Dignified care for older people: Mixed methods evaluation of the impact of the hospital environment - single rooms or multi-bedded wards

Bevan, Vicki; Edwards, Chris; Woodhouse, Ken; Singh, Inderpal

doi:10.1097/01.hxr.0000508390.33501.be

Cited by 4 publications

(29 citation statements)

References 18 publications

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“…Indeed, only two studies showed increased infections in shared accommodation. (26,83) Nevertheless, in one study patients(77) preferred single rooms for infection prevention. In a study of more than 1 million patients of all ages across 2018 hospitals in the USA, O’Neill and colleagues(95) found that single rooms were significantly associated with reductions in central-line-associated bloodstream infections.…”

Section: Resultsmentioning

confidence: 97%

“…Routine care was assessed in adults in 10 studies(8,69,75,77,79,80,84,87,89,93) and eight involved mixed age populations and care levels that stated or were assumed to include adults and routine care. (26,35,36,67,71,72,88,95) Hospital-acquired infection rates were shown to be reduced in single rooms in six studies.…”

Section: Resultsmentioning

confidence: 99%

“…Forty-eight publications, including six evidence syntheses, reported on privacy (see supplementary table 9). (8,9,19,26,28,30–34,36,38–42,44,47,51,58,59,68,77,86,98,99,101–122) Eighteen were before-and-after studies, 23 were contemporaneous studies, one used mixed designs, and six were evidence syntheses. Nine had low quality scores but 19 had high quality scores.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight studies assessed privacy among adults receiving routine care,(8,26,28,30,31,33,34,36,39,41,42,58,77,99,101,102,105,108,109,112–119) with seven of these reporting statistical analyses. (26,28,30,36,41,42,105,114) Key aspects of privacy in single rooms were improved confidentiality when discussing personal information, use of private bathrooms, and privacy during early post-partum care (e.g., assistance with feeding).…”

Section: Resultsmentioning

confidence: 99%

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The 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 narrative synthesis systematic literature review

Bertuzzi¹,

Martin

Clarke

et al. 2022

Preprint

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Objectives: Assess the impact of single rooms versus multioccupancy accommodation on inpatient health-care outcomes and processes. Design: Systematic review. Setting: Hospitals and secondary care units. Participants: Inpatients receiving routine, emergency, high-dependency, or intensive care with a named type of hospital accommodation. Main outcome measures: Qualitative synthesis of findings. Results: Of 4,861 citations initially identified, 215 were deemed suitable for full-text review, of which 145 were judged to be relevant to this review. Five main method types were reported: 60 before-and-after comparisons, 75 contemporaneous comparisons, 18 qualitative studies of accommodation preferences, 10 evidence syntheses. 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, but no clearly consistent conclusions could be drawn about overall benefits of single rooms versus shared accommodation (multioccupancy rooms, bays, or wards). 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, men, older adults, children, and adolescents were more likely to prefer shared accommodation to avoid loneliness. While shared accommodation seemed to be the most cost-effective approach for construction, 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.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The 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 narrative synthesis systematic literature review

Bertuzzi¹,

Martin

Clarke

et al. 2022

Preprint

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show abstract

“…Dementia-friendly environments have been proposed to promote patient well-being, mobility, independence, and meaningful interaction between other patients and staff/family; however, there has been little emphasis on single room design [4]. Single room environments do provide enhanced, dignified care [5,6,7,8], but at the expense of higher perceived loneliness [9]. Hospitalisation is associated with higher adverse outcomes for those with dementia [3,10,11] and people with dementia are at a 2.5 times higher risk of inpatient falls [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of Hospital Design on Acutely Unwell Patients with Dementia

2017

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Abstract:Increasing emphasis on patient privacy and satisfaction has seen more 100% single-room hospitals opened across the UK. Few studies have addressed the impact of these new hospital designs (single rooms) on clinical outcomes specifically for acutely unwell frail patients with dementia. The objective of this study was to profile and compare the clinical outcomes of acutely unwell patients with dementia admitted to two different hospital environments. This prospective observation study was conducted for 100 dementia patients admitted at Ysbyty Ystrad Fawr (hospital with 100% single rooms) and Royal Gwent Hospital (traditional multi-bed wards) under the same University Health Board. The length of stay (LoS) was significantly longer for patients admitted to single rooms. The clinical profile of the patients was similar in both hospitals and has no association with LoS. There was no significant difference in terms of incidence of inpatient falls, fall-related injury, discharge to a new care home, 30-day readmission, or mortality. The single room environment appears to influence LoS, as previously reported; however, following the introduction of quality improvement initiatives to prevent inpatient falls, single rooms do not appear to be associated with higher inpatient fall incidence. We propose more research to understand the relationship between single rooms and LoS.

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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

Bertuzzi¹,

Martin²,

Clarke³

et al. 2023

BMJ Open

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ObjectivesAssess the impact of single rooms versus multioccupancy accommodation on inpatient healthcare outcomes and processes.DesignSystematic review and narrative synthesis.Data sourcesMedline, Embase, Google Scholar and the National Institute for Health and Care Excellence website up to 17 February 2022.Eligibility criteriaEligible 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 synthesisData were extracted and synthesised narratively, according to the methods of Campbellet al.ResultsOf 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.ConclusionsThe 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 numberCRD42022311689.

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Dignified care for older people: Mixed methods evaluation of the impact of the hospital environment - single rooms or multi-bedded wards

Cited by 4 publications

References 18 publications

The 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 narrative synthesis systematic literature review

The 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 narrative synthesis systematic literature review

Impact of Hospital Design on Acutely Unwell Patients with Dementia

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

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