Mapping the Impact of ICU Design on Patients, Families and the ICU Team: A Scoping Review
Creators: name: Rose, Louise
name: Noble, Harriet
name: Saha, Sian
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences

description: A scoping review of published evidence on the influence of critical care/high dependency (HDU) environments on patient, family and staff outcomes. Objectives 1. To identify outcomes, measures, and timing of measures used in studies of critical care environmental design 2. To describe the effect of various ICU design characteristics on these outcomes. ELIGIBILITY We will apply the following PICOST (population, intervention, comparator, outcome, study design, and other limits) eligibility criteria: Population a. patients and family members admitted to critical care or a HDU environment b. healthcare personnel working in a critical care or a high dependency environment Intervention New or modified designs of critical care or HDU environments/aspects of environment including patient rooms, central areas, family waiting areas, and universal support services. Aspects of design may include, but are not limited to: a) Logistics and layout including single versus multiple occupancy rooms, storage systems, waste management, isolation rooms b) Core bedside technology including informatics, ceiling- or wall-mounted mobile articulating columns/arms, monitoring, patient lift and manual handling devices, computers, point-of-care testing, clinical workstation c) Infrastructure (heating, air handling; plumbing; lighting; flooring; walls; ceiling; windows; communications, connectivity) d) Sound, light, temperature, smell, air quality e) Artwork, entertainment, room personalization f) Garden, nature, outside space g) Family space, waiting area, accommodation Comparator Existing critical care or high dependency environment/design aspect (or no comparator) Outcomes Examples of outcomes of interest include the following, however we will report on all outcomes as described by study authors Psycho-emotional: delirium/subsyndromal delirium; anxiety; depression; acute stress; PTSD, agitation, fear, frustration, loneliness, experience, general wellbeing, annoyance Recovery: functional recovery, psycho-emotional recovery, mobilization, sleep, cognitive function, health-related quality of life Staff: burnout, morale, satisfaction, intent to leave, PTSD, anxiety, depression, wellbeing Organisational: staffing, workload, teamwork, quality of care, patient safety, staff safety, use of physical restraint Family: anxiety; depression; acute stress; PTSD, agitation, fear, frustration, general well-being, weight gain, health related quality of life, caregiver burden Design Randomized controlled trials (parallel, cluster, cross-over) quasi-randomized, non-randomised and observational design, user evaluations, qualitative (observation and interview). Other Additional limits include publication date (2007–2020) and language of publication (English only). METHODS We will conduct this review according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocol (PRISMA-P) guidelines and complete a PRISMA-P checklist. Data Sources and Search Strategy We will iteratively determine our search strategy with guidance from an experienced information specialist. Search strategies will utilize a combination of controlled vocabulary and keyword combinations. We will adjust vocabulary and syntax across databases. We will remove animal-only studies and opinion pieces (e.g., editorials, letters). As we are including a range of study designs, we will not apply study-specific filters. Prior to search execution, a second information specialist will use the Peer Review for Electronic Search Strategies (PRESS) template to review and approve the search strategy. We will limit our search to published literature. We will search the following electronic databases (Jan 2007 to Jul 2018): Medline, CINAHL, Embase, Web of Science, Cochrane Library, PROSPERO, and the Joanna Briggs Institute. Study Selection and Data Extraction We will use a pre-designed screening tool listing inclusion and exclusion criteria, and pilot test screening with two reviewers to establish &gt;90 % agreement. Two reviewers will examine independently examine study titles and abstracts. We will obtain full text articles considered potentially relevant by either reviewer and examine for eligibility. Disagreements will be resolved through discussion and referred to a third author for arbitration if necessary. We will manage the screening process using Endnote; all decisions resulting from full-text review will be recorded in an Excel file. One reviewer will extract study data using a standardized form developed a priori; a second reviewer will check all data extraction for accuracy. We will extract data on study characteristics (e.g., year published, country(ies) study was performed, study design; aspects of ICU/HDU innovative/modified design studied, comparator design (if applicable), participant characteristics, outcomes and measures used, study results including qualitative themes if application. We will not assess risk of bias or study quality. Data Synthesis We will summarize study (including types of outcomes reported and measures used), ICU/HDU design/environment and participant characteristics using descriptive analyses. We will synthesize quantitative and qualitative outcomes narratively.