Headwalls are always a point of debate. Do you just build the devices to the wall and stop there or do you use a purchased headwall unit? The in-the-wall advocates will tell you that you do not need to spend $1,000 or more for a hunk of plastic, aluminum, plastic laminate, or whatever it is, in order to have a place to terminate the devices (gasses, power, low voltage). Those who favor the purchased units will say that it is better for cleaning and easier to make location changes or additions later.

Some folks will even get into the issue of how it looks. It does take close quality control to get every device placed neatly when building into the wall, and the purchased device covers some sins and makes for a nice appearance. This probably has more impact on the staff and visitors than the patients, who seldom look over their shoulders to see what the headwall looks like. The higher-end purchased headwalls may come fitted with movable devices, which are a nice feature in an intense clinical environment like an ICU, but devices are seldom moved in a typical med-surg unit. It can be beneficial to obtain one of the purchased units early on and show it to your local electrical and plumbing inspectors, so that any issues they may have with the internal construction—UL labels, and the like—are resolved before it’s too late.

I favor the wall-only approach, just because I'm wired to look for anyplace where I can save money. Whichever option you choose, my overriding advice is mock it up, mock it up, mock it up, and to also do a benchmark in the field at the first patient room. Finally, for quality assurance and a little laugh with the trades, remind everybody which side is their right and which is their left. This is so important when the rooms and headwalls are back to back!