Noisy and restless: 24 h in an NHS community hospital ward, a qualitative and quantitative analysis of the patient environment
Noisy and restless: 24 h in an NHS community hospital ward, a qualitative and quantitative analysis of the patient environment
This case study assesses a hospital patient bay environment in terms of the potential for nurse led interventions to improve the patient experience and possible outcomes. The paper demonstrates where nurses have potential to enhance the environment and where patients contribute most to disruption. A section of an older persons acute-care ward (a patient bay) in an NHS community hospital in the South of England was evaluated by comparing quantitative environmental data (lighting, sound, air temperature, relative humidity, carbon dioxide and patient bed movements) with qualitative observed events, such as patient examinations noted over a 24-h period.
Inferential tests showed a relationship between the movement of patients in their beds and noise levels in the patient bay (a) above 68 dB during the day, (b) above 60 dB at night and (c) above 85 dB across the 24-h period. Staff accounted for 10% of the observed noise events that exceeded 68 dB during the day and 24% of the observed noise events that exceeded 60 dB at night. There was an observed correlation between observed noise events created by staff and the movement of the patients in their beds (a) 49% during the day and (b) 46% during the night, suggesting there is scope for the nursing staff to reduce noise in the patient bay areas and increase patient periods of rest. The introduction of “quiet-time” rest periods during the day and a general reduction of noise in the patient bay during the night is therefore recommended to enhance patient wellbeing.
hospital, indoor environment, noise, nursing staff, patients
Sawyer, Louise, Kathleen
74d91d33-83cb-40f2-931f-cdd3457e6447
Kemp, Simon
942b35c0-3584-4ca1-bf9e-5f07790d6e36
James, Patrick
da0be14a-aa63-46a7-8646-a37f9a02a71b
Harper, Michael
43fc00d4-9458-4c49-a0bf-21a6f4b3844e
15 May 2020
Sawyer, Louise, Kathleen
74d91d33-83cb-40f2-931f-cdd3457e6447
Kemp, Simon
942b35c0-3584-4ca1-bf9e-5f07790d6e36
James, Patrick
da0be14a-aa63-46a7-8646-a37f9a02a71b
Harper, Michael
43fc00d4-9458-4c49-a0bf-21a6f4b3844e
Sawyer, Louise, Kathleen, Kemp, Simon, James, Patrick and Harper, Michael
(2020)
Noisy and restless: 24 h in an NHS community hospital ward, a qualitative and quantitative analysis of the patient environment.
Building and Environment, 175, [106795].
(doi:10.1016/j.buildenv.2020.106795).
Abstract
This case study assesses a hospital patient bay environment in terms of the potential for nurse led interventions to improve the patient experience and possible outcomes. The paper demonstrates where nurses have potential to enhance the environment and where patients contribute most to disruption. A section of an older persons acute-care ward (a patient bay) in an NHS community hospital in the South of England was evaluated by comparing quantitative environmental data (lighting, sound, air temperature, relative humidity, carbon dioxide and patient bed movements) with qualitative observed events, such as patient examinations noted over a 24-h period.
Inferential tests showed a relationship between the movement of patients in their beds and noise levels in the patient bay (a) above 68 dB during the day, (b) above 60 dB at night and (c) above 85 dB across the 24-h period. Staff accounted for 10% of the observed noise events that exceeded 68 dB during the day and 24% of the observed noise events that exceeded 60 dB at night. There was an observed correlation between observed noise events created by staff and the movement of the patients in their beds (a) 49% during the day and (b) 46% during the night, suggesting there is scope for the nursing staff to reduce noise in the patient bay areas and increase patient periods of rest. The introduction of “quiet-time” rest periods during the day and a general reduction of noise in the patient bay during the night is therefore recommended to enhance patient wellbeing.
Text
approved_submission_SAWYER_24h
- Accepted Manuscript
More information
Accepted/In Press date: 6 March 2020
e-pub ahead of print date: 10 March 2020
Published date: 15 May 2020
Additional Information:
Funding Information:
For this case study, the qualitative data gathered from observations noted by a researcher was analysed against the quantitative data gathered from air temperature, relative humidity, light, sound and CO2 monitors together with movement sensors on windows and patient beds using R [40]. The study took place over a 24-h period from 14:30:00 on Thursday October 12, 2017 to 14:30:00 on Friday October 13, 2017 in a four-bed patient bay located near the nurses' station on an older-persons? acute-care ward in a NHS community hospital in the South of England. Ethics approval was granted for the 24 h and longer 9-month study by the Health Research Authority, ?Sustainability benefits of behavioural change in NHS Trusts?, IRAS 223344, REC 17/HRA/1897. No personal data was collected from patients, the level of patient information was limited to defining if a studied patient bay was male or female. Nurses provided written consent for participation in the qualitative aspect of the study. The starting point was post lunch and so represented a relatively quiet period of the day to start the observations.
Publisher Copyright:
© 2020
Keywords:
hospital, indoor environment, noise, nursing staff, patients
Identifiers
Local EPrints ID: 439419
URI: http://eprints.soton.ac.uk/id/eprint/439419
ISSN: 0360-1323
PURE UUID: 9dbac84a-1eb1-4201-ae37-cc12b35737f7
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Date deposited: 22 Apr 2020 16:30
Last modified: 17 Mar 2024 05:29
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Contributors
Author:
Louise, Kathleen Sawyer
Author:
Michael Harper
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