bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a Usability Evaluation Tool to Assess the Patient Room Bathroom
Authors: Fink Nicole , Pak Richard , Battisto Dina 
Published: February 2015

Objective: The goal of this project was to create an easy-to-administer and inexpensive tool that can help identify usability issues in a patient room bathroom during the design process so improvements can be made before the final product is constructed and put into operation. Background: The bathroom is an essential part of any hospital patient room, yet it is associated with nurse dissatisfaction and patient falls. Minimal literature has examined whether the physical structure of various elements within the bathroom are efficient, safe, and satisfactory for the majority of users. Furthermore, there is a paucity of human factor guidelines for architects and designers to follow to ensure the usability of bathroom space for a wide variety of users. Methods: The authors adapted a common technique used in software usability: the heuristic evaluation. A heuristic evaluation is a “discount” evaluation method used to quickly and efficiently evaluate the usability flaws of user interfaces. Three methods were used to provide input for the heuristic evaluation: (1) Review of existing heuristic evaluations, reported hospital bathroom problems, and safety checklists; (2) Interviews with nurses and nursing assistants; and (3) Focus groups with nurses. Analysis of the interview and focus group transcripts enabled the categorization of the types of problems nurses encounter in the patient room bathroom. These categories served as the basis for the heuristics in the heuristic evaluation tool. Results: Eleven major heuristics (or categories of problems in the bathroom) were identified initially. The authors then went through several iterations of designing and refining the heuristic evaluation to form parsimonious categories and subcategories. Each of the eventual six major heuristic categories contains a general description as well as specific exemplar questions. These detailed subcategories enable an evaluator to easily gauge whether a bathroom adheres to the guideline, to write any comments about a particular issue, and to rate the severity of any problems. Conclusions: The bathroom heuristic evaluation was designed to be a discount usability evaluation tool. It can be used to assess a hospital bathroom during the design process for major usability issues, enabling necessary alterations before a final product is developed.
The Effects of Nature Images on Pain in a Simulated Hospital Patient Room
Authors: Vincent Ellen , Battisto Dina , Grimes Larry , McCubbin James 
Published: February 2015

Background: Views of nature have been reported to relieve stress and pain, making nature an ideal medium for use in healthcare settings. In hospitals whose design does not allow for a view of nature, virtual and surrogate views of nature may be viable therapeutic options. Objective: This study tests the effects of specific nature images, as defined by Appleton's prospect refuge theory of landscape preference, on participants experiencing pain. The hypotheses were: (1) Nature views are variable in their impact on specific psychological and physiological health status indicators; and (2) Prospect and refuge nature scenes are more therapeutic than hazard nature scenes. The research question was (1) Which nature image categories are most therapeutic as evidenced by reduced pain and positive mood? Methods: An experiment using mixed methods assessed the effects of four different nature scenes on physiological (blood pressure, heart rate) and psychological (mood) responses when a person was subjected to a pain stressor. Four groups were subjected to a specific nature image category of prospect, refuge, hazard, or mixed prospect and refuge; the fifth group viewed no image. The Short-Form McGill Pain Questionnaire and the Profile of Mood States survey instruments were used to assess pain and mood, respectively. Continuous physiological readings of heart rate and blood pressure were collected. Pain was induced through a cold pressor task, which required participants to immerse their nondominant hand in ice water for up to 120 seconds. Results: The mixed prospect and refuge image treatment showed significantly lower sensory pain responses, and the no-image treatment indicated significantly higher affective pain perception responses. The hazard image treatment had significantly lower diastolic blood pressure readings during the pain treatment, but it also had significantly high total mood disturbance. Conclusions: Although there was no clear “most” therapeutic image, the mixed prospect and refuge image showed significant potential to reduce sensory pain. The hazard image was the most effective at distracting participants from pain, but it should not be considered a positive distraction because it also received the highest mood disturbance scores of all groups.
The Effects of Presence and Influence in Nature Images in a Simulated Hospital Patient Room
Authors: Vincent Ellen , Battisto Dina , Grimes Larry 
Published: February 2015

Background: Nature images are frequently used for therapeutic purposes in hospital settings. Nature images may distract people from pain and promote psychological and physiological well-being, yet limited research is available to guide the selection process of nature images. Objective: The hypothesis is that higher degrees of presence and/or influence in the still photograph make it more effective at holding the viewer's attention, which therefore may distract the viewer from pain, and therefore be considered therapeutic. Research questions include: (1) Is there a significant difference in the level of perceived presence among the selected images? (2) Is there a significant difference in the level of perceived influence among the selected images? (3) Is there a correlation between levels of presence and levels of influence? Methods: 109 college students were randomly assigned to one of four different image categories defined by Appleton's prospect refuge theory of landscape preference. Categories included prospect, refuge, hazard, and mixed prospect and refuge. A control group was also included. Each investigation was divided into five periods: prereporting, rest, a pain stressor (hand in ice water for up to 120 seconds), recovery, and postreporting. Physiological readings (vital signs) were measured repeatedly using a Dinamap automatic vital sign tracking machine. Psychological responses (mood) to the image were collected using a reliable instrument, the Profile of Mood States. Results: No significant statistical difference in levels of presence was found among the four image categories. However, levels of influence differed and the hazard nature image category had significantly higher influence ratings and lower diastolic blood pressure readings during the pain treatment. A correlation ( r = .62) between presence and influence was identified; as one rose, so did the other. Mood state was significantly low for the hazard nature image after the pain stressor experience. Conclusions: Though the hazard image caused distraction from pain, it is nontherapeutic because of the low mood ratings it received. These preliminary findings contribute methodology to the research field and stimulate interest for additional research into the visual effects of nature images on pain.
Developing the Birth Unit Design Spatial Evaluation Tool (BUDSET) in Australia: A Qualitative Study
Authors: Foureur Maralyn J. , Epi Grad Dip Clin , Leap Nicky , Davis Deborah L. , Forbes Ian F. , Homer Caroline S. E. 
Published: February 2015

Objective: To develop a tool known as the Birth Unit Design Spatial Evaluation Tool (BUDSET), to assess the optimality of birth unit design. Background: The space provided for childbirth influences the physiology of women in labor. Optimal birth spaces are likely to enable women to have physiologically normal labor and birth. The measurement of an optimal birth space is currently impossible, because limited tools are available. Research into optimal birth unit design is also limited. Methods: The BUDSET was developed using a qualitative study. Data collection included an extensive literature review, interviews with key informants (architects, midwife clinicians, and researchers) and an expert panel. A Pattern Language format was used to synthesize the literature and data obtained from the key informants. Results: The BUDSET is based on 18 design principles and is divided into four domains (Fear Cascade; Facility; Aesthetics; Support) with three to eight assessable items in each. Conclusion: Birth units must be designed so that they facilitate and support the physiology of normal childbirth. The BUDSET may provide a way to assess the optimality of birth units and determine which domain areas may need to be improved.
Application of Space Syntax Theory in the Study of Medical-Surgical Nursing Units in Urban Hospitals
Authors: Trzpuc Stefnee J. , Martin Caren S. 
Published: February 2015

Additional research is needed to explore how the design of urban, medical-surgical nursing units influences communication patterns, perceptions of social support, and overall job satisfaction for nurses. Space syntax theory has typically been used to study communication in office environments; more recently, it has been applied to the study of healthcare environments. The purpose of this study was to explore the applicability of space syntax theory as a theoretical framework for studying nurses' communication in medical-surgical nursing units in urban hospitals. Background: The nursing profession is rapidly changing, and nurses' work is psychologically and physically intense. At the same time, nurses are responsible for patient safety, optimal care delivery, and patient outcomes ( Bureau of Labor Statistics, 2009 ; Clarke, 2007 ; Clarke & Donaldson, 2008 ; Institute of Medicine, 2000 ; Institute of Medicine, 2004 ). Nurses are central to the delivery of care and act as a conduit for communication among members of the patient care team. Some of the design characteristics that create a more appealing environment for patients, such as views of nature and single-patient rooms, may not be fully understood as they relate to nurses' tasks and responsibilities, and they could be detrimental to nursing communication. Methods: This study analyzed three medical-surgical nursing unit floor plans using two constructs of space syntax theory, and it verified analysis through three semi-structured interviews with end users. Results: The use of space syntax theory for analyzing medical-surgical nursing unit floor plans is complex. Findings indicated that nurses' perceptions of two constructs of space syntax theory, visibility and accessibility, did not consistently match the anticipated benefits of the floor plan designs. Conclusions: Understanding how and when nurses communicate with each other could help designers of healthcare spaces create more effective environments that support nurses' work and personal health and welfare. The findings of this study suggest that further exploration is needed to confirm this theory's application to healthcare environments.
Making the Case for Evidence-Based Design in Healthcare: A Descriptive Case Study of Organizational Decision Making
Authors: Shoemaker Lorie K. , Kazley Abby Swanson , White Andrea 
Published: February 2015

Objective: The aim of this study was to describe the organizational decision-making process used in the selection of evidence-based design (EBD) concepts, the criteria used to make these decisions, and the extent to which leadership style may have influenced the decision-making process. Five research questions were formulated to frame the direction of this study, including: (1) How did healthcare leaders learn of innovations in design? (2) How did healthcare leaders make decisions in the selection of healthcare design concepts? (3) What criteria did healthcare leaders use in the decision-making process? (4) How did healthcare leaders consider input from the staff in design decisions? and (5) To what extent did the leadership style of administrators affect the outcomes of the decision-making process? Background: Current issues affecting healthcare in the community led the principal investigator's organization to undertake an ambitious facilities expansion project. As part of its planning process, the organization learned of EBD principles that seemingly had a positive impact on patient care and safety and staff working conditions. Although promising, a paucity of empirical research addressed the cost/benefit of incorporating many EBD concepts into one hospital setting, and there was no research that articulated the organizational decision-making process used by healthcare administrators when considering the use of EBD in expansion projects. Methods: A mixed-method, descriptive, qualitative, single-case study and quantitative design were used to address the five research questions. The Systems Research Organizing Model provided the theoretical framework. A variety of data collection methods was used, including interviews of key respondents, the review of documentary evidence, and the Multifactor Leadership Questionnaire. Results: A participatory process was used throughout the design decision phases, involving staff at all levels of the organization. The Internet and architects facilitated learning about EBD. Financial considerations were a factor in decision making. The prevalence of the transformational leadership style among the organization's administrators exceeded the U.S. mean.
Testing the Birth Unit Design Spatial Evaluation Tool (BUDSET) in Australia: A Pilot Study
Authors: Foureur Maralyn J. , Leap Nicky , Davis Deborah L. , Forbes Ian F. , Homer Caroline S. E. 
Published: February 2015

Objective: To pilot test the Birth Unit Design Spatial Evaluation Tool (BUDSET) in an Australian maternity care setting to determine whether such an instrument can measure the optimality of different birth settings. Background: Optimally designed spaces to give birth are likely to influence a woman's ability to experience physiologically normal labor and birth. This is important in the current industrialized environment, where increased caesarean section rates are causing concerns. The measurement of an optimal birth space is currently impossible, because there are limited tools available. Methods: A quantitative study was undertaken to pilot test the discriminant ability of the BUDSET in eight maternity units in New South Wales, Australia. Five auditors trained in the use of the BUDSET assessed the birth units using the BUDSET, which is based on 18 design principles and is divided into four domains (Fear Cascade, Facility, Aesthetics, and Support) with three to eight assessable items in each. Data were independently collected in eight birth units. Values for each of the domains were aggregated to provide an overall Optimality Score for each birth unit. Results: A range of Optimality Scores was derived for each of the birth units (from 51 to 77 out of a possible 100 points). The BUDSET identified units with low-scoring domains. Essentially these were older units and conventional labor ward settings. Conclusion: The BUDSET provides a way to assess the optimality of birth units and determine which domain areas may need improvement. There is potential for improvements to existing birth spaces, and considerable improvement can be made with simple low-cost modifications. Further research is needed to validate the tool.
Estimates of Crowding in Long-Term Care: Comparing Two Approaches
Authors: Algase Donna L. , Antonakos Cathy , Beattie Elizabeth , Beel-Bates Cynthia , Song Jun-Ah 
Published: February 2015

Objective: Because studies of crowding in long-term care settings are lacking, the authors sought to: (1) generate initial estimates of crowding in nursing homes and assisted living facilities; and (2) evaluate two operational approaches to its measurement. Background: Reactions to density and proximity are complex. Greater density intensifies people's reaction to a situation in the direction (positive or negative) that they would react if the situation were to occur under less dense conditions. People with dementia are especially reactive to the environment. Methods: Using a cross-sectional correlational design in nursing homes and assisted living facilities involving 185 participants, multiple observations ( N = 6,455) of crowding and other environmental variables were made. Crowding, location, and sound were measured three times per observation; ambiance was measured once. Data analyses consisted of descriptive statistics, t-tests, and one-way analysis of variance. Results: Crowding estimates were higher for nursing homes and in dining and activity rooms. Crowding also varied across settings and locations by time of day. Overall, the interaction of location and time affected crowding significantly ( N = 5,559, df [47, 511], F = 105.69, p < .0001); effects were greater within location-by-hour than between location-by-hour, but the effect explained slightly less variance in Long-Term Care Crowding Index (LTC-CI) estimates (47.41%) than location alone. Crowding had small, direct, and highly significant correlations with sound and with the engaging subscale for ambiance; a similar, though inverse, correlation was seen with the soothing subscale for ambiance. Conclusions: Crowding fluctuates consistent with routine activities such as meals in long-term care settings. Furthermore, a relationship between crowding and other physical characteristics of the environment was found. The LTC-CI is likely to be more sensitive than simple people counts when seeking to evaluate the effects of crowding on the behavior of elders—particularly those with dementia—in long-term care settings. aging in place.
Toward a “Smart” Nightstand Prototype: An Examination of Nightstand Table Contents and Preferences
Authors: Brooks Johnell O. , Smolentzov Linnea , DeArment Amy , Logan William , Green Keith , Walker Ian , Honchar Julia , Guirl Chris , Beeco Rebekkah , Blakeney Carrie , Boggs Amy , Carroll Carson , Duckworth Kenna , Goller Linda , Ham Sloan , Healy Stan , Heaps Carolyn , Hayden Caroline , Manganelli Joe , Mayweather Lyndsay , Mixon Hillary , Price Koty , Reis Ashley , Yanik Paul 
Published: February 2015

Objective: Two studies were conducted to obtain an understanding of the types of items seniors keep in their nightstands and to understand how users feel about the possibility of “smart” furniture. Background: To enable aging in place and universal design, it is vital to understand the needs of a broad range of aging individuals, especially since there is little research on nightstand usage and design. Methods: Study 1 allowed for the development of a structured inventory of nightstand use today in assisted living and rehabilitation facilities. Study 1 led to Study 2, demonstrating the need to conceptualize new ideas for smart nightstands. Feedback was obtained from intergenerational participants who could discuss their needs and preferences for a smart nightstand. Results: In Study 1, more than 150 items were recorded and categorized into 25 different groups. The authors found that participants utilized the top portion of their nightstand as opposed to the lower sections; most items were found on top of the nightstand or in the top drawer. In Study 2, the authors found that the vast majority of participants are willing to consider the use of a smart nightstand. Participants discussed key functions and design preferences, which included carefully designed storage, the ability to move the nightstand up and down, contemporary design, and interaction through voice activation. Conclusion: Existing nightstands do not meet the needs of current users. This research provides greater understanding of the existing limitations associated with nightstands. Study 2 confirmed that user-centered design and the use of technology can be used to enhance daily living. Smart furniture may play a role in promoting the health and independence of diverse user groups.
Healthful Environments for Hospitalized Infants
Authors: Marshall-Baker Anna 
Published: February 2015

Purpose: Medical and technological advances dominate the design of infant incubators because of their essential role in the survival of critically ill neonates. Yet other important design considerations, such as caregiver interaction, discomfort at bedside, and harmful materials, often are overlooked. The purpose of this paper is to consider the effects of existing incubator designs and to suggest criteria for the next generation of infant incubators. Background: Incubators of the mid-1940s established an industry standard that exists to this day: portholes in an infant chamber positioned over a mechanical system, resting on top of storage cabinets or drawers. This design is unresponsive to many of the infants' needs and significantly influences parent/infant interaction. The physical effects and social barriers that the incubator presents to the health and well-being of infants are compounded by the use of unhealthful substances and materials such as formaldehyde. Collectively, these conditions call for an incubator that not only ameliorates physical and social obstacles, but also uses benign materials. Conclusions: Simple alterations to existing incubator design, such as introducing color and pattern, providing arm rests, and freeing space beneath the infant chamber to accommodate seated caregivers, would encourage more prolonged periods of contact with the infant occupants, thereby improving their behavioral organization and recovery. Replacing harmful materials with alternatives such as formaldehyde-free substrates in the cabinetry also will improve the developmental outcomes of the infant occupants. These types of recommended changes embrace the intent of the incubator to provide a controlled, secure environment while acknowledging that incubators are not merely medical equipment, but the living spaces of their infant occupants.
Lactation Space Design: Supporting Evidence-Based Practice and the Baby-Friendly Hospital Initiative
Authors: Thompson Tammy Smith , Heflin LaShawna 
Published: February 2015

The design of spaces where lactation occurs within a healthcare facility often lacks careful attention to the environmental requirements of breastfeeding. Although numerous studies evoke overwhelming support for lactation initiation in hospitals, few designers may understand the importance of such spaces. Furthermore, many designers may be unaware of the contributions they may make to this initiative. Countless studies that support the philosophy that breast milk is the best nutritional option for babies have been conducted. There are many health and economic advantages of breastfeeding for babies, mothers, and communities. Research suggests that exclusive breastfeeding for the first 6 months of life reduces the rate of illness throughout infancy and beyond, saves lives, and could save billions of dollars in the United States each year. The Baby Friendly Hospital Initiative is a global program established to promote within healthcare facilities the facilitation of breastfeeding infants from birth. Results of this initiative show a significant increase in breastfeeding rates in many countries. The intuitive design response to such favorable research is to enhance the lactation environment, assuming that mothers who feel comfortable in lactation spaces will use them more frequently, which promotes lactation in healthcare facilities. Considering the numerous research-supported advantages of breastfeeding, designers would be prudent to seek and apply knowledge of the environmental needs to the design of lactation spaces. This may be achieved by becoming familiar with lactation procedures to understand the circulation, adjacencies, and spatial requirements of lactation programs. Incorporating this information into the design may allow the development of ideal spaces that facilitate lactation.