The effect of ward design on the well‐being of post‐operative patients

Abstract

Changes in the design of hospital wards have usually been determined by architects and members of the nursing and medical professions; the views and preferences of patients have seldom been sought directly. The Hospital Anxiety and Depression scale and the Disturbance Due to Hospital Noise questionnaire were administered to 64 female patients on bay and Nightingale wards together with a questionnaire designed for this study. Perceptions of social and physical factors of ward design were examined, and their relationship to psychological well-being and sleep patterns. The results show that the bay ward seemed to offer a more favourable environment for patients but some of the disadvantages of bay wards are balanced by better staffing levels and better and more modern facilities. Visibility to nurses was lower on the bay ward. The Nightingale ward was perceived as significantly noisier than the bay ward and noise levels were significantly correlated to anxiety scores. Paradoxically the increase in noise levels appeared to improve the perceived level of privacy on the Nightingale ward. Seventy-five per cent of patients were found to prefer the bay ward design, and since neither design appears to have major disadvantages their continued introduction should be encouraged. However, recommendations are made concerning the optimizing of patients' well-being within the bay ward setting.

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

“…The literature suggests that ill patients wanted nurses to be closer. 12,13,42 Some patients in our study reported a high level of connection with staff, with staff perceived to be giving them full attention, listening and interested in the patient as a person, while others felt a sense of disconnection. A study of cancer patients in Denmark 68 found that refuge from fellow patients was hard to achieve in multibedded rooms and the fact that personal conversations might be overheard by fellow patients caused important information to be withheld from health-care professionals.…”

“…29 In other studies, patients rated privacy and personal space as important but they also said that when ill they wanted nurses to be closer. 12,13,42 There is also evidence of more speech privacy and higher patient-reported satisfaction with doctor and nurse communication in single room patient accommodation. 11 A study of patient-physician communication in the Netherlands suggested that patients find it easier to raise questions with staff during ward rounds in single rooms than in multibedded rooms and feel that staff are more empathetic towards them.…”

“…10 Evidence-based hospital design aims to improve outcomes for specific design characteristics or interventions, 11 including room occupancy, ventilation systems, the acoustic environment, views of nature/landscapes, [12][13][14] lighting, ergonomic design, and floor layouts and work settings. 2,15,16 More is now known about the impact of hospital design on patient safety, 17 patient and staff satisfaction, a patient's stress experience and organisation performance metrics.…”

Design indicators for better accommodation environments in hospitals: inpatients’ perceptions

“…Such indicators included: job satisfaction (Tyson et al, 2002), staff turnover (Aiken et al, 2008;Applebaum et al, 2010), patient satisfaction (Douglas and Douglas, 2005;Stern et al, 2003) and patient privacy and dignity (Thrall, 2005). A well-designed, well laid-out, spacious and welldecorated accommodation environment is considered to significantly benefit both patient wellbeing and staff performance (Lorenz, 2007;Mroczek et al, 2005;Pattison and Robertson, 1996).…”

Understanding healing environments : effects of physical environmental stimuli on patients' health and well-being

“…First, Pattison and Robertson (1996) compared a bay ward (bays of four or more beds parallel with the corridor and the external wall) with a Nightingale ward (long, single, open-plan room) where female patients were nursed after surgical procedures involving similar degrees of post-operative discomfort. Patients scored higher on disturbance due to noise on the Nightingale ward than on the bay ward, but no differences were found in sleep scores.…”