Design to Improve Visibility

Abstract

Objective: This study analyzes 10 intensive care units (ICUs) to understand the associations between design features of space layout and nurse-to-patient visibility parameters. Background: Previous studies have explored how different hospital units vary in their visibility relations and how such varied visibility relations result in different nurse behaviors toward patients. However, more limited research has examined the specific design attributes of the layouts that determine the varied visibility relations in the unit. Changes in size, geometry, or other attributes of design elements in nursing units, which might affect patient observation opportunities, require more research. Methods: This article reviews the literature to indicate evidence for the impact of hospital unit design on nurse/patient visibility relations and to identify design parameters shown to affect visibility. It further focuses on 10 ICUs to investigate how different layouts diverge regarding their visibility relations using a set of metrics developed by other researchers. Shape geometry and corridor width, as two selected design features, are compared. Results: Corridor width and shape characteristics of ICUs are positively correlated with visibility. Results suggest that floor plans, which are repeatedly broken down into smaller convex (higher convex fragmentation values), or units, which have longer distances between their rooms or between their two opposite ends (longer relative grid distances), might have lower visibility levels across the unit. The findings of this study also suggest that wider corridors positively affect visibility of patient rooms. Conclusion: Changes in overall shape configuration and corridor width of nursing units may have important effects on patient observation and monitoring opportunities.