Lower Incidence of In-Hospital Falls in Patients Hospitalized in Window Beds Than Nonwindow Beds

Iwamoto, Junko; Saeki, Keigo; Kobayashi, Miwa; Yamagami, Yuki; Yoshida, Osamu; Kurumatani, Norio; Obayashi, Kenji

doi:10.1016/j.jamda.2019.07.006

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…A retrospective cohort study found that, for shared‐room designs, the incidence rate of in‐hospital patient falls was significantly lower among patients hospitalized in window beds than those in beds located away from the window. The study's authors suggested that bed location could be part of a strategy for preventing in‐hospital falls 21 …”

Section: Case Study: Design For Outcomes In Hospital Carementioning

confidence: 99%

“…The study's authors suggested that bed location could be part of a strategy for preventing in-hospital falls. 21 Infection control. The 2008 review of evidence-based design studies sug-gested that the physical environment influences nosocomial infection rates by affecting all three major transmission routes-air, direct contact, and water.…”

Section: Case Study: Design Trends In Dementia Carementioning

confidence: 99%

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The Bioethics of Built Space: Health Care Architecture as a Medical Intervention

Anderson¹,

Teti²,

Hercules³

et al. 2022

Hastings Center Report

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Decisions made in health care architecture have profound effects on patients, families, and staff. Drawing on research in medicine, neuroscience, and psychology, design is being used increasingly often to alter specific behaviors, mediate interpersonal interactions, and affect patient outcomes. As a result, the built environment in health care should in some instances be considered akin to a medical intervention, subject to ethical scrutiny and involving protections for those affected. Here we present two case studies. The first includes work aimed at manipulating the behavior of persons with neurocognitive impairments, often in long‐term care facilities. This is done to ensure safety and minimize conflicts with staff, but it raises questions about freedom, consent, and disclosure. The second concerns design science in service of improved outcomes, which involves research on improving patient outcomes or the performance of health care teams. There is evidence that in some ICU designs, certain rooms correlate to better outcomes, giving rise to questions about equity and fairness. In other cases, a facility’s architecture seems to be putting a finger on the scale of equipoise, raising questions about the intentionality of clinical judgment, freedom of choice, and disclosure. As a result of this innovation occurring outside the boundaries of traditional care delivery and oversight, important ethical questions emerge concerning both the individual patient and patient populations. We discuss, analyze, and make recommendations about each and suggest future directions for these and related issues.

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Section: Case Study: Design For Outcomes In Hospital Carementioning

confidence: 99%

Section: Case Study: Design Trends In Dementia Carementioning

confidence: 99%

The Bioethics of Built Space: Health Care Architecture as a Medical Intervention

Anderson¹,

Teti²,

Hercules³

et al. 2022

Hastings Center Report

View full text Add to dashboard Cite

show abstract

“… Iwamoto et al (2020) conducted a study comparing the rates of in-hospital falls in 2,767 patients admitted to hospital with a window-adjacent bed or a nonwindow-adjacent bed. They found a ∼50% reduction in falls in the group of patients with window-adjacent beds, even after adjustment for demographic and other important factors.…”

Section: Resultsmentioning

confidence: 99%

“…The presence of windows and natural daylight was most often investigated with respect to delirium-related outcomes, likely because access to means of reorientation to time and place are frequently cited interventions to prevent delirium ( Groves, 2019 ; Lee et al, 2021 ). The vast majority of these studies found no improvement in delirium-related outcomes among patients with access to daylight ( Aomura et al, 2021 ; Arenson et al, 2013 ; Chiu et al, 2018 ; Kohn et al, 2013 ; Smonig et al, 2019 ); however, the study by Iwamoto et al (2020) found a ∼50% reduction in falls in patients admitted to a window-bed. Whether this effect was mediated by a delirium state in this study is uncertain as the authors did not measure delirium.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Exposure to Nature on Inpatient Hospital Stays: A Scoping Review

Guidolin,

Jung,

Hunter

et al. 2024

HERD

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Aim: To summarize the existing literature surrounding the influence of natural elements on course in hospital and to introduce clinicians to the concept of biophilic design and the potential for incorporation of nature into the hospital environment as a component of a therapeutic hospitalization. Background: For decades, architects and designers have espoused the benefits of incorporating natural elements into the healthcare environment for therapeutic purposes. The benefits of this “biophilic” design philosophy has been investigated predominantly in long-term care or rehabilitation settings; however, some of the most appealing opportunities lie in the acute care setting. Methods: This scoping review surveyed the literature surrounding the influence of exposure to nature on course in acute hospitalizations. After screening 12,979 citations, 41 articles were included. Exposures were divided into seven categories, the most common of which were the presence of a window/natural light, a natural scene through a window, and nature soundscapes. These articles were reviewed in a narrative fashion and thematic analysis was conducted. Results: Studies were extremely heterogeneous in their design, research questions, and reported outcomes. Types of exposure to nature studied were exposure to a real natural scene through a window, presence of a window/nature light, nature in the healthcare environment, art depicting nature, direct contact with nature, nature soundscapes, and nature experienced through virtual reality (VR). Conclusions: Exposure to nature during an acute hospital admission appears to have a real but small therapeutic effect, predominantly on psychological metrics like anxiety/depression, pain, and patient satisfaction. Greater beneficial effects are seen with greater durations of exposure to nature and greater degrees of immersion into nature (e.g., creating multisensory experiences using emerging technology like VR).

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“…Instead, hospitalized individuals are mostly exposed to indoor lighting which remains at a constant intensity despite circadian changes in lighting outdoors. In settings where windows are physically unavailable, such as rooms without externally facing walls commonly encountered in the emergency department (ED), there can be significant morbidity associated with lack of exposure to the outdoors [1,2]. Most importantly, natural light and views of the outdoors provide important stimuli that calibrate circadian rhythm and orientation [3].…”

Section: Introductionmentioning

confidence: 99%

Assessing Patient Experience and Orientation in the Emergency Department with Virtual Windows

Keschner¹,

Hasdianda²,

Miyawaki³

et al. 2022

Proceedings of the Annual Hawaii International Conference on System Sciences

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Patients have benefitted from increasingly sophisticated diagnostic and therapeutic innovations over the years. However, the design of the physical hospital environment has garnered less attention. This may negatively impact a patient's experience and health. In areas of the hospital, such as the emergency department (ED), patients may spend hours, or even days, in a windowless environment. Studies have highlighted the importance of natural light and imagery, as they are essential in providing important stimuli to regulate circadian rhythm and orientation, and to mitigate the onset of certain medical conditions. In hospital locations where standard windows may be infeasible, the use of a virtual window may simulate the benefits of an actual window. In this pilot study, we assessed patient experience and orientation with virtual windows in the ED. We demonstrated that virtual windows are an acceptable technology that may improve patient experience and orientation.

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Lower Incidence of In-Hospital Falls in Patients Hospitalized in Window Beds Than Nonwindow Beds

Cited by 7 publications

References 27 publications

The Bioethics of Built Space: Health Care Architecture as a Medical Intervention

The Bioethics of Built Space: Health Care Architecture as a Medical Intervention

The Influence of Exposure to Nature on Inpatient Hospital Stays: A Scoping Review

Assessing Patient Experience and Orientation in the Emergency Department with Virtual Windows

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