bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lessons Learned: Clinicians' Post-Occupancy Perspective of Facility Design Involvement
Authors: Reno Kathy , Okland Kathy , Finis Nanne , LaMantia Gina , Call Roger , Cardon Kerrie , Gerber Deborah , Zeigler Janet 
Published: February 2015

OBJECTIVE: The research was conducted to determine clinician knowledge needs for competent involvement with the facility design process as well as to gather lessons learned on building stronger design teams. BACKGROUND: As clinical stakeholders are invited to the healthcare facility design table, the question arises as to the ability of professionally diverse team members to translate each other's comments and ideas accurately. In the past, hospitals were designed by a handful of hospital leaders and architects. More recently, multiple players have become involved throughout the design and construction of new healthcare facilities. Clinical consultants from two international healthcare companies observed that many clinicians were unprepared to effectively translate their needs to the architectural community or to competently utilize architectural tools and documents. METHODS: A qualitative, post-occupancy cross-case study was conducted to understand how clinicians could increase their competencies for successful involvement in facility design. Focus group interviews were held with teams from healthcare facilities occupying their new facility for more than 6 months and less than 2 years. RESULTS: Curriculum topics were validated and additional areas recommended based on the interviews. Open-ended questioins on lessons learned provided several new dimensions to the research. CONCLUSIONS: Although validating the curriculum was the initial intent, the feedback from the focus groups on lessons learned provided rich concepts for practice implications and further research on post-occupancy.
Exploring the Function and Use of Common Spaces in Assisted Living for Older Persons
Authors: Andersson Morgan , Ryd Nina , Malmqvist Inga 
Published: February 2015

OBJECTIVE: This exploratory study examines the function and use of common spaces in assisted living facilities (ALFs) from the residential and workplace perspectives. BACKGROUND: The impact of the physical environment on human activities in healthcare settings has been emphasized in many studies. Few studies, however, have explored the daily use of common spaces and the impact on the usability of ALFs. METHODS: Four explorative methods–observation, group interviews, individual interviews, and questionnaires—were used to investigate 14 ALFs in Sweden. The study involves residents, staff, relatives, architects, and people responsible for planning and construction of eldercare. This research strategy combines quantitative and qualitative methods to enhance the validity of the results. Method triangulation and data triangulation were used and the data were analyzed using Qualitative Content Analysis (QCA). RESULTS: The results show that residents and staff have different objectives for use and these differences affect usability, although explicit conflicts are rare. The residents, staff, and other stakeholders have different views about the demarcation of home and workplace and the role of common spaces as venues for social interaction. CONCLUSIONS: Both the residential and the workplace perspective must be considered when planning assisted living facilities. Otherwise, inherent conflicts between these perspectives will manifest as a result of the physical design. Common spaces have diverse functions that are reflected in their spatial organization. Therefore, ALFs should be designed so the intended function of a specific space is apparent to all users.
The Legacy of Florence Nightingale's Environmental Theory: Nursing Research Focusing on the Impact of Healthcare Environments
Authors: Zborowsky Terri 
Published: February 2015

OBJECTIVE: The purpose of this paper is to explore nursing research that is focused on the impact of healthcare environments and that has resonance with the aspects of Florence Nightingale's environmental theory. BACKGROUND: Nurses have a unique ability to apply their observational skills to understand the role of the designed environment to enable healing in their patients. This affords nurses the opportunity to engage in research studies that have immediate impact on the act of nursing. METHODS: Descriptive statistics were performed on 67 healthcare design-related research articles from 25 nursing journals to discover the topical areas of interest of nursing research today. Data were also analyzed to reveal the research designs, research methods, and research settings. These data are part of an ongoing study. RESULTS: Descriptive statistics reveal that topics and settings most frequently cited are in keeping with the current healthcare foci of patient care quality and safety in acute and intensive care environments. Research designs and methods most frequently cited are in keeping with the early progression of a knowledge area. CONCLUSIONS: A few assertions can be made as a result of this study. First, education is important to continue the knowledge development in this area. Second, multiple method research studies should continue to be considered as important to healthcare research. Finally, bedside nurses are in the best position possible to begin to help us all, through research, understand how the design environment impacts patients during the act of nursing.
The Impact of Windows and Daylight on Acute-Care Nurses' Physiological, Psychological, and Behavioral Health
Authors: Zadeh Rana Sagha , Shepley Mardelle McCuskey , Williams Gary , Chung Susan Sung Eun 
Published: February 2015

OBJECTIVE: To investigate the physiological and psychological effects of windows and daylight on registered nurses. BACKGROUND: To date, evidence has indicated that appropriate environmental lighting with characteristics similar to natural light can improve mood, alertness, and performance. The restorative effects of windows also have been documented. Hospital workspaces generally lack windows and daylight, and the impact of the lack of windows and daylight on healthcare employees' well being has not been thoroughly investigated. METHODS: Data were collected using multiple methods with a quasi-experimental approach (i.e., biological measurements, behavioral mapping, and analysis of archival data) in an acute-care nursing unit with two wards that have similar environmental and organizational conditions, and similar patient populations and acuity, but different availability of windows in the nursing stations. RESULTS: Findings indicated that blood pressure ( p < 0.0001) decreased and body temperature increased ( p = 0.03). Blood oxygen saturation increased ( p = 0.02), but the difference was clinically insignificant. Communication ( p < 0.0001) and laughter ( p = 0.03) both increased, and the subsidiary behavior indicators of sleepiness and deteriorated mood ( p = 0.02) decreased. Heart rate ( p = 0.07), caffeine intake ( p = 0.3), self-reported sleepiness ( p = 0.09), and the frequency of medication errors ( p = 0.14) also decreased, but insignificantly. CONCLUSIONS: The findings support evidence from laboratory and field settings of the benefits of windows and daylight. A possible micro-restorative effect of windows and daylight may result in lowered blood pressure and increased oxygen saturation and a positive effect on circadian rhythms (as suggested by body temperature) and morning sleepiness.
Effects of Environmental Design on Patient Outcome: A Systematic Review
Authors: Laursen Jannie , Danielsen Anne , Rosenberg Jacob 
Published: February 2015

OBJECTIVE: The aim of this systematic review was to assess how inpatients were affected by the built environment design during their hospitalization. BACKGROUND: Over the last decade, the healthcare system has become increasingly aware of how focus on healthcare environment might affect patient satisfaction. The focus on environmental design has become a field with great potential because of its possible impact on cost control while improving quality of care. METHODS: A systematic literature search was conducted to identify current and past studies about evidence-based healthcare design. The following databases were searched: Medline/PubMed, Cinahl, and Embase. Inclusion criteria were randomized clinical trials (RCTs) investigating the effect of built environment design interventions such as music, natural murals, and plants in relation to patients' health outcome. RESULTS: Built environment design aspects such as audio environment and visual environment had a positive influence on patients' health outcomes. Specifically the studies indicated a decrease in patients' anxiety, pain, and stress levels when exposed to certain built environment design interventions. CONCLUSIONS: The built environment, especially specific audio and visual aspects, seems to play an important role in patients' outcomes, making hospitals a better healing environment for patients.
Space Planners' Perception of an Assessment Instrument for Briefs in the Pre-Design Phase of New Healthcare Environments
Authors: Elf Marie , Wijk Helle 
Published: February 2015

OBJECTIVE: The main purpose of the study was to investigate the usability of a newly developed instrument designed to assess the content and quality briefs (CQB-I) in programs for new healthcare environments. We studied the perception of using the instrument on a group of space planners. BACKGROUND: The study is part of a larger project designed to ensure the quality of the planning of new healthcare environments with a focus on documents (programs or briefs) created in the early phases of the planning process. In this study, we used an instrument that measures the clarity of the mission statement for the project based on user needs and care activities that will take place in the new healthcare environment. The instrument further evaluates whether there are clear patient-related outcome measures specified and whether the information in the documents is person-oriented and evidence-based. METHODS: The study used a mixed-method design where the relevance and usability of the instrument was estimated and a focus group interview was conducted. RESULTS: The study showed that a CQB-I is perceived to be a relevant instrument primarily as a guide for programming, but also for monitoring the produced programs. CONCLUSIONS: Instruments like CQB-I can help to bring research results into planning and contribute to dialogue and collaboration in the early phases of a planning process by orienting planning participants to user needs and facilitating the discussion and articulation of clear performance indicators.
Design Characteristics of Acute Care Units in China
Authors: Lu Yi , Wang Yijia 
Published: February 2015

OBJECTIVE: To describe the current state of design characteristics of acute care units in China's public hospitals and compare these with characteristics with acute care units in the United States. BACKGROUND: The healthcare construction industry in China is one of the fastest growing sectors in China and, arguably, in the world. Understanding the physical design of acute care units in China is of great importance because it will influence a large population. METHODS: Descriptive study was performed of unit configuration, size, patient visibility, distance to nursing station and supplies, and lighting conditions in 25 units in 19 public hospitals built after 2003. Data and information were collected based on spatial and visibility analysis. RESULTS: The study identified major design characteristics of the recently built (from 2003 onward) acute care units in China, comparing them, where appropriate, with those in U.S. It found there are three dominant types of unit layout: single-corridor (52%), triangular (36%), and double-corridor (12%). The number of private rooms is very low (11%), compared with two- or three-bed rooms. Centralized nursing stations are the only type of nurses' working area. China also has a large unit size in terms of number of patient beds. The average number of patient beds in a unit is 40.6 in China (versus 32.9 in U.S.). The care units in China have longer walking distance from nursing station to patient bedside. The percentage of beds visible from a nursing station is lower in China than in the U.S. The access to natural light and direct sunlight in patient rooms is greater in China compared with those in U.S.—100% of patient rooms in China have natural lighting. A majority of them face south or southeast and thus receiving direct sunlight (91.4%). CONCLUSIONS: Because of the differences in economies and building codes, there are dramatic differences between the spatial characteristics of acute care units in China and the United States.
Impact of the Design of the Built Environment on People with Dementia: An Evidence-Based Review
Authors: Marquardt Gesine , Bueter Kathrin , Motzek Tom 
Published: February 2015

OBJECTIVE: In this review the impact of the design of the built environment on people with dementia in long-term care settings is systematically analyzed and summarized. Architects and designers will be provided with credible evidence on which they can confidently base their design decisions. Researchers will be able to determine which environmental aspects have been well investigated and where there are gaps in the current state of the research. BACKGROUND: A great number of studies have established a relationship between the design of the physical environment of long-term care settings and outcomes of people with dementia. However, the methods employed are heterogeneous and the results are often conflicting. Consequently, the process of integrating the best evidence available into architectural designs may be hindered. METHODS: A systematic literature search was conducted reviewing studies that meet certain inclusion criteria. Using an evidence-based approach, the methodical quality of the studies was rated. RESULTS: One hundred sixty-nine studies were found. They were thematically summarized into four main categories: basic design decisions, environmental attributes, ambience, and environmental information. The effectiveness of the interventions on the behavior, cognition, function, well being, social abilities, orientation, and care outcomes on people with dementia was illustrated by matrices. CONCLUSIONS: Results of this review indicate that, with the exception of cognition, specific design interventions are beneficial to the outcomes of people with dementia. Overall, the field of environmental design for people with dementia is well researched in many aspects and only few gaps in knowledge were identified.
Assessing the Physical Service Setting
Authors: Steinke Claudia 
Published: February 2015

Objective: To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. Background: The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Methods: Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses ( n = 180) throughout a province in Canada. Results: The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Conclusions: Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting.
An Exploration of the Nightstand and Over-the-Bed Table in an Inpatient Rehabilitation Hospital
Authors: Healy Stan , Manganelli Joe , Rosopa Patrick J. , Brooks Johnell O. 
Published: February 2015

Objective: This study seeks to determine where patients in a rehabilitation hospital keep the greatest percentage of their belongings, that is, in/on the nightstand or on the over-the-bed table. Background: This study provides an inventory of patient items located on the over-the-bed table and in/on the nightstand. Understanding the functions of furnishings within the patient room is key for future preparation for designing a next-generation over-the-bed table or for redesigning a more useful nightstand. Methods: The contents on the top of the nightstand; the contents in the top, middle, and bottom drawers of the nightstand; items next to the nightstand; and the contents on the over-the-bed table within patient rooms were inventoried and placed into categories using similar, patient item categories as the Brooks et al. (2011) study, which examined the contents of the nightstand and the over-the-bed table in assisted living and skilled nursing facilities. Results: Overall, patients in a rehabilitation hospital had a greater percentage of their belongings on the top of the nightstand as compared to their belongings located in all three combined drawers of the nightstand. Overall, patients had a greater percentage of their belongings located on the over-the-bed table as compared to their belongings located on the nightstand. Conclusions: Tabletop surface area was used extensively in patient rooms at a rehabilitation hospital, but nightstand drawers were underutilized.
Ambient Versus Traditional Environment in Pediatric Emergency Department
Authors: Robinson Patricia S. , Green Jeanette 
Published: February 2015

Objective: We sought to examine the effect of exposure to an ambient environment in a pediatric emergency department. We hypothesized that passive distraction from ambient lighting in an emergency department would lead to reduction in patient pain and anxiety and increased caregiver satisfaction with services. Background: Passive distraction has been associated with lower anxiety and pain in patients and affects perception of wait time. A pediatric ED was designed that optimized passive distraction techniques using colorful ambient lighting. Methods: Participants were nonrandomly assigned to either an ambient ED environment or a traditional ED environment. Entry and exit questionnaires assessed caregiver expectations and experiences. Pain ratings were obtained with age-appropriate scales, and wait times were recorded. Results: A total of 70 participants were assessed across conditions, that is, 40 in the ambient ED group and 30 in the traditional ED group. Caregivers in the traditional ED group expected a longer wait, had higher anxiety pretreatment, and felt more scared than those in the ambient ED group. Caregivers in the ambient ED group felt more included in the care of their child and rated quality of care higher than caregivers in the traditional ED group. Pain ratings and administrations of pain medication were lower in the ambient ED group. Conclusions: Mean scores for the ambient ED group were in the expected direction on several items measuring satisfaction with ED experiences. Results were suggestive of less stress in caregivers, less pain in patients, and higher satisfaction levels in the ambient ED group.
An Empirical Examination of the Impacts of Decentralized Nursing Unit Design
Authors: Pati Debajyoti , Harvey Thomas E. , Redden Pamela , Summers Barbara , Pati Sipra 
Published: February 2015

Objective: The objective of the study was to examine the impact of decentralization on operational efficiency, staff well-being, and teamwork on three inpatient units. Background: Decentralized unit operations and the corresponding physical design solution were hypothesized to positively affect several concerns—productive use of nursing time, staff stress, walking distances, and teamwork, among others. With a wide adoption of the concept, empirical evidence on the impact of decentralization was warranted. Methods: A multimethod, before-and-after, quasi-experimental design was adopted for the study, focusing on five issues, namely, (1) how nurses spend their time, (2) walking distance, (3) acute stress, (4) productivity, and (5) teamwork. Data on all five issues were collected on three older units with centralized operational model (before move). The same set of data, with identical tools and measures, were collected on the same units after move in to new physical units with decentralized operational model. Data were collected during spring and fall of 2011. Results: Documentation, nurse station use, medication room use, and supplies room use showed consistent change across the three units. Walking distance increased (statistically significant) on two of the three units. Self-reported level of collaboration decreased, although assessment of the physical facility for collaboration increased. Conclusions: Decentralized nursing and physical design models potentially result in quality of work improvements associated with documentation, medication, and supplies. However, there are unexpected consequences associated with walking, and staff collaboration and teamwork. The solution to the unexpected consequences may lie in operational interventions and greater emphasis on culture change.
Possible confounding factors on cerebral diffusion tensor imaging measurements
Authors: Nenonen Miina , Hakulinen Ullamari , Brander Antti , Ohman Juha , Dastidar Prasun , Luoto Teemu M 
Published: February 2015

BackgroundDiffusion tensor imaging (DTI) is prone to numerous systemic confounding factors that should be acknowledged to avoid false conclusions.PurposeTo investigate the possible effects of age, gender, smoking, alcohol consumption, and education on cerebral DTI parameters in a generally healthy homogenous sample with no neurological or psychiatric diseases.Material and MethodsForty ( n = 40) subjects (mean age, 40.3 years; SD, 12.3) underwent brain DTI with 3 T magnetic resonance imaging (MRI). At enrolment, all the subjects were interviewed with respect to general health, education, history of smoking, and alcohol consumption. Studied DTI parameters included: (i) fractional anisotropy (FA); and (ii) apparent diffusion coefficient (ADC). Region-of-interest (ROI)-based measurements were estimated at 13 anatomical locations bilaterally on the axial images, except for the corpus callosum in which the ROIs were placed on the sagittal images. Circular ROI measurements were mainly used. Freehand ROI method was used with the forceps minor, uncinate fasciculus, and thalamus. Intra-observer variability and repeatability were assessed.ResultsThe most consistent finding was that aging decreased FA values in the frontal brain regions. Regarding the other confounding factors, the results were discontinuous and no concrete conclusions could be drawn from these findings. In general, intra-observer repeatability of the DTI measurement was considered relatively good.ConclusionAge should be noted as considerable confounding factors in ROI-based DTI analysis. More research on the effects of gender, smoking, alcohol consumption, and education is needed.