. The goals are continued improvement and preparation for the patient to be discharged to home. (Inpatients generally are transferred to their rooms after first-stage recovery.)

Patients also will be prepped for surgery in one of these 20 private rooms. After first-stage recovery, outpatients will return to the same room where they were prepped. They typically will be cared for by the same nurse, and the familiar environment should help reduce anxiety. Families of patients undergoing short operations (one hour or less) will be able to stay in the pre/post rooms while their child is in surgery.

Like the PACU rooms, these rooms will be same-handed in design and will feature a headwall system. One of the prep/recovery rooms will serve as an isolation room for patients with a contagious illness. This room will provide a negative pressure environment. As a result, air flow has been designed to keep germs from leaving the room and entering the hallway.

Three medication rooms and a blanket warmer will be positioned at convenient locations for the care team. Level 5 will also feature a pediatric pharmacy that serves the ORs, PACU, and pre/post rooms.

All operating rooms will be located in the offstage, or staff-only, areas of Level 5. Instruments for surgery will be delivered to a clean case supply room via a clean lift that comes up from Level 4. Used instruments will be sent from ORs to a soiled workroom. From there, they will be transported to Level 4 via a soiled lift to reduce the potential for cross-contamination.

A large anesthesiology workroom will be located directly across the hall from ORs 1 and 2. Other offstage areas will include several rooms for equipment storage and alcoves for storing stretchers. Also located offstage will be patient and service elevators and storage for the housekeeping staff.

Getting there: Take the public elevators to Level 5; look for the green canoe icon. A connector restricted to those working in surgery will link the area near the pediatric cardiac catheterization labs on Level 5 of John Pappajohn Pavilion to Level 5 of our new children’s hospital.