Evaluation of Multisensory Interactions Between the Healing Built Environment and Nurses in Healthcare Nursing Stations: Case Study of Tehran Hospitals

BACKGROUND

Nursing stations are important features of medical centers that are constantly in use. As nursing is an inherently stressful occupation, nursing stations should be designed to minimize stress on those who must spend time there.

AIM

This study evaluated the effect of environmental design factors on mitigating the stress levels on nurses in nursing stations by determining the environmental factors that most influence the perceptual senses that affect physical and psychological comfort.

METHODS

A quantitative approach was used to evaluate the parameters that affect the sensory perceptions of nurses in nursing stations at four hospitals in Tehran. A survey was conducted to identify environmental design parameters that affect the visual, auditory, tactile, kinesthetic, and olfactory senses.

RESULTS

The results revealed that the olfactory category scored highest, followed by the auditory, visual and tactile categories, which had similar scores, and kinesthetic was ranked last.

CONCLUSION

A connection was revealed between the educational level of the nurses and environmental factors affecting their sensory perception in terms of materials, aesthetics and the appropriate number of windows as a visual sense, and ergonomics as a kinesthetic sense. Significantly, the gender variable differed in the Furniture variable based on comfort of seating with respect structure. Based on the results of this study, a combination of olfactory, visual, and auditory factors should be required at the nursing stations to decrease the stress level of nurses.

Concordance of SARS-CoV-2 RNA in Aerosols From a Nurses Station and in Nurses and Patients During a Hospital Ward Outbreak

Importance

Aerosol-borne SARS-CoV-2 has not been linked specifically to nosocomial outbreaks.

Objective

To explore the genomic concordance of SARS-CoV-2 from aerosol particles of various sizes and infected nurses and patients during a nosocomial outbreak of COVID-19.

Design, Setting, and Participants

This cohort study included patients and nursing staff in a US Department of Veterans Affairs inpatient hospital unit and long-term-care facility during a COVID-19 outbreak between December 27, 2020, and January 8, 2021. Outbreak contact tracing was conducted using exposure histories and screening with reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2. Size-selective particle samplers were deployed in diverse clinical areas of a multicampus health care system from November 2020 to March 2021. Viral genomic sequences from infected nurses and patients were sequenced and compared with ward nurses station aerosol samples.

Exposure

SARS-CoV-2.

Main Outcomes and Measures

The primary outcome was positive RT-PCR results and genomic similarity between SARS-CoV-2 RNA in aerosols and human samples. Air samplers were used to detect SARS-CoV-2 RNA in aerosols on hospital units where health care personnel were or were not under routine surveillance for SARS-CoV-2 infection.

Results

A total of 510 size-fractionated air particle samples were collected. Samples representing 3 size fractions (>10 μm, 2.5-10 μm, and <2.5 μm) obtained at the nurses station were positive for SARS-CoV-2 during the outbreak (3 of 30 samples [10%]) and negative during 9 other collection periods. SARS-CoV-2 partial genome sequences for the smallest particle fraction were 100% identical with all 3 human samples; the remaining size fractions shared >99.9% sequence identity with the human samples. Fragments of SARS-CoV-2 RNA were detected by RT-PCR in 24 of 300 samples (8.0%) in units where health care personnel were not under surveillance and 7 of 210 samples (3.3%; P = .03) where they were under surveillance.

Conclusions and Relevance

In this cohort study, the finding of genetically identical SARS-CoV-2 RNA fragments in aerosols obtained from a nurses station and in human samples during a nosocomial outbreak suggests that aerosols may have contributed to hospital transmission. Surveillance, along with ventilation, masking, and distancing, may reduce the introduction of community-acquired SARS-CoV-2 into aerosols on hospital wards, thereby reducing the risk of hospital transmission.

The Social Logic of Nursing Communication and Team Processes in Centralized and Decentralized Work Spaces

This pre-post multi-method study explored how nurses made sense of changes in nurse station design and how they characterized communication processes within a hospital unit before and after it moved from an existing hospital into a newly designed trauma-1 level hospital. Quantitative observations (116 h) of real-time communication were gathered in both hospitals. Additionally, 41 nursing staff (nurses, nursing care technicians, nurse managers) participated in a qualitative study. Three months before moving, four focus groups were conducted with 16 nursing professionals working in traditional centralized nurse station units. One year later, four additional focus groups were conducted with 25 nursing staff in new decentralized units. The observational data resulted in two key findings: first, nursing staff participated in about 70 percent of interactions with nurses, techs, doctors, and families. Second, nursing communication decreased in decentralized units. In-depth qualitative analysis revealed that nursing communication was more frequent, relational and supportive in centralized spaces while distinguished by fragmentation and information exchange in decentralized units. Drawing upon theories of supportive design and healthcare systems, these findings illustrate how nurses in centralized units characterized communication as proximity, teamwork and relationships. Nurses in decentralized units described communication in terms of distance, fragmentation, and information exchange. Implications of this study suggest that centralized spaces may facilitate nursing communication while decentralized units are supportive of proximity to patients. Exploring how communication and design together constitute the logic of healthcare delivery contributes to our understanding of how communication processes comprise the social organization of nursing care.

[Study on the Issues Faced by Home-Visit Nursing Stations for Repletion and Reinforcement of Disasters Preparedness]

BACKGROUND

Amid concerns about the occurrence of large-scale disasters, preparation for such disasters is an emergency issue.

PURPOSE

In this study, we clarified new burdens in repletion and reinforcement of disaster preparedness in home-visit nursing stations that support home care patients and their families.

METHODS

A questionnaire survey was conducted in homevisit nursing stations of areas where large-scale disasters are predicted to occur. Based on the survey, the burdens in preparation were analyzed.

RESULTS

Based on the obtained data, three categories were formed:"a burden related to presupposition of the preparation","a burden related to concretization of the preparation", and "a burden related to practice of the preparation".

DISCUSSION

For an appropriate reduction in the burdens, a necessity for further studies was indicated; these included studies on the complete picture of suitable disaster preparedness for home care, studies on the development of models that enable practical, effective, and efficient preparation, and studies on positioning of the system.

Designing the Glucose Telemetry for Hospital Management: From Bedside to the Nursing Station

PURPOSE OF THE REVIEW

Hospitalized patients with diabetes are monitored with point-of-care glucose testing. Continuous glucose monitoring (CGM) devices represent an alternative way to monitor glucose values; however, the in-hospital CGM use is still considered experimental. Most inpatient studies used "blinded" CGM properties and only few used the real-time/unblinded CGM features. One major limitation of the CGM devices is that they need to be placed at the patients' bedside, limiting any therapeutic interventions. In this article, we review the real-time/unblinded CGM use and share our thoughts about the development of future inpatient CGM systems.

RECENT FINDINGS

We recently reported that glucose values can be wirelessly transmitted to the nursing station, providing remote continuous glucose monitoring. Future inpatient CGM devices may be utilized for patients at risk for hypoglycemia similarly to the way that we use cardiac telemetry to monitor hospitalized patients who are at increased risk for cardiac arrhythmias.

[Identifying the Regional Features in the Visiting Nursing Station Trade Area Using GIS]

In order to clarify the characteristics of the area where the visiting nursing station is located, we conducted a study to identify the regional characteristics of the visiting nursing station in Ishikawa Prefecture, using geographical information system(GIS). We mapped the elderly population, aging rate, and location data for the visiting nursing station using QGIS, and created trade areas(Voronoi diagrams). The aging rate for each trade area is 22.4%(min 8.8% to max 44.6%), about 5 times. The difference in area is about 850 times as large as the central value of 9.2 km2(min 0.5 km2 to max 423.2 km2). In addition, there was a tendency for stations with a large trade area to have a higher aging rate than that of smaller stations. Understanding the characteristics of the area surrounding visiting nursing stations using GIS facilitates the clarification of potential needs and opportunities for providing visiting nursing services that are suitable for each area.

More features, greater connectivity

Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

Towards Legitimate Nursing Work? Historical Discursive Constructions of Abortion in The Canadian Nurse, 1950-1965

To the detriment of women's health, the abortion work of nurses in Canada has gone largely unexamined and is not well understood. This historical discourse analysis examines discursive constructions of nurses' abortion work and ongoing renegotiations of professional identity in The Canadian Nurse from 1950 to 1965. By investigating what has shaped and continues to inform nurses' understandings and enactment of abortion work over time, I hope to contribute to a foundation from which to evaluate contemporary abortion services and to foster conditions that support nurses in providing safe abortion care.

Speech intelligibility in hospitals

Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII < 0.45). Further, occupied spaces were found to have 10%-15% lower SII than unoccupied spaces on average. Additionally, staff perception of communication problems at nurse stations was significantly correlated with SII ratings. In a targeted second phase, a unit treated with sound absorption had higher SII ratings for a larger percentage of time as compared to an identical untreated unit. Taken as a whole, the study provides an extensive baseline evaluation of speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

A remote drip infusion monitoring system employing Bluetooth

We have developed a remote drip infusion monitoring system for use in hospitals. The system consists of several infusion monitoring devices and a central monitor. The infusion monitoring device employing a Bluetooth module can detect the drip infusion rate and an empty infusion solution bag, and then these data are sent to the central monitor placed at the nurses' station via the Bluetooth. The central monitor receives the data from several infusion monitoring devices and then displays graphically them. Therefore, the developed system can monitor intensively the drip infusion situation of the several patients at the nurses' station.