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Nursing work and sensory experiences of hospital design: A before and after qualitative study following a move to all-single room inpatient accommodation

Originally Published:
2017
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
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Key Concepts/Context

The term “embodiment” refers to the experience of living within a human body while conducting daily activities. The authors of this study suggest that empirical investigation of embodiment within the field of nursing has been relatively neglected. Studying how ward designs influence nursing staff practices and experiences can generate a deeper understanding of how the built environment influences the functionality and overall efficacy of healthcare environments themselves. This study builds off of previous work by the authors that examined staff and patient experiences following a move into a newly renovated healthcare facility featuring single-patient rooms.

Objectives

To explore the sensory dimensions of staff experiences within hospital wards before and after a shift from open plan ward arrangements to all single-room patient accommodations.

Methods

Twenty-five one-on-one interviews were conducted with nursing staff from two of the four wards involved in the authors’ original study. Twelve nurses were interviewed before the ward was remodeled with single-patient rooms, while 13 nurses were interviewed after the remodeling. Transcripts of the interviews were analyzed and organized into three key dimensions: 1) the ways in which nursing staff were able to hear and see patients within the ward, 2) the ways in which nurses were aware of colleagues’ presence and workload on the ward, and 3) the extent to which nurses could be heard and seen by patients.

Design Implications
Before designing a given clinical space to accommodate all single-patient rooms, healthcare designers should incorporate nursing staff perspectives on communicative patterns and visibility issues. While single-patient rooms can offer increases in privacy and lower noise levels, they may present obstacles in situations that require frequent communication.
Findings

The majority of nurses participating in this study expressed feelings of anxiety from the inability to monitor several patients simultaneously caused by the introduction of single-patient rooms. Participants noted that safeguarding patients from falls also felt more difficult. However, participants stated that single-patient rooms afforded more privacy and reduced noise levels. The authors suggest that these results show how single-patient rooms, while offering privacy, can prevent nurses from providing optimal care.

Limitations

This study focuses on a relatively small group of participants and uses mostly qualitative data to reach its conclusions. No data on changes in patient fall rates or other similar statistics describing ward efficacy before or after the move were involved.

Design Category
Unit configuration and layout
Outcome Category
Staff satisfaction
Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Donetto, S.