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.0000511879.99010.5d

Cited by 6 publications

(33 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: Prevention Of Infectionmentioning

confidence: 99%

“…Fifty-one publications, six of which were evidence syntheses, reported patients' satisfaction with care (see Figure 4 and supplementary Table 12). (8,12,19,25,27,28,30,32,33,35,36,(38)(39)(40)42,44,49,50,57,58,60,62,74,77,86,99,101,103,105,(107)(108)(109)(111)(112)(113)(114)(116)(117)(118)(119)121,125,128,129,131,133,136,(142)…”

Section: Satisfaction With Carementioning

confidence: 99%

“…(33,86,(116)(117)(118)129,133) Generally they preferred interaction with other patients, and in two reports they stated that they found the shared accommodation more secure and safe. (117,118) Specific reasons given for preferring single rooms were privacy, (30,58,77,99,112,131,133) comfort/environment, (27,42,101,108,143), level of care and information, effect on recovery, (32,36,42,101,113,114,136) and safety. (30,35) Intensive care…”

Section: Routine Carementioning

confidence: 99%

“…Although the impact of single rooms on healthcare staff was not the focus of this review, 14 of the included publications reported the views of HCPs as well as patient-reported outcomes that we used to explore monitoring of patients (see Figure 4 and supplementary Table 13). (11,13,17,21,28,30,47,68,77,106,108,112,114,133) Four were before-and-after studies, eight were contemporaneous studies, one used mixed study designs, and one was an evidence synthesis.…”

Section: Patient Monitoring and Safeguardingmentioning

confidence: 99%

“…Of 20 studies assessing routine care, 18 concerned adults and the elderly. (7,8,22,26,27,35,36,41,63,65,69,77,112,113,134,143,147,149) Among these, eight found that length of stay was shorter in single rooms, (7,16,26,27,41,65,112,147,149) but in the study by Maben et al(26) this was true only for an older people's ward and not for a medical assessment unit, and in that by Lawson and Phiri,(27) while it was true for non-surgical orthopaedic patients and psychiatric patients, no difference was seen for surgical orthopaedic patients. One study found that length of stay was shorter in shared accommodation among older patients with dementia, overall and among those who had experienced inpatient falls.…”

Section: Routine Carementioning

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: Prevention Of Infectionmentioning

confidence: 99%

Section: Satisfaction With Carementioning

confidence: 99%

Section: Routine Carementioning

confidence: 99%

Section: Patient Monitoring and Safeguardingmentioning

confidence: 99%

Section: Routine Carementioning

confidence: 99%

See 3 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

Can the physical environment itself influence neurological patient activity?

Shannon

Elf

Чурилов

et al. 2018

Disability and Rehabilitation

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Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.

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Bringing the single versus multi-patient room debate to vulnerable patient populations: a systematic review of the impact of room types on hospitalized older people and people with neurological disorders

Shannon

Lipson-Smith

Elf

et al. 2018

Intelligent Buildings International

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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 6 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

Can the physical environment itself influence neurological patient activity?

Bringing the single versus multi-patient room debate to vulnerable patient populations: a systematic review of the impact of room types on hospitalized older people and people with neurological disorders

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