bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staff Perceptions before and after Adding Single-Family Rooms in the NICU
Authors: Bosch Sheila , Bledsoe Tamara , Jenzarli Ali 
Published: February 2015

Objective: The purpose of this study is to evaluate staff perceptions of environmental quality before and after the renovation of an existing open-bay neonatal intensive care unit (NICU) and the addition of 23 single-family NICU rooms in the Wasie Neonatal ICU at Joe DiMaggio Children's Hospital. Background: In recent years there has been an increase in the design and construction of single-family rooms (SFRs) because they provide more privacy for families, offer better control over environmental stimuli such as lighting and noise, and possibly reduce infections. On the other hand, this model can cause staff members to feel isolated from one another, reduce their ability to respond quickly in a crisis situation, or impose additional demands on them. Few studies document the advantages and disadvantages of the SFR NICU model. Methods: This study utilized pre- and post-move surveys to investigate staff perceptions of the NICU. Results: Overall, staff members perceive the quality of the work environment, and the safety and quality of the environment provided to patients and their families, as better in the renovated, combination NICU design (SFR and open bay) when compared to the open-bay, pre-move design. Conclusion: In spite of the potential drawbacks of having SFRs in the NICU, the study demonstrates that nurses may perceive associated benefits, such as a reduction of job stress and improvements in parental privacy, along with other positive outcomes.
Sound Levels, Staff Perceptions, and Patient Outcomes During Renovation Near the Neonatal Intensive Care Unit
Authors: Trickey Amber W. , Arnold Cody C. , Parmar Ankit , Lasky Robert E. 
Published: February 2015

Objective: Sound levels, staff perceptions, and patient outcomes were evaluated during a year-long hospital renovation project on the floor above a neonatal intensive care unit (NICU). Background: Construction noise may be detrimental to NICU patients and healthcare professionals. There are no comprehensive studies evaluating the impact of hospital construction on sound levels, staff, and patients. Methods: Prospective observational study comparing sound measures and patient outcomes before, during, and after construction. Staff were surveyed about the construction noise, and hospital employee satisfaction scores are reported. Results: Equivalent sound levels were not significantly higher during construction. Most staff members (89%) perceived the renovation period as louder, and 83% reported interruptions of their work. Patient outcomes were the same or more positive during construction. Very low birth weight (VLBW infants were less likely to require 24+ hours' mechanical ventilation during construction: 54% vs. 59% before ( OR = 1.6, p = 0.018) and 62% after ( OR = 1.48, p = 0.065); and they required a shorter total period of mechanical ventilation: 3.6 days vs. 8.0 before ( p = 0.011) and 9.5 after ( p = 0.001). VLBW newborns' differences in ventilation days were mostly in the upper extremes; medians were similar in all periods: 0.6 days vs. 1 day preconstruction and 2 days postconstruction. Conclusions: Construction above the NICU did not cause substantially louder sound levels, but staff perceived important changes in noise and work routines. No evidence suggested that patients were negatively affected by the renovation period. Meticulous construction planning remains necessary to avoid interference with patient care and caregiver work environments.
Group Differences in Preferences for a Novel Nightstand
Authors: Brooks Johnell O. , Smolentzov Linnea , Mossey Mary E. , Carroll Carson , Kendrick Katherine , Sprogis Kylie , Manganelli Joe , Healy Stan L. , Kopera Kevin , Walker Ian , Green Keith 
Published: February 2015

Objective: Multiple user groups (patients and employees at a rehabilitation facility, community-dwelling seniors, and university students) participated in a study that examined their preferences for the features and functions of three novel nightstand prototypes. Background: It is valuable to get input from different user groups in order to improve furniture usefulness and usability, especially furniture prevalent in clinical settings where users of all age groups are found. Methods: Feedback was obtained from different user groups in both clinical (rehabilitation facility) and nonclinical (university) settings. This was done using structured interviews to ask participants about multiple features of the novel nightstand designs. Results: There were several features that all groups preferred. There were also some distinctly opposing opinions between groups. In general, the patient group showed the most similarities to the other groups. Conclusion: This research explores differences and similarities in preferences for nightstand design across a variety of user groups. It yields ideas for improving the nightstand design to be useful for a wider group of people.
Affordances of the Care Environment for People with Dementia—An Assessment Study
Authors: Topo Päivi , Kotilainen Helinä , Eloniemi-Sulkava Ulla 
Published: February 2015

Background: Evidence on the importance of the physical environment for the well-being of people with dementia has been growing steadily. Objective: This article aims to (1) introduce an assessment tool for evaluating the physical care environment for people with dementia; (2) describe the method's initial results and the subsequent feedback provided to the 10 care units; and (3) describe the follow-up results 1 year later. The goal has been to provide care workers and managers with information that affects the well-being of people with dementia and to provide this information on the care environment in the context of their own work environment. Methods: The assessment was part of a randomized controlled intervention using nonpharmaceutical methods to decrease behavioral and psychological symptoms of people with dementia. During the half-day visits, photographs and field notes were taken, and a final assessment was carried out via the Residential Care Environment Assessment (RCEA) tool developed at the beginning of the study and based on affordance theory. Follow-up data were gathered after 12 months. Results: There were several possibilities for improvements in the provision of residential care in a person-centered environment. Improvements were needed mostly in comfort and in providing opportunities for engagement, activity, and expression of identity. However, in practice, it was difficult to achieve the improvements even with an intensive intervention study. Conclusions: The authors conclude that the physical care environment involves a complex set of issues and stakeholders in which the impetus to fulfill responsibilities to carry out improvements can easily fall away.
The Effect of Hospital Unit Layout on Nurse Walking Behavior
Authors: Yi Lu , Seo Hyun-Bo 
Published: February 2015

Objective: To confirm a new method for the research question, “How do different hospital unit layouts affect nurses' walking behavior and distance?” Background: Concern is renewed regarding nurses' long walking distances because of the trend toward larger patient rooms with family areas inside, resulting in a larger overall unit size. Studies have found unit design characteristics that support nurses' efficient walking, but few have done it in units designed for patient- and family-centered care. To examine the effect of unit design on nurses' walking behavior, the authors propose a new method of observing a specific task. Methods: The authors observed nurses during the task of medication administration. Results: Contrary to their hypotheses, results showed: (1) Experienced nurses had more unnecessary stops and longer walking distances than new nurses because of interactions; and (2) nurses in the smaller wing of the unit walked more than those in the larger wing of the same unit. The authors posit that the closeness between the nurses' path to the medication supply room and the central nurses' station affected the frequency of interactions and prompted a deviation from the shortest and most efficient path during medication administration. Conclusion: Observing a specific task to identify the effect of unit layout was effective, determining that overall unit shape or unit layout type might not be a good predictor of nurses' walking behavior; instead the characteristics of the path that connects functional spaces such as patient room and medication area might better predict nurses' walking behavior.
Factors Impeding Flexible Inpatient Unit Design
Authors: Pati Debajyoti , Evans Jennie , Harvey Thomas E. , Bazuin Doug 
Published: February 2015

Objective: To identify and examine factors extraneous to the design decision-making process that could impede the optimization of flexibility on inpatient units. Background: A 2006 empirical study to identify domains of design decisions that affect flexibility on inpatient units found some indication in the context of the acuity-adaptable operational model that factors extraneous to the design process could have negatively influenced the successful implementation of the model. This raised questions regarding extraneous factors that might influence the successful optimization of flexibility. Method: An exploratory, qualitative method was adopted to examine the question. Stakeholders from five recently built acute care inpatient units participated in the study, which involved three types of data collection: (1) verbal protocol data from a gaming session; (2) in-depth semi-structured interviews; and (3) shadowing frontline personnel. Data collection was conducted between June 2009 and November 2010. Results: The study revealed at least nine factors extraneous to the design process that have the potential to hinder the optimization of flexibility in four domains: (1) systemic; (2) cultural; (3) human; and (4) financial. Conclusions: Flexibility is critical to hospital operations in the new healthcare climate, where cost reduction constitutes a vital target. From this perspective, flexibility and efficiency strategies can be influenced by (1) return on investment, (2) communication, (3) culture change, and (4) problem definition. Extraneous factors identified in this study could also affect flexibility in other care settings; therefore, these findings may be viewed from the overall context of hospital design.
The Environment of Inpatient Healthcare Delivery and Its Influence on the Outcome of Care
Authors: O'Connor Margaret , O'Brien Anthony , Bloomer Melissa , Morphett Julia , Peters Louise , Hall Helen , Parry Arlene , Recoche Katrina , Lee Susan , Munro Ian 
Published: February 2015

Aim: This paper addresses issues arising in the literature regarding the environmental design of inpatient healthcare settings and their impact on care. Background: Environmental design in healthcare settings is an important feature of the holistic delivery of healthcare. The environmental influence of the delivery of care is manifested by such things as lighting, proximity to bedside, technology, family involvement, and space. The need to respond rapidly in places such as emergency and intensive care can override space needs for family support. In some settings with aging buildings, the available space is no longer appropriate to the needs—for example, the need for privacy in emergency departments. Many aspects of care have changed over the last three decades and the environment of care appears not to have been adapted to contemporary healthcare requirements nor involved consumers in ascertaining environmental requirements. The issues found in the literature are addressed under five themes: the design of physical space, family needs, privacy considerations, the impact of technology, and patient safety. Conclusion: There is a need for greater input into the design of healthcare spaces from those who use them, to incorporate dignified and expedient care delivery in the care of the person and to meet the needs of family.
Sleep as a Moderating Value in Healthcare Facility Design
Authors: Kennedy Maria Regina Clemesha 
Published: February 2015

Background: Healthcare design is produced by large design teams with vital input from clients and expert consultants. Throughout the design process, choices are made based on evaluations by all parties; however, some of these evaluations cannot be reduced to a common metric. Many complex interactions defy objective evaluation. It is proposed that jointly agreed-on values can be deployed as moderators in subjective evaluations, allowing design teams to work together more harmoniously. Object: Design evidence base for one use-value: sleep. A literature review considers the evidence currently found regarding the value of sleep for hospital inpatients and the actual quality of inpatient sleep. Intrinsic and extrinsic reasons for shortened or poor sleep are reviewed, with an emphasis on environmental considerations. There are many manners in which designers and caregivers are aware that good sleeping conditions can be provided; therefore it is by choice, albeit unwittingly, that poor sleeping conditions have arisen. Conclusion: The value of sleep to hospital inpatients is very high, even in the short term. Inpatients' sleep is currently not as good as it could or should be. Conflicting views, varied constraints, and requirements might be harmonized and give way to successful innovation if design teams and project stakeholders adopt moderating values as a guide for design evaluations.
The Effect of Garden Designs on Mood and Heart Output in Older Adults Residing in an Assisted Living Facility
Authors: Goto Seiko , Park Bum-Jin , Tsunetsugu Yuko , Herrup Karl , Miyazaki Yoshifumi 
Published: February 2015

Objective: The objective of this study is to trace short-term changes in mood and heart function in elderly individuals in response to exposure to different landscaped spaces. Background: Nineteen elderly but cognitively intact residents of an assisted living facility participated in the study. They were exposed to three landscaped spaces: a Japanese style garden, an herb garden, and a simple landscaped area planted with a single tree. Methods: To assess the effect of different landscaped spaces on older adults, individuals were monitored for mood and cardiac function in response to short exposures to spaces. Mood state was assessed using Profile of Mood States (POMS) before and after viewing the spaces. Cardiac output was assessed using a portable electrocardiograph monitor before and during the viewing. Results: We found that the structured gardens evoked greater responses in all outcome measures. Scores on the POMS improved after observation of the two organized gardens compared to responses to the simple landscaped space with a single tree. During the observation period, heart rate was significantly lower in the Japanese garden than in the other environments, and sympathetic function was significantly lower as well. Conclusions: We conclude that exposure to organized gardens can affect both the mood and cardiac physiology of elderly individuals. Our data further suggest that these effects can differ depending on the types of landscape to which an individual is exposed.
An Investigation of Noncompliant Toilet Room Designs for Assisted Toileting
Authors: Sanford Jon , Bosch Sheila J. 
Published: February 2015

Objective: By comparing an Americans with Disabilities Act Accessibility Guidelines (ADAAG) compliant design with alternative designs, this pilot study resulted in recommendations for designing patient bathrooms to facilitate assisted toileting. Background: The ADA Accessibility Guidelines were developed primarily to address the needs of disabled populations, such as returning Vietnam veterans, with sufficient upper body strength to transfer independently directly from a wheelchair to the toilet. However, the majority of older persons with disabilities (90%) stand to transfer to the toilet, rather than laterally moving from the wheelchair to the toilet. Methods: The research used a repeated measures research design to evaluate caregiver responses during assisted toileting for various toilet configurations. The study included 20 patients who were transferred onto and off of a toilet for each of four different configurations by one or two caregivers. Toileting trials were videotaped and analyzed by an occupational therapist. Additionally, caregivers completed five-question, self-report surveys after each toileting trial. Results: Survey data indicate that staff members prefer the largest of the tested configurations, where the centerline of the toilet is 30 inches from the sidewall, rather than the 18 inches required by the ADAAG, and where there are two fold-down grab bars provided. Caregivers perceived the grab bar locations as better for helping them safely transfer subjects in a modified (non-ADAAG) configuration, and also that the grab bar style in a modified configuration (non-ADAAG) improved safety when transferring subjects. Conclusions: Although caregivers were observed to safely transfer residents to and from the toilet for all configurations tested, regulations regarding accessibility of patient bathrooms should acknowledge the perceived benefits of increasing the distance from the sidewall to the centerline of the toilet to as much as 30 inches and allowing two fold-down grab bars instead of the required sidewall and back-wall grab bars.
Moderating Role of Interior Amenities on Hospital Medical Directors' Patient-Related Work Stresses
Authors: Lin Blossom Yen-Ju , Lin Yung-Kai , Juan Chi Wen , Lee Suhsing , Lin Cheng-Chieh 
Published: February 2015

Objective: Considering hospital medical directors' work stress, this study aims to examine how interior amenities might moderate the effect of work stress on their health. Background: Previous studies have revealed that hospital medical directors—senior physicians in the management positions with high-demand jobs in clinical practices and management—had a lower self-rated health. Methods: This was a cross-sectional survey study and 737 hospital medical directors in Taiwan were included. A developed and structured questionnaire covered the dimensions of patient-related work stress (i.e., physician-patient relationship stress and patient condition stress), hospital interior amenities (i.e., indoor plants, aquarium, music, art and exhibitions, and private or personalized spaces that are common or surround the workplace of healthcare professionals), and self-rated health status and health complaints. Hierarchical regressions were performed. Results: Hospital medical directors' physician-patient relationship stresses were found to have more negative effects on their self-reported health status and complaints than do their patient condition stresses; however, only indoor plants were found to have moderating effects on their short-term health complaints ( p < 0.05). On the other hand, the hospital medical directors' patient condition stresses were negatively related to their short-term health complaints; however, music, art and exhibitions, and private or personalized spaces in the workplaces had moderating effects ( p < 0.05). Conclusions: Considering the unavoidable patient-related work stresses imposed on hospital medical directors, some proposed interior amenities can produce buffering effects on work stress to some extent. Future studies could focus on finding alternatives to relieve hospital medical directors' physician-patient relationship work stresses.
Corporate Sustainability: The Environmental Design and Human Resource Management Interface in Healthcare Settings
Authors: Sadatsafavi Hessam , Walewski John 
Published: February 2015

Purpose of the Paper: The purpose of this study is to provide healthcare organizations with a new perspective for developing strategies to enrich their human resource capabilities and improve their performance outcomes. The focus of this study is on leveraging the synergy between organizational management strategies and environmental design interventions. Background: This paper proposes a framework for linking the built environment with the human resource management system of healthcare organizations. The framework focuses on the impact of the built environment regarding job attitudes and behaviors of healthcare workers. Research from the disciplines of strategic human resource management, resource-based view of firms, evidence-based design, and green building are utilized to develop the framework. Theoretical Framework: The positive influence of human resource practices on job attitudes and behaviors of employees is one mechanism to improve organizational performance outcomes. Organizational psychologists suggest that human resource practices are effective because they convey that the organization values employee contributions and cares about their well-being. Attention to employee socio-emotional needs can be reciprocated with higher levels of motivation and commitment toward the organization. In line with these findings, healthcare environmental studies imply that physical settings and features can have a positive influence on job attitudes and the behavior of caregivers by providing for their physical and socio-emotional needs. Conclusions: Adding the physical environment as a complementary resource to the array of human resource practices creates synergy in improving caregivers' job attitudes and behaviors and enhances the human capital of healthcare firms.
Examination of Overbed Tables: Healthcare Provider and User Preferences
Authors: Manganelli Joe , Threatt Anthony , Brooks Johnell O. , Smolentzov Linnea , Mossey Mary , Healy Stan , Walker Ian , Green Keith 
Published: February 2015

OBJECTIVE: This exploratory study examined the preferences of healthcare providers and patients with respect to overbed table features and functions, as well as how the devices tend to be used. BACKGROUND: In order to improve the design of overbed tables, it is important to understand which features and functions of existing models are valued by healthcare providers and patients. METHODS: A sample of overbed table models was presented to volunteers, who were asked to choose which models' implementation of specific features and functions they preferred. Structured interviews incorporating both forced choice and free response questions were administered to the volunteers—healthcare providers and patients at a rehabilitation hospital. RESULTS: While the overbed tabletop and extendable tray are heavily used, all other features of the overbed table models are rarely used. Usability of the models exhibits the potential for improvement. Healthcare providers' and patients' feature preferences differ and occasionally conflict. CONCLUSIONS: Existing overbed tables are valued primarily for the top surface. Other features and functions of the overbed table present opportunities for refinement of design, durability, and usability. There are strong patterns of agreement and disagreement in the preferences of healthcare providers and patients with respect to overbed table design, use, features, and functionality. There is potential to improve overbed table designs from both the perspectives of the staff and the patient.