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Schafthuizen L, van Dijk M, van Rosmalen J, Ista E. Mobility level and factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms. BMC Nurs 2024; 23:11. [PMID: 38163905 PMCID: PMC10759502 DOI: 10.1186/s12912-023-01648-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Although stimulating patients' mobility is considered a component of fundamental nursing care, approximately 35% of hospitalized patients experience functional decline during or after hospital admission. The aim of this study is to assess mobility level and to identify factors affecting mobility status in hospitalized patients admitted in single-occupancy patient rooms (SPRs) on general wards. METHODS Mobility level was quantified with the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) and EQ-5D-3L. GENEActiv accelerometer data over 24 h were collected in a subset of patients. Data were analyzed using generalized ordinal logistic regression analysis. The STROBE reporting checklist was applied. RESULTS Wearing pajamas during daytime, having pain, admission in an isolation room, and wearing three or more medical equipment were negatively associated with mobilization level. More than half of patients (58.9%) who were able to mobilize according to the EQ-5D-3L did not achieve the highest possible level of mobility according to the JH-HLM. The subset of patients that wore an accelerometer spent most of the day in sedentary behavior (median 88.1%, IQR 85.9-93.6). The median total daily step count was 1326 (range 22-5362). CONCLUSION We found that the majority of participating hospitalized patients staying in single-occupancy patient rooms were able to mobilize. It appeared, however, that most of the patients who are physically capable of walking, do not reach the highest possible level of mobility according to the JH-HLM scale. Nurses should take their responsibility to ensure that patients achieve the highest possible level of mobility.
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Affiliation(s)
- Laura Schafthuizen
- Department of Internal Medicine, section Nursing Science, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Monique van Dijk
- Department of Internal Medicine, section Nursing Science, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erwin Ista
- Department of Internal Medicine, section Nursing Science, Erasmus University Medical Center, Rotterdam, The Netherlands
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2
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Lipson-Smith R, Zeeman H, Muns L, Jeddi F, Simondson J, Bernhardt J. The role of the physical environment in stroke recovery: Evidence-based design principles from a mixed-methods multiple case study. PLoS One 2023; 18:e0280690. [PMID: 37294748 PMCID: PMC10256226 DOI: 10.1371/journal.pone.0280690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/05/2023] [Indexed: 06/11/2023] Open
Abstract
Hospital design can impact patient outcomes, but there is very little healthcare design evidence specific to stroke rehabilitation facilities. Our aim was to explore, from the patient perspective, the role of the physical environment in factors crucial to stroke recovery, namely, stroke survivor activity (physical, cognitive, social), sleep, emotional well-being, and safety. We conducted a mixed-methods multiple-case study at two inpatient rehabilitation facilities in Victoria, Australia, (n = 20 at Case 1, n = 16 at Case 2) using "walk-through" semi-structured interviews, behavioural mapping, questionnaires, and retrospective audit. Four interrelated themes emerged: 1) entrapment and escape; 2) power, dependency, and identity in an institutional environment; 3) the rehabilitation facility is a shared space; and 4) the environment should be legible and patient-centred. Quantitative data revealed patterns in patient activity; stroke survivors spent over 75% of their time in bedrooms and were often inactive. Convergent mixed methods analysis was used to generate a new conceptual model of the role of the physical environment in stroke survivors' behaviour and well-being, highlighting the importance of variety and interest, privacy without isolation, and patient-centred design. This model can be used by designers, healthcare providers, and policy makers to inform the design of rehabilitation environments.
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Affiliation(s)
- Ruby Lipson-Smith
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Heidi Zeeman
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Leanne Muns
- Bendigo Health, Clinical Operations, Bendigo, Victoria, Australia
| | - Faraz Jeddi
- Bendigo Health, Department of Integrated Medicine, Bendigo, Victoria, Australia
| | - Janine Simondson
- St Vincent’s Hospital Melbourne, Physiotherapy and Rehabilitation Unit, St George’s Hospital, Kew, Victoria, Australia
| | - Julie Bernhardt
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
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3
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Bertuzzi A, Martin A, Clarke N, Springate C, Ashton R, Smith W, Orlowski A, McPherson D. Clinical, humanistic and economic outcomes, including experiencing of patient safety events, associated with admitting patients to single rooms compared with shared accommodation for acute hospital admissions: a systematic review and narrative synthesis. BMJ Open 2023; 13:e068932. [PMID: 37147093 PMCID: PMC10163491 DOI: 10.1136/bmjopen-2022-068932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES Assess the impact of single rooms versus multioccupancy accommodation on inpatient healthcare outcomes and processes. DESIGN Systematic review and narrative synthesis. DATA SOURCES Medline, Embase, Google Scholar and the National Institute for Health and Care Excellence website up to 17 February 2022. ELIGIBILITY CRITERIA Eligible papers assessed the effect on inpatients staying in hospital of being assigned to a either a single room or shared accommodation, except where that assignment was for a direct clinical reason like preventing infection spread. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesised narratively, according to the methods of Campbell et al. RESULTS: Of 4861 citations initially identified, 145 were judged to be relevant to this review. Five main method types were reported. All studies had methodological issues that potentially biased the results by not adjusting for confounding factors that are likely to have contributed to the outcomes. Ninety-two papers compared clinical outcomes for patients in single rooms versus shared accommodation. No clearly consistent conclusions could be drawn about overall benefits of single rooms. Single rooms were most likely to be associated with a small overall clinical benefit for the most severely ill patients, especially neonates in intensive care. Patients who preferred single rooms tended to do so for privacy and for reduced disturbances. By contrast, some groups were more likely to prefer shared accommodation to avoid loneliness. Greater costs associated with building single rooms were small and likely to be recouped over time by other efficiencies. CONCLUSIONS The lack of difference between inpatient accommodation types in a large number of studies suggests that there would be little effect on clinical outcomes, particularly in routine care. Patients in intensive care areas are most likely to benefit from single rooms. Most patients preferred single rooms for privacy and some preferred shared accommodation for avoiding loneliness. PROSPERO REGISTRATION NUMBER CRD42022311689.
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Affiliation(s)
| | | | | | | | - Rachel Ashton
- Ashton Editorial Consulting, London, UK
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
| | - Wayne Smith
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
| | - Andi Orlowski
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
- Department of Primary Care and Public Health, Imperial College London, London, UK
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4
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Xuan X, Duan X, Feng Z. The Demand for Specialization and Its Influence on the Design of Inpatient Nursing Units: Can Standardized Design Be Done Once and for All? HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:154-170. [PMID: 35389290 DOI: 10.1177/19375867221089706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study explores the specialized nursing requirements of different clinical departments and their influence on the design of nursing units, which ultimately improves the nursing staff's efficiency and work experience. BACKGROUND Specialization of nursing work is important in the provision of quality of healthcare. Most of the research related to nursing units has focuses on general medical-surgical nursing units and has not differentiated between clinical departments. METHOD This study was conducted in one inpatient building at a large general hospital in China. Survey data were collected from 11 clinical departments via questionnaire, and interviews were conducted in 10 of the clinical departments. RESULTS All 11 clinical departments had significant differences in their evaluations of and requirements for the arrangement of their physical space. Specialized requirements were found in three areas: nursing work processes, arrangement and needs of clinical spaces, and allocation of facilities and equipment. CONCLUSION Evaluation of the specialized requirements of different clinical departments would contribute to the body of knowledge on nursing unit design and has a positive effect on the development and improvement of design theory. Suggestions for how the design of nursing units could be improved to support the specialized demands of different departments are provided.
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Affiliation(s)
- Xiaodong Xuan
- Department of Architecture, College of Architecture & Art, Hefei University of Technology, Hefei, China
| | - Xiaoxia Duan
- The Second Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu, Anhui, China
| | - Zihao Feng
- Creative Studio III, Tus-Design Group Co., Ltd., Suzhou, Jiangsu, China
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Bishop E, Miller C, Miller S, McKellar C. How staying in a single room affects the experiences of haematology inpatients in an Australian cancer hospital. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S22-S29. [PMID: 35271362 DOI: 10.12968/bjon.2022.31.5.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND It has been suggested that single rooms for patients improve patient dignity and privacy and reduce infection transmission, but they can be socially isolating. It is not well understood how single rooms affect long-stay patients. AIMS To understand the experience of being an inpatient in a ward with single-room design. METHODS A qualitative, phenomenological study was conducted using semi-structured interviews with patients (n=10) in a newly built cancer hospital with a 100% single-room haematology ward. Interviews were analysed using Colaizzi's (1978) seven-step analysis. FINDINGS Patients described their experiences of their acute stay using the concepts of privacy, isolation and independence, as well as enabling sleep. Privacy enabled patients to have their own toilet, was perceived to aid infection control and provided silence. Privacy came at a cost of isolation, but patients re-framed this as expected and necessary for self-preservation. Furthermore, they were unsure as to whether other patients would reciprocate social contact and instead relied on the healthcare team. Patients sought independence during their acute stay as it enabled them to control the environment and create a space for healing. The ability to sleep and be rested was also a critical feature of patients' stay. CONCLUSION The research highlighted that haematology patients prefer single rooms. However, because they experienced isolation, it also highlighted the importance of facilitating and enabling peer support within the haematology setting.
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Affiliation(s)
- Emma Bishop
- An Honours Student, Bachelor of Nursing, La Trobe University, Bundoora, Victoria, Australia, at the time of undertaking the research, and is now a registered nurse
| | - Charne Miller
- Site Director, Alfred Health Clinical School, La Trobe University, Victoria, Australia
| | - Sam Miller
- Co-ordinator, Masters of Nursing Programme, La Trobe University, Victoria, Australia
| | - Catherine McKellar
- Director of Nursing Education, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia, at the time of the research
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D'Souza S, Hersh D, Godecke E, Ciccone N, Janssen H, Armstrong E. Patients' experiences of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward following stroke: a qualitative description approach. Disabil Rehabil 2021; 44:6304-6313. [PMID: 34780322 DOI: 10.1080/09638288.2021.1965226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities. PURPOSE Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model. METHODS A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews were conducted with seven patients, including four with aphasia, within 22 days post-stroke who had access to the CEE model. RESULTS Patients described variable experiences accessing different elements of the CEE model which were influenced by individual patient factors, staff factors, hospital features as well as staff time pressures. Those who were able to access elements of the CEE model described positive opportunities for engagement in language activities. CONCLUSIONS While findings are encouraging, further exploration of the feasibility of a CEE model in this complex setting is indicated to inform the development of this intervention.Implications for rehabilitationPatient access to a CEE model is challenging in a hospital setting.Patients who were able to access elements of the CEE model described positive opportunities for engagement in language activities.Patients' access to the CEE model was influenced by patient factors, staff factors, hospital features as well as staff time pressures.
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Affiliation(s)
- Sarah D'Souza
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Heidi Janssen
- School of Health Sciences, Hunter New England Local Health District, NSW Health, Australia
| | - Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Geelen SJG, van Dijk-Huisman HC, de Bie RA, Veenhof C, Engelbert R, van der Schaaf M, Lenssen AF. Barriers and enablers to physical activity in patients during hospital stay: a scoping review. Syst Rev 2021; 10:293. [PMID: 34736531 PMCID: PMC8569983 DOI: 10.1186/s13643-021-01843-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low levels of physical activity are common during the hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during a hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during a hospital stay for acute care, using the Theoretical Domains Framework (TDF). METHODS We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO, and Cochrane Library (inception to September 2020), which included quantitative, qualitative, and mixed-methods studies reporting barriers and enablers to physical activity during a hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded, and categorized all barriers and enablers into TDF domains. RESULTS Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54). CONCLUSIONS Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during a hospital stay and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients' physical activity behavior. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation. SCOPING REVIEW REGISTRATION No protocol was registered for this review.
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Affiliation(s)
- Sven Jacobus Gertruda Geelen
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands.
| | - Hanneke Corine van Dijk-Huisman
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands.
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
| | - Robert Adriaan de Bie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Cindy Veenhof
- Physical Therapy Research, Department of Rehabilitation, Physical Therapy Sciences & Sports, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Expertise Centre Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Raoul Engelbert
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Marike van der Schaaf
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Antoine François Lenssen
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
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8
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Patient Satisfaction Determinants of Inpatient Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111337. [PMID: 34769856 PMCID: PMC8582779 DOI: 10.3390/ijerph182111337] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/26/2021] [Accepted: 10/12/2021] [Indexed: 12/19/2022]
Abstract
The aim of the study was to analyse and evaluate the determinants influencing the overall satisfaction of patients with inpatient healthcare in the conditions of the Czech Republic. A total of the 1425 patients, who experienced hospitalisation and agreed to participate, were questioned in the study. A research questionnaire was used to obtain data on satisfaction with hospitalisation. The subject of the research consisted of the indicators related to the following factors: (i) satisfaction with the hospital, clinic, room and meals; (ii) satisfaction with medical staff-nurses, physician expertise and other staff; (iii) the quality of the treatment provided; (iv) satisfaction with leaving the hospital. The formulated statistical hypotheses were evaluated through structural equation modelling. The results of the analyses brought interesting findings. Satisfaction with medical staff is the most significant factor which has a positive effect on satisfaction with hospitalisation. Physician expertise (with trust and good communication skills) is more important for patients than satisfaction with nurses or other staff. The results obtained from the study represent valuable information for policymakers, regional healthcare plans, as well as for managers of hospitals.
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Søndergaard SF, Beedholm K, Kolbæk R, Frederiksen K. Patients' and Nurses' Experiences of All Single-Room Hospital Accommodation: A Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:292-314. [PMID: 34636692 DOI: 10.1177/19375867211047548] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM AND OBJECTIVE To identify, examine, and map literature on the experiences of single-room hospital accommodation, exploring what is known about how single-room accommodation in hospitals is viewed by patients and nurses. BACKGROUND Worldwide, hospital design is changing to mainly single-room accommodation. However, there is little literature exploring patients' and nurses' experiences of single-room designs. DESIGN Scoping review following the Joanna Briggs Institute guidance on scoping reviews. METHODS We conducted the search in medical databases for scientific and gray literature. The four authors independently used a data extraction tool to include sources from the searches. The sources were discussed during the process, and in case of a disagreement between two reviewers, the third and fourth reviewer would be invited to participate in the discussion until consensus was achieved. RESULTS We included 22 sources published during the period 2002-2020, with a majority (n = 16) during the period 2013-2020. The sources were distributed on 10 different countries; however, England dominated with 14 publications. We found three main maps for reporting on patients' experiences: (1) personal control, (2) dignity, and (3) by myself. For the nurses' experiences, we found four main maps: (1) the working environment, (2) changes of nursing practice, (3) privacy and dignity, and (4) patient safety. CONCLUSION We suggested that patients' and nurses' experiences are predominantly interdependent and that the implications of single-room accommodation is a large and complex issue which goes beyond hospital design.
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Affiliation(s)
- Susanne Friis Søndergaard
- Centre for Research in Clinical Nursing, Regional Hospital Viborg, VIA University College, Aarhus University, Denmark
| | | | - Raymond Kolbæk
- Centre for Research in Clinical Nursing, Regional Hospital Viborg, VIA University College, Aarhus University, Denmark.,Deakin University, Burwood, Victoria, Australia
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Felice Tong YY, Karunaratne S, Youlden D, Gupta S. The Impact of Room-Sharing on Length of Stay After Total Hip or Knee Arthroplasty: A Retrospective Study. Arthroplast Today 2021; 8:289-294.e2. [PMID: 34095406 PMCID: PMC8167312 DOI: 10.1016/j.artd.2021.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background Prolonged length of stay (LOS) after elective total hip (THA) and knee (TKA) arthroplasty is often associated with worse patient outcomes. Social support through room-sharing has been identified as a factor that may reduce LOS in a hospital setting, but has not yet been examined in an orthopedic population. The aim of this study was to evaluate the effect of single- vs shared-room accommodation after elective TKA or THA on hospital LOS. Method A retrospective study was conducted using data from hospital medical records at our institution. Patients receiving unilateral, elective THA or TKA over a 2-year period were eligible. Patients were allocated to either a single room or four-bed shared room. The primary outcome was LOS; secondary outcomes included complications, discharge destination, and return to operating theater. Results One hundred eighty-five patients (70 THA, 115 TKA; mean age 65.74 ± 10.38, 59% female) were included, of whom 82 were allocated to a single room and 103 to a shared room. There was no statistically significant difference in LOS between the 2 groups (5.18 ± 2.21 days [single] vs 4.88 ± 2.12 days [shared]; mean difference −0.29 [95% CI −0.92-0.33], P = .36). Analysis modeling for multiple confounders found no association among room allocation, LOS, and discharge destination. However, more patients in single rooms required discharge to rehabilitation (27% vs 9%) and return to theater (7% vs 1%). Conclusions Room allocation did not correlate with a difference in LOS in patients undergoing elective THA or TKA.
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Affiliation(s)
- Yui Yee Felice Tong
- Sydney Medical Program, University of Sydney, Camperdown, New South Wales, Australia.,Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Sascha Karunaratne
- Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Daniel Youlden
- Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Sanjeev Gupta
- Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Purssell E, Gould D, Chudleigh J. Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis. BMJ Open 2020; 10:e030371. [PMID: 32075820 DOI: 10.1136/bmjopen2019-030371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes. DESIGN Systematic review with meta-analysis. DATA SOURCES Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched. RESULTS Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation. CONCLUSION The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.
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Affiliation(s)
- Edward Purssell
- School of Health Sciences, City, University of London, London, UK
| | - Dinah Gould
- School of Health Sciences, City, University of London, London, UK
| | - Jane Chudleigh
- School of Health Sciences, City, University of London, London, UK
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12
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Purssell E, Gould D, Chudleigh J. Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis. BMJ Open 2020; 10:e030371. [PMID: 32075820 PMCID: PMC7044903 DOI: 10.1136/bmjopen-2019-030371] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 12/03/2019] [Accepted: 01/30/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes. DESIGN Systematic review with meta-analysis. DATA SOURCES Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched. RESULTS Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation. CONCLUSION The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.
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Affiliation(s)
- Edward Purssell
- School of Health Sciences, City, University of London, London, UK
| | - Dinah Gould
- School of Health Sciences, City, University of London, London, UK
| | - Jane Chudleigh
- School of Health Sciences, City, University of London, London, UK
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13
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Bazzi M, Lundèn M, Ahlberg K, Bergbom I, Hellström M, Lundgren SM, Fridh I. Patients’ lived experiences of waiting for and undergoing endovascular aortic repair in a hybrid operating room: A qualitative study. J Clin Nurs 2019; 29:810-820. [DOI: 10.1111/jocn.15129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/09/2019] [Accepted: 11/10/2019] [Indexed: 12/27/2022]
Affiliation(s)
- May Bazzi
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Maud Lundèn
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Karin Ahlberg
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Ingegerd Bergbom
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Mikael Hellström
- Department of Radiology Sahlgrenska University Hospital and Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Solveig M. Lundgren
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Isabell Fridh
- Faculty of Caring Sciences, Work Life & Social Welfare University of Borås Borås Sweden
- Department of Anesthesiology and Intensive Care Sahlgrenska University Hospital Gothenburg Sweden
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14
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de Matos LBN, Fumis RRL, Nassar Junior AP, Lacerda FH, Caruso P. Single-Bed or Multibed Room Designs Influence ICU Staff Stress and Family Satisfaction, But Do Not Influence ICU Staff Burnout. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2019; 13:234-242. [PMID: 31597490 DOI: 10.1177/1937586719878445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare the impact of single-bed versus multibed room intensive care units (ICU) architectural designs on the stress and burnout of ICU staff and on the stress and satisfaction of family visitors. BACKGROUND There are countless architectural variations among ICUs, but all involve single-bed or multibed rooms. Although it is well known that ICU design affects important patient outcomes, the effect of ICU design on family and staff has been insufficiently studied. METHODS Among ICU staff and family visitors, stress was evaluated with Lipp's Inventory of Stress Symptoms. ICU staff burnout was evaluated with the Maslach Burnout Inventory. Family visitor satisfaction was evaluated with Molter's Critical Care Family Needs Inventory. RESULTS Among 156 ICU professionals who were interviewed, similar burnout rates were observed between ICU staff who worked single-bed versus multibed rooms. However, stress reported by ICU staff within the previous 24 hr was higher among the ICU staff who worked in single-bed rooms (14.3% vs. 4.7%, p = .04). Among 176 family visitors who were interviewed, a similar level of stress was reported by family members who visited patients in single-bed or multibed rooms. However, the satisfaction of family members visiting patients in single-bed rooms was higher (96.0% vs. 84.6%, p = .02). CONCLUSIONS Single-bed ICU design was associated with greater satisfaction of family visitors yet with higher levels of stress for ICU staff. Meanwhile, similar burnout levels were observed for ICU staff who worked in single-bed or multibed rooms.
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Affiliation(s)
- Liane Brescovici Nunes de Matos
- Intensive Care Unit, A.C. Camargo Cancer Center, São Paulo, Brazil.,Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de, São Paulo, Brazil
| | | | | | | | - Pedro Caruso
- Intensive Care Unit, A.C. Camargo Cancer Center, São Paulo, Brazil.,Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de, São Paulo, Brazil
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15
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Roos AKØ, Skaug EA, Grøndahl VA, Helgesen AK. Trading company for privacy: A study of patients’ experiences. Nurs Ethics 2019; 27:1089-1102. [DOI: 10.1177/0969733019874497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Ethical considerations The study was conducted according to the principles of Declaration of Helsinki, and was approved by the Norwegian Social Science Data Services. Objective To describe patients’ experiences of staying in multiple- and single-bed rooms. Patients and methods This qualitative study employed a descriptive and exploratory approach, and systematic text condensation was used to analyze the material. Data were collected in a hospital trust in Norway. A total of 39 in-depth interviews were performed with patients discharged from the medical, surgical, and maternity departments. Results Patients had ambiguous views on whether multiple-bed rooms or single-bed rooms were to be preferred. Main results include how patients cherished “the importance of others” but at the same time valued “the importance of privacy.” Being hospitalized in multiple-bed rooms was for many patients a very positive experience in terms of social interaction. Patients in single-bed rooms reported being more dependent on nurses to maintain social contact and obtain safety. Conclusion This research provides new knowledge on how the need for privacy can be in contradiction with the need for socializing with other patients. When hospitalized, the physical structure of a hospital impacts with whom patients interact and to what extent they depend on the nursing staff to have their social needs met.
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16
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Factors influencing the perception of protective isolation in patients undergoing haematopoietic stem cell transplantation: A multicentre prospective study. Eur J Cancer Care (Engl) 2019; 28:e13148. [PMID: 31429155 DOI: 10.1111/ecc.13148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/04/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT). METHODS This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post-transplant. Statistical linear regression analysis was performed. RESULTS The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (β = .152), education level (β = -.245), double room (β = .186), satisfaction with visiting hours (β = -.174) and emotional support from nurses (β = -.169) were independently associated with isolation-related suffering. Significant predictors of the relationship with oneself included body temperature (β = -.179), fatigue (β = -.192) and emotional support from nurses (β = -.292). Factors independently associated with the relationship with others were education (β = -.230), chemotherapy cycles (β = -.218), pain (β = .150) and satisfaction with visiting hours (β = -.162). CONCLUSION Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support.
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Affiliation(s)
- Valentina Biagioli
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Elena Ponticelli
- Department of Oncology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Marco Clari
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Sica
- Institute of Haematology, Cattolica del Sacro Cuore University, Rome, Italy
| | - Marco Cioce
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | - Francesca Bonifazi
- Institute of Hematology and Medical Oncology "Seràgnoli", S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit, Federico II University Hospital, Naples, Italy
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17
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Andersson M, Fridh I, Lindahl B. Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments. Nurs Inq 2019; 26:e12301. [DOI: 10.1111/nin.12301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Morgan Andersson
- Department of Architecture and Civil Engineering Chalmers University of Technology Gothenburg Sweden
| | - Isabell Fridh
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
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18
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Anåker A, von Koch L, Heylighen A, Elf M. "It's Lonely": Patients' Experiences of the Physical Environment at a Newly Built Stroke Unit. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2019; 12:141-152. [PMID: 30336696 PMCID: PMC6637812 DOI: 10.1177/1937586718806696] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to explore patients' experiences of the physical environment at a newly built stroke unit. BACKGROUND For a person who survives a stroke, life can change dramatically. The physical environment is essential for patients' health and well-being. To reduce infections, a majority of new healthcare facilities mainly have a single-room design. However, in the context of stroke care, knowledge of how patients experience the physical environment, particularly their experience of a single-room design, is scarce. METHOD This study used a qualitative design. Patients (n = 16) participated in semistructured individual interviews. Data were collected in December 2015 and February 2017 in Sweden; interviews were transcribed verbatim and analyzed using content analysis. RESULTS Two main themes were identified: (i) incongruence exists between community and privacy and (ii) connectedness with the outside world provides distraction and a sense of normality. In single rooms, social support was absent and a sense of loneliness was expressed. Patients were positively distracted when they looked at nature or activities that went on outside their windows. CONCLUSIONS The physical environment is significant for patients with stroke. This study highlights potential areas for architectural improvements in stroke units, primarily around designing communal areas with meeting places and providing opportunities to participate in the world outside the unit. A future challenge is to design stroke units that support both community and privacy. Exploring patients' experiences could be a starting point when designing new healthcare environments and inform evidence-based design.
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Affiliation(s)
- Anna Anåker
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Ann Heylighen
- Department of Architecture, Research[x]Design, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Marie Elf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Department of Architecture and Civil Engineering, The School of Architecture, Chalmers University of Technology, Gothenburg, Sweden
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19
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Boylan MR, Slover JD, Kelly J, Hutzler LH, Bosco JA. Are HCAHPS Scores Higher for Private vs Double-Occupancy Inpatient Rooms in Total Joint Arthroplasty Patients? J Arthroplasty 2019; 34:408-411. [PMID: 30578151 DOI: 10.1016/j.arth.2018.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/19/2018] [Accepted: 11/22/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Private hospital rooms have a number of potential advantages compared to shared rooms, including reduced noise and increased control over the hospital environment. However, the association of room type with patient experience metrics in total joint arthroplasty (TJA) patients is currently unclear. METHODS For private versus shared rooms, we compared our institutional Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores in patients who underwent primary TJA over a 2-year period. Regression model odds ratios (ORs) were adjusted for surgeon, date of surgery, and length of stay. RESULTS Patients in private rooms were more likely to report a top-box score for overall hospital rating (85.6% vs 79.4%, OR = 1.53, P = .011), hospital recommendation (89.3% vs 83.0%, OR = 1.78, P = .002), call button help (76.0% vs 68.7%, OR = 1.40, P = .028), and quietness (70.4% vs 59.0%, OR = 1.78, P < .001). There were no significant differences on surgeon metrics including listening (P = .225), explanations (P = .066), or treatment with courtesy and respect (P = .396). CONCLUSION For patients undergoing TJA, private hospital rooms were associated with superior performance on patient experience metrics. This association appears specific for global and hospital-related metrics, with little impact on surgeon evaluations. With the utilization of HCAHPS data in value-based initiatives, placement of TJA patients in private rooms may lead to increased reimbursement and higher hospital rankings. LEVEL OF EVIDENCE Level III, retrospective cohort.
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Affiliation(s)
- Matthew R Boylan
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York
| | - James D Slover
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York
| | - Joan Kelly
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York
| | - Lorraine H Hutzler
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York
| | - Joseph A Bosco
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York
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20
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Development and initial validation of a questionnaire to assess patients’ perception of protective isolation following haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2018; 28:e12955. [DOI: 10.1111/ecc.12955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/22/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Valentina Biagioli
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | - Michela Piredda
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | | | - Francesco Marchesi
- Haematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit; Fondazione Policlinico Tor Vergata; Rome Italy
| | | | - Elena Ponticelli
- Department of Oncology; Città della Salute e della Scienza University Hospital; Turin Italy
| | - Marco Clari
- Department of Quality and Safety of Care; Città della Salute e della Scienza University Hospital; Turin Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre; Fondazione IRCCS Ca' Granda; Milan Italy
| | - Simona Sica
- Institute of Haematology; Cattolica del Sacro Cuore University; Rome Italy
| | - Marco Cioce
- Haematology Unit; Fondazione Policlinico Universitario Agostino Gemelli; Rome Italy
| | | | - Francesca Bonifazi
- Alma Mater Studiorum University of Bologna; Bologna Italy
- Institute of Hematology and Medical Oncology ‘Seràgnoli’; S. Orsola-Malpighi University Hospital; Bologna Italy
| | - Rosaria Alvaro
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit; Federico II University Hospital; Naples Italy
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21
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Anåker A, von Koch L, Sjöstrand C, Heylighen A, Elf M. The physical environment and patients' activities and care: A comparative case study at three newly built stroke units. J Adv Nurs 2018; 74:1919-1931. [PMID: 29676493 DOI: 10.1111/jan.13690] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Abstract
AIM To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units. BACKGROUND Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce. DESIGN This work is a comparative descriptive case study. METHOD Patients (N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 - December 2015. RESULTS The units differed in the patients' levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single-room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients' activities and care. CONCLUSIONS Patients' activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment.
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Affiliation(s)
- Anna Anåker
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neurovascular Diseases, Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Sjöstrand
- Department of Neurovascular Diseases, Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ann Heylighen
- Department of Architecture, Research[x]Design, KU Leuven, Leuven, Belgium
| | - Marie Elf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Department of Architecture and Civil Engineering, The School of Architecture, Chalmers University of Technology, Gothenburg, Sweden
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22
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Mackie BR, Marshall A, Mitchell M. Acute care nurses' views on family participation and collaboration in fundamental care. J Clin Nurs 2018; 27:2346-2359. [PMID: 29171145 DOI: 10.1111/jocn.14185] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To understand the beliefs, attitudes and perceptions of nurses regarding family participation and collaboration in the care of their hospitalized adult relative. BACKGROUND Family participation in care is known to enhance the quality of patient care. Nurses are uniquely placed to support such participation, including the delivery of fundamental care. However, nurses' attitudes and beliefs may help or hinder participation. DESIGN A mixed methods approach with an exploratory sequential design was used. SETTING A regional referral hospital in Australia. PARTICIPANTS Nurses were eligible to participate in the study if they were permanent staff of the hospital, and who in their day-to-day work had direct contact with adult patients and their families on acute care wards. METHODS Observer-as-participant observation data and semi-structured interviews were undertaken. 30 hr of observational data were gathered, and 14 nurses were interviewed. Data collection occurred between September and December 2016. Following separate analysis, data were triangulated. RESULTS Analysis uncovered two contrasting categories: (i) enacting family participation (four themes); and (ii) hindering family participation (five themes). CONCLUSION The findings of our study demonstrated that the practices of nurses do not always align with healthcare policies, and strategies to support nurses to enact patient- and family-centred practices are needed. RELEVANCE TO CLINICAL PRACTICE Nurses can use these findings to make informed evidence-based changes to the way they practice and communicate with families to ensure fundamental care is delivered.
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Affiliation(s)
- Benjamin R Mackie
- School of Nursing, Midwifery and Paramedicine, Menzies Health Institute Queensland, University of the Sunshine Coast, Sippy Downs, Qld, Australia.,Griffith University, Brisbane, Qld, Australia
| | - Andrea Marshall
- Menzies Health Institute Queensland and Gold Coast Health, Southport, Qld, Australia
| | - Marion Mitchell
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Qld, Australia
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23
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Chung S, Youn S, Park B, Lee S, Kim C. A Sleep Education and Hypnotics Reduction Program for Hospitalized Patients at a General Hospital. Psychiatry Investig 2018; 15:78-83. [PMID: 29422929 PMCID: PMC5795035 DOI: 10.4306/pi.2018.15.1.78] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 02/22/2017] [Accepted: 04/16/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We applied a program of sleep education and hypnotics reduction for inpatients (the i-sleep program). This study explored whether the i-sleep program is effective for reducing the prescription rate of sleeping pills to inpatients in a general hospital. METHODS We estimated the proportion of inpatients prescribed hypnotics at admission to and discharge from the hospital, excluding pediatric care units, before (2014) and after (2015) the program. In addition, we estimated the proportion of inpatients prescribed sleeping pills among all inpatients on the first day of each month of 2014 and 2015. RESULTS The proportion of inpatients prescribed hypnotics as discharge medication among inpatients who had been prescribed them at the time of admission decreased significantly, from 57.0% to 46.8%, after the i-sleep program (RR=0.82, 95% CI: 0.79-0.86). The proportion of inpatients newly prescribed sleeping pills after admission to the hospital did not significantly decrease (1.97% to 2.00%; RR=1.01, 95% CI: 0.96-1.07). The mean prescription rate of sleeping pills per day was 8.18% in 2014 and 7.78% in 2015. CONCLUSION The i-sleep program reduced the proportion of inpatients who continued to take sleeping pills from admission until discharge, although it did't reduce the prescription rate per day.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soyoung Youn
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Boram Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Suyeon Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Changnam Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Iyendo TO. Sound as a supportive design intervention for improving health care experience in the clinical ecosystem: A qualitative study. Complement Ther Clin Pract 2017; 29:58-96. [PMID: 29122270 DOI: 10.1016/j.ctcp.2017.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/17/2017] [Accepted: 08/22/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Most prior hospital noise research usually deals with sound in its noise facet and is based merely on sound level abatement, rather than as an informative or orientational element. This paper stimulates scientific research into the effect of sound interventions on physical and mental health care in the clinical environment. METHODS Data sources comprised relevant World Health Organization guidelines and the results of a literature search of ISI Web of Science, ProQuest Central, MEDLINE, PubMed, Scopus, JSTOR and Google Scholar. RESULTS Noise induces stress and impedes the recovery process. Pleasant natural sound intervention which includes singing birds, gentle wind and ocean waves, revealed benefits that contribute to perceived restoration of attention and stress recovery in patients and staff. CONCLUSIONS Clinicians should consider pleasant natural sounds perception as a low-risk non-pharmacological and unobtrusive intervention that should be implemented in their routine care for speedier recovery of patients undergoing medical procedures.
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25
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Anåker A, von Koch L, Sjöstrand C, Bernhardt J, Elf M. A comparative study of patients' activities and interactions in a stroke unit before and after reconstruction-The significance of the built environment. PLoS One 2017; 12:e0177477. [PMID: 28727727 PMCID: PMC5519004 DOI: 10.1371/journal.pone.0177477] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023] Open
Abstract
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients' lounge was located in a far corner of the unit with a smaller entrance than the patients' lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients' activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.
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Affiliation(s)
- Anna Anåker
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Dalarna University, School of Education, Health and Social Studies, Falun, Sweden
| | - Lena von Koch
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Karolinska University Hospital, Department of Neurology, Stockholm, Sweden
| | - Christina Sjöstrand
- Karolinska University Hospital, Department of Neurology, Stockholm, Sweden
- Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden
| | - Julie Bernhardt
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Marie Elf
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
- Dalarna University, School of Education, Health and Social Studies, Falun, Sweden
- Chalmers University of Technology, School of Architecture, Gothenburg, Sweden
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Chung S, Youn S. The Optimizing Strategies for Prescription of Sleeping Pills for Insomnia Patients. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Biagioli V, Piredda M, Mauroni MR, Alvaro R, De Marinis MG. The lived experience of patients in protective isolation during their hospital stay for allogeneic haematopoietic stem cell transplantation. Eur J Oncol Nurs 2016; 24:79-86. [DOI: 10.1016/j.ejon.2016.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/17/2016] [Accepted: 09/01/2016] [Indexed: 12/15/2022]
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Youn S, Hann CWC, Park B, Lee S, Kim C, Yi K, Chung S. The Sleeping Pill Prescription Rate for Inpatients at a General Hospital. SLEEP MEDICINE RESEARCH 2016. [DOI: 10.17241/smr.2016.00045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Loneliness is a painful experience for patients. To clarity the concept of patient loneliness, this study undertook an evolutionary concept analysis based on a literature search in the main relevant databases. We identified 7 dimensions in adult patients' experiences of loneliness. These dimensions of loneliness have different causes and theoretical foundations, which have different implications for patient care. Patients may be lonely in their different relationships, including those with nurses and doctors. Loneliness in relation to health care professionals is a new application of the concept of loneliness that provides a useful starting point for future research.
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