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• Medical errors continue to lead to significant mortality and morbidity in healthcare. • Recognition of errors by students is low, and implementing safety recognition into the curricula is imperative. • A "room of errors" study in a small midwestern university effectively increased first-semester students' abilities to recognize common medical errors. Errors in healthcare remain one of the leading causes of death in the United States each year. Nurses are an integral part of the healthcare team and spend the most direct-care time with patients, placing them at the forefront of error mitigation. This study aims to evaluate the beginning nursing students' awareness of safety issues at the bedside. Thirty-four students independently completed a "Room of Errors" simulation in week two of the first semester of a four-year baccalaureate nursing program. A repeat simulation was completed in week 13 with only 25 students participating, and a paired t-test was used to compare the results of those who completed both experiences. Although the average number of errors identified increased from 9.68 to 14.64 out of 42 (p=<0.001), the mean number of errors found per student remained low. While statistical significance is present, the number of errors not identified remains high. Continued research on best practices for implementing safety standards into nursing programs is necessary. [ABSTRACT FROM AUTHOR]

Messages are conveyed to users through every element within the space. People receive these messages through sense organs. People and space interact constantly because of the way that they perceive and transmit space. People also establish their action boundaries, identify their motivational criteria, and feel a sense of belonging to the place they experience as a result of this interaction. In this way, the location, with all of its characteristics, influences the mental health of those who inhabit it. The colors chosen for patient rooms have a significant impact on the emotional and mental health of the patients, given the medical procedures and rehabilitation programs that they undergo. Patients' healing processes may vary based on the physical characteristics of the environment in which they are situated. Hospitals are intricate functional structures, so specific design requirements should be established by assessing every department independently. The purpose of this study is to determine how people's perception of spatial quality in general patient rooms where two adults stay during treatment is affected by the use of color. In the research method, adjective pairs were determined in line with spatial quality in order to reveal the perceptual effect of color variables in patient rooms. The survey technique was applied according to this experimental design. By simulating the patient room- which was proposed as the study area- in a digital environment with a one-to-one scale, the colors identified as the dependent variable in the study's methodology were visualized independently. The survey technique was employed to ask questions about the perceptual effect of colors on people who have experienced patient rooms by using adjective pairs based on the spatial quality level. The orange color used in patient room interior design was found to be eye-catching, communication facilitator, inviting, pleasing, encouraging, and sincere, while the blue color was found to be comforting and refreshing, based on data acquired from the survey, which was administered to 168 people in total. Many spaces in hospital buildings serve a variety of purposes, and the patients who use these spaces have a range of needs. For this very reason, it is advised that these hospital units be included in the interior design process utilizing information supported by empirical research, with each space being specially designed to meet its unique requirements and functions.

Summary: Background: Due to the disadvantages of manual disinfection of patient rooms, mobile disinfection robots using ultraviolet C (UV–C) radiation are increasingly being used. Assessing their in situ effectiveness remains challenging. Aim: This study describes a new method to prove adequate in situ disinfection (≥5-log reduction in bacterial load), and uses this method to assess the efficacy of a mobile disinfection robot using UV-C radiation. Methods: Agar plates serving as proxies for smooth surfaces in patient rooms were inoculated with bacterial suspension and placed on various surfaces in a patient room. After irradiation by an automated mobile UV-C robot, reduction in colony growth was determined by comparing the irradiated plates to a reference series of non-irradiated plates, enabling the evaluation of whether an adequate reduction in colony-forming units (CFU's) of ≥5-log was reached on these irradiated surfaces. Findings: The new technique described here proved a successful method for demonstrating an in situ ≥5-log reduction in CFU's for five different bacterial pathogens. Of the 32 plates placed on UV-accessible surfaces, 31 showed an adequate reduction in CFU's of ≥5-log. One plate could not be assessed. Conclusion: Inoculated agar plates placed in patient rooms before irradiation and subsequently compared to a reference series can be used to assess in situ efficacy of mobile disinfection robots using UV-C radiation. Our findings support the idea that UV-C robots, used adjunctively to conventional manual washing and disinfection, may achieve adequate bacterial load reduction on UV-accessible smooth surfaces in patient rooms for a selected subset of pathogens.

As advanced technologies become prevalent, they are being used more widely in numerous fields. The building sector is not an exception. One of these cutting-edge technologies is responsive facades, which are used in buildings and have an undeniable effect on daylighting. However, they have not been adequately evaluated for improving visual comfort in hospitals. This study investigates visual comfort in a standard patient room, based on applying four responsive facades. Simulations were conducted using HoneybeePlus, a plugin in the Grasshopper. Simulation-based results of annual indicators, including Annual Sunlight Exposure (ASE) and spatial Daylight Autonomy (sDA), showed that different facades could result in several optimal modes. Furthermore, a more comprehensive investigation should consider factors such as Daylight Glare Probability (DGP) and Daylight Glare Index (DGI). Glare indicators revealed that facade directly affects patient visual comfort and can even have an adverse effect. When the optimal responsive facade is chosen, it enhances users' visual comfort throughout the year, yet there will be still glare probability in some cases. Based on the results, this probability decreases as patient distance increases, and Window to Wall Ratio (WWR) is not particularly effective in reducing glare. Nevertheless, when it comes to daylight availability, WWR cannot be ignored, and the first façade with WWR 60% showed the best overall performance.

As advanced technologies become prevalent, they are being used more widely in numerous fields. The building sector is not an exception. One of these cutting-edge technologies is responsive facades, which are used in buildings and have an undeniable effect on daylighting. However, they have not been adequately evaluated for improving visual comfort in hospitals. This study investigates visual comfort in a standard patient room, based on applying four responsive facades. Simulations were conducted using HoneybeePlus, a plugin in the Grasshopper. Simulation-based results of annual indicators, including Annual Sunlight Exposure (ASE) and spatial Daylight Autonomy (sDA), showed that different facades could result in several optimal modes. Furthermore, a more comprehensive investigation should consider factors such as Daylight Glare Probability (DGP) and Daylight Glare Index (DGI). Glare indicators revealed that facade directly affects patient visual comfort and can even have an adverse effect. When the optimal responsive facade is chosen, it enhances users' visual comfort throughout the year, yet there will be still glare probability in some cases. Based on the results, this probability decreases as patient distance increases, and Window to Wall Ratio (WWR) is not particularly effective in reducing glare. Nevertheless, when it comes to daylight availability, WWR cannot be ignored, and the first façade with WWR 60% showed the best overall performance. [ABSTRACT FROM AUTHOR]

Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk.Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes. This study introduces an innovative approach using AR technology to advance methods for healthcare facility design efficiently.Ten healthy participants enrolled in this study to examine different hospital room designs in AR. Factors of interest included room configuration, door type, exit side of the bed, toilet placement, and the presence of IV equipment. AR trackers captured trajectories of the body as participants navigated through these AR hospital layouts, providing insights into user behavior and preferences.Door type influenced the degree of backward and sideways movement, with the presence of an IV pole intensifying the interaction between door and room type, leading to increased sideways and backward motion. Participants displayed varying patterns of backward and sideways travel depending on the specific room configurations they encountered.AR can be an efficient and cost-effective method to modify room configurations to identify important design factors before conducting physical testing. The results of this study provide valuable insights into the effect of environmental factors on movement patterns in simulated hospital rooms. These results highlight the importance of considering environmental factors, such as the type of door and bathroom location, when designing healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: Environmental contamination of norovirus (NoV) is believed to be a significant source for further transmission in hospitals.Aim: To investigate the risk of acquiring NoV in a cleaned room previously occupied by a patient with NoV infection. The risk of having a roommate with recent NoV infection was also assessed.Methods: In a retrospective cohort, comprising 33,788 room stays at five infectious Disease wards in southern Sweden from 2013 to 2018, the risk of acquiring NoV infection after admission to an exposed or non-exposed room was analysed with uni- and multivariable statistical analysis, controlling for age, colonization pressure and any roommate. RNA sequencing of the NoV strains involved in suspected room transmission was also performed.Results: Five of the 1106 patients exposed to a room with a prior occupant with NoV infection and 49 in the non-exposed group acquired NoV infection. An association between NoV acquisition was found in the univariable analysis (odds ratio (OR) 3.3, P=0.01), but not when adjusting for potential confounders (OR 1.9, P=0.2). Sequencing of the NoV samples showed that only two of the five exposed patients with acquired NoV infection were infected by identical strains to the prior room occupant, inferring a room transmission risk of 0.2% (95% confidence interval 0.05-0.78%). None of the 52 patients who shared room with a roommate with NoV symptoms resolved for ≥48 h acquired NoV infection.Conclusions: In absolute terms, the risk of room transmission of NoV is low. Discontinuation of isolation ≥48 h after resolution of symptoms seems adequate. [ABSTRACT FROM AUTHOR]

This study evaluates 171 hospital bed tower designs from the past decade. The Floor-building gross square feet (BGSF)/Bed, patient care area, ratio between them, and the bed count per unit were analyzed. The findings suggest that the average patient care area has decreased 5%–10% to a 305 departmental gross square feet (DGSF)/Bed average. The patient care area, support, circulation, and area grossing on floor were found to average 908 Floor-BGSF/Bed, and were impacted by the total beds/unit. It was determined that larger bed count per unit designs with 32–36 beds/unit average 21.9% less Floor-BGSF/Bed than designs with 24 beds/unit. The research evaluates design solutions impacted by a shifting environment of regulatory change and escalating costs. The hospital bed towers represent new facilities, horizontal/vertical expansions, and 25+ design teams. Design and/or construction took place during a 10-year period (2008–2018). The acute patient unit designs were reviewed and electronically quantified. The area measurement methodology aligns with the guidelines set forth in the "Area Calculation Method for Health Care" guidelines. Each project team was faced with a unique but similar set of circumstances. The balance between core values, guiding principles, budget, and quality of care was always present and included a diverse combination of owners, designers, construction delivery methods, profit models, and clinical approaches. In today's world, common solutions are grounded in providing the best value. Project teams face a number of challenges during design. The lack of information should never be one. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part of this fight to reduce the spread. Traditional audits, however, are insufficient. This study assesses surface cleaning practices using ultravoilet (UV) marker technology and the extent to which this technology can help improve cleaning audits and practices. One hundred and forty-four audits (1,235 surfaces) were retrieved. UV-marker cleaning audits conducted at a major teaching hospital in 2018 after implementing a new cleaning protocol. In addition, semi-structured interviews were conducted with cleaning staff and supervisors. On average, 63% of surfaces were appropriately cleaned. Toilet handles (80%) and toilet seats underside (83%) scored highest while main room sink fixtures (54%), light switch (55%), and bedrails (56%) scored lowest. Training, staffing and time constraints may play a role in low cleaning rates. The high-touch patient surfaces in the bedroom remain neglected and a potential source of infections. UV marker audits provided an objective measure of cleaning practices that managers and staff were unaware of. UV-markers audits can play a key role in revealing deficiencies in cleaning practices and help in raising awareness of these deficiencies and improving cleaning practices. • A UV markers audit revealed unexpected unsatisfactory cleaning practices. • Toilet surfaces were most likely to be cleaned. • High touch surfaces closed to patient beds were least likely to be cleaned. • UV markers audits coupled with feedback processes can improve cleaning. [ABSTRACT FROM AUTHOR]

Objectives: This research investigated medical/surgical (Med/Surg) patient room design to accommodate the needs of hospital staff, while at the same time accommodating the needs of patients and their visitors. Background: Designing hospital patient rooms that provide a comfortable healing experience for patients, while at the same time meeting the needs of the hospital staff, is a challenging process. Prior research has shown that many hospital patient room designs adversely affect the ability of hospital staff to perform their tasks effectively, efficiently, and safely. Method: Twenty-seven design sessions were conducted in which 104 participants, representing 24 different occupations, worked in small mixed occupational groups to design an ideal single patient Med/Surg patient room to fit their collective needs using a full-scale mock-up. During analysis, the investigators reduced the resulting 27 room designs to 5 hybrid designs that were sequentially reviewed by patients and visitors and by staff to address design conflicts. Results: This design process identified 51 desirable room design features that were incorporated into 66 evidence-based design guidelines for the different areas within the Med/Surg patient room including the entry way (16 guidelines), the patient clinical area (22 guidelines), the bathroom (17 guidelines), the family area (8 guidelines), and storage areas for patients and their visitors (3 guidelines). Conclusions: The guidelines developed through this study identified many opportunities for improving the design of hospital Med/Surg rooms to allow staff to be more effective, efficient, and safer, while at the same time addressing the design needs of patients and their visitors. [ABSTRACT FROM AUTHOR]

Background: Due to the disadvantages of manual disinfection of patient rooms, mobile disinfection robots using ultraviolet C (UV-C) radiation are increasingly being used. Assessing their in situ effectiveness remains challenging., Aim: This study describes a new method to prove adequate in situ disinfection (≥5-log reduction in bacterial load), and uses this method to assess the efficacy of a mobile disinfection robot using UV-C radiation., Methods: Agar plates serving as proxies for smooth surfaces in patient rooms were inoculated with bacterial suspension and placed on various surfaces in a patient room. After irradiation by an automated mobile UV-C robot, reduction in colony growth was determined by comparing the irradiated plates to a reference series of non-irradiated plates, enabling the evaluation of whether an adequate reduction in colony-forming units (CFU's) of ≥5-log was reached on these irradiated surfaces., Findings: The new technique described here proved a successful method for demonstrating an in situ ≥5-log reduction in CFU's for five different bacterial pathogens. Of the 32 plates placed on UV-accessible surfaces, 31 showed an adequate reduction in CFU's of ≥5-log. One plate could not be assessed., Conclusion: Inoculated agar plates placed in patient rooms before irradiation and subsequently compared to a reference series can be used to assess in situ efficacy of mobile disinfection robots using UV-C radiation. Our findings support the idea that UV-C robots, used adjunctively to conventional manual washing and disinfection, may achieve adequate bacterial load reduction on UV-accessible smooth surfaces in patient rooms for a selected subset of pathogens., (© 2023 The Authors.)

The outcome of care for patients sentenced to forensic psychiatric care is of importance not only for the patient but also for society, in preventing new crimes. In recent years, a person‐centered perspective is influencing the care, recognizing the design of the physical environment as a therapeutic resource. To capture the complexity of patients' experience of the physical environment, a qualitative approach is needed. The aim of this study was to investigate the meanings of the patient room as a place and space in forensic psychiatric in‐patient care from the patients' perspective. An explorative qualitative design was chosen, data were collected by photovoice; a combination of photographs, taken by the patients, followed by interviews. Eleven (N = 11) patients were interviewed. The interviews were analysed by a thematic analysis method. Four themes emerged from the data revealing the meanings of the patient room as a place and space: (i) striving towards normality; (ii) being anchored and protected; (iii) being at‐home and homeness; and (iv) being in communion and meaningfulness. The findings show that the physical environment has a say in patients' basic needs and a role in maintaining normality. Substandard reveals a lack of respect and dignity towards this patient group. Involving patients in the design process of new facilities can be a way to make progress. [ABSTRACT FROM AUTHOR]

Highlights • Thermal comfort requirements of hospital patients and visitors were investigated. • The applicability of international and local thermal standards was examined. • The effect of outdoor temperature on indoor comfort temperature was analyzed. • Hospital temperatures could be increased to improve patient and visitor comfort. • Increased temperatures would result in cost and energy savings for hospitals. Abstract The current indoor thermal comfort standards and guidelines for hospital wards in the tropics may be insufficient for maintaining thermal comfort for occupants and ensuring energy efficiency in hospitals. Therefore, field survey assessments of thermal comfort were conducted in three Malaysian hospitals with air conditioning capabilities for patient rooms. This study evaluated existing thermal conditions and thermal comfort preferences of patients and their visitors. A total of 389 responses were collected in hot and humid conditions. Indoor thermal measurements were collected in each hospital and compared to the local guidelines. The lower temperature results compared to the Malaysian standard MS1525 (2014) and the Industry Code of Practice on Indoor Air Quality (2010) by the Department of Occupational Safety and Health (DOSH) in Malaysia indicated that specific thermal comfort guidelines were required for hospital wards in Malaysia. The mean comfort operative temperatures were estimated to be 25.3 °C for patients and 25.5 °C for visitors. The relationships between the indoor comfort temperature and running mean outdoor temperature (27.0 − 31.0 °C) in the three hospitals were also determined. These adaptive relationships can serve as a guide for building service engineers and researchers seeking to reduce energy use in hospitals. [ABSTRACT FROM AUTHOR]

An increase in providing hospital bedside imaging examinations could be contributing to the risk of musculoskeletal injuries among imaging professionals. Given the increasing demand for portable bedside imaging, a research project was conducted in three phases: (1) interviews and focus group sessions, (2) full-scale mock-up sessions where occupational stakeholders created prototype rooms, and (3) evaluation sessions of inpatient room prototypes by all stakeholders. The study data from diagnostic medical sonographers (DMS), cardiac sonographers (CS), vascular technologists (VT), and radiographers (RTs) were retrospectively pulled from the overall research to address the following research question: What hospital room designs and components facilitate or hinder medical imaging professionals in providing bedside imaging? Data analyses utilize constant comparative analysis, quantitative counts, and discourse analysis across all three phases of the project. The results highlight the importance of a working area surrounding the patient’s bed that allows for imaging and patient care activities. And this study provides new evidence to inform design considerations that could facilitate the performance of diagnostic patient care at the bedside and reduce exposure to work-related musculoskeletal disorder risks factors. [ABSTRACT FROM AUTHOR]

A methodological study was conducted to test the validity and reliability of the patient safety (PS) scale developed by Rashid (2007) for evaluating nurses' perception of adult intensive care unit (ICU) design features related to patient safety. Data for the study were collected using a Webbased survey instrument. A link to the survey instrument was posted on theWeb site of American Association of Critical-Care Nurses (AACN) for ICU nurses in different US states to participate. A sample of 587 valid responses was divided into 2 halves for cross-validation. The first half of the sample was used for exploratory factor analysis and the second half for confirmatory factor analysis. This method was applied to identify any latent factor structure in the PS scale. Based on the factor analyses, 4 relevant PS subscales--Efficient Work Process, Patient Room, Accessibility and Visibility, and Maintain Sterility--were identified. These PS subscales were used to investigate whether ICU unit characteristics, nurse characteristics, and hospital type affected nurses' perception of ICU design features in relation to patient safety. The study shows that nurses' perception of ICU design features related to patient safety can be influenced by such factors as nurse characteristics and unit characteristics. When using the scales, therefore, the designers can be aware of the influence of these external factors on nurses' perception. It is hoped that the PS subscales evaluating nurses' perception of ICU physical environmental features related to patient safety would help designers and health care personnel make better ICU design choices. [ABSTRACT FROM AUTHOR]

The indoor environment of patient rooms should provide adequate conditions for the safe recovery of the patient. However, in clinical standards, the requirements for conditions in standard patient rooms are either omitted or limited to stating the temperature or humidity. Simultaneously, patients in different countries often feel uncomfortable, and the data indicate large discrepancies in patient room thermal conditions across the world. Therefore, this study aimed to determine how patients in Polish hospitals perceive the indoor environment in their rooms, as well as the relationship between individual patient characteristics (gender and age) and feelings about selected elements of the indoor environment, in addition to feelings related to the self-assessment of the impact of the indoor environment on the recovery process. The results of the presented study indicate that the analysed thermal environment elements are essential in patient rooms and should be given appropriate attention. The individual characteristics of patients, including those caused by illness and medication, make it impossible to create a comfortable environment for each patient in a multi-patient room, and solutions and guidelines to support the recovery process of patients should continue to be developed, including solutions that provide opportunities to create a controlled environment around each patient. • We analysed patients' sensations of the thermal environment and air quality. • Polish patients perceive the thermal environment as 'neutral' or 'warm'. • Patients are very sensitive to air dryness. • The sensation of air dryness effect patients' thermal and draught sensations. • Broad regulation of air temperature should be possible in patients' rooms. [ABSTRACT FROM AUTHOR]

Healthcare facilities are being evaluated throughout the world determine to what extent they are meeting the needs of patients. Evidence-based research is gaining importance in Turkey as hospital designers strive to increase patients’ satisfaction. In this paper, we will examine the results of a case study conducted to evaluate the spatial quality of patients’ rooms in the context of their satisfaction. Two private general healthcare buildings in Gaziantep were examined in the case study. We chose to evaluate private hospitals because we assumed they would have better conditions than state hospitals. We also took into consideration that these healthcare institutions are in the process of accreditation. Surgeries are frequently conducted here and long-term stays are common. In order to evaluate the subject thoroughly, we used a both a questionnaire and a checklist to gather information. Problems with the spatial quality of the rooms will be identified in the discussion chapter. The examples chosen for the study have showed significant development in available services and space. Using the data obtained from the case study, we have chosen three categories of design criteria through which to evaluate these facilities. Findings will be presented under the headings of function, aesthetics and safety in the results chapter.

Objective: The objective of this article was to explore interior spatial qualifications on patient perception of two densities of multioccupancy hospital rooms. Background: The research setting of this study was the three- and six-person capacity hospital rooms used for treatment of patients at a large hospital in a major metropolitan city in Turkey. Method: The subjects used in the study were randomly selected from among patients treated in the surgical medical sciences’ departments of the hospital. Accordingly, a research questionnaire was applied to a total of 101 subjects. Results: Results have shown that the three-person rooms were assessed more positively for privacy, functional, and perceptual qualifications compared to the six-person rooms. An increase in the number of persons and interior units of rooms affects negatively the auditory privacy and privacy areas of other patients. Conclusion: Consequently, although these rooms with different spatial sizes were very similar for concentration of persons and commodities, six-person rooms were perceived to be more crowded than three-person rooms. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. Background: In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. Method: One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Results: Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. Conclusions: There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. [ABSTRACT FROM AUTHOR]

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Pervasive Intelligent Technologies for Health". Background: This paper addresses the evaluation with hospital staff of an in-patient environment that supports patients, family, nursing staff and medical specialists during the recovery process of neurology patients and especially patients recovering from a stroke. We describe the methods that were used to evaluate the Adaptive Daily Rhythm Atmospheres (ADRA), Artificial Skylight (AS) and Adaptive Stimulus Dosage (ASD) concepts. Objectives: The goal of this evaluation was to gather qualitative and quantitative feedback from hospital staff about the usefulness, the usability and desirability of the Adaptive Daily Rhythm Atmospheres (ADRA), Artificial Skylight (AS) and Adaptive Stimulus Dosage (ASD) concepts that were implemented as different phases of a novel heal-ing patient room. This paper reports the effects of these concepts with regard to 1) the healing process of the patient and 2) the workflow of the staff. These results are part of a larger R&D project and provide the initial feedback in an iterative user-centered design methodology. Methods: After signing informed consents, the group of participants was taken to the laboratory environment where they were introduced to the Adaptive Healing Environment Patient Room and where they could also experience the room. Then, the participants were seated next to the patient bed so they had a similar viewing angle as the patients. The participants received a booklet with questionnaires. The items on this questionnaire addressed the influence on the healing process (i.e., the possible effect the concept/phase has on the healing process of the patient, meaning faster recovery, better sleep and enhanced well-being) and influence on the workflow (i.e., the possible effect of such a concept/ phase on the working activities of the staff in the ward). We presented every concept (AS and ASD) and all the phases of ADRA. After every presentation of the concept or phase of the ADRA system the participants rated the concept or phase anonymously on a 7-point Likert scale. In addition to rating the phase in the therefore designed booklets, they were also asked to motivate their ratings in writing. Subsequently, a focus group discussion took place. During the discussion the two note takers wrote down all the comments. Afterwards the quantitative results were analyzed with the non-parametric Kruskal- Wallis test. Significant effects were further analyzed in a post-hoc Mann-Whitney test. Results: The results show that hospital staff expects a positive effect on the healing process of the patient for the Artificial Skylight, the Adaptable Stimulus Dosage concept and the different ADRA phases that provide a clear daily rhythm structure during the day. In fact the staff members from different healthcare institutions and with different professional roles agreed on most aspects. In addition, the staff also expected a positive effect for almost all phases on the efficiency of the clinical workflow, also for the AS and ASD concepts. This is a very promising result as the phases were designed primarily with the healing effect of the patient in mind. Conclusions: The hospital staff evaluation in the laboratory setting gave us an indication of the likely impact of the Adaptive Healing Environment Patient Room on the healing progress of patients. Furthermore, this laboratory evaluation of the concepts was an important step that enabled to improve the shortcomings of the current concept before starting clinical trials. In addition, we generated feedback from different departments from different institutions, which suggest that they all see similar added values for the patient room [ABSTRACT FROM AUTHOR]

Care services within the patient rooms are the most critical and time consuming processes in patient care deliveries in emergency department, clinics, and other healthcare facilities. In this paper, we introduce a Markov chain model to study such processes. A closed, parallel, and reentrant network with limited resources is used to model the process. Formulas to evaluate the patient length of stay and staff utilizations are developed. System-theoretic properties are discussed. The extension to non-Markovian scenarios is also investigated. Such a model provides a quantitative tool for healthcare professionals to study and improve patient flow in care deliveries. [ABSTRACT FROM AUTHOR]

The Patient Room is one of the most important and costly rooms in the design of an inpatient bed unit. As a result, the patient room mock-up requires knowledge of the components that inform the patient room environment. This article provides the intensive care nurse with questions about patient care processes and unit policies that should be considered in a mock-up. The mock-up outcome should align with the project's goals and objectives of the health care system, infuse the principles of evidence-based design, and ensure that the design accommodates the best workflow for the patient population that will be served. The template will serve as a guide to evaluate the various features of the patient room and for the mock-up discussion between the nurse and the architect. [ABSTRACT FROM AUTHOR]

In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical design of these award-whining ICUs may help design better ICUs. [ABSTRACT FROM AUTHOR]

Previous research highlights the impact of care and treatment in ICUs on the patient recovery process and wellbeing. However, little is known about how the interior design in the ICU settings may affect patients' wellbeing. Objective: The aim of this study is, by using a lifeworld perspective, to reveal the meanings of the ICU settings as a place of care. Design: Nine patients from three ICUs in Sweden participated. Data were collected using photovoice methodology and were analysed using a reflective lifeworld phenomenological approach. Results: The ICU setting as a place of care for critically ill patients is a complex and multidimensional phenomenon. The place is constituted of patients, staff and technical equipment. The struggle for life and occurrences taking place there determine how the room is perceived. The tone and touch of caring together with interior design are fundamental for the room as lived. The room is experienced in various moods; a place of vulnerability, a place inbetween, a place of trust and security, a life-affirming place, a place of tenderness and care and an embodied place. Conclusion: Promoting patients' well-being and satisfaction of care involves integrating a good design and a caring attitude and paying attention to patients' needs. [ABSTRACT FROM AUTHOR]

This descriptive study was intended to measure the percentage of the time that patient beds were kept in high position in an adult acute inpatient surgical unit with medical overflow in a community hospital in Michigan, United States. The percentage of the time was calculated for morning, evening, and night shifts. The results showed that overall, occupied beds were in a high position 5.6% of the time: 5.40% in the day shift, 6.88% in the evening shift, and 4.38% in the night shift. It is recognized that this study was unable to differentiate whether those times patient beds being kept in a high position were appropriate for an elevated bed height (e.g., staff were working with the patient). Further research is warranted. Falls committees may conduct high-bed prevalence surveys in a regular basis as a proxy to monitor staff members' behaviors in keeping beds in a high position. [ABSTRACT FROM AUTHOR]

Summary: The rooms in Intensive Care Units are considered as high-tech environments and believed to affect recovery process and wellbeing of patients. Moreover, the design and interiors affect the interplay between the patient and the next of kin. Objective: The aim of this study was to describe and interpret the meanings of the intensive care patient room as experienced by next of kin. Design: Next of kin (n =14) from two different intensive care units participated. Data were collected through photo-voice and analysed using a phenomenological hermeneutical method. Results: Three major themes emerged; dwelling in the room and time, becoming at home and extension of the room. The results show that the room is perceived as a lived and extended place and space. The design, interiors and furnishing in the patient room are fundamental in shaping the next of kin''s experiences in the room and affect wellbeing. Conclusions: How intensive care patient rooms are designed, the place given to next of kin and the way they are received in the room are decisive for the support given to the loved one. Simple interventions can make the patient room a more healing environment. [Copyright &y& Elsevier]

The cost of nosocomial infections in the United States is estimated to be $4 billion to $5 billion annually. Applying a scientifically based analysis to disease transmission and performing a site specific risk analysis to determine the design of the ventilation system can provide real and long term cost savings. Using a scientific approach and convincing data, this paper hypothetically illustrates how a ventilation system design can be optimized to potentially reduce infection risk to occupants in an isolation room based on a thorough risk assessment without necessarily increasing ventilation airflow rate. A computational fluid dynamics (CFD) analysis was performed to examine the transport mechanism, particle path and a suggested control strategy for reducing airborne infectious disease agents. Most studies on the transmission of infectious disease particles have concentrated primarily on air changes per hour (ACH) and how ACH provides a dilution factor for possible infectious agents. Although increasing ventilation airflow rate does dilute concentrations better when the contaminant source is constant, it does not increase ventilation effectiveness. Furthermore, an extensive literature review indicates that not every exposure to an infectious agent will necessarily cause a recipient infection. The results of this study suggest a hypothesis that in an enclosed and mechanically ventilated room (e.g., an isolation room), the dominant factor that affects the transmission and control of contaminants is the path between the contaminant source and exhaust. Contaminants are better controlled when this path is uninterrupted by an air stream. This study illustrates that the ventilation system design, i.e., when it conforms with the hypothesized path principle, may be a more important factor than flow rate (i.e., ACH). A secondary factor includes the distance from the contaminant source. This study provides evidence and supports previous studies that moving away from the patient generally reduces the infection risk in a transient (coughing) situation, although the effect is more pronounced under higher flow rate. It is noted that future research is needed to determine the exact mode of transmission for most recently identified organisms. [ABSTRACT FROM AUTHOR]

Background: The prevailing focus on cognitive load reduction in healthcare environment standardization excludes a domain of healthcare delivery that could contribute significantly to safety and efficiency through standardization, but it has escaped discussion in the context of the biomechanics of care delivery. Inappropriate biomechanics not only can harm caregivers but compromise care delivery. Little, however, is known regarding the biomechanics of patient care and the way it interacts with the configurational issues typically targeted in healthcare environment standardization. Objectives: Examine the types of potentially harmful or stressful actions exhibited by nurses during patient care delivery in an acute medical/surgical setting. Examine the sources influencing unsafe actions. Method: Twenty nurses provided three types of simulated care in an experimental setting involving nine care configurations that were systematically manipulated. A kinesiology expert coded 80 simulation segments representing two types of task and two levels of environmental challenge to identify potentially stressful and harmful actions. Exploratory and regression analyses were conducted on the data. Results: Analysis suggests that a considerable proportion of potentially harmful and stressful actions are associated with the design of the physical elements as opposed to the configurational factors typically addressed in standardization. Both of these factors interact to produce work-arounds that result in unsafe actions. Conclusion: The standardization of healthcare environments needs a larger framework to address both cognitive lapses and the biomechanics of care delivery [ABSTRACT FROM AUTHOR]

Objective: The goal of this project was to create an easy-to-administer and inexpensive tool that can help identify usability issues in a patient room bathroom during the design process so improvements can be made before the final product is constructed and put into operation. Background: The bathroom is an essential part of any hospital patient room, yet it is associated with nurse dissatisfaction and patient falls. Minimal literature has examined whether the physical structure of various elements within the bathroom are efficient, safe, and satisfactory for the majority of users. Furthermore, there is a paucity of human factor guidelines for architects and designers to follow to ensure the usability of bathroom space for a wide variety of users. Methods: The authors adapted a common technique used in software usability: the heuristic evaluation. A heuristic evaluation is a "discount" evaluation method used to quickly and efficiently evaluate the usability flaws of user interfaces. Three methods were used to provide input for the heuristic evaluation: (1) Review of existing heuristic evaluations, reported hospital bathroom problems, and safety checklists; (2) Interviews with nurses and nursing assistants; and (3) Focus groups with nurses. Analysis of the interview and focus group transcripts enabled the categorization of the types of problems nurses encounter in the patient room bathroom. These categories served as the basis for the heuristics in the heuristic evaluation tool. Results: Eleven major heuristics (or categories of problems in the bathroom) were identified initially. The authors then went through several iterations of designing and refining the heuristic evaluation to form parsimonious categories and subcategories. Each of the eventual six major heuristic categories contains a general description as well as specific exemplar questions. These detailed subcategories enable an evaluator to easily gauge whether a bathroom adheres to the guideline, to write any comments about a particular issue, and to rate the severity of any problems. Conclusions: The bathroom heuristic evaluation was designed to be a discount usability evaluation tool. It can be used to assess a hospital bathroom during the design process for major usability issues, enabling necessary alterations before a final product is developed. [ABSTRACT FROM AUTHOR]