The experience of person‐centred practice in a 100% single‐room environment in acute care settings—A narrative literature review

Abstract

Aims and objectives To review published research into the staff and adult patient experience of person‐centred practice in a 100% single‐room environment in acute care. Background There has been a significant move towards the 100% single‐room environment within healthcare systems. Furthermore, there has been a global move for developing person‐centred practice in a range of healthcare settings. Some studies have linked the role of the physical environment to patient outcomes and improved patient satisfaction; however, these are limited. Overall, there is little evidence in the international literature of the experience of care in single rooms in adult, acute care settings. Design A narrative description was developed using the major constructs of the person‐centred practice framework (PcPF). The PRISMA checklist provided additional rigour. Method Problems, Exposure, Outcomes (PEO) refined the search terms to: person‐centred, adult acute care, single room, staff experience and patient experience. CINAHL, Medline Ovid, Psycinfo, Embase, Web of Science and Scopus were searched for full‐text English language papers of empirical studies published between 2012–2017. PRISMA illustrated final paper determination, and the CASP/EPHPP frameworks were used for a critical appraisal of the 12 selected papers. Results The literature recognises the increasing complexity of health care in the acute care environment globally. The international literature available identifies staffs’ desire to practise person‐centredness, but much of the evidence is focused on care delivery. The impact of the single‐room environment on person‐centred practice links mainly to the constructs of the care environment and person‐centred processes within the PcPF. Conclusion This review focuses on empirical studies relating to person‐centred practice in the single‐room environment published in the last 5 years. While there is a significant body of work relating to person‐centredness and the delivery of person‐centred practice, and the impact of the environment on care delivery, there appears to limited evidence linking person‐centred practice, staff and patient experience and the single‐room environment. Relevance to clinical practice By understanding the context in which care is delivered, multiprofessional teams can explore how the delivery of person‐centred practice may be influenced by the physical environment and what changes to culture, systems and processes may be required to enhance the experience of care for patients and the delivery of care for staff.

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

“…There were no significant differences in cognitive development, length of admission, growth, complications of ICU admission and mortality. Four other systematic reviews3 40 154 155 and two scoping reviews39 156 assessed outcomes in a more general hospital population and generally found mixed evidence of benefits from single rooms, with each review identifying between 12 and 44 studies that reported advantages, disadvantages and neutral findings for most clinical outcomes, but a more positive result for patient privacy and satisfaction.…”

‘Owning the space’—person‐centred practice in a 100% single‐room acute‐care environment: an ethnographic study

“…A literature review by Kelly et al, (2019) found that key elements such as communication, authentic engagement and the physical environment were recognised as important. This review also found that while there was increasing evidence of the impact of culture and care processes on patient and staff experience, generally the relationship between the experiences of the two groups was not explored.…”

“…The interviews were audiorecorded and lasted on average 30 minutes. An interview guide (Figure 4) was created based on the findings of a literature review (Kelly et al, 2019) and on person-centred outcomes from the Person-centred Practice Framework (McCormack & McCance, 2017). Questions were open-ended with prompts where required.…”

“…While the impact of the environment on care delivery and patient experience has been documented (O’Halloran et al, 2011), there is little evidence relating to single rooms in adult acute‐care settings. A literature review by Kelly et al, (2019) found that key elements such as communication, authentic engagement and the physical environment were recognised as important. This review also found that while there was increasing evidence of the impact of culture and care processes on patient and staff experience, generally the relationship between the experiences of the two groups was not explored.…”