Rethinking the intensive care environment: considering nature in nursing practice

Abstract

Intensive care unit nurses must actively consider and manage the environment in which nursing occurs to facilitate the best patient outcomes.

Psychogenic stress in hospitalized veterinary patients: Causation, implications, and therapies

“…There are numerous sources of unwanted sound, or “noise,” within the ICU, which can disrupt sleep and activate the stress response . Sound levels measured in various human ICUs ranged from 50 to 72 dBA, which is higher than the recommended World Health Organization (WHO) and Environmental Protection Agency (EPA) ranges of 45 dBA in the day and 35 dBA at night .…”

“…Sound levels measured in various human ICUs ranged from 50 to 72 dBA, which is higher than the recommended World Health Organization (WHO) and Environmental Protection Agency (EPA) ranges of 45 dBA in the day and 35 dBA at night . To provide perspective, a vacuum cleaner operates at a sound level of 70 dBA . Sources of noise in the ICU included machine alarms, heating and cooling systems, telephones, intercoms, and the vocalization of other patients .…”

“…Delirium is reported in up to 60–80% of mechanically ventilated patients and 20–50% of nonmechanically ventilated patients and is more common in the elderly . It is usually the result of the patient's primary illness (the “initiator” of delirium) and hospital‐related factors such as sleep deprivation, immobility, and drugs . Delirium has serious consequences including increased length of stay and risk of death in hospital, long‐term cognitive impairment and physical disability, greater health care costs, and need for institutionalization.…”

“…Identifying potential sources of stress in hospitalized patients is imperative, as the adverse consequences of activation of the stress response are clearly defined. Not only does the patient have to deal with the physiologic burden of their disease, but they must also cope with the many forms of psychogenic stress imposed by the hospital environment …”

Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework

“…Minor topics below 10%, but interesting for future research, are: occupants' education, emergency management, tobacco smoke reduction, and security, as shown in Table 4. Since the seminal EBD and Biophilia studies [16,48], we know visual environment has important benefits on patient's health outcomes, staff satisfaction [49], and organizational performance [50]. All the tools collected deal with this topic and a significant amount of indicators (119; 13% of the total; 25% of the health-related) assess the quality of visual environment, mainly in terms of interior design (30/119), views (21/119), light control (13%), outdoor design (13%), artificial light (10%), and outdoor access (7%), as highlighted in Table 5.…”