Nursing staff’s experiences of working in an evidence-based designed ICU patient room—An interview study

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Abstract

Introduction

It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments.

Objective

The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room.

Method

Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis.

Findings

The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions.

Conclusions

The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs’ wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units.

Section snippets

The intensive care unit environment

It is known that health care environment and lived space are important aspects of care. As early as in the nineteenth century Nightingale (1859) described the importance of the health care environment on health and wellbeing. She acknowledged the importance of aspects in the patients’ environment such as noise, light, ventilation and cleanliness as assisting the healing. But instead of embracing Nightingale’s philosophy, hospitals and intensive care units (ICUs) were built like industries with

Aim

The aim of this paper was to explore the experiences of nursing staff working in an Evidence-based designed ICU patient room.

Method

This study is explorative and data were collected through qualitative research interviews and analysed using inductive content analysis (Elo and Kyngäs, 2008). The method aims to achieve a condensed but broad description of the actual phenomenon under scrutiny and the outcome of the analysis is in form of concepts or categories that describe the phenomenon (Elo and Kyngäs, 2008, Polit and Beck, 2016).

Findings

Four categories with subcategories emerged from the analysis (Table 1). The findings are presented below and illustrated by quotations from the interviewees.

Discussion

This study indicates that the ICU environment itself can be experienced as a healing atmosphere for both patients and staff by building or refurbishing ICUs following the principles of EBD. Improving the healthcare environment led to the nursing staff experiencing a personal alertness and wellbeing that fostered their caring activities vis-á-vis the patients. Moreover, the findings revealed that an ICU patient room needs to be spacious in order to function well.

One of the most important roles

Limitations

The findings in this study provide a rich description of the experiences of nursing staff working in an evidence-based designed ICU patient room. Both CCNs and ANs were invited to participate but not physicians because, unlike CCNs and ANs, they are not at the bedside around the clock and they can therefore be seen as visitors to the patient room (Halford and Leonard, 2003). The open-ended interviews allowed the participants to talk freely, producing detailed descriptions concerning the subject

Funding sources

This work was supported by the Swedish Research Council, Stockholm, Sweden (grant number 521-2013-969). They had no involvement in any part of the research process.

Conflict of interest

There are no conflict of interest.

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